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A positive ReceptivaDx result for BCL6 does not correlate with abnormal ERA results or decreased expression of receptivity-associated markers: two sides of the endometrial receptivity coin in fertility evaluation and treatment. BCL6的ReceptivaDx阳性结果与ERA结果异常或受孕率相关标记物表达减少无关:这是生育评估和治疗中子宫内膜受孕率问题的两个方面。
Pub Date : 2024-10-16 DOI: 10.1016/j.xfss.2024.10.005
David Huang, Emily Flynn, Ana Almonte-Loya, Brittany Davidson, Meagan Chan, Amber Casillas, Juan C Irwin, Gabriela K Fragiadakis, Hakan Cakmak, Alexis J Combes, Marcelle I Cedars, Marina Sirota, Linda C Giudice

Objective: To investigate if a positive result on ReceptivaDx for evaluation of B-cell lymphoma 6 (BCL6), a proposed marker of progesterone resistance associated with impaired uterine receptivity, correlates with a suboptimal profile of receptivity-associated markers in the window of implantation using the endometrial receptivity array and single-nucleus transcriptomic analysis.

Design: Retrospective clinical cohort study; pilot study of single-nucleus RNA sequencing of prospectively collected window of implantation endometrium undergoing ReceptivaDx BCL6 evaluation.

Setting: Academic center.

Patients: Patients with infertility who underwent endometrial biopsy for concurrent endometrial receptivity array analysis (ERA; Igenomix, Valencia, Spain) and BCL6 immunostaining (ReceptivaDx; Cicero Diagnostics, Inc., Huntington Beach, CA).

Intervention: Positive BCL6 result on ReceptivaDx (histologic score >1.4).

Main outcome measures: Prereceptive ERA result; relative expression levels of endometrial receptivity-associated epithelial genes by single-nucleus sequencing.

Results: One hundred and seventy-two patients with concurrent ERA and ReceptivaDx evaluation were included in the analysis: 40 were BCL6-positive and 132 were BCL6-negative. One patient (2.5%) in the BCL6-positive group had a prereceptive ERA result, compared with 29 patients (22.0%) in the BCL6-negative group (P<.01). BCL6 positivity was associated with decreased odds of a prereceptive ERA result (odds ratio, 0.09; 95% confidence interval, 0.01-0.69; P=.02). Single-nucleus transcriptomic analysis of 5,718 epithelial cell nuclei from four individuals showed significant cell type-specific transcriptomic changes associated with a positive ReceptivaDx BCL6 result in both natural cycle (NC) and programmed cycle (PC) endometrium: there were 2,801 significantly differentially expressed genes comparing NC BCL6-positive with -negative, and 1,062 differentially expressed genes comparing PC BCL6-positive with -negative. Of the 34 receptivity-associated epithelial markers evaluated, 16 were significantly upregulated in NC BCL6-positive vs. -negative endometrium epithelial nuclei. In PC epithelial nuclei, 12 of the 34 receptivity-associated genes were significantly upregulated, whereas only one was significantly downregulated in BCL6-positive vs. -negative endometrium.

Conclusions: A positive ReceptivaDx BCL6 result does not correlate with a prereceptive ERA. Epithelial cells from BCL6-positive endometrium did not show significantly decreased expression in most of the receptivity markers evaluated. These findings demonstrate discordance between the interpretation of "endometrial receptivity" by ReceptivaDx and ERA, and highlight the need for further validation of endometrial evaluation methods in fertility treatment.

目的利用子宫内膜接受性阵列和单核转录组学分析,研究 ReceptivaDx 评估 B 细胞淋巴瘤 6 (BCL6)(一种与子宫接受性受损相关的孕酮抗性拟议标记物)的阳性结果是否与植入窗中接受性相关标记物的次优特征相关:回顾性临床队列研究;对接受ReceptivaDx BCL6评估的前瞻性收集的植入窗子宫内膜进行单核RNA测序的试点研究 设置: 学术中心对象: 接受ReceptivaDx BCL6评估的不孕症患者:接受子宫内膜活检,同时进行子宫内膜受体阵列分析(ERA®;Igenomix)和BCL6免疫染色(ReceptivaDx™;Cicero Diagnostics, Inc.)的不孕症患者:ReceptivaDx™的BCL6阳性结果(组织学评分'HSCORE'>1.4) 主要结局指标:接受前ERA结果;通过单核测序检测子宫内膜接受性相关上皮基因的相对表达水平 结果:172例同时接受ERA和ReceptivaDx评估的患者纳入分析:40例BCL6阳性,132例BCL6阴性。BCL6阳性组中有一名患者(2.5%)的ERA结果为阳性,而BCL6阴性组中有29名患者(22.0%)的ERA结果为阴性:ReceptivaDx BCL6阳性结果与接受前ERA结果无关。BCL6 阳性子宫内膜的上皮细胞在大多数受孕标记物的表达上都没有明显下降。这些发现表明 ReceptivaDx 和 ERA 对 "子宫内膜接受性 "的解释不一致,并强调了在生育治疗中进一步验证子宫内膜评估方法的必要性。
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引用次数: 0
Progesterone receptor status predicts aggressiveness of human endometriotic lesions in murine avatars. 孕酮受体状态可预测小鼠子宫内膜异位症病变的侵袭性
Pub Date : 2024-10-10 DOI: 10.1016/j.xfss.2024.10.004
Valerie A Flores, Cagdas Sahin, Hugh S Taylor

