Circulating Antisperm Antibody （ASA） in Women is not Associated with Missed Abortions at the First-trimester Pregnancy

Objective To determine the role of the circulating antisperm antibody (ASA) in the pathogenesis of missed abortion at the first-trimester pregnancy. Methods Sixty-two patients with a history of missed abortion at the first-trimester pregnancy were enrolled into this study. Indirect immunobead test (IBT) was used to measure the circulating ASA levels. Fifty healthy women with the first-trimester pregnancy set as the control. Results No case had the positive level of ASA according to the World Health Organization criteria (50% or more of the motile sperm with immunobead binding). Only 1 case in patient group and 1 case in the control had 10%-20% of the motile spermatozoa with ASA-IgG bead binding. In both patient and control groups, ASA-IgA was found to be completely negative binding. Conclusion The circulating ASA is not associated with the pathogenesis of missed abortions at the first-trimester pregnancy.     

Evaluation on Antisperm Antibody in Infertile Women with Chronic Salpingitis

Objective To evaluate the level of antisperm antibody （ASA） in infertile women with chronic salpingtis. Methods Forty-eight infertile women with chronic salpingtis were enrolled into this study. Serum samples were screened by the direct immunobead test for ASA type IgG and IgA according to the WHO laboratory manual. About 50% or more of the motile sperm attaching to one or more immunobeads were regarded as clinical positivity according to the WHO criteria. About 20% 50% motile sperm that had adherent particles were deemed to be sub-positive. Results Of the 48 patients with chronic salpingtis assessed for ASA-IgG, 4 had immunobead bindings ranged from 50% to 60%, and the positive rate was 8.3%. In addition, 5 cases had 20%-40% of immunobead bindings, and the sub-positive rate was 10.4%. For ASA-IgA detecting, 2 cases with ASA-IgG positivity also had ASA-IgA immunobead bindings, and the positive rates were 22%, and 28%, respectively. Conclusion The incidence of ASA could be found in infertile women with chronic salpingtis, which suggests that an increased risk for the production of ASA would exist in the inflammatory status o f fallopian tube.     

Evaluation of Circulating ASA in Women with Secondary Infertility

Objective To evaluate levels of the circulating antisperm antibody (ASA ) in women with secondary infertility.Methods Eighty-three women defined as secondary infertility were enrolled into this study.B...     

The WHO near miss criteria are appropriate for admission of critically ill pregnant women to intensive care units in China

Background Evaluation of the severity of the pregnant women with suitable admission to the Intensive Care Unit (ICU)is very important for obstetricians.By now there are no criteria for critically ill o...     

非肥胖多囊卵巢综合征不孕患者瘦素mRNA和蛋白表达的对照研究

目的探讨非肥胖多囊卵巢综合征(PCOS)不孕患者黄素化颗粒细胞瘦素mRNA的表达和血清、卵泡液瘦素水平。方法对超促排卵条件下16例非肥胖PCOS不孕患者和24名正常对照进行研究。采用逆转录聚合酶链反应(RTPCR)半定量测定卵巢黄素化颗粒细胞瘦素mRNA的表达,用酶联免疫吸附法(ELISA)测定血清和卵泡液中瘦素蛋白水平的表达。结果(1)两组对象的卵巢黄素化颗粒细胞上均有瘦素mRNA的表达,但表达量差异无统计学意义(P>005)。(2)两组对象血清瘦素、卵泡液瘦素水平比较,差异均无统计学意义(均P>005)。(3)PCOS组患者血清瘦素与卵泡液瘦素水平比较,差异无统计学意义(P>005);对照组血清瘦素与卵泡液瘦素水平比较,差异也无统计学意义(P>005)。(4)两组对象中卵泡液瘦素水平均与血清瘦素水平显著正相关(PCOS组rs=0838,P=0000;对照组rs=0837,P=0000),血清瘦素水平均与体重指数显著正相关(PCOS组rs=0665,P=0005;对照组rs=0712,P=0000);(5)两组对象中卵巢黄素化颗粒细胞瘦素mRNA表达与卵泡液瘦素水平均无相关性(均P>005)。结论非肥胖PCOS患者卵巢黄素化颗粒细胞有瘦素mRNA的表达,其表达量无异常;非肥胖PCOS患者血清、卵泡液瘦素水平与正常妇女类似,血清瘦素主要来源于脂肪组织,卵泡液瘦素水平主要取决于循环瘦素水平。     

