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ABSTRACT: Objectives To investigate whether the endometrial thickness, endometrial volume, and endometrial and subendometrial vascularization index, flow index, and vascularization-flow index were useful for diagnosing endometrial polyps in infertility. Methods Transvaginal and 3-dimesional power Doppler sonography was performed to calculate the endometrial echogenicity, endometrial thickness, endometrial volume, and endometrial and subendometrial vascularization index, flow index, and vascularization-flow index, followed by hysteroscopy in the follicular phase of the menstrual cycle (postmenstrual days 3-7). A total of 555 patients were selected, and 4 groups were defined according to the comparison of sonographic and hysteroscopic diagnoses: group A (sonographically positive but hysteroscopically negative), group B (sonographically and hysteroscopically negative), group C (sonographically negative but hysteroscopically positive), and group D (sonographically and hysteroscopically positive). Results A total of 426 patients were enrolled in the final analysis. Significantly higher endometrial thickness and volume were found in groups C and D compared with groups A and B (P < .05). There were no significant differences among the 4 groups in terms of the endometrial and subendometrial vascularization index, flow index, and vascularization-flow index (P > .05). The sensitivity, specificity, and positive and negative predictive values of endometrial thickness and volume in predicting endometrial polyps were 62.7%, 69.8%, 26.9%, and 91.9% and 39.3%, 88.2%, 35.8%, and 89.7%, respectively. Combined sonographic evaluation (sonographic echogenicity, endometrial thickness, and endometrial volume) showed higher sensitivity, specificity, and positive and negative predictive values (65.6%, 89.0%, 50.0%, and 93.9%) compared with a single indicator. Conclusions A combination of endometrial echogenicity, thickness, and volume on sonography may be better than a single indicator for predicting endometrial polyps in infertility. However, the endometrial or subendometrial vascularization index, flow index, and vascularization-flow index are not useful for prediction.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 02/2013; 32(2):247-55. · 1.25 Impact Factor
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Linlin Cui,
Han Zhao,
Bo Zhang,
Zhongyu Qu,
Jiayin Liu,
Xiaoyan Liang,
Xiaoming Zhao,
Junli Zhao, Yingpu Sun,
Peng Wang,
Tao Li,
Yuhua Shi,
Zi-Jiang Chen
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ABSTRACT: STUDY QUESTION: Are there any correlations between the phenotypes of polycystic ovary syndrome (PCOS) and the genotypes of the PCOS susceptibility single nucleotide polymorphisms (SNPs) in THADA, DENND1A and LHCGR? SUMMARY ANSWER: The PCOS susceptibility genes, THADA and DENND1A, carry risk alleles that are associated with endocrine and metabolic disturbances in patients with PCOS. WHAT IS KNOWN ALREADY: PCOS is a heterogeneous endocrinopathy characterized by oligo-anovulation, hyperandrogenism and polycystic ovaries. In a previous genome-wide association study, the SNP variants rs13429458, rs12478601, rs2479106, rs10818854 and rs13405728 in the THADA, DENND1A and LHCGR genes were identified as being independently associated with PCOS. The aim of this study was to identify any additional correlations between the phenotypes of PCOS and genotypes of the five SNPs described in the previous study. STUDY DESIGN, SIZE, DURATION: In the present cross-sectional study, a total of 1731 PCOS patients and 4964 controls were enrolled. PARTICIPANTS/MATERIALS, SETTING, METHODS: Patients were diagnosed according to Rotterdam criteria. Clinical information was collected from the patients and controls. Endocrine and metabolic parameters were evaluated for phenotype-genotype correlation analyses. MAIN RESULTS AND THE ROLE OF CHANCE: Using a recessive model, the AA group for rs13429458 in THADA was associated with increased luteinizing hormone (LH) (P < 0.01) and testosterone (T) (P = 0.02) levels in subjects with PCOS; the LH/follicle-stimulating hormone ratio was also higher in the AA group (P < 0.01). Also using a recessive model, the CC genotype of rs12478601, also in THADA, was associated with increased levels of low-density lipoprotein (P = 0.02). Using a dominant model, the GG + AG group for rs2479106 in DENND1A was associated with elevated serum insulin levels 2 h after a glucose load in the patients with PCOS (P = 0.02). All of the comparisons were adjusted for age and BMI. LIMITATIONS, REASONS FOR CAUTION: The relatively younger age of the participants may represent a considerable bias when evaluating metabolic alterations as a function of different genotypes, as significant metabolic disturbances may emerge later in life. Furthermore, the sample sizes of several sub-genotype groups were relatively small; to some extent this limited the statistical power of the analysis. WIDER IMPLICATIONS OF THE FINDINGS: The PCOS susceptibility genes, THADA and DENND1A, carry risk alleles that are associated with endocrine and metabolic disturbances in PCOS patients of Han Chinese descent. The findings have shown genuine heterogeneity, stratified on the basis of both clinical findings and genotypes. Replication of these results is expected in other ethnic groups. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by the National Basic Research Program of China (973 program) (2010CB945002, 2012CB944700), the National Natural Science Foundation of China (81000238, 81070461, 81000236, 30973170), the Graduate Independent Innovation Foundation of Shandong University (GIIFSDU) (21300070613242, 21300070613246), the Science Research Foundation item of no-earnings health vocation (201002013) and the National Key Technology Research and Development Program (2011BAI17B00). There are no competing interests.
