OBJECTIVE:To explore the correlation between antinuclear antibodies (ANAs) and pregnancy loss (PL), and to observe its impact on the pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in recurrent PL (RPL) patients. METHODS:In this retrospective study, patients first seen at the hospital between January 2016 and December 2022 and who underwent two ANA tests within 4-6 weeks were included. After exclusion of confounding factors, patients were allocated to the non-pregnancy loss (non-PL), single-PL, or RPL group according to previous number of PLs, and the correlation between PL and ANAs was analyzed. The first embryo transfer (ET) after in vitro IVF/ICSI without immunological treatment was placed in the RPL group, and patients were classified into the ANA-negative or ANA-positive subgroup according to ANA titer. The effect of ANAs on pregnancy outcomes in the RPL patients after IVF/ICSI-ET was further analyze. RESULTS:The results of multivariate unordered logistic regression showed that when the non-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P = 0.023) but not for single PL (P = 0.654). When the single-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P = 0.022). Multivariate logistic regression analysis revealed that the early PL rate of the ANA-positive subgroup was significantly higher than that of the ANA-negative subgroup (P = 0.009), and the total PL rate of the ANA-positive subgroup was significantly higher than that of the ANA-negative subgroup (P = 0.049). CONCLUSION:The results showed that ANA positivity may be related to RPL occurrence, but there was no significant correlation between ANA positivity and single PL. ANA positivity is associated with PL occurrence in RPL patients after transfer, and the correlation is reflected mainly in the first trimester.

Background Due to the high risk of complications in fresh transfer cycles among expected high ovarian response patients, most choose frozen-thawed embryo transfer (FET). There are currently few researches on whether the FET outcomes of expected high ovarian response patients with regular menstrual cycles are similar to those of normal ovarian response. Therefore, our objective was to explore and compare pregnancy outcomes and maternal and neonatal outcomes of natural FET cycles between patients with expected high ovarian response and normal ovarian response with regular menstrual cycles based on the antral follicle count (AFC). Methods This retrospective cohort study included 5082 women undergoing natural or small amount of HMG induced ovulation FET cycles at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2017, to March 31, 2021. The population was divided into expected high ovarian response group and normal ovarian response group based on the AFC, and the differences in patient characteristics, clinical outcomes and perinatal outcomes between the two groups were compared. Results Regarding clinical outcomes, compared with the normal ovarian response group, patients in the expected high ovarian response group had a higher clinical pregnancy rate (57.34% vs. 48.50%) and live birth rate (48.12% vs. 38.97%). There was no difference in the early miscarriage rate or twin pregnancy rate between the groups. Multivariate logistic regression analysis suggested that the clinical pregnancy rate (adjusted OR 1.190) and live birth rate (adjusted OR 1.171) of the expected high ovarian response group were higher than those of the normal ovarian response group. In terms of maternal and infant outcomes, the incidence of very preterm delivery in the normal ovarian response group was higher than that in the expected high ovarian response group (0.86% vs. 0.16%, adjusted OR 0.131), Other maternal and infant outcomes were not significantly different. After grouping by age (< 30 y, 30–34 y, 35–39 y), there was no difference in the incidence of very preterm delivery among the age subgroups. Conclusion For patients with expected high ovarian response and regular menstrual cycles undergoing natural or small amount of HMG induced ovulation FET cycles, the clinical and perinatal outcomes are reassuring. For patients undergoing natural or small amount of HMG induced ovulation FET cycles, as age increases, perinatal care should be strengthened during pregnancy to reduce the incidence of very preterm delivery.