多囊卵巢综合征不育患者与其他不育患者心理健康状况对比研究

应用症状自评量表（SCL-90）对122例多囊卵巢综合征（PCOS）不育患者与112例非PCOS不育患者的心理健康状况进行调查及对比分析,结果表明排除不育症对心理健康的影响,PCOS患者本身就存在强迫、人际关系敏感、抑郁及敌对的心理障碍;痤疮是引起PCOS患者心理障碍的危险因素（OR=3．379,95％CI=1．096～10．419）;继发不育的PCOS不育患者心理障碍较原发不育的患者尤为明显（P〈0．05）。临床诊治过程中应考虑心理因素对该病的影响,以进行综合全面的治疗,改善治疗效果。     

二甲双胍治疗多囊卵巢综合征克罗米酚抵抗疗效观察

目的: 探讨二甲双胍(MTF)治疗多囊卵巢综合征(PCOS)不孕患者克罗米酚(CC)抵抗的效果. 方法: 22例CC抵抗PCOS不孕患者中合并胰岛素抵抗(IR)者20例,改为口服MTF,3 mo未妊娠者加服CC 3个周期. 采取自身对照法,观察其用药前后排卵恢复情况、妊娠结局及血胰岛素水平、IR指数、体重指数(BMI)、性激素等指标的变化. 结果: 20例合并IR的患者服用MTF 6 mo后12例(60%)恢复排卵;其中10例(50%)妊娠,均未发生流产;8例无效,但用药6 mo后BMI、空腹胰岛素(I0),IR指数,T及LH/FSH均明显降低(P均＜0.05). 结论: CC抵抗PCOS不孕患者多数存在IR,应用MTF治疗可改善患者的排卵率及妊娠率,且经济方便.     

Does HPV infection do harm to IVF outcomes and subsequent pregnancy outcomes?

研究背景：因不孕症行IVF助孕患者成功率及妊娠结局是否受HPV感染影响一直存在争议,本文通过数据观察希望能得到更近一步的结果。 方法：回顾性分析3880例新鲜周期IVF助孕病例,TCT异常并行新鲜周期胚胎移植患者分为2组,HPV阳性组（n=56）和HPV阴性组（n=56）。两组数据比较应用t检验和卡方检验方法。对于HPV对临床妊娠组与非临床妊娠组的影响应用单因素及多因素分析描述。 结果： 3880病例中157例合并TCT异常（4%）。149例患者行HPV HCII检测,其中112例患者（81.2%）接受新鲜周期胚胎移植术。HPV阴性和阳性组分别56例,比较两组患者年龄、BMI均相似,不孕因素分类亦相似。IVF过程中促性腺激素用量、获卵数、临床妊娠率和流产率以及新生儿出生体重等均无明显差异。多因素分析提示无论HPV阳性与否或是HPV HC II滴度高低均对IVF后临床妊娠率无显著影响。 结论： HPV阳性似乎不影响人工助孕后成功率。作者不推荐在IVF周期前“过度治疗”HPV感染,因为时间的延误使患者年龄增大,可能会进一步降低卵巢功能,而卵巢功能降低才是影响IVF术后成功率的主要原因。     

腹腔镜下卵巢打孔治疗多囊卵巢综合症临床疗效分析

目的评价腹腔镜下卵巢打孔术对多囊卵巢综合征（PCOS）所致不孕症的疗效。方法在腹腔镜下对PCOS患者的卵巢进行多点电凝打孔术，比较手术前后血卵泡刺激素（FSH），黄体生成素（LH）和雄激素（T）值的变化及月经情况的改变，观测术后排卵情况、妊娠情况，并与常规药物治疗及开腹手术治疗进行比较。结果排卵率为90．0％（27／30），妊娠率达76．7％（23／30）。术后LH和T值明显下降，差异有显著性（P〈0．01）。结论腹腔镜下卵巢多点电凝打孔术不仅具有较高的治愈率，而且手术操作简单安全、并发症少、术后粘连少，是治疗PCOS致不孕患者的一种有效方法。     

