Chorionic Gonadotropin Hormone Research Articles

Continuous endometrial volumetric analysis for endometrial receptivity assessment on assisted reproductive technology cycles

BackgroundHuman implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. In order to assess endometrial receptivity in Assisted Reproductive Technology (ART) cycles serial evaluation of endometrial volumetric analysis may have a predictive value on a positive outcome.MethodsSerial 3D transvaginal ultrasound performed in women on ART cycle to evaluate embryo implantation predictors. Prospective case control study of 169 subjects were assessed. Endometrial pattern, thickness, volume and adjusted endometrial volume (ratio between endometrial volume and uterine volume) was performed to all subjects on a continuous process from baseline, during controlled ovarian stimulation, trigger day with human chorionic gonadotropin hormone (hCG) and at embryo transfer day.ResultsDemographics and ART procedures and scores, was similar between the two groups. Endometrial morphology also showed no difference between the two groups. Endometrial volume and adjusted endometrial volume was significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation.ConclusionsSerial 3D endometrial volume and adjusted endometrial volumes provides a predicting clinical tool enhancing elective embryo transfers in fresh ART cycle. Thus providing a non-invasive continuous technique for endometrial receptivity assessment that reflects endometrial changes during ART procedures.

Single-cell transcriptomics identifies divergent developmental lineage trajectories during human pituitary development

The anterior pituitary gland plays a central role in regulating various physiological processes, including body growth, reproduction, metabolism and stress response. Here, we perform single-cell RNA-sequencing (scRNA-seq) of 4113 individual cells from human fetal pituitaries. We characterize divergent developmental trajectories with distinct transitional intermediate states in five hormone-producing cell lineages. Corticotropes exhibit an early intermediate state prior to full differentiation. Three cell types of the PIT-1 lineage (somatotropes, lactotropes and thyrotropes) segregate from a common progenitor coexpressing lineage-specific transcription factors of different sublineages. Gonadotropes experience two multistep developmental trajectories. Furthermore, we identify a fetal gonadotrope cell subtype expressing the primate-specific hormone chorionic gonadotropin. We also characterize the cellular heterogeneity of pituitary stem cells and identify a hybrid epithelial/mesenchymal state and an early-to-late state transition. Here, our results provide insights into the transcriptional landscape of human pituitary development, defining distinct cell substates and subtypes and illustrating transcription factor dynamics during cell fate commitment.

Combination of medical and surgical management in successful treatment of caesarean scar pregnancy: a case report series

BackgroundThere is no clear consensus on the management of caesarean scar pregnancy (CSP), a complex and life-threatening condition. The objective of this study was to present a novel approach to management of CSP that combines medical therapy of multidose methotrexate and mifepristone with active surgical management by uterine curettage and consecutive local haemostasis.Case presentationWe report on a prospective case series of six women with first trimester pregnancy, in whom the diagnosis of CSP was confirmed by 2D and color Doppler transvaginal ultrasound and serial hormone chorionic gonadotropin (hCG) testing. Women were between 23 and 36 years old and had at least one previous delivery by caesarean. At admission, gestational age ranged between 6 to 14 weeks, and serum hCG levels between 397 and 23,000 mUI/ml. Upon decision of pregnancy termination, medical management was undertaken in all cases and 1 mg/kg systemic Methotrexate was administered between 1 and 5 daily doses. Mifepristone was part of the treatment in cases with live pregnancy. Surgical management was employed for the cases were an embryo was seen by ultrasound, being prompted by inadequate response to Methotrexate and/or signs of miscarriage with vaginal bleeding. Curettage combined with local isthmic balloon or vaginal pack tamponade prevented further complications. High treatment rates with preservation of fertility was achieved in all patients except one who underwent hysterectomy for invasive placentation. Ultrasound and hCG levels surveillance ensured that the resolution of pregnancy was achieved.ConclusionWomen with history of delivery by caesarean section should be carefully monitored in future pregnancies for prompt diagnosis of CSP. Early diagnosis of CSP allows selection of successful conservative therapy. Through this case series we contribute with our experience to the body of knowledge about the management of this serious complication of early pregnancy.