The relationship between antinuclear antibodies (ANA) and recurrent pregnancy loss (RPL) or single pregnancy loss (PL) is unclear. In this retrospective study, patients first seen at the hospital between January 2016 and December 2022 and who underwent two ANA tests within 4-6 weeks were included. After exclusion of confounding factors, patients were divided into the non-PL, single-PL or RPL group according to previous number of PLs, and the correlation between PL and ANA was analysed. The first embryo transfer (ET) after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) without immunological treatment was selected in the RPL group, and patients were classified into the ANA-negative subgroup or ANA1:80 subgroup according to ANA titre. The effect of ANA on pregnancy outcomes in the RPL patients after IVF/ICSI-ET was further analysed. The results of multivariate unordered logistic regression showed that when the non-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P=0.023) but not for single PL (P=0.654). When the single-PL group was used as the reference, ANA positivity was an independent risk factor for RPL (P=0.022). There was no significant difference in ANA titre among the three groups of ANA-positive patients (P=0.106). Multivariate logistic regression analysis revealed that the early PL rate of the ANA1:80 subgroup was significantly higher than that of the ANA-negative subgroup (P=0.039), and the total PL rate of the ANA1:80 subgroup was significantly higher than that of the ANA-negative subgroup (P=0.033). The results showed that ANA positivity may be related to RPL occurrence, but there was no significant correlation between ANA positivity and single PL. ANA positivity (titre 1:80) is associated with PL occurrence in RPL patients after transplantation, and the correlation is reflected mainly in the first trimester. RPL patients should be screened for ANA and receive treatment.

Objective:To explore whether season and temperature on oocyte retrieval day affect the cumulative live birth rate and time to live birth.Methods:This was a retrospective cohort study. A total of 14420 oocyte retrieval cycles from October 2015 to September 2019. According to the date of oocyte retrieval, the patients were divided into four groups (Spring(n=3634);Summer(n=4414); Autumn(n=3706); Winter(n=2666)). The primary outcome measures were cumulative live birth rate and time to live birth. The secondary outcome measures included the number of oocytes retrieved, number of 2PN, number of available embryos and number of high-quality embryos.Results:The number of oocytes retrieved was similar among the groups. Other outcomes, including the number of 2PN (P=0.02), number of available embryos (p=0.04), and number of high-quality embryos (p<0.01) were different among the groups. The quality of embryos in summer was relatively poor. There were no differences between the four groups in terms of cumulative live birth rate (P=0.17) or time to live birth (P=0.08). After adjusting for confounding factors by binary logistic regression, temperature (P=0.80), season (P=0.47) and duration of sunshine(P=0.46) had no effect on cumulative live births. Only maternal age (P<0.01) and basal FSH (P<0.01) had an effect on cumulative live births. Cox regression analysis suggested no effect of season(P=0.18) and temperature(P=0.89) on time to live birth. Maternal age did have an effect on time to live birth (P<0.01).Conclusion:Although season has an effect on the embryo, there was no evidence that season or temperature affect the cumulative live birth rate or time to live birth. It is not necessary to select a specific season when preparing for IVF.

Abstract Background The normal physiological function of LH requires a certain concentration range, but because of pituitary desensitization, even on the day of HCG, endogenous levels of LH are low in the follicular-phase long protocol. Therefore, our study aimed to determine whether it is necessary to monitor serum LH concentrations on the day of HCG (LHHCG) and to determine whether there is an optimal LHHCG range to achieve the desired clinical outcome. Methods A retrospective cohort study included 4502 cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from January 1, 2016, to June 30, 2019, in a single department. The main outcome measures included retrieved eggs, available embryos, and live birth rate. Results The LHHCG was divided into five groups: Group A (LH ≤ 0.5), Group B (0.5 IU/L < LH ≤ 1.2 IU/L), Group C (1.2 IU/L < LH ≤ 2.0 IU/L), Group D (2.0 IU/L < LH ≤ 5.0 IU/L), Group E (LH > 5 IU/L). In terms of the numbers of retrieved eggs (15.22 ± 5.66 vs. 13.54 ± 5.23 vs. 12.90 ± 5.05 vs. 12.30 ± 4.88 vs. 9.6 ± 4.09), diploid fertilized oocytes (9.85 ± 4.70 vs. 8.69 ± 4.41 vs. 8.39 ± 4.33 vs. 7.78 ± 3.96 vs. 5.92 ± 2.78), embryos (7.90 ± 4.48 vs. 6.83 ± 4.03 vs. 6.44 ± 3.88 vs. 6.22 ± 3.62 vs. 4.40 ± 2.55), and high-quality embryos (4.32 ± 3.71 vs. 3.97 ± 3.42 vs. 3.76 ± 3.19 vs. 3.71 ± 3.04 vs. 2.52 ± 2.27), an increase in the LHHCG level showed a trend of a gradual decrease. However, there was no significant difference in clinical outcomes among the groups (66.67% vs. 64.33% vs. 63.21% vs. 64.48% vs. 63.33%). By adjusting for confounding factors, with an increase in LHHCG, the number of retrieved eggs decreased (OR: -0.351 95%CI − 0.453-[− 0.249]). Conclusion In the follicular-phase long protocol among young women, monitoring LHHCG is recommended in the clinical guidelines to obtain the ideal number of eggs.

