Investigating a subfertile couple

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Macrophages promoted the colony forming ability of putative endometrial stromal stem cells

Poster Session - Blood Disorders & Stem Cell Immunology: no. 69DMM 2011 entitled: Re-engineering Regenerative MedicineWomen with endometriosis have a decreased cell-mediated immunity1 and contain more activated macrophages2. Human endometrial and endometriotic stem/progenitor cells have been identified using the clonogenic assay3, 4 ENREF 4 ENREF 4. Large colony forming units (CFUs, >4000 cells) are initiated from stem/progenitor cells and small CFUs (<4000 cells) are from transit-amplifying cells. Retrograded endometrial stem cells may have a role in the pathogenesis of endometriosis. In this study, the regulatory mechanism between macrophages and putative stem cells was examined. Endometrium (n=12)/ovarian endometrioma (n=16) were obtained from women undergoing hysterectomy and …postprin

Nanoparticle labeling identifies slow cycling human endometrial stromal cells

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Spatial and temporal characterization of endometrial mesenchymal stem-like cells activity during the menstrual cycle

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Sequential use of letrozole and gonadotrophin in women with poor ovarian reserve: a randomized controlled trial

Sequential use of letrozole and human menopausal gonadotrophin (HMG) was compared with HMG only in poor ovarian responders undergoing IVF. Patients (n=53) with less than four oocytes retrieved in previous IVF cycles or less than five antral follicles were randomized to either letrozole for 5days followed by HMG or HMG alone. The letrozole group had lower dosage of HMG (P<0.001), shorter duration of HMG (P<0.001) and fewer oocytes (P=0.001) when compared with controls. Live-birth rate was comparable with a lower miscarriage rate in the letrozole group (P=0.038). Serum FSH concentrations were comparable in both groups except on day 8, while oestradiol concentrations were all lower in the letrozole group from day 4 (all P<0.001). Follicular fluid concentrations of testosterone, androstenedione, FSH and anti-Mullerian hormone were higher in the letrozole group (P=0.009, P=0.001, P=0.046 and P=0.034, respectively). Compared with HMG alone, sequential use of letrozole and HMG in poor responders resulted in significantly lower total dosage and shorter duration of HMG, a comparable live-birth rate, a significantly lower miscarriage rate and a more favourable hormonal environment of follicular fluid. The management of poor ovarian responders or women with poor ovarian reserve in IVF is controversial. The use of letrozole has been studied; however, results are inconsistent. This randomized trial studied the sequential use of letrozole and gonadotrophin compared with gonadotrophin alone in poor responders undergoing IVF. The sequential use of letrozole and gonadotrophin led to a significantly lower dosage and shorter duration of gonadotrophin use, significantly fewer oocytes, comparable live-birth rate, a significantly lower miscarriage rate and a more favourable hormonal environment at a lower cost.postprin

A randomized double-blind controlled trial of the use of dydrogesterone in women with threatened miscarriage in the first trimester: study protocol for a randomized controlled trial

BACKGROUND: Miscarriage is a common complication of pregnancy occurring in 15-20 % of all clinically recognized pregnancies. Currently, there is still no good scientific evidence to support the routine use of progestogens for the treatment of threatened miscarriage because the existing studies were not large enough to show a significant difference and some of them were not randomized or double-blind. METHODS: This is a double-blind, randomized controlled trial. A total of 400 patients presenting with first-trimester threatened miscarriage will be enrolled. They will be randomized to take dydrogesterone 40 mg per os, followed by 10 mg per os three times a day or placebo until twelve completed weeks of gestation or 1 week after the bleeding has stopped, whichever is longer. The primary outcome is the percentage of miscarriage before 20 weeks of gestation. DISCUSSION: We postulate that the dydrogesterone therapy will significantly reduce the risk of miscarriage in women with threatened miscarriage. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov, NCT02128685 . Registered on 29 April 2014.published_or_final_versio

