11 July 2025, Volume 36 Issue 4

    

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CONTENTS IN BRIEF
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  Concentration and influencing factors of organophosphorus pesticide among pregnant women in their first trimester in Beijing

  LI Yuan, CHEN Junxi, WANG Aili, AN Hang, HAN Weiling, HUANG Junhua, ZHENG Wei, LI Zhiwen, HUANG Cheng, LI Guanghui

  Chinese Journal of Reproductive Health. 2025, 36(4): 301-306.

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  Objective To investigate the concentration and related factors of organophosphorus pesticides(OPs) exposure among pregnant women in their first trimester in Beijing. Methods Pregnant women in their first trimester were recruited at Beijing Obstetrics and Gynecology Hospital from July 2018 to October 2020. Questionnaires were used to collect the general demographic information of pregnant women and ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to determine the concentrations of six non-specific metabolites of OPs—dialkyl phosphates(DAPs) in the urine of pregnant women. Results A total of 232 pregnant women were included in the study. Detection rates of urinary DAPs ranged from 19.4% to 95.3%, with the detection rate of diethylphosphate(DEP) being the highest(95.3%). DEP and dimethylphosphate(DMP) were the major components of the six DAPs measured. The geometric mean(GM) concentration range of six DAPs was 0.07-17.28 ng/mg Cre after adjusted for creatinine, DEP and DMP were 17.28 ng/mg Cre and 6.46 ng/mg Cre, respectively. The results of multivariate linear regression analysis revealed that pre-pregnancy BMI was an influencing factor on the concentration of maternal organophosphorus exposure in early pregnancy, and the pregnant women with low pre-pregnancy BMI have higher concentrations of DAPs in their urine(P<0.05). Conclusion Pregnant women in their first trimester are widely exposed to organophosphorus pesticide in Beijing, and the overall exposure level was at a moderate level. The exposure was related to pre-pregnancy BMI, and attention needs to be paid to the impact of organophosphorus pesticide exposure during pregnancy on the health of mothers and infants.
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  Constructing a quantitative assessment model for factors contributing to live birth outcome in in vitro fertilization and embryo transfer treatment population

  LIN Weinan, ZHUANG Lili, LIU Zhenteng, ZHANG Han, LAN Changxin, REN Mengyuan, LU Qun, SHI Xiao, WANG Bin, BAO Hongchu

  Chinese Journal of Reproductive Health. 2025, 36(4): 307-312.

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  Objective The aim of this study was to quantify the contribution of different variables to the live birth outcome of In Vitro Fertilization and Embryo Transfer(IVF-ET) treatment and to identify the sensitive ranges of key variables, providing scientific decision-making references for clinicians and patients. Methods This retrospective cohort study was conducted based on an existing cohort, including a total of 5 859 fresh treatment cycles from the Reproductive Medicine Department of Yuhuangding Hospital in Yantai. A combination of univariate logistic regression analysis, multivariate Lasso regression analysis and random forest(RF) importance coefficient analysis was used for preliminary variable selection. Additionally, a literature search was conducted to supplement the preliminary variable set based on the correlation results of previous studies. The random forest algorithm was applied to construct a machine learning model with the selected variables, and the importance coefficients of the variables were calculated. Finally, partial dependence plots were used for quantitative analysis of key variables to determine their sensitive ranges. Results The live birth rate of fresh embryo transfer cycles included in this study was approximately 43%. Twenty-eight important variables were identified, with female age and the total number of high-quality embryos being the most important variables affecting the live birth outcome of embryo transfer. The success rate of live birth gradually decreased with increasing female age, and the decreasing trend became more pronounced when the female age was ≥37 years. When the total number of high-quality embryos reached 2, the probability of live birth increased to a peak and then leveled off. Conclusion Female patients undergoing IVF-ET fresh cycle treatment before the age of 37 and having a total of 2 high-quality embryos cultured are likely to achieve better live birth outcomes.
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  Screening of items for the specific module of the infertility patient reported outcome measurement scale

  ZHANG Yani, CHEN Xiufen, LIN Bing, HUANG Jinzhi, LUO Tianxin, CHEN Tianliang, WAN Chonghua, YANG Zheng

  Chinese Journal of Reproductive Health. 2025, 36(4): 313-321.

