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Objective: To determine whether endometrial thickening is an important factor for pregnancy outcomes in platelet-rich plasma (PRP) treatment for patients with thin endometrium. Methods: Data from the registry database of the Japan Gynecologic PRP Study Group from April 2019 to October 2021 were analyzed retrospectively. A total of 208 patients who underwent single blastocyst transfer (SBT) after PRP due to thin endometrium (¡8 mm) in their previous cycle were included in the study. Their pregnancy outcomes were compared with their own historical data before PRP infusion. The same patient group was then divided into 136 patients whose endometrium thickened after PRP and 72 patients whose endometrium did not, and the pregnancy outcomes of the two groups were compared. Furthermore, to eliminate embryonic confounding, 28 patients who had single euploid blastocyst transfer (SEBT) with preimplantation genetic testing for aneuploidy (PGT-A) were selected from the same patient group and divided into two groups of 22 patients whose endometrium thickened and 6 patients whose endometrium did not, and the pregnancy outcomes were compared in the same method. Results: After PRP administration, the clinical pregnancy rate, live birth rate, and miscarriage rate were all significantly improved compared with the historical controls (34.1 vs 20.0, [Formula: see text]; 22.6 vs 3.9, [Formula: see text]; 33.8 vs 73.4, [Formula: see text]). There were no statistically significant differences in the respective rates between the “thickened endometrium” group and the “unthickened endometrium” group in SBT group (36.0 vs [Formula: see text], [Formula: see text]; 25.7 vs [Formula: see text], [Formula: see text]; 28.5 vs [Formula: see text], [Formula: see text], respectively). Likewise, in the SEBT with PGT-A group, there were no statistically significant differences in results between the two groups (36.4 vs [Formula: see text], [Formula: see text]; 36.4 vs [Formula: see text], [Formula: see text]; 0 vs [Formula: see text], respectively). Conclusions: PRP administration to patients with thin endometrium improves pregnancy outcomes even when endometrial thickening is not achieved.

In this paper, a concurrent optimization method of shape and topology for natural vibration design of shell structures is presented. The fundamental vibration eigenvalue is maximized under volume constraints for shape and topology optimization. The free-form optimization method for shells and the solid isotropic material with penalization (SIMP) method are respectively employed and combined effectively for shape and topology design, in which shape and fictitious homogenized-density variations are used as design variables and simultaneously determined. In other words, the optimal topology is determined in the variable design surface optimized by shape optimization. The optimal design problem is formulated as a distributed-parameter optimization problem, and the sensitivity functions with respect to shape and density variations are theoretically derived. Both the optimal shape and density variations are determined with the unified H1 gradient method, where the sensitivity functions are respectively applied as the Robin condition to the design surface in order to determine the optimal shape and topology. We also show an improved method for the spurious (or localized) mode problem of shell structures, which often occurs in the lower density region in topology optimization for vibration design. With the proposed method, shell structure for light weight and improved low-order vibration characteristics can be obtained without any design parameterization, free of numerical instabilities such as checkerboard pattern and zigzag-shape problems.

Abstract Purpose To evaluate the efficacy and safety of self‐injections of the prefilled recombinant human chorionic gonadotropin (r‐hCG) in a syringe in assisted reproductive technology (ART) treatment for the maturation trigger (MT), as compared to self‐injections of conventional hCG and intranasal administration of gonadotropin‐releasing hormone agonist (GnRH‐a). Methods Between January and April, 2017, 396 patients who underwent oocyte retrieval were recruited. Of these, 396 patients were classified into three groups, according to the types of MT: (1) the urinary human chorionic gonadotropin (u‐hCG) group that consisted of patients who had a self‐injection of u‐hCG (n = 127); (2) the GnRH‐a group that received nasal administration of GnRH‐a (n = 159); and (3) the r‐hCG group that had a self‐injection of r‐hCG (n = 110). Several ART outcomes were evaluated. Results The mature oocyte retrieval rate was not different between the u‐hCG, r‐hCG, and GnRH‐a groups and the fertilization and cleavage rates were similar between the three groups. The clinical pregnancy rates did not significantly differ between the GnRH‐a group and the u‐hCG group; however, it was significantly lower in the GnRH‐a group, compared to the r‐hCG group. No difference was observed in the incidence of moderate or more severe ovarian hyperstimulation syndrome among the three groups. Conclusion The self‐injection of the prefilled r‐hCG is a favorable MT for ART patients.

Members of the 14-3-3 family are intracellular dimeric phosphoserine-binding proteins that can associate with and modulate the activities of many proteins. In our efforts to isolate the genes regulated by progesterone (P4) using suppressive subtractive hybridization, we previously found that 14-3-3t is one of the genes upregulated by P4. In this study, we demonstrated by quantitative RT-PCR (qRT-PCR), western blot analyses, and immunohistochemistry that 14-3-3t mRNA and protein levels were increased in the rat uterus after P4 treatment. Furthermore, qRT-PCR indicated that P4 increased 14-3-3t mRNA levels in human endometrial epithelial cells and endometrial stromal cells (ESCs). Western blot and qRT-PCR analyses revealed that in vitro decidualization using cAMP and medroxyprogesterone 17-acetate increased levels of 14-3-3t mRNA and protein in ESCs. We have shown by qRT-PCR and western blot analyses thatP4 increased themRNAand protein levels of 14-3-3t in Ishikawa cells that stably expressP4 receptor-B (PR-B). Immunocytochemistry revealed that 14-3-3t colocalizes with PR and translocates from the cytoplasm to the nucleus in response toP4.Moreover, by luciferase reporter assay,we demonstrated that 14-3-3t enhances the transcriptional activity of PR-B. Taken together, we propose that 14-3-3t is a P4-responsive gene in uterine cells that modulates P4 signaling. [ABSTRACT FROM AUTHOR]