Objective To compare the outpatient in gynecology department with health screening women in aspects of general condition, bearing, livelihood, economics and family, and to analyze the factors that relate to premature ovarian failure (POF) and diminished ovarian reserve (DOR). Method To survey 178 outpatients of gynecology department and health screening women visited from January to December of 2007, and to investigate the possible related factors through a questionnaire including the condition of basic information (e.g. age, marital status, occupation and education), menstruation, pregnancy and delivery, contraception, health, livelihood, economics, psychology, society, family and so on. The data were analyzed with SPSS 13.0 software. Results A total of 45 POF patients, 83 DOR patients and 50 healthy women were included. The results of questionnaire showed that the physiological factor was the main reason for the occurrence of POF and DOR; the menstrual disorders, autoimmune diseases (such as systemic lupus erythematosus, idiopathic thrombocytopenic purpura, glomerulonephritis, rheumatoid arthritis, etc.), malignancy cancer, pelvic surgery, smoking and drug abuse, and lack of sleep were closely related to POF and DOR; the social and psychological factors were other main reasons to cause POF and DOR. Conclusion The onset of both POF and DOR is caused by many factors, such as physical, social and psychological factors. The effective prevention and treatment for these diseases should be conducted positively in accordance with these three aspects.
ObjectivesTo systematically review the efficacy and safety of traditional Chinese herbal medicine Kuntai in the treatment of premature ovarian insufficiency (POI).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on Kuntai for treating premature ovarian insufficiency from inception to August, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsTwenty-one RCTs involving 1 777 patients were included, which were categorized as Kuntai vs. western medicine and Kuntai combined with western medicine vs. western medicine. The results of meta-analysis showed that: the efficacy of Kuntai was equivalent to western medicine; effective rate (RR=2.78, 95%CI 1.73 to 4.45, P<0.000 01), the change of Kupperman’s score (MD=−3.25, 95%CI −3.75 to −2.76, P<0.000 01), the change of serum FSH (MD=−6.99, 95%CI −8.07 to −5.90, P<0.000 01), E2 (MD=7.01, 95%CI 3.01 to 11.01, P=0.000 6) and LH (MD=−4.66, 95%CI −6.45 to −2.86, P<0.000 01) in Kuntai combined with hormone replacement therapy (HRT) group were higher than that in the HRT group.ConclusionsKuntai combined with HRT is superior to HRT alone in the effective rate, the change of Kupperman’s score, the change of serum FSH, E2 and LH for patients with premature ovarian insufficiency. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
ObjectiveTo explore the associations between estrogen receptor α (ESR1) gene intron 1 PvuⅡ (−397 T/C, rs2334693), XbaⅠ (−351 A/G, rs9340799) polymorphisms and premature ovarian failure (POF).MethodsLiterature published before February 2021 were retrieved in PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang, and CQVIP databases, according to the inclusion and exclusion criteria developed before. Odds ratio (OR) and 95% confidence interval (CI) were used for data analysis, the Q test and I2 statistic were used for heterogeneity analysis. Random-effect model or fixed-effect model was used according to I2 value. All analyses were performed by RevMan 5.3 software.ResultsSix case-control studies were included in this meta-analysis. For the associations between ESR1 gene intron 1 PvuⅡ polymorphisms and POF, there was no statistical difference in TT vs. CC model [OR=0.72, 95%CI (0.31, 1.70), P=0.46], TC vs. CC model [OR=1.09, 95%CI (0.83, 1.43), P=0.54], recessive model [OR=1.08, 95%CI (0.68, 1.70), P=0.74], or dominant model [OR=0.77, 95%CI (0.42, 1.42), P=0.41]. For the associations between ESR1 gene intron 1 XbaⅠ polymorphisms and POF, there was no statistical difference in AA vs. GG model [OR=0.88, 95%CI (0.44, 1.75), P=0.72], AG vs. GG model [OR=1.23, 95%CI (0.84, 1.79), P=0.29], recessive model [OR=1.14, 95%CI (0.81, 1.61), P=0.44], or dominant model [OR=0.75, 95%CI (0.41, 1.35), P=0.34], either. No statistical difference was found in the ethno-based subgroup analyses (P>0.05). Most models had obvious heterogeneities.ConclusionsCurrent evidence can’t confirm the associations between ESR1 gene PvuⅡ, XbaⅠ polymorphisms and POF. High-quality, multi-central and large-sample studies are still necessary to support this conclusion.
ObjectiveTo analyze the status quo of outcome indicators in the randomized controlled trials (RCTs) of premature ovarian failure (POF)/primary ovarian insufficiency (POI) published at home and abroad, and provide a sufficient basis for the selection of outcome indicators in related studies in the future.MethodsChina National Knowledge Infrastructure, Chongqing VIP Data, Wanfang Data, SinoMed, PubMed, the Cochrane Library, and Embase were searched for RCT articles of POF/POI published between the establishment of the databases and June 2021. Two researchers independently screened and extracted the literature, and finally summarized the outcome indicators of the included studies.ResultsA total of 186 articles meeting the inclusion criteria were selected, including 180 articles in Chinese and 6 articles in English. The choice of outcome indicators was diverse. Of the 186 articles, 2 Chinese articles and 1 English article used primary and secondary outcome indicators; 19 Chinese articles and 4 English articles used independent indicators, 4 Chinese articles used composite indicators, and 157 Chinese articles and 2 English articles used both independent indicators and composite indicators.ConclusionsThe selection and use of outcome indicators in clinical RCTs of POF/POI are not standardized, and there are problems such as neglect of primary and secondary outcome indicators, and lack of standards for the selection of clinical research outcome indicators. As a result, the credibility of the curative effect is reduced, and the results of similar studies cannot be combined and compared.
ObjectiveTo systematically review the efficacy of umbilical cord mesenchymal stem cells in the treatment of premature ovarian failure. MethodsCNKI, WanFang Data, SinoMed, PubMed and EMbase databases were electronically searched to collect animal experiments of the efficacy of umbilical cord mesenchymal stem cells in the treatment of premature ovarian failure from inception to September 17th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.4.1 software. ResultsA total of 9 studies involving 302 mice were included. The results of meta-analysis showed that: umbilical cord mesenchymal stem cell transplantation could increase primal follicles (SMD=1.51, 95%CI 0.80 to 2.22, P<0.000 1), primary follicles (SMD=1.43, 95%CI 0.76 to 2.09, P<0.000 1), secondary follicles (SMD=1.39, 95%CI 0.78 to 2.01, P<0.000 01) and sinus follicles (SMD=1.15, 95%CI 0.49 to 1.82, P=0.000 7). It significantly increased the concentration of estradiol in rats with premature ovarian failure (SMD=2.38, 95%CI 1.75 to 3.01, P<0.000 01), and decreased serum follicle-stimulating hormone concentration (SMD=−1.98, 95%CI −2.80 to −1.17, P<0.000 01). ConclusionCurrent evidence shows that umbilical cord mesenchymal stem cell transplantation can repair ovarian tissue and improve ovarian endocrine function in mice. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.