This study aimed to explore the outcomes of progestin-primed ovarian stimulation protocol （PPOS） in aged infertile women who failed to get pregnant in the first IVF/ICSI-ET cycles with GnRH-a long protocol. A self-c...This study aimed to explore the outcomes of progestin-primed ovarian stimulation protocol （PPOS） in aged infertile women who failed to get pregnant in the first IVF/ICSI-ET cycles with GnRH-a long protocol. A self-controlled study was conducted to retrospectively investigate the clinical outcomes of 104 aged infertile patients who didn＇t get pregnant in the first IVF/ICSI-ET treatment by stimulating with GnRH-a long protocol （non-PPOS group）, and underwent PPOS protocol （PPOS group） in the second cycle between January 2016 and December 2016 in the Center for Reproductive Medicine, Renmin Hospital of Wuhan University. The primary outcomes included clinical pregnancy rate of frozen-thawed embryos transfer （FET） in PPOS group, and good-quality embryo rate in both groups. The secondary outcomes were fertilization rate, egg utilization rate and cycle cancellation rate. The results showed that there were no significant differences in basal follicle stimulating hormone （bFSH）, antral follicle count （AFC）, duration and total dosage of gonadotropin （Gn）, number of oocytes retrieved, intracytoplasmic sperm injection （ICSI） rate, fertilization rate, and cycle cancellation rate between the two groups （P〉0.05）. However, the oocyte utilization rate and good-quality embryo rate in PPOS group were significantly higher than those in non-PPOS group （P〈0.05）. By the end of April 2017, 62 FET cycles were conducted in PPOS group. The clinical pregnancy rate and embryo implantation rate were 22.58% and 12.70%, respectively. In conclusion, PPOS protocol may provide better clinical outcomes by improving the oocyte utilization rate and good-quality embryo rate for aged infertile patients who failed to get pregnant in the first IVF/ ICSI-ET cycles.展开更多
The specific bindings of estrogen,progestin and androgen were determined inthe cytosol fraction of myomatous,adenomyotic and postmenopausal uterine tissues andof the normal endometrium and myometrium as well.It was fo...The specific bindings of estrogen,progestin and androgen were determined inthe cytosol fraction of myomatous,adenomyotic and postmenopausal uterine tissues andof the normal endometrium and myometrium as well.It was found that theconcentrations of estrogen,progestin and androgen cytosol receptors were significantlyhigher in myomatous tissue than in normal myometrium;there was also an obvious differ-ence of the concentration of the sex steroid receptors between normal endometrium andadenomyotic tissue;and the uterine tissues of postmenopausal women still retained highlevels of these sex steroid receptors.In addition,the regulation of sex steroids in thepathogenesis of myoma and adenomyosis is discussed.展开更多
Estrogens and artificial progestins used in hormone replacement therapy increase breast cancer risk. This seems to bedue to a promoting and not initiating effect. A synergic effect of estradiol and hyperinsulinism has...Estrogens and artificial progestins used in hormone replacement therapy increase breast cancer risk. This seems to bedue to a promoting and not initiating effect. A synergic effect of estradiol and hyperinsulinism has been shown. Insulinplays a role in the increase of breast cancer risk when associated with android obesity, sedentariness, type II diabetes,and high glycemic index food, alcohol and trans fatty acids intake. Natural menopause induces insulin resistance anddoes not induce a risk decrease. The role of insulin gives a new outlook on the influence of HRT in breast cancer promotion:estradiol alone, which improves insulin-sensitivity, does not increase breast cancer risk. Artificial progestinsassociated with estrogens increase the risk, whereas estrogens associated with progesterone do not. This could be dueto the fact that artificial progestins increase insulin resistance, whereas natural progesterone does not. Adipose tissue,which is an endocrine gland, is insulin dependant. Breast cancer and its seriousness are correlated to adipocytokincirculating levels such as resistin, leptin, interleukin 1, adipocyte fatty acid-binding protein, and are inversely correlatedto the level of adiponectin. Insulin could play a synergic role with sexual steroids by a direct effect and by increasingadipose tissue secretions.展开更多
The incidence of endometrial cancer(EC)has been on the rise,with a notable increase observed in younger female population.Approximately 80%of EC patients are associated with endometrial hyperplasia,a condition charact...The incidence of endometrial cancer(EC)has been on the rise,with a notable increase observed in younger female population.Approximately 80%of EC patients are associated with endometrial hyperplasia,a condition characterized by excessive stimulation from unopposed estrogen.Progestin,as the antagonist of estrogen,is recommended for patients with fertility conservation requirements.However,some patients may exhibit insensitivity to progestin treatment,and those with comorbidities such as obesity and diabetes may experience suboptimal therapeutic effects.To improve the efficacy of progestin treatment and address the fertility needs of patients,it is imperative to elucidate the underlying mechanisms of progestin insensitivity in EC.In this review,we explore the role of progestin in EC and its clinical effectiveness.We discuss the factors contributing to progestin insensitivity,highlight recent advancements in research aimed at enhancing treatment sensitivity,and propose potential avenues for future investigation.展开更多
基金This work was supported by the National Natural Science Foundation of China （No.1471456）, and Guidance Foundation of Renmin Hospital of Wuhan University （No. RMYD2018Z13）.