BackgroundWith the increasing use of frozen embryo transfer (FET), the best endometrial preparation protocol is continuously being discussed. The hormone replacement therapy (HRT) cycle and letrozole-induced ovulation (L-OI) cycle are available protocols for patients with abnormal ovulation. Previous comparisons of the two protocols have focused on pregnancy outcomes, with less attention to perinatal outcomes, and population heterogeneity was large; thus, convincing conclusions about which protocol is more appropriate could not be drawn.MethodsWe performed a retrospective cohort study using propensity score matching (PSM) analysis for a population of patients undergoing FET cycles in the reproductive center of the Third Affiliated Hospital of Zhengzhou University from January 2016 to September 2020. The main outcome measures were clinical pregnancy rate, live birth rate, very preterm delivery (VPTD), preterm delivery (PTD), low birth weight (LBW), macrosomia, small for gestational age (SGA), large for gestational age (LGA), hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), premature rupture of membranes (PROM), placenta previa, and congenital abnormality.ResultsA total of 8010 women were enrolled. Due to the large heterogeneity among the patients, we conducted 1:1 PSM, and 1461 women matched in each group. Compared with the HRT group, the L-OI group had a smaller proportion of thin endometrium (27.38% vs. 41.07%) and thicker endometrium on the day of embryo transfer (9.63 ± 1.82 vs. 8.91 ± 1.38). There were no significant differences in clinical pregnancy rate, early abortion rate or live birth rate between the groups. There was no significant difference in perinatal outcomes of singleton live birth, including VPTD, PTD, postterm delivery, LBW, macrosomia, SGA, LGA, GDM, HDP, placenta previa, and congenital malformation.ConclusionFor women with abnormal ovulation, the pregnancy and perinatal outcomes of HRT and L-OI protocols are reassuring. It seems that both protocols are safe and effective for endometrial preparation in frozen-thawed embryo transfer in the clinic.

目的 旨在探讨促排卵药物供精人工授精的临床结局是否有影响.方法 本研究选取2016年1月1日-2018年12月31日在郑州大学第三附属医院生殖医学科行供精人工授精(Artificial Insemination by Donor,AID)患者,总周期数1 995周期.分为自然周期组(1 266周期)和刺激周期组(729周期).刺激周期促排卵药物为来曲唑(Letrozole,LE)和/或尿促性素(Human Menopausal Gonadotropin,HMG).结果 经二元logistic回归分析进行校正后刺激周期组和自然周期组的临床妊娠率(35.12％、35.62％)、异位妊娠率(1.56％、0.67％)、流产率(10.55％、10.42％)、活产率(30.59％、31.60％)、足月活产率(66.02％、70.95％)、死产率(0.27％、0.079％)、早产率(3.91％、3.10％)、过期产率(17.19％、14.86％)、低体重儿率(0.82％、0.80％)、巨大儿率(3.98％、3.98％)、多胎率(0.78％、0.67％)、性别比(男/女)(111.32、114.04)均无统计学差异(P＞0.05).结论 促排卵药物LE/HMG对供精人工授精的临床结局没有影响.

