Intrauterine adhesions (IUA) frequently occur after infectious or mechanical injury to the endometrium, which may lead to infertility and/or pregnancy complications. There are few effective treatments due to the complex function of endometrium and shortage of native materials. 17β-estradiol (E 2 ) is commonly used as an ancillary treatment in IUA patients, but it is limited by its poor solubility in aqueous solutions and low concentrations at the injured sites. In this research, a mini-endometrial curette was used to injure the rat’s endometrium to form an IUA model. 17β-estradiol was encapsulated into the micelles of heparin-poloxamer and a thermosensitive hydrogel (E 2 -HP hydrogel) was formed. This sustained releasing system was applied to restore the structure and function of the injured uterus. E 2 -HP hydrogel was constructed and relevant characteristics including gelation temperature and micromorphology were evaluated. Sustained release of 17β-estradiol from HP hydrogel was performed both in vitro and in vivo. Ultrasonography measurement and pathologic characteristics on the IUA rats were performed to evaluate the therapeutic effect of E 2 -HP hydrogel. Endoplasmic reticulum (ER) stress-related apoptosis was analyzed to explore the possible mechanisms in IUA recovery. E 2 -HP hydrogel showed a prolonged release of E 2 at the targeting region and more effective endometrium regeneration in IUA rats. Significant improvements in both gland numbers and fibrosis area were observed in the E 2 -HP hydrogel group. We also demonstrated that E 2 -HP hydrogel in the recovery of IUA was closely related to the suppression of ER stress signals via the activation of downstream signals, PI3K/Akt and ERK1/2. HP hydrogel might be an effective approach to deliver E 2 into the injured endometrium. Therapeutic strategies targeting ER stress using E 2 -HP hydrogel might be a promising solution for the treatment of women with intrauterine adhesions.

Since the reproductive toxicity of COVID‐19 vaccines have not been assessed in previous clinical trials, and studies have shown that SARS‐CoV‐2 is associated with a decrease in sperm parameters. Although it has been reported that the mRNA SARS‐CoV‐2 vaccines do not adversely affect semen parameters, whether this conclusion applies to inactivated vaccines remains unclear. Here, we conducted a study among patients who accepted in vitro fertilization (IVF) at the reproductive centre between June and August of 2021. In the enrolled cases, men who have completed two doses of COVID‐19 inactivated vaccine were included in “vaccine group” (N = 105), and those who were not vaccinated were included in “control group” (N = 155). In this study, we compare the sperm parameters and embryo quality between these two groups. Our data showed that the sperm parameters were similar in terms of volume, sperm concentration, sperm count, progressive motility, total motility and total motile sperm count between these two groups. Similarly, no significant differences were observed in IVF outcomes. The mean number of 2PN, cleavage‐stage embryos, blastocysts, and good‐quality blastocysts was 8.59 ± 4.47, 5.06 ± 3.17 and 2.08 ± 1.79 in vaccine group, 7.75 ± 4.14, 4.34 ± 3.06 and 1.74 ± 1.54 in control group, respectively. The high‐quality blastocyst rate was 41.05% (218 of 531) in vaccine group and 40.03% (269 of 672) in control group (p > 0.05). In addition, no differences were observed in biochemical and clinical pregnancy rates between the two groups. In summary, our results revealed that COVID‐19 inactivated vaccine administration exhibited no negative effect on sperm parameters and embryo quality in IVF.

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Purpose. To assess the expression of insulin-like growth factor binding protein (IGFBP) family and its prognostic impact in ovarian cancer (OC) patients. Materials and Methods. The mRNA expression and protein expression of individual IGFBPs in healthy ovarian samples and OC tissues were explored through Oncomine, Gene Expression Profiling Interactive Analysis, and Human Protein Atlas database. Additionally, the prognostic values of the six IGFBP members in patients with OC were evaluated by Kaplan-Meier plotter. Results. IGFBP2 and IGFBP4 mRNA expression were remarkably upregulated in patients with OC. To be specific, the mRNA expression of IGFBP2 was upregulated in patients with serous ovarian cancer (SOC), while IGFBP1/3/4/5/6 mRNA levels were downregulated. In addition, the IGFBP4 protein expression was upregulated in SOC, and the IGFBP6 protein expression was upregulated in both of SOC and endometrioid ovarian cancer (EOC) tissues. High IGFBP1 mRNA levels showed favorable overall survival (OS) and progression-free survival (PFS) in all OC. Meanwhile, increased IGFBP5/6 mRNA levels revealed worsen OS and PFS in all OC patients. IGFBP4/6 mRNA levels predicted unfavorable OS and PFS only in SOC patients. Moreover, the aberrant mRNA expression of IGFBP1/2/4/5/6 was correlated with significantly prognosis in patients receiving different chemotherapeutic regimens. Conclusion. This study indicates that the IGFBP family reveals distinct prognosis in patients with OC. IGFBP1/2/4/5/6 are useful prognostic predictors for chemotherapeutic effect in OC patients, and IGFBP2/4 are potential tumor markers for the diagnosis of OC.

The combined measurement of CA125, CA19-9, and the NLR provided an efficient method for the diagnosis of MCT with torsion.