PRIMARY MEDIASTINAL CHORIOCARCINOMA (PMC) IN A YOUNG WOMAN WITH HEMOPTYSIS AND A LUNG MASS

SESSION TITLE: Medical Student/Resident Lung Cancer Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Primary mediastinal choriocarcinoma (PMC) is an extra gonadal, non-gestational, angioinvasive rare germ cell neoplasm that mostly arises along the midline structures. PMC contains syncytiotrophoblastic cells which secrete human chorionic gonadotropin hormone (hCG). An elevated hCG is considered an important serologic tumor marker in the diagnosis of mediastinal germ cell tumor, in the absence of gestation and with no previous gynecologic malignancy. CASE PRESENTATION: A 39 year-old woman with no past medical history was admitted to the hospital with severe right sided chest pain associated with hemoptysis that started 2 weeks prior to admission. Physical exam revealed decreased breath sounds on the right hemithorax with dullness to percussion. Bloodwork was significant for β-HCG of 6,566 mlU/ml with negative alpha fetoprotein, and normal lactate dehydrogenase. A CT scan of the chest revealed a large necrotic solid mass with numerus enlarged vessels located in the anterior mediastinum (Figure 1). PET scan was negative for any metastatic lesions. Transvaginal ultrasound was negative for intrauterine or ectopic pregnancy. Transthoracic core biopsy showed poorly differentiated choriocarcinoma. Immunohistochemistry staining was positive for β-HCG, placental alkaline phosphatase, and pancytokeratin AE1/AE3 (Figure 2). The tumor was not amenable to surgical resection due to its large size and high vascularity. The patient was started on cisplatin and etoposide followed by etoposide, MTX, Act-D, cyclophosphamide, and vincristine (EMA-CO). After the first course of chemotherapy, the levels of β-HCG markedly decreased. DISCUSSION: PMC is a rare malignancy in both genders, more prevalent in men than in women. The natural process of PMC has been poorly understood. Possible theories include: (1) trophoblastic embolus related to a gestational event after a long period of latency; (2) metastases from a primary gonadal choriocarcinoma; (3) retained primordial germ cells that migrated during embryogenesis. An extensive workup is required to exclude other β-HCG-positive tumors from PMC, such as primary poorly differentiated non-small cell carcinoma of the lung, and gestational metastatic choriocarcinoma. Our patient was found to have a large highly vascular mass in the presence of elevated β-HCG, and absence of primary genital tumor. The histological features showed extensive areas of hemorrhage and necrosis and biphasic cellular population including cytotrophoblastic and syncytiotrophoblastic cells. In contrast to gestational choriocarcinoma, PMC is rapidly progressive and fatal in the great majority of cases with a dismal 5 years survival of less than 5%. CONCLUSIONS: Due to the rarity of PMC, currently there is no consensus regarding treatment guidelines. Thus, case reports such as this contribute to the scant literature to raise the profile of this rare and devastating disease. Reference #1: Ruan Z, Wang S, Wang Z, Jing Y. A rare case of bilateral massive hemothorax from spontaneous rupture of a primary mediastinal mixed germ cell tumor. Ann Thorac Surg. 2012;93:664–666 Reference #2: Bachmann J, Ernestus K, Werner T, et al. Detection of primary choriocarcinoma in the mediastinum by F-18 FDG positron emission tomography. Clin Nucl Med. 2007;32:663–665. Reference #3: Serno J, Zeppernick F, Jakel J, Primary pulmonary choriocarcinoma; cas report and the review of the literature, Gynecologic nad obstetric investigation, vol. 74, no. 2, pp. 171-176,2012 DISCLOSURES: No relevant relationships by Marwah Abduljabbar, source=Web Response No relevant relationships by Sara Mehrsefat, source=Web Response No relevant relationships by jorge otoya, source=Web Response No relevant relationships by Noman Subhani, source=Web Response no disclosure on file for Maria Wallis-Crespo

