Publications by authors named "Ernest Ng"

Article Synopsis
  • Levonorgestrel (LNG) is primarily used as an emergency contraceptive by delaying ovulation, and this study aimed to explore its effects on the human Fallopian tube's ciliary movement and muscle contractions.
  • In an experimental setup using tissue samples from women, the researchers tested LNG at various concentrations to see any changes in ciliary beat frequency and muscular contractions.
  • Results showed that while LNG did not significantly affect ciliary movement or muscle tone, the highest concentration (100 ng/ml) did reduce muscular contractions, indicating that the Fallopian tube is not likely a target for LNG's contraceptive effects at typical emergency contraception doses.
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Background: The child cancer, neuroblastoma (NB), is characterised by a low incidence of mutations and strong oncogenic embryonal driver signals. Many new targeted epigenetic modifier drugs have failed in human trials as monotherapy.

Methods: We performed a high-throughput, combination chromatin-modifier drug screen against NB cells.

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  • * This review summarizes what is currently known about B cell functions during pregnancy, highlighting different B cell types and their influences on pregnancy outcomes.
  • * It also discusses the impact of B cell-related autoantibodies, cytokines, and signaling pathways on complications like pregnancy loss, preeclampsia, and preterm birth.
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  • The study investigates whether low levels of 25-hydroxyvitamin D (25(OH)D) are linked to a higher risk of miscarriage in women experiencing threatened miscarriage.
  • It analyzed serum samples from 371 women, revealing a miscarriage rate of 12.1%, with no significant difference in rates between those deficient in vitamin D and those who were not.
  • Notably, while lower vitamin D levels did not correlate with miscarriages overall, women presenting earlier in their pregnancy (6 weeks or less) showed a higher miscarriage rate if they were non-deficient in vitamin D.
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Background: At menstruation, the functional layer of the human endometrium sheds off due to the trigger of the release of inflammatory factors, including interleukin 6 (IL-6), as a result of a sharp decline in progesterone levels, leading to tissue breakdown and bleeding. The endometrial mesenchymal stem-like cells (CD140bCD146 eMSC) located in the basalis are responsible for the cyclical regeneration of the endometrium after menstruation. Endometrial cells from the menstruation phase have been proven to secrete a higher amount of IL-6 and further enhance the self-renewal and clonogenic activity of eMSC.

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Introduction: In recent years, the use of frozen embryo transfers (FET) has rapidly increased following the freeze-all strategy due to the advantages of increased maternal safety, improved pregnancy rates, lower ectopic pregnancy rates and better obstetric and neonatal outcomes. Currently, there is still no good scientific evidence to support when to perform FET following a stimulated in vitro fertilisation (IVF) cycle in the freeze-all strategy.

Methods/analysis: This will be a randomised controlled trial.

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Introduction: Low vitamin D status is prevalent among women with polycystic ovary syndrome (PCOS). The objective of the study is to assess the effect of vitamin D supplementation on (1) the ovulation rate to letrozole and (2) other reproductive, endocrine and metabolic outcomes after 1 year of supplementation in women with PCOS.

Methods And Analysis: This is a multicentre, randomised, double-blind, controlled clinical trial.

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  • Chemotherapy is important for treating gestational trophoblastic neoplasia (GTN), but its effects on fertility are not fully understood, leading to a study comparing GTN patients and those with molar pregnancies (MP).
  • The study involved 57 GTN patients and analyzed serum AMH levels before and after treatment with single-agent or combination chemotherapy, revealing that combination therapy resulted in lower levels, particularly noticeable at 12 months.
  • Despite the differences in hormone levels, pregnancy success rates were similar between the two groups, with longer times to first pregnancy for those on combination therapy, highlighting the need for careful patient counseling regarding fertility post-treatment.
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Introduction: Progestin can inhibit the pituitary luteinising hormone (LH) surge during ovarian stimulation for in vitro fertilisation (IVF) and studies show progestin-primed ovarian stimulation (PPOS) is effective in blocking the LH surge in IVF. More and more centres are using PPOS because this regimen appears simpler and cheaper. This study aims to compare the euploidy rate of blastocysts following the PPOS protocol and the gonadotropin-releasing hormone antagonist protocol in women undergoing preimplantation genetic testing for aneuploidy (PGT-A).

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Background: The monthly regeneration of human endometrial tissue is maintained by the presence of human endometrial mesenchymal stromal/stem cells (eMSC), a cell population co-expressing the perivascular markers CD140b and CD146. Endometrial regeneration is impaired in the presence of intrauterine adhesions, leading to infertility, recurrent pregnancy loss and placental abnormalities. Several types of somatic stem cells have been used to repair the damaged endometrium in animal models, reporting successful pregnancy.

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Objective: To compare the live birth rate of the first frozen embryo transfer (FET) after ovarian stimulation by the progestin-primed ovarian stimulation (PPOS) protocol vs. the antagonist protocol in women with an anticipated high ovarian response who were undergoing in vitro fertilization.

Design: Randomized controlled trial.

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Purpose: This study aimed to optimize the non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) in the laboratory by comparing two collection timing of the spent culture medium (SCM), two embryo rinsing protocols, and the use of conventional insemination instead of intracytoplasmic sperm injection (ICSI).

Methods: Results of two embryo rinsing methods (one-step vs sequential) and SCM collected on day 5 vs day 6 after retrieval were compared against trophectoderm (TE) biopsies as reference. Results from day 6 SCM in cycles fertilized by conventional insemination were compared with PGT-A using ICSI.

