Analysis of risk factors for postoperative anxiety and depression in endometriosis patients with reproductive intention

BACKGROUND The occurrence of postoperative depression and anxiety in patients with endomet-riosis(EMS)not only causes psychological distress,but may also harm their physical health.AIM To explore the postoperative depression status,and its influencing factors,of EMS patients with reproductive intention.METHODS A total of 321 EMS patients with reproductive intent were included.Using the self-rating anxiety scale and self-rating depression scale,EMS patients with anxiety or depression were distinguished.A clinical model for predicting anxiety or depression in EMS patients was constructed and evaluated using a nomogram,receiver operating characteristic curve,and calibration curve.RESULTS The results of the single factor analysis showed that smoking,coffee,EMS stage,chronic pelvic pain,and sexual discomfort may be related to anxiety.Further,smoking,drinking,spouse,annual household income and EMS stage may be related to depression in EMS patients.Multivariate logistic regression illustrated that smoking,coffee,chronic pelvic pain and sexual discomfort may be inde-pendent risk factors for anxiety in EMS patients,while smoking,EMS stage(Phase III and Phase IV),spouse and high annual household income may be independent risk factors for depression in EMS patients.Additionally,the models used to predict the risk of anxiety or depression in EMS patients have good predictive value.CONCLUSION The anxiety and depression of EMS patients may be related to many factors.In clinical treatment,additional attention should be paid to the psychological status of EMS patients.

Effect of the P1 Medium and the ECM Medium on Embryo Quality in IVF

Objective To investigate the effect of the glucose-free preimplantation stage one （P1） medium and the ECM medium on embryo development quality in IVF. Methods The patients with ≥4 zygotes of 2PN were studied. A total of 201 retrieval cycles were included in a prospective randomized study. Each patient was herself control. Half of zygotes of 2PN were transferred into ECM medium （group A） and half into P1 medium （group B）for further culture. Embryo development was evaluated on the day of embryo transfer. The efficacy of ECM was compared with P1 as culture medium for the development of preimplantation embryos. Results No statistically significant differences were noted between the two groups regarding embryo-cleavage rate （97.13% vs 97.55%） and rate of normal-cleaving embryos （58.29% and 58.37%）. The rate of top-quality embryos was statistically higher in group A than in group B （27.59% vs 19.75%, P〈O.05）. Embryo quality, as assessed by morphological parameters （the amount of detached anuclear fragments 〉30%）, was better in group A than in group B （19.86% vs 21.75%）, however, there was no statistically significance. Both the rate of good-quality embryos （47.95% vs 46.17%） and available embryos （63.22% vs 61.19%） were higher in group A than in group B, but there was also no statistically significance. Conclusion The ECM medium may be associated with a better embryo quality compared with the P1 medium.

Imprinting methylation and assisted reproductive technology

Assisted reproductive technology （ART） is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.