fertilization

施肥
  • 文章类型: Journal Article
    为了探索2兄弟受精过程中顶体反应途径内纯合CATSPER2(精子阳离子通道)缺失的功能意义,谁有无法解释的不孕症和听力损失。
    病例报告。
    两个双胞胎兄弟,年龄30岁,听力损失和无法解释的不孕症。
    耳聋的分子遗传学诊断.孕酮和离子霉素对CATSPER2突变患者精子和可育对照诱导后的顶体反应和钙动员测定的评估。
    常规体外受精过程中的受精率。分子基因检测.顶体反应精子与花生凝集素凝集素染色的百分比。用荧光探针记录孕酮和离子霉素诱导的细胞内钙信号。
    S先生和他的兄弟都很正常,常规精子参数。在常规体外受精后,两兄弟都有反复的宫腔内授精失败和一次受精失败。S先生在胞浆内单精子注射后获得了2名健康婴儿。遗传分析发现STRC(立体蛋白)基因的纯合子缺失(NM153700:c.1-?5328?del),可删除CATSPER2基因。已知STRC基因的突变与听力损失有关。精子功能测试显示,孕酮无法激活细胞内钙信号并诱导顶体反应。
    我们证明了在具有CATSPER2突变的患者中,孕酮后不存在钙信号和顶体反应。我们强调男性医学访谈和听力损失遗传调查的重要性。我们表明体外受精-卵胞浆内单精子注射是必要的,即使在正常精子参数存在的地方。
    UNASSIGNED: To explore the functional implications of a homozygous CATSPER 2 (cation channel for sperm) deletion within the acrosome reaction pathway during fertilization in 2 brothers, who have unexplained infertility and hearing loss.
    UNASSIGNED: Case report.
    UNASSIGNED: Two twin brothers aged 30 years with hearing loss and unexplained infertility.
    UNASSIGNED: Molecular genetic diagnosis of deafness. Evaluation of the acrosome reaction and calcium mobilization assays after induction by progesterone and ionomycin on spermatozoa of the CATSPER 2-mutated patient and on fertile controls.
    UNASSIGNED: Fertilization rate during conventional in vitro fertilization. Molecular genetic test. Percentage of acrosome-reacted spermatozoa with peanut agglutinin lectin staining. Recording of progesterone and ionomycin-induced intracellular calcium signals with a fluorescent probe.
    UNASSIGNED: Mr. S and his brother have normal, conventional sperm parameters. Both brothers have had repeated intrauterine insemination failures and one fertilization failure after conventional in vitro fertilization. Mr. S obtained 2 healthy babies after intracytoplasmic sperm injection. Genetic analysis found a homozygote deletion of the STRC (stereocilin) gene (NM 153700: c.1-? 5328+?del) that removes the CATSPER 2 gene. Mutation of the STRC gene is known to be associated with hearing loss. Sperm functional tests revealed an inability of progesterone to activate intracellular calcium signaling and to induce acrosome reaction.
    UNASSIGNED: We demonstrate the absence of a calcium signal and acrosome reaction after progesterone in our patient with a CATSPER 2 mutation. We emphasize the importance of the male medical interview and of the genetic investigation of hearing loss. We show that in vitro fertilization-intracytoplasmic sperm injection is necessary, even where normal sperm parameters are present.
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  • 文章类型: Case Reports
    背景:非沟通性角妊娠(NCRHP)导致母亲和胎儿的生命危险。NCRHP的早期诊断和腹腔镜切除术对于预防灾难性疾病很重要。然而,延迟诊断到第二或第三个三个月,使得很难准确诊断NCRHP和双角子宫妊娠之间,因为这两种情况都表现为子宫破裂和大量腹膜出血。此外,这些罕见病例在妊娠试验中具有挑战性,并与后续妊娠的不良结局相关.
