Objective:To investigate the pregnancy outcomes in patients ≤35 years old with diminished ovarian reserve (DOR) undergoing intrauterine insemination (IUI).Methods:A retrospective cohort study was conducted by analyzing the clinical data of 6 229 IUI cycles performed in patients aged ≤35 years at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between June 2016 and March 2024. Based on serum anti-Müllerian hormone (AMH) levels, the subjects were divided into two groups: patients with AMH <1.1 μg/L were classified as the DOR group (489 cycles), and patients with AMH ≥1.1 μg/L were classified as the normal ovarian reserve (NOR) group (5 740 cycles). Propensity score matching (PSM) was applied to control for confounding factors, after 1∶1 PSM matching, 486 cycles were included in each group. Clinical pregnancy rate, miscarriage rate, live birth rate, biochemical pregnancy rate, and ectopic pregnancy rate were compared between the two groups by generalized estimating equations.Results:The clinical pregnancy rate was 21.19% (103/486) in DOR group and 24.07% (117/486) in NOR group, with no statistically significant difference ( P=0.294). The live birth rate was 18.31% (89/486) in DOR group and 20.16% (98/486) in NOR group, also without significant difference ( P=0.469). Additionally, no significant differences were observed in miscarriage rate, biochemical pregnancy rate, or ectopic pregnancy rate between the two groups (all P>0.05). Conclusion:In patients aged ≤35 years with DOR, pregnancy outcomes from IUI are comparable to those in young patients with NOR.

Objective:To investigate the pregnancy outcomes in patients ≤35 years old with diminished ovarian reserve (DOR) undergoing intrauterine insemination (IUI).Methods:A retrospective cohort study was conducted by analyzing the clinical data of 6 229 IUI cycles performed in patients aged ≤35 years at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between June 2016 and March 2024. Based on serum anti-Müllerian hormone (AMH) levels, the subjects were divided into two groups: patients with AMH <1.1 μg/L were classified as the DOR group (489 cycles), and patients with AMH ≥1.1 μg/L were classified as the normal ovarian reserve (NOR) group (5 740 cycles). Propensity score matching (PSM) was applied to control for confounding factors, after 1∶1 PSM matching, 486 cycles were included in each group. Clinical pregnancy rate, miscarriage rate, live birth rate, biochemical pregnancy rate, and ectopic pregnancy rate were compared between the two groups by generalized estimating equations.Results:The clinical pregnancy rate was 21.19% (103/486) in DOR group and 24.07% (117/486) in NOR group, with no statistically significant difference ( P=0.294). The live birth rate was 18.31% (89/486) in DOR group and 20.16% (98/486) in NOR group, also without significant difference ( P=0.469). Additionally, no significant differences were observed in miscarriage rate, biochemical pregnancy rate, or ectopic pregnancy rate between the two groups (all P>0.05). Conclusion:In patients aged ≤35 years with DOR, pregnancy outcomes from IUI are comparable to those in young patients with NOR.

