The age-related decay in oocyte quality contributes to the gradual decline in fertility and the final occurrence of natural sterility. In this study, we aimed to investigate the effects of the hyperbaric oxygen treatment (HBOT) on oocyte quality in aging mouse oocyte. Eight- and forty-week-old female C57BL/6 J mice were treated with HBO for 10 days, and the quality of oocytes was analyzed. The results revealed that HBOT improved the age-related serum AMH levels. While compared with untreated aged mice, HBOT showed reduced follicular apoptosis and improved oocyte maturation, fertilization, and blastocyst formation in aged mice. HBO triggered changes in the microRNA expression in the ovaries of aged mice. In this study, 27 DEGs were identified in the HBOT mouse ovarian tissues, of which 9 were upregulated and 18 were downregulated. Notably, KEGG analysis revealed that these genes involved in different biological processes differed significantly in the ovary. Among these, the PI3K-Akt signaling was the most prominent pathway that controlled the recruitment and growth of primordial follicles. The calcium signaling pathway was found to be involved during the peri-implantation period. These results suggest that HBOT can be applied to improve the quality of oocytes, and it could be a potential clinical application to improve the fertility of aged female.
BackgroundA successful pregnancy using in vitro fertilization and embryo transfer (IVF-ET) requires a receptive endometrium, good-quality embryos, and a synchronized embryo-endometrial dialogue. Although embryo quality and endometrial receptivity (ER) have been fully assessed to exclude substandard conditions, the probability of successful ET is relatively low. Currently, embryo-endometrial synchrony is considered to be a possible explanation, because delayed, advanced, or narrowed window of implantation (WOI) may lead to ET failure.ObjectiveThis study aims to establish a nomogram incorporating a series of ultrasonic ER markers on the day before implantation to assess the embryo-endometrial synchrony, which may contribute to the improvement of clinical pregnancy outcomes.MethodsTotally 583 women with 1135 complete IVF cycles were retrospectively analyzed. Among them, 357 women with 698 cycles and 226 women with 437 cycles were assigned to the training and validation cohorts, respectively. Ultrasonic ER markers obtained on the day before implantation were collected for analyses. In the training cohort, the screened correlates of clinical pregnancy failure were utilized to develop a nomogram for determining whether an infertile woman is suitable for the ET next day. This model was validated both in the training and validation cohorts.ResultsSpiral artery (SA) resistance index (RI), vascularisation index (VI), and flow index (FI) were independently associated with the ET failure (all P < 0.05). They were served as the components of the developed nomogram to visualize the likelihood of implantation failure in IVF-ET. This model was validated to present good discrimination and calibration, and obtained clinical net benefits both in the training and validation cohorts.ConclusionWe developed a nomogram that included SA-RI, VI, and FI on the day before implantation. It may assist physicians to identify patients with displaced WOI, thus avoiding meaningless ET prior to implantation.