Objective: To use murine avatars for studying human endometriotic lesion response to 2 different hormonal regimens to determine whether progesterone receptor (PR) can prospectively predict response to progestin-based therapy. Endometriosis is a chronic gynecologic disease afflicting 1-in-10 reproductive-age women; however response to medical therapy is highly variable because endometriotic lesions do not consistently respond to first-line progestin-based therapy. We have previously demonstrated in a retrospective study that PR status in lesions is correlated with response to progestins. Here, we hypothesize that a prospective approach using PR status to predict response to medical will allow clinicians to individualize effective, timely treatment for this debilitating disease.

Design: Patient-derived xenograft murine model.

Setting: The study was performed in an academic center and hospital research laboratory.

Animal(s): Eight-week old NOD/SCID mice undergoing transplantation of endometrioma lesions collected from women undergoing surgery for endometriosis.

Intervention(s): Daily subcutaneous injections with vehicle (dimethyl sulfoxide), medroxyprogesterone acetate (MPA), or gonadotropin-releasing hormone (GnRH) antagonist, cetrorelix, for 1 month.

Main outcome measure(s): Lesion size 1 month after treatment.

Result(s): Lesions with high PR demonstrated a robust response to MPA compared with lesions with low PR. The mean post-MPA treatment size in high-PR lesions was sixfold smaller than that in low-PR lesions. Low-PR lesions respond far more completely to GnRH antagonist than to MPA. Surprisingly, there were differences in response to GnRH antagonist between low- and high-PR lesions. High-PR lesions responded almost completely to GnRH antagonist with a 21-fold smaller posttreatment size on average than low-PR lesions.

Conclusion(s): The use of murine avatars to test clinical response is a novel approach in endometriosis. Hormonal suppression of disease is a cornerstone of therapy; however, response is not fully predictable. We have previously shown that women with low-PR lesions respond poorly to progestin-based therapy. Here, we prospectively validate our previous work using a mouse xenograft model, demonstrating that lesions with low-PR expression do not respond to progestin-based therapy; PR status predicted response to progestin-based therapy. Moreover, PR status identifies a more aggressive form of endometriosis that is not only progesterone resistant but is also less dependent on estradiol for growth. Our findings highlight the need to develop novel nonhormonal therapies aimed at targeting the more aggressive forms of endometriosis that do not rely on the usual hormonal signals.