Background and objectivesInsulin resistance (IR) is closely related to the decline or deficiency of testosterone in males. Triglyceride glucose-body mass (TyG-BMI) is considered to be a novel indicator of IR. We conducted this analysis to investigate the association between TyG-BMI and male testosterone, and to explore whether its ability to predict testosterone deficiency is superior to HOMA-IR and TyG.MethodsThis was a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES, 2011–2016). The TyG-BMI index was calculated from serum triglyceride, fasting plasma glucose and BMI. The association of TyG-BMI with male testosterone was estimated by weighted multivariable regression.ResultsWe included 3394 participants for the final analysis. After adjusting for confounders, TyG-BMI was found to show an independent negative association with testosterone (β=-1.12, 95%CI: -1.50, -0.75, P<0.0001). Multivariate-adjusted beta also showed testosterone levels were significantly lower in the two highest TyG-BMI group (Q3, Q4) compared to the lowest group (Q1). Similar results were seen in all of the subgroup populations by stratified analysis (all P-interaction >0.05). Furthermore, ROC curve analysis indicated that the area under the curve of TyG-BMI index (0.73, 95% CI: 0.71, 0.75) was larger than that of HOMA-IR index (0.71, 95% CI: 0.69, 0.73) and TyG index (0.66, 95% CI: 0.64, 0.68).ConclusionOur result suggested a negative association between TyG-BMI index and testosterone in adult males. The predictability of the TyG-BMI index for testosterone deficiency is better than that of HOMA-IR index and TyG index.

BackgroundIt is commonly believed that using frozen sperms after TESA was effective for OA patients. Nevertheless, scholars are worried about the prognosis of ICSI with frozen testicular sperm. In this study, we aim to compare the pregnancy and neonatal outcomes of ICSI using cryopreserved versus fresh spermatozoa collected by TESA.MethodsA total of 317 cases of OA patients treated with ICSI in a university affiliated hospital from January 2016 to December 2020 were included in this retrospective study, and they were divided into two groups according to the sperm used for ICSI: Frozen sperm group (N=154) and Fresh sperm group(N=163). The outcomes were measured by the following indicators: Two pronucleus (2PN) fertilization rate, 2PN cleavage rate, high-quality blastocyst rate, average number of embryos transferred, implantation rate, clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, preterm birth rate, live birth rate (LBR) , sex ratio at birth (male) and average newborn birth weight.ResultsThe present data showed no statistically significant difference in 2PN fertilization rates, 2PN cleavage rates, high-quality blastocyst rates and the average number of embryos transferred in the two groups. Similarly, no difference was found in implantation rate, clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, premature delivery rate, LBR and sex ratio at birth (P>0.05). The average newborn birth weight was similar in the two groups (2932.61±728.40 vs 3100.32±515.64) (P>0.05), but there was a higher incidence of Low-Birth-Weight newborn in the frozen group (20.91% vs 8.49%)(P<0.05). ConclusionsAs for men with obstructive azoospermia, the use of frozen testicular sperm by TESA was efficient. There was a similar pregnancy outcome of ICSI using frozen or fresh spermatozoa collected by TESA. However, it may lead to higher incidence of newborns of low birth weight, which needs further research based on larger samples.

Background There are very few data on the maternal and neonatal safety effects of inactivated COVID-19 vaccines. Several studies have reported the safety of SARS-CoV-2 vaccination during pregnancy, with no adverse effect on maternal and neonatal outcomes. However, data on the safety of prenatal vaccination are scarce. Therefore, more relevant data are needed to inform maternal, pregnancy, and infant outcomes. Objective To evaluate the prenatal maternal inactivated COVID-19 vaccination and the impact on maternal and neonatal outcomes. Methods A retrospective cohort study among women who delivered between January and June 2022 at the first affiliated hospital of wenzhou medical university. Those who have completed at least one dose of inactivated vaccine before or during pregnancy were included in “vaccinated group”, and those who were not vaccinated were included in “unvaccinated group”, the maternal, pregnancy and neonatal outcomes were evaluated. Propensity score matching (PSM) was performed to balance the baseline parameters of the two groups. Results A total of 1926 women were enrolled in this study, 827 (42.94%) women were prenatally vaccinated, and 1099 (57.06%) unvaccinated. The gestational week of delivery were slightly smaller in the vaccinated group, 38.77 ± 1.83 weeks in the vaccinated group and 39.01 ± 1.45 weeks in the unvaccinated group. There was a higher rate of overall preterm delivery in the vaccinated group (aOR 1.638, 95% CI 1.108–2.422; p = 0.013; Table 3, Fig. 2), however, the probability of delivery before 34 weeks and before 32 weeks (early preterm delivery) were similar (p > 0.05). A total of 2009 infants were born, 851 in the vaccinated group and 1158 in the unvaccinated group. There were similar neonatal outcomes in the two groups. Conclusions Although we found a slightly smaller gestational week of delivery and a possible increased rate of late preterm birth in the vaccination group, there was no difference in mean neonatal weight, incidence of low birth weight infants and other neonatal adverse complications. Meanwhile, there was no difference in pregnancy and maternal outcomes between the two groups.