Volitional tank spawning of domestic striped bass (Morone saxatilis) using human chorionic gonadotropin (hCG) and gonadotropin releasing hormone analogue (GnRHa)- induced ‘pace-setting’ females

Seventy-one tank spawning trials were conducted to evaluate the efficacy of exogenous hormone compounds and a novel “pace-set” strategy for inducing volitional tank spawning behavior in 5th generation domestic striped bass. Female fish (4.74 ± 0.73 kg; mean ± standard deviation) were treated with human chorionic gonadotropin (hCG; 29 trials), gonadotropin releasing hormone analog (GnRHa; 39 trials) or received no hormone treatment (control; 3 trials). Spawning trials were conducted using single females placed in spawning tanks with two (12 trials) or three (38 trials) males or with paired females placed in spawning tanks with three (4 trials) males. Significant differences in egg production, fry production, hatching rate, and fry/kg female body weight were generally not observed between exogenous hormone treatment groups (alpha = 0.05), with the exception of egg production differing between paired females spawning with three males (Student's t-test, p = 0.0255). However, a trend suggesting that increasing the number of males or females within the tanks improves yield of larvae (fry/kg female body weight) was observed. The untreated control females failed to spawn within 7 days. The pace-set spawning was conducted whereby one female treated with either hCG (7 trials) or GnRHa (7 trials) was placed in a spawning tank with one untreated female and multiple males. The results of these trials show for the first time that a hormone-induced female striped bass can be used to stimulate successful volitional spawning of an untreated female in the same tank with fry/kg female body weight production similar to that of hormone-treated fish. Microsatellite-based parentage of select tank spawns and four additional trials conducted with an increased number of males (19 trials total) showed that female striped bass typically spawn with at least two males; a single pair mating was only observed for one spawning trial. These data allowed for the determination of effective broodstock size (Nb) of each tank spawning trial at between 2.00 and 5.60 when considering all male contributions. The Nb generally increased as the number of males and female fish in the tank increased (from 2.53 for one female and two males to 5.52 for two females and six males). These results indicate that domestic striped bass are promiscuous and will generally reproduce in captivity using tank spawning procedures that allow for a high level of genetic diversity to be retained among the offspring. The pace-set method reduces hormone use and may be applied to commercial striped bass production as well as captive spawning of other fish species.

Sex Hormones Changes in Blood and Their Effect on Fecundity of African Catfish (Clarias gariepinus Burchell, 1822) after Being Injected with Different Doses of Human Chorionic Gonadotropin (HCG) Hormone

This study was conducted to investigate the effect of different dosesinjection of human chorionic gonadotropin (HCG) hormone on fecundityand serum sex hormones (FSH, LH, estrogen (E2), progesterone (P4),testosterone (T)) of African catfish (Clarias gariepinus). African catfishspawners were intermuscularly injected with different doses of HCG(500, 1500, 3000, 6000 IU/kg female), and group is not injected as acontrol; males were injected at half the female dose. The results showedthat, fish group injected by 6000 IU HCG/ kg female had the highestgonadsomatic index, absolute fecundity and relative fecundity, while,the lowest value of absolute fecundity and relative fecundity wererecorded with 500 IU HCG/ kg female. The group injected with thehighest amount of HCG (6000 IU/ kg female) recorded the lowest valuefrom egg diameter, while the highest egg diameter was observed in 500IU HCG/ kg female. In females, the group injected with 6000 IU HCG/kg female reflected the lowest level of FSH and the highest level of LHand the highest level of P4 compared to other treatments. Level of Trecorded the highest level with 1500 IU HCG/ kg female. The controlgroup reflected the highest level of FSH and E2, while the control groupreflected the lowest level of T and P4 level. In males, serum FSH, LH,P4 and E2 in male groups injected with HCG were relatively higher thanthose recorded in the control group. The highest level of T was recordedin treatment injected with the highest dose of HCG and decreased inother treatments until recorded the lowest level of T in the controlgroup. It was observed, HCG hormone has successfully and accelerateinduced spawning in African catfish (Clarias gariepinus) and increasedin reproductive performance with the increase in HCG dosage and ascompared to group not injected.

