短时受精失败后补行ICSI的实验室指标和新生儿情况分析

目的：探讨常规体外受精(IVF)失败后补行卵胞浆内单精子显微注射(ICSI)的实验室指标和新生儿情况。方法：回顾性分析2011年1－12月在成都锦江妇幼保健院接受ICSI治疗的患者203例(对照组)和IVF失败后补行ICSI的患者117例(实验组)的实验室检查结果、临床数据和新生儿情况。结果：实验组患者多精受精率(3.00%)显著高于对照组(1.39%)(P<0.05)。对照组中有1例引产,1例早产儿在产后10d夭折。实验组与对照组的正常受精率、卵裂率、D3优胚率、囊胚形成率、冷冻周期率、移植周期率、胚胎着床率、妊娠率、多胎妊娠率、异位妊娠率、早期流产率、晚期流产率、活胎分娩率以及胎儿畸形率差异均无统计学意义(P＞0.05)。新生儿情况对比发现,两组间婴儿性别比、身长、体质量、Apgar评分差异亦无统计学意义(P＞0.05)。单、双胎妊娠新生儿中,实验组孕周、体质量、身长和Apgar评分与对照组比较差异均无统计学意义。结论：常规IVF受精失败后,及时补行ICSI能显著提高受精率和优胚率,进而改善临床结局。     

兔着床后全胚胎培养方法的建立

目的:建立用于发育毒物研究和评价的兔着床后全胚胎培养方法。方法:取怀孕第9天(gestation day 9,GD9)的孕兔胚胎,参照Carney和Naya的方法,剥离胚胎后单瓶培养,体外培养48 h后将发育情况与文献报道的结果进行对比;并用5.0mmol/L的甲氧基乙酸(methoxyacetic acid,MAA)作为致畸阳性物对所建立的培养方法作进一步验证,采用Carney建立的兔胚胎形态评分系统进行评分。结果:本研究中23个GD9兔胚胎体外培养48 h后,存活率为100%,头长平均增长2.15倍,卵黄囊闭合和胚胎弯曲情况、体节数、自发畸形率、形态评分均数等指标均与文献报道的体外培养发育情况相近,5.0 mmol/L的MAA显示对兔胚胎有发育毒性,包括卵黄囊闭合减少、头部肿胀、面部器官缺失、体节紊乱、尾神经管闭合不全等,形态评分低于溶剂对照(P0.05)。结论:本研究所建立的兔着床后全胚胎培养方法是可行的。     

Growth Hormone (GH) Improvement of Ovarian Responses and Pregnancy Outcome in Poor Ovarian Responders: A Randomized Study

Recent evidence has emphasized growth hormone benefits in increasing the ovarian response and improving thepregnancy rate in poor responders (POR), caused by aging, ovarian surgery, chemotherapy and other reasons, undergoingIVF/ICSI. The most important factor in the treatment of POR patients is the quality and quantity of oocytes followingovarian stimulation; thus, efforts should be made to provide opportunities for young patients to improve their fertilityand ovarian responses. The use of GH in these patients may offer a promising aid to successful fertility.In the presentsingle-blinded clinical trial, POR patients were randomly assigned to receive one of three regimens: (A) Gonadotropin,a GnRH antagonist and GH from the eighth day of the cycle for about 5 days (n = 34); (B) Gonadotropin, a GnRHantagonist and GH from the third day of the previous cycle for about 20 days (n = 32); and (C) Gonadotropin, a GnRHantagonist, and a placebo from the eight day of the cycle for about 5 days (n = 26). Oocyte quality and pregnancy rateswere compared across the three groups. A significantly lower number of collected oocytes, MII oocytes, fertilizedoocytes, transferred embryos, and clinical pregnancy rate in the placebo group was noted as compared to the twoexperimental groups receiving GH. Live clinical pregnancies in B group were significantly greater than in the othergroups. Our results together indicate that GH may play an important role in recruitment of dominant follicles andenhance follicular survival and the cell proliferation leading to high- quality embryos. Accordingly,     

