Prediction of pregnancy in IVF cycles on the fourth day of ovarian stimulation

Purpose Prediction of IVF outcome on the first days of ovarian stimulation has focused clinical research for many years. The aim of this work is to predict the probability of pregnancy on the fourth day of ovarian stimulation for IVF cycle, using parameters usually determined in this stage—estradiol, antral follicle count—together with parameters determined previously: FSH on the third day of cycle and women age. Materials and methods One hundred and ten patients with primary infertility due to a tubal factor were recruited to participate in a prospective study. FSH was determined on the third day of spontaneous cycle. Antral follicles and estradiol were measured on the fourth day of ovarian stimulation. After oocyte pick-up, quality and quantity of oocytes and embryos and pregnancy rates were assessed. Results In stepwise multiple logistic regression the variables with better predictiveness over pregnancy are: antral follicles count, estradiol and woman age. The logistic regression analyses demonstrate that the capacity of the model that uses these variables to predict pregnancy is 75%, with a positive predictive value of 69% and a negative predictive value of 80%. Conclusions On the fourth day of ovarian stimulation of IVF cycles, the variables with highest predictiveness are: antral follicle count, estradiol and women age. When these variables are included in a model of prediction, the capacity to predict pregnancy is 75%. On the fourth day of ovarian stimulation for IVF cycles, antral follicles count, estradiol and woman age predict IVF outcome as reflected by quantity and quality of oocytes, embryos obtained and pregnancy rates.     

人腔前卵泡体外培养研究

目的探讨FSH对人腔前卵泡(preantralfollicle)体外生长的影响.方法培养液中加入不同浓度的FSH,观察卵泡存活天数和卵泡发育增大.结果卵泡体外存活天数对照组为2.80±1.69天,Ⅰ、Ⅱ、Ⅲ组(FSH浓度为0.5IU/ml、1IU/ml、2IU/ml)分别为5.36±0.63、5.47±2.50、8.13±4.19天,与对照组相比,分别为P＜0.05、P＜0.01、P＜0.001.卵泡增大比率对照组为20.00%,Ⅰ、Ⅱ、Ⅲ组分别为35.71%、60.00%、81.25%,与对照组相比分别为P＞0.05、P＜0.05、P＜0.01.结论FSH能使卵泡体外存活天数延长,卵泡发育增大,并大致呈正相关关系.     

淋巴滤泡中补体成分沉积的意义

目的:观察补体成分在淋巴组织中的表达,探讨不同发育阶段淋巴滤泡中补体激活与免疫球蛋白沉积及滤泡树突状细胞之间的关系。方法:采用免疫组化方法对淋巴组织标本进行IgG、IgM、IgA、C3c、C4c、C1q和C4d标记,同时对其部分标本进行双标染色。结果:淋巴组织次级滤泡的Ⅰ~Ⅳ期的生发中心才出现不同程度的IgG、IgM、IgA、C3c、C4c、C1q、C4d阳性表达;免疫球蛋白与补体成分重叠沉积,并呈不规则网线状包绕在滤泡树突状细胞周围。其中以C4d的阳性表达最强。结论:淋巴滤泡生发中心有大量免疫球蛋白和补体成分围绕滤泡树突状细胞沉积,可能与中心淋巴细胞的发育和选择有关。     

窦卵泡数与多囊卵巢综合征相关因素的研究进展

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是育龄期女性常见的一种内分泌疾病,是导致女性不孕的常见原因。PCOS患者典型的超声学表现为卵巢多囊样改变(polycystic ovary morphology,PCOM),即:单侧或双侧卵巢2~9mm的卵泡数≥12个,和/或卵巢体积(ovarian volume,OV)10ml。PCOS患者中关于窦卵泡数(antral follicle count,AFC)研究聚焦在PCOM定义中卵泡数的截断值上,但目前国际上对PCOM定义仍采纳2003年Rotterdam标准。PCOM形成机制仍未明确,可能与高雄激素及抗苗勒管激素(anti müllerian hormone,AMH)影响相关。PCOS患者的AFC与月经周期长短、雄激素、LH/FSH值、代谢感染指标存在相关性。PCOS患者30岁前AFC减少速度较正常人群慢,但在30岁以后与正常人群减少速度一样。     

