经阴道三维超声评价未破裂卵泡黄素化综合征患者卵巢储备功能分析

目的 分析经阴道三维超声对于未破裂卵泡黄素化综合征患者卵巢储备功能评价的价值。 方法 选择不孕症患者100例作为研究对象，根据相关评价标准将确诊为未破裂卵泡黄素化综合征者200例作为研究组，其他正常排卵不孕者80例作为对照组，对比2组各卵泡期子宫内膜厚度、血清性激素6项水平、各卵泡期优势侧卵巢血流参数及围排卵期成熟卵泡血流分级情况。 结果 2组血管化指数、血流指数及血管化血流指数在组间、时点间及组间·时点间交互作用差异均有统计学意义（P＜0.01）。对照组围排卵期成熟卵泡血流多为3~4级，研究组多为1~2级，差异有统计学意义（P＜0.01）。 结论 血流量低、成熟卵泡新生血管数量少是未破裂卵泡黄素化综合征的血流灌注特点，经阴道三维超声检查，更利于早期评价卵巢储备功能，指导临床识别、预测卵泡发育不良及早期排卵障碍。     

Female Pattern Hair Loss: a clinical and pathophysiological review

Female Pattern Hair Loss or female androgenetic alopecia is the main cause of hair loss in adult women and has a major impact on patients'' quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia, with characteristic clinical, dermoscopic and histological patterns. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal and environmental factors. In addition, response to treatment is variable. In this article, authors discuss the main clinical, epidemiological and pathophysiological aspects of female pattern hair loss.     

条件基因敲除技术在卵泡发育调控机制研究中的应用进展

卵泡发育是受内分泌、旁分泌及基因调节的复杂生理过程。条件基因敲除能选择去除调控特定发育阶段特定细胞或器官的基因,是在体基因功能研究的主要手段。近年来该技术被广泛应用于卵泡发育调控机制的研究。本文综述了条件基因敲除技术在始基卵泡激活、卵母细胞成熟、排卵、黄体形成及早期胚胎发育等机制研究中的应用进展。     

In utero bisphenol A exposure disrupts germ cell nest breakdown and reduces fertility with age in the mouse

Bisphenol A (BPA) is a known reproductive toxicant in rodents. However, the effects of in utero BPA exposure on early ovarian development and the consequences of such exposure on female reproduction in later reproductive life are unclear. Thus, we determined the effects of in utero BPA exposure during a critical developmental window on germ cell nest breakdown, a process required for establishment of the finite primordial follicle pool, and on female reproduction. Pregnant FVB mice (F0) were orally dosed daily with tocopherol-striped corn oil (vehicle), diethylstilbestrol (DES; 0.05 μg/kg, positive control), or BPA (0.5, 20, and 50 μg/kg) from gestational day 11 until birth. Ovarian morphology and gene expression profiles then were examined in F1 female offspring on postnatal day (PND) 4 and estrous cyclicity was examined daily after weaning for 30 days. F1 females were also subjected to breeding studies with untreated males at three to nine months. The results indicate that BPA inhibits germ cell nest breakdown via altering expression of selected apoptotic factors. BPA also significantly advances the age of first estrus, shortens the time that the females remain in estrus, and increases the time that the females remain in metestrus and diestrus compared to controls. Further, F1 females exposed to low doses of BPA exhibit various fertility problems and have a significantly higher percentage of dead pups compared to controls. These results indicate that in utero exposure to low doses of BPA during a critical ovarian developmental window interferes with early ovarian development and reduces fertility with age.     

睾酮对小鼠卵泡体外发育的影响

目的探讨高浓度睾酮对体外培养的小鼠卵泡生长发育的影响。方法以出生后12日龄的ICR雌鼠体外培养卵泡为研究模型,将卵泡随机分为以下4个组,每组30个:正常对照组(control组)、10-4mol/L睾酮处理组、10-5mol/L睾酮处理组和10-6mol/L睾酮处理组。将卵泡随机分为以下3个组,每组30个:正常对照组(control组)、睾酮处理组(T组,T=10-5mol/L)和雄激素受体拮抗剂氟他胺预处理后再加睾酮处理组(F+T组,F=10-5mol/L,T=10-5mol/L)。在60mm无菌细胞培养皿上进行微滴培养,每天在倒置显微镜下观察卵泡轮廓,颗粒细胞增生情况,卵母细胞形态以及有无卵母细胞逸出等,并记录卵泡存活和退化的情况。结果 10-4mol/L睾酮能抑制卵泡的生长,而10-5mol/L睾酮能够促进颗粒细胞的增殖和卵泡的生长;同时,在卵泡生长前期,睾酮能刺激卵泡的发育,在后期则呈抑制作用,即卵泡发育停滞、退化或死亡。结论在初级和次级卵泡阶段,10-5mol/L睾酮能促进卵泡的发育,而在窦状卵泡阶段则抑制卵泡的发育。     

