OBJECTIVE:To investigate the link between serum 25-hydroxyvitamin D [25(OH)D] and obesity in postmenopausal women, and to evaluate the potential mediating effect of the atherogenic index of plasma (AIP). METHODS:In this cross-sectional analysis, data from 3386 postmenopausal women were extracted from the National Health and Nutrition Examination Survey (2011-2018). Participants were stratified by vitamin D status: deficient (< 50 nmol/L), insufficient (50-75 nmol/L), and sufficient (≥ 75 nmol/L). Adjusted weighted regression models assessed associations with body mass index (BMI) and obesity (BMI ≥ 30 kg/m2), while mediation analysis quantified the role of AIP. RESULTS:After comprehensive covariate adjustment, a significant inverse relationship was observed between serum 25(OH)D and BMI (β = -2.36, 95% CI: -3.16, -1.55). Vitamin D deficient women exhibited a mean BMI increase of 1.98 units (95% CI: 0.96, 3.00) and an elevated odds of obesity (OR = 1.81, 95% CI: 1.30, 2.50) relative to the sufficient group. These findings were robust across demographic and clinical subgroups. Mediation analysis indicated AIP accounted for 9.53% of the association with BMI and 9.40% with obesity (both p < 0.001). CONCLUSION:This study demonstrates a significant inverse association between vitamin D status and obesity in postmenopausal women, with lipid metabolism, as reflected by AIP, partially mediating this relationship. Further longitudinal research is required to establish causality.

The study evaluated the changes of the intrauterine environment before and after IUI and explored the relationship between these changes and pregnancy rate. The study used a prospective cohort design and included infertility patients undergoing IUI. At specific time points before and after IUI treatment, high-precision thermal radiation imaging equipment was used to collect whole-body thermal radiation images of patients. During image acquisition, the patient is kept still to ensure image quality. The collected thermal radiation images will be analyzed by professional image processing software to extract key thermal radiation parameters, such as temperature distribution and thermal radiation intensity. These thermal radiation parameters were then correlated with patient clinical data (such as age, causes of infertility, treatment options, etc.) and pregnancy outcomes. The results showed significant changes in the distribution of thermal radiation in the uterine area after IUI treatment, and these changes were closely related to the pregnancy outcomes of the patients. Patients whose average temperature in the uterine area increased after treatment, and whose temperature distribution was more uniform, had a significantly higher pregnancy rate than other patients. Temperature changes in certain specific areas of the thermal radiation images, such as the area near the fallopian tube opening, were also found to have a significant correlation with pregnancy rates.

There is a local renin-angiotensin system (RAS) in the ovary, which is involved in regulating many important physiological processes, but the specific mechanism remains unclear. Polycystic ovarian syndrome (PCOS) is the most frequently reported non-iatrogenic condition with abnormal RAS expression, characterized by overweight or obesity and insulin resistance (IR), both of which are significantly correlated with many long-term complications. These conditions are closely linked to circulatory or local RAS, serving as potential common regulatory nodes. The present study analyzed single-cell RNA sequencing (scRNA-seq) data from mouse ovaries during the reproductive period to obtain the expression levels and location information of RAS components in all cell clusters. It further analyzed the cyclical fluctuations of RAS and the differential gene sets during the estrous cycle. Protein-protein interaction analysis predicted the most closely interacting pathway with RAS, and preliminary evidence of crosstalk between angiotensin II (AngII) and the insulin signaling pathway was identified in the scRNA-seq data. A PCOS mouse model was constructed, replicating clinical reproductive and metabolic complications, and the crosstalk between AngII and IRS1/PI3K/AKT was verified. In conclusion, this study revealed the dynamic changes of the ovarian local RAS at the cellular level during the estrous cycle, and described the role of RAS in regulating ovarian function from a single-cell perspective. It also provided evidence that IR, caused by the crosstalk between AngII and IRS1/PI3K/AKT pathways, may be a potential underlying mechanism of PCOS.