人精子穿去透明带金黄地鼠卵实验和精子DNA完整性检测在体外受精-胚胎移植中的应用

目的：探讨人精子穿去透明带金黄地鼠卵实验（SPA）和精子DNA完整性检测在体外受精-胚胎移植术（IVF-ET）助孕中的应用价值。方法：选择兰州大学第一医院生殖医学研究中心,行IVF-ET助孕的不孕不育夫妇中的41名男性,根据不孕不育原因分为完全男方因素引起的不孕不育组（n=20）和完全女方因素引起的不孕不育组（n=21）,比较分析两组男方年龄、穿透率、受精指数、IVF受精率、DNA碎片率、卵裂率、优质胚胎率、胚胎着床率及临床妊娠率的差别。结果：完全男方因素引起的不孕不育组和完全女方因素引起的不孕不育组之间,在男方年龄、IVF受精率、卵裂率、胚胎着床率、临床妊娠率等方面的差异均无统计学意义（P均〉0.05）,在穿透率、受精指数、DNA碎片率方面的差异均具有统计学意义（P〈0.05）;前者的SPA穿透率与IVF受精率、卵裂率和优质胚胎率之间均存在显著正相关（r=0.908,0.55,0.852,P均〈0.05）,DNA碎片率与IVF受精率和优质胚胎率均存在显著负相关（r=-0.636,-0.634,P均〈0.05）;后者SPA穿透率与IVF受精率、卵裂率和优质胚胎率之间均存在显著正相关（r=0.893,0.53,0.626,P均〈0.05）,DNA碎片率与IVF受精率和优质胚胎率之间均存在显著负相关（r=-0.636,-0.634,P均〈0.05）。结论：SPA和精子DNA完整性检测在辅助生殖技术中可能具有一定的应用价值。     

抗金黄地鼠精液抗体作为杀精子剂的实验研究

背景与目的： 探讨抗精液抗体作为阴道内杀精子剂的可行性。 材料与方法： 制备抗金黄地鼠精液抗血清,用抗血清与金黄地鼠精液混合后,做体外精子活率分析、精子凝集实验;用流式细胞仪分析精子线粒体功能,取雌鼠卵细胞做体外受精及精卵融合试验;并做抗血清处理后精子的子宫内注射实验和交配后阴道内精子活率测定,以探讨抗精液抗体在体外和体内制动精子的作用。 结果： 抗精液抗体能够完全凝集和制动精子,流式细胞仪检测结果显示抗血清处理组精子线粒体荧光强度为180.28±82.24,明显低于对照组(309.74±148.37),差异具有统计学意义(P<0.01);体外受精实验中处理组的受精率为0.9％,显著低于对照组的37.50％(P<0.01);子宫内精子注射实验中实验组受精卵率为1％,显著低于对照组的15％(P<0.01);交配后阴道内精子活率测定显示,实验组中所有精子均不活动,而对照组精子活率为60％。 结论： 抗精液抗体在体外、阴道和子宫内都能够完全凝集和制动精子,可以阻止精卵融合。抗精液抗体可以作为阴道内杀精子剂。     

Radiological abnormalities in children born as a result of assisted conception

Over 15 000 children are born each year as a result of the various techniques of assisted conception. In 1991, there were 2083 live births in Australia and New Zealand as a result of these techniques. Radiological abnormalities relating to the increased rate of prematurity, a probable increase in the risk of congenital malformations and a number of cases of neural crest tumours seen in these infants will be presented.     