目的:利用小鼠化身研究人类子宫内膜异位症病变对两种不同激素疗法的反应:利用小鼠化身研究人类子宫内膜异位症病变对两种不同激素方案的反应,以确定PR能否前瞻性地预测对孕激素疗法的反应。子宫内膜异位症是一种慢性妇科疾病,每 10 名育龄妇女中就有 1 人患病;然而,由于子宫内膜异位症病变对基于孕激素的一线疗法的反应并不一致,因此对药物疗法的反应非常不稳定。我们曾在一项回顾性研究中证实,病变部位的孕酮受体(PR)状态与对孕激素的反应相关。在此,我们假设,利用 PR 状态来预测对药物的反应的前瞻性方法将使临床医生能够对这种使人衰弱的疾病进行有效、及时的个体化治疗:设计:患者衍生异种移植小鼠模型 对象:八周大的 NOD/SCID 小鼠八周大的 NOD/SCID 小鼠,接受从接受子宫内膜异位症手术的妇女身上收集的子宫内膜瘤病灶移植:每天皮下注射载体(DMSO)、醋酸甲羟孕酮(MPA)或GnRH拮抗剂西曲瑞克,为期1个月:结果:与 PR 值低的病变相比,PR 值高的病变对 MPA 的反应强烈。高 PR 病变在 MPA 治疗后的平均大小是低 PR 病变的 6 倍。低 PR 病变对 GnRH 拮抗剂的反应远比对 MPA 的反应完全。令人惊讶的是,低 PR 病变和高 PR 病变对 GnRH 拮抗剂的反应存在差异。与低 PR 病变相比,高 PR 病变对 GnRH 拮抗剂的反应几乎是完全的,治疗后的平均大小缩小了 21 倍:结论:使用小鼠化身测试临床反应是子宫内膜异位症的一种新方法。激素抑制疾病是治疗的基石,但反应并不能完全预测。我们以前的研究表明,低 PR 病变的妇女对孕激素治疗的反应很差。在这里,我们利用小鼠异种移植模型对之前的工作进行了前瞻性验证,证明低 PR 表达的病变对孕激素治疗没有反应;PR 状态可预测对孕激素治疗的反应。此外,PR 状态还能确定一种更具侵袭性的子宫内膜异位症,这种子宫内膜异位症不仅对孕激素有抵抗力,而且其生长对雌二醇的依赖性也较低。我们的研究结果凸显了开发新型非激素疗法的必要性,这些疗法旨在针对不依赖于常规激素信号的更具侵袭性的子宫内膜异位症。
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引用次数: 0
Bleomycin in vitro exposure decreases markers of human male gamete competence. 博莱霉素体外暴露会降低人类男性配子能力的标志物。
Pub Date : 2024-10-10 DOI: 10.1016/j.xfss.2024.10.003
Ana Lobo de Almeida, Ana Gonçalves, Alberto Barros, Mário Sousa, Rosália Sá

Objective: To investigate the in vitro impact of bleomycin on human sperm deoxyribonucleic acid (DNA) integrity, functionality, and morphology, with the aim of elucidating the underlying mechanism and anticipating potential repercussions on patients' reproductive function.

Design: Controlled laboratory-based in vitro investigation.

Setting: University and clinical in vitro fertilization treatment center.

Patient(s): Surplus human ejaculate donated for research by 45 reproductive-age participants exhibiting normozoospermic sperm parameters after clinical semen analysis. None of the participants had received a cancer diagnosis or undergone radiotherapy, chemotherapy, or both.

Intervention(s): After clinical semen analysis, sperm samples were centrifuged, diluted in sperm preparation medium, and exposed to bleomycin (100 μg/mL) for 2 hours at 37 °C in a humidified incubator with 5% CO2.

Main outcome measure(s): In vitro human sperm competence was evaluated by comparing raw sperm, sperm incubated with sperm preparation medium, and sperm exposed to bleomycin. Competence indicators included sperm motility, vitality, DNA and acrosome integrity, and mitochondrial membrane potential. Transmisson electron microscopy was employed to correlate the ultrastructural morphological findings with functional assays.

Result(s): Exposure to bleomycin for 2 hours in vitro significantly decreased sperm vitality, motility, and chromatin condensation compared with raw and control sperm. It also significantly increased sperm DNA fragmentation and the proportion of sperm with low mitochondrial membrane potential. Additionally, bleomycin significantly retarded the acrosomal response compared with control but did not affect the formation of intracellular and extracellular reactive oxygen species. Bleomycin-induced ultrastructural morphological changes supported the detected functional alterations.

Conclusion(s): Bleomycin negatively impacts male gamete competency in humans. Healthcare professionals should vigilantly monitor and further investigate the gonadotoxicity effects of bleomycin, in addition to its recognized lung toxicity. Meanwhile, it is recommended that patients with cancer undergoing bleomycin-containing chemotherapy regimens receive guidance on fertility preservation strategies.