Effect of different doses of human chorionic gonadotropin (HCG) hormone on stripping response and reproductive performance of the African catfish (Clarias gariepinus).

This study was conducted to investigate the effect of different doses injection of human chorionic gonadotropin (HCG) hormone on stripping response and reproductive performance of African catfish (Clarias gariepinus). African catfish spawners were intramuscularly injected with different doses of HCG (500, 1500, 3000, 6000 IU/kg female); males were injected at half the female dose. The results showed that fish group injected by 6000 IU/ kg female had the highest ovaries weight and gonadsomatic index, but, recorded the lowest value from ovulated egg diameter. The lower latency period was recorded with 6000 IU/ kg female (12 h). While, the highest latency period were in 500, 1500 IU/ kg (28 h) and 3000 IU/ kg (22 h). The number of fertilized eggs/ female and fertilization rate (%) were significantly different (P£0.05) among the experimental treatments, with the highest number of fertilized eggs/ female and fertilization rate were observed with 6000 IU/ kg female (60848 fertilized eggs/ female with 84.45%) and the lowest number of fertilized eggs/ female and fertilization rate were presented with 500 IU/ kg female (3372 fertilized eggs/ female with 10.15%). The number of larvae/ female and hatching rate showed significant differences (P£0.05) among different level of HCG hormone with the highest number of larvae and hatching rate with 6000 IU/ kg female (49657 larvae/ female with 81.45%) followed by those 3000 IU/ kg female (43177 larvae/ female with 73.65%), 1500 IU/ kg female (12099 larvae/ female with 57.9 %), while the incubation eggs of group injected with 500 IU/ kg female don’t show any hatching larvae. It was observed, HCG hormone has successfully and accelerate induced spawning in African catfish (Clarias gariepinus)and increased in reproductive performance with the increase in HCG dosage.

Comparing the Effectiveness of Doing Intra-uterine Insemination 36 and 42 Hours After Human Chorionic Gonadotropin (HCG) Injection on Pregnancy Rate: A Randomized Clinical Trial.

Objective: Intrauterine insemination (IUI) is an assisted conception technique that involves the deposition of a processed semen sample in the upper uterine cavity, overcoming natural barriers to sperm ascent in the female reproductive tract. Hence, we compared the results of doing intra-uterine insemination 36 and 42 hours after human chorionic gonadotropin (hCG) hormone injection to achieve clinical and chemical pregnancy rates. Materials and methods: One hundred and sixty infertile women with unexplained infertility participated in this clinical trial. They were divided into two groups: those who underwent IUI 36 hours after hCG injection (control group), and those who underwent IUI 42 hours after hCG injection (case group). Statistical analyses were done using IBM-SPSS 25.0. and Chi-square test were used for data analysis. Results: The percentages of clinical and chemical pregnancies were significantly higher in the 42h group compared to the other group (P = 0.038 vs. P = 0.009, respectively). There was no significant difference regarding frequency of abortion, twin and ectopic pregnancies between the two groups (P > 0.05). Conclusion: Doing IUI 42 hours after hCG injection can significantly increase chances of fertility compared to doing it 36 hours after hCG injection.