文摘This study aimed to explore the outcomes of progestin-primed ovarian stimulation protocol （PPOS） in aged infertile women who failed to get pregnant in the first IVF/ICSI-ET cycles with GnRH-a long protocol. A self-controlled study was conducted to retrospectively investigate the clinical outcomes of 104 aged infertile patients who didn＇t get pregnant in the first IVF/ICSI-ET treatment by stimulating with GnRH-a long protocol （non-PPOS group）, and underwent PPOS protocol （PPOS group） in the second cycle between January 2016 and December 2016 in the Center for Reproductive Medicine, Renmin Hospital of Wuhan University. The primary outcomes included clinical pregnancy rate of frozen-thawed embryos transfer （FET） in PPOS group, and good-quality embryo rate in both groups. The secondary outcomes were fertilization rate, egg utilization rate and cycle cancellation rate. The results showed that there were no significant differences in basal follicle stimulating hormone （bFSH）, antral follicle count （AFC）, duration and total dosage of gonadotropin （Gn）, number of oocytes retrieved, intracytoplasmic sperm injection （ICSI） rate, fertilization rate, and cycle cancellation rate between the two groups （P〉0.05）. However, the oocyte utilization rate and good-quality embryo rate in PPOS group were significantly higher than those in non-PPOS group （P〈0.05）. By the end of April 2017, 62 FET cycles were conducted in PPOS group. The clinical pregnancy rate and embryo implantation rate were 22.58% and 12.70%, respectively. In conclusion, PPOS protocol may provide better clinical outcomes by improving the oocyte utilization rate and good-quality embryo rate for aged infertile patients who failed to get pregnant in the first IVF/ ICSI-ET cycles.
文摘The specific bindings of estrogen,progestin and androgen were determined inthe cytosol fraction of myomatous,adenomyotic and postmenopausal uterine tissues andof the normal endometrium and myometrium as well.It was found that theconcentrations of estrogen,progestin and androgen cytosol receptors were significantlyhigher in myomatous tissue than in normal myometrium;there was also an obvious differ-ence of the concentration of the sex steroid receptors between normal endometrium andadenomyotic tissue;and the uterine tissues of postmenopausal women still retained highlevels of these sex steroid receptors.In addition,the regulation of sex steroids in thepathogenesis of myoma and adenomyosis is discussed.
文摘Estrogens and artificial progestins used in hormone replacement therapy increase breast cancer risk. This seems to bedue to a promoting and not initiating effect. A synergic effect of estradiol and hyperinsulinism has been shown. Insulinplays a role in the increase of breast cancer risk when associated with android obesity, sedentariness, type II diabetes,and high glycemic index food, alcohol and trans fatty acids intake. Natural menopause induces insulin resistance anddoes not induce a risk decrease. The role of insulin gives a new outlook on the influence of HRT in breast cancer promotion:estradiol alone, which improves insulin-sensitivity, does not increase breast cancer risk. Artificial progestinsassociated with estrogens increase the risk, whereas estrogens associated with progesterone do not. This could be dueto the fact that artificial progestins increase insulin resistance, whereas natural progesterone does not. Adipose tissue,which is an endocrine gland, is insulin dependant. Breast cancer and its seriousness are correlated to adipocytokincirculating levels such as resistin, leptin, interleukin 1, adipocyte fatty acid-binding protein, and are inversely correlatedto the level of adiponectin. Insulin could play a synergic role with sexual steroids by a direct effect and by increasingadipose tissue secretions.
基金supported by the National Key Technology Research and Developmental Program of China(2022YFC2704400 and 2022YFC2704402)National Natural Science Foundation Key Program(82230050).
文摘The incidence of endometrial cancer(EC)has been on the rise,with a notable increase observed in younger female population.Approximately 80%of EC patients are associated with endometrial hyperplasia,a condition characterized by excessive stimulation from unopposed estrogen.Progestin,as the antagonist of estrogen,is recommended for patients with fertility conservation requirements.However,some patients may exhibit insensitivity to progestin treatment,and those with comorbidities such as obesity and diabetes may experience suboptimal therapeutic effects.To improve the efficacy of progestin treatment and address the fertility needs of patients,it is imperative to elucidate the underlying mechanisms of progestin insensitivity in EC.In this review,we explore the role of progestin in EC and its clinical effectiveness.We discuss the factors contributing to progestin insensitivity,highlight recent advancements in research aimed at enhancing treatment sensitivity,and propose potential avenues for future investigation.
