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DBP Exposure Affects Oocyte Fertilization Via Extracellular Vesicles-Derived miR-116-5p in Ovarian Granulosa Cells Through Downregulating FOXO3a Expression. DBP暴露通过下调FOXO3a的表达影响卵巢颗粒细胞中通过细胞外囊泡产生的miR-116-5p的卵母细胞受精。
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-10 DOI: 10.1007/s43032-024-01559-y
Hongmei Liao, Wenqu Tian, Wen Yao, Qingchun Guo, Yi Wang, Juan Li, Danyu Qing, Yufeng Li, Taoran Deng

Mono-butyl phthalate (MBP), the metabolite of dibutyl phthalate (DBP), is the most abundant phthalate metabolite found in Chinese women. Extracellular vesicles (EVs) are nanoscale lipid bilayer particles produced by extensive kinds of cells, serving a key role in intercellular communication. Extracellular vesicle miRNAs (EV-miRNAs) in follicular fluid (FF) have been evidenced to be associated with female reproductive health. The objective of this study was to investigate the associations of EV-miRNAs expressed profile with DBP exposure in FF of female participants and expose its potential mechanism in impaired oocyte development. Based on participants' FF MBP concentrations and fertilization status, we compared the miRNA expression between the FF-EVs of group A (high DBP exposure and impaired fertilization) and group B (low DBP exposure and normal fertilization). Compared with group B, miR-1246, miR-3679-5p, miR-423-5p, miR-5585-3p, miR-116-5p, miR-172-5p were upregulated, while miR-34b-3p was downregulated in group A. Target genes of the differently expressed miRNAs were predicted, and the functional analysis was performed. Furthermore, we exposed human ovarian granulosa tumor cell line (KGN) to MBP (4ug/L) to isolate the EVs from the culture medium and validated the expression levels of different miRNAs. We found that MBP exposure was significantly associated with increased levels of miR-116-5p (P = 0.01). In addition, we demonstrated that the most different miRNA, miR-116-5p regulated oocyte fertilization by inhibiting FOXO3a. Our findings suggested that EV-miRNAs in the FF might mediate MBP toxicity in oocytes.

邻苯二甲酸单丁酯(MBP)是邻苯二甲酸二丁酯(DBP)的代谢产物,是中国女性体内发现的最丰富的邻苯二甲酸酯代谢物。细胞外囊泡(EVs)是由多种细胞产生的纳米级脂质双分子层颗粒,在细胞间通信中发挥着关键作用。卵泡液(FF)中的胞外囊泡miRNAs(EV-miRNAs)已被证实与女性生殖健康有关。本研究旨在调查女性参与者卵泡液中 EV-miRNAs 表达谱与 DBP 暴露的关联,并揭示其在卵母细胞发育受损中的潜在机制。根据参与者的 FF MBP 浓度和受精状态,我们比较了 A 组(高 DBP 暴露和受精受损)和 B 组(低 DBP 暴露和正常受精)FF-EV 之间的 miRNA 表达。与 B 组相比,A 组的 miR-1246、miR-3679-5p、miR-423-5p、miR-5585-3p、miR-116-5p、miR-172-5p 上调,而 miR-34b-3p 下调。此外,我们将人卵巢颗粒细胞瘤细胞株(KGN)暴露于 MBP(4ug/L),从培养液中分离出 EVs,并验证了不同 miRNA 的表达水平。我们发现,MBP 暴露与 miR-116-5p 水平的升高明显相关(P = 0.01)。此外,我们还证明了最不同的 miRNA miR-116-5p 通过抑制 FOXO3a 来调节卵母细胞受精。我们的研究结果表明,FF 中的 EV-miRNA 可能会介导卵母细胞中的 MBP 毒性。
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引用次数: 0
Correction: Cuproptosis-Related Gene FDX1 Identified as a Potential Target for Human Ovarian Aging. 更正:杯突相关基因 FDX1 被确定为人类卵巢衰老的潜在靶点。
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1007/s43032-024-01670-0
Chia-Chun Wu, Chia-Jung Li, Li-Te Lin, Pei-Hsuan Lin, Zhi-Hong Wen, Jiin-Tsuey Cheng, Kuan-Hao Tsui
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引用次数: 0
Novel Loss-of-function Variants of ZP3 Associated with Premature Ovarian Insufficiency. 与卵巢早衰有关的新型 ZP3 功能缺失变异基因
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-11-01 DOI: 10.1007/s43032-024-01732-3
Lang Zhou, Xi Yang, Shuting Ren, Yuncheng Pan, Zixue Zhou, Yiqing Liu, Jitong Mo, Feng Zhang, Xiaojin Zhang, Yanhua Wu

