This is a retrospective,observational study to evaluate the effect of maternal age on the outcomes of in vitro fertilization and embryo transfer(IVF-ET).11830 IVF-ET cycles from 10268 women were included.Four groups o...This is a retrospective,observational