Polycystic ovary syndrome (PCOS) is one of the most common gynaecological endocrine diseases in women and the main cause of anovulatory infertility. Compared with women with normal ovulation, PCOS patients are more likely to face ovarian hyperstimulation syndrome, poor-quality of oocyte and fertilization failure in assisted reproduction treatment, so ovulation induction in PCOS patients has attracted much attention in the reproductive field. Progestin-primed ovarian stimulation (PPOS) protocol uses exogenous progesterone effectively to block luteinizing hormone surge to achieve ideal number of retrieved oocytes, embryo quality and pregnancy outcomes. This article reviews the mechanism, clinical application and development of PPOS protocol in PCOS patients.

Polycystic ovary syndrome (PCOS) is one of the most common gynaecological endocrine diseases in women and the main cause of anovulatory infertility. Compared with women with normal ovulation, PCOS patients are more likely to face ovarian hyperstimulation syndrome, poor-quality of oocyte and fertilization failure in assisted reproduction treatment, so ovulation induction in PCOS patients has attracted much attention in the reproductive field. Progestin-primed ovarian stimulation (PPOS) protocol uses exogenous progesterone effectively to block luteinizing hormone surge to achieve ideal number of retrieved oocytes, embryo quality and pregnancy outcomes. This article reviews the mechanism, clinical application and development of PPOS protocol in PCOS patients.

Objective: To elucidate clinical characteristics and build a prognostic nomogram for patients with vulvar cancer. Methods: The study population was drawn from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly assigned to training and validation sets. Cox proportional hazards model and competing risk model were used to identify the prognostic parameters of overall survival (OS) and cancer-specific survival (CSS) to construct a nomogram. The nomogram was assessed by concordance index (C-index), area under the curve (AUC), calibration plot, and decision curve analysis (DCA). Results: A total of 20,716 patients were included in epidemiological analysis, of whom 7,025 patients were selected in survival analysis, including 4,215 and 2,810 in training and validation sets, respectively. The multivariate Cox model showed that the predictors for OS were age, marital status, histopathology, differentiation and tumor node metastasis (TNM) stages, whether to undergo surgery and chemotherapy. However, the predictors for CSS were age, race, differentiation and TNM stages, whether to undergo surgery and radiation. The C-index for OS and CSS in the training set were 0.76 and 0.80. The AUC in the training set for 1-, 3- and 5-year OS and CSS were 0.84, 0.81, 0.80 and 0.88, 0.85, 0.83, respectively, which was similar in the validation set. The calibration curves showed good agreement between prediction and actual observations. DCA revealed that the nomogram had a better discrimination than TNM stages. Conclusions The nomogram showed accurate prognostic prediction in OS and CSS for vulvar cancer, which could provide guidance to clinical practice.

A global expert consensus (the Delphi consensus) on follicular development, pituitary inhibition, triggering ovulation, and luteal phase support was organized and published in 2021 by Merck Darmstadt, Germany, to further complement the 2019 European Society of Human Reproduction and Embryology (ESHRE) Guidelines on Ovarian Stimulation by in vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection(ICSI). Compared with the ESHRE guidelines, the Delphi consensus incorporates more types of research evidence and expert experience, and finally the expert group has reached a good consensus on follicular development, pituitary suppression and triggering of ovulation, but luteal support is still controversial. This article intends to provide a reference for the optimization of assisted reproductive technology through the interpretation of this consensus.

A global expert consensus (the Delphi consensus) on follicular development, pituitary inhibition, triggering ovulation, and luteal phase support was organized and published in 2021 by Merck Darmstadt, Germany, to further complement the 2019 European Society of Human Reproduction and Embryology (ESHRE) Guidelines on Ovarian Stimulation by in vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection(ICSI). Compared with the ESHRE guidelines, the Delphi consensus incorporates more types of research evidence and expert experience, and finally the expert group has reached a good consensus on follicular development, pituitary suppression and triggering of ovulation, but luteal support is still controversial. This article intends to provide a reference for the optimization of assisted reproductive technology through the interpretation of this consensus.

Although assisted reproductive technology has made great progress, the recurrent implantation failure of embryos remains a dilemma to be solved. The key to improve the implantation rate lies in the developmental synchronization of endometrium with embryo and the maximum receptivity to embryos. Due to individualized differences in window of implantation (WOI) time, it is difficult in the field of assisted reproduction to accurately judge the optimal time for embryo implantation. Previous researches mostly used transvaginal ultrasound, serum estrogen and progesterone levels, endometrial biopsy and other methods to judge the time of endometrial WOI. However, errors remain. Recent years, big achievement has been made in modern molecular genetic diagnosis and microarray technology. Some scholars have also applied it to judge the endometrial receptivity and WOI, and found that it has a good guiding value. This article reviews the basic situation, clinical application and application prospect of endometrial receptivity array in order to provide reference for personalized embryo transfer (pET) in infertility patients.

Although assisted reproductive technology has made great progress, the recurrent implantation failure of embryos remains a dilemma to be solved. The key to improve the implantation rate lies in the developmental synchronization of endometrium with embryo and the maximum receptivity to embryos. Due to individualized differences in window of implantation (WOI) time, it is difficult in the field of assisted reproduction to accurately judge the optimal time for embryo implantation. Previous researches mostly used transvaginal ultrasound, serum estrogen and progesterone levels, endometrial biopsy and other methods to judge the time of endometrial WOI. However, errors remain. Recent years, big achievement has been made in modern molecular genetic diagnosis and microarray technology. Some scholars have also applied it to judge the endometrial receptivity and WOI, and found that it has a good guiding value. This article reviews the basic situation, clinical application and application prospect of endometrial receptivity array in order to provide reference for personalized embryo transfer (pET) in infertility patients.

Although many studies have confirmed that uterine arterial embolization has good short-term and long- term effects for the treatment of uterine fibroids, certain failure rate does exist. Many researches have indicated that the surgical failure is mainly related to the collateral arterial supplies, among which the ovarian artery supply is the commonest cause. This review aims to make a further understanding of the influence of ovarian artery on the outcomes of uterine fibroid embolization.