目的:研究博莱霉素对人类精子DNA完整性、功能和形态的体外影响:研究博莱霉素对人类精子DNA完整性、功能和形态的体外影响,旨在阐明其潜在机制并预测对患者生殖功能的潜在影响:设计:实验室体外对照研究:45名育龄参与者捐献的多余人类射精用于研究,这些参与者在临床精液分析后显示出正常无精症精子参数。所有参与者均未接受过癌症诊断,也未接受过放疗、化疗或同时接受这两种治疗:临床精液分析后,对精子样本进行离心,在精子制备培养基(SPM)中稀释,并在37ºC、5% CO2的加湿培养箱中接触博莱霉素(100 μg/mL)两小时:主要结果指标:通过比较原始精子、经 SPM 培养的精子和暴露于博莱霉素的精子,对体外人类精子能力进行评估。能力指标包括精子运动能力、活力、DNA和顶体完整性以及线粒体膜电位。透射电子显微镜将超微结构形态学结果与功能测定结果联系起来:结果:与未处理精子和对照精子相比,体外暴露于博莱霉素两小时会显著降低精子活力、运动能力和染色质凝集(P < 0.001)。博莱霉素还能明显(P < 0.001)增加精子的DNA碎片和线粒体膜电位低的精子比例。此外,与对照组相比,博莱霉素明显(P < 0.05)延缓了顶体反应,但不影响细胞内和细胞外活性氧的形成。博莱霉素诱导的超微结构形态学变化支持了检测到的功能性改变:博莱霉素对人类男性配子能力有负面影响。结论:博莱霉素对人类男性配子能力有负面影响,医护人员应警惕并进一步研究博莱霉素的性腺毒性影响。同时,建议接受博莱霉素化疗方案的癌症患者接受生育力保护策略指导。
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引用次数: 0
Reviewer of the Year 2023. F&S Science celebrates excellence in our world class reviewers. 2023 年度审稿人。F&S Science 为世界级审稿人的卓越表现喝彩。
Pub Date : 2024-10-04 DOI: 10.1016/j.xfss.2024.10.002
Hortensia Ferrero
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引用次数: 0
The immune landscape of uterine fibroids as determined by mass cytometry 通过质控细胞仪确定子宫肌瘤的免疫格局
Pub Date : 2024-08-01 DOI: 10.1016/j.xfss.2024.06.004

Objective

To study the differences in immune cell profiles in uterine fibroids (Fibs) and matched myometrium (Myo).

Design

Observational study.

Setting

Laboratory study.

Patient(s)

The study included tissue that was collected from 10 pairs of Fib and matched Myo from women, not on hormonal medications, undergoing hysterectomy and myomectomy.

Intervention(s)

None.

Main Outcome Measure(s)

Differences in immune cell and cytokine composition between Fib and matched Myo.

Result(s)

The mass cytometry analysis indicated that Fibs had a significantly higher number of natural killer (NK) cells, total macrophages, M2 macrophages, and conventional dendritic cells when compared with matched Myo from the same patient. In contrast, Fibs had significantly fewer CD3 and CD4 T cells when compared with Myo. The mass cytometry analysis results did not show any significant difference in the number of resting mast cells. Immunoflurorescent and immunohistochemical imaging confirmed the cytometry by time of flight results, showing a significantly higher number of NK cells, tryptase-positive mast cells indicative of mast cell activation, total macrophages, and M2 cells in Fibs and a significantly lower number of CD3 and CD4 T cells. The cytokine assay revealed significantly increased levels of human interferon α2, interleukin (IL)-1α, and platelet-derived growth factor AA and significantly lower levels of macrophage colony-stimulating factor and IL-1 receptor antagonist in Fib.

Conclusion(s)

Our results show significant differences in immune cell populations and cytokine levels between Fib and Myo. These differences could account for the increased inflammation in fib and a potential mechanism by which these tumors evade the immune system. These findings provide a foundation for further studies exploring the role of immune cells in Fib development.