    方法:一名31岁的gravida1para0韩国女性来到我们的不孕不育中心,经定时性交后尿液妊娠试验证实为阳性。在她被安排定时性交之前,在最初的不孕症检查中,根据超声扫描和子宫输卵管造影术,怀疑患有子宫右角非交通的单角子宫.在妊娠5周时,在右侧非沟通的基本角中观察到妊娠囊。血清β-人绒毛膜促性腺激素(b-hCG)水平为2052.0mIU/mL。选择性腹腔镜切除右角,包含一个孕囊,伴随着同侧输卵管切除术,进行无不良事件。经过3个月的恢复期和三个周期的概念试验,包括定时性交和宫腔内授精,使用拮抗剂方案进行体外受精(IVF),并确认成功怀孕。患者从妊娠21+6周到35+6周住院,接受了环扎术和用皮质类固醇治疗的保胎剂。她通过剖腹产分娩了一个早期男婴。
    结论:在这种罕见的情况下,在腹腔镜下对NCRHP进行适当管理后,通过IVF成功妊娠,突显了NCRHP病例早期诊断和干预的重要性.及时识别和管理NCRHP对于预防灾难性疾病的发生和通过辅助生殖技术(ART)提高成功妊娠的预后至关重要。因此,对NCRHP的高度怀疑指数很重要,并采用了一系列诊断方法.
    BACKGROUND: Non-communicating rudimentary horn pregnancy (NCRHP) lead to life-threatening condition for both mother and fetus. Early diagnosis of NCRHP and laparoscopic resection is important to prevent catastrophic conditions. However, delayed diagnosis until the second or third trimester makes it difficult to accurately diagnose between NCRHP and bicornuate uterine pregnancy, as both conditions present uterine rupture and massive hemoperitoneum. Furthermore, these rare cases are challenging in pregnancy trials and associated with adverse outcomes in subsequent pregnancies.
    METHODS: A 31-year-old gravida 1 para 0 Korean woman visited our infertility center with a confirmed positive urine pregnancy test after timed intercourse. Before she was scheduled to have timed intercourse, a unicornuate uterus with a non-communicating right uterine horn was suspected based on an ultrasound scan and hysterosalpingography during the initial infertility workup. A gestational sac was observed in the right non-communicating rudimentary horn at 5 weeks of gestation. Serum beta-human chorionic gonadotropin (b-hCG) level was 2052.0mIU/mL. An elective laparoscopic resection of the right rudimentary horn containing a gestational sac, along with ipsilateral salpingectomy, was performed with no adverse event. After 3-month of recovery period and three cycles of conceptional trials involving timed intercourse and intrauterine insemination, in-vitro fertilization (IVF) was performed using the antagonist protocol, and successful pregnancy was confirmed. The patient had been hospitalized from 21 + 6 weeks to 35 + 6 weeks of gestation, underwent cerclage placement and tocolytics with corticosteroid treatment. She delivered an early-term male baby by cesarean section.
    CONCLUSIONS: In this rare case, the successful pregnancy achieved through IVF following the appropriate management of NCRHP under laparoscopy underscores the critical importance of early diagnosis and intervention in cases of NCRHP. Timely identification and management of NCRHP are vital to prevent the occurrence of catastrophic conditions and to enhance the prognosis of a successful pregnancy through assisted reproductive technology (ART). Therefore, a high index of suspicion for NCRHP is important and employs a range of diagnostic modalities.
