Abstract:In vitro culture and cryopreservation of oocytes are two critical steps of assisted reproductive technology,and oxidative stress is a major limiting factor affecting the developmental quality of oocytes during above steps.At present,the commonly used natural antioxidants in clinical practice(such as melatonin,resveratrol,etc.)can alleviate oxidative damage,but the application effect is limited by inherent defects such as poor water solubility,low bioavailability and short metabolic half-life.In recent years,the rapid development of nanomaterial technology has provided new solutions to this challenge.Notably,nanoparticle-based antioxidant systems,owing to their unique free radical scavenging capacity and excellent biocompatibility,have been demonstrated significant advantages in in vitro manipulation of gamete.This article reviews the application progress of nanoparticles in the field of assisted reproduction,including the biological effects,potential mechanisms of reproductive toxicity,clinical prospects and future directions.

Abstract:With the increase of male life span,the level of androgen secreted by testicular Leydig cells reduce continuously,which leads to the late onset of hypogonadism(LOH).Concurrently,spermatogenesis in the seminiferous tubules is compromised,leading to the reduction in both the quantity and quality of sperm,thereby decreasing male fertility.Males who suffered from testicular natural aging,influence of external environmental factors,metabolic factors,microcirculatory disorders,or certain disease states,generated reactive oxygen species in testes.Meanwhile,the mechanisms of antioxidant stress,such as superoxide dismutase,the Keap1/Nrf2 antioxidant pathway,the ubiquitination pathway,USP15,and the seminal plasma antioxidant system,exhibit relative inadequacy.Consequently,the continuous accumulation of oxidative stress inflicts the direct or/and indirect damage on the functions of Leydig cells and seminiferous tubules,which represents one of the primary pathophysiological mechanisms underlying LOH.Accumulating evidences have indicated that antioxidant therapy holds promise in retarding the progression of LOH.In this review,we comprehensively examine the oxidative stress in the testes of aging men and the occurrence of LOH,and discusse the potential application prospects of novel antioxidants in middle-aged and elderly male populations.

Abstract:Objective:To analyze the indications for prenatal diagnosis and postnatal follow-up outcomes in 21 fetuses diagnosed with 2q13 microdeletion syndrome.Methods:A retrospective analysis was conducted on 4 832 pregnant women who underwent amniocentesis for karyotyping and single nucleotide polymorphism array(SNP-array)testing at Prenatal Diagnosis Center of Quanzhou Women's and Children's Hospital between April 2020 and February 2024 due to various high-risk factors.Descriptive statistical methods were employed to evaluate the karyotype results,indications for invasive prenatal diagnosis,ultrasound findings,and postnatal follow-up outcomes of the 21 fetuses with 2q13 microdeletion syndrome.Results:Among the 21 fetuses identified with 2q13 microdeletion,14 exhibited abnormal ultrasound findings;one couple were carriers of β-thalassemia;one case was flagged by noninvasive prenatal testing for sex chromosome abnormalities;one case was identified through high-risk serum screening;three cases involved advanced maternal age;and one case involved chromosomal abnormalities in both the mother and her first child.Karyotype analysis revealed that one case showed an inversion of chromosome 16,and that no abnormalities were detected in the remaining 20 cases.SNP-array testing revealed 2q13 microdeletion fragments ranging in size from 103.5 to 1 771.0 kb.Genetic testing revealed that four cases were maternally inherited,three were paternally inherited,two were de novo mutations,and twelve couples declined further verification.Four pregnancies were electively terminated after the informed decision-making based on comprehensive assessments,with no apparent external abnormalities observed in the fetuses.One case was lost to follow-up,11 newborns were healthy at birth,and five exhibited varying degrees of congenital anomalies.Conclusions:The phenotypic manifestations of 2q13 microdeletion syndrome are highly variable,with most cases inherited from phenotypically normal parents.Genetic verification and long-term postnatal follow-up are essential for accurate clinical genetic counseling.

