Objective:To investigate the effect of low dosage of human chorionic gonadotropin (hCG) replacing human menopausal gonadotropin (hMG) in the late follicular stage during progestin-primed ovarian stimulation (PPOS) on the outcome of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) for polycystic ovary syndrome (PCOS) patients. Methods:The patients with PCOS who underwent IVF/ICSI-frozen-thawed embryo transfer (FET) treatment in the Department of Assisted Reproduction of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2015 to December 2017 were retrospectively analyzed. Ovarian stimulation adopted PPOS. According to whether low dosage of hCG was used to replace hMG in the late follicular stage of PPOS, they were divided into two groups: group A, PPOS routine group (hMG + progesterone), complete application of hMG (141 cycles); group B, hMG/hCG+progesterone, low dosage of hCG (200 IU/d) was used to completely replace hMG in the late follicular stage of PPOS (80 cycles). The clinical data and pregnancy related indexes of the two groups were compared. The main outcome measures included the number of oocytes retrieved, the number of available embryos and clinical pregnancy rate.Results:There was no significant difference in the duration of ovarian stimulation between group A and group B [(9.7±2.6) d vs. (10.3±3.4) d, P=0.16]. The duration of hMG administration [(7.8±3.5) d] and the dosage of hMG [(1 592.8±840.5) IU] in group B were significantly lower than those in group A [(9.7±2.6) d, P=0.01; (1 825.2±795.3) IU, P=0.04]. There were no significant differences in the number of oocytes retrieved (17.3±8.9 vs.17.8±8.8) and the number of available embryos (6.2±4.1 vs. 6.0±3.2) between the two groups ( P>0.05). In the subsequent FET cycle, the clinical pregnancy rate [52.8% (105/199) vs. 49.2% (60/122)], the embryo implantation rate [37.1% (139/375) vs. 37.1% (86/232)], the early abortion rate [4.8% (5/105) vs. 5.0% (3/60)] and the ongoing pregnancy rate [47.7% (95/199) vs. 44.3% (54/122)] were not statistically different between group A and group B. Conclusion:The use of low dosage of hCG instead of hMG in the late follicular stage of PPOS in patients with PCOS, which can safely and effectively maintain follicular growth and development, without affecting the outcome of IVF/ICSI-FET for PCOS patients.

Objective:To investigate the effect of low dosage of human chorionic gonadotropin (hCG) replacing human menopausal gonadotropin (hMG) in the late follicular stage during progestin-primed ovarian stimulation (PPOS) on the outcome of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) for polycystic ovary syndrome (PCOS) patients. Methods:The patients with PCOS who underwent IVF/ICSI-frozen-thawed embryo transfer (FET) treatment in the Department of Assisted Reproduction of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2015 to December 2017 were retrospectively analyzed. Ovarian stimulation adopted PPOS. According to whether low dosage of hCG was used to replace hMG in the late follicular stage of PPOS, they were divided into two groups: group A, PPOS routine group (hMG + progesterone), complete application of hMG (141 cycles); group B, hMG/hCG+progesterone, low dosage of hCG (200 IU/d) was used to completely replace hMG in the late follicular stage of PPOS (80 cycles). The clinical data and pregnancy related indexes of the two groups were compared. The main outcome measures included the number of oocytes retrieved, the number of available embryos and clinical pregnancy rate.Results:There was no significant difference in the duration of ovarian stimulation between group A and group B [(9.7±2.6) d vs. (10.3±3.4) d, P=0.16]. The duration of hMG administration [(7.8±3.5) d] and the dosage of hMG [(1 592.8±840.5) IU] in group B were significantly lower than those in group A [(9.7±2.6) d, P=0.01; (1 825.2±795.3) IU, P=0.04]. There were no significant differences in the number of oocytes retrieved (17.3±8.9 vs.17.8±8.8) and the number of available embryos (6.2±4.1 vs. 6.0±3.2) between the two groups ( P>0.05). In the subsequent FET cycle, the clinical pregnancy rate [52.8% (105/199) vs. 49.2% (60/122)], the embryo implantation rate [37.1% (139/375) vs. 37.1% (86/232)], the early abortion rate [4.8% (5/105) vs. 5.0% (3/60)] and the ongoing pregnancy rate [47.7% (95/199) vs. 44.3% (54/122)] were not statistically different between group A and group B. Conclusion:The use of low dosage of hCG instead of hMG in the late follicular stage of PPOS in patients with PCOS, which can safely and effectively maintain follicular growth and development, without affecting the outcome of IVF/ICSI-FET for PCOS patients.