Introduction:This study aimed to develop a preoperative predictive model for pathological grading of bladder urothelial carcinoma by integrating multi-parameter, thin-slice enhanced computed tomography (CT) texture features with relevant clinical indicators. Methods:CT images and clinical data were retrospectively collected from 372 individuals diagnosed with bladder urothelial carcinoma at our institution between January 2015 and October 2020. The cohort was categorized into high-grade urothelial carcinoma (HGUC; n = 190) and low-grade urothelial carcinoma (LGUC; n = 182). Participants were randomly assigned to a training group (n = 259) and a validation group (n = 113) in a 7:3 ratio. Regions of interest (ROIs) were delineated on all enhanced CT images using 3D-Slicer software, and 1,223 texture features encompassing first-order, second-order, high-order, and filtered attributes were extracted. Features with an intraclass correlation coefficient (ICC) above 0.75 were retained for further analysis via least absolute shrinkage and selection operator (LASSO) regression. A logistic regression model was constructed based on the selected features to develop a clinical prediction tool. The model's performance was evaluated using the concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results:Eleven radiomics features demonstrated significant associations with the pathological grade of bladder urothelial carcinoma. Among the models evaluated, the logistic regression model exhibited the highest discriminative power, with an area under the curve (AUC) of 0.858. Multivariate analysis identified age and proteinuria as independent predictors. The integrated model, incorporating both clinical and imaging features, outperformed models based on clinical or radiomic data alone (AUC = 0.864). Conclusion:This study presents the first CT-based nomogram that integrates multiparametric radiomic features with comprehensive clinical indicators to preoperatively predict pathological grade in bladder urothelial carcinoma. The model offers a robust, accurate, and non-invasive tool that can facilitate individualized treatment planning and enhance clinical decision-making.

Chronic stress could impair ovarian reserve through hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to reduced oocyte quality and endocrine dysfunction. The ovarian renin-angiotensin system (OVRAS) modulates follicular development, and excessive activation of the ACE-AngII-AT1R axis increases oxidative stress, disrupting ovarian function. This study investigates OVRAS's role in chronic unpredictable stress (CUS)-induced diminished ovarian reserve (DOR) and explores the protective effects of chlorogenic acid (CGA). Female mice were subjected to CUS (10 intervention methods were randomly applied to mice according to low, medium, and high frequency) and CGA treatment. Hormone levels, estrous cycles, ovarian morphology, oxidative stress, and apoptosis were evaluated. Results demonstrated that CUS overactivated the ACE-AngII-AT1R axis, increasing oxidative stress and apoptosis in granulosa cells (GCs). CGA improved ovarian function, reduced oxidative stress, and downregulated ACE-AngII-AT1R axis activity. CGA may alleviate stress-induced DOR by mitigating oxidative stress and apoptosis via modulation of the ACE-AngII-AT1R axis.

Background:Non-obstructive azoospermia (NOA) is a prevalent cause of male infertility, characterized by the lack of sperm in the ejaculate due to impaired spermatogenesis. Accurate prediction of testicular sperm extraction (TESE) outcomes is pivotal for counseling and managing patients, yet remains challenging due to variability in clinical presentations. This study aimed to establish a predictive model for TESE outcomes in patients with NOA. Methods:We retrospectively analyzed 425 patients who visited the Andrology Outpatient Clinic of the First Affiliated Hospital of Soochow University between January 2010 and January 2024. Of these, 216 had positive sperm retrieval, and 209 had negative outcomes. We compared testicular volume, reproductive hormone levels, and other clinical parameters between two groups. Multivariate logistic regression was used to identify independent risk factors that were used to establish a predictive nomogram. A calibration curve was used to evaluate the model's fit, whereas receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were used to assess diagnostic effectiveness and net benefit. Results:The differences were significant in serum follicle-stimulating hormone (FSH) (P<0.001), body mass index (P=0.04), elastase levels (P=0.005), and testicular microlithiasis levels (P=0.005) between the groups. Multivariate regression identified FSH (P<0.001), testicular volume (P<0.001), and testosterone levels (P=0.003) as independent risk factors for TESE outcomes. FSH levels were negatively correlated [odds ratio (OR) =0.905, 95% confidence interval (CI): 0.876-0.935, P<0.001], while testicular volume (OR =1.453, 95% CI: 1.328-1.591, P<0.001) and testosterone (OR =1.326, 95% CI: 1.098-1.601, P=0.003) were positively correlated. Nomogram based on these factors showed a good fit with an area under the ROC curve of 0.879. The DCA plot demonstrated substantial clinical benefits. Conclusions:In patients with NOA, low testicular volume, low testosterone levels, and high FSH levels were independent risk factors for unsuccessful TESE. The predictive nomogram provided excellent predictive power for positive TESE outcomes.