Premature ovarian insufficiency (POI) is one of the leading causes of female infertility. To date, the genetic etiology of POI has been elucidated in approximately 20-25% of the total cases. The human zona pellucida (ZP) plays an important role in the organization and differentiation of granulosa cells, follicle formation, and sperm recognition. Mutations in ZP1, ZP2, and ZP3 have been reported to cause female infertility due to oocyte degeneration, empty follicle, or in vitro fertilization failure. In this study, we identified three novel missense mutations in ZP3 (NM_001110354.2): c.643G > A (p.Asp215Asn), c.215 C > T (p.Thr72Ile), and c.152T > C (p.Leu51Pro) in three sporadic Han Chinese POI patients through whole-exome sequencing. These variants are absent from population databases and were predicted to be deleterious by multiple in silico tools. Structure prediction analysis showed that the affected amino acid altered the ZP3 protein structure. Western blot further confirmed that these ZP3 variants reduced the expression and secretion of ZP components. In summary, this study reports three novel deleterious variants in ZP3 associated with POI, thereby broadening the mutation spectrum of ZP3 in POI patients.

卵巢早衰(POI)是导致女性不孕的主要原因之一。迄今为止,约有 20%-25% 的早衰性卵巢功能不全病例的遗传病因已被阐明。人类透明带(ZP)在颗粒细胞的组织和分化、卵泡形成和精子识别中发挥着重要作用。据报道,ZP1、ZP2 和 ZP3 基因突变可导致卵母细胞退化、空卵泡或体外受精失败等女性不孕症。在本研究中,我们通过全外显子组测序在三名散发性中国汉族 POI 患者中发现了 ZP3(NM_001110354.2)的三个新型错义突变:c.643G > A(p.Asp215Asn)、c.215 C > T(p.Thr72Ile)和 c.152T > C(p.Leu51Pro)。这些变异在人群数据库中并不存在,但通过多种硅学工具预测这些变异是有害的。结构预测分析表明,受影响的氨基酸改变了 ZP3 蛋白的结构。Western 印迹进一步证实,这些 ZP3 变异降低了 ZP 成分的表达和分泌。总之,本研究报告了三个与 POI 相关的 ZP3 新型有害变异,从而拓宽了 POI 患者的 ZP3 变异谱。
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引用次数: 0
Effect of Dietary Interventions on Endometriosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 饮食干预对子宫内膜异位症的影响:随机对照试验的系统回顾和元分析》。
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-02 DOI: 10.1007/s43032-024-01701-w
Jéssica Kleinkauff Meneghetti, Mirela Tschiedel Pedrotti, Isabel Meneghetti Coimbra, João Sabino Lahorgue da Cunha-Filho

This study aimed to systematically review existing randomized clinical trials on the effect of dietary interventions on endometriosis. A search was performed on the Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinical Trials, EMBASE, PubMed, Lilacs, and Cielo databases. The search terms were used: "endometriosis", "endometrioma", "diet", "supplements" and "nutrition". Electronic literature searches through databases yielded 866 publications. Two authors performed The study selection independently (and blinded), and disagreements were discussed. Eleven RCTs were included in the systematic review, with 716 women randomized. Most studies reported a positive effect on endometriosis pain scores; however, they were characterized by moderate or high-risk bias. Of these, six RCTs, including 457 women with endometriosis, were included in the meta-analysis. Compared with Placebo, antioxidant use was associated with a reduction in dysmenorrhea (mean difference - 1.95 [CI 95%, -3.78 to -0.13]. Supplementation was not significant for reducing chronic pelvic pain (mean difference - 2.22 [95% CI, -4.99 to 0.55] and dyspareunia (MD - 2.56 [95% CI, - 5. 22 to 0.10]. Both analyses showed a high degree of heterogeneity. Moreover, studies with low risk of bias did not show significant results compared to those on Placebo. The effects of nutrient compounds seem to have the potential to reduce pain in women with endometriosis, mainly to reduce dysmenorrhea. However, the available studies present high heterogeneity and moderate/high risk of bias. More randomized clinical trials are needed to accurately determine dietary interventions' short- and long-term efficacy and safety in managing endometriosis pain.