DUAL-TRIGGERING WITH HUMAN CHORIONIC GONADOTROPIN AND GONADOTROPIN RELEASING HORMONE AGONIST IS BENEFICIAL FOR ACQUISITION OF MATURE OOCYTES IN LETROZOLE-COMBINED OVARIAN STIMULATION CYCLES

It is critical to set up an efficient maturation method to increase the yield of mature oocytes, especially for cancer patients with fewer chances of fertility preservation (FP) before gonadotoxic therapy. The purpose of this study is to investigate whether dual triggering with human chorionic gonadotropin (hCG) and gonadotropin-releasing hormone agonist (GnRHa) for final oocyte maturation improve the controlled ovarian stimulation (COS) outcomes for women undergoing FP.

Evaluation of Different eCG Doses + Progesterone to Induce Reproductive Activity During the Transitional Reproductive Season in Anestrous Creole Goats

Background: Goats from subtropical and temperate latitudes show reproductive seasonality. For this reason, the products obtained from goats also shows the same seasonality, reducing the finances of goat keepers. Several studies have focused on reducing reproductive seasonality through the use of hormonal protocols based on progestogens, in addition to the use of equine chorionic gonadotropin (eCG) hormone, used for its double biological activity that ensures an optimal response to induce estrus and pregnancy in goats. The objective was to assess whether reduced doses of eCG are effective in inducing reproductive activity in anestrous goats. Methods: During the transition reproductive period (June), mix-breed Creole goats (n=39), were treated with intramuscular progesterone (P4), later, the experimental treatments, consisting in different doses (50, 100, 50+50 or 200 IU) of equine chorionic gonadotropin (eCG) were applied. After the application of the experimental protocols, the reproductive activity of the goats was evaluated. Result: This study shows that one dose of 100 IU of eCG effectively induced reproductive behavior in anestrous Creole goats towards the end of the seasonal anestrus. This protocol makes the use of exogenous hormones more efficient, with reduce doses, decreasing expenses and is practical use by goat producers.

Identification and semi-relative quantification of intact glycoforms by nano-LC-(Orbitrap)MS: application to the α-subunit of human chorionic gonadotropin and follicle-stimulating hormone.

Human chorionic gonadotropin (hCG) and follicle-stimulating hormone (FSH) belong to the family of glycoprotein polypeptide hormones called gonadotropins. They are heterodimers sharing the α-subunit structure that has 2 N-glycosylation sites. A method based on nano-reversed-phase liquid chromatography coupled to high-resolution mass spectrometry with an Orbitrap analyzer was developed for the first time to characterize the glycosylation state of the α-subunit at the intact level. A recombinant hCG-based drug, Ovitrelle®, was analyzed. This method combined with an appropriate data treatment allowed the detection of not only the major isoforms but also the minority ones with a high mass accuracy. More than 30 hCGα glycoforms were detected without overlapping of the isotopic patterns. The figures of merit of the method were assessed. The relative standard deviations (RSDs) of the retention time ranged between 0.1 and 6.08% (n = 3), with an average of 0.4%. The RSDs of the peak area measured on the extracted ion chromatogram of each glycoform are below 38% (n = 3), with an average of 16%, thus allowing semi-relative quantification. The ability to accurately profile glycosylated variants of hCGα was next demonstrated by comparing qualitatively and semi-quantitatively 3 batches of Ovitrelle®. The method was also used to analyze 3 batches of a recombinant FSH-based drug, Puregon®, and 30 FSHα glycoforms were detected and semi-quantified. This demonstrates the high potential of this method for fast quality control or comparison of the glycosylation of glycoprotein-based pharmaceutical preparations. Graphical abstract.