单药长春瑞滨对乳腺癌原代细胞杀伤效果的体外研究

 目的 探讨长春瑞滨用于复发性乳腺癌患者的治疗效果和应用前景。方法 取得原发性和复发性乳腺癌患者的癌组织标本，采用胶原酶消化法获取乳腺癌原代细胞，应用原代培养和MTT法检测5种化疗药物在体外对乳腺癌原代细胞的杀伤效果。结果 对原发性乳腺癌原代细胞，紫杉醇和多西紫杉醇（多西他赛）的杀伤效果（敏感率分别为91.04 ％、92.54 ％）优于多柔比星、表柔比星和长春瑞滨（敏感率分别为73.13 ％、74.63 ％、71.64 ％；P＜0.01）；对复发性乳腺癌原代细胞，长春瑞滨和紫杉醇、多西紫杉醇的杀伤效果（敏感率分别为74.07 ％、66.67 ％、66.67 ％）明显优于多柔比星和表柔比星（敏感率分别为37.04 ％、40.74 ％；P＜0.01）。结论 长春瑞滨可以作为化疗一线药物应用于复发性乳腺癌患者。     

中药香加皮提取物的体内外抑瘤效果研究

背景与目的:研究中药香加皮水提取物(cortex periplocae extract,CPE)的体内、外抗肿瘤效果.材料与方法:采用MTT法和克隆形成实验,检测CPE对6种不同组织来源肿瘤细胞(K562、BGC-823、TE-13、SMMC-7721、MCF-7和HeLa)增殖反应的影响;将CPE灌胃给予S180和colon 26荷瘤小鼠,观察其对肿瘤形成及小鼠生存期的影响.结果:CPE对6种不同肿瘤细胞株均有明显的抑制作用(P＜0.05),其中对K562,BGG-823,TE-13的抑制作用量效关系明显(r分别为0.89、0.71和0.72,P值均＜0.05).将CPE灌胃S180或colon26荷瘤小鼠,可明显抑制肿瘤在体内的生长,并可明显延长荷瘤小鼠的生存期(P＜0.05).结论:CPE对6种不同组织来源的肿瘤细胞均具有抑制作用,可明显抑制荷瘤小鼠肿瘤的生长,延长荷瘤小鼠寿命.香加皮作为抗肿瘤药物有待进一步开发研究.     

蛇床子素的提取及其体外抗肿瘤活性的研究进展

蛇床子素是天然的香豆素类化合物,可以从多种中药中提取分离.近年来,国内外研究发现蛇床子素对多种肿瘤细胞具有显著的抑制作用.本文综述蛇床子素提取工艺及其体外抗肿瘤活性的研究进展,为进一步进行蛇床子素体内抗肿瘤活性研究及其应用于临床提供参考.     

In vitro maturation is a viable option for urgent fertility preservation in young women with hematological conditions

Fertility preservation embraces different techniques developed to improve young women chances of becoming mothers after healing. Among them, in vitro maturation (IVM) procedure is based on oocyte retrieval without any gonadotropin treatment, feasible under locoregional or local anesthesia, with very low operative complications. The present retrospective analysis of a preliminary case series of 25 women diagnosed with Hodgkin or non-Hodgkin lymphoma aims to evaluate the feasibility of IVM for urgent fertility preservation purposes in hematological context. A median of five mature oocytes was cryopreserved after one cycle of IVM, performed without delaying the start of the chemotherapy (median delay from histological diagnosis to start of the chemotherapy 17.5 days). No association was found between lymphomas' characteristics and the number of recovered or frozen oocytes. Although experimental, this technique could be relevant when fertility preservation has to be performed within a short time frame and without additional surgery nor any risk of malignant cells reintroduction.     

硒抗砷,氟,甲基汞致畸作用的体外实验研究

用大鼠全胚胎培养法并结合电镜技术探讨了硒与砷，氟，甲基汞之间是否存在交互作用及作用类型。结果表明三者均能诱发体外培养的胚胎发育异常，并呈剂量反应关系。加入０．５μｇ／ｍｌ硒后明显拮抗１．０μｇ／ｍｌ砷，１０μｇ／ｍｌ氟和０．４μｇ／ｍｌ汞的致畸性及胚胎毒性，但不能缓解３．０μｇ／ｍｌ砷和２０μｇ／ｍｌ氟的发育毒性，主要呈现砷，氟的独立作用。