Objective:To explore the reasons for delayed medical treatment in patients with polycystic ovary syndrome (PCOS) using the treatment pathway theory as a framework, and to propose corresponding strategies to guide timely medical care for PCOS patients.Methods:Purposeful sampling was used to select 14 PCOS patients who sought treatment at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between November 2022 and May 2023. Semi-structured interviews were conducted, and directed content analysis was applied to analyze and extract data.Results:The delay in seeking medical treatment for PCOS patients ranged from five to 60 months. Four main themes and 11 sub-themes were identified as reasons for treatment delays: misconception and delayed recognition of the disease (misunderstanding of symptoms, intermittent symptom presentation) ; delayed seeking of medical help (mismanagement of symptoms, feelings of shame, role conflict, distance and financial constraints, lack of social support) ; delayed diagnosis by healthcare providers (misdiagnosis by healthcare providers, lack of medical resources and services) ; and delayed participation in treatment (lack of health education from medical staff, no immediate fertility needs) .Conclusions:Delays in seeking medical care for PCOS patients are common. Efforts should be made to enhance public education on PCOS for adolescent and reproductive-age women, emphasize the management of the disease in patients without immediate fertility needs, improve primary healthcare institutions' capacity for managing PCOS, and mobilize the social support system to encourage patients to seek medical treatment early, thus reducing the occurrence of delayed medical care.

Objective To develop a health-promoting lifestyle scale for women with polycystic ovary syndrome(PCOS),and to test its reliability and validity,and preliminarily apply it.Methods Based on the Pender health promotion model,the item pool of the scale was constructed through literature research,semi-structured interviews and group discussions.After 2 rounds of Delphi expert consultation and pre-survey,the initial scale was formed.From April to July 2022,316 patients with PCOS in the health management center,reproductive medicine center and endocrinology department of a tertiary hospital in Nanjing were selected for item analysis,exploratory factor analysis and reliability test,respectively.From August to October 2022,358 PCOS patients were selected for confirmatory factor analysis.From November 2022 to February 2013,294 PCOS patients were selected,and the scale was used to investigate the status of health-promoting lifestyle in PCOS patients.Results The health-promoting lifestyle scale for PCOS patients included 5 dimensions and 33 items.The total content validity index of the scale was 0.942,and the content validity index of each item was 0.810-1.000.5 common factors were extracted by 2 exploratory factor analyses,and the cumulative variance contribution rate was 62.399％.Confirmatory factor analysis showed that the model fit was good.The Cronbach's a coefficient of the total scale was 0.930;the split-half reliability was 0.842;the test-retest reliability was 0.888.The preliminary application results showed that the total score of health-promoting lifestyle in PCOS patients was(96.925±14.273),and the average score of items was(2.937±0.433),which was at a medium level.Conclusion The health-promoting lifestyle scale for PCOS patients has good reliability and validity,which can be used as a tool for medical staff to assess the level of health-promoting lifestyle of PCOS patients,and can help nurses to quickly identify the level and dimensions of health-promoting lifestyle of patients,so as to formulate individualized precise health management plans.

Objective:To construct the admission criteria and job responsibility scheme for polycystic ovary syndrome (PCOS) case managers.Methods:The first draft of the scheme was constructed through literature research, pre-consultation and group discussion. From February to April 2022, the convenient sampling method was used to select 18 experts for two rounds of Delphi expert letter consultation. Analytic hierarchy process was used to determine the weight of each indicator.Results:The effective response rates of the questionnaire for two rounds of expert inquiries were 94.74% (18/19) and 100.00% (18/18), respectively. The expert authority coefficients were 0.892 and 0.897, respectively. After two rounds of expert consultation, the Kendall's W of the first, second, and third level indexes for the admission criteria and job responsibilities of PCOS case managers were 0.361, 0.306, 0.283 and 0.250, 0.134, 0.142 ( P<0.05), respectively. The final admission criteria for PCOS case managers included 3 first level indicators, 8 second level indicators and 30 third level indicators. Their job responsibilities included 5 first level indicators, 13 second level indicators and 46 third level indicators. Conclusions:The admission standards and job responsibility scheme for PCOS case managers systematically and comprehensively reflect the characteristics of disease management for PCOS patients in China, which are reliable and scientific, and provide reference value for the screening and work practice of PCOS case managers.

