Performing Testicular or Epididymal Sperm Retrieval Prior to the Injection of hCG

Purpose: Our purpose was to determine the feasibility and efficacy of performing testicular or epididymal sperm retrieval prior to the injection of human chorionic gonadotropin (hCG). Methods: This report deals with 87 sperm-positive percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sperm aspiration (PTSA), or testicular sperm extraction (TESE) cycles. All sperm retrieval procedures were performed prior to administration of hCG to the women. Retrieved spermatozoa were cultured in vitro in simple medium for approximately 40 hr prior to intracyto-plasmic sperm injection. Results: In all but one cycle in which TESE was performed for nonobstructive azoospermia, motile sperm were available for ICSI. The overall fertilization rate was 53%. Pregnancy rate per transfer and implantation rate per embryo were 41.2 and 15.7%, respectively. Conclusions: Satisfactory fertilization and pregnancy rates can be achieved when PESA, PTSA, or TESE is performed prior to the injection of hCG followed by in vitro culture of spermatozoa approximately 40 hr before ICSI. Scheduling of testicular or epididymal sperm retrieval cases in this way appears to ease the workload on laboratory and operating room personnel. Furthermore, withholding hCG when sperm is absent may obviate the unnecessary risk of ovarian hyperstimulation when spermatozoa cannot be retrieved.     

Is normal β-hCG regression curve helpful in the diagnosis of persistent trophoblastic disease?

OBJECTIVE: The aim of this study was to evaluate the probable usefulness of normal beta-human chorionic gonadotropin (beta-hCG) regression curve in the diagnosis of persistent trophoblastic disease (PTD). METHODS: A log-value regression curve was developed from the means and 95% confidence limits of serial weekly serum beta-hCG titers of 43 patients with uneventful complete hydatidiform moles and 14 patients, who were previously confirmed as PTD. RESULTS: All 14 PTD patients (100%) had abnormal values, beyond normal range, within 4 weeks. beta-hCG was in its upper values, compared to normal regression curve at 2.29 +/- 0.19 weeks. This was earlier than plateau or rise detection at 4.21 +/- 0.33 weeks (P < 0.001). Within 3 weeks of evacuation, 13 of 14 (92.86%) PTD patients' beta-hCG values exceeded the normal range, whereas only six of 14 (42%) showed a rise or plateau. CONCLUSION: Our finding indicates that the normal beta-hCG regression curve may be useful for quicker detection of PTD than the plateau or rise of level.     

Human chorionic gonadotropin assay in cervical secretions for accurate diagnosis of preterm labor.

OBJECTIVES: We planned to determine whether the concentration of human chorionic gonadotropin (hCG) in cervical secretions could be a useful marker for accurate diagnosis of preterm labor, and whether the use of cervical hCG assay in combination with the Bishop score would improve the prediction of delivery within 7 days, and to determine the cut-off values for hCG in prediction of delivery within 100 h, 7 and 14 days, as well as before 35 and 37 weeks of gestation in a group of women at high risk for preterm delivery. METHODS: The study was conducted in the perinatology department of Zeynep Kamil Women and Children Diseases Education and Research Hospital between February 2002 and February 2003. One hundred and two subjects with a diagnosis of threatened preterm labor with intact membranes were included in the study. For hCG measurements, a cotton swab was rolled intracervically for 10 s to absorb fluid. Bishop scores were assessed. The correlation test was employed for the variables influencing hCG values. The ROC curve analysis was used to establish an optimal cut-off concentration for cervical hCG and an optimal cut-off level for Bishop score. The continuous variables were analyzed by the unpaired, independent, two-tailed t-test and categorical data were analyzed by the chi-square test. RESULTS: A significant positive correlation was present between the cervical hCG concentrations and Bishop scores (r=0.72, P<0.0001), and a highly negative correlation between the cervical hCG concentrations and the time interval from sampling time until delivery (r=-0.80, P<0.0001) was detected. The cut-off value for cervical hCG concentration and its sensitivity, specificity, positive and negative predictive values, accuracy, relative risk and likelihood ratio for accurate determination of delivery within 100 h were > or =32 mIU/ml, 98%, 55%, 70%, 96%, 77%, 19.68 and 2.18, respectively. However, these values were > or =32 mIU/ml, 97%, 84%, 89%, 95%, 92%, 17.37 and 6.06, respectively, for prediction of delivery within 7 days; > or =30 mIU/ml, 97%, 79%, 87%, 94%, 89%, 15.15 and 4.62, respectively, for prediction of delivery within 14 days; > or =33 mIU/ml, 89%, 92%, 94%, 83%, 90%, 5.83 and, 11.55, respectively, for prediction of delivery before 35 weeks; and finally > or =27 mIU/ml, 76%, 50%, 85%, 37%, 71%, 1.34 and 1.52, respectively, for prediction of delivery before 37 weeks. CONCLUSIONS: Cervical hCG expression seems to be rewarding in accurate diagnosis of preterm labor. This test has the advantage of low cost and wide availability.     