[Objective]To evaluate the role of mature cumulus cells from oocyte-cumulus complex(OCC)in in-vitro maturation(IVM)and establish a new culture technique which is convenient to carry out.[Methods]The cumulus cells of OCC were cut off and dispersed by 1 mL syringe.The cumulus cells were co-cultured with the immature oocytes retrieved from the COH cycles after they adherent to the bottom of the dish.The immature oocytes were experienced IVM procedures in different culture media.They were divided into 3 groups(the oocytes at germinal vesicle stage from one woman were allotted to the same group randomly).Group 1(solution A):basic culture medium+human follicular fluid(hFF);Group 2(solution B):solution A+ cumulus cells(OCC);Group 3(solution C):solution A+ OCC+ follicle stimulating hormone(FSH)+ epidermal growth factor (EGF).Then,the maturation rate,fertilization rate and formation rate of available embryo were observed.[Results]In 113 treatment cycles,298 immature oocytes were performed IVM with solution A,B,and C.The difference for 24 hour maturation rates among 3 groups wag statistically significant(A:45.2%,B:61.7%,C:78.2%,P＜0.05).There was no statistical difference for 25～48 hour maturation rates and normal fertilization rates of mature oocytes.The differences of cleavage rates and rescued embryo rates between group 1 and 2,group 1 and 3 were statistically significant(P＜0.05).The formation rates of available embryo showed an increasing trend from group 1,2,to 3.[Conclusion]After being dispersed by simply beat upon with syringe and adherent culture,the mature cumulus eells from mature OCCs in COH cycles,together with growth factors in the follicular fluid or extraneously supplemented,could promote the IVM of immature oocyte.

Objective To explore the effectiveness of the fallopian tubes embolization for the hydrosalpinx before in vitro fertilization and embryo transfer(IVF-ET).Methods The fallopian tubes embolization was performed on 46 hydrosalpinx patients-Fimt the hysterosalpingography was performed to show the positions and shape of the hydrosalpinx.Then the hydrops was drawn into the celiac cavity in order to be absorbed after performing fallopian tube recanalization. Finally,transv(o)ihal therapy was performed,putting the embolization microcoils into the fallopian tube through a micro-catheter.One month after the fallopian tubes embolization,hystemsalpingography was conducted to check for the effectiveness of the embolization.After 3 months.all the 46 patients received the treatment of IVF-ET,Results The interventional treatment of 82 fallopian tubes obtained one time success among 46 cases of fallopian tubes embolization.Among them,obvious results were achieved in 72 fallopian tubes,taking up 88%0f tIle total;effective results were seen in 10 fallopian tubes.accounting for 12%0f the total.No one was invalid.In the same period,compared with the 91 cases of non-hydrosalpinx as the control group.the embolization group of patients achieved a higher fertilization rate(69%),and clinical pregnancy rate(41%),compared with the control group(63%and 39%respectively),but without a significant difference(P>0.05).However,the ectopic pregnancy rate(O)and the abortion rate(8%)were significantly lower than the control group(8%,16%respectively;P<0.05).Conclusions Fallopian tubes embolization used in hydrosalpinx treatment before IVF-ET is an innovative approach,simple,safe,economical,with no negative impact on ovarian functiorr It can significantly increase the clinical pregnancy rate and prevent the occurrence of tubal pregnancy.It is a feasible and effective method.