BACKGROUND:Calcium phosphate(CaP)coatings are widely used to improve the integration of titanium implants into bone but these coatings are associated with risks of infection.It is thus desirable to confer antibacterial properties to CaP coatings. OBJECTIVE:To prepare CaP-MgO composite coatings by impregnating magnesium oxide(MgO)sol into CaP coatings and assess the in vitro antibacterial activities and cytocompatibility. METHODS:An electrolyte was determined by titration and used for CaP coating electrodeposition on titanium(referred to as Ti-CaP).MgO was impregnated into the coating by immersing in an MgO sol with different mass fractions(15%,30%,50%)and subsequently calcined to form MgO-CaP composite coatings,which were recorded as Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg,respectively.Microstructure,tensile properties,critical load,and Mg2+ release of coatings in vitro were characterized.Antibacterial activity was assayed using spread plate method by culturing S.aureus on the pure titanium sheet surface and Ti-CaP,Ti-Cap-15mg,Ti-Cap-30mg and Ti-Cap-50mg surfaces for 24 and 48 hours.Mouse osteoblast suspension was inoculated on pure titanium sheets and Ti-CaP,Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg coated titanium sheets,respectively.Cell proliferation was detected by CCK-8 assay,and cell survival rate was calculated.The morphology of composite coating soaked in DMEM was also observed. RESULTS AND CONCLUSION:(1)Homogeneous,microporous CaP coatings consisting of octacaclium phosphate crystal flakes were prepared on titanium by electrodeposition.After sol impregnation-calcination,MgO aggregates were filled into the inter-flake voids.The extent of MgO filling and Mg concentration in the coating increased with the number of sol impregnation procedures.When immersed in phosphate buffered saline,all composite coatings actively released Mg2+ within 1 day;subsequently,the Mg2+ release slowed down on day 3.A small amount of Mg2+ release was still detected on day 7.The yield strength,tensile strength and fracture growth rate of Ti-CaP-30Mg coated titanium were not significantly different from those of pure titanium(P>0.05).There was no significant difference in the critical load of Ti-CaP,Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg groups(P>0.05).(2)Except that pure titanium sheet and Ti-CaP had no antibacterial properties,the other samples had good antibacterial properties,and the antibacterial rate increased with the increase of MgO content in the coating.(3)After 1 and 3 days of co-culture,the cell survival rate of Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg groups was lower than that of pure titanium group and Ti-CaP group(P<0.05).After 5 and 7 days of culture,there was no significant difference in cell survival rate among five groups(P>0.05).The content of MgO in the coating decreased gradually with the time of immersion in the medium.(4)The MgO sol impregnation added antibacterial properties to the CaP coatings while retained their biocompatibility.

Objective:To explore the impact on the fertility and outcomes of females with squamous intraepithelial lesion (SIL) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and obstetric outcomes after local treatment. Methods:Patients with SIL undergoing IVF/ICSI were set as the SIL group in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2020. While, control group was matched using the propensity scoring method in a 1∶3 ratio in accordance with the age, body mass index, and basic follicle-stimulating hormone, antral follicle count and the oocytes retrieval time. Pregnancy outcomes were compared by analyzing the basic conditions of the two groups, the index of the IVF/ICSI cycles, the clinical pregnancy rate and the implantation rate of the fresh cycles, the cumulative pregnancy rate, the cumulative live birth rate, and obstetric outcomes of patients giving live birth after local treatment were also analyzed.Results:The demographic characteristics were of no significant differences between the SIL group and control group (all P>0.05). As for the IVF/ICSI results, no significant differences were observed in the duration of gonadotropins (Gn) used, total dosage of Gn used, No. of oocytes retrieved, normal fertilization rate, No. of available embryos, No. of high-quality embryos, and No. of blastocyst formation between the two groups (all P>0.05). For fresh embryo transfer cycles, the number of transferred embryos was lower, the clinical pregnancy rate and the implantation rate in the SIL group were higher than those in control group, while the differences were not significant (all P>0.05). The differences of time to pregnancy,the cumulative pregnancy rate and the cumulative live birth rate between SIL group and control group were not statistically significant (all P>0.05). There were no statistically significant differences in delivery methods, gestational age, newborn birth weight, and incidence of pregnancy complications between the two groups (all P>0.05). According to local surgical treatment, 79 patients with SIL who achieved live birth were divided into cold knife conization subgroup, loop electrosurgical excisional procedure subgroup, and no-operation subgroup. There were no statistically significant differences in delivery methods, gestational age, newborn birth weight and incidence of pregnancy complications among the three subgroups (all P>0.05). Conclusion:SIL did not affect fertility of patients or assisted pregnancy outcomes of IVF/ICSI, and local surgical treatment does not increase the risk of preterm birth, low birth weight infants.

