Objective:To analyze the consecutive pregnancy outcomes in women with different times of tubal pregnancy (TP) history.Methods:The data of 415 patients with a history of TP≥1 times admitted in Gynecology Department of Obstetrics & Gynecology Hospital of Fudan University from January 2019 to April 2023 were retrospectively analyzed. They were divided into two groups: the first TP group ( n=359) and the second TP group ( n=56). Clinical data and consecutive pregnancy outcomes were collected and the differences of TP rate between patients treated by retaining fallopian tubes and those treated by salpingectomy were analyzed. Patients with a second TP were divided into two subgroups: ipsilateral recurrence subgroup and contralateral recurrence subgroup, and difference of TP rate between the two subgroups was assessed. Risk factors for recurrent TP were assayed by binary logistic analysis. Results:Intrauterine pregnancy rate in the first TP group was higher than that in the second TP group [66.0% (237/359) vs. 48.2% (27/56), P=0.008]. Salpingectomy resulted in significantly lower rate of intrauterine pregnancy [35.7% (35/98)] compared with treatment with methotrexate or salpingotomy or extrusion of fallopian tubes in the first TP group, 77.0% (97/126), 78.2% (93/119), 90.0% (9/10), respectively; all P<0.001]. There was no difference of intrauterine pregnancy rate among patients treated by expectant management or methotrexate or salpingectomy or salpingotomy in the second TP group (all P>0.05). There were 24 cases in the ipsilateral recurrent subgroup and 32 cases in the contralateral recurrent subgroup. The rates of recurrent intrauterine pregnancy, ipsilateral ectopic pregnancy and contralateral ectopic pregnancy were not different between the two subgroups (all P>0.05). Logistic regression analysis suggested time interval from prior TP to next pregnancy ≥36 months were positively correlated with occurrence of the second TP ( OR=5.012, 95% CI: 2.525-9.949, P<0.001). Patients concept by in vitro fertilization and embryo transfer (IVF-ET) after the first TP had higher rate of intrauterine pregnancy compared with natural conception [91.4% (53/58) vs. 61.1% (184/301), P<0.001] and IVF-ET significantly decreased the occurrence of the second TP ( OR=9.666, 95% CI: 3.303-28.287, P<0.001). Patients concepted by IVF-ET after the second TP had higher rate of intrauterine pregnancy compared with natural conception [76.5% (13/17) vs. 35.9% (14/39), P<0.001] and IVF-ET significantly decreased the occurrence of the third TP ( OR=5.987, 95% CI: 1.529-23.447, P=0.010). Conclusion:For patients who experience first-time TP, preserving the fallopian tube can help them gain the opportunity for intrauterine pregnancy. For patients with recurrent ipsilateral fallopian TP, there is currently insufficient evidence to support the benefit of removing the affected fallopian tube. Whether it is the first or the second TP, IVF-ET can help patients achieve a higher intrauterine pregnancy rate.

Objective:To analyze the consecutive pregnancy outcomes in women with different times of tubal pregnancy (TP) history.Methods:The data of 415 patients with a history of TP≥1 times admitted in Gynecology Department of Obstetrics & Gynecology Hospital of Fudan University from January 2019 to April 2023 were retrospectively analyzed. They were divided into two groups: the first TP group ( n=359) and the second TP group ( n=56). Clinical data and consecutive pregnancy outcomes were collected and the differences of TP rate between patients treated by retaining fallopian tubes and those treated by salpingectomy were analyzed. Patients with a second TP were divided into two subgroups: ipsilateral recurrence subgroup and contralateral recurrence subgroup, and difference of TP rate between the two subgroups was assessed. Risk factors for recurrent TP were assayed by binary logistic analysis. Results:Intrauterine pregnancy rate in the first TP group was higher than that in the second TP group [66.0% (237/359) vs. 48.2% (27/56), P=0.008]. Salpingectomy resulted in significantly lower rate of intrauterine pregnancy [35.7% (35/98)] compared with treatment with methotrexate or salpingotomy or extrusion of fallopian tubes in the first TP group, 77.0% (97/126), 78.2% (93/119), 90.0% (9/10), respectively; all P<0.001]. There was no difference of intrauterine pregnancy rate among patients treated by expectant management or methotrexate or salpingectomy or salpingotomy in the second TP group (all P>0.05). There were 24 cases in the ipsilateral recurrent subgroup and 32 cases in the contralateral recurrent subgroup. The rates of recurrent intrauterine pregnancy, ipsilateral ectopic pregnancy and contralateral ectopic pregnancy were not different between the two subgroups (all P>0.05). Logistic regression analysis suggested time interval from prior TP to next pregnancy ≥36 months were positively correlated with occurrence of the second TP ( OR=5.012, 95% CI: 2.525-9.949, P<0.001). Patients concept by in vitro fertilization and embryo transfer (IVF-ET) after the first TP had higher rate of intrauterine pregnancy compared with natural conception [91.4% (53/58) vs. 61.1% (184/301), P<0.001] and IVF-ET significantly decreased the occurrence of the second TP ( OR=9.666, 95% CI: 3.303-28.287, P<0.001). Patients concepted by IVF-ET after the second TP had higher rate of intrauterine pregnancy compared with natural conception [76.5% (13/17) vs. 35.9% (14/39), P<0.001] and IVF-ET significantly decreased the occurrence of the third TP ( OR=5.987, 95% CI: 1.529-23.447, P=0.010). Conclusion:For patients who experience first-time TP, preserving the fallopian tube can help them gain the opportunity for intrauterine pregnancy. For patients with recurrent ipsilateral fallopian TP, there is currently insufficient evidence to support the benefit of removing the affected fallopian tube. Whether it is the first or the second TP, IVF-ET can help patients achieve a higher intrauterine pregnancy rate.