Objective:To explore the current status and influencing factors of exercise intention in patients with polycystic ovary syndrome (PCOS) .Methods:From March to July 2022, 174 PCOS patients admitted to the Health Management Center of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected as the study subject by convenience sampling. A survey was conducted using the General Information Questionnaire, Exercise Intention Scale, Exercise Self-efficacy Scale and the Exercise Social Support Scale.Results:The Exercise Intention Scale score of 174 PCOS patients was 15.00 (13.00, 18.00). The results of multiple linear regression analysis showed that education level, PCOS related disease visits, exercise self-efficacy, exercise social support, and exercise self-identification were the influencing factors of exercise intention in PCOS patients, and the difference was statistically significant ( P<0.05), which could explain 42.4% of the total variation. Conclusions:The subjective intention of patients with polycystic ovary syndrome to participate in exercise needs further improvement. Medical and nursing staff should focus on patients with polycystic ovary syndrome who have low levels of education and fewer visits, and focus on enhancing their self-efficacy and self-identification in exercise. At the same time, medical and nursing staff should actively mobilize social support systems to promote their subjective intention to exercise at a high level.

Objective:To construct a lifestyle management scheme for infertile patients with polycystic ovary syndrome (PCOS) during pregnancy preparation, so as to provide reference for clinical practice.Methods:Based on the summary of evidence in the early stage of the team, the first draft of the scheme was preliminarly drawn up with reference to the dietary guidelines for pregnant women. Finally, the lifestyle management scheme was determined through two rounds of Delphi expert correspondence.Results:The effective recovery rate of the two rounds of expert correspondence questionnaire was 100%, the expert authority coefficients were 0.88 and 0.90, respectively, and the Kendall coordination coefficients were 0.18 and 0.22, respectively. The significance test was P<0.001. Finally, a lifestyle management scheme including 8 first level items, 25 second level items and 81 third level items was formed. Conclusion:The lifestyle management scheme of PCOS infertile patients during pregnancy preparation based on evidence-based and expert correspondence is scientific and practical, which can provide objective and specific implementation strategies for clinical practice.

Objective:To construct a lifestyle management scheme for infertile patients with polycystic ovary syndrome (PCOS) during pregnancy preparation, so as to provide reference for clinical practice.Methods:Based on the summary of evidence in the early stage of the team, the first draft of the scheme was preliminarly drawn up with reference to the dietary guidelines for pregnant women. Finally, the lifestyle management scheme was determined through two rounds of Delphi expert correspondence.Results:The effective recovery rate of the two rounds of expert correspondence questionnaire was 100%, the expert authority coefficients were 0.88 and 0.90, respectively, and the Kendall coordination coefficients were 0.18 and 0.22, respectively. The significance test was P<0.001. Finally, a lifestyle management scheme including 8 first level items, 25 second level items and 81 third level items was formed. Conclusion:The lifestyle management scheme of PCOS infertile patients during pregnancy preparation based on evidence-based and expert correspondence is scientific and practical, which can provide objective and specific implementation strategies for clinical practice.

Objective:To systematically review the qualitative studies on the experience of lifestyle improvement in patients with polycystic ovary syndrome (PCOS) , so as to provide a basis for formulating operable lifestyle management measures.Methods:PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Scopus, Science Direct, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, VIP and other Chinese and English databases were searched by computer. Qualitative studies on the experience of lifestyle improvement in PCOS patients were searched from January 1, 2016 to November 30, 2021. According to the Joanna Briggs Institute (JBI) Evidence-based Health Care Center Qualitative Research Quality Assessment Criteria (2016 edition) , the pooled integration method was used to integrate the research results.Results:A total of 9 studies were included, 58 clear study results were extracted, similar study results were summarized into 13 new categories and 3 integrated results were synthesized including, including the motivation of PCOS patients to improve their lifestyle, the perceived obstacles of PCOS patients to improve their lifestyle and the reasons for PCOS patients to gradually adapt to the improvement of their lifestyle.Conclusions:Medical staff should promote the internal drive of health management based on the motivation of lifestyle improvement of PCOS patients, help PCOS patients overcome obstacles in lifestyle improvement with the help of mobile applications and provide comprehensive and systematic support for patients through the multi-linkage of medical institutions, family and society. At the same time, a multidisciplinary management team is formed to jointly participate in the improvement of patients' individualized lifestyle to improve their health-promoting lifestyle level.

