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Chinese expert consensus on clinical practice of female fertility preservation

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Reproductive and Developmental Medicine 2022年第1期6卷 42-50页

作者： Wen Li ri-cheng chian on behalf of the Fertility Preservation Committee of Chinese Maternal and Child Association Department of Assisted Reproduction International Peace Maternity and Child Health HospitalShanghai Jiao Tong University School of MedicineShanghai 200030China Center for Reproductive Medicine Shanghai 10th People's Hospital of Tongji UniversityShanghai 200072China 不详

Many female fertility preservation-related technologies have recently been developed in response to increasing demand for such treatments. To establish standard practices of female fertility preservation in China, the Chinese Maternal and Child Health Association Affiliated Fertility Preservation Professional Committee assembled specialists to construct a consensus, referring to the current clinical guidelines of some countries combined with clinical practice and expert opinions. The consensus includes two parts: (1) indications for female fertility preservation and related techniques, in which we sought to be inclusive regarding the indications for fertility preservation;and (2) practical guidance for the clinical application of the female fertility preservation technologies.

关键词： Fertility preservation Neoplasms Reproductive techniques Assisted Oocyte cryopreservation Ovarian tissue cryopreservation

Offspring from oocytes grown in frozen-thawed ovarian tissues transplanted to male and female bodies

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Reproductive and Developmental Medicine 2022年第1期6卷 13-19页

作者： Jie Yan Yu-Fang Cai Shan-Jun Dai Xiao-Jin He Ying-Pu Sun Yun-Xia Cao Jie Qiao ri-cheng chian Center for Reproductive Medicine Peking University Third HospitalBeijing 100191China Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education School of Basic MedicineNingxia Medical UniversityYinchuan 750004China Center for Reproductive Medicine The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Center for Reproductive Medicine Anhui Medical UniversityHefei 230032China Center for Reproductive Medicine Shanghai 10th People's Hospital of Tongji UniversityShanghai 200072China

Objective: There are few reports of live births from heterotopic transplantation of frozen-thawed ovarian tissue. The purpose of this study is to assess the follicular development in the frozen-thawed ovarian tissues following heterotopic transplantation in both female and male bodies.Methods: Cluster of differentiation 1 (CD1) mice (6-8 weeks) were used in this study as ovarian tissue donors and foster mothers for embryo transfer. Sperm from CD1 male mice were used for insemination by intracytoplasmic sperm injection (ICSI). Nude severe combined immunodeficiency mice (8 weeks) were employed as recipients of ovarian tissue transplantation. The frozen-thawed ovarian tissues were transplanted to 4 sites on each mouse, female and male, subcutaneously. After 3 months, both female and male mice were injected with 5.0 IU gonadotropins intraperitoneally. Post 48 hours of injection, the mouse was killed for ovarian transplant collection. Only fully grown oocytes with contacted cumulus cells (cumulus-oocyte complexes) were then selected for maturationin vitro.In vitro matured oocytes were inseminated with fresh sperm by ICSI, and the developed blastocysts were frozen using the vitrification method and stored until embryo transfer. After thawing, the thawed blastocysts were incubated for at least 2 hours before the transfer. The foster mice mothers mated with vasectomised male 3 days previously. Live birth was monitored at 19 days after transfer, and the resulted offspring was raised for fertility test.Results: The relatively high recovery rates of the transplanted ovarian tissues were collected in both frozen-thawed and fresh ovarian tissue transplants from both female and male bodies. The fully grown immature oocytes became maturein vitro and the fertilized zygotes developed to blastocyst stage. There are no differences between frozen-thawed and fresh ovarian transplants in term of oocyte quality and embryo development to blastocyst rates. Nineteen-day post-transfer, 3 foster mothers from the frozen-thawed ovarian tissue

关键词： Ovarian tissue Cryopreservation Transplantation Oocytes Live births

Changes in human sperm motility and DNA fragmentation index after incubation at different temperatures following density gradient centrifugation and swim-up procedures

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Reproductive and Developmental Medicine 2022年第4期6卷 243-248页

作者： Yan-Nan Yang Ling Wang Yu-Bing Liu Yun-Jing Xue Chen-Chen Liu Fei Shi Xue Dai ri-cheng chian Center for Reproductive Medicine Shanghai 10th People’s Hospital of Tongji UniversityShanghai 200072China