本研究旨在系统回顾有关饮食干预对子宫内膜异位症影响的现有随机临床试验。研究人员在 Cochrane Central Register of Controlled Trials (CENTRAL)、Cumulative Index to Nursing and Allied Health Literature (CINAHL)、Clinical Trials、EMBASE、PubMed、Lilacs 和 Cielo 等数据库中进行了检索。使用的检索词包括"子宫内膜异位症"、"子宫内膜异位瘤"、"饮食"、"补充剂 "和 "营养"。通过数据库进行电子文献检索,共获得 866 篇出版物。两位作者独立(盲法)进行了研究筛选,并对分歧进行了讨论。系统综述共纳入了 11 项研究性试验,716 名妇女接受了随机试验。大多数研究报告了对子宫内膜异位症疼痛评分的积极影响,但这些研究存在中度或高风险偏倚。荟萃分析纳入了其中的六项研究,包括 457 名子宫内膜异位症妇女。与安慰剂相比,使用抗氧化剂与痛经减少有关(平均差异-1.95 [CI 95%, -3.78 to -0.13])。补充抗氧化剂对减少慢性盆腔疼痛(平均差异-2.22 [95% CI,-4.99 至 0.55])和性生活障碍(MD - 2.56 [95% CI,-5.22 至 0.10])无明显作用。这两项分析均显示出高度的异质性。此外,与安慰剂研究相比,偏倚风险较低的研究结果并不显著。营养复合物的作用似乎有可能减轻子宫内膜异位症妇女的疼痛,主要是减轻痛经。然而,现有研究存在高度异质性和中度/高度偏倚风险。需要进行更多的随机临床试验,以准确确定饮食干预对控制子宫内膜异位症疼痛的短期和长期疗效及安全性。
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引用次数: 0
Zinc as a Possible Critical Element to Prevent Harmful Effects of COVID-19 on Testicular Function: a Narrative Review. 锌可能是防止 COVID-19 对睾丸功能产生有害影响的关键元素:叙述性综述。
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-10 DOI: 10.1007/s43032-024-01638-0
Marouane Chemek, Ammar Kadi, Fatimah Kadhim Ibrahim Al-Mahdawi, Irina Potoroko

Research into innovative non-pharmacological therapeutic routes via the utilization of natural elements like zinc (Zn) has been motivated by the discovery of new severe acute respiratory syndrome-related coronavirus 2 (SARS-COV2) variants and the ineffectiveness of certain vaccination treatments during COVID-19 pandemic. In addition, research on SARS-COV-2's viral cellular entry and infection mechanism has shown that it may seriously harm reproductive system cells and impair testicular function in young men and adolescents, which may lead to male infertility over time. In this context, we conducted a narrative review to give an overview of the data pertaining to Zn's critical role in testicular tissue, the therapeutic use of such micronutrients to enhance male fertility, as well as in the potential mitigation of COVID-19, with the ultimate goal of elucidating the hypothesis of the potential use of Zn supplements to prevent the possible harmful effects of SARS-COV2 infection on testis physiological function, and subsequently, on male fertility.