Objective:To investigate the effect of different assisted reproductive technologies (ART) and transplanted embryos at different developmental stages on live birth sex ratio in frozen-thawed embryo transfer (FET) cycles.Methods:From April 2010 to October 2018, the clinical data of patients and neonatal underwent in vitro fertilization-frozen-thawed embryo transfer (IVF-FET), intracytoplasmic sperm injection-frozen-thawed embryo transfer (ICSI-FET) and preimplantation genetic testing-frozen-thawed embryo transfer (PGT-FET) cycles that led to birth in the Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center were retrospectively analyzed. The relationship of the sex ratio of the live births to different ART and transplanted embryos at different developmental stages was studied. Results:1) IVF-FET cycles included 898 couples (920 FET cycles) and 1166 babies, with a general sex ratio of 106.7. The live birth sex ratio increased gradually at pre-morula stage, morula stage and blastocyst stage embryo transfer (99.0, 135.4, 142.6), but no statistical difference was observed between the groups ( P>0.05). 2) ICSI-FET cycles included 415 couples (433 FET cycles) and 555 babies, with a general live birth sex ratio of 111.0. After the transfer of embyos at different stages the proportion of male babies displayed no significant difference ( P>0.05). 3) PGT-FET cycles included 33 couples (33 FET cycles) and 33 babies, with a general live birth sex ratio of 153.8. Transplantation of blastocysts in IVF, ICSI or PGT had no significant effect on the proportion of male babies ( P>0.05). Conclusion:In FET cycles, compared with embryo transfer at early stage, late stage embryo transfer may be associated with a higher live birth sex ratio. The transfer of ICSI-FET embryos at different developmental stages and the transfer of blastocysts by IVF, ICSI or PGT technique did not affect the sex ratio of live birth.

Objective:To investigate the effect of different assisted reproductive technologies (ART) and transplanted embryos at different developmental stages on live birth sex ratio in frozen-thawed embryo transfer (FET) cycles.Methods:From April 2010 to October 2018, the clinical data of patients and neonatal underwent in vitro fertilization-frozen-thawed embryo transfer (IVF-FET), intracytoplasmic sperm injection-frozen-thawed embryo transfer (ICSI-FET) and preimplantation genetic testing-frozen-thawed embryo transfer (PGT-FET) cycles that led to birth in the Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center were retrospectively analyzed. The relationship of the sex ratio of the live births to different ART and transplanted embryos at different developmental stages was studied. Results:1) IVF-FET cycles included 898 couples (920 FET cycles) and 1166 babies, with a general sex ratio of 106.7. The live birth sex ratio increased gradually at pre-morula stage, morula stage and blastocyst stage embryo transfer (99.0, 135.4, 142.6), but no statistical difference was observed between the groups ( P>0.05). 2) ICSI-FET cycles included 415 couples (433 FET cycles) and 555 babies, with a general live birth sex ratio of 111.0. After the transfer of embyos at different stages the proportion of male babies displayed no significant difference ( P>0.05). 3) PGT-FET cycles included 33 couples (33 FET cycles) and 33 babies, with a general live birth sex ratio of 153.8. Transplantation of blastocysts in IVF, ICSI or PGT had no significant effect on the proportion of male babies ( P>0.05). Conclusion:In FET cycles, compared with embryo transfer at early stage, late stage embryo transfer may be associated with a higher live birth sex ratio. The transfer of ICSI-FET embryos at different developmental stages and the transfer of blastocysts by IVF, ICSI or PGT technique did not affect the sex ratio of live birth.

One of the great challenges in assisted reproduction today is the management of cases with poor-quality oocytes. Ooplasmic transfer (OT) has been used with the aim of augmenting embryo viability in patients with multiple implantation failures, usually associated with developmentally compromised oocytes. The justification for the technique was that the ooplasm from the donor contained beneficial components lacking in the recipient's oocytes, and that the transfer of these components to the recipient's oocytes would result in normal growth and viability. This review focuses on concerns regarding its use in assisted reproduction, like mitochondrial functioning, mitochondrial DNA heteroplasmy, regulation of apoptosis, cleavage division, epigenetic modifications, oocyte contents and mRNA which are the factors affecting oocytes due to mixing of two entities. The applications, efficacy and adverse effects of OT techniques in human are summarized.