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  Objective To screen the items suitable for the specific module of the infertility scale in the patient reported outcome instruments system for chronic disease (PROISCD-IN), and to lay the foundation for the development of a full scale. Methods Items were screened following a structured decision-making approach. Firstly, a topic group and core group were established and a pool of alternative items was proposed. After the first round of discussion, a preliminary scale was formed for pre-investigation. Infertility patients who attended the gynaecology and reproduction departments of Shunde Women′s and Children′s Hospital of Guangdong Medical University and staff working in the infertility clinic were interviewed in September-October 2022.The preliminary screening of items was completed using six methods including coefficient of variation, correlation coefficient, Cronbach′s alpha coefficient, factor analysis, patient importance score and medical importance score. The items were then modified and improved through discussions with experts, medical staffs and patients. Results Based on the six screening methods and the opinions of experts, medical staffs and patients, 14 items were finally selected to form a specific module of the infertility scale (PROISCD-IN). Conclusion The screening of specific module items in the PROISCD-IN outcome measurement scale for infertility patients was strictly adhered to, and the formed specific module has good reliability and validity, which can provide a scientific measurement tool for intergrating patient perspective evidence in the evaluation system of infertility patient.
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  Effects of insemination methods on cleavage patterns of preimplantation embryos and pregnancy outcomes

  WANG Peiqing, XU Zhipeng, SHI Jianbin, GAO Lina, ZHANG Ningyuan

  Chinese Journal of Reproductive Health. 2025, 36(4): 322-327.

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  Objective To observe the embryo development in vitro during pre-implantation using a time-lapse imaging culture system, and analyze the impact of fertilization methods on early embryo cleavage patterns and implantation outcomes. Methods Patients who entered the in vitro fertilization cycle at the Reproductive Medicine Department of Gulou Hospital in Nanjing from June 2022 to June 2023 were selected. A total of 130 cases of blastocyst culture and single blastocyst transfer cycles were selected from the time-lapse imaging culture system, and were divided into a conventional in vitro fertilization(IVF group, n=99) and an intracytoplasmic sperm injection(ICSI group, n=31) according to the method of fertilization, and a retrospective analysis was conducted. A total of 1422 embryos were obtained from the IVF group(n=1066) and the ICSI group(n=356), and 874 embryos were cultured to the blastocyst stage after 2PN, divided into the IVF group(n=641) and the ICSI group(n=233) according to the method of fertilization. The effects of different fertilization methods on cleavage patterns and blastocyst formation were analyzed, and the pregnancy outcomes of patients undergoing single blastocyst transfer in the IVF group(n=99) and the ICSI group(n=31) were tracked. Results Compared to the ICSI group, the IVF group had a significantly lower proportion of abnormal cleavage in the early embryo stage(P<0.01), and had better embryo development speed and cleavage synchronization; The blastocyst formation rate was significantly higher(P<0.05). In the normal cleavage mode, the rate of embryonic development was comparable between the two fertilization methods, with no significant difference in the blastocyst formation rate(P>0.05). The blastocyst formation rate for embryos with normal cleavage was significantly higher than that of embryos with abnormal cleavage(P<0.01). There was no significant difference in clinical pregnancy rate, miscarriage rate, and live birth rate among blastocysts derived from different fertilization and cleavage methods after transplantation(P>0.05). Conclusion Although the outcome of single blastocyst transfer is not affected by the method of fertilization, the overall blastocyst formation ability in ICSI cycles is lower than that in IVF cycles, which indicated that the fertilization method still has an impact on embryo utilization. In the daily clinical work, the selection of fertilization methods should be cautious, the indications for ICSI should be strictly controlled, ICSI operating procedures should be followed, and damage to oocytes should be minimized as much as possible. At the same time, single blastocyst transfer should be promoted to achieve optimal embryo selection, in order to improve pregnancy rates and reduce multiple pregnancies.
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  Bioinformatics analysis of genes associated with oxidative stress in childhood type 1 diabetes by combined multilevel transcriptomics

  SHA Sha, JIN Ni, XIE Xinyi, RUAN Yanghao, OUYANG Yin

  Chinese Journal of Reproductive Health. 2025, 36(4): 328-333.

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  Objective To explore the genes associated with oxidative stress response in the pathogenesis of type 1 diabetes mellitus(T1DM) in children. Methods The Genecards database was used to obtain the genes related to "oxidative stress (OS)", and the GEO dataset was used to GSE33440, which analyzed the gene expression of peripheral blood mononuclear cells of 16 children with type 1 diabetes mellitus (T1DM group) and 6 adult healthy controls (healthy subjects group) to determine the gene expression changes related to T1DM, and the molecular function and biological pathways of OS-related differential genes were explored by GO and KEGG enrichment analysis. Furthermore, combined with the single-cell transcriptome GSE141784 dataset, the dynamic changes of mRNA expression of candidate genes, the specificity of cell types and the biological processes involved in them were discussed. Results Compared with the healthy subjects, the expression of 250 genes in the T1DM group was increased and the expression of 296 genes decreased. GO and KEGG analyses showed that OS-DEGs were significantly enriched in C-type lectin receptor signaling pathway, lipid and atherosclerotic pathway, Salmonella infection pathway and toxoplasmosis pathway. Combined with PPI network analysis, 10 core differential genes were screened, including TLR4, PTGS2, IKBKG, etc. Single-cell data analysis showed that TLR4 and IKBKG were uniformly and highly expressed in all groups of cells during the pathogenesis of T1DM, while PTGS2 was mainly highly expressed in classical dendritic cells and macrophages. Conclusion TLR4, PTGS2 and IKBKG may be involved in the pathogenesis of T1DM by regulating oxidative stress, and TLR4 and PTGS2 may interact with each other.
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  Clinical efficacy analysis of methylprednisolone sodium succinateas adjunctive treatment of severe mycoplasma pneumoniae pneumonia in pediatric patients and its impact on blood LDH, CRP levels and T lymphocyte subsets in children