Objective:To investigate the embryo transfer strategies of early follicular phase prolonged protocol, to reduce the risk of multiple birth rate while achieving a higher live birth rate.Methods:It was a retrospective cohort study. Patients who underwent gonadotropin-releasing hormone (GnRH) agonist protocols in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to February 2019 were included. According to the type of embryos transferred, we divided all cycles into four groups, fresh cycle cleavage stage embryo transfer group (group A), fresh cycle blastocyst transfer group (group B), freeze-thaw cleavage stage embryo transfer group (group C), freeze-thaw blastocyst transfer group (group D). The main outcome measures were live birth rate and multiple birth rate. Binary logistic regression was used to correct confounding factors.Results:The risk of moderate to severe ovarian hyperstimulation syndrome (OHSS) in group A [4.8% (110/2283)] was higher than that in group C [1.0% (6/614), P<0.001] and group D [2.1% (16/762), P<0.001]. The risk of moderate to severe OHSS in group B [3.8% (42/1116)] was higher than that in group C ( P<0.001). The multiple birth rate of the two embryos transfer group [group A 23.4% (535/2283), group C 20.8% (128/614) ] was significantly higher than that of the one blastocyst transfer group [group B 1.4% (16/1116), group D 0.9% (7/762)], and the difference was statistically significant ( P<0.001). The clinical pregnancy rate [68.7% (767/1116)] and the live birth rate [59.6% (665/1116)] of group B were higher than those of group A [63.5% (1449/2283), P=0.003; 54.8% (1250/2283), P=0.008], group C [60.1% (369/614), P<0.001; 51.6% (317/614), P=0.001] and group D [62.7% (478/762), P=0.007; 52.8% (402/762), P=0.003], but there was no statistical difference among group A, group C and group D. Taking group B as a reference, the live birth rate of group A (a OR=0.86, 95% CI=0.74-0.99, P=0.044), group C (a OR=76, 95% CI=0.62-0.93, P=0.008) and group D (a OR=0.79, 95% CI=0.65-0.95, P=0.013) was lower than that of group B. Conclusion:For the early follicular phase prolonged protocol, based on the control of OHSS, fresh cycle single blastocyst transplantation is preferred. While obtaining a higher live birth rate, the multiple birth rate is significantly reduced.

Objective:To explore whether endometrial thickness (EMT) ≤7.5 mm is associated with singleton low birth weight (LBW) from single fresh blastocyst transfer. Methods:This was a retrospective cohort study. Only women ≤ 40 years old who underwent single fresh blastocyst transfer and had singleton live births were included in the study. LBW was the primary outcome of this study. Neonatal malformation was the secondary outcome. Logistic regression was used to evaluate the association between (EMT) ≤7.5 mm and singleton LBW. Results:A total number of 2847 women met the study inclusion criteria. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT >12.0 mm group (P<0.001). The rate of LBW in the EMT ≤7.5 mm group was 24.9%, which was significantly higher than the 4.0% in the EMT 7.6~12.0 mm group and the 5.3% in the EMT >12.0 mm group (P<0.001). The total neonatal malformation rate was similar between the groups (1.1%, 0.8% and 1.5%, P=0.21). After logistic regression analysis, EMT ≤7.5 mm was found to be an independent risk factor for LBW (adjusted odds ratio [AOR]: 4.39, 95% CI: 1.85˜10.46, P<0.001). Conclusion:EMT ≤7.5 mm on the hCG trigger day is an independent risk factor for LBW in singleton pregnancies from single fresh blastocyst transfer. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT >12.0 mm groups. The total neonatal malformation rate was comparable between the groups.

