Gynecologic Endocrinology Department

Gynecologic Endocrinology Department

I. Menstrual Disorders Outpatient Clinic and Endocrinology Laboratory

The Obstetrics and Gynecology Hospital Affiliated with Fudan University established the Menstrual Disorders Outpatient Clinic and Endocrinology Laboratory in 1953, established reproductive hormone testing, and launched clinical obstetric and gynecologic endocrinology, laying the foundation for the development of reproductive endocrinology clinical care and research at our hospital.

II. Shanghai Center for Diagnosis and Treatment of Female Reproductive Endocrine Disorders

The Shanghai Center for Diagnosis and Treatment of Female Reproductive Endocrine Disorders was established in 1997. It is one of Shanghai’s clinical medical diagnosis and treatment centers, approved by the Maternal and Child Health Division of the Shanghai Municipal Health Bureau. Professor Yu Chuanxin established the center and served as its director, while Professor Zhou Jianping and Professor Lin Jinfang served as deputy directors.

The center’s mission and objectives: to develop distinctive expertise in the diagnosis and treatment of female reproductive endocrine disorders, overcome difficult diseases in the field of reproductive medicine, standardize the diagnosis and treatment of female reproductive endocrine disorders, broadly improve the diagnostic and treatment capabilities of medical personnel, and serve women’s reproductive health.

The center has a comprehensive diagnostic and treatment system integrating outpatient clinics, wards, and an endocrine testing laboratory. Its scope of diagnosis and treatment covers all types of problems and diseases caused by reproductive endocrine disorders at every stage of the female life cycle, including classic gynecologic endocrine diseases, infertility due to various causes, perimenopausal syndrome, and disorders of sex differentiation and development.

Several generations of experts have made major contributions to the development of reproductive endocrinology at the Obstetrics and Gynecology Hospital Affiliated with Fudan University and have accumulated extensive experience in the diagnosis and treatment of gynecologic endocrine diseases. First generation: Wang Shuzhen; second generation: Li Songxuan, Zheng Huaimei, and Lu Xiangyun; third generation: Yu Chuanxin; fourth generation: Zhou Jianping and Lin Jinfang.

【Department Features】

I. Outpatient services: Both the Yangpu and Huangpu campuses have full-day specialty clinics for “Reproductive Endocrine Infertility and PCOS,” staffed by experts at the level of associate chief physician or above. The diagnostic and treatment system and procedures for endocrine infertility have been established and further improved.

The outpatient service also includes specialty clinics for “Adolescent Menstrual Disorders,” “Nutrition,” “Perimenopause,” and “Decreased Ovarian Function.”

In addition, the “Difficult Perimenopause MDT Clinic” and the “Refractory PCOS MDT Clinic (morning blood draw and laboratory testing, specimen collection, nutritional assessment, emotional-disorder scale assessment, dietary questionnaire assessment, exercise guidance, nutritional guidance, group psychological counseling, preconception assessment, complication assessment, interpretation of laboratory reports, and preparation of an individualized diagnosis and treatment plan by multiple specialists for one patient)” provide joint care by senior experts from multiple disciplines. This breaks down barriers between specialties, effectively advances the quality of diagnosis and treatment, and enables efficient individualized care for patients.

A remote consultation system is currently being piloted. For difficult cases, an in-hospital consultation is conducted first, followed by discussion with renowned domestic and international experts to develop a reasonable and scientifically based treatment plan. Examples include ovarian tissue cryopreservation for young patients with tumors.

II. Fertility Ward (Ward 17): In addition to routine fertility-related surgeries, such as surgery for tubal infertility, myomectomy for uterine fibroids in women who have not yet given birth, and ovarian cystectomy, the department plans to introduce new technologies such as ovarian activation and transplantation for patients with ovarian failure who have not yet given birth, reproductive-tract corrective surgery for intersex conditions (including vulvoplasty), and complex tumor-related surgeries that preserve fertility.

The department is currently following the concept of enhanced recovery after surgery (enhanced recovery after surgery, ERAS) and implementing a short-stay model (discharge after 48 h and faster turnover). It is strengthening preoperative examinations and safety assessments in the fertility surgery outpatient service, reducing perioperative risks while making maximum use of the limited medical resources currently available.

III. The endocrinology outpatient clinic and fertility ward accept referrals of critical cases (including treatment of refractory abnormal uterine bleeding accompanied by severe anemia and severe OHSS) and difficult cases from hospitals at all levels. Records of difficult-case discussions and a consultation system have also been established.