目的:研究子宫肌瘤(Fib)和匹配子宫肌层(Myo)免疫细胞谱的差异:研究子宫肌瘤(Fib)和匹配子宫肌瘤(Myo)免疫细胞谱的差异:观察性研究研究对象: 实验室研究研究包括从接受子宫切除术和子宫肌瘤剔除术的未服用激素药物的妇女的10对子宫肌瘤和匹配子宫肌层中收集的组织:主要结果测量:结果:质控细胞仪分析表明,与来自同一患者的匹配子宫肌瘤相比,子宫肌瘤的 NK 细胞、巨噬细胞总数、M2 巨噬细胞和传统树突状细胞数量明显较高。相比之下,子宫肌瘤的 CD3 和 CD4 T 细胞数量明显少于子宫肌层。质谱分析显示,静止肥大细胞的数量没有明显差异。IFC 和 IHC 成像证实了 CytoF 的结果,显示子宫肌瘤中的 CD3 和 CD4 T 细胞数量明显较高:我们的研究结果表明,Fib 和 Myo 的免疫细胞群和细胞因子水平存在明显差异。在 Fib 中,巨噬细胞、M2 巨噬细胞、NK 细胞和树突状细胞的总数明显增加,而 CD3 和 CD4 T 细胞则明显减少。IHC 证实静息肥大细胞总数无差异,但纤维中胰蛋白酶阳性肥大细胞明显增加。与匹配的子宫肌层相比,纤维的IFNA2、IL-1α和PDGF-AA水平明显更高,而IL-1RA和M-CSF水平明显更低。这些发现为进一步研究免疫细胞在纤维发育中的作用奠定了基础。
{"title":"The immune landscape of uterine fibroids as determined by mass cytometry","authors":"","doi":"10.1016/j.xfss.2024.06.004","DOIUrl":"10.1016/j.xfss.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><p>To study the differences in immune cell<span> profiles in uterine fibroids<span> (Fibs) and matched myometrium (Myo).</span></span></p></div><div><h3>Design</h3><p>Observational study.</p></div><div><h3>Setting</h3><p>Laboratory study.</p></div><div><h3>Patient(s)</h3><p><span>The study included tissue that was collected from 10 pairs of Fib and matched Myo from women, not on hormonal medications, undergoing hysterectomy and </span>myomectomy.</p></div><div><h3>Intervention(s)</h3><p>None.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Differences in immune cell and cytokine composition between Fib and matched Myo.</p></div><div><h3>Result(s)</h3><p>The mass cytometry<span><span><span><span> analysis indicated that Fibs had a significantly higher number of natural killer (NK) cells, total macrophages, M2 macrophages<span>, and conventional dendritic cells when compared with matched Myo from the same patient. In contrast, Fibs had significantly fewer CD3<span> and CD4 T cells when compared with Myo. The mass </span></span></span>cytometry analysis results did not show any significant difference in the number of resting mast cells. Immunoflurorescent and immunohistochemical imaging confirmed the cytometry by time of flight results, showing a significantly higher number of NK cells, tryptase-positive mast cells indicative of mast </span>cell activation, total macrophages, and M2 cells in Fibs and a significantly lower number of CD3 and CD4 T cells. The cytokine assay revealed significantly increased levels of </span>human interferon<span> α2, interleukin (IL)-1α, and platelet-derived growth factor AA and significantly lower levels of macrophage colony-stimulating factor and IL-1 receptor antagonist in Fib.</span></span></p></div><div><h3>Conclusion(s)</h3><p>Our results show significant differences in immune cell populations and cytokine levels between Fib and Myo. These differences could account for the increased inflammation in fib and a potential mechanism by which these tumors evade the immune system. These findings provide a foundation for further studies exploring the role of immune cells in Fib development.</p></div>","PeriodicalId":73012,"journal":{"name":"F&S science","volume":"5 3","pages":"Pages 272-282"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing the consistency of motion of spermatozoa through nanoscale motion tracing 通过纳米级运动追踪表征精子运动的一致性。
Pub Date : 2024-08-01 DOI: 10.1016/j.xfss.2024.07.002

Objective

To demonstrate nanoscale motion tracing of spermatozoa and present analysis of the motion traces to characterize the consistency of motion of spermatozoa as a complement to progressive motility analysis.

Design

Anonymized sperm samples were videographed under a quantitative phase microscope, followed by generating and analyzing superresolution motion traces of individual spermatozoa.

Setting

Not applicable.

Patient(s)

Centrifuged human sperm samples.

Intervention(s)

Not applicable.

Main Outcome Measure(s)

Precision of motion trace of individual sperms, presence of a helical pattern in the motion trace, mean and standard deviations of helical periods and radii of sperm motion traces, speed of progression.

Result(s)

Spatially sensitive quantitative phase imaging with a superresolution computational technique MUltiple SIgnal Classification ALgorithm allowed achieving motion precision of 340 nm using ×10, 0.25 numerical aperture lens whereas the diffraction-limited resolution at this setting was 1,320 nm. The motion traces thus derived facilitated new kinematic features of sperm, namely the statistics of helix period and radii per sperm.

Through the analysis, 47 sperms with a speed >25 μm/s were randomly selected from the same healthy donor semen sample, it is seen that the kinematic features did not correlate with the speed of the sperms. In addition, it is noted that spermatozoa may experience changes in the periodicity and radius of the helical path over time. Further, some very fast sperms (e.g., >70 μm/s) may demonstrate irregular motion and need further investigation.

Presented computational analysis can be used directly for sperm samples from both fertility patients with normal and abnormal sperm cell conditions.

We note that MUltiple SIgnal Classification ALgorithm is an image analysis technique that may vaguely fall under the machine learning category, but the conventional metrics for reporting found in Enhancing the QUAlity and Transparency Of health Research network do not apply. Alternative suitable metrics are reported, and bias is avoided through random selection of regions for analysis. Detailed methods are included for reproducibility.