  YIN Li,WANG Xue, GAO Mimi, LIU Anna, LI Fang

  Chinese Journal of Reproductive Health. 2025, 36(4): 334-338.

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  Objective To evaluate the clinical efficacy of methylprednisolone sodium succinate(MSS) as adjuvant therapy in the treatment of severe mycoplasma pneumoniae pneumonia in pediatric patients, and its impact on serum lactate dehydrogenase(LDH), C-reactive protein(CRP), and T lymphocyte subsets. Methods A total of 120 children with severe mycoplasma pneumonia admitted to the Department of Pediatrics at the Second Hospital of Hebei Medical University from January 2023 to January 2024 were selected. Three groups are divided, treatment group(conventional treatment and MSC) with 80 patients, including 40 patients treated with MSC for 3 days(Short-course group) and 40 patients for 5 days(extended group). The control group consisted of 40 cases receiving conventional treatment. Pairwise comparisons were conducted by comparing the time for body temperature to return to normal, resolution of cough and rales, as well as improvements in C-reactive protein(CRP) and lactate dehydrogenase(LDH) before and after treatment. Results Compared with the control group, the treatment group had a significantly shorter time for body temperature to return to normal, resolution of rales, and disappearance of cough(P<0.05), while there were no statistically significant differences for the parameters between the short-course and extended groups. In terms of inflammatory markers(CRP and LDH), there were no statistically significant differences between the two groups before treatment. After treatment, the improvement in the treatment group was better than that in the control group, with statistically significant differences. There were no statistically significant differences in the improvement of CRP and LDH before and after treatment within the treatment group. In the comparison of T lymphocyte subsets, the improvement of CD4⁺ and CD8⁺ in the treatment group was more significant compared to the control group, with statistically significant differences. There were no statistically significant differences in the improvement of CD4⁺ and CD8⁺ between the short-course and extended groups in the treatment group. Conclusion MSC as adjuvant therapy for children with severe mycoplasma pneumonia demonstrates significant clinical efficacy, which can shorten the the time for body temperature to return to normal, cough and rale to disappear, and can significantly improve the recovery of inflammatory indicators(CRP and LDH), thereby alleviating pain in children and shortening hospital stay.
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  Effect evaluation of hypnotherapy combined with health education on improving menopausal syndrome

  LIU Xiaohong, DUAN Hua, YANG Mukun, BAI Wenpei

  Chinese Journal of Reproductive Health. 2025, 36(4): 339-343.

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  Objective To explore the effects of hypnotherapy combined with health education on menopausal symptoms Methods. Methods This study used prospective randomized controlled studies, 70 patients with mild to moderate menopause-related symptoms were selected as study participants from May 2019 to February 2022, and randomly divided into joint group and health education group according to a random number table 1∶1. Both groups were given perimenopausal health care related knowledge and health education, and the joint group was additionally given hypnotherapy to the patients twice a week for 4 weeks for a total of 8 sessions. The health education group was in a natural state after receiving health education. The modified Kupperman Rating Scale, Anxiety Self-rating Scale, Depression Self-rating Scale and Pittsburgh Sleep Quality Index Scale were used before the intervention and one month after the intervention to evaluate the two groups of patients. Results The median menopausal symptom score was 12.0(10.2, 15.2) in the joint group and 24.5(23.0, 30.0) in the health education group after 1 month of intervention, and the difference between the groups was statistically significant(P<0.05). One month after the intervention, the median scores of the anxiety self-assessment scale, depression self-assessment scale and Pittsburgh sleep scale in the joint group were 46.0(40.5, 50.0), 41.5(37.2, 43.0), 6.5(5.0, 11.0), which were significantly lower than the health education group of 51.0(48.0, 52.5), 50.0(45.7, 52.0), 12.5(11.0, 15.0), respectively(P<0.05). Conclusion Hypnotherapy combined with health education can effectively relieve menopausal symptoms, anxiety and depression, and improve sleep quality in perimenopausal patients.