Objective:The purpose of this study was to evaluate the sperm motility and DNA integrity at different temperatures to analyze whether the sperms are suitable on the second day for insemination of in vitro matured oocytes by intra-cytoplasmic sperm injection(ICSI)following density gradient centrifugation(DGC)and swim-up(SU)procedures.Methods:Semen samples were collected from 30 outpatients who visited the Center for Reproductive Medicine for semen analyses.Following sperm selection by DGC and SU procedures,the liquified semen samples were divided into three groups and incubated at 4,25,and 37°C,respectively.Following incubation for 24,48,and 72 hours,the sperm motility and sperm DNA fragmentation index(DFI)were analyzed.Results:Following the combination of DGC and SU procedures,the sperm motility(91.8%±8.6%vs.50.8%±13.1%)and DFI(5.1%±7.9%vs.13.0%±11.6%)were significantly improved(Prior incubation.However,sperm motility significantly increased(76.9%±10.4%)(Prison to that of the other 2 groups.However,the sperm DFI did not significantly increase when the sperm samples were incubated at 4(5.7%±5.9%)and 25°C(6.8%±5.6%)for 24 hours compared to that before incubation(5.1%±7.9%).Conclusions:These results indicate that the sperm quality,in terms of motility and DFI,can be efficiently improved by DGC in combination with SU.Following which,the sperm samples can be incubated at 25°C and be used on the second day for insemination of in vitro matured oocytes by ICSI.

关键词： Sperm motility Density gradient centrifugation Swim-up DNA fragmentation index matured oocytes

Effect of pre-IVF incubation in maturation medium on oocyte maturity,fertilization,embryonic development,and clinical outcomes following embryo transfer

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Reproductive and Developmental Medicine 2022年第3期6卷 162-168页

作者： Jian-Hua Li Jian-Ye Wang Ting-Ting Jiao Min Li Yan Wei Ye Wang Yan-Bin cheng Shui-Wen Zhang Shuang Tian ri-cheng chian Reproductive Medical Center Senior Department of Obstetrics and Gynecologythe Seventh Medical Center of PLA General Hospital100700 BeijingChina Center for Reproductive Medicine Shanghai Tenth People’s Hospital of Tongji University200072 ShanghaiChina

Objective:Collected human cumulus-oocyte complexes(COCs)are usually inseminated after 4 to 6 hours in in vitro fertilization(IVF)laboratories.The purpose of this study was to determine the effect of short-term pre-IVF incubation in culture medium on subsequent oocyte maturation,fertilization,and embryonic development,as well as clinical outcomes.Methods:Sixty patients were divided randomly into 2 groups,pre-IVF incubation for 5 hours:1)with(+)the designed oocyte maturation medium;2)without(-)the designed oocyte maturation medium(transferred directly to fertilization medium for 5 hours before insemination).Oocyte maturation and fertilization were assessed,and the rate of cleavage and good quality embryos were evaluated between the 2 groups on days 2 and 3,respectively.Blastocyst development was based on the remaining number of embryos on day 3,continuously cultured to day 5 after embryo transfer or frozen on day 3,and was compared between the 2 groups.Clinical pregnancy,implantation,and miscarriage rates were also compared.Results:Oocyte maturation rates did not differ between groups(85.8±14.1%vs.90.7±9.1%).However,the range of oocyte maturation rates(58.3%-100.0%)for each patient was significantly higher in the(-)group than in the(+)pre-incubation group(71.4%-100.0%).There were no differences in fertilization rates(89.9±10.0%vs.86.5±12.2%)and good quality embryos(70.8±19.1%vs.62.1±23.7%)between groups;however,the blastocyst development rates were significantly different between groups(73.1±20.1%vs.58.8±18.2%,P<0.05).Nevertheless,clinical pregnancy(62.5%vs.61.1%)and implantation(46.9%vs.47.2%)rates did not differ between groups.Conclusions:These results indicate that a short pre-IVF incubation time in the designed culture medium promotes oocyte maturation and embryonic development,suggesting that short pre-IVF incubation of COCs in the designed culture medium may be important for subsequent final oocyte maturation and early embryonic development.