由于发现了新的严重急性呼吸系统综合症相关冠状病毒 2(SARS-COV2)变种,以及 COVID-19 大流行期间某些疫苗接种治疗无效,人们开始研究利用锌(Zn)等天然元素进行非药物治疗的创新途径。此外,对 SARS-COV-2 病毒进入细胞和感染机制的研究表明,它可能会严重危害生殖系统细胞,损害青年男性和青少年的睾丸功能,久而久之可能导致男性不育。在这种情况下,我们对有关锌在睾丸组织中的关键作用、此类微量营养素在提高男性生育能力方面的治疗用途以及 COVID-19 的潜在缓解作用的数据进行了叙述性综述,其最终目的是阐明可能使用锌补充剂来预防 SARS-COV2 感染对睾丸生理功能可能产生的有害影响以及随后对男性生育能力可能产生的有害影响的假设。
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引用次数: 0
Experimental Varicocele Impairs DNA Methylation and Demethylation in Germ Cells, TESE, and Epididymal Spermatozoa, Impacting Active DNA Demethylation in Zygotes. 实验性精索静脉曲张会损害生殖细胞、TESE和附睾精子中的DNA甲基化和去甲基化,影响子代中活跃的DNA去甲基化。
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-07 DOI: 10.1007/s43032-024-01651-3
Sana Moshari, Mazdak Razi, Mohammad Hossein Nasr-Esfahani, Marziyeh Tavalaee, Mehdi Hajian

Varicocele causes infertility. The current study has investigated the impact of experimental varicocele on DNA methylation, demethylation, and damage in the germ cells, TESE-derived and epididymal spermatozoa. Moreover, the results were compared between epidydimal and TESE-derived spermatozoa. Finally, the varicocele-induced effect on active DNA demethylation (ADD) of male pronucleus and pre-implantation embryo development was assessed. The mature male rats were divided into control, control-sham (undergone simple laparotomy), and experimental varicocele-induced groups (n = 6/each group). The left renal vein semi-ligation was considered to induce varicocele. The expression levels of DNA methyltransferase 1 (DNMT1) and ten-eleven-translocation proteins (TET1, 2, 3), and global DNA methylation in testicular tissue, TESE, and epididymis-derived spermatozoa, and the ADD in zygotes male pronucleus as well as pre-implantation embryo development were assessed. The expression levels of DNMT1 and TET1, 2, 3 in testicles, TESE, and epididymis-derived spermatozoa were decreased in the varicocele group compared to the control and control-sham groups. The TESE-derived spermatozoa exhibited higher DNMT1, higher DNMT1, and TET 1, 2, and no change in TET3 expression compared to epididymis-derived spermatozoa. The varicocele group represented lower DNA methylation in the testicles, TESE-derived and epididymal spermatozoa, higher 5mC+ signal in male pronucleus, and a lower pre-implantation embryo development compared to control and control-sham rats. The TESE-derived spermatozoa exhibited higher 5mC protein expression compared to epididymal spermatozoa. In conclusion, varicocele can negatively impact the DNA methylation/demethylation processes impairing spermatogenesis and leading to fertilization failure, which may ultimately result in a decrease in embryo development by increasing susceptibility to DNA damage.

精索静脉曲张会导致不育。本研究调查了实验性精索静脉曲张对生殖细胞、TESE 衍生精子和附睾精子中 DNA 甲基化、去甲基化和损伤的影响。此外,还比较了附睾精子和 TESE 衍生精子的结果。最后,还评估了精索静脉曲张对雄性代细胞核活性 DNA 去甲基化(ADD)和植入前胚胎发育的影响。将成熟雄性大鼠分为对照组、对照岑氏组(进行简单开腹手术)和实验性精索静脉曲张诱发组(n = 6/每组)。左肾静脉半结扎被视为诱发精索静脉曲张。评估了DNA甲基转移酶1(DNMT1)和十-十一-转位蛋白(TET1、2、3)的表达水平,以及睾丸组织、TESE和附睾衍生精子中的全局DNA甲基化、子代男性前核中的ADD和植入前胚胎发育情况。与对照组和对照-ham 组相比,精索静脉曲张组睾丸、TESE 和附睾衍生精子中 DNMT1 和 TET1、2、3 的表达水平降低。与附睾衍生精子相比,TESE 衍生精子的 DNMT1、DNMT1 和 TET 1、2 表达较高,TET3 表达则无变化。与对照组和对照-ham 组大鼠相比,精索静脉曲张组大鼠睾丸、TESE 衍生精子和附睾精子中的 DNA 甲基化水平较低,雄性前核中的 5mC+ 信号较高,植入前胚胎发育水平较低。与附睾精子相比,TESE 衍生精子的 5mC 蛋白表达更高。总之,精索静脉曲张会对 DNA 甲基化/去甲基化过程产生负面影响,损害精子发生,导致受精失败,最终可能会增加 DNA 损伤的易感性,导致胚胎发育下降。
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引用次数: 0
Sequential Transfer of Blastocysts on Day 5 and Day 6 in Patients with Repeated Implantation Failure in Frozen Embryo Transfer Cycle. 在冷冻胚胎移植周期中反复移植失败患者的第 5 天和第 6 天连续移植囊胚。
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-25 DOI: 10.1007/s43032-024-01734-1
Qi Jin, Xiaohua Jiang, Lu Zong, Tong Wu, Shengxia Zheng, Limin Wu, Bo Xu