趋化因子在多囊卵巢综合征患者血清中的表达

目的了解趋化因子在多囊卵巢综合征患者（PCOS）血清中的水平。方法将24例PCOS患者分成非肥胖型PCOS组（PCOS-nob组）和肥胖型PCOS组（PCOS-ob组）,各12例;另设同期体检月经规律的12例正常者为对照组。采用酶联免疫的方法测定三组患者血清中白介素-8（IL-8）、巨噬细胞趋化蛋白-1（MCP-1）和正常T细胞表达分泌活化调节因子（RANTES）的水平,并进行统计学分析。结果PCOS-nob组和PCOS-ob组IL-8浓度均高于对照组,分别为（518.27±257.60）、（731.52±503.00）和（130.93±127.67）Pg/mL,差异有统计学意义（P〈0.01）;PCOS-nob组MCP-1浓度高于对照组,分别为（126.11±56.81）和（106.08±30.81）Pg/mL,但差异无统计学意义（P〉0.05）;PCOS-nob组MCP-1浓度高于对照组,分别为183.85±40.02和106.08±30.81（Pg/mL）,差异有统计学意义（P〈0.01）;PCOS-nob组和PCOS-ob组RANTES浓度稍低于对照组,分别为41.75±10.54、40.62±15.42和47.93±15.65,但差异无统计学意义（P〉0.05）。结论IL-8在非肥胖型和肥胖型PCOS患者中表达均有升高趋势,MCP-1在肥胖型PCOS患者中有升高趋势,没有发现RANTES在PCOS患者中有升高趋势。     

非超重／肥胖多囊卵巢综合征合并妊娠孕妇的临床特点及围产结局

目的 研究非超重／肥胖多囊卵巢综合征(PCOS)合并妊娠孕妇的临床特点及围产结局.方法 对2008年5月至2010年7月北京妇产医院产科门诊初次就诊孕妇进行PCOS史的筛查,将61例孕前体质量指数(BMI) ＜24 kg/m2的PCOS单胎孕妇作为研究组,对照组按年龄及孕前体质指数和研究组进行2:1配对,将122例符合条件的非PCOS孕妇纳入对照组,随访两组的妊娠经过直到分娩.多胎妊娠、原有高血压、糖尿病、高脂血症、甲状腺功能异常、心脏病、肾脏病等慢性疾病者未纳入本研究.结果 PCOS组孕妇的血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平明显高于对照组;PCOS组妊娠期糖尿病,子痫前期的发生率分别为27.9％( 17/61)、13.1％ (8/61),明显高于对照组15.6％(19/122)、1.6％(2/122),两组差异有统计学意义(P ＜0.05,＜0.01).妊娠期高血压、羊水过多、羊水过少、胎膜早破、胎盘早剥等妊娠并发症及新生儿并发症的发生率,两组比较差异无统计学意义(P＞0.05).结论 孕前BMI ＜24 kg/m2 PCOS患者妊娠后妊娠期糖尿病、子痫前期发生的危险性仍显著增高,独立于肥胖,似乎PCOS本身对此发挥了重要的影响.     

Does human papillomavirus infection do harm to in-vitro fertilization outcomes and subsequent pregnancy outcomes?

Background Some studies suggested that human papillomavirus (HPV) infection could reduce the clinical pregnancy rate and double the spontaneous abortion rate compared with non-infected women after in-v...     

女性不孕与解脲脲原体生物群及抗精子抗体的相关性

目的探讨女性不孕患者解脲脲原体（UU）不同生物群与抗精子抗体（ASA）的相关性。方法对80例女性不孕者（观察组）及80例健康孕妇（对照组）行UU及其生物群检测,采用ELISA法检测ASA阳性率;分析UU与ASA的相关性。结果观察组UU及其T960生物群与ASA阳性率均明显高于对照组（P〈0.01）,观察组UU以T960生物群为主;对照组UU主要以Parvo生物群为主。两组Parvo生物群比较无统计学意义。观察组ASA阳性者UU及T960生物群感染率明显高于ASA阴性者（P〈0.01）,两者Parvo生物群差异无统计学意义。结论女性不孕的发生与UU及ASA有关;T960生物群更容易引起不孕。     