关键词： Pre-IVF incubation Oocyte Maturation Fertilization Embryonic development Clinical outcomes

Mitochondrial Dysfunction and Age-related Oocyte Quality

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Reproductive and Developmental Medicine 2017年第1期1卷 45-54页

作者： Han Li ri-cheng chian Center for Reproductive Medicine the 10th People’s Hospital of Tongjin UniversityShanghai 200072China Department of Obstetrics and Gynecology McGill UniversityMontrealCanada

Fertility disorders have become a growing problem worldwide. It is well known that female fertility decreases with age, previous studies suggested that the age-related decline in female fertility potential was largely due to decrease in oocyte quality and mitochondrial dysfunction. Mitochondria play a crucial role during the process of oocyte maturation. Mitochondrial genetic, numerical and structural defects occur in oocyte aging process, mitochondrial abnormalities are believed to contribute to age-related infertility. Improvement of the mitochondrial function can lead to better fertility outcomes, and application of mitochondria replacement strategy or mitochondrial transfer to age-related infertility will be possible in the future. This review paper, we are trying to discuss current understanding about age-related changes in oocyte quality and mitochondrial dysfunction.

关键词： Mitochondrial Dysfunction Oocyte Quality Therapeutic Strategies

How fertility preservation guidelines have progressed worldwide:Potential implications and inspiration

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Reproductive and Developmental Medicine 2022年第1期6卷 34-41页

作者： Min-Xin Chen Ying Zhang Qing-Qing Cai Shuo Zhang Ran Xu Hua Chen Yu Kang Yue Wu ri-cheng chian Cong-Jian Xu President Office Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China Fertility Preservation Center Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China Department of Genetics Shanghai JIAI Genetics and IVF InstituteShanghai 200011China Department of International Law China Foreign Affairs UniversityBeijing 100032China Department of Infertility Shanghai JIAI Genetics and IVF InstituteShanghai 200011China Clinical Research Center Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200090China Center for Reproductive Medicine Shanghai 10th People's Hospital of Tongji UniversityShanghai 200072China

To summarize fertility preservation (FP) guidelines and consensus provided by medical facilities worldwide. Five reference databases (PubMed/Embase, China BioMedical Literature Database, ClinicalKey, Wanfang Data, and China Knowledge Resource Integrated) and 7 guideline databases (Guideline International Network, National Collaborating Centre for Women’s and Children’s Health, National Guideline Clearinghouse, The National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guideline Group, and Canadian Medical Association infobase) were searched. Official websites of societies were searched to find relevant guidelines and consensus, and guidelines and published systematic reviews and consensus were reviewed from inception through May 2021. A literature search was performed regarding guidance offered in professional facilities, and 304 records (including 4 in Chinese) of existing guidelines for full-text review were found. Moreover, 55 guidelines were identified after a manual search. The literature review demonstrated that FP guidance and options were unevenly distributed worldwide for women who wanted to post-pone pregnancy or had impaired fertility after gonadal toxicity. With promising cancer survival rates and diversified family decisions, more attention should be paid to the improvement and update of accessible guidelines and regulatory infrastructure to inform patients about the available options and empower them to make informed choices. Restrictions to such services can be gradually eased due to the efficacy and safety of certain FP techniques for the right candidates to initiate pregnancy conception.

关键词： Fertility preservation Cancer patient Aging Guidance

A novel tube for sperm density gradient centrifugation procedure

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Reproductive and Developmental Medicine 2023年第4期7卷 224-229页

作者： Yun-Jing Xue Wei Du Cun-Zhong Deng Yuan Xu Chen-Chen Liu Yan-Nan Yang Ling Wang Yu-Zhen Lv Zheng Li ri-cheng chian Center for Reproductive Medicine Shanghai 1Oth People's Hospital of Tongji UniversityShanghai 200072China Center for Reproductive Medicine Women's and Children's Hospital of Jiaozuo CityJiaozuo 454001China Department of Andrology Center for Men's HealthShanghai General HospitalShanghai 200080China Department of ART Shanghai General HospitalShanghai200080China.

