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Purpose This study aimed to screen key genes and pathways involved in obese polycystic ovary syndrome (PCOS), and predict drugs for treatment of obese PCOS via bioinformatics approaches. Methods Microarray dataset GSE10946 were downloaded from the Gene Expression Omnibus database, including 7 cumulus cell samples from obese PCOS patients and 6 lean control samples. Differentially expressed genes (DEGs) between obese PCOS and controls were obtained using Bayesian test after data preprocessing, followed by functional enrichment analyses for DEGs. Besides, protein-protein interaction (PPI) network and sub-network analyses were performed. Furthermore, drug prediction was carried out based on the DEGs. Results A total of 793 DEGs were identified in PCOS compared with control, including 352 up-regulated and 441 down-regulated DEGs. Specifically, upregulated RNA polymerase I subunit B (POLR1B), DNA polymerase epsilon 3, accessory subunit (POLE3), and DNA polymerase delta 3, accessory subunit (POLD3) were enriched in pathway of pyrimidine metabolism associated with obesity and PCOS, and 5-hydroxytryptamine receptor 2C (HTR2C) was enriched calcium signaling pathway. Additionally, 10 significant potential drugs, such as spironolactone targeting androgen receptor (AR), trimipramine targeting adrenoceptor beta 2 (ADRB2), and L-ornithine targeting ornithine decarboxylase antizyme 3 (OAZ3), were obtained. Conclusions In conclusion, POLR1B, POLE3, POLD3, and HTR2C might play important roles in obese PCOS via involvement of pyrimidine metabolism and calcium signaling pathway. Moreover, AR, ADRB2, and OAZ3 might be targets of spironolactone, trimipramine, and L-ornithine in the treatment of obese PCOS.

Objective To evaluate the effect of DHEA supplementation on in vitro fertilization (IVF) parameters and pregnancy outcomes in patients older than 37 years with normal ovarian reserve. Study design A retrospective cohort study was conducted to evaluate the impact of DHEA supplementation on IVF outcome of infertile women over 37 years with normal ovarian reserve between January 2012 and July 2014. 243 patients (study group) received 75 mg of DHEA daily (25 mg three times daily) before the IVF cycle. Another 243 patients (control group) received infertility treatment, but did not receive DHEA. The IVF outcome parameters in each group were compared. Results Both groups did not show statistically significant differences in terms of patient demographics characteristics, mean numbers of oocytes retrieved and mature oocytes rate. While patients in the DHEA group have the significantly higher implantation rate and live birth rate compared with controls (30.13% versus 22.70%, 43.33% versus 28.26%). We also found that the cycle cancellation rate and miscarriage rate were lower in the DHEA group (1.23% versus 5.34%, 13.33% versus 28.89%). Conclusion DHEA supplementation may significantly improve IVF outcomes in infertile women over the age of 37.

This study assessed the true accuracy of follicular output rate (FORT) as a prognostic indicator of response to FSH and reproductive competence after IVF/intracytoplasmic sperm injection. A total of 1643 cycles, including 140 polycystic ovary syndrome (PCOS) patients who underwent ovarian stimulation, were studied. FORT was calculated as the ratio of preovulatory follicle count on the day of stimulation×100/small antral follicle count (3-10mm in diameter) at baseline. Low, medium and high FORT groups were defined according to tertile values. Among 1503 non-PCOS cycles, numbers of retrieved oocytes and of all embryos that could be transferred, as well as rates of good-quality embryos, embryo implantations and clinical pregnancies, progressively increased with FORT. In PCOS patients, FORT were significantly lower in patients who achieved clinical pregnancy compared with those who did not (0.56±0.21 versus 0.66±0.29, P=0.031). Fertilization and good-quality embryo rates were significantly higher with medium FORT than low and high FORT (P=0.001 and P=0.047, respectively). Medium FORT in PCOS patients and high FORT in non-PCOS patients may predict better outcomes for IVF/ICSI.

CD4 + CD25 + T cells (Treg cells) and macrophages play roles in the maintenance of maternal–fetal immunological tolerance. Treg cells suppress the function of macrophages via mechanisms mediated by cell–cell contact and production of soluble factors. The purpose of this study was to investigate regulation of macrophages by Treg cells within decidua from patients with unexplained recurrent miscarriage (RM) and normal control women during early pregnancy. Treg cells and macrophages were isolated from deciduas of unexplained RM ( n = 15) and control women ( n = 15) by magnetic cell separation and co-cultured for six days. Regulation of macrophages by Treg cells was assessed in the presence and absence of neutralizing anti-TGFβ antibodies and in transwell experiments. Expression of CD80, CD86, IL10, and IFNγ by macrophages was measured by flow cytometry or ELISA. Macrophage expression of CD80 and CD86 was higher in deciduas of unexplained RM patients compared with controls whereas the expression of IL10 was lower. There was no difference in the expression of IFNγ by macrophages between the two groups. Treg cells inhibited macrophage expression of CD80, CD86 and IFNγ and increased the expression of IL10. The regulatory effects of Treg cells were abrogated in the presence of neutralizing anti-TGFβ antibodies or by transwell culture. The phenotype of macrophages therefore differed in unexplained RM patients compared with normal early pregnant subjects. Macrophage regulation by Treg cells was shown to be mediated by cell–cell contact and TGFβ and this capacity was decreased in unexplained RM patients.

Objective To investigate the reproduction-assisting effects of laparoscopic “core-pulling” salpingectomy for patients with hydrosalpinx on ovarian reserve, responsiveness to stimuli and outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods Infertile females receiving treatment in Reproductive Medicine Center of Yantai Yuhuangding Hospital due to fallopian tube disorders (n=214) were enrolled from July 2006 to December 2007 and further divided into three groups. “Core-pulling” procedure group (group A) consisted of patients receiving pretreatment with “core-pulling” salpingectomy due to hydrosalpinx in our center (n=31), wherein 16 patients received IVF-ET. Conventional procedure group (group B) consisted of patients receiving conventional salpingectomy for hydrosalpinx or ectopic pregnancy in our center or other institutes prior to IVF-ET (n=59). Control group (group C) consisted of patients receiving IVF-ET without the history of previous hydrosalpinx or salpingectomy (n=124). Results At baseline, the antral follicle count of group B was significantly less than that of groups A and C (8.6 ± 2.5 vs 8.3 ± 2.0 vs 9.8 ± 2.4). The mature oocytes retrieved numbered less than the other two groups, in a statistically significant manner compared with group C (13.1 ± 5.7 vs 10.6 ± 5.0 vs 12.0 ± 6.2). Patients of groups A and B received more gonadotropin while the dosage of group B differed significantly from group C (31.0 ± 17.7 vs 37.6 ± 8.3 vs 30.0 ± 4.6). E 2 level on hCG injection day was slightly lower in group B than in the other two groups, statistically significant compared with that of group C, but not compared with that of group A. After receiving IVF-ET, patients of group A showed significantly higher conception rate than groups B and C (62.5% vs 43.6% vs 39.2%). Conclusion Compared with the conventional procedure, laparoscopic “core-pulling” salpingectomy should be recommended for patients with hydrosalpinx intending to receive IVF-ET, which did not interfere with the ovarian reserve or responsiveness but improve the conception rate in clinical practice.