Human Reproduction 12/2012; · 4.47 Impact Factor
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Han Zhao,
Jianfeng Xu,
Haobo Zhang,
Jielin Sun, Yingpu Sun,
Zhong Wang,
Jiayin Liu,
Qiang Ding,
Shaoming Lu,
Rong Shi, [......],
Hong Chen,
Guangyu Li,
Junzhao Zhao,
Shuhua Zou,
Hong Jiang,
Cuifang Hao,
Yueran Zhao,
Jinglong Ma,
S Lilly Zheng,
Zi-Jiang Chen
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ABSTRACT: A genome-wide association study of Han Chinese subjects was conducted to identify genetic susceptibility loci for nonobstructive azoospermia (NOA). In the discovery stage, 802 azoospermia cases and 1,863 controls were screened for genetic variants in the genome. Promising SNPs were subsequently confirmed in two independent sets of subjects: 818 azoospermia cases and 1,755 controls from northern China, and 606 azoospermia cases and 958 controls from central and southern China. We detected variants at human leukocyte antigen (HLA) regions that were independently associated with NOA (HLA-DRA, rs3129878, p(combine) = 3.70 × 10(-16), odds ratio [OR] = 1.37; C6orf10 and BTNL2, rs498422, p(combine) = 2.43 × 10(-12), OR = 1.42). These findings provide additional insight into the pathogenesis of NOA.
The American Journal of Human Genetics 04/2012; 90(5):900-6. · 10.60 Impact Factor
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Zi-Jiang Chen,
Han Zhao,
Lin He,
Yuhua Shi,
Yingying Qin,
Yongyong Shi,
Zhiqiang Li,
Li You,
Junli Zhao,
Jiayin Liu, [......],
Cuifang Hao,
Chun-E Ren,
Yajie Zhang,
Shiling Chen,
Wei Zhang,
Aijun Yang,
Junhao Yan,
Yuan Li,
Jinlong Ma,
Yueran Zhao
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ABSTRACT: Polycystic ovary syndrome (PCOS) is a common metabolic disorder in women. To identify causative genes, we conducted a genome-wide association study (GWAS) of PCOS in Han Chinese. The discovery set included 744 PCOS cases and 895 controls; subsequent replications involved two independent cohorts (2,840 PCOS cases and 5,012 controls from northern Han Chinese; 498 cases and 780 controls from southern and central Han Chinese). We identified strong evidence of associations between PCOS and three loci: 2p16.3 (rs13405728; combined P-value by meta-analysis P(meta) = 7.55 × 10⁻²¹, odds ratio (OR) 0.71); 2p21 (rs13429458, P(meta) = 1.73 × 10⁻²³, OR 0.67); and 9q33.3 (rs2479106, P(meta) = 8.12 × 10⁻¹⁹, OR 1.34). These findings provide new insight into the pathogenesis of PCOS. Follow-up studies of the candidate genes in these regions are recommended.
Nature Genetics 01/2011; 43(1):55-9. · 35.53 Impact Factor
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ABSTRACT: This first large-scale report of birth defects in 15,405 offspring conceived by assisted reproductive technologies in China found infants born after IVF alone to have a birth defect frequency comparable to that in the general Chinese population; rates were nonsignificantly higher in infants conceived with use of intracytoplasmic sperm injection compared with those conceived after IVF alone.
Fertility and sterility 01/2011; 95(1):458-60. · 3.97 Impact Factor
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ABSTRACT: To review the experience with and clinical outcomes for recipients of embryos from oocytes donated under different regulatory standards in China. Initially, the oocytes were provided by one of the patient's consanguineous sisters. Then, the oocytes were obtained from another patient treated with assisted reproduction techniques (ART). Presently, oocytes thus produced are cryopreserved for at least 6months before transfer.
The records from all women treated with ART at First Affiliated Hospital of Zhengzhou University since 2001 were reviewed and the pregnancy rates and clinical outcomes were determined for each of the 3 periods.
In the second period, the mean implantation and clinical pregnancy rates were significantly higher for the 22 oocyte recipients than for their donors. In the third period, the rates for the 56 recipients were compared with the 78 other regular ART patients fertilized with their own oocytes. There were 40 live births for 32 of the recipients over 28 cycles, and the rates of implantation and clinical pregnancy were much higher for the recipients than for the other ART patients (P<0.001).
Using freshly donated eggs yields a higher pregnancy rate but there is a risk of infectious disease. Using frozen oocytes can significantly decrease this risk but implantation rates are lower.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 07/2010; 110(1):53-6. · 1.41 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the advantages of 3-dimensional (3D) sonography in embryo transfer.
With the use of 2-dimensional (2D) and 3D sonography to measure the transfer distance from the fundus (TDF), 319 patients were allocated into 4 groups according to the disparity between 2D and 3D images: group 1 showed disparity of less than 3 mm; group 2 showed disparity of 3 to 5 mm; group 3 showed disparity of 6 to 9 mm; and group 4 showed disparity of 10 mm or greater. The general characteristics and pregnancy outcomes were compared among the 4 groups.
For 140 patients, the TDF measured by 2D sonography was different from that measured by 3D sonography, with a positive to negative range of 3 to 13 mm. Compared with the first 3 groups, the clinical pregnancy and implantation rates were lowest in group 4 (7.7% versus 34.1%, 38.1%, and 40%; 3.6% versus 18.2%, 21.2%, and 22.2%; P < .05).
Compared with 2D sonography, uterine cavity and catheter placement may be better achieved with 3D sonography, which would improve the embryo transfer technique.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 06/2009; 28(5):573-8. · 1.25 Impact Factor
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ABSTRACT: To examine the expression levels of cyclooxygenase (COX)-1 and COX-2 in the endometrium before and after insertion of the copper intrauterine device (Cu-IUD).
Ten patients were investigated. Two endometrial biopsies were taken from the uterus of each patient. The first biopsy was taken prior to insertion of the Cu-IUD, and the second was taken 1 month after insertion on the same day of the menstrual cycle and from the same location. The levels of COX-1 and COX-2 mRNA and protein in the endometrium were determined using reverse transcriptase polymerase chain reaction (RT-PCR) and Western blotting.
Before insertion, expression of COX-2 mRNA and proteins was 0.399+/-0.014 and 14.75+/-1.31, respectively. Post insertion, expression of COX-2 mRNA and proteins was 0.563+/-0.041 and 18.61+/-1.93, respectively. A significant increase (P<0.05) of COX between pre and post insertion of the Cu-IUD was only seen with COX-2. There was no significant change in the level of COX-1 mRNA or proteins before and after insertion of the Cu-IUD.
COX-2 is the primary isoenzyme stimulating overproduction of prostaglandins in the endometrium after the insertion of Cu-IUDs.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 03/2009; 105(2):166-8. · 1.41 Impact Factor
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ABSTRACT: To determine the best site for embryo placement in uterine cavities of varying shapes.
In this prospective investigation, 638 embryo transfers were allocated to two groups: for group 1 (n=558) embryos were transferred into uterine cavities of normal shape; for group 2 (n=80) embryos were transferred into uterine cavities of abnormal shape. The uterine cavity was divided into 3 equal regions: upper, middle, and lower. Pregnancy outcomes for placements in each region were compared within and between the 2 groups.
No significant differences were found in rates of pregnancy or implantation among the 3 regions in group 1. In contrast, the implantation rate in group 2 was highest when embryos were placed in the middle region of the uterine cavity: 28.8% compared with 6.8% and 8.3% for the upper and lower regions, respectively (P<0.05).
For the normal uterine cavity, pregnancy outcomes do not depend on embryo placement. However, for uterine anomalies, embryo placement in the middle region of the uterine cavity gave the best outcome.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 02/2009; 105(2):140-4. · 1.41 Impact Factor
