Abstract:Endometriosis is one of the important factors of female infertility. The possible causes of infertility include the change in peritoneal fluid, abnormal pelvic anatomy, the decreased ovarian function and the decreased endometrial receptivity. The surgery is still the main treatment of endometriosis. The pregnancy outcome after surgery is associated with the surgical time, operation method, stage and type of endometriosis. Surgery should be performed in the early stage of endometriosis as much as possible, and laparoscopic surgery is of the first choice. It is recommended that the endometriosis fertility index (EFI) score can be used to assess the fertility. Drug therapy as adjuvant therapy can not improve the patient′s fertility although it can delay recurrence. When the surgical treatment failed or there are persistent tubal factors leading to infertility, the assisted reproductive technology should be preferentially advised for those infertility women to improve timely their fertility.

Abstract:The development of ovarian follicle is a complicated process invoved in a variety of cells and multiple stages. Granulosa cell and oocyte are important cells of ovarian follicle. Folliculogenesis requires a carefully orchestrated cross talk between the oocyte and granulosa cells. With the adaption of gonadotropin and other hormones or signal molecules, granulosa cells proliferated, differentiated, exchange material and signal molecular with surrounding granulosa cells, oocytes as well as theca cells through the gap junction. Meanwhile, oocytes can also secrete factors to retract granulosa cells. The interaction between granulosa cells and oocyte involves multiple signaling pathways, which determine the follicle maturation or atresia. Cytokines generation and transmission are changed by some of the over-activated or inhibited signal pathways, which could induce apoptosis. However, the specific mechanism was unclear. This review discussed the follicular formation, the interaction between oocyte and granulosa cells and theca cells during development, as well as signaling pathways.

Abstract:Objective:To evaluate the clinical outcomes of endometrial reepithelialization between hysteroscopic scissors and resectoscope in those patients underwent transcervical rcsection of septum (TCRS).Methods:This is a randomized controlled study including 60 women with partial septate uterus,in our center from January 2015 to December 2016.Thirty cases underwent hysteroscopic metroplasty using hysteroscopic scissors (group A) and 30 cases had the procedure using the bipolar electrodes (group B).Main characteristics of the patients and operative parameters (operative time,blood loss,complications) were recorded.The hysteroscopic examination was performed after 1 and 2 months of surgery to evaluate the endometrial healing process including endometrial reepithelialization,intrauterine adhesions and residual suptum.Results:Although the operating time in the group A was significantly faster than that in the group B [(13.90±3.95) min vs.(23.13±5.15) min,P=0.00],there was no significant difference in the blood loss between the 2 groups [(8.67±2.25) mL vs.(8.83±2.15) mL,P=0.77].There were not any intraoperative complications in two groups,and intrauterine adhesion or residual septum in two months follow-up visit.The poor reepithelialization in the group A was less than that in the group B [16.67％ (5/30) vs.93.33％ (28/30),P=0.00],in the 1 month's visit.However,the endometrium reepithelialization was completely satisfied in two groups after surgery.Conclusions:The endometrial reepithelialization is faster in the scissors group than that in the resectoscope group in the first month after surgery.However,the epithelialization status can be well satisfied in two groups within 2 months.

Abstract:Ovarian reserve refers to the number and quality of follicles raised in the female ovaries,which reflects the fertility potential of women.Premature ovarian failure (POF) is one of the most important causes of infertility,which is defined as the ovarian dysfunction in women before the age of 40,accompanied by perimenopausal syndrome,infertility,low level of estrogen and high levels of gonadotropins,etc..If the ovarian reserve can be correctly evaluated in the early stage of POF,and the POF patients can be treated timely,POF can be delayed.The perimenopausal symptoms can be reduced,and the possibility of pregnancy increased.In addition,the early and accurate evaluation of ovarian reserve is essential to forecast the fertility potential and to guide the drug regimen.Recently,there is a dispute over the estimate of ovarian reserve.Most researchers believe that for the limitation of single indicator for the evaluation of ovarian reserve,the multi-indicator combination is often preferred.The article summarizes the research progress on the evaluation of ovarian reserve,which provides us a reference for the evaluation of ovarian reserve,the treatment and study of POF,and for those POF patients to get timely diagnosis and appropriate treatment.

Abstract:Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age.With the development of age,the metabolism disorders of PCOS become worse and worse.Many long-term complications of PCOS would be induced by insulin resistance and hyperandrogenism,including diabetes,metabolism syndrome,non-alcoholic fatty liver disease,cardiovascular disease,pregnancy complication,endometrial cancer and mental problem.The prevention and treatment of those long-term complications of PCOS are principally included as follows,the improvement of life style and insulin resistance,anti-inflammatory,the down-regulation of androgen,and recover of menstrual regularity.Acupuncture,a method of Chinese traditional medicine,has been tried to treat the long-term complications of PCOS in recent years,as a replacement or supplement of therapic drugs including oral contraceptives and down-androgen drugs.