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Article Synopsis
  • Early-onset preeclampsia (EOPE) is a serious pregnancy problem that starts early but shows symptoms later on, and it's hard to predict or treat.
  • A protein called adrenomedullin (ADM) is found in high amounts in the placenta during early pregnancy, and it helps with important processes in the placenta.
  • Research shows that when ADM is low in pregnant women who go on to develop EOPE, it can lead to complications, but increasing ADM levels can help reduce these issues in studies with mice.
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Severe endometrium damage causes pathological conditions such as thin endometrium and intrauterine adhesion, resulting in uterine factor infertility. Mesenchymal stem cell (MSC) therapy is a promising strategy in endometrial repair; yet, exogenous MSCs still raise concerns for safety and ethical issues. Human adipose-derived mesenchymal stem cells (ADMSCs) residing in adipose tissue have high translational potentials due to their autologous origin.

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  • This text highlights the importance of maternal-fetal interactions, particularly focusing on glycosylation, which involves attaching sugar chains (glycans) to molecules essential for a healthy pregnancy.
  • It aims to review recent research on glycosylation's roles at the maternal-fetal interface and its effects on pregnancy outcomes, including complications like implantation failure and preeclampsia.
  • The review utilized a thorough search of relevant literature from 1980 to 2023 to gather insights on glycosylation, glycosyltransferases, and glycan-binding proteins affecting endometrial receptivity and placentation.
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Purpose: To evaluate the impact of embryo banking on the cumulative live birth rate (CLBR) and the time to live birth (TTLB) in poor ovarian responders (POR) according to the Bologna criteria.

Methods: A total of 276 infertile women undergoing IVF with POR were included in this retrospective study. They were divided into two groups with ( = 121) or without ( = 155) embryo banking at the discretion of the attending physicians.

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Article Synopsis
  • - The study aimed to determine if adding piroxicam, a cyclo-oxygenase inhibitor, to levonorgestrel (a common emergency contraception) would enhance its effectiveness after ovulation.
  • - Conducted in a double-blind, placebo-controlled trial involving 860 women, the results showed that the combination of levonorgestrel and piroxicam significantly reduced the pregnancy rate compared to levonorgestrel alone (94.7% vs. 63.4% effectiveness).
  • - The addition of piroxicam did not lead to significant differences in menstrual cycle changes or adverse effects, suggesting it is a safe and effective enhancement to emergency contraception.
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Introduction: The success rate of in vitro fertilisation (IVF) treatment for couples with infertility remains low due to lack of a reliable tool in selecting euploid embryos for transfer. This study aims to compare the efficacy in embryo selection based on morphology alone compared with non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) and morphology in infertile women undergoing IVF.

Methods And Analysis: This is a randomised double-blind controlled trial conducted in two tertiary assisted reproduction centres.

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Background: In IVF/ICSI treatment, the process of embryo implantation is the success rate-limiting step. Endometrial scratching has been suggested to improve this process, but it is unclear if this procedure increases the chance of implantation and live birth (LB) and, if so, for whom, and how the scratch should be performed.

Objective And Rationale: This individual participant data meta-analysis (IPD-MA) aims to answer the question of whether endometrial scratching in women undergoing IVF/ICSI influences the chance of a LB, and whether this effect is different in specific subgroups of women.

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  • A study investigated the effectiveness and safety of acupuncture, doxylamine-pyridoxine, and their combination for treating moderate to severe nausea and vomiting during pregnancy (NVP) in 352 early-pregnancy women across 13 hospitals in China from mid-2020 to early 2022.
  • Results showed that all treatment groups (acupuncture, doxylamine-pyridoxine, and the combination) significantly reduced nausea scores compared to controls, with the combination being the most effective.
  • However, the treatment with doxylamine-pyridoxine was associated with a higher risk of having babies who were small for their gestational age, and the true clinical significance of these findings remains unclear
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Breast cancer is the most common cancer in reproductive age women. The aim of this study is to assess the knowledge, attitude and intention on fertility preservation among women diagnosed to have breast cancer. This is a multi-centre cross-sectional questionnaire study.

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Background: To evaluate the association of serum advanced glycation end-products (AGEs) and its soluble receptor of AGE (sRAGE) levels with dysglycaemia and metabolic syndrome in women with polycystic ovary syndrome (PCOS).

Methods: This was an analysis of a cohort of women with PCOS who were prospectively recruited for a longitudinal observational study on their endocrine and metabolic profile between January 2010 and December 2013. The association of serum AGEs and sRAGE levels with dysglycaemia and metabolic syndrome at the second-year visit (the index visit) and the sixth-year visit (the outcome visit) were determined.

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Human fertilization begins when a capacitated spermatozoon binds to the zona pellucida (ZP) surrounding a mature oocyte. Defective spermatozoa-ZP interaction contributes to male infertility and is a leading cause of reduced fertilization rates in assisted reproduction treatments (ARTs). Human ejaculate contains millions of spermatozoa with varying degrees of fertilization potential and genetic quality, of which only thousands of motile spermatozoa can bind to the ZP at the fertilization site.

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Article Synopsis
  • There is a need for better non-invasive biomarkers to select embryos with high potential in IVF, and small non-coding RNAs (sncRNAs) are being explored as a solution.
  • A systematic review identified 18 studies showing dysregulation of various sncRNAs in follicular fluid and embryo culture medium, suggesting their role in predicting embryo quality.
  • The meta-analysis indicated that sncRNAs have promising predictive performance (AUC of 0.81) as non-invasive biomarkers, but significant variability among studies calls for future multicenter research to improve methods and sample sizes.
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