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Course report

Postgraduate Research Training in Reproductive Health 2004

Fudan University, Shanghai

Questions and answers

organised by

The Fudan University, Shanghai
The Geneva Foundation for Medical Education and Research (GFMER)
The UNDP/UNFPA/WHO/World Bank Special Programme for Research in Human Reproduction, Department of Reproductive Health and Research, Family and Community Health Cluster World Health Organization (WHO/RHR)
The International Association of Maternal and Neonatal Health (IAMANEH)

in collaboration with

The Department of Health of the Canton of Geneva
The Faculty of Medicine, Geneva University and
The Geneva Medical Association

  1. What is the definition of live birth?
  2. Is there any evidence of stress ( e.g. emotional) on the success rate of conception?
    Currently, there is not enough evidence to confirm the role of stress on pregnancy outcome in couples treated for infertility.References
    1. Lovely LP, Meyer WR, Ekstrom RD, Golden RN. Effect of stress on pregnancy outcome among women undergoing assisted reproduction procedures. South Med J. 2003 Jun;96(6):548-51. [PubMed]
    2. Wilson JF, Kopitzke EJ. Stress and infertility. Curr Womens Health Rep. 2002 Jun;2(3):194-9. [PubMed]
    3. Boivin J. A review of psychosocial interventions in infertility. Soc Sci Med. 2003 Dec;57(12):2325-41. [PubMed]
  3. About IVF: on the second day after oocyte retrieval, if we observe a zygote with one pronucleus, shall we perform the transfer or give up?
    No , you should not continue because of increased risk of fetal abnormalities.
    Reference : Feng H, Hershlag A. Fertilization abnormalities following human in vitro fertilization and intracytoplasmic sperm injection. Microsc Res Tech. 2003 Jul 1;61(4):358-61. [PubMed]
  4. I plan to study the changes of MMPs and MMPI in PCOS patients, but the references are limited. Please give me some advices or information.References
    1. Oksjoki S, Rahkonen O, Haarala M, Vuorio E, Anttila L. Differences in connective tissue gene expression between normally functioning, polycystic and post-menopausal ovaries. Mol Hum Reprod. 2004 Jan;10(1):7-14. [PubMed]
    2. Ben-Shlomo I, Goldman S, Shalev E. Regulation of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of MMP, and progesterone secretion in luteinized granulosa cells from normally ovulating women with polycystic ovary disease. Fertil Steril. 2003 Mar;79 Suppl 1:694-701. [PubMed]
    3. Lahav-Baratz S, Kraiem Z, Shiloh H, Koifman M, Ishai D, Dirnfeld M. Decreased expression of tissue inhibitor of matrix metalloproteinases in follicular fluid from women with polycystic ovaries compared with normally ovulating patients undergoing in vitro fertilization. Fertil Steril. 2003 Mar;79(3):567-71.[PubMed]
    4. Shalev E, Goldman S, Ben-Shlomo I. The balance between MMP-9 and MMP-2 and their tissue inhibitor (TIMP)-1 in luteinized granulosa cells: comparison between women with PCOS and normal ovulatory women. Mol Hum Reprod. 2001 Apr;7(4):325-31. [PubMed] - [Free full-text] ; Email : shalev_e@clalit.org.il
    5. Henmi H, Endo T, Nagasawa K, Hayashi T, Chida M, Akutagawa N, Iwasaki M, Kitajima Y, Kiya T, Nishikawa A, Manase K, Kudo R. Lysyl oxidase and MMP-2 expression in dehydroepiandrosterone-induced polycystic ovary in rats. Biol Reprod. 2001 Jan;64(1):157-62. [PubMed]
  5. We know that HRT can improve urologic symptoms as well as prevent osteoporosis in postmenopausal women. According to the WHI report, HRT can increase breast cancer risk. How can the beneficial effects and adverse effects be balanced?
    The following links provide guidelines on the treatment with HRT, taking into account the WHI study:
    1. Estrogen and progestogen use in peri- and postmenopausal women: September 2003 position statement of The North American Menopause Society
    2. Postmenopausal hormone replacement therapy for primary prevention of cardiovascular and cerebrovascular disease: Recommendation statement from the Canadian Task Force on Preventive Health Care
    3. Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33. [PubMed]
    4. The View of the International Menopause Society on the Women's Health Initiative
  6. Is it necessary to use antibiotics in every induced abortion operation? If not, in which situation antibiotics are needed?
  7. External cephalic version: In our country, obstetricians don’t like to do this operation, because this may induce fetal distress. What about the evidence of the risk of this operation?