Insights on luminescence quenching of ZnO tetrapods in the detection of hCG

Metal oxide semiconductors, and particularly zinc oxide (ZnO), are amongst the most investigated materials to be applied as transducer elements in biosensing devices due to properties as biochemical stability, biocompatibility and functionalisation simplicity. In the present work, ZnO nanotetrapods were produced by the laser-assisted flow deposition technique to be used as transducers in a photoluminescence (PL)-based immunosensor to detect the human chorionic gonadotropin (hCG) hormone. The produced nanostructures were analysed by electron microscopy, Raman and PL spectroscopies. The ZnO tetrapods exhibit an intense PL in both the ultraviolet and visible range, whose intensity changed after the direct immobilisation of the anti-hCG antibodies into the semiconductor’s surface. The changes in the PL intensity after the interaction of the immobilised antibodies with hCG were used as the transduction mechanism for the envisaged sensors. It was observed that when antibody-antigen interactions occur, charge rearrangement at the surface of the semiconductor leads to a reduction in overall intensity of the PL signal with increasing hCG concentration, allowing to establish a correlation between the PL output and the probed concentration. Therefore, such behaviour suggests the adequacy of the developed ZnO-based transducers to be incorporated into optical biosensors. Additionally, the possible interaction mechanisms between the ZnO surface and the immobilised molecules responsible for the changes in the PL spectra were discussed.

Evaluating T and B cell lineage differentiation stage and related prognostic impact in miscarriage

The WHO (World Health Organization) defines miscarriage as two or more pregnancies documented in woman medical history ended up with spontaneous miscarriage at stage of up to 22 weeks of pregnancy from conception. Habitual miscarriage of pregnancy (HMP) is one of high priority problems for infertile marriages comprising 5-20% among other causes of miscarriage. As many as 80% of all idiopathic HMP cases are associated with immune-related disorders. Currently, many researchers have being paying more attention to examining effects of T and B cells at varying differentiation stage in developing immune response against allogenic graft and formation immunological tolerance. However, it is worth noting that pregnancy-associated human hormone chorionic gonadotropin (HCG) exhibits a marked immunosuppressive effect by regulating regulatory T (Treg) cell functional activity. It has been proven that HCG contributes to increasing Tregs level in periphery and recruiting them to the embryo implantation zone, thus establishing immunological tolerance during pregnancy. However, no data regarding HCG effects on T and B cells at various differentiation stage were obtained during HMP. A correlation analysis between frequency of T and B cells at various differentiation stage and level of serum HCG in women with HMP was performed. It was found that low level HCG was associated with decreased naive T and B cell frequency paralleled with elevated percentage of effector memory CD8+ (Tem) that may serve as a poor prognostic sign especially in early stage of pregnancy.

Maternal thyroid disease and its effects on the fetus and perinatal outcomes.

Thyroid disease is common in women of childbearing age and can have significant effects on the development of the fetus and perinatal outcomes. Maternal thyroid hormone is critical for proper fetal neurodevelopment, and the fetus relies on thyroid hormone from its mother for the first half of pregnancy. Both overt maternal hypothyroidism and overt maternal hyperthyroidism have been shown to be associated with adverse effects on central nervous system gray matter and neurocognitive development of offspring as well as increased obstetrical risks. Treatment of overt thyroid conditions improves outcomes. Subclinical maternal hypothyroidism may increase adverse neurocognitive and obstetrical outcomes although data are conflicting. To date, treatment of subclinical hypothyroidism has not shown benefit. Subclinical hyperthyroidism is well tolerated in pregnancy. Thyroid autoantibodies alone may also affect neurodevelopment and obstetrical outcomes; however, recent data have shown no improvement with levothyroxine treatment. Several rare maternal genetic thyroid conditions can affect the fetus including a thyroid-stimulating hormone receptor mutation leading to hypersensitivity to human chorionic gonadotropin and thyroid hormone resistance. The thyroid plays a crucial role in fetal health and understanding it is important for optimal care.

The endocannabinoid system modulates the ovarian physiology and its activation can improve in vitro oocyte maturation.