克罗米酚联合二甲双胍治疗多囊卵巢综合征的疗效及其对性激素、胰岛素抵抗水平的影响

目的 探讨克罗米酚联合二甲双胍治疗多PCOS的疗效及其对性激素、胰岛素抵抗水平的影响.方法 选择定边县人民医院妇产科2015年4月至2016年6月期间收治的88例PCOS不孕患者为研究对象,根据随机数表法将患者分为观察组与对照组,每组44例.对照组患者予克罗米酚治疗,观察组同时联合应用二甲双胍治疗,疗程均为3个月.比较两组患者治疗前后的血清FSH、LH、T水平以及HOMA-IR的变化;治疗后随访3个月,记录促排卵疗效及妊娠率.结果 治疗后,观察组患者的血清LH、T水平及HOMA-IR分别为(8.89±1.46)U/L、(1.94±0.73)nmol/L、(2.23±0.72),均明显低于对照组的(11.68±1.84)U/L、(2.28±0.69)nmol/L、(2.76±0.76),差异均有统计学意义(P<0.05);随访3个月,观察组患者的卵泡成熟时间为(11.05±1.18)d,明显短于对照组的(12.27±1.23)d,排卵率、妊娠率分别为75.00％、35.64％,均明显高于对照组的52.27％、18.18％,差异均有统计学意义(P<0.05).结论 克罗米酚联合二甲双胍治疗PCOS不孕可有效调节患者性激素水平,改善胰岛素抵抗,提高促排卵效果及妊娠率.     

反复流产和不孕症与支原体和免疫因素的关系

目的 :探讨反复自发性流产 (RSA)与支原体感染和抗心磷脂抗体 (ACA)之间的关系及不孕症与支原体感染和抗精子抗体 (ASA)之间的关系 .方法 :采用培养法分别对 338例RSA患者 (观察组 )和 2 4 8例不孕症患者 (观察组 )进行解脲支原体 (UU)和人型支原体 (MH)检测 ;采用ELISA法分别检测血清ACA IgM和ACA IgG(RSA观察组 )以及ASA IgM和ASA IgG(不孕症观察组 ) .同时分别选择 1 0 5例正常妇女作为对照组 .比较观察组和对照组各项指标阳性检出率 .结果 :RSA患者和不孕症患者支原体感染阳性率均高于对照组(P <0 .0 5 ) ;RSA患者血清ACA IgM阳性检出率明显高于对照组 (P <0 .0 5 ) ;不孕症观察组ASA IgM阳性检出率均显著高于对照组 (P <0 .0 5 ) ;RSA患者中 ,支原体感染阳性组ACA IgM ,ACA IgG以及ACA IgM +ACA IgG阳性率均明显高于支原体感染阴性组 (P <0 .0 5 ) ;不孕症患者中 ,支原体感染阳性组ASA IgM和ASA IgGA阳性率均明显高于支原体感染阴性组 (P <0 .0 5 ) .结论 :支原体感染是RSA和不孕症的原因之一 ;自身免疫性抗体与RSA和不孕症有一定关系 ;ACA和ASA均与支原体感染有相关性     

阴道超声监测卵泡发育在多囊卵巢综合征治疗中的临床应用

目的探讨阴道超声监测卵泡发育在多囊卵巢综合征(PCOS)促排卵治疗中的价值。方法对来我院就诊的PCOS患者92例,行促排卵治疗281周期,利用阴道超声监测卵泡发育及子宫内膜情况,指导同房或人工受精。结果 281周期中,排卵168次。妊娠32例,稽留流产6例。未破裂卵泡黄素化31次,未见优势卵泡63次,取消周期19次。卵巢过度刺激综合征4例。结论经阴道超声监测排卵并指导临床用药,对于PCOS治疗具有非常重要的临床价值。     

Comparison of Hormonal and Metabolic Characteristics and Ovary Response to Induced Ovulation in Amenorrheic and Oligomenorrheic Women with PCOS

Objective To compare differences in endocrine and metabolic characteristics and response to induced ovulation treatment between oligomenorrheic and amenorrheic women with polycystic ovary syndrome (PCOS). Methods A total of 154 infertile PCOS patients presenting with oligomenorrhea or amenorrhea were retrospectively analysed, the differences in endocrine and metabolic characteristics and induced ovulation outcome parameters between oligomenorrheic and amenorrheic women were compared. Results Total follicle count, serum levels of total testosterone (TT), luteotropic hormone (LH) and insulin resistant index (HOMA-IR) were significantly higher in amenorrheic patients compared with oligomenorrheic patients (P<0.05). There were no differences in age, body mass index (BMI), follicle stimulating hormone (FSH), glucose, insulin levels and lipid level between the two groups. During clomiphene citrate (CC) and hMG induced ovulation (203 cycles), the ovulation rate in amenorrheic group was significantly lower than that of oligomenorrheic group (84.62% vs 96.80%, P<0.01). The duration to reach a dominant follicle, the cycles need to add hMG and the total dose of hMG were higher in women with amenorrhea compared with those with oligomenorrhea. No significant differences were found between the two groups in the total number of mature follicles, estradiol level and endometrial thickness on the day of hCG administration and pregnancy rate. Conclusion The degree of cycle irregularity might be a simple and effective clinical parameter to estimate the degree of metabolic and endocrine disorders and response to induced ovulation.     

