Fertility outcomes in infertile women with complex hyperplasia or complex atypical hyperplasia who received progestin therapy and in vitro fertilization

本回顾性队列研究包括了年龄在45岁以下被诊断为伴有或不伴有不典型增生的子宫内膜复杂性增生患者,对孕激素治疗后的临床结局及妊娠结局进行了比较。结果表明,伴有或不伴有不典型增生的子宫内膜复杂性增生接受孕激素治疗后,其临床及妊娠结局并没有显著差异。我们认为对于这些患者,在短暂的孕激素治疗控制病情后,尽快施行体外受精-胚胎移植治疗(IVF)将有利于改善其妊娠结局。

Pharmacogenetic study of Asn680Ser and-29A>G in FSHR gene in Chinese women undergoing controlled ovarian hyperstimulation

The outcome of controlled ovarian hyperstimulation(COH)is various and unpredictable.According to previous studies,2 single nucleotide polymorphisms,Asn680Ser and-29A/G,have a pharmacogenetic association with ovarian response to COH.However,studies on the Asn680Ser polymorphism have yielded inconsistent conclusions and only a few studies with small sample sizes have been performed on-29A/G.The association of these 2 polymorphisms with ovarian response remains unclear.The present study evaluated the association of Asn680Ser and-29A/G genotypes with COH.A total of 414 Chinese women undergoing in vitro fertilization-embryo transfer were included.Genotypes for these single nucleotide polymorphisms were identified by high-resolution melting-curve analysis.The value of exogenous follicle-stimulating hormone dosage per oocyte divided by the body surface area(Dosage/Oocyte
Surface)was calculated for each patient as an indicator of ovarian response.The results of statistical analyses showed no association between Asn680Ser genotype and ovarian response.As for-29A/G,heterozygote individuals had more oocytes retrieved(P=0.034).Combinatorial analysis of these 2 single nucleotide polymorphisms showed that genotype A/G-Asn/Asn had lower basal-follicle-stimulating hormone and more oocytes retrieved.Analysis of genotype association with ovarian response also revealed this genotype had a significantly higher risk of developing hyper response(OR=7.86;95%CI:1.31-9.43).To some extent,there were associations between the studied polymorphisms and ovarian response;however,the power of this link is weak and has limited value for clinical prediction.

Perinatal outcome and postnatal health in children born from cryopreserved embryos

Frozen-thawed embryo transfer(FET)has been increasingly adopted as an adjunct to in vitro fertilization or intracytoplasmic sperm injection in recent years.It can reduce the risks of ovarian hyperstimulation syndrome and multiple pregnancies,and may even improve pregnancy outcomes in some subgroups such as patients with polycystic ovary syndrome.However,embryo cryopreservation may cause DNA damage,epigenetic changes,and alterations to gene expression profiles,and the potential impacts of cryopreservation on the embryos and on the long-term health of the resulting offspring are receiving increasing attention.Here,we aim to summarize the impact of cryopreservation on the embryos,perinatal outcomes,and long-term health of the offspring,hoping to explore the potential mechanisms and help guide the next steps in designing clinical studies.In this review,we found that there was no apparent difference in most perinatal outcomes between neonates born following FET and fresh embryo transfer,except for higher risks of large-for-gestational age and macrosomia in FET neonates.Studies on the long-term health and development of FET children are currently lacking;however,the limited evidence so far has found no risk of growth retardation,or chronic or malignant diseases.Large,well-designed,prospective studies taking full consideration of the confounding factors,including parental information,lifestyle,and environmental factors,are needed to confirm these conclusions.