Conclusion(s)

Kinematic features derived from nanoscale motion traces of spermatozoa contain information complementary to the speed of the sperms, allowing further distinction among the progressively motile sperms. Some highly progressive spermatozoa may have irregular motion patterns, and whether irregularity of motion indicates poor quality regarding artificial insemination needs further investigation. The presented technique can be generalized for sperm analysis for a variety of fertility conditions.

目的:展示精子的纳米级运动轨迹,并分析精子运动的一致性,作为渐进运动分析的补充:展示精子的纳米级运动轨迹,并对运动轨迹进行分析,以确定精子运动的一致性,作为渐进式运动分析的补充:设计:在定量相显微镜下对匿名精子样本进行录像,然后生成并分析单个精子的超分辨率运动轨迹:离心人类精子样本:主要结果指标:单个精子运动轨迹的精确度、运动轨迹中是否存在螺旋模式、精子运动轨迹螺旋周期和半径的平均值和标准偏差、运动速度:利用超分辨率计算技术MUltiple SIgnal Classification ALgorithm (MUSICAL)进行空间敏感定量相位成像,使用10×、0.25 NA镜头可实现340纳米的运动精度,而在此设置下的衍射极限分辨率为1320纳米。由此得出的运动轨迹有助于获得精子的新运动学特征,即每个精子的螺旋周期和半径统计。通过对从同一健康捐精者的精液样本中随机抽取的速度大于 25 μm/sec 的 47 个精子进行分析,发现运动学特征与精子的速度无关。此外,我们还注意到,精子的螺旋路径周期和半径可能会随着时间的推移而发生变化。此外,一些速度极快的精子(例如>70微米/秒)可能会表现出不规则运动,这需要进一步研究。所提出的计算分析可直接用于正常和异常精子细胞条件的生育患者的精子样本。我们注意到,MUSICAL 是一种图像分析技术,可能隐约属于机器学习范畴,但 EQUATOR 中的传统报告指标并不适用。我们报告了其他合适的指标,并通过随机选择分析区域来避免偏差。报告中还包含了详细的方法,以确保可重复性:从精子的纳米级运动轨迹中得出的运动学特征包含精子速度的补充信息,可进一步区分渐进运动的精子。一些高度渐进的精子可能具有不规则的运动模式,而运动的不规则性是否表明人工授精的质量不佳,还需要进一步研究。该技术可用于各种生育条件下的精子分析。
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引用次数: 0
From the Editor-in-Chief 主编的话
Pub Date : 2024-08-01 DOI: 10.1016/j.xfss.2024.07.003
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引用次数: 0
Donor side effects experienced under minimal controlled ovarian stimulation with in vitro maturation vs. conventional controlled ovarian stimulation for in vitro fertilization treatment 在体外受精(IVF)治疗中,最小控制卵巢刺激(COS)和体外成熟(IVM)对传统 COS 的副作用。
Pub Date : 2024-08-01 DOI: 10.1016/j.xfss.2024.05.002

Objective

To evaluate oocyte retrieval experiences and side effects under minimally controlled ovarian stimulation (COS) treatment for in vitro maturation (IVM) of oocytes compared with conventional COS treatment.

Design

A retrospective survey study.

Setting

Clinical in vitro fertilization treatment center.

Patient(s)

Data were collected from subjects undergoing minimal COS treatment (n = 110; 600–800 IU follicle-stimulating hormone) for IVM of oocytes and conventional COS treatment for egg donation (n = 48; 1,800–2,600 IU follicle-stimulating hormone) from April 2022 to November 2023.

Intervention(s)

Minimal and conventional COS treatments.

Main Outcome Measure(s)

The most common side effects experienced during ovarian stimulation and after oocyte pick-up, satisfaction level, and the likelihood of recommending or repeating minimal or conventional COS. Statistical analysis included Mann-Whitney U test and χ2 tests, with a significance level.

Result(s)

During minimal COS treatment, most subjects did not experience breast swelling (86%), pelvic or abdominal pain (76%), nausea or vomiting (96%), and bleeding (96%). After oocyte pick-up, the majority (75%) reported no pelvic or abdominal pain. The most common side effect was abdominal swelling (52%). Compared with conventional COS cycles, minimal COS subjects reported significantly less postretrieval pain, with 33% experiencing no pain (vs. 6%) and with a reduced severe level of pain (5% vs. 19%), leading to fewer subjects requiring pain medication (25% vs. 54%). Additionally, 85% of women were very satisfied with minimal stimulation treatment and would recommend or repeat the treatment.