Study of Association between Polycystic Ovary Syndrome and Dietary Intake

Objective To compare dietary intake and composition of women with and without polycystic ovary syndrome (PCOS), and finally to figure out the relationship between dietary intake and PCOS. Methods Eighty-six women attending an outpatient gynecological endocrinology unit, underwent evaluation of anthropometry, dietary intakes by means of a food frequency questionnaire (FFQ), 47 women with PCOS and 39 age-matched control women were investigated. Dietary intake was assessed by 24 h recalls. Associations between nutrients, BMI, WHR and glycometabolic measurements of PCOS were analyzed using multiple linear correlation and multiple linear regression analysis. Results 1) Obesity PCOS patients (BMI≥25 kg/m2) took significantly more carbohydrates (P<0.05) and fat (P<0.01) of diet than the control women in 24 h before the first visit. There was significantly lower ratio of protein (P<0.01) and higher ratio of lipid (P<0.01) in obesity PCOS patients than those in the control. Obesity PCOS women took significantly more calories (P<0.05) and higher ratio of lipid (P<0.01) than non-obesity PCOS women (BMI<25 kg/m2). There were no significantly statistical differences between the non-obesity PCOS women and controls. 2) There were positive correlations between BMI and energy lipid intake, but negative correlations between BMI and the ratio of protein in the diet intake (P<0.05). In PCOS women, fasting insulin (FINS), area under curve of insulin (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were all positively related with BMI (all P<0.05). 3) Multiple stepwise regression analysis showed that BMI was positively associated with the amount of fat and negatively associated with the ratio of protein in diet in 24 h (both P<0.001). HOMA-IR was positively related with fat intake and negatively related with protein composition (both P<0.05). Conclusion The statistical differences exist in the nutritional composition of obesity PCOS patient’s diets, which may contribute to obesity PCOS development.     

不孕女性维生素D水平与抗苗勒氏管激素的相关性及对妊娠结局的预测

目的：探讨不孕女性血清25(OH)D水平与抗苗勒氏管激素(anti-Müllerian hormone, AMH)间的关系及二者对体外受精和胚胎移植妊娠结局的预测作用。方法：纳入2018年11月至2019年9月间756例应用体外受精和胚胎移植助孕的不孕女性,根据体内维生素D水平将入组人群分为3组(血清25(OH)D≤10μg/L为A组,10μg/L<血清25(OH)D<20μg/L为B组,血清25(OH)D≥20μg/L为C组),检测患者血清AMH水平,分析组间差异并探讨各不孕类型[输卵管/男方因素、多囊卵巢综合征(polycystic ovary syndrome, PCOS)、排卵障碍(非PCOS原因)、子宫内膜异位症、不明原因不孕、其他]中维生素D水平与血清AMH水平之间的相关性,以及在全部不孕女性中血清25(OH)D水平和血清AMH水平对妊娠结局的独立/协同预测作用。结果：(1) 87.7%的入组研究对象处于维生素D不足或缺乏的状态;(2) A、B、C三个不同维生素D水平组的血清AMH分别为1.960 (1.155, 3.655)μg/L、2.455(1.370, ...     

间苯三酚对子宫内膜负向蠕动波的影响

目的 评估子宫内膜蠕动对于冷冻胚胎移植(frozen-thawed embryo transfer,FET)结局的影响,观察间苯三酚对子宫内膜负向蠕动波的抑制效果及其对妊娠结局的影响.方法 选择2015年7月至2016年12月因输卵管因素或男方因素且符合入选标准的在本中心行FET的患者作为观察对象.根据子宫内膜蠕动波的监测结果将患者分为有负向波组(281例)和无负向波组(302例),其中有负向波者随机分为实验组(139例)和对照组(142例),比较3组间负向波的抑制效果及患者的临床妊娠率、流产率、异位妊娠发生率.结果 无负向波组的临床妊娠率明显高于实验组及对照组(P＜0.05),实验组与对照组临床妊娠率比较差异无统计学意义(P＞0.05).3组患者的流产率及异位妊娠率比较差异均无统计学意义(P＞0.05).结论 子宫内膜负向蠕动波在周期有较高的发生率,而且可能是降低临床妊娠率的原因之一;间苯三酚对子宫内膜负向蠕动波可能有一定的抑制作用,但是对提高临床妊娠率及妊娠结局无明显影响.