Objective To compare the positive rate ofthyroid autoantibodies in infertile women with different ovarian reserve function,and investigate the immune factors of diminished ovarian reserve.Methods A cross-sectional study was conducted on infertile women admitted to Department of Reproductive Medicine of Beijing Gynaecology and Obstetrics Hospital from June to December,2020.The levels of anti-Müllerian hormone (AMH ),thyroid stimulating hormone (TSH ),thyroglobulin antibody (TGAb ) and thyroid peroxidase antibody (TPOAb)were detected in the 526 enrolled infertile patients.According to their AMH level,they were divided into normal ovarian reserve group and diminished ovarian reserve group.After they were stratified according to their age,the differences of TSH,TGAb and TPOAb levels were compared in the different age groups to analyze the related factors for diminished ovarian reserve.Results Univariate analysis showed that the diminished ovarian reserve group had significantly higher positive rates of TPOAb (18.8％ vs 11.1％,P=0.024)and TGAb (18.8％ vs 8.0％,P=0.001 )than the normal ovarian reserve group.Multivariate logistic regression analysis indicated that age and TGAb positivity were related to diminished ovarian reserve[OR=1.083(95％ CI:1.021～1.150),P=0.008;OR=1.159(95％ CI:1.034～1.301 ),P=0.011].Subgroup analysis suggested that the positive TGAb and TPOAb were significantly correlated with AMH level in the 36-～40-year-old group (P<0.05).Conclusion The infertile women with diminished ovarian reserve have higher TGAb and TPOAb levels,and the diminishment in those aged 36～40 years might be related to the positive TGAb and TPOAb.

To analyze whether the serum concentration of estradiol on the day of progesterone conversion could predict the pregnancy outcome of frozen-thawed embryo transfer in hormone replacement cycle. In this paper, a case-control study was conducted to retrospectively analyze the 230 cycles of hormone replacement therapy-frozen thawed embryo transfer(HRT-FET)conducted by the Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to December 2020. The concentration of serum estradiol was between 139.5-3 941.0 pg/ml. According to the percentile of serum estradiol concentration on the day of endometrial transformation, patients were divided into three groups: control group (<25th percentile, n=58), high estradiol group (25th-75th percentile, n=112) and ultra-high estradiol group (>75th percentile, n=60). Comparing the basic characteristics and pregnancy outcome of the three groups, the main observation index was the live birth rate, and the secondary observation index was the clinical pregnancy rate. F test and Kruskal-Wallis ( H) test were used to compare the measurement data, and χ 2 test was used to compare the counting data. The results showed that there was no significant difference in age, anti-Müllerian hormone(AMH), antral follicle count(AFC), body mass index(BMI), years of infertility and the proportion of primary infertility among the three groups( F=2.375, H=5.479, H=5.374, F=1.391, H=4.779, χ2=1.969, P>0.05). FET cycle treatment: There was no significant difference in the concentration of progesterone (P) before transformation, the thickness of endometrium on the day of transformation, the proportion of single embryo transfer and blastocyst transfer among the three groups ( H=5.359, H=5.957, χ2=0.626, χ2=4.532, P>0.05). The days of estrogen administration before endometrial transformation in the three groups during the FET cycle were 13.0 (12.0, 14.0) days in the high estradiol group and 13.0 (12.0, 15.0) days in the ultra-high estradiol group, which were significantly longer than those in the control group 13.0(12.0, 13.3)days. The E2 concentration before intimal transformation in high estradiol group was 1 560.4 (1 170.2, 1 848.2) pg/ml, while that in ultra-high estradiol group was 2 420.9 (2 131.0, 2 849.2) pg/ml, which was significantly higher than that in control group 238.8 (206.9, 287.0) pg/ml. The pregnancy outcome of the three groups: the clinical pregnancy rate of the three groups was 37.9% in the control group, 51.8% in the high estradiol group and 40.0% in the ultra-high estradiol group, of which the high estradiol group had the highest clinical pregnancy rate, followed by the ultra-high estradiol group. But there was no significant difference among the three groups (χ2=3.853, P>0.05). The embryo implantation rate of the three groups was 19.3%, 25.0%, 32.8%, respectively, and the embryo implantation rate of the ultra-high estradiol group was the highest, but there was no significant difference among the three groups (χ2=5.544, P>0.05).The live birth rate of the three groups was 37.9%, 39.3%, 40.0%, respectively, and the difference was not statistically significant (χ2=0.05, P>0.05). A total of 14(13.5%) abortions occurred in 104 clinical pregnancies, all of which occurred in the high estradiol level group. Of the 104 clinical pregnancies, 24 (23.1%) had twin pregnancies, which occurred in the high estradiol level group (10 cases) and the ultra-high estradiol level group (14 cases). There were no twin pregnancies in the control group. Ectopic pregnancy occurred in 4 of 230 FET cycles (1.7%), 2 in control group and 2 in high estradiol group, and no ectopic pregnancy in ultra-high estradiol group.