使用多肿瘤标志物蛋白质芯片诊断系统(C-12)检测胃癌的临床价值

目的研究多肿瘤标志物蛋白芯片诊断系统用于胃癌的诊断价值。方法用多肿瘤标志物蛋白芯片诊断系统检测50例正常人,70例胃良性疾病及80例胃癌患者血清中十二种常见的肿瘤标志物:甲胎蛋白(AFP),癌胚抗原(CEA),神经元特异性烯醇化酶(NSE),糖原125(CA125),糖原153(CA153),糖原242(CA242),糖原199(CA199),前列腺特异性抗原(PSA),游离前列腺特异性抗原(f-PSA),铁蛋白(FER),β-人绒毛膜促性腺激素(β-HCG),人生长激素(HGH)的水平并进行统计学分析。结果80例胃癌患者血清有74例血清肿瘤标志物为阳性(阳性率为92.75%),70例良性胃疾病中10例肿瘤标志物为阳性(阳性率为14.28%),50份正常对照血清有1例血清肿瘤标志物为阳性(特异性为98%)。试验还发现部分胃癌患者血清中出现NSE,HGH,PSA,f-PSA。结论多肿瘤蛋白芯片的应用,对胃癌患者的术前肿瘤良恶性的判定有一定的临床应用价值。     

异位妊娠MTX保守治疗过程中破裂出血病例的临床分析

目的:评价异位妊娠在MTX保守治疗过程中发生破裂出血的危险因素。方法:回顾性分析100例MTX保守治疗的异位妊娠妇女,主要测量指标为血浆HCG水平。结果:异位妊娠MTX保守治疗前、后HCG水平的上升速度与输卵管破裂出血密切相关;保守治疗给药前48 h HCG上升超过66%或给药后HCG仍持续性升高,则提示输卵管破裂可能性大;65%异位妊娠破裂出血在峡部。结论:MTX治疗前、后HCG上升的速度是预示输卵管破裂出血的良好指标;保守治疗给药前HCG上升速度超过66%/48 h或用药后HCG仍持续性升高,提示可能需要外科手术治疗;妊娠囊的着床部位也是输卵管破裂的高危因素。     

胚胎移植后11天血β-hCG水平与妊娠结局关系的研究

目的:探讨体外受精-胚胎移植后11天单次血β-hCG水平的临床预测价值,分析其与不同妊娠结局的关系。方法:选取胚胎移植后11天测定血清β-hCG确定妊娠并继续妊娠至12周以上的患者192例,分为无效妊娠组(包括生化妊娠、异位妊娠和妊娠早期流产)和继续妊娠组(包括单胎妊娠、双胎妊娠和三胎妊娠),比较各组间的血清β-hCG水平,分析其与各妊娠结局的关系。结果:胚胎移植后11天,无效妊娠组的血β-hCG水平为81·43±73·15U/L明显低于继续妊娠组的323·75±315·29U/L,具有显著性差异(P<0·001);单胎妊娠组血β-hCG水平均明显低于双胎妊娠组和三胎妊娠组,差异亦具有显著性(P<0·001)。当血中β-hCG介于10~50U/L时,生化妊娠和异位妊娠的阳性预测价值为81·8%,阴性预测价值达94·4%;当血β-hCG≤100U/L时,早期流产的阳性预测价值为80·8%,阴性预测价值为77·8%;当血β-hCG>250U/L时,双胎、三胎妊娠的阳性预测价值为83·3%,阴性预测价值为74·4%。结论:胚胎移植后11天单次血清β-hCG水平能有效地预测体外受精-胚胎移植周期不同的妊娠结局,具有临床指导意义。     