Conclusion(s)

Reducing the hormonal dose for ovarian stimulation has a beneficial effect on subjects, suggesting the combination of minimal COS treatment with IVM techniques is a well-tolerated alternative for women who cannot or do not wish to undergo conventionally controlled ovarian hyperstimulation treatment.

目的:评估体外成熟(IVM)中最小控制卵巢刺激(COS)下的卵母细胞获取经验和副作用:评估体外成熟(IVM)中最小控制卵巢刺激(COS)与传统 COS 相比的卵母细胞获取经验和副作用:设计:回顾性调查研究研究对象:西班牙临床体外受精(IVF)治疗中心:数据收集自2022年4月至2023年11月接受最小COS(n=110;600-800 IU FSH)体外受精和常规COS捐卵(n=48;1800-2600 IU FSH)的受试者:主要结果指标:卵巢刺激过程中和OPU后最常见的副作用、满意度以及推荐或重复最小或常规COS的可能性。统计分析包括曼-惠特尼检验和卡方检验,显著性水平设定为 p结果:在最小 COS 过程中,大多数受试者没有出现乳房胀痛(86%)、盆腔或腹痛(76%)、恶心或呕吐(96%)和出血(96%)。取卵后,大多数受试者(75%)没有出现盆腔或腹部疼痛。最常见的副作用是腹部肿胀(52%)。与传统的 COS 周期相比,最小 COS 受试者报告的取卵后疼痛明显减少,33% 的受试者没有疼痛感(对 6%;P=0.0011),剧烈疼痛程度降低(5% 对 19%;P=0.0097),需要服用止痛药的受试者减少(25% 对 54%;P=0.0003)。此外,85%的妇女对最小刺激非常满意,并愿意推荐或重复这种治疗方法:结论:减少卵巢刺激的激素剂量对受试者有好处,这表明对于不能或不愿接受常规控制性卵巢过度刺激的妇女来说,将最小COS与IVM技术相结合是一种耐受性良好的替代方法。
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引用次数: 0
Reviewer of the Year 2023: F&S Science celebrates excellence in our world-class reviewers 年度评论员
Pub Date : 2024-08-01 DOI: 10.1016/j.xfss.2024.07.001
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引用次数: 0
A comparison of obstetric and neonatal outcomes in polycystic ovary syndrome and congenital adrenal hyperplasia: a retrospective analysis of a population database 多囊卵巢综合征与 CAH 的产科和新生儿预后比较:对人口数据库的回顾性分析
Pub Date : 2024-08-01 DOI: 10.1016/j.xfss.2024.05.001

Objective

To investigate potential differences in pregnancy, delivery, and neonatal outcomes between 2 hyperandrogenic conditions in reproductive-aged women: polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia (CAH).

Design

Retrospective population-based study with data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database from 2004–2014.

Setting

Not applicable.

Patient(s)

A total of 14,881 women with PCOS and 298 women with CAH.

Intervention(s)

Not applicable.

Main Outcome Measure(s)

Gestational diabetes mellitus, placenta previa, pregnancy-induced hypertension (HTN), gestational HTN, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on HTN, preterm birth, preterm premature rupture of membrane, abruptio placenta, chorioamnionitis, mode of delivery, maternal infection, hysterectomy, blood transfusion, venous thromboembolism (deep vein thrombosis and pulmonary embolism during pregnancy, intrapartum, or postpartum), maternal death, chorioamnionitis, septicemia during labor, postpartum endometritis, septic pelvic, peritonitis, small for gestational age, congenital anomalies, and intrauterine fetal demise.

Result(s)

After adjusting for potential confounders, we found that women with PCOS were at increased risk of developing pregnancy-induced HTN (adjusted odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.12–2.77) and gestational diabetes (adjusted OR = 1.68; 95% CI: 1.12–2.52) when compared with women with CAH. Contrary women with CAH were at increased risk for delivery via cesarean section (adjusted OR = 0.59; 95% CI: 0.44–0.80) and small for gestational age neonates (adjusted OR = 0.32; 95% CI: 0.20–0.52).

Conclusion(s)

To our knowledge, this study is the first to directly compare obstetric and neonatal outcomes between patients with PCOS and CAH. Despite the similar phenotypes and some common hormonal and biochemical profiles, such as insulin resistance, hyperinsulinemia, and hyperandrogenism, our results suggest the existence of additional metabolic pathways implicated in the pathogenesis of pregnancy complications.