To analyze whether the serum concentration of estradiol on the day of progesterone conversion could predict the pregnancy outcome of frozen-thawed embryo transfer in hormone replacement cycle. In this paper, a case-control study was conducted to retrospectively analyze the 230 cycles of hormone replacement therapy-frozen thawed embryo transfer(HRT-FET)conducted by the Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to December 2020. The concentration of serum estradiol was between 139.5-3 941.0 pg/ml. According to the percentile of serum estradiol concentration on the day of endometrial transformation, patients were divided into three groups: control group (<25th percentile, n=58), high estradiol group (25th-75th percentile, n=112) and ultra-high estradiol group (>75th percentile, n=60). Comparing the basic characteristics and pregnancy outcome of the three groups, the main observation index was the live birth rate, and the secondary observation index was the clinical pregnancy rate. F test and Kruskal-Wallis ( H) test were used to compare the measurement data, and χ 2 test was used to compare the counting data. The results showed that there was no significant difference in age, anti-Müllerian hormone(AMH), antral follicle count(AFC), body mass index(BMI), years of infertility and the proportion of primary infertility among the three groups( F=2.375, H=5.479, H=5.374, F=1.391, H=4.779, χ2=1.969, P>0.05). FET cycle treatment: There was no significant difference in the concentration of progesterone (P) before transformation, the thickness of endometrium on the day of transformation, the proportion of single embryo transfer and blastocyst transfer among the three groups ( H=5.359, H=5.957, χ2=0.626, χ2=4.532, P>0.05). The days of estrogen administration before endometrial transformation in the three groups during the FET cycle were 13.0 (12.0, 14.0) days in the high estradiol group and 13.0 (12.0, 15.0) days in the ultra-high estradiol group, which were significantly longer than those in the control group 13.0(12.0, 13.3)days. The E2 concentration before intimal transformation in high estradiol group was 1 560.4 (1 170.2, 1 848.2) pg/ml, while that in ultra-high estradiol group was 2 420.9 (2 131.0, 2 849.2) pg/ml, which was significantly higher than that in control group 238.8 (206.9, 287.0) pg/ml. The pregnancy outcome of the three groups: the clinical pregnancy rate of the three groups was 37.9% in the control group, 51.8% in the high estradiol group and 40.0% in the ultra-high estradiol group, of which the high estradiol group had the highest clinical pregnancy rate, followed by the ultra-high estradiol group. But there was no significant difference among the three groups (χ2=3.853, P>0.05). The embryo implantation rate of the three groups was 19.3%, 25.0%, 32.8%, respectively, and the embryo implantation rate of the ultra-high estradiol group was the highest, but there was no significant difference among the three groups (χ2=5.544, P>0.05).The live birth rate of the three groups was 37.9%, 39.3%, 40.0%, respectively, and the difference was not statistically significant (χ2=0.05, P>0.05). A total of 14(13.5%) abortions occurred in 104 clinical pregnancies, all of which occurred in the high estradiol level group. Of the 104 clinical pregnancies, 24 (23.1%) had twin pregnancies, which occurred in the high estradiol level group (10 cases) and the ultra-high estradiol level group (14 cases). There were no twin pregnancies in the control group. Ectopic pregnancy occurred in 4 of 230 FET cycles (1.7%), 2 in control group and 2 in high estradiol group, and no ectopic pregnancy in ultra-high estradiol group.

Polycystic ovary syndrome (PCOS), a common clinical endocrine disorder, is the main cause of anovulatory infertility in women of childbearing age. The clinical practice guideline for ovulation induction in PCOS patients has been supported by the Society of Obstetricians and Gynaecologists of Canada (SOGC) in 2018. First line management of infertility once a diagnosis of PCOS is made should include weight loss and lifestyle modifications. Subsequently, first line medical therapy for ovulation induction should include selective estrogen receptor modulator—clomiphene citrate (CC) and aromatase inhibitor—letrozole (LE). The gonadotropins (Gn) should be considered as the second-line medical therapy, and in vitro fertilization treatment should be the third-line medical therapy. Insulin resistant patients can take the insulin sensitizer—metformin. When there are other indications for laparoscopy, laparoscopic ovarian drilling (LOD) may be considered in cases of CC or LE resistant PCOS. The clinical preventive action, that individual and progressive principles should be followed to normalize ovulation induction in PCOS patients.

Polycystic ovary syndrome (PCOS), a common clinical endocrine disorder, is the main cause of anovulatory infertility in women of childbearing age. The clinical practice guideline for ovulation induction in PCOS patients has been supported by the Society of Obstetricians and Gynaecologists of Canada (SOGC) in 2018. First line management of infertility once a diagnosis of PCOS is made should include weight loss and lifestyle modifications. Subsequently, first line medical therapy for ovulation induction should include selective estrogen receptor modulator—clomiphene citrate (CC) and aromatase inhibitor—letrozole (LE). The gonadotropins (Gn) should be considered as the second-line medical therapy, and in vitro fertilization treatment should be the third-line medical therapy. Insulin resistant patients can take the insulin sensitizer—metformin. When there are other indications for laparoscopy, laparoscopic ovarian drilling (LOD) may be considered in cases of CC or LE resistant PCOS. The clinical preventive action, that individual and progressive principles should be followed to normalize ovulation induction in PCOS patients.