Objective:To investigate the optimal number of oocytes retrieved of early follicular phase prolonged protocol and to reduce the risk of ovarian hyperstimulation syndrome (OHSS) while achieving a high cumulative live birth rate (CLBR).Methods:It was a retrospective cohort study. Patients who underwent the first in vitro fertilization or intracytoplasmic sperm injection in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2014 to December 2017 were included. According to the number of oocytes retrieved, we divided all patients into 5 groups, group A: 1-5 oocytes, group B: 6-10 oocytes, group C: 11-15 oocytes, group D: 15-20 oocytes, group E: >20 oocytes. The basic and clinical data of 5 groups were analyzed. The main outcome measures were CLBR and the incidence of OHSS. Binary logistic regression was used to correct confounding factors to analyze the factors affecting the CLBR and the incidence of OHSS. We calculated the CLBR and the incidence of OHSS in each group. Results:The maternal age (a OR=0.93, 95% CI=0.90-0.97, P<0.001) and body mass index (a OR=0.95, 95% CI=0.92-0.99, P=0.02) were risk factors for CLBR. The number of oocytes retrieved was the protection factor for CLBR (a OR=1.27, 95% CI=1.20-1.35, P<0.001). The maternal age (a OR=0.94, 95% CI=0.91-0.97, P<0.001), body mass index (a OR=0.96, 95% CI=0.93-0.99, P=0.04), and increase in the number of oocytes retrieved (a OR=1.84, 95% CI=1.64-2.06, P<0.001) were the independent risk factors of the incidence of OHSS. With the increase of the number of oocytes retrieved (group A to group C), CLBR increased significantly [51.6% (157/304), 64.8% (869/1314), 75.2% (1334/1774), P<0.001], while the differences among groups C, D and E were not statistically significant ( P>0.05). With the increase in the number of oocytes retrieved (group A to group E), the incidence of OHSS increased significantly [0.3% (1/304), 3.3% (44/1314), 5.0% (88/1774), 9.8% (104/1065), 15.4% (77/499), P<0.001], especially when the number of oocytes retrieved was >15. Conclusion:For the early follicular phase prolonged protocol, the optimal number of oocytes retrieved is 11-15, which can obtain higher CLBR, and reduce the incidence of OHSS.

目的 分析来曲唑联合羟乙基淀粉注射液在卵巢过度刺激综合征(OHSS)高危患者中的应用效果.方法 于2016年1月至2018年12月,根据用药方案将于该院行取卵术和全胚冷冻的OHSS高危患者206例分为观察组(103例)与对照组(103例),对照组患者术后予以羟乙基淀粉注射液治疗,观察组患者术后予以来曲唑联合羟乙基淀粉注射液治疗,比较患者治疗前后血清雌二醇(E2)水平,以及轻度、中度、重度OHSS发生率.结果 治疗前(人绒毛膜促性腺激素注射日),E2水平组间比较差异无统计学意义(P>0.05).治疗后,观察组E2水平明显下降并低于对照组(P<0.05).与对照组相比,观察组轻度OHSS发生率较高,中度OHSS发生率较低(P<0.05),但重度OHSS发生率组间比较差异无统计学意义(P>0.05).结论 OHSS高危患者取卵术后行来曲唑联合羟乙基淀粉注射液治疗,可降低雌激素水平,促使中度OHSS轻度化,降低中度OHSS发生率,具有较好的OHSS防治效果.

目的:探究致康胶囊治疗取卵术后出血的临床疗效.方法:选取郑州大学第三附属医院2016年1月至2019年1月收治的68例取卵术后出血患者,按照治疗方法不同分为两组,各34例.对照组通过常规保守疗法进行治疗,观察组则是在对照组的常规保守疗法基础上加服致康胶囊,观察两组患者的治疗效果.结果:治疗后观察组患者的盆腔积液深度、疼痛缓解情况、住院时间及卵巢恢复体积指标均明显低于对照组,差异均具有统计学意义(P＜0.05).两组患者的月经复潮时间比较,差异无统计学意义(P＞0.05).结论:致康胶囊对治疗取卵术后出血的疗效显著,能有效缩短患者住院时间,缓解疼痛.