Objective:To explore surgical approaches to preserve fertility and assisted reproductive technology strategies for pregnancy in patients with recurrent borderline ovarian tumors.Methods:A case of recurrent borderline ovarian tumor was retrospectively analyzed. The patient was admitted several times and underwent right adnexectomy and cysts debulking in the left ovary for recurrent borderline tumors. The patient was infertile for 3 years without contraception. Considering the patient's strong desire for childbearing, ovulation treatment was performed with a microstimulation protocol. The left ovarian tumor enlarged significantly during the process of assisted reproductive technology for pregnancy assistance, left oophorectomy was carried by laparoscopic and healthy ovarian cortex was frozen to preserve fertility.Results:The patient underwent 5 times of controlled ovulation cycles, acquired 7 available embryos. The patient had a successful pregnancy and delivered a live baby on the third frozen embryo cycle transfer. The patient still had 2 embryos and 3 pieces of ovarian tissue frozen.Conclusion:Patients with borderline ovarian tumors who are young and have fertility needs can undergo fertility preserving surgery and assisted reproductive technology to help them get pregnant, which may lead to a higher risk of disease recurrence to a certain extent, but it does not affect the quality of patients' survival and allows the patient to achieve her fertility aspirations.

Objective:To explore the impact on the fertility and outcomes of females with squamous intraepithelial lesion (SIL) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and obstetric outcomes after local treatment. Methods:Patients with SIL undergoing IVF/ICSI were set as the SIL group in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2020. While, control group was matched using the propensity scoring method in a 1∶3 ratio in accordance with the age, body mass index, and basic follicle-stimulating hormone, antral follicle count and the oocytes retrieval time. Pregnancy outcomes were compared by analyzing the basic conditions of the two groups, the index of the IVF/ICSI cycles, the clinical pregnancy rate and the implantation rate of the fresh cycles, the cumulative pregnancy rate, the cumulative live birth rate, and obstetric outcomes of patients giving live birth after local treatment were also analyzed.Results:The demographic characteristics were of no significant differences between the SIL group and control group (all P>0.05). As for the IVF/ICSI results, no significant differences were observed in the duration of gonadotropins (Gn) used, total dosage of Gn used, No. of oocytes retrieved, normal fertilization rate, No. of available embryos, No. of high-quality embryos, and No. of blastocyst formation between the two groups (all P>0.05). For fresh embryo transfer cycles, the number of transferred embryos was lower, the clinical pregnancy rate and the implantation rate in the SIL group were higher than those in control group, while the differences were not significant (all P>0.05). The differences of time to pregnancy,the cumulative pregnancy rate and the cumulative live birth rate between SIL group and control group were not statistically significant (all P>0.05). There were no statistically significant differences in delivery methods, gestational age, newborn birth weight, and incidence of pregnancy complications between the two groups (all P>0.05). According to local surgical treatment, 79 patients with SIL who achieved live birth were divided into cold knife conization subgroup, loop electrosurgical excisional procedure subgroup, and no-operation subgroup. There were no statistically significant differences in delivery methods, gestational age, newborn birth weight and incidence of pregnancy complications among the three subgroups (all P>0.05). Conclusion:SIL did not affect fertility of patients or assisted pregnancy outcomes of IVF/ICSI, and local surgical treatment does not increase the risk of preterm birth, low birth weight infants.

Objective:To explore surgical approaches to preserve fertility and assisted reproductive technology strategies for pregnancy in patients with recurrent borderline ovarian tumors.Methods:A case of recurrent borderline ovarian tumor was retrospectively analyzed. The patient was admitted several times and underwent right adnexectomy and cysts debulking in the left ovary for recurrent borderline tumors. The patient was infertile for 3 years without contraception. Considering the patient's strong desire for childbearing, ovulation treatment was performed with a microstimulation protocol. The left ovarian tumor enlarged significantly during the process of assisted reproductive technology for pregnancy assistance, left oophorectomy was carried by laparoscopic and healthy ovarian cortex was frozen to preserve fertility.Results:The patient underwent 5 times of controlled ovulation cycles, acquired 7 available embryos. The patient had a successful pregnancy and delivered a live baby on the third frozen embryo cycle transfer. The patient still had 2 embryos and 3 pieces of ovarian tissue frozen.Conclusion:Patients with borderline ovarian tumors who are young and have fertility needs can undergo fertility preserving surgery and assisted reproductive technology to help them get pregnant, which may lead to a higher risk of disease recurrence to a certain extent, but it does not affect the quality of patients' survival and allows the patient to achieve her fertility aspirations.