Objective To investigate the relationship between insulin resistance and endogenous androgens at early and late phase of postmenopause.Methods A total of 105 women with early postmenopause (≤5 years since menopause) and 107 women with late postmenopause (≥ 10 years since menopause) were enrolled in this study.In the mean time,those women were classified into normal weight [body mass index (BMI),BMI ＜24 kg/m2] group and overweight (BMI≥24 kg/m2) group.Sex hormonebinding globulin (SHBG),testosterone (T),dehydroepiandrosterone-sulfate (DHEA-S),fasting blood glucose(FBG),fasting insulin (FINS)levels were measured and then calculated free androgen index(FAI) and homeostatic model assessment of insulin resistance (HOMA-IR).The relationship between sex hormones and insulin resistance was analyzed by partial correlation and multiple linear regression analyses.Results Compared to early postmenopausal women,late postmenopausal women had higher FINS [(7.9 ± 6.6) mU/L versus (6.6 ±4.0) mU/L] and HOMA-IR(2.1 ± 1.9 versus 1.7 ± 1.1),but they had lower DHEA-S [(0.9 ± 0.5) mg/L versus (1.1 ± 0.5) mg/L,all P ＜ 0.05)].Both in early postmenopausal and late postmenopausal groups,overweight women had higher HOMA-IR (early group,2.2 ± 1.0 versus 1.2 ±0.9 ; late group,2.8 ± 2.6 versus 1.6±1.1)and FINS early group[(6.9±2.9) mU/L versus (4.6±2.0) mU/L] ;late group [(10.2 ± 9.3) mU/L versus (6.4 ± 3.6) mU/L] than those at women with normal weight group(all P ＜ 0.05).In early postmenopausal group,overweight women had lower SHBG [(52 ±37) nmol/L versus (71 ±37) nmol/L] and higher FAI(2.5 ±2.1) versus (1.3 ± 1.1) than those at normal weight women group(all P ＜ 0.05).In late postmenopausal group,overweight women had higher DHEA-S (1.0 ± 0.5) mg/L versus (0.8 ± 0.4) mg/L (P ＜ 0.05).The analyses suggested that in early postmenopausal group,SHBG was correlated negatively with FINS and HOMA-IR (β =-0.386,P ＜ 0.05 ;β =-0.553,P ＜0.05),DHEA-S was correlated positively with FBG (β =0.348,P ＜ 0.05) in early postmenopausal group.FAI was correlated positively with FBG in late postmenopausal group (β =0.505,P ＜ 0.05).Conclusions The increased androgenic activities are associated with insulin resistance after of menopause.These correlations are different at different stages of postmenopause,which SHBG levels correlate with high risk of insulin resistance and DHEA-S levels correlates with high blood glucose levels at early postmenopause and FAI correlates with high blood glucose levels at late postmenopause.

To investigate different doses of daidzein (DAI) in regulating bone formation of osteoblasts, and the regulating mechanisms of estrogen receptors (ERs) and peroxisome proliferator-activated receptor γ (PPARγ) in bone formation.