基础窦卵泡数预测IVF患者临床妊娠结局的Meta分析

目的 通过Meta分析探讨基础窦卵泡数预测IVF妊娠结局的临床应价值。方法 收集国内外有关基础窦卵泡数与IVF-ET临床妊娠结局的相关研究,符合纳入与排除标准的相关文献共11篇,采用RevMan 5.2软件对纳入的文献进行Meta分析。结果 通过对纳入的11项研究进行Meta分析显示,基础窦卵泡数越多,获卵数、临床妊娠率、继续妊娠率、种植率越高,差异有统计学意义。获卵数（SMD_合并=-0.87,95% CI：-1.22~-0.52;Z=4.84,P=0.000）,临床妊娠率（OR_合并=0.62,95% CI：0.54~0.72,Z=6.19,P=0.000）继续妊娠率（OR_合并=0.21,95% CI：0.08~0.59,Z=3.00,P=0.003）;种植率（OR_合并=0.59,95% CI：0.49~0.72,Z=5.31,P=0.000）,结果表明,基础窦卵泡数越多,获卵数和临床妊娠率就越高。结论 基础窦卵泡数可能是体外受精前量化卵巢储备功能的有利检测指标,并直接影响临床妊娠结局。     

A Case of Cutaneous Bronchogenic Cyst Presenting with Lymphoid Follicles

Cutaneous bronchogenic cysts are rare, and stem from developmental abnormalities of the tracheobronchial tree. The condition is often misdiagnosed clinically, with the correct diagnosis usually established by histopathologic examination. Published reports of bronchogenic or branchial anomalies are increasing, and the traditional defining characteristics of location and histopathology are proving to be less reliable for the identification of cutaneous bronchogenic cysts. In this report, we describe a case of a cutaneous bronchogenic cyst that presented with unusual histologic features, and was associated with several lymphoid follicles.     

Drug delivery into the skin by degradable particles

Recently, it was demonstrated that particles could be utilized as carrier systems for drugs into the hair follicles. In the present study, a two-component drug delivery system is presented consisting of degradable particles loaded with fluorescein isothiocyanate and a separate protease formulation for degradation. The particles were applied alone, 30 min previous to the protease application and simultaneously with the protease onto porcine skin. Subsequently, biopsies were removed, and the penetration depths of the particles were analyzed using laser scanning microscopy.The obtained results demonstrate that the particles alone achieved a penetration depth of around 900 μm. Similar results were obtained for the successive application of particles and protease, whereas a release of the fluorescent dye was only observed in the upper 250 μm corresponding to the penetration depth of the protease. In the case of the simultaneous application, the particles were partly dissolved before application, leading to a reduced particle size and diminished penetration depth.The results revealed that degradable particles are a promising tool for drug delivery into the skin.     

Chronic granulomatous disease of childhood: Gastric manifestation and response to salazosulfapyridine therapy

The case history of a 10-year-old boy with chronic granulomatous disease (CGD) and gastric obstruction is presented. First abdominal symptoms occurred at 4 years of age when antral narrowing was detected. Due to unresponsiveness to antibiotic and steroid treatment, salazosulfapyridine therapy was initiated. Objective remission was observed within 3 months and salazosulfapyridine was withdrawn after a further 6 months of therapy. At 6 years of age clinical and radiological recurrence of gastric obstruction was observed. Salazosulfapyridine was reinstated and continued as maintenance therapy. The child has been well for more than 4 years. Salazosulfapyridine therapy can be recommended as safe conservative treatment of gastric obstruction in CGD.