Following the merger of the Shanghai Center for Diagnosis and Treatment of Female Reproductive Endocrine Disorders and the Shanghai Jiai Genetic and Infertility Diagnosis and Treatment Center into one department, the two centers have been able to strengthen their links in both form and substance and make full use of their respective resources. They are carrying out the aforementioned IVA surgery for POI, as well as ovarian tissue cryopreservation and functional restoration for patients with malignant tumors, thereby providing genuine fertility preservation.

IV. Dissemination of achievements:

5 national-level continuing education courses each year:

1. National Training Course on Advances in the Diagnosis and Treatment of Female Reproductive Endocrinology

2. Training Course on Advances in the Diagnosis and Treatment of PCOS

3. Training Course on the Fundamentals and Applications of Gynecologic Endocrinology

4. Jiai China–United States High-Level Forum on Reproductive Medicine

5. Training Course on Advances in Basic and Clinical Research on Perimenopausal Medicine and Chronic Pelvic Pain

6. Training Course on Clinical Genetics in Obstetrics and Gynecology

【Teaching】

I. Undergraduate and postgraduate education:

The teaching secretary assesses attendance at clinical and theoretical training. Supervising teachers lead trainees in outpatient and ward diagnosis and treatment, improving their theoretical knowledge and practical skills. The department accepts students in 5-year and 8-year programs, international students for clerkships and internships, and doctors in standardized residency training and specialty training rotations, totaling approximately 40 person-visits each year. Fifteen doctoral and master’s students have been trained.

II. Continuing education: The department accepts specialist physicians at the level of attending physician or above from medical and health institutions in provinces, cities, and autonomous regions throughout the country for further training in clinical gynecologic endocrinology. Experts at the level of associate chief physician or above are responsible for instruction, training specialized technical leaders for peer medical and health institutions. More than 50 visiting physicians are accepted each year.

A mentorship system is used. Visiting physicians follow their respective supervising teachers in outpatient and ward work and participate in rounds and difficult-case discussions. During their training, they may attend in-hospital courses and lectures by various experts. Voluntarily, and under the guidance of their supervising teachers, they may design a research topic, collect relevant clinical data during the training period (projects involving ethics must receive approval), organize and write up the data, and have the supervising teacher revise it into a manuscript. Publications using data from this hospital must identify it appropriately.

III. The following theoretical training programs are provided for undergraduates, postgraduate students, and continuing-education participants:

1. Hospital-wide gynecology lecture every Tuesday evening

2. Small specialized lecture on gynecologic endocrinology at 17:00 on the Wednesday evening of the second and fourth weeks of each month

【Research】

(1) Sun Xiaoxi: National Natural Science Foundation of China General Program — Free microRNAs in human follicular fluid: searching for new molecular markers associated with embryo developmental potential and studying the corresponding molecular mechanisms

(2) Li Bin: National Natural Science Foundation of China General Program — Molecular mechanisms of the directed differentiation of induced pluripotent stem cells into ovarian granulosa cells

(3) Zhang Shaofen: National Natural Science Foundation of China General Program — Study of the molecular mechanisms by which ERs/PPARγ cross-talk mediates the effects of phytoestrogens on bone formation

(4) Zou Shien: National Natural Science Foundation of China General Program — Study of the molecular mechanisms by which gene methylation regulates natural menopause by affecting the estrogen signaling pathway

(5) Zou Shien: National Natural Science Foundation of China Young Scientists Fund — Molecular mechanism by which isoflavones promote bone formation by inhibiting NFκB activity through ERs

(6) Li Xin: National Natural Science Foundation of China General Program — Molecular mechanism by which metformin combined with Diane-35 reverses PCOS-related early endometrial cancer based on the insulin receptor–mTOR signaling pathway

(7) Gu Chao: National Natural Science Foundation of China Young Scientists Fund — Study of the mechanism by which SIRT1 regulates the progesterone receptor signaling pathway in endometrial cancer

(8) Sun Yijuan: National Natural Science Foundation of China General Program — Study of the mechanism underlying the association between the developmental potential of oocytes after vitrification and H1F00 expression levels

(9) Shi Yingli: National Natural Science Foundation of China General Program — Molecular mechanism by which miR-449b regulates CSFR1 and affects endometriotic implantation

(10) Shi Yingli: National Natural Science Foundation of China Young Scientists Fund — Molecular mechanism by which miR-183 affects the growth and invasive function of endometriotic stromal cells

(11) Zhang Wenbi: National Natural Science Foundation of China Young Scientists Fund — Study of the mechanism by which estrogen-induced differentiation of bone marrow mesenchymal stem cells contributes to the development of endometriosis

Department Experts