Abstract:Spacetime-Medicine theory,based on traditional Chinese medicine(TCM),can be traced back to Huang Di Nei Jing.This theory argues that the masses of factors such as geographic environment and living conditions affect the physiological functions of the human body and the transmission of diseases.As a academic thought of TCM,Spacetime-Medicine theory has been applied in the diagnosis,treatment,and prevention of diseases and health maintenance.However,the reports on the Spacetime-Medicine theory of PCOS are fragmented.In this paper,we reviewed the ancient literatures,traced the characteristics of similar PCOS-related diseases in ancient texts,summarized ancient and modern treatment methods,and explained how geographical differences influence the diagnosis and treatment of PCOS,so as to reveale the evolutionary pattern of PCOS-related diseases.We hereby explore the concept of Spacetime-Medicine theory in relation to PCOS.Additionally,we explore the development of the PCOS-related treatment by the connection of traditional and modern Chinese medicine with modern technological advances,such as genomics and metabolomics,to provide a reference for the innovations and breakthroughs in the diagnosis and treatment of PCOS in terms of the modernization of TCM theory in the reproductive medicine.

Abstract:Pregnancy luteoma(PL)is an ovarian tumor-like lesion with very low incidence,which mostly occurs in the second and the third trimester.The etiology and pathogenesis of PL are unclear,and clinical manifestations vary greatly.There are no specific imaging features and serological markers.The misdiagnosis and mistreatment are prone to occur due to insufficient understanding and treatment experience.We report a case of PL,in which the patient presented with hyperandrogenism,hydrothorax and ascites,and elevated serum alpha-fetoprotein(AFP)and carbohydrate antigen 125(CA125).Imaging suggested bilateral large ovarian masses.The possibility of malignant ovarian tumor cannot be ruled out,and surgical treatment was recommended.The patient refused to undergo surgery.After reviewing relevant literatures,we realized the possibility of PL.Conservative treatment and clinical observation were adopted.After a one-month follow-up,the symptoms disappeared,liver function returned to normal,and serum AFP and CA125 normal.Gynecological color ultrasound showed no abnormalities in the uterus and bilateral adnexa,ruling out ovarian malignancy.The follow-up was continued for 22 months with no abnormal conditions,and clinical outcome was satisfactory.Eventually,the bilateral PL was diagnosed,and the surgery as for this case was successfully avoided.

Abstract:Endometriosis(EMs)is one of the major causes of infertility in women of reproductive age.Defective decidualization is a key factor contributing to EMs-related infertility.Aberrant epigenetic regulation,progesterone resistance and dysregulated endometrial immune-inflammatory microenvironment are important pathological mechanisms underlying the decidualization defects in EMs,yet the specific mechanisms remain unclear.By reviewing relevant literatures,it has been found that epigenetic abnormalities in EMs mainly affect the expressions of decidualization-related genes through DNA methylation,RNA methylation,and histone modifications.Progesterone resistance in the endometrium leads to abnormal regulation of downstream gene expression and signaling pathways of progesterone receptors,hindering the decidualization process.Moreover,abnormal changes in endometrial immune cells,cytokines,and inflammatory pathways lead to dysregulation of the endometrial immune-inflammatory microenvironment,which impair the processes of decidualization and embryo implantation,which ultimately result in EMs-related infertility.

Abstract:Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women of reproductive age.In addition to their inherent polycystic ovary,hyperandrogenism and ovarian dysfunction,there are obesity,type 2 diabetes,dyslipidemia and other metabolic abnormalities.With the change of living environment,the incidence of PCOS gradually increases.If the condition is not improved for a long time,it will not only affect reproductive health,but also affect general health.Although we have made a little progress in understanding PCOS,the complicated etiology and heterogeneous clinical manifestations suggested that the comprehensive treatment was very important for those PCOS women.For those PCOS women with fertility demand,the ovulation induced with drugs will help them to get pregnancy.However,the objective of the ovulation induction should be to get a single developed follicle,and to avoid the multiple developing follicles.In IVF/ICSI cycles,an excess of developing follicles should be avoided so as to prevent ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy.The research progress of the etiology,pathogenesis and treatment of PCOS were briefly discussed in this review.