BACKGROUND:At present, embryologists are attempting to use conventional in vitro fertilization (cIVF) as an alternative to intracytoplasmic sperm injection (ICSI) for preimplantation genetic testing (PGT). However, the potential parental contamination origin of sperm cells and cumulus cells is considered the main limiting factor in the inability of cIVF embryos to undergo PGT. METHODS:In this study, we established an IVF-PGTA assay for parental contamination tests with a contamination prediction model based on allele frequencies and linkage disequilibrium (LD) to compute the log-likelihood ratio (LLR) under competing ploidy hypotheses, and then verified its sensitivity and accuracy. Finally, comparisons of the effectiveness of SNP-based analysis and LLR-based IVF-PGTA among 40 cIVF embryos was performed, based on both statistical analysis of the parental contamination rate and chromosomal ploidy concordance rate between TE biopsy and ICM isolations. RESULTS:With IVF-PGTA assay, biopsies with 10% maternal contamination could be detected accurately, and contamination caused by sperm cells could be eliminated completely. Utilizing LLR-based or single Nucleotide Polymorphism (SNP) -based analyses, our comprehensive examination of 40 clinically discarded fresh cIVF embryos revealed an absence of paternal contamination. Strikingly, the LLR-based analysis uniquely revealed a mere instance of 24% maternal contamination within the trophectoderm cell (TE) biopsy of 5* embryo. Furthermore, it was solely through this analysis that embryo (9-F) was identified as a triploid of paternal origin. CONCLUSIONS:In this study, we developed a new bioinformatics analysis method for identifying parental contamination during IVF-PGT, especially for couples with nonmale factor infertility.

Background Age-related reproductive aging is a natural and irreversible physiological process, and delaying childbearing is increasingly common all over the world. Transplantation of mesenchymal stem cells (MSCs) is considered a new and effective therapy to restore ovarian function, but the relevant mechanisms remain unclear. Recently, it has been found that there is a local Renin-angiotensin system (RAS) in human ovary and it plays a key role. Methods After collecting follicular fluid from women who received oocyte retrieval for pure male factor infertility, the level of RAS components in it were detected, and the correlation analysis by linear regression. Then, the in vivo experiments on female C57BL/6 mice were designed to measure ovarian function, and the transcription and translation levels of RAS pathway were detected by molecular biology methods. Moreover, the role of RAS in regulating inflammation and oxidative stress in the co-culture system were explored in in vitro experiments on KGN cells. Results First, a total of 139 samples of analyzable follicular fluid were obtained. The local RAS of ovary, which is independent of systemic RAS (P > 0.05), is affected by age (Pearson r < 0, P < 0.05) and related to ovarian function, inflammation, oxidative stress indexes and assisted reproduction laboratory outcomes (P < 0.05). Next, the ovary/body weight of aging mice decreased significantly and serum sex hormones levels changed significantly (P < 0.01). The number of functional follicles decreased, while the atresia follicles increased (P < 0.05). After MSCs transplantation, all the above measures have been partially recovered (P < 0.05). Although several RAS components in aging ovary changed, MSCs only improved the expression level of AT1R (P < 0.05). Furthermore, the secretion ability and mitochondrial membrane potential of aging KGN cells decreased, while the intracellular ROS level and the aging cells ratio increased (P < 0.01). All the above measures have been partially recovered when co-cultured with MSCs (P < 0.05). After Ang(1-7) were added into the co-culture system, the above have been more significantly restored compared with Ang II (P < 0.05). Nevertheless, there was no statistical difference in estradiol level no matter which one was added (P > 0.05). Conclusions Together, our findings indicate that a novel possible mechanism to explain how stem cells restore age-related ovarian functional decline.