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  • 文章类型: Journal Article
    目的:提高对体外受精-胚胎移植合并肺结核(TB)孕妇临床特征及影像学特点的认识。
    方法:回顾性分析2017年1月1日至2021年12月31日昆明市第三人民医院收治的50例妊娠肺结核患者。根据受孕方法将这些患者分为体外受精和胚胎移植(IVF-ET)受孕组和自然受孕组。然后收集并比较临床和影像学数据。
    结果:IVF-ET组的平均年龄(n=13,31.85±5.84岁)高于自然受孕组(n=37,27.05±5.5岁)。发烧的比例,IVF-ET组的血源性结核和肺外结核(92.31%,84.62%和76.92%,分别)高于自然受孕组(40.54%,16.22%,27.03%,分别)。IVF-ET组中颅内结核的妊娠患者百分比(76.9%)高于自然受孕组(10.8%)。IVF-ET受孕组终止妊娠的百分比(84.62%)高于自然受孕组(48.65%)。以上结果均有统计学差异(p<0.05)。
    结论:总体而言,IVF-ET受孕合并广泛的肺结核病变导致严重的全身毒性症状,严重的疾病和不良的妊娠结局。因此,建议在进行IVF-ET之前进行TB筛查。
    OBJECTIVE: To improve the understanding of the clinical features and imaging characteristics of pregnant women with and without in-vitro fertilisation-embryo transfer combined with pulmonary tuberculosis (TB).
    METHODS: A retrospective analysis was conducted involving 50 patients with pregnancy who had pulmonary TB and were admitted to the Third People\'s Hospital of Kunming (China) between 1 January 2017 and 31 December 2021. These patients were divided into an in-vitro fertilisation and embryo transfer (IVF-ET) conception group and a natural conception group according to the conception method. The clinical and imaging data were then collected and compared.
    RESULTS: The mean age of the IVF-ET group (n = 13, 31.85 ± 5.84 years) was higher than in the natural conception group (n = 37, 27.05 ± 5.5 years). The proportions of fever, haematogenous TB and extrapulmonary TB in the IVF-ET group (92.31%, 84.62% and 76.92%, respectively) were higher than those in the natural conception group (40.54%,16.22%,27.03%,respectively). The percentage of patients with pregnancy who had intracranial TB (76.9%) in the IVF-ET group was higher than in the natural conception group (10.8%). The percentage of pregnancy terminations in the IVF-ET conception group (84.62%) was higher than in the natural conception group (48.65%). All the above results had statistically significant differences (p < 0.05).
    CONCLUSIONS: Overall, IVF-ET conception combined with extensive pulmonary TB lesions lead to heavy systemic toxic symptoms, severe disease and poor pregnancy outcomes. Therefore, screening for TB prior to performing IVF-ET is recommended.
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  • 文章类型: Case Reports
    异位妊娠是一种极为罕见的情况,其中子宫内和子宫外妊娠并存。在自发的概念中,异位妊娠仅发生在1/30000妊娠中。异位妊娠的治疗必须尽可能微创,以保持宫内妊娠的发展。Superfetation,定义为两个或两个以上不同胎龄的胎儿共存,仍然特别特殊且解释不清(第二次排卵?胚胎滞育?)。这里,我们提出了一个非常罕见的病例,自发异位进化妊娠伴胎儿过多,由估计在妊娠8+1周(WG)的道格拉斯袋中的胚胎和估计在5+4WG的进行性宫内妊娠组成。我们通过经阴道途径超声引导心内注射氯化钾治疗宫外孕,9天后,患者接受了探查性腹腔镜检查,灌洗和抽吸腹部异位妊娠,原因是疼痛和生物炎症综合征,可能是由盆腔肿块综合征和胎儿坏死引起的腹膜刺激引起的。她尚未分娩,目前在36WG。
    Heterotopic pregnancy is an extremely rare condition in which an intrauterine and an extrauterine pregnancy co-exist. In spontaneous conceptions, heterotopic pregnancy occurs in only 1/30 000 pregnancies. The treatment of heterotopic pregnancy must be as minimally invasive as possible to preserve the development of the intrauterine pregnancy. Superfetation, defined as the coexistence of 2 or more foetuses of different gestational ages, remains particularly exceptional and poorly explained (second ovulation? embryonic diapause?). Here, we present an extremely rare case of a spontaneous heterotopic evolutive pregnancy with superfetation, consisting of an embryo in the pouch of Douglas estimated at 8 + 1 weeks of gestation (WG) and a progressive intrauterine pregnancy estimated at 5 + 4 WG. We treated the extrauterine pregnancy with an intra-cardiac injection of potassium chloride echo-guided via the vaginal route, and the patient then underwent exploratory laparoscopy 9 days later and lavage and aspiration of the abdominal heterotopic pregnancy due to pain and biological inflammatory syndrome probably caused by pelvic mass syndrome and peritoneal irritation from the foetal necrosis. She has not yet given birth and is currently at 36 WG.