Abstract:Objective:To evaluate the effictiveness of the doula delivery analgesia apparatus combined with the whole process painless delivery in those elderly parturient women.Methods:A total of 160 cases of elderly primipara in maternal and child health hospital of shenzhen city from January 2016 to January 2017 were randomly divided into two groups.Cases in the observation group (n=80) were treated with the doula delivery analgesia apparatus combined with the whole process painless delivery,while cases in the control group (n=80) with the traditional delivery way in the conventional labour room.The duration of labor and the outcomes of mother and infant were compared.Results:The first and second stages of labor,and total labor stage,in the observation group were significantly shorter than those in the control group (P＜0.05).However,there was no significant difference in the third stage of labor between the two groups (P＞0.05).The rate of vaginal delivery in the observation group was significantly higher than that in the control group (P＜0.05).There was no significant difference in the rate of neonatal asphyxia between the two groups (P＞0.05).The observation group had better security sense,and lower rate anxiety and fear when compared with the control group (P＜0.05).The VAS score of labor pain in the observation group was significantly better than that in the control group [(3.53±1.22) vs.(8.15± 1.48),t=9.576,P=0.000].Conclusions:The doula delivery analgesia apparatus combined with the whole process painless delivery can be recommended to use in those elderly parturient women,with the advantages of the alleviated pain,the shorten delivery time and the improved mental state.The rate of vaginal delivery in those women with this method can also be increased.

Abstract:The rising incidence of infertility among couples of childbearing age has been a global concern. The ovulatory and tubal factors are the common causes of female infertility, including the inflammation, adhesion and obstruction of oviduct. Pelvic inflammatory disease is the most common cause for oviduct infertility, which affected by Chlamydia trachomatis, Ureaplasma urealyticum, Gonococcus or tubercle bacillus. Besides, appendicitis, induced abortion, abdominopelvic surgery, endometriosis and congenital dysplasia of fallopian tube are also the pathogenesis of oviduct infertility. The prevalence of tubal infertility brings not only the great economic burden to the society, but also the psychological pressure to the patients. This systematic review on the epidemiology and etiology of tubal infertility may help doctors to optimize the prevention, diagnosis and treatment of tubal infertility.

Abstract:Thin endometrium can cause unsuitable endometrial receptivity, affect the embryo implantation, and ultimately reduce the pregnancy rate. A variety of methods have been tried to treat this disease so far. However, there is not a universal method with the exact efficacy, which means that the treatment of thin endometrium is still a challenge for clinician. Several treatment modalities have been offered to patients with thin endometrium, including the endometrial local micro-injury, hormones (estrogen and GnRH-agonist), vasoactive medicines (aspirin, vitamin E, pentoxifylline, L-arginine and sildenafil), intrauterine infusion of G-CSF and the new clinical trial of regenerative medicine. We reviewed and compared those treatments of thin endometrium, so as to provide a reference for clinician to treat individually patients by improving endometrial receptivity, increasing the pregnancy rate, and optimizing patient management.

Abstract:The etiology of recurrent spontaneous abortion (RSA) is very complicated.The prethrombotic state related to RSA is hotspot research in recent years.More and more research indicated that the pathogenic factor of RSA could include the coagulation factor V mutation,prothrombin gene polymorphism,MTFHR gene mutation,protein C deficiency,protein S defect,fibrinogen gene mutation,anti-phospholipid syndrome antibody,angiotensin converting enzyme gene insertion and deletion,and PAI-1 gene polymorphism.There is no sufficient evidence that low-molecular-weight heparin can improve pregnancy outcome in RSA the patients with prethrombotic state.Medical researchers still actively explore the therapeutic regimen of RSA the prethrombotic state related to RSA,and put forward some useful treatment suggestions based on their experience in treatment of RSA and in assisted reproductive technology.