The cannabinoid (CB) system has been involved in many aspects of reproduction and it is known that the systemic chronic use of exogenous CBs are deleterious to reproductive processes. Even so, it is not known what happens in relation to the physiology of the ovary when CB receptors are absent. The present study investigated the effect of the lack of CB1 and CB2 receptors in mice ovarian morphology, folliculogenesis, oocyte retrieval, and oocyte maturation and evaluated the use of Δ9-tetrahydrocannabinol (THC) on oocyte in vitro maturation (IVM) by comparing classical IVM and two-step IVM by analyzing the meiotic competence of the oocytes and their evolution toward embryos. Thus, when CB1 and CB2 receptors were missed, the ovary area and volume was significantly less and the action of the equine chorionic gonadotropin (eCG) hormone was diminished. In addition, the mutant genotypes had fewer ovarian follicles and they were less competent after eCG administration compared with wild-type mice, and this lack of CB receptors showed a mismatch of oocyte maturation. However, the in vitro use of THC showed improvements in oocytes IVM after a Pre-IVM step for 48 hr, as those oocytes reached a significantly higher polar body rate, a larger diameter and the best result on blastocysts rate was achieved when THC was used during the IVM step.

Induced spawning of Asian bumblebee catfish (Pseudomystus siamensis Regan, 1913)

Asian bumblebee catfish (Pseudomystus siamensis Regan, 1913) is an indigenous and economically valuable species in southern provinces of Vietnam. It is being exploited for food and ornamentation. This study used fish pituitary gland (FPG), human chorionic gonadotropin (HCG) and luteinizing hormone releasing hormone analogue (LHRHa) to induce spawning of the fish. The three spawning inducers affected on final oocyte maturation (FOM) and ovulation (FOMO) of females. The optimal revolving dose to induce FOM and FOMO was 10 mg/kg for FPG, 4.000 UI/kg for HCG and 120 μg/kg of female for LHRHa. The suitable periods of egg stripping and artificial insemination were from 9 - 11 h post resolving injection (hpri). Maximum spawning response was obtained with the optimal revolving dose of LHRHa (120 μg/kg). At the suitable stripping period (10 hpri) the rates of spawning, egg fertilization, egg hatching, larval survival, and relative fecundity were 64.5%, 70%, 44.5%, 39.3%, and 38,500 egg/kg of female, respectively.

Analysis of chromosomes and the T helper 17 and regulatory T cell balance in patients with recurrent spontaneous abortion.

The present study investigated the genetic etiology and possible immunological pathogenesis of recurrent spontaneous abortion by analyzing chromosome abnormalities, and the balance between T helper 17 (Th17) and regulatory T (Treg) cells. A total of 54 patients with recurrent spontaneous abortion were selected. The villus and decidual tissues, and peripheral venous blood were collected from each patient. Villus chromosome analysis was performed by high-throughput gene sequencing. Flow cytometry was used to detect Th17 and Treg cells in patients without chromosome abnormalities (n=30) and the control group (normal pregnancy; n=32). Immunoglobulin (IG) combined with human chorionic gonadotropin hormone (HCG) treatment was given to patients without chromosome abnormalities (n=30). Changes in the expression levels of Th17 and Treg cells before and after treatment were compared with patients with successful pregnancy (n=18). Before treatment, compared with the control group, the proportion of Th17 cells in peripheral blood and decidual tissue was increased and the proportion of Treg cells decreased. After treatment, compared with patients before treatment, the proportion of Th17 cells decreased and Treg cells increased, and the Th17 and Treg cells balance was reversed with a biased towards Treg cells. The present results suggested that the Th17 and Treg cell immune imbalance may be an important immune factor in recurrent spontaneous abortion. IG combined with HCG therapy may improve pregnancy outcomes by reversing the imbalance between Th17 and Treg cells.

Peri-implantation urinary hormone monitoring distinguishes between types of first-trimester spontaneous pregnancy loss.