Introduction: Depression and sleep disturbances are commonly seen non-motor symptoms in patients with Parkinson's disease (PD). This study used polysomnography to examine the relationship between mild-moderate depression in PD and sleep characteristics, particularly slow wave activities (SWA). Methods: 59 PD patients were split into two groups: nd-PD (n = 27) (patients with PD without depression) and dPD (n = 32) (patients with PD with mild-moderate depression). Their clinical features, polysomnography parameters, and demographics were evaluated. Early and late sleep SWA spectrum densities and overnight SWA decline in different brain regions were particularly analyzed. Results: Non-rapid eye movement 3 (N3) sleep duration and percentage were greater in the d-PD group. N3 percentage was linked to depression (p = 0.014). During late sleep, higher SWA (0.5-4Hz) in the frontal and central regions, higher low-SWA (0.5-2Hz) in the whole brain, central and occipital regions, and higher highSWA (2-4Hz) in the frontal region was observed in the d-PD group. During early sleep, there was also higher low-SWA (0.5-2Hz) in the occipital region. Patients in d-PD group exhibited reduced overnight high-SWA (2-4Hz) decline (Delta high-SWA) in the whole brain and occipital regions. Delta high-SWA(2-4Hz) in the occipital region were associated with depression (p = 0.049). Conclusion: PD patients with mild-moderate depression have impaired slow wave sleep, exhibiting as increased N3 sleep, SWA, and reduced overnight SWA decline. This implies that synaptic strength reduction during sleep and impaired synaptic homeostasis regulation may be associated with depression in PD. Reduced overnight highSWA decline in the occipital region may serve as a novel electrophysiological biomarker for indicating depression in PD.

Background: the context and purpose of the study Methods: how the study was performed and statistical tests used Results: the main findings Conclusions: Age-related reproductive aging is a natural and irreversible physiological process, and delaying childbearing is increasingly common all over the world. Transplantation of umbilical cord-derived mesenchymal stem cells (MSCs) is considered a new and effective therapy to restore ovarian function, but the relevant mechanisms remain unclear. In recent years, it has been found that there is a local renin-angiotensin system (RAS) in human ovary and it plays a key role.In our research, local RAS of ovary, which is independent of circulating RAS, is affected by age and related to ovarian function. Furthermore, the in vivo(mice) and in vitro (KGN cells) experiments were designed to confirm that transplantation of MSCs improves age-related ovarian dysfunction by the local RAS. Together, our findings indicate that a novel possible mechanism to explain how stem cells restore age-related ovarian dysfunction.

The etiology of polycystic ovary syndrome (PCOS) is complex and variable, and there is no exact cause or good treatment method. Most of the methods of hormones are used to temporarily meet the needs of patients. Experimental evidence has shown that trehalose has, anti-apoptotic, anti-oxidative, glucose-lowering, and insulin resistance effects. However, whether trehalose has a therapeutic effect on PCOS is unknown. It has been reported that the ovarian renin-angiotensin system (OVRAS) is involved in the development of PCOS, but it has not been fully elucidated. This study aims to explore the effect of trehalose on PCOS and elucidate the related OVRAS mechanism. We first observed that body weight, estrous cycle, ovarian follicles at all levels, glucose tolerance, serum hormones, and insulin resistance were improved by trehalose treatment in the PCOS mouse model. Moreover, trehalose treatment also ameliorated ovarian oxidative stress and apoptosis in PCOS mice, as determined by TUNNEL apoptosis staining, total SOD in ovarian homogenate, and WB assay. OVRAS mainly involves two classic pathways, namely the ACE/AngII/AT1R/AT2R, and ACE2 / Ang1-7/ MASR, Which play different functions. In PCOS mouse ovaries, we found that ACE/AngII/AT1R was up-regulated and ACE2/Ang1-7/MASR and AT2R were down-regulated by PCR and WB experiments, However, trehalose treatment changed its direction. In addition, we also found that trehalose ameliorated DHEA-induced oxidative stress and apoptosis in KGN by PCR and WB experiments, mainly by down-regulating ACE/AngII/AT1R. Our study shows that trehalose improves symptoms of PCOS mainly by down-regulating ACE/AngII/AT1R, revealing a potential therapeutic target for PCOS.

Objective:To investigate the clinical effect of aspirin (ASA) combined with low molecular weight heparin (LMWH) in the treatment of recurrent spontaneous abortion (RSA). Methods:PubMed, Cochrane, Wanfang, CNKI, and other databases were searched to collect randomized controlled trials (RCT) of aspirin combined with LMWH in the treatment of RSA from the establishment of the database to July 31, 2023. The literature was screened, and the information was extracted according to the pre-established criteria. The Reviews Manager 5.4 software was used for data analysis. Results:A total of 10 RCTs containing 1865 patients with RSA were included in this study. Meta-analysis showed that the regimen of aspirin combined with LMWH treatment significantly increased the neonatal birth rate (P < .01); and the occurrence of preeclampsia was significantly reduced when compared with regimens such as aspirin alone (P = .02); there were no significant differences between the two groups in the incidence of preterm birth (P = .21), neonatal birth weight (P = .38), the incidence of a small amount of patient hemorrhage (P = .41) and fetal growth restriction (P = .93). Conclusion:The combination of aspirin and LMWH offers a clinically significant improvement in live birth rates and reduction in preeclampsia for RSA patients, suggesting a beneficial strategy for clinical practice and future research directions.