Objective:Density gradient centrifugation(DGC),swim up(SU),or a combination of DGC and SU is used to prepare sperm for infertility treatments using assisted reproductive technologies(ARTs).This study aimed to investigate the efficiency of a new device for detecting sperm DGC.Methods:Sperm samples were collected from 119 males who required semen analysis at three differentin vitro fertilization(IVF)centers(71 samples from Center A,28 samples from Center B,and 20 samples from Center C).Semen samples were divided into two groups for DGC:(1)a normal centrifugation tube and(2)a specially designed RC-Tube.The sperm concentration,motility,and DNA fragmentation index(DFI)were assessed using DGC.Sperm concentration and motility were assessed using a MAKLER counting chamber.Sperm DFI was measured and analyzed using flow cytometry using a DFI Kit.Results:There were no significant differences in sperm concentrations recovered following DGC between the two groups(31.1%±1.7%vs.28.8%±1.3%).Sperm motility was not significantly different following the DGC procedure in both groups(77.6%±1.6%.vs.75.8%±1.6%).The percentage of sperm DFI was also not significantly different following DGC between the two groups(10.4%±1.0%vs.10.5%±1.0%).Conclusions:The newly designed RC-Tube is efficient for sperm DGC and can be used to simplify sperm preparation for infertility treatment.

关键词： Sperm Centrifugation Motility DFI RC-Tube

Strategies of Infertility Treatment with Human Immature Oocytes

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Reproductive and Developmental Medicine 2018年第4期2卷 237-248页

作者： ri‑cheng chian Ling Wang Zhi‑Yong Yang Center for Reproductive Medicine The 10th People’s Hospital of Tongji UniversityShanghai 200072China

Human immature oocytes can be matured in vitro following culture. In vitro maturation(IVM) refers to maturation in culture of immature oocytes at different stages that may or may not have been exposed to short courses of gonadotropins. The source of immature oocytes is an important feature for the subsequent embryonic development and pregnancy, as well healthy live births. IVM is an efficient treatment that has already achieved significant outcomes in terms of acceptable pregnancies and implantation rates and resulted in the births of several thousands of healthy babies. As the development of IVM treatment continues, an attractive possibility for improving the already successful outcome is to combine a natural cycle in vitro fertilization(IVF) treatment with an immature oocyte retrieval followed by IVM of those immature oocytes.If the treatment processes can be simplified with immature oocyte retrieval, different types of infertile women may be able to take advantage of these treatments. Although IVM treatment is still considered experimental by the society, it is time to reconsider the IVM technological evolution. Mild stimulation IVF combined with IVM treatment represents a viable alternative to the standard treatment, and as data accumulate over time, it may prove to be an optimal first-line treatment approach.

关键词： Immature Oocytes In vitro Maturation Infertility Treatment

Efficient silencing of the multicopy DUX4 gene by ABE-mediated start codon mutation in human embryos

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Journal of Genetics and Genomics 2022年第10期49卷 982-985页

作者： Yubing Liu Xinmei Lu Min Ye Ling Wang Rongxin Tang Zhiyong Yang Bongkoch Turathum Chenchen Liu Yujing Xue Menghua Wu Yannan Yang Ermeng Gao Di Zhang Feng Yang Keh-Kooi Kee Xingxu Huang Guanglei Li ri-cheng chian Center for Reproductive Medicine Tenth People's Hospital of Tongji University301 Middle Yanchang RoadShanghai 200072China Center for Reproductive Medicine Zhongshan HospitalFudan University180 Fenglin RoadShanghai 200032China Center for Stem Cell Biology and Regenerative Medicine Department of Basic Medical SciencesSchool of MedicineTsinghua UniversityBeijing 100084China Department of Basic Medical Science Faculty of Medicine Vajira HospitalNavamindradhiraj UniversityBangkok 10300Thailand School of Life Science and Technology Shanghai Tech University100 Haike RoadPudong New AreaShanghai 201210China

The Dux gene plays an important role in mouse embryo development(De Iaco et al.,2017;Hendrickson et al.,2017;Whiddon et al.,2017).It participates in the maternal-to-zygotic transition(MTZ),which mainly includes maternal transcript degradation and zygotic genome activation(ZGA)and is the key process for embryonic development.Approximately 11-100 copies of the DUX4 gene form a tandem cluster in the human genome(Snider et al.,2009,2010).

关键词： development maternal