BackgroundLutenising hormone (LH) and human chorionic gonadotropin (hCG) hormone are useful biochemical markers to indicate ovulation and embryonic implantation, respectively. We explored “point‐of‐care” LH and hCG testing using a digital home‐testing device in a cohort trying to conceive.ObjectiveTo determine conception and spontaneous pregnancy loss rates, and to assess whether trends in LH‐hCG interval which are known to be associated with pregnancy viability could be identified with point‐of‐care testing.MethodsWe recruited healthy women aged 18‐44 planning a pregnancy. Participants used a home monitor to track LH and hCG levels for 12 menstrual cycles or until pregnancy was conceived. Pregnancy outcomes (viable, clinical miscarriage, or biochemical pregnancy loss) were recorded. Monitor data were analysed by a statistician blinded to pregnancy outcome.ResultsFrom 387 recruits, there were 290 pregnancies with known outcomes within study timeline. Adequate monitor data for analysis were available for 150 conceptive cycles. Overall spontaneous first‐trimester pregnancy loss rate was 30% with clinically recognised miscarriage rate of 17%. The difference to LH‐hCG interval median had wider spread for biochemical losses (0.5‐8.5 days) compared with clinical miscarriage (0‐5 days) and viable pregnancies (0‐6 days). Fixed effect hCG profile change distinguished between pregnancy outcomes from as early as day‐2 post‐hCG rise from baseline.ConclusionsThe risk of first‐trimester spontaneous pregnancy loss in our prospective cohort is comparable to studies utilising daily urinary hCG collection and laboratory assays. A wider LH‐hCG interval range is associated with biochemical pregnancy loss and may relate to late or early implantation. Although early hCG changes discriminate between pregnancies that will miscarry from viable pregnancies, this point‐of‐care testing model is not sufficiently developed to be predictive.

Hypogonadism and Cryptorchidism.

Congenital cryptorchidism (undescended testis) is one of the most common congenital urogenital malformations in boys. Prevalence of cryptorchidism at birth among boys born with normal birth weight ranges from 1.8 to 8.4%. Cryptorchidism is associated with a risk of low semen quality and an increased risk of testicular germ cell tumors. Testicular hormones, androgens and insulin-like peptide 3 (INSL3), have an essential role in the process of testicular descent from intra-abdominal position into the scrotum in fetal life. This explains the increased prevalence of cryptorchidism among boys with diseases or syndromes associated with congenitally decreased secretion or action of androgens, such as patients with congenital hypogonadism and partial androgen insensitivity syndrome. There is evidence to support that cryptorchidism is associated with decreased testicular hormone production later in life. It has been shown that cryptorchidism impairs long-term Sertoli cell function, but may also affect Leydig cells. Germ cell loss taking place in the cryptorchid testis is proportional to the duration of the condition, and therefore early orchiopexy to bring the testis into the scrotum is the standard treatment. However, the evidence for benefits of early orchiopexy for testicular endocrine function is controversial. The hormonal treatments using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) to induce testicular descent have low success rates, and therefore they are not recommended by the current guidelines for management of cryptorchidism. However, more research is needed to assess the effects of hormonal treatments during infancy on future male reproductive health.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ СТОМАТОЛОГИЧЕСКОГО СТАТУСА БЕРЕМЕННЫХ ЖЕНЩИН

Currently, oral diseases require an interdisciplinary approach to solving the problem. In most cases, patients go to a doctor during an acute stage or exacerbation of the disease. The high prevalence and increase of inflammatory oral diseases among pregnant women is one of the most significant social problems. Inflammatory processes in the oral cavity can be a provoking factor for the inflammatory reaction of the whole body and subsequently affect the development of the fetus. During pregnancy, a number of changes occur in the oral cavity in the woman's body: the microbiological picture changes, the pathogenicity of the microflora increases, the hormonal background is rebuilt: the production of progesterone, chorionic gonadotropin and other hormones increases. All these factors can lead to changes in the dentate system: deterioration of oral hygiene, increased salivation, halitosis, the appearance of gum bleeding and a change in the pH of saliva. We presented data on the examination of pregnant women in the Tambov Region. We assessed dental status of pregnant women based on dental indices: CPITN, PMA and H.R. Muhleman’s gum bleeding index, estimates of changes in saliva pH of pregnant women.