Premature ovarian insufficiency (POI) is a serious disease significantly affecting the physical and mental health of women of reproductive age, not just impacting fertility outcomes. Ovarian damage due to chemotherapy remains a major cause of this condition. Recent studies have indicated the involvement of the long non-coding RNA HOTAIR in the progression of various diseases, showcasing important biological functions, yet its role in POI remains unclear. We conducted microarray dataset analysis and qRT-PCR experiments, demonstrating downregulation of HOTAIR expression in ovarian tissue and granulosa cells. Various functional experiments using plasmids overexpressing HOTAIR confirmed its promotion of cisplatin-induced granulosa cell autophagy and proliferation. Mechanistically, dual-luciferase assays showed that HOTAIR modulates ATG14 levels in POI by binding miR-148b-3p, thereby enhancing levels of autophagy and proliferation. In this study, we first explored the impact of miR-148b-3p on POI and found that overexpression of miR-148b-3p reversed the promotion of autophagy and proliferation induced by HOTAIR overexpression. The inhibitory effect of miR-148b-3p inhibitor on KGN cell autophagy and proliferation improvement could also be reversed by silencing ATG14. Overall, our findings indicate the promoting role of HOTAIR in POI and its potential as a biomarker for POI by modulating the miR-148b-3p/ATG14 axis to improve mechanisms of autophagy and proliferation in POI.

Objective: To investigate the association between the local renin-angiotensin system (RAS) in human follicular fluid (hFF) and age, ovarian function, in vitro fertilization (IVF) outcome. Design: Study on the correlation of non-intervention. Setting: Reproductive Medicine Center, First Affiliated Hospital of Soochow University. Sample: hFF of 139 women who received IVF simply because of their husband’s factors from January 2021 to February 2022. Methods: The correlation between age and RAS in hFF was analyzed by simple linear regression, and multivariate linear regression was used to further analyze the correlation between the RAS and IVF outcome. Main Outcome Measures: The levels of RAS components in hFF were measured, including Renin, ACE, ACE2, AngⅡ and Ang(1-7). Results: ①The influence of age on ACE-AngⅡ-AT1/2R axis was more significant than that on ACE2-Ang(1-7)-MAS axis in hFF; ②Provides evidence that gonadotropins mediate RAS activation of local ovarian follicles; ③It is still impossible to prove the effect of RAS on steroid hormone production, at least in ovarian follicles RAS cannot affect steroid hormones in the systemic circulation; ④Age and the level of RAS components in hFF have certain clinical value in predicting the number of oocyte retrieval and the rate of MⅡ maturation. Conclusions: The local RAS in ovarian follicles is affected by age and correlated with ovarian function and IVF outcome.

Recurrent miscarriage (RM), defined as three or more consecutive spontaneous miscarriages, affects many women of childbearing age. The pathological basis of RM is an imbalance in apoptosis, with the MDM2-p53 pathway playing a crucial role. In this study, we synthesized poly(6-acetoxyl-ε-caprolactone)-graft-(4-amino-benzimidazole) (PCCL-4-ABI) by modifying poly(6-acetoxyl-ε-caprolactone) (PCCL) with 4-amino-benzimidazole (4-ABI). The introduction of carboxyl and 4-ABI groups endowed the PCL backbone with fluorescence, pH responsiveness, and UCST responsiveness. The temperature-dependent release behavior of compound 1-loaded PCCL-4-ABI nanofluorescent materials was attributed to UCST transition. We successfully developed a novel nanofluorescent polymer drug delivery platform, PCCL-4-ABI@1, and evaluated its regulatory effects on p53 and MDM2 in trophoblast cells (HTR-8/SVneo). The results showed that the system loaded with low molecular weight heparin increased MDM2 and decreased p53 expression in a dose-dependent manner, thereby inhibiting trophoblast cell apoptosis. This study developed a biodegradable poly(ε-caprolactone) with UCST behavior, significant for the advancement of thermoresponsive fluorescent nanoparticle systems.