Objective to analyze the uterine artery and spiral artery blood flow parameters in patients with unexplained recurrent spontaneous abortion (URSA) with different pregnancy outcomes, to compare the predictive value of uterine artery and spiral artery blood flow parameters in pregnancy outcome, and to explore the possible mechanism of URSA and the effect of different drug regimens on pregnancy outcome in URSA patients. Methods a retrospective cohort study was conducted to analyze the clinical data of 174 pregnant women with unexplained recurrent abortion and 144 pregnant women without adverse pregnancy history. According to the pregnancy outcome, the pregnant women with unexplained recurrent abortion were divided into normal pregnancy outcome group (URSA-N,n = 138) and adverse pregnancy outcome group (URSA-A,n = 36). The pregnant women in the control group were divided into normal pregnancy outcome group (CON-N,n = 129) and adverse pregnancy outcome group (CON-A,n = 15). The blood flow parameters of uterine artery and spiral artery in mid-luteal phase, 11–13 weeks of gestation, 15–17 weeks of gestation and 19–21 weeks of gestation were compared, and the predictive value of uterine artery blood flow parameters and spiral artery blood flow parameters on pregnancy outcome was compared. the effects of aspirin and aspirin combined with low molecular weight heparin on pregnancy outcome in patients with unexplained recurrent abortion were evaluated. Results there was no significant difference in age and body mass index (BMI) between URSA group and CON group. The number of spontaneous abortion and BMI in URSA-N group were less than those in URSA-A group. There was no significant difference in age and BMI between CON groups. The spiral artery blood flow parameters of URSA-N group and CON-N group were lower than those of URSA-A group and CON-A group at mid-luteal phase, 11–13 weeks, 15–17 weeks and 19–21 weeks of gestation, respectively. The uterine artery blood flow parameters (mRI, mPI, mS/D) in the middle luteal period, uterine artery pulse index (mPI) at 11–13 weeks of gestation, peak systolic flow rate/diastolic (mS/D) flow rate at 15–17 weeks of gestation in URSA-N group were lower than those in URSA-A group, and the uterine artery blood flow parameters (mRI, mPI, mS/D) of the CON-N group were lower than those of the CON-A group at the middle luteal stage and weeks 11–13 of gestation. The area under the ROC curve of spiral artery blood flow parameters (mRI,mPI,mS/D) was larger than that of uterine artery. There were significant differences in the efficacy of different drugs between the URSA-N group and the URSA-A group, and aspirin combined with low molecular weight heparin could improve the pregnancy outcome.The area under the ROC curve of spiral artery blood flow parameters (mRI,mPI,mS/D) was larger than that of uterine artery. There were significant differences in pregnancy outcomes among different treatment schemes, and aspirin combined with low molecular weight heparin could improve the pregnancy outcome. The area under the ROC curve of spiral artery blood flow parameters (mRI,mPI,mS/D) was larger than that of uterine artery. There were significant differences in the efficacy of different drugs between the URSA-N group and the URSA-A group, and aspirin combined with low molecular weight heparin could improve the pregnancy outcome. Conclusion the blood flow parameters (mRI,mPI,mS/D) of uterine artery and spiral artery in adverse pregnancy outcome group are higher than those in normal pregnancy outcome group. Abnormal blood flow parameters of uterine artery and spiral artery may be one of the causes of URSA and adverse pregnancy outcome. Spiral artery blood flow parameters are more valuable than uterine artery blood flow parameters in predicting pregnancy outcome. Aspirin combined with low molecular weight heparin can improve the pregnancy outcome of URSA patients more than aspirin alone.
Objective To analyze the uterine artery blood flow parameters of patients with recurrent spontaneous abortion (RSA) at different gestational ages and to investigate the effects of aspirin and low molecular weight heparin (LMWH) on uterine artery blood flow parameters and pregnancy outcomes. Methods This was a retrospective cohort study involving analysis of clinical data for 140 patients: 47 in an aspirin group, 49 in a combination group, and 44 in a control group. The uterine artery blood flow parameters of the three groups in the middle luteal period and 10th, 12th, 16th, and 20th gestational weeks were compared. Trends in uterine artery flow parameters were predicted by function fitting, and the uterine artery flow parameters and pregnancy outcomes between different drug administration regimens were compared. Results With increasing gestational age, the uterine artery blood flow parameters of the three groups gradually decreased. In the middle luteal phase, the uterine artery blood flow parameters (mRI, mPI, mS/D) of the recurrent spontaneous abortion group, that is, the aspirin and combination groups, were significantly higher than those of the control group. Uterine artery blood flow parameters from 10 to 20 weeks of gestation were as follows: combined group < aspirin group < normal pregnancy group. The mean resistance index (mRI) in the combination group decreased most rapidly compared with the aspirin group between 10 and 20 weeks of gestation. The live birth rate was higher in the combination group than in the aspirin group. Conclusions Both aspirin and aspirin combined with LMWH can reduce uterine artery blood flow parameters, and combination therapy is superior to aspirin alone. In the RSA group, the rate of mRI decline may predict pregnancy outcome to some extent. Combination therapy can improve the live birth rate and reduce the miscarriage rate.
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