The aim of this study was to evaluate which frozen embryo transfer (FET) strategy benefits the recurrent implantation failure (RIF) population. A retrospective study of 336 women with RIF was performed from July 2020 to October 2023. The patients were divided into three groups according to the FET protocol. The three FET protocols included transferring a blastocyst on both days 5 and 6 (Group 1, n = 138); transferring a cleavage-stage embryo on day 3 and a blastocyst on day 5 (Group 2, n = 55); and transferring double blastocysts on day 5 (Group 3, n = 143).The sequential day 5 and day 6 blastocyst ET strategy significantly improved in vitro fertilization success rates compared with those of both the traditional double-blastocyst day 5 transfer strategy and the strategy involving one cleavage-stage embryo transfer on day 3 and one blastocyst transfer on day 5 in RIF patients. Compared with those observed in Day 5 double-blastocyst transfer, the rates of clinical pregnancy and implantation increased (51.75% vs. 64.49%, P < 0.001 and 37.06% vs. 41.3%, P = 0.005, respectively), while the rates of biochemical pregnancy and multiple gestation decreased (18.18% vs. 12.32%, P = 0.006 and 43.24% vs. 28.09%, P = 0.044, respectively) with the new protocol.Blastocysts from sequential embryo transfer on day 5 and day 6 were more effective than those from the traditional FET protocol at improving pregnancy outcomes and lowering the multiple pregnancy rate in RIF patients. When only one or zero good-quality blastocysts are available, sequential blastocyst ET on days 5 and 6 should be considered.

本研究旨在评估哪种冷冻胚胎移植(FET)策略对复发性着床失败(RIF)人群有益。2020 年 7 月至 2023 年 10 月期间,对 336 名 RIF 妇女进行了回顾性研究。根据FET方案,患者被分为三组。三种 FET 方案包括在第 5 天和第 6 天移植一个囊胚(第 1 组,n = 138);在第 3 天移植一个分裂期胚胎,在第 5 天移植一个囊胚(第 2 组,n = 55);在第 5 天移植双囊胚(第 3 组,n = 143)。与传统的第 5 天双囊胚移植策略和第 3 天移植一个卵裂期胚胎、第 5 天移植一个囊胚的策略相比,第 5 天和第 6 天连续囊胚 ET 策略显著提高了 RIF 患者的体外受精成功率。与第 5 天双囊胚移植相比,临床妊娠率和植入率均有所提高(51.75% 对 64.49%,P<0.05)。
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引用次数: 0
Methylation Status at DMRs of C14MC and C19MC in Spermatozoa and Chorionic Villi of Individuals Experiencing Recurrent Spontaneous Abortions. 复发性自然流产患者精子和绒毛中 C14MC 和 C19MC 的 DMRs 甲基化状况
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-22 DOI: 10.1007/s43032-024-01737-y
Mamata Datar, Vandana Bansal, Padmaja Samant, Kumari Nishi, Nafisa H Balasinor