Caloric restriction promotes the reproductive capacity of female rats via modulating the level of insulin-like growth factor-1 (IGF-1)

The insulin-like growth factor-1 (IGF-1) plays an important role in the regulation of reproductive function. In the present study, we examined the effects of caloric restriction (CR) on the reproductive lifespan in rats and investigated the potential role of IGF-1. After 10 weeks of treatment, we determined the distribution of the ovarian follicles at various stages and measured the plasma level of IGF-1, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estrogen (ESG). Our results show that IGF-1 level was decreased after CR and correlated with the decrease in the levels of LH, FSH and ESG. Moreover, a higher percentage of primordial follicles and surviving follicles was observed in CR rats than in control rats (P < 0.05). Immunohistochemical analysis showed that IGF-1 was extensively expressed in the cytoplasm of granulosa cells in the surviving follicles at different stages but not in the atretic follicles. Taken together, these results suggest that caloric restriction promotes the reproductive capacity of female rats via modulating the level of IGF-1, which then regulate pituitary gonadotrope cells to reduce the release of LH, FSH and ESG, and modulate follicular development.     

Effects of acupuncture on Luteinized Unruptured Follicle Syndrome: A meta-analysis of randomized controlled trials

PurposeThis meta-analysis aimed to evaluate the comprehensive efficiency and safety of acupuncture on Luteinized Unruptured Follicle Syndrome based on Randomized Controlled Trials (RCTs).MethodsSix electronic databases (i.e. Wanfang, VIP, China National Knowledge Infrastructure, Pubmed, Cochrane, and Embase) were searched from inception to July 2019. Randomized controlled trials were eligible to evaluate the effects of acupuncture alone or acupuncture as an adjunct. The primary outcomes were the ovulation rate and pregnancy rate. Two reviewers proceeded study selection and quality assessment of included trials and performed heterogeneity of included studies before meta-analysis.Trial Sequential Analysis was used to assess the risk of random error and estimate required information size. The Grading of Recommendations Assessment, Development and Evaluation was applied for assessing level of evidence.Results10 studies involving 715 participants were included Meta-analysis showed acupuncture alone and acupuncture as an adjunct both could significantly improve ovulation, which were confirmed by Trial Sequential Analysis. The evidence of acupuncture improving pregnancy rate was insufficient. Improved serum luteinizing hormone and estradiol levels, and decreased pulsatility index and resistance index of ovary artery were shown in both two subgroups. Level of evidence of most outcomes was “low” or “very low”, so the results should be cautiously interpreted.ConclusionsAcupuncture alone or be combined with drugs are effective on Luteinized Unruptured Follicle Syndrome especially for improving ovulation . While concurrent evidence is insufficient, and further studies of high quality are needed to strengthen the conclusion.     

小卵泡排卵致不孕症69例临床观察

目的探讨小卵泡排卵的诊断及治疗方法。方法 回顾性分析69例小卵泡排卵患者B超监测卵泡发育情况,并对其进行周期性促排卵治疗。结果69例患者均进行了2个周期以上的监测,重复出现小卵泡排卵的56例,重复出现率81.16%（56/69）。经促排卵药物治疗后临床妊娠率46.03%（29/63）,周期妊娠率为23.02%（29/126）。结论小卵泡排卵是造成不孕的主要原因之一。B超监测卵泡发育情况是诊断小卵泡排卵的主要方法,促排卵是治疗小卵泡排卵所致不孕症的有效方法。     

促排后行未成熟卵泡穿刺术治疗多囊卵巢综合征的效果观察

目的观察促排卵后超声下行未成熟卵泡穿刺术（IMFP）治疗多囊卵巢综合征（PCOS）的效果。方法选择多囊卵巢综合征患者共86人,分2组。观察组43例,穿刺前用少量人类尿促性腺激素（HMG）促排卵;对照组43例,穿刺前未用HMG。在超声引导下行未成熟卵泡抽吸术,尽可能将能看到的卵泡全部抽吸干净,连续2—3个周期,穿刺后检查患者的内分泌和卵巢基础窦卵泡计数,直至达到基础窦卵泡计数≤10个／卵巢,并随访6个月记录其妊娠情况。结果两组患者窦卵泡计数、LH、LH／FSH、T值均较术前降低;卵巢过度刺激综合征发生率降低而妊娠率升高,其中观察组效果优于对照组（P〈0．01）。结论超声引导下IMFP可在一定时间内有效改善PCOS患者的内分泌状态,明显减少卵巢内窦卵泡计数,使其在以后的促排卵周期中OHSS发生率降低,排卵率及妊娠率提高,是治疗重度PCOS的一种有效途径。