隐睾患儿术后性激素和抗精子抗体的检测

目的探讨隐睾患儿抗精子抗体(AsAb)与手术、绒毛膜促性腺激素(HCG)应用的相关性及术后血清雌二醇(E2)、睾酮(T)水平的变化。方法随机抽取隐睾患儿40例,分为应用HCG组(12例)及未用HCG组(28例)取腹股沟手术和正常同龄儿各20例作为对照组,检测各组血清AsAb、E2、T水平。结果各组患儿血清E2、T水平结果比较差异无统计学意义(P>0.05);在40例隐睾患儿组中IgG阳性率为53.57%,腹股沟手术组中IgG阳性率为15.00%,正常对照组无一例AsAb阳性;HCG治疗组与未用HCG治疗组AsAb阳性率比较差异无统计学意义(P>0.05)。结论隐睾患儿AsAb产生的机制可能与血睾屏障的破坏、内分泌紊乱等因素有关;应用HCG对AsAb的产生无影响。     

氯米芬联合HCG对不孕症患者内分泌指标及子宫内膜容受性的影响

目的:探讨氯米芬联合人绒毛膜促性腺激素(HCG)对不孕症患者内分泌指标及子宫内膜容受性(ER)的影响。方法:回顾性分析某院妇产科2018年11月~2019年11月接收的96例不孕症患者临床资料,将采用氯米芬联合HCG治疗的患者归为观察组(49例),将单独采用氯米芬治疗的患者归为对照组(47例),对比两组患者治疗前、治疗3个月内分泌指标、ER及卵巢体积变化情况以及治疗期间不良反应发生情况。结果:治疗3个月后,两组促卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)及孕酮(P)水平均较治疗前高,且观察组FSH、LH、E_2及P水平高于对照组,差异有统计学意义(P<0.05);治疗3个月后,两组子宫内膜厚度(Em)指标较治疗前上升,卵巢体积较治疗前缩小,且观察组Em指标较大,卵巢体积较小,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:不孕症患者采用氯米芬联合HCG治疗效果良好,可有效改善内分泌指标,提升ER指标,且安全性较高,值得临床推广。     

Effect of GnRH-II on the ESC proliferation,apoptosis and VEGF secretion in patients with endometriosis in vitro

Objective: To study the effect of GnRH-II on the cell proliferation, apoptosis and secreting vascular endothelial growth factor (VEGF) of ectopic, eutopic and normal endometrial stromal cells (ESC) from patients with or without endometriosis (EMs) in vitro. Methods: The ectopic, eutopic and normal ESC were isolated, cultured and identified, then added 0 M, 10^-10 M, 10^-8 M, 10^-6 M GnRH-II. The growth and proliferation of three ESC were measured by MTT assay; the cell apoptosis were detected with the method of Hoechst staining and Flow Cytometry test; ELISA was used to measure the VEGF concentration change by three ESC secretion. Results: GnRH-II inhibited the proliferation of ectopic, eutopic ESC from patients with endometriosis and normal ESC from control patients, in a dose- and time-dependent manner (P<0.05); GnRH-II increased the apoptotic rate of three ESC in a dose-dependent manner (P<0.05); The concentration of VEGF in three ESC was significantly decreased after the treatment of GnRH-II, in a dose-dependent manner (P<0.01); And these above effects were the strongest on the ectopic than on the eutopic or normal, there were statistical significance (P<0.05); and three was no significantly difference between the eutopic and normal (P>0.05). Conclusions: GnRH-II significantly inhibited the cell proliferation, induced cell apoptosis and decreased the VEGF secreting of ectopic, eutopic and normal ESC in EMs in vitro, and these effects were the strongest on ectopic ESC, which suggested that GnRH-II may become a new effective treatment for endometriosis.