Inhibin B(INHB) and anti-Müllerian hormone(AMH) detection have important clinical significance in assisted reproductive technology.INHB for evaluation of male testis function is very meaningful,playing a guiding role in the treatment of oligospermatism.INHB has very high clinical diagnosis value for evaluation of ovarian reserve function,being an important indicator to predict the effect of controlled ovarian hyperstimulation.AMH for evaluation of women ovarian function is significant,and is a diagnosis index of reproductive domain related diseases such as polycystic ovary syndrome and one of the important indices for evaluation of assisted reproductive outcomes.

Objective To explore the application of ultrasonography combined with hysteroscopy for the diagnosis of dated uterine false passage. Methods From May 2012 to May 2013, a total of 3437 cases were examined in the center by ultrasonic monitoring combined with hysteroscopic examinations.Dated uterine false passage was found in 4 cases.Under the guidance of ultrasonography, the hysteroscope was introduced into the uterine cavity.The ultrasonic probe was put at the site above the pubic symphysis for comprehensive examinations, with uterine distention fluid as reference. Results There were 2 cases of uterine anteversion and 2 cases of retroversion.There were 1 case of intracervical mouth stenosis, 1 case of intracervical mouth adhesion, and no intracervical mouth stricture or adhesion in 2 cases.The uterine false passage was located in the anterior wall in 2 cases and located in the back wall in 2 cases.The distance to serosal surface was about 3 mm at the thinnest place.The uterine false passage was 3-4 cm in depth. Conclusion Ultrasound monitoring combined with hysteroscopic examination can determine the part of the uterine endometrium line, improve the accuracy of diagnosis and treatment of intrauterine lesions.

Objective To investigate the prediction value of ultrasound endometrial pattern at the day of hCG administration on clinical outcome in patients undergoing in vitro fertilization-embryo transfer (IVF-ET).Methods 679 cycles of IVF-ET conducted between January 2011 and December 2012 in Beijing Obstetrics and Gynecology Hospital were reviewed retrospectively.All cycles were divided into three groups based on the endometrial pattern measured on the hCG day:group A (n =411) with triple line endometrium,group B (n =228) with no obvious triple line endometrium,group C (n =40) with homogeneous hyperechoic endometrium.Clinical outcomes such as implantation rate,pregnancy rate and miscarriage rate were analyzed.Results Among three groups,the implantation rates were 27.05％,20.33％,19.57％,respectively (x2 =9.04,P =0.01); the pregnancy rates were 34.31％,25.00％,12.50％,respectively (x2 =12.20,P =0.00).The implantation rate and pregnancy rate in group A were higher than the other two groups (P ＜0.05).The miscarriage rates were 16.31％,19.30％,40.00％,respectively(P ＞ 0.05),there were no significant difference among them.Conclusions The ultrasound endometrium pattern on the day of hCG administration has predictive value on clinical outcome in patients undergoing in vitro fertilization-embryo transfer.

Objective To evaluate the application of domestic probe fluorescence in situ hybridization (FISH) in prenatal diagnosis on uncultured amniocytes aneuploid. Methods One thousand three hundred and sixty-nine uncultured amniocytes (16-24 gestational weeks) from 37 hospitals in China were selected for prenatal diagnosis. 5 chromosomes (21, 13, 18, X and Y) were detected with muhicolor FISH. In the mean time, cytogenetic karyotype analysis was performed as control. Results Of all the samples, 1361 samples were successfully tested by FISH, the rate of successful detection was 99.42% (1361/1369). Thirty-five samples were shown with abnormal karyotypes by domestic FISH probe, the abnormal rate is 2. 57% (35/1361 ), including trisomy 21 (22 samples), trisomy 13 (4 samples), trisomy 18(6 samples), X0 (1 sample) and XXY (2 samples). Results of both FISH and cytogenetic karyotype analysis exhibited extreme concordance. Conclusion Domestic FISH probe used in prenatal diagnosis on uncultured aminiocytes showed the following advantages, such as highly efficient, low cost, small amounts of samples needed and reliable results.

OBJECTIVETo establish a new diagnostic method for Down's syndrome using polymerase chain reaction (PCR).

METHODSDNA extracted from five healthy individuals and five Down's syndrome patients was amplified in six specific tetranucleotide repeat loci on chromosome 21 using PCR. An accurate diagnosis was made by analyzing allelic distribution at each locus.

RESULTSAll Down's syndrome patients were identified as having at least two loci with three alleles, while none of the healthy individuals had three alleles. In addition, when two alleles were identified for a particular locus in the Down's syndrome samples, it was more likely that the intensity ratio between the two alleles was close to 2:1.

CONCLUSIONThe molecular method can provide a fast, accurate, and economical alternation for the traditional cytogenetic diagnostic method for Down's syndrome.