目的 探讨多囊卵巢综合征(PCOS)和先天性肾上腺皮质增生症(CAH)这两种育龄妇女高雄激素症在妊娠、分娩和新生儿结局方面的潜在差异。设计以人群为基础的回顾性研究,数据来自2004-2014年的医疗成本和利用项目--全国住院患者样本数据库。主要结果指标:妊娠糖尿病、前置胎盘、妊娠诱发高血压(HTN)、妊娠高血压、子痫前期、子痫、子痫前期和子痫叠加高血压、早产、早产胎膜早破、胎盘早剥、绒毛膜羊膜炎、分娩方式、产妇感染、输血、静脉血栓栓塞(孕期、产中或产后的深静脉血栓和肺栓塞)、产妇死亡、绒毛膜羊膜炎、分娩期败血症、产后子宫内膜炎、化脓性盆腔炎、腹膜炎、胎龄小、先天性畸形和胎儿宫内死亡。研究结果:在对潜在的混杂因素进行调整后,我们发现与患有CAH的妇女相比,患有多囊卵巢综合征的妇女罹患妊娠诱发高血压(调整后比值比[OR]=1.76;95%置信区间[CI]:1.12-2.77)和妊娠糖尿病(调整后比值比[OR]=1.68;95%置信区间[CI]:1.12-2.52)的风险更高。与此相反,CAH 女性通过剖宫产分娩(调整后 OR = 0.59;95% CI:0.44-0.80)和小胎龄新生儿(调整后 OR = 0.32;95% CI:0.20-0.52)的风险增加。尽管表型相似且存在一些共同的激素和生化特征,如胰岛素抵抗、高胰岛素血症和高雄激素,但我们的研究结果表明,在妊娠并发症的发病机制中还存在其他代谢途径。
{"title":"A comparison of obstetric and neonatal outcomes in polycystic ovary syndrome and congenital adrenal hyperplasia: a retrospective analysis of a population database","authors":"","doi":"10.1016/j.xfss.2024.05.001","DOIUrl":"10.1016/j.xfss.2024.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate potential differences in pregnancy, delivery, and neonatal outcomes between 2 hyperandrogenic conditions in reproductive-aged women: polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia (CAH).</p></div><div><h3>Design</h3><p>Retrospective population-based study with data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database from 2004–2014.</p></div><div><h3>Setting</h3><p>Not applicable.</p></div><div><h3>Patient(s)</h3><p>A total of 14,881 women with PCOS and 298 women with CAH.</p></div><div><h3>Intervention(s)</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Gestational diabetes mellitus, placenta previa, pregnancy-induced hypertension (HTN), gestational HTN, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on HTN, preterm birth, preterm premature rupture of membrane, abruptio placenta, chorioamnionitis, mode of delivery, maternal infection, hysterectomy, blood transfusion, venous thromboembolism (deep vein thrombosis and pulmonary embolism during pregnancy, intrapartum, or postpartum), maternal death, chorioamnionitis, septicemia during labor, postpartum endometritis, septic pelvic, peritonitis, small for gestational age, congenital anomalies, and intrauterine fetal demise.</p></div><div><h3>Result(s)</h3><p>After adjusting for potential confounders, we found that women with PCOS were at increased risk of developing pregnancy-induced HTN (adjusted odds ratio [OR] = 1.76; 95% confidence interval [CI]: 1.12–2.77) and gestational diabetes (adjusted OR = 1.68; 95% CI: 1.12–2.52) when compared with women with CAH. Contrary women with CAH were at increased risk for delivery via cesarean section (adjusted OR = 0.59; 95% CI: 0.44–0.80) and small for gestational age neonates (adjusted OR = 0.32; 95% CI: 0.20–0.52).</p></div><div><h3>Conclusion(s)</h3><p>To our knowledge, this study is the first to directly compare obstetric and neonatal outcomes between patients with PCOS and CAH. Despite the similar phenotypes and some common hormonal and biochemical profiles, such as insulin resistance, hyperinsulinemia, and hyperandrogenism, our results suggest the existence of additional metabolic pathways implicated in the pathogenesis of pregnancy complications.</p></div>","PeriodicalId":73012,"journal":{"name":"F&S science","volume":"5 3","pages":"Pages 293-300"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666335X24000284/pdfft?md5=6dad6783275a10ecbc45dd50837e39dc&pid=1-s2.0-S2666335X24000284-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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