Objective:To observe the effects of the modified ultra-long protocol on fertilization rate and pregnancy outcomes of patients with polycystic ovary syndrome (PCOS) complicated by infertility treated by in vitro fertilization-embryo transfer (IVF-ET).Methods:The clinical data of 80 patients with PCOS complicated by infertility admitted to Pingdingshan Family Planning Science and Technology Research Institute from January 2018 to January 2020 were retrospectively analyzed. Among them, 42 patients treated by the modified ultra-long protocol were included in the modified group, and 38 patients who were treated by the antagonistic protocol were included in the antagonist group. Usage of gonadotropins, relevant indicators on the day of injection of human villous gonadotropin (HCG), such as endometrial thickness, luteinizing hormone (LH), follicle stimulating hormone (FSH), progesterone and estradiol, fertilization (average number of eggs taken, number of mature eggs, number of successfully fertilized eggs), pregnancy outcomes (clinical pregnancy, miscarriage rate, continuous pregnancy rate) were recorded and compared between the two groups.Results:Compared with the antagonist group, the modified group took gonadotropins for longer time, moreover, the numbers of mature eggs and successfully fertilized eggs were larger in the modified group ( P<0.05). The endometrial thickness, estradiol level, clinical pregnancy rate and continuous pregnancy rate of the modified group were higher than those of the antagonist group, however, the LH level and the total usage of medication of the modified group were lower than those of the antagonist group, and the difference was statistically significant ( P<0.05). There was no significant difference in progesterone level, egg retrieval number, ectopic pregnancy rate and miscarriage rate between the two groups ( P>0.05). Conclusions:Receiving IVF-ET treatment and adopting a modified ultra-long protocol of megication can significantly improve the success rate of fertilization for PCOS patients with infertility, compared with antagonist protocol. And the treatment method can help to improve the clinical pregnancy outcome of patients, which is an optimized way to promote elimination.

目的:探讨2-3-7-8四氯二苯并二噁英(2-3-7-8 Tetrachlorodibenzo-p-Dioxin,TCDD)富内暴露对雄性子代生殖毒性的影响及机制.方法:成功交配后,将母鼠随机分组.高剂量组(0.5 μg/kg)、低剂量组(0.1 μg/kg)和溶剂对照组,每组各6只,TCDD组及对照组于孕8～14 d(gestation day 8-14,GD8-14)采用灌胃方式分别给予TCDD及玉米油处理.孕鼠自然分娩,测量雄性仔鼠肛门至生殖器的距离(anal to genital distance,AGD);计算睾丸的脏器系数;利用精子质量分析仪对仔鼠精子的质量及数量进行分析测定;酶联免疫吸附法对雄性子代血清睾酮(testosterone,T)水平进行测定;测定凋亡相关蛋白Bax、Bcl2、Caspase-3的表达水平.结果:0.1 μg/kg组、0.5 μg/kg组仔鼠与对照组仔鼠相比,AGD[(1.49±0.04) cm、(1.32±0.01)cm和(1.21±0.02) cm]有所缩短(P=0.000),精子数目[(72.33±4.46)×106个/mL、(63.67±3.44)×106个/mL、(45.33±5.47)×106个/mL]与精子活率[(78.53±1.26)％、(64.40±3.14)％、(53.87±3.65)％]明显降低,精子畸形率[(2.17±0.75)％、(4.83±0.75)％、(8.00±1.10)％]升高(-0.000),血清中T水平[(2.68±0.06) ng/mL、(2.38±0.08) ng/mL和(2.10±0.09) ng/mL]明显下降(-0.000),差异均有统计学意义,0.5 μg/kg TCDD组雄性仔鼠的睾丸质量(P=0.001)和睾丸脏器系数(P=0.004)降低的差异有统计学意义;睾丸组织细胞Bax蛋白相对表达量(0.836±0.004、1.185±0.004、1.414±0.001)随染毒剂量的递增而上升(P=0.000),Bcl-2(1.368±0.053、1.108±0.040、0.751±0.022)则相反(P=0.001),同时,0.5 μg/kg TCDD染毒组Pro-Caspase-3蛋白表达明显降低,但Cleaved-Caspase-3蛋白表达明显增加(P=0.000).结论:宫内暴露TCDD可使雄性仔鼠出现雌性化特征,影响雄性仔鼠生育能力,对雄性子代具有生殖毒性,其机制可能与仔鼠睾丸组织细胞增殖-凋亡失衡和细胞凋亡的线粒体通路被激活有关.