Recurrent spontaneous abortions (RSA) is defined as a loss of two or more consecutive clinically recognized pregnancies before the 20th week of gestation. In RSA, several causative maternal factors are known, but still, 50% of the cases remain unexplained. Evidence suggests that paternal factors are also equally important. Epigenetic phenomenon such as genomic imprinting and regulation of gene expression by miRNAs plays an important role in embryonic and placental development. Two large miRNA clusters, C14MC (Chromosome 14 microRNA cluster) and C19MC (Chromosome 19 microRNA cluster) are imprinted and expressed in the placenta during pregnancy and are known to regulate functionally important processes such as the trophoblast proliferation, adhesion, and migration. Hence, we studied the DNA methylation at the Differentially Methylated Regions (DMRs) of these clusters in spermatozoa and chorionic villi by pyrosequencing. In Spermatozoa, few Cytosine followed by Guanosine (CpG) sites at DMRs of C14MC and C19MC showed significant hypermethylation. In Chorionic villi, CpG sites showed significant hypomethylation in the RSA group as compared to control group. Semen parameters like sperm concentration, sperm motility, morphology, and chromatin compaction were comparable in control and RSA groups. The study suggests aberrant DNA methylation in spermatozoa and chorionic villi at DMRs of both miRNA coding clusters to be associated with RSA.

复发性自然流产(RSA)是指在妊娠 20 周前连续两次或两次以上失去临床公认的妊娠。在 RSA 中,已知有几种母体致病因素,但仍有 50% 的病例无法解释。有证据表明,父亲的因素也同样重要。表观遗传现象,如基因组印记和 miRNA 对基因表达的调控,在胚胎和胎盘发育过程中发挥着重要作用。两个大的 miRNA 簇,C14MC(染色体 14 microRNA 簇)和 C19MC(染色体 19 microRNA 簇)在妊娠期间被印记并在胎盘中表达,已知它们调控滋养细胞增殖、粘附和迁移等重要功能过程。因此,我们通过热测序法研究了精子和绒毛中这些基因簇的差异甲基化区(DMRs)的DNA甲基化情况。在精子中,C14MC 和 C19MC DMRs 上的胞嘧啶和鸟苷(CpG)位点出现了明显的高甲基化。在绒毛中,与对照组相比,RSA 组的 CpG 位点出现了明显的低甲基化。对照组和 RSA 组的精液参数,如精子浓度、精子活力、形态和染色质压实度相当。研究表明,精子和绒毛中两个 miRNA 编码簇 DMRs 的 DNA 甲基化异常与 RSA 有关。
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引用次数: 0
Successful Live Birth Outcome in A Patient with Empty Follicle Syndrome: A Case Report and Literature Review. 空卵泡综合征患者的成功活产:病例报告与文献综述
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-20 DOI: 10.1007/s43032-024-01738-x
Fang Hong, Bin Chen, Liu Liu, Xiaomei Tong

Here, we report on a rare case of a successful live birth in a patient with empty follicle syndrome. A 35-year-old woman with ovulatory disorder and a 4-year history of primary infertility conducted in vitro fertilization-embryo transfer (IVF-ET) treatment in our hospital. The patient experienced six controlled ovarian stimulation cycles. In the first two cycles, despite adequate ovarian response, normal development of multiple follicles, and normal serum estradiol (E2) levels, no oocytes were retrieved from these mature follicles during the aspiration procedure. The patient was diagnosed with "empty follicle syndrome". Whole exome sequencing (WES) identified a missense mutation in the luteinizing hormone/chorionic gonadotropin receptor (LHCGR). In subsequent cycles, we try to increase the trigger dosage, combine gonadotropin-releasing hormone agonists (GnRH agonist) with human chorionic gonadotropin (HCG) for a dual trigger, supplement with luteinizing hormone (LH)-like active substances during the stimulation process, and extend the time between triggering and oocyte retrieval. In the end, successful oocyte retrieval and pregnancy were achieved.

