A pilot study on the use of letrozole with either misoprostol or mifepristone for termination of pregnancy up to 63 days

Background: Letrozole is a third-generation selective aromatase inhibitor. Animal data suggested that it might be useful in medical abortion. We performed two pilot studies to assess the feasibility of using letrozole in combination with either mifepristone or misoprostol for termination of pregnancy up to 63 days. Study Design: We recruited 40 subjects who requested legal termination of pregnancies up to 63 days. Medical abortion was performed with letrozole 7.5 mg daily for 2 days followed by 800 mcg vaginal misoprostol in 20 subjects and letrozole 7.5 mg combined with 200 mg mifepristone in another 20 subjects. Results: The mean induction-to-abortion interval of the regimen of letrozole and misoprostol was 9.1 h (median 7.9 h, range 2.7-23.6 h). The complete abortion rate was 80% (95% CI: 56.3-94.3%). For those with gestation of ≤49 days, the complete abortion rate was 87.5% (14/16; 95% CI: 61.7-98.5%). The mean induction-to-abortion interval of letrozole combined with mifepristone was 90.1 h (median 93.4 h, range 66.0-121.2 h). The complete abortion rate was 71.4% (95% CI: 47.8-88.7%). Conclusion: These preliminary results suggest that a regimen of letrozole and misoprostol may be useful in medical abortion, but the combination with mifepristone is less effective and takes longer. Randomized studies comparing letrozole and misoprostol to misoprostol alone are warranted. © 2011 Elsevier Inc. All rights reserved.postprin

Pre-implantation genetic diagnosis in Hong Kong

This paper presents the first two successful cases of pre-implantation genetic diagnosis in Hong Kong and discusses the indications and the advantages over prenatal diagnosis. Patients should be informed about the procedure and extensively counselled about the possibility of misdiagnosis and the need for conventional prenatal diagnosis during pregnancy.published_or_final_versio

Effects of adrenomedullin on the expression of inflammatory cytokines and chemokines in oviducts from women with tubal ectopic pregnancy: an in-vitro experimental study

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Male germ cell-specific protein Trs4 binds to multiple proteins

Temperature-related sequence 4 (Trs4) has been identified as a testis-specific gene with expression sensitive to the abdominal temperature changes induced by artificial cryptorchidism. In murine testes, Trs4 mRNA was detected in round spermatids and its protein was localized mainly in the elongating spermatids as well as in the acrosomes and tails of mature spermatozoa. Using a yeast two-hybrid screening system, we identified Rshl-2, Gstmu1, and Ddc8 as putative binding partners of the Trs4 protein in mouse testes. Their interactions were confirmed by in vivo and in vitro binding assays. Further studies demonstrated that Ddc8, a newly identified gene with unknown functions, displayed a similar expression pattern with Trs4 in mouse testes. In particular, Trs4, Ddc8, and Rshl-2 proteins were co-localized to the tails of mature spermatozoa. These results suggested that Trs4 might be involved in diverse processes of spermiogenesis and/or fertilization through interactions with its multiple binding partners. © 2009 Elsevier Inc.postprin

Adrenomedullin as a biomarker for tubal ectopic pregnancy: new evidence from adrenomedullin function in the nasal ciliary epithelium

Oral Session 3: Female Reproductive Tract: abstract no. O019INTRODUCTION: Adrenomedullin (ADM) is a potent vasodilator belonging to the calcitonin family with a high homology to calcitonin gene-related peptide (CGRP). The combination of calcitonin receptor-like receptor and receptor activity-modifying protein (RAMP) isoforms determines the ligand selectivity for CGRP and ADM. Our laboratory previously showed that oviduct produced the greatest amount of adrenomedullin in the rat female reproductive tract. ADM was found to play a crucial role in transporting the gametes/embryos by increasing the oviductal ciliary beat and inhibiting the contraction of the rat oviduct. Similar results were also found in hum…postprin

Assisted reproduction in Hong Kong: Status in the 1990s

Information on assisted reproduction in Hong Kong for the period from January 1992 to December 1993 was collected from the three centres that offer assisted reproduction. Altogether, 912 treatment cycles of in vitro fertilisation and embryo transfer, 158 treatment cycles of gamete intrafallopian transfer, and 87 cycles of zygote intrafallopian transfer were initiated during this period. The delivery rates per cycle started were 8.4% for in vitro fertilisation, 29.1% for gamete intrafallopian transfer, and 13.8% for zygote intrafallopian transfer. During the same period, 233 cycles of replacement of frozen thawed embryos were completed with a delivery rate of 11.2% per cycle. Pregnancies were also achieved using oocyte donation and micromanipulation techniques.published_or_final_versio

Molecular and functional characterization of a testis-specific TRS4 gene in spermatogenesis