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  • 文章类型: Journal Article
    群居动物应调整其繁殖策略以适应社会环境。理论预测,集群生活的好处将超过竞争的成本。然而,在繁殖期间,动物如何优化其生殖适应性以应对不断变化的社会环境,这在很大程度上是未知的。我们用了四虫LudeniZacher,单倍体蜘蛛螨,调查产卵雌性如何响应集群大小的变化而改变其生活史特征(即,聚集和分散)具有一致的人口密度(1‰/cm2)。我们证明了(1)在雌性从大型集群(16‰)转移到小型集群(1‰,5和10他们产下更少、更大的卵,女性偏见的性别比例更高;(2)在女性从小集群转移到大集群后,他们产下更少更小的蛋,女性偏见的性别比例也较高,(3)增加卵子大小显著增加后代性别比(%女儿),但并没有增加未成熟的生存率。结果表明,(1)雌性在小种群中受精更多的卵,但在较大的种群中降低受精阈值并受精较小的卵,(2)在卵子数量和大小方面的生殖调整可能更有助于最大程度地减少儿子之间的配偶竞争,但不会增加下一代的居民数量。当前的研究提供了证据,表明蜘蛛螨可以根据动态的社会环境操纵其生殖输出并调节后代的性别比例。
    Animals living in clusters should adjust their reproductive strategies to adapt to the social environment. Theories predict that the benefits of cluster living would outweigh the costs of competition. Yet, it is largely unknown how animals optimize their reproductive fitness in response to the changing social environment during their breeding period. We used Tetranychus ludeni Zacher, a haplodiploid spider mite, to investigate how the ovipositing females modified their life-history traits in response to the change of cluster size (i.e., aggregation and dispersal) with a consistent population density (1 ♀/cm2). We demonstrate that (1) after females were shifted from a large cluster (16 ♀♀) to small ones (1 ♀, 5 and 10 ♀♀), they laid fewer and larger eggs with a higher female-biased sex ratio; (2) after females were shifted from small clusters to a large one, they laid fewer and smaller eggs, also with a higher female-biased sex ratio, and (3) increasing egg size significantly increased offspring sex ratio (% daughters), but did not increase immature survival. The results suggest that (1) females fertilize more larger eggs laid in a small population but lower the fertilization threshold and fertilize smaller eggs in a larger population, and (2) the reproductive adjustments in terms of egg number and size may contribute more to minimize the mate competition among sons but not to increase the number of inhabitants in the next generation. The current study provides evidence that spider mites can manipulate their reproductive output and adjust offspring sex ratio in response to dynamic social environments.