在此,我们报告了一例罕见的空卵泡综合征患者成功活产的病例。一位 35 岁的女性患者患有排卵障碍和 4 年的原发性不孕史,在我院接受了体外受精-胚胎移植(IVF-ET)治疗。患者经历了六个控制性卵巢刺激周期。在前两个周期中,尽管卵巢反应充分,多个卵泡发育正常,血清雌二醇(E2)水平也正常,但在抽吸过程中却没有从这些成熟卵泡中提取到卵母细胞。患者被诊断为 "空卵泡综合征"。全外显子组测序(WES)确定了黄体生成素/绒毛膜促性腺激素受体(LHCGR)的错义突变。在随后的周期中,我们尝试增加触发剂量,将促性腺激素释放激素激动剂(GnRH 激动剂)与人绒毛膜促性腺激素(HCG)结合起来进行双重触发,在刺激过程中补充类似黄体生成素(LH)的活性物质,并延长触发与卵母细胞提取之间的时间。最终,患者成功取卵并怀孕。
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引用次数: 0
Improving the Dehydroepiandrosterone Induced PCOS Rat Model: Interplay of Age, High Fat Diet, and Treatment Regimen on Reproductive and Metabolic Phenotypes. 改进脱氢表雄酮诱导多囊卵巢综合征大鼠模型:年龄、高脂饮食和治疗方案对生殖和代谢表型的相互作用
IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-20 DOI: 10.1007/s43032-024-01742-1
Pooja Mallya, Guruprasad Kalthur, Anne Boyina Sravani, Shaila A Lewis

Polycystic ovary syndrome (PCOS) is a ubiquitous reproductive condition with triggering hallmarks such as glucose intolerance, hyperandrogenism, and dyslipidemia. Despite the existence of various PCOS animal models, an ideal model which could encompass all PCOS-specific phenotype is of dire need. Dehydroepiandrosterone (DHEA) induced PCOS rats are frequently employed; though, determining the superior model among pubertal and prepubertal rats, incorporation of high fat diet (HFD), and their sustainability remains uncertain. This study aims to examine the age factor, impact of HFD, and DHEA regimen in model development. Prepubertal and pubertal Sprague-Dawley rats were subcutaneously injected with DHEA (6 mg/kg and 60 mg/kg/day, respectively) with and without HFD up to 21 days. Serum testosterone, glucose, lipid profile, ovary morphology, and estrous cycle were evaluated. Following 21 days of treatment with DHEA, pubertal PCOS rats exhibited better reproductive phenotype than prepubertal rats. However, there was no significant difference in the lipid profile. Accordingly, both the age-group rats were concomitantly treated with DHEA and HFD for additional 3 weeks on alternate day basis after model development. The persistence of reproductive and metabolic features on treatment withdrawal were also simultaneously investigated by alienating the rats into continuous and stop dosing groups. The DHEA + HFD and DHEA treated pubertal rats in continuous dosing group showed significant PCOS features (p < 0.05) compared to stop dosing, prepubertal, and control groups. To conclude, continual dosing with DHEA on alternate days for 3 weeks is necessary to sustain metabolic and reproductive phenotypes of PCOS.

多囊卵巢综合征(PCOS)是一种普遍存在的生殖系统疾病,具有葡萄糖不耐受、高雄激素和血脂异常等诱发特征。尽管存在各种多囊卵巢综合征动物模型,但仍迫切需要一种能涵盖所有多囊卵巢综合征特异表型的理想模型。脱氢表雄酮(DHEA)诱导的多囊卵巢综合征大鼠经常被采用;不过,在青春期大鼠和青春期前大鼠中确定优选模型、纳入高脂饮食(HFD)及其可持续性仍不确定。本研究旨在探讨模型建立过程中的年龄因素、高脂饮食的影响和 DHEA 方案。对青春期前和青春期的 Sprague-Dawley 大鼠皮下注射 DHEA(分别为 6 毫克/千克和 60 毫克/千克/天),同时添加或不添加高脂饮食长达 21 天。对大鼠的血清睾酮、血糖、血脂、卵巢形态和发情周期进行了评估。使用 DHEA 治疗 21 天后,青春期多囊卵巢综合征大鼠的生殖表型优于青春期前大鼠。然而,血脂谱却没有明显差异。因此,在建立模型后,两个年龄组的大鼠都同时使用 DHEA 和 HFD 隔日治疗 3 周。通过将大鼠分为连续给药组和停止给药组,还同时研究了停药后生殖和代谢特征的持续性。连续给药组的 DHEA + HFD 和 DHEA 治疗青春期大鼠表现出明显的多囊卵巢综合征特征(p
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