SRF Student Prize: O23INTRODUCTION: Spermatogenesis is a process in which diploid spermatogonia undergo mitotic, meiotic divisions and cellular differentiation to produce haploid spermatozoa that are capable to fertilize an egg. To understand the molecular mechanisms on how spermatogenesis in rodents is regulated, we investigated the gene expression of heat-treated testis in a rat model and identified TRS4 as a heat-sensitive gene in testis. Mouse TRS4 gene is located at chromosome 6A 3.1 with 13 exons, which encodes a protein with a predicted molecular weight, 90 kDa. Bioinformatic analysis showed that TRS4 has a high sequence homology among rat, mouse and human. TRS4 protein possesses an ubiquitin domain near N-terminus and an IQ-calmodulin binding motif inside exon 4-6 region of the gene. METHODS: In this study, we aimed: (i) to study the spatiotemporal expression of TRS4 mRNA in mouse tissues and post-natal mouse testes by quantitative PCR; (ii) to study interacting partners of TRS4 protein in the testis; and (iii) to generate TRS4 conditionally knockout mice by genetargeting approach. RESULTS AND DISCUSSION: Quantitative PCR studies showed that TRS4 mRNA was specifically expressed in the testis and post-natally on Day 20 onward. TRS4 mRNA was also localized at the spermatids stage of seminiferous tubules of adult mouse testes by in-situ hybridization. By co-immunoprecipitation and Western blotting, TRS4 was found to interact with α-actin, but not VAD1.2 and VAD1.3 (acrosome-expressing proteins), or syntaxin 1. TRS4 conditional gene targeting vector was constructed by flanking the exon 4-6 region of TRS4 gene with two LoxP sites. The Cre/Flp recombination of this completed vector was characterized in vivo by 293-Cre and 293-Flp E.Coli cells respectively. Putative TRS4 targeted mouse ES clones were being screened by Southern Blotting. Results from the present study should shed light to understand the role of TRS4 in spermatogenesis.The 2009 Annual Conference of the Society for Reproduction and Fertility (SRF), St Catherine’s College, Oxford, U.K., 12-14 July 2009

Molecular and functional characterization of a testis-specific TRS4 gene in spermatogenesis

Poster Presentations - Theme 4: Reproduction & Development: no. 4.11The 13th Research Postgraduate Symposium, the University of Hong Kong, Hong Kong, China, 10-11 December 2008

Changes in endometrial and subendometrial blood flow in IVF

A good blood supply to the endometrium is usually considered as an essential requirement for implantation. Endometrial and subendometrial blood flow was evaluated on the days of human chorionic gonadotrophin (HCG) administration and embryo transfer and the percentage change in endometrial and subendometrial blood flow between these 2 days was assessed as a predictor of pregnancy during IVF treatment. A three-dimensional (3D) ultrasound examination with power Doppler was performed in 293 patients undergoing the first IVF cycle to determine endometrial thickness, endometrial volume, vascularization index, flow index and vascularization flow index of endometrial and subendometrial regions on the days of HCG and embryo transfer. Patients in non-pregnant and pregnant groups had comparable endometrial thickness, endometrial volume and 3D power Doppler flow indices of endometrial and subendometrial regions measured on either day. Percentage changes in endometrial and subendometrial 3D power Doppler flow indices were also similar. In conclusion, endometrial and subendometrial blood flow on the days of HCG and embryo transfer and the percentage change in endometrial and subendometrial blood flows between these 2 days were not predictive of pregnancy in IVF treatment. © 2009 Published by Reproductive Healthcare Ltd.link_to_subscribed_fulltex

Relationship between uterine blood flow and endometrial and subendometrial blood flows during stimulated and natural cycles

Objective: To evaluate the relationship between uterine Doppler flow and endometrial and subendometrial blood flows during stimulated and natural cycles. Design: A prospective observational study. Setting: A tertiary-assisted reproduction unit. Patient(s): Infertile patients undergoing IVF treatment. Interventions: A three-dimensional ultrasound examination with power Doppler was performed on the day of egg retrieval in stimulated cycles and the day after the LH surge in natural cycles. Main Outcome Measure(s): Pulsatility and resistance indices of uterine vessels, and the vascularization, flow, and vascularization flow indices of endometrial and subendometrial regions. Result(s): Uterine pulsatility and resistance indices were negatively correlated with subendometrial vascularization, flow, and vascularization flow indices in both stimulated and natural cycles, whereas uterine resistance index was negatively correlated with endometrial vascularization and flow indices in natural cycles only. Subendometrial vascularization and vascularization flow indices were significantly lower in patients with an uterine resistance index <0.95 than those with an uterine resistance index <0.95. Conclusion(s): Uterine blood flow is a poor reflection of subendometrial blood flow during stimulated and natural cycles, and its measurement cannot reflect endometrial blood flow during stimulated cycles. ©2006 by American Society for Reproductive Medicine.link_to_subscribed_fulltex