Umbilical cord-derived mesenchymal stem cell (UCMSC) transplantation has been deeply explored for premature ovarian insufficiency (POI) disease. However, the associated mechanism remains to be researched. To explore whether and how the microRNA 21 (miR-21) functions in POI mice with UCMSCs transplantation, the autoimmune-induced POI mice model was built up, transplanted with or without UCMSCs transfect with the LV-hsa-miR-21-5p/LV-hsa-miR-21-5p-inhibition, with the transfection efficiency analyzed by QRT-PCR. Mice hormone secretion and the anti-Zona pellucida antibody (AZPAb) levels were analyzed, the ovarian morphological changes and folliculogenesis were observed, and the ovarian apoptosis cells were detected to evaluate ovarian function. The expression and localization of the PTEN/Akt/FOXO3a signal pathway-related cytokines were analyzed in mice ovaries. Additionally, the spleen levels of CD8 + CD28-T cells were tested and qualified with its significant secretory factor, interleukin 10 (IL-10). We found that with the LV-hsa-miR-21-5p-inhibition-UCMSCs transplantation, the mice ovarian function can be hardly recovered than mice with LV-NC-UCMSCs transplantation, and the PTEN/Akt/FOXO3a signal pathway was activated. The expression levels of the CD8 + CD28-T cells were decreased, with the decreased levels of the IL-10 expression. In contrast, in mice with the LV-hsa-miR-21-5p-UCMSCs transplantation, the injured ovarian function can be reversed, and the PTEN/AKT/FOXO3a signal pathway was detected activated, with the increased levels of the CD8 + CD28-T cells, and the increased serum levels of IL-10. In conclusion, miR-21 improves the ovarian function recovery of POI mice with UCMSCs transplantation, and the mechanisms may be through suppressing the PTEN/AKT/FOXO3a signal pathway and up-regulating the circulating of the CD8 + CD28-T cells.

ObjectiveTo assess CD276 expression and explore its relationship with the clinicopathological characteristics and prognosis of patients with bladder cancer.MethodsIn total, RNA-sequencing data and clinical profiles of 436 bladder cancer cases from The Cancer Genome Atlas (TCGA) were assessed using the University of California Santa Cruz Xena (UCSC) platform. We compared the CD276 levels in cancerous and adjacent normal tissues and used the R software for statistical association with the clinical stage, grade, and survival (the overall survival, disease-specific survival, and progression-free survival). A single-gene GSEA analysis on TCGA-BLCA data was performed to explore potential pathways through which CD276 might influence bladder cancer. Additionally, CD276 expression was analyzed by comparing data from 9 cancerous tissues and 3 adjacent normal tissues in the GEO dataset GSE7476. Furthermore, we analyzed 133 cancerous bladder and adjacent tissue samples from the Soochow University Hospital, collected between January 1, 2016, and September 30, 2022, to assess the CD276 protein expression using immunohistochemistry. We examined the relationship between tumor CD276 levels and clinical outcomes and prognosis of bladder cancer.ResultsBioinformatic analysis revealed elevated CD276 expression in tumors compared to that in adjacent tissues (p<0.05), correlating with poor survival. GSEA revealed that CD276 was significantly involved in extracellular matrix-related pathways. Immunohistochemistry confirmed CD276 overexpression in tumor tissues, with higher levels linked to advanced pathological grades and worse prognosis.ConclusionCD276 is markedly upregulated in bladder cancer and associated with severe pathological features, advanced disease, potential for metastasis, and diminished survival rates. It may promote bladder cancer development and progression by influencing extracellular matrix-related-related pathways, making it a viable diagnostic and prognostic biomarker for bladder cancer.

OBJECTIVE:The aim of this study was to use three-dimensional (3D) ultrasound to detect ultrasound parameters related to the uterine artery and endometrium, evaluate endometrial receptivity, and investigate the predictive value of each parameter for ectopic pregnancy (EP) after in vitro fertilization-embryo transfer (IVF-ET).PATIENTS AND METHODS:Fifty-seven cases of pregnancy following IVF-ET in our institution were collected and split into EP and intrauterine pregnancy (IP) groups based on the location of pregnancy, with 27 cases in EP and 30 cases in IP. Endometrial thickness, type, volume, endometrial blood flow parameters, and uterine artery blood flow parameters were all measured one day before transplantation in both groups, and the differences between the two groups were examined.RESULTS:There were differences in endometrial blood flow typing between the two groups, with type III endometrium accounting for the highest proportion in both; the uterine spiral artery pulsatility index PI was significantly higher in the EP group than in the IP group; there were no statistical differences in uterine volume, uterine artery resistance index mRI, or uterine artery resistance index S/D between the two groups; there were no statistical differences in uterine volume, or uterine artery.CONCLUSIONS:Intracavitary 3D ultrasound can assess endometrial tolerance and may predict pregnancy outcome after IVF-ET.

