Management of poor responders in assisted reproduction still remained a big challenge for fertility specialists, despite of the high number of published papers on poor ovarian response in literature for the past two decades. Until now definition for poor responder patients is still not universally accepted in the field of the scientific community. However, these groups of patients usually have a lower controlled ovarian stimulation or IVF treatment outcomes when compared with normal responders. The limitation in identifying and solving the challenges of poor ovarian response in IVF treatment is due to the difficulty of no universally accepted definition in most of the literature. Poor responders are patients unable to develop sufficient number of mature oocytes for collection or the production of ≤ 3 follicles after a standard stimulation protocol. The number of developed follicles and number of eggs retrieved after a standard stimulation of ovary are the two major criteria used in predicting poor ovarian response. In this review, we have discussed the different concepts of controlling ovarian stimulation for the management of poor responders during in vitro fertilization (IVF) treatment.
More and more study on the epididymal function and sperm maturation has shown that epididymis will be one of the best target organs of male contraception, although at present there is not a male contraceptive medicine based on epididymis for clinical practice. The promoting research aspects in epididymal contraception in animal included affecting directly epididymis (such as Sulpasalazine), interfering energy metabolism and sperm mobility (such as Chlorinated Glycerol), altering the internal environment of epididymis (such as copper particles and TW19). The epididymal specific proteins could bring out some new target antigens for immunological contraception, to produce contraceptive vaccine. Some special genes, which expressed distinctively in epididymis such as SC342, bin1, have been cloned and studied on their function. These works would be helpful not only for clinical diagnosis and treatment of epididymitis and male infertility, but also for male contraceptive research and progress.
To observe the change of erythropoietin (EPO) in patients of hypogonadism who received androgen replacement treatment and explore the mechanism of androgen-induced increase of red blood cells and haemoglobin.Eight patients with Klinefelter's syndrome, divided into two groups, received TU intramuscular injections of 500 mg or 1000 mg dose, respectively. After three months, seven patients received the second injection of crossover dose. Testosterone levels in serum were measured with RIA before and after the injections treatment. RBC count, impacted volume of blood cells and haemoglobin concentration were measured before treatment and 4, 8 weeks after treatment. At the same interval, EPO levels were measured with ELISA method.Development of the secondary sex characters was improved in all patients after the TU injection. Serum testosterone levels raised significantly and reached the peak one week after the injections. Effective level of testosterone lasted for over 6 weeks. RBC count, impacted volume of blood cells and haemoglobin increased at different degrees after TU injections, but these changes were not significant in statistic(P < 0.05). The increased levels remained for 8 weeks. EPO levels were elevated significantly (P < 0.01 or 0.05) after the TU injection(Pbat > 0.05). The second injection could still make the EPO level go up.Androgen replacement treatment can increase the EPO levels in patients of hypogonadism, which is one of the mechanism of RBC production increase.
To explore the genetic etiology of recurrent hydatidiform mole (RHM) and provide accurate guidance for reproduction.Peripheral venous blood samples of the probands with RHM and members from 5 unrelated pedigrees were collected. Genomic DNA was extracted by using routine method, and whole exome sequencing was carried out to detect variants of RHM-associated genes including NLRP7 and KHDC3L. Sanger sequencing and real-time quantitative PCR (RT-qPCR) were used to validate the candidate variants and delineate their parental origin.Homozygous or compound heterozygous variants of the NLRP7 gene were identified in four patients from three pedigrees, which included a homozygous deletion of exon 1 to 4 of NLRP7 in patient P1 and her elder sister, compound heterozygous variants of NLRP7 c.939delG (p.Q314Sfs*6) pat and c.1533delG (p.N512Tfs*4) mat in patient P2, and compound heterozygous variants of NLRP7 c.2389_2390delTC (p.A798Qfs*6) pat and c.2165A>G (p.D722G) mat in patient P4. All variants were interpreted as pathogenic or likely pathogenic according to the American College of Medical and Genomics (ACMG) guidelines. Among these, NLRP7 exons 1 to 4 deletion, c.939delG (p.Q314Sfs*6), c.1533delG (p.N512Tfs*4) and c.2389_2390delTC (p.A798Qfs*6) were unreported previously.Variants of the NLRP7 gene probably underlay autosomal recessive RHM in the three pedigrees, and definitive molecular diagnosis is beneficial for accurate genetic counseling. Above finding has also enriched the spectrum of the NLRP7 variants underlying RHM.
Objective To investigate the effect of BPA on progesterone,estradiol production and expression of P450arom,P450scc and steroid acute regulator (StAR) genes in rat granulosa cells.Methods The granulosa cells were isolated from rat ovarian and cultured with MCcoy′5A medium.After cultured for 72 hours,the cells were treated with various concentrations of BPA (0,10-7,10-6,10-5,10-4M). The culture media at 48 h after treatment were collected for the measurements of progesterone,estradiol level with high sensitive RIA. Gene expression of two key enzymes related with progesterone,estradiol production,P450arom and P450Scc,as well as StAR,in the cultured granulose cells was detected by RT-PCR. Results Progesterone levels in medium rised gradully as BPA concentration increased(P0.05),but dropped unexpectedly in 10-4M group(P0.01). However,estradiol level was decreased at the concentrations 10-7 M to 10-4 M(P0.01).The expression of P450Scc mRNA was increased as BPA increased from 10-7M to 10-5M(P0.05),but signficantly decreased at BPA 10-4 M(P0.01).So did for progesterone.The expression of StAR mRNA in granulosa cells was increased markedly at BPA 10-4M. Conclusion The results indicate that BPA may interrupt ovarian steroidogenesis though acting on steroidogenesis enzymes and StAR.
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