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  • 文章类型: Case Reports
    扩展携带者筛查(ECS)是指评估个体携带者状态的综合遗传分析。ECS的使用越来越频繁,由于下一代测序(NGS)和阵列比较基因组杂交(aCGH)等技术的可用性,允许进行广泛的基因组规模分析。这里,我们报告了一对夫妇在男性伴侣家庭中接受ECS治疗的自闭症谱系障碍病例。在这对夫妇中进行了aCGH和全外显子组测序(WES)。aCGH分析在女性伴侣中确定了两个缺失涉及与行为和神经发育障碍相关的基因。在丈夫中未发现临床相关的改变。有趣的是,WES分析在男性伴侣中确定了LPL基因中的致病性变异,该变异正在成为自闭症的新候选基因。这个案例表明ECS可能在临床环境中有用,尤其是在受孕前对双方进行分析时,从而允许估计他们的风险来传递遗传条件。在另一边,有几个问题与可能的偶然发现和难以解释的结果有关.一旦通过制定具体的准则来定义这些限制,ECS可以具有更大的扩散。
    Expanded carrier screening (ECS) means a comprehensive genetic analysis to evaluate an individual\'s carrier status. ECS is becoming more frequently used, thanks to the availability of techniques such as next generation sequencing (NGS) and array comparative genomic hybridization (aCGH), allowing for extensive genome-scale analyses. Here, we report the case of a couple who underwent ECS for a case of autism spectrum disorder in the male partner family. aCGH and whole-exome sequencing (WES) were performed in the couple. aCGH analysis identified in the female partner two deletions involving genes associated to behavioral and neurodevelopment disorders. No clinically relevant alterations were identified in the husband. Interestingly, WES analysis identified in the male partner a pathogenic variant in the LPL gene that is emerging as a novel candidate gene for autism. This case shows that ECS may be useful in clinical contexts, especially when both the partners are analyzed before conception, thus allowing the estimation of their risk to transmit an inherited condition. On the other side, there are several concerns related to possible incidental findings and difficult-to-interpret results. Once these limits are defined by the establishment of specific guidelines, ECS may have a greater diffusion.
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  • 文章类型: Journal Article
    在论文中,分析了自发布里渊散射(SpBS)的影响作为分布式声学传感器(DAS)中的噪声源。SpBS波的强度随时间波动,这些波动增加了DAS中的噪声功率。根据实验数据,光谱选择的SpBS斯托克斯波强度的概率密度函数(PDF)为负指数,这与已知的理论概念相对应。基于此声明,给出了SpBS波引起的平均噪声功率的估计。该噪声功率等于SpBS斯托克斯波的平均功率的平方,其又比瑞利反向散射功率低约18dB。DAS中的噪声成分是针对两种配置确定的,第一个用于初始反向散射光谱,第二个用于拒绝SpBS斯托克斯和反斯托克斯波的光谱。可以确定,在分析的特定情况下,SpBS噪声功率占主导地位,超过了热功率,射击,和DAS中的相位噪声。因此,通过拒绝光电探测器输入端的SpBS波,可以降低DAS中的噪声功率。在我们的案例中,这种抑制是通过非对称马赫-曾德尔干涉仪(MZI)进行的。SpBS波的抑制与宽带光电探测器最相关,这与使用短探测脉冲来实现DAS中的短标距长度相关联。
    In the paper, the effect of spontaneous Brillouin scattering (SpBS) is analyzed as a noise source in distributed acoustic sensors (DAS). The intensity of the SpBS wave fluctuates over time, and these fluctuations increase the noise power in DAS. Based on experimental data, the probability density function (PDF) of the spectrally selected SpBS Stokes wave intensity is negative exponential, which corresponds to the known theoretical conception. Based on this statement, an estimation of the average noise power induced by the SpBS wave is given. This noise power equals the square of the average power of the SpBS Stokes wave, which in turn is approximately 18 dB lower than the Rayleigh backscattering power. The noise composition in DAS is determined for two configurations, the first for the initial backscattering spectrum and the second for the spectrum in which the SpBS Stokes and anti-Stokes waves are rejected. It is established that in the analyzed particular case, the SpBS noise power is dominant and exceeds the powers of the thermal, shot, and phase noises in DAS. Accordingly, by rejecting the SpBS waves at the photodetector input, it is possible to reduce the noise power in DAS. In our case, this rejection is carried out by an asymmetric Mach-Zehnder interferometer (MZI). The rejection of the SpBS wave is most relevant for broadband photodetectors, which are associated with the use of short probing pulses to achieve short gauge lengths in DAS.