目的:探讨2,3,7,8-四氯二苯并对二噁英(TCDD)对小鼠腭突间充质细胞增殖和凋亡的影响.方法:采用随机数字表法将SPF级C57BL/6N孕鼠分为TCDD组和对照组,在妊娠第10天(GD10)分别以64μg/kg TCDD和等量玉米油灌胃,取GD13、GD14、GD15胚胎头部,行组织形态学观察.收集GD13正常胎鼠腭组织,分离腭突间充质细胞,用0.0、0.1、1.0、10.0 nmol/L TCDD处理72 h后,采用MTT法检测细胞增殖并计算增殖抑制率,检测Br-du阳性率,采用荧光定量RT-PCR和Western blot法检测细胞中PCNA、Bax、Caspase-3 mRNA和蛋白表达水平.结果:组织形态学显示TCDD组胎鼠双侧腭突未接触和融合.随着TCDD作用浓度的增加,小鼠腭突间充质细胞增殖抑制率逐渐增加,Brdu阳性率逐渐降低,细胞中Bax、Caspase-3 mRNA和蛋白表达逐渐增加,而PCNA mRNA和蛋白表达逐渐降低(P<0.05).结论:TCDD可能通过抑制腭突间充质细胞的增殖并促进其凋亡,导致腭裂的发生.

Objective: Polycystic ovary syndrome (PCOS), a heterogeneous endocrine disorder, affects female reproductive function, but its etiology has not been elucidated. In this study, we analyzed the differential genes related to ovarian steroid biosynthesis in patients with PCOS, to explore the mechanism of PCOS. Methods: The GSE59456 data were downloaded from the Gene Expression Omnibus database. We identified differentially expressed genes (DEGs) in ovaries between the female Sprague-Dawley rats those implanted with 5 alpha-dehydrotestestrone (DHT) and those in control (CTL, implanted with empty capsule). Gene ontology, pathway enrichment analysis, and protein-protein interaction (PPI) network construction were subsequently performed. Results: In total, 530 upregulated DEGs and 522 downregulated DEGs were identified. The identified DEGs were mostly associated with steroid biosynthesis. In the PPI network, the module M1 was mainly related to steroid biosynthesis, and five genes (Hsd17b7, Tm7sJ2, Idi1, Msmo1, and Sqle) of the module M1 were from the aforementioned group of upregulated genes. Furthermore, the 19 DEGs (Idi1, Cga, C1qb, Thy], Gpx1, Ctss, Lp1,A2m, Cited2,Plppr4,Prkar2b,Slc44a1,Inha, Rbp4, Pla2g2a,Gata4,Fabp3, Cpa2, and Cpa1)between DHT and CTL groups were associated with the process of the transformation of primordial follicles to primary follicles. Conclusions: These DEGs, such as Hsd17b7, Tm7sJ2,Idi1, Msmo1, Sqle, Rbp4, Gata4,Inha,and Cited2, may be used to elucidate the etiology of PCOS, which may provide new insights into the exploration of pathological mechanism and biomarkers for polycystic ovary.

目的:探讨来曲唑联合克罗米芬方案和甲羟孕酮方案对高龄女性行IVF/ICSI助孕结局的影响.方法:回顾性分析2016年3月至2017年2月在郑州大学第三附属医院生殖中心先后行来曲唑联合克罗米芬方案和甲羟孕酮方案的高龄不孕女性患者(IVF/ICSI),根据促排卵方案分为来曲唑联合克罗米芬方案组(A组)和甲羟孕酮方案组(B组),比较两组之间临床结局的差别.结果:A组和B组在Gn用量、Gn天数、获卵数、成熟卵数、受精数、正常受精数、卵裂数、正常卵裂数、可利用胚胎数、优质胚胎数、受精率、正常受精率、卵裂率、生化妊娠率和临床妊娠率方面,两组均没有显著性差异(P>0.05),但在促排费用方面,A组比B组稍低(P=0.01).结论:对于高龄女性,来曲唑联合克罗米芬方案和甲羟孕酮方案在临床结局方面并没有显著差别,我们推荐在经济上稍有优势的来曲唑联合克罗米芬方案.