BACKGROUND:Assisted reproductive technology (ART) is associated with an increased risk of adverse metabolic health in offspring, and these findings have been demonstrated in animal models without parental infertility issues. However, it is unclear what changes lead to abnormal metabolism. The activation of the renin-angiotensin system (RAS) has been related to various aspects of metabolic syndrome. Thus, we focused on the local RAS of the liver, which is the central organ for glucose and lipid metabolism in offspring conceived by in vitro fertilization (IVF), and studied the role of local liver RAS in metabolic diseases.METHODS:Male C57BL/6 mouse offspring obtained by natural pregnancy and IVF were fed a standard chow diet or a high-fat diet (HFD) from 4 weeks of age through 16 weeks of age. We assessed glucose and lipid metabolism, hepatic histopathology, and the gene and protein expression of key RAS components. In addition, the blocker losartan was used from 4 weeks of age through 16 weeks of age to investigate the regulatory mechanisms of abnormal local RAS on metabolic activity in the IVF offspring liver.RESULTS:The growth trajectories of IVF offspring body and liver weights were different from those of naturally pregnant offspring. Impaired glucose tolerance (IGT) and insulin resistance (IR) occurred in IVF-conceived male offspring. After continuous HFD feeding, male offspring in the IVF group underwent earlier and more severe IR. Furthermore, there was a trend of lipid accumulation in the livers of chow-fed IVF offspring. Hepatic steatosis was also more serious in the IVF offspring after HFD treatment. Type 1 receptor (AT1R), which is the primary receptor mediating the action of angiotensin (Ang) II, has been confirmed to be upregulated in IVF offspring livers. Losartan reduced or even eliminated most of the significant differences between the IVF and NC groups after HFD consumption.CONCLUSIONS:The upregulation of AT1R expression in the liver increased the activity of the local RAS, resulting in abnormal glucose and lipid metabolism and lipid accumulation in the liver, significantly increasing the risk of nonalcoholic fatty liver disease (NAFLD) in IVF offspring.

Background NIPT is becoming increasingly important as its use becomes more widespread in China. More details are urgently needed on the correlation between maternal risk factors and fetal aneuploidy, and how these factors affect the accuracy of prenatal aneuploidy screening. Methods Information on the pregnant women was collected, including maternal age, gestational age, specific medical history and results of prenatal aneuploidy screening. Additionally, the OR, validity and predictive value were also calculated. Results A total of 12,186 analysable karyotype reports were collected with 372 (3.05%) fetal aneuploidies, including 161 (1.32%) T21, 81 (0.66%) T18, 41 (0.34%) T13 and 89 (0.73%) SCAs. The OR was highest for maternal age less than 20 years (6.65), followed by over 40 years (3.59) and 35–39 years (2.48). T13 (16.95) and T18 (9.40) were more frequent in the over-40 group ( P < 0.01 ); T13 (3.62/5.76) and SCAs (2.49/3.95) in the 35–39 group ( P < 0.01 ). Cases with a history of fetal malformation had the highest OR (35.94), followed by RSA (13.08): the former was more likely to have T13 (50.65) ( P < 0.01 ) and the latter more likely to have T18 (20.50) ( P < 0.01 ). The sensitivity of primary screening was 73.24% and the NPV was 98.23%. The TPR for NIPT was 100.00% and the respective PPVs for T21, T18, T13 and SCAs were 89.92, 69.77, 53.49 and 43.24%, respectively. The accuracy of NIPT increased with increasing gestational age (0.81). In contrast, the accuracy of NIPT decreased with maternal age (1.12) and IVF-ET history (4.15). Conclusions ①Pregnant patients with maternal age below 20 years had higher risk of aneuploidy, especially in T13; ②A history of fetal malformations is more risky than RSA, with the former more likely to have T13 and the latter more likely to have T18; ③Primary screening essentially achieves the goal of identifying a normal karyotype, and NIPT can accurately screen for fetal aneuploidy; ④A number of maternal risk factors may influence the accuracy of NIPT diagnosis, including older age, premature testing, or a history of IVF-ET. In conclusion, this study provides a reliable theoretical basis for optimizing prenatal aneuploidy screening strategies and improving population quality.