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  • 文章类型: Case Reports
    背景:宫颈妊娠是一种罕见的异位妊娠。由于罕见的情况,宫颈妊娠的管理具有挑战性,后期介绍,这与医疗失败的风险增加有关,术后出血过多,可能需要子宫切除术。在文献中没有关于超过9+0周妊娠的活宫颈异位妊娠的药物管理的良好证据,在这些病例中没有关于甲氨蝶呤剂量的标准方案。
    方法:我们提出这个案例来描述一个11+5周宫颈妊娠的同时进行的医学和手术治疗。最初的β-人绒毛膜促性腺激素(β-hCG)血清水平为108,730IU/L。患者羊膜内接受60mg甲氨蝶呤,然后在24小时后肌内接受另一剂量的60mg甲氨蝶呤。第03天胎儿心跳停止。在第07天,β-hCG为37,397IU/L。在第13天,患者通过插入宫颈内Foley导管来排空剩余的受孕产物,以最大程度地减少出血。在第34天,β-hCG为阴性。
    结论:在晚期宫颈妊娠的治疗中,可以考虑同时使用甲氨蝶呤诱导胎儿死亡并进行手术疏散,以避免过度失血,最后是子宫切除术.
    BACKGROUND: Cervical pregnancy is a rare type of ectopic pregnancy. The management of cervical pregnancy is challenging because of the rarity of the condition, late presentation, which is associated with increased risk of failed medical treatment, and excessive post-evacuation bleeding that may require hysterectomy. There is no good evidence in the literature regarding the pharmacological management of living cervical ectopic pregnancy of more than 9 + 0 weeks of gestation, and there is no standard protocol on methotrexate doses in these cases.
    METHODS: We present this case to describe a concomitant medical and surgical management of a living 11 + 5 weeks cervical pregnancy. The initial beta-human chorionic gonadotropins (ß-hCG) serum level was 108,730 IU/L. The patient received 60 mg of methotrexate intra-amniotically followed by another dose of 60 mg of methotrexate intramuscularly 24 h later. Fetal heartbeats stopped on day 03. On day 07, the ß-hCG was 37,397 IU/L. On day 13, the patient had evacuation of the remaining products of conception with the insertion of an intracervical Foley catheter to minimize the bleeding. On day 34, the ß-hCG was negative.
    CONCLUSIONS: The concomitant use of methotrexate to induce fetal demise along with surgical evacuation may be considered in the management of advanced cervical pregnancy to avoid excessive blood loss, and ultimately hysterectomy.
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  • 文章类型: Case Reports
    以下报告描述了自发受孕后异位妊娠伴对侧黄体的情况。患者是一名33岁的女性(妊娠3,节段C切片3),妊娠试验呈阳性,和宫内节育器(IUD)。患者无症状。在阴道超声检查中,我们观察到一个正常形状和大小的前子宫,20x12毫米的壁内肌瘤和不规则的子宫内膜厚度16.5毫米,没有子宫内囊.检测到左输卵管异位妊娠和对侧黄体,可能是由于卵子通过相反的管(卵母细胞移行)。进一步的腹腔镜和组织病理学研究证实了我们的发现,异位妊娠成功切除.总之,卵母细胞移行是一个常见的事件,当我们希望为一个输卵管试图受孕的患者提供医疗建议时,应该考虑。即使仅存在单管,患者也有真正的机会怀孕。
    The following report describes the case of an ectopic pregnancy with contralateral corpus luteum after spontaneous conception. The patient was a 33- year-old female (gravida 3, segmentary C sections 3), with positive pregnancy test, and an Intrauterine Device (IUD). The patient was asymptomatic. At vaginal ultrasound, we observed an anteverted uterus of normal shape and size, a 20 x 12 mm intramural myoma and an irregular endometrial thickness of 16.5 mm, with no intrauterine sac. An ectopic pregnancy in the left Fallopian tube and a contralateral corpus luteum were detected, possibly as consequence of ovum pick up through the opposite tube (oocyte transmigration). Further laparoscopic and histopathologic studies confirmed our findings, and the ectopic pregnancy was successfully removed. In conclusion, oocyte transmigration is a common event and should be account when we wish to provide medical advice to patients with a single Fallopian tube trying to conceive. There are real chances for a patient to become pregnant even when only a single tube is present.
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  • 文章类型: Case Reports
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