[Show abstract][Hide abstract] ABSTRACT: Objective:
To investigate the significance of the related indexes of three-dimensional color power angiography (3D-CPA) combined with SonoVue angiography in the diagnosis and prognosis evaluation of intrauterine adhesion (IUA).
The accuracy, sensitivity, and specificity were evaluated between 3D-TVS and hysteroscopy. Endometrial thickness, volume (V), mean gray value (MG), vascularization index (VI), flow index (FI), vascularization flow index (VFI), and other related indexes before and after the angiography were compared. According to the hysteroscopy findings, the patients were divided into three groups: mild, medium, and severe. The endometrial thickness at 3 months postoperatively and the pregnancy rates at 1 year postoperatively were compared.
Compared with the hysteroscopy, sensitivity: 0.970 (0.021), specificity: 0.667 (0.086), (the values inside the bracket were the standard error), positive likelihood ratio: 2.909, negative likelihood ratio: 0.045. There was a significant difference in endometrial thickness and V between the three groups (P<0.05), and there was a significant difference in MG, VI, FI, and VFI between the mild and severe group (P>0.05). During intravenous injection of SonoVue, the blood flow of each group increased (P<0.001), and the VI, FI, and VFI of each group were significantly different (P<0.05). Compared with the preoperative values, the endometrial thickness, V, MG, VI, FI, and VFI significantly changed at 3 months postoperatively (P<0.05). The mild group and high VI group had a higher pregnancy success rate at one year postoperatively.
3D-CPA can indirectly diagnose IUA, and may play an important role in prognosis assessment.
No preview · Article · Jan 2016 · European journal of obstetrics, gynecology, and reproductive biology
[Show abstract][Hide abstract] ABSTRACT: Our goal was to develop a safe, efficient, and practical clinical plan for successful pregnancies for patients with recurrent spontaneous miscarriages by adjustment of their hormone levels after ovulation. We treated 61 patients with recurrent miscarriages and 110 patients with two miscarriages. All patients had miscarriages before or during the 12th week of pregnancy, and unsuccessfully underwent progesterone therapy. We measured their hormone levels and administered appropriate doses of estrogen, progesterone, and luteinizing hormones to attain normal levels (respectively, 150 pg/ml, 16 ng/ml, and 6 mIU/ml). The hormone doses were reduced upon detection of fetal heart beating, and the treatment continued until the 12th week of pregnancy. The patients were followed up by phone after the child birth. In patients with recurrent miscarriages, these were prevented in 57/61 (93.44 %). In patients with two miscarriages, successful pregnancies were in 106/110 (96.4 %) patients. The vast majority of patients in both groups gave birth to healthy babies. There was only one case per each group of induced labor due to trisomy 21 (patient with a history of recurrent miscarriages) or trisomy 17 (patient with two previous miscarriages). Individualized adjustment of hormone levels after ovulation prevents miscarriages and improves the pregnancy success rates.
No preview · Article · Feb 2015 · Cell Biochemistry and Biophysics
[Show abstract][Hide abstract] ABSTRACT: The present study investigated the expression of the apoptosis-related genes fas-associated via death domain (FADD) and Bcl-2 in the endometrium during the window of implantation in polycystic ovary syndrome (PCOS) patients. The aim was to explore the role of cell apoptosis in endometrial receptivity during this period. The subjects were divided into experimental and control group. The experimental group comprised 12 infertile women with PCOS, and the control group comprised 12 women who were infertile because of tubal pathological factors but had normal menstrual cycles. Endometria were collected by biopsy 7d after ovulation. Six samples from each group were randomly selected and subjected to gene chip analyses. The expression of endometrial FADD and Bcl-2 was determined by immunohistochemistry, and cell apoptosis was detected by the TUNEL method. Compared with the control group, 194 differentially expressed genes were found in the PCOS group, 102 of which were upregulated and 92 were downregulated. The differentially expressed genes were divided into 15 types according to function. Among the nine genes related to cell apoptosis, five (including Bcl-2) were upregulated and four were downregulated (including FADD). Bcl-2 expression during the window of implantation in the PCOS group increased compared with the control group, showing a significant difference (P<0.05). FADD expression in the PCOS group notably decreased compared with that in the control group, which also showed a significant difference (P<0.05). Cell apoptosis analysis showed a significant difference between the average apoptotic indices in the PCOS and control groups (P<0.05). Significant differences were observed between the endometrial gene expression in the PCOS and control groups. The decrease in cell apoptosis during the window of implantation in PCOS patients may be one of the causes of the reduced endometrial receptivity.
[Show abstract][Hide abstract] ABSTRACT: Women with polycystic ovary syndrome (PCOS) exhibit a lower pregnancy rate, which may be related to decreased estrogen receptor (ER) expression or endometrial receptivity. We measured expression of ERα, ERβ and the novel G protein-coupled ER (GPR30) in endometrium during window of implantation (WOI) in PCOS patients. Fifteen Chinese women with PCOS were compared to 15 normal subjects. Serial trans-vaginal ultrasonic scanner (TVUS) examinations detected follicular development, and endometrial thickness and pattern were assessed via TVUS on the day of ovulation. GPR30 expression was detected in the cytoplasm of endometrial epithelial cells, and was significantly lower in the PCOS group (p < 0.05). ERα and ERβ expression was lower in the PCOS group, and was detected mainly in the nucleus of endometrial epithelial cells. There was no significant difference in endometrium thickness (p > 0.05), but there was a significant difference in the ultrasonic pattern (p < 0.05). Endometrial expression of GPR30, ERα and ERβ was decreased during WOI in PCOS patients, and was accompanied by poor endometrial receptivity, low pregnancy rate and higher spontaneous abortions. We propose that restored receptor expression might improve endometrial receptivity and help lower infertility associated with PCOS.
No preview · Article · Apr 2011 · Gynecological Endocrinology