Synchrony of clinical and laboratory surveillance for influenza in Hong Kong

Background: Consultation rates of influenza-like illness (ILI) in an outpatient setting have been regarded as a good indicator of influenza virus activity in the community. As ILI-like symptoms may be caused by etiologies other than influenza, and influenza virus activity in the tropics and subtropics is less predictable than in temperate regions, the correlation between of ILI and influenza virus activity in tropical and subtropical regions is less well defined. Methodology and Principal Findings: In this study, we used wavelet analysis to investigate the relationship between seasonality of influenza virus activity and consultation rates of ILI reported separately by General Out-patient Clinics (GOPC) and General Practitioners (GP). During the periods 1998-2000 and 2002-2003, influenza virus activity exhibited both annual and semiannual cycles, with one peak in the winter and another in late spring or early summer. But during 2001 and 2004-2006, only annual cycles could be clearly identified. ILI consultation rates in both GOPC and GP settings share a similar non-stationary seasonal pattern. We found high coherence between ILI in GOPC and influenza virus activity for the annual cycle but this was only significant (P<0.05) during the periods 1998-1999 and 2002-2006. For the semiannual cycle high coherence (p<0.05) was also found significant during the period 1998-1999 and year 2003 when two peaks of influenza were evident. Similarly, ILI in GP setting is also associated with influenza virus activity for both the annual and semiannual cycles. On average, oscillation of ILI in GP and of ILI in GOPC preceded influenza virus isolation by approximately four and two weeks, respectively. Conclusions: Our findings suggest that consultation rates of ILI precede the oscillations of laboratory surveillance by at least two weeks and can be used as a predictor for influenza epidemics in Hong Kong. The validity of our model for other tropical regions needs to be explored. © 2008 Yang et al.published_or_final_versio

Up-regulation of endocrine gland-derived vascular endothelial growth factor but not vascular endothelial growth factor in human ectopic endometriotic tissue

Objective: To study the expression of vascular endothelial growth factor (VEGF), endocrine gland-derived VEGF (EG-VEGF/PK1), and its receptors (PKR1 and PKR2) in eutopic and ectopic endometrial tissues. Design: A case-control study. Setting: University reproduction unit. Patient(s): Infertile women undergoing diagnostic laparoscopy for tubal patency. Intervention(s): Endometrial and endometriotic tissue sampling from women with and without endometriosis. Main Outcome Measure(s): Quantitative polymerase chain reaction (PCR) analysis of genes in eutopic and ectopic endometrial tissues. The EG-VEGF protein was studied by immunohistochemistry. Result(s): In normal endometrium, EG-VEGF messenger RNA (mRNA) expression was 50-fold higher in the secretory than in the proliferative phase, but that of PKR1 was 6-fold higher in the latter than in the former. The PKR2 transcript was detected in the proliferative but not the secretory endometrium. In patients with endometriosis, eutopic endometrial PKR2 transcript level was 4-fold higher in the proliferative than in the secretory phase. No differences in EG-VEGF or PKR1 were found in proliferative versus secretory endometrium in these patients. There were no significant differences in the expression of EG-VEGF in eutopic endometrium of normal women and in those with endometriosis. In the paired laser-captured microdissected eutopic endometrial and ectopic endometriotic samples, a significantly higher EG-VEGF, but not VEGF, transcript level was detected in the ectopic when compared with eutopic samples; whereas the expressions of PKR1 and PKR2 were barely detectable. The H-scoring confirmed that the stroma of endometriotic samples had a significantly higher EG-VEGF protein expression than that in the paired eutopic endometrium. Conclusion(s): High levels of EG-VEGF expression may play an important role in angiogenesis in endometriotic tissues. © 2010 American Society for Reproductive Medicine.postprin

Co-culture with macrophages enhances the clonogenic and invasion activity of endometriotic stromal cells

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Is 250 μg rHCG always better and safer than 500 μg rHCG? [8]

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