ObjectiveTo compare the clinical outcomes of different pituitary down regulation protocols with gonadotropin-releasing hormone agonist (GnRH-a) in patients undergoing in vitro fertilization and embryo transfer (IVF-ET) treatment. MethodsThe clinical data of 358 IVF cycles in women at 40 years old or younger from November 2012 to January 2013 in the West China Second University Hospital were analyzed retrospectively. All the 358 cycles were divided into two groups, according to whether the leading follicle diameter was <14 mm (group A, 158 cycles) or ≥14 mm (group B, 200 cycles) after discontinuing the GnRH-a. The clinical outcomes were compared between the two groups. ResultsCompared with group B, the amount of gonadotropins used was significantly more, and the time of gonadotropin use was also significantly longer in group A (P<0.05). However, the serum level of estradiol (E2), progesterone (P) and Luteinizing hormone (LH), incidence of premature P rise, retrieved ovum number, the rates of implantation, clinical pregnancy, miscarriage and live birth did not significantly differ between the two groups (P>0.05). ConclusionDiscontinuing the use of GnRH-a in early stage of controlled ovarian stimulation can keep effective pituitary down regulation and it has the same optimal clinical outcomes in patients undergoing IVF-ET.
ObjectiveTo explore the effect of chronic unpredictable mild stress (CUMS) on the reproductive function of mice and provide a suitable animal model for reproduction and stress. MethodsA total of 240 female Kunming mice were feed for 5 days, and then divided randomly into the control group (n=90) and experimental group (n=150). The mice in the experimental group were stressed by 9 chronic mild unpredictable stress factors for 4 weeks and validated by open field test and sucrose consumption test. We administrated pregnant mare serum gonadotropin (PMSG)/human chorionic gonadotropin (HCG) for induction of superovulation and observed the ovarian response and embryo development potential. ResultsAfter 4-week CUMS stimulation, the weight gain, 2% sugar consumption test and open field test were significantly different between the mice in two groups (P>0.05). After PMSG/HCG was administrated, the antra follicles and preovulatory follicles significantly reduced significantly in the experiment group than that in the control group (P<0.05); the number of oocytes, fertilization rate, 2-cell embryos, D4 embryos, blastocysts, high quality embryo rate and D5 bed points were all significantly decreased in the experiment group than those in the control group (P<0.05). ConclusionThe CUMS female Kunming mice model is a kind of emotional stress animal model with low reproductive function, which is effective, operable and repeatable; it could be used for further study on the mechanism of reproductive medicine.
ObjectiveTo quantify cytokine and chemokine mRNA expression in follicular fluid cells obtained at the time of oocyte retrieval before IVF in women with and without polycystic ovary syndrome (PCOS). MethodsBetween January and August 2014, 80 subjects undergoing IVF-ET were chosen to be studied. Among them, 40 had PCOS, and the other 40 were controls. Follicular fluid cells were subjected to quantitative RT-PCR to evaluate growth-regulated oncogene-α (GRO-α), tumor necrosis factor-α (TNF-α), interleukins (IL-6, IL-8) expression relative to β-actin. And the chemokine was measured in serum and follicular fluids by immunoassays. These mRNA transcriptions production was proved by sequencing. ResultsGRO-α, TNF-α, IL-6 and IL-8 mRNA were expressed in follicular fluid cells. Their expressions were significantly higher in PCOS compared with controls (P<0.05). They were also detected higher in PCOS than controls in serum and follicular (P<0.05), but the difference of IL-6 level between PCOS and controls in lean patients was not statistically significant (P>0.05). ConclusionGRO-α, IL-8, TNF-α, and IL-6 may play important roles in the occurrence and development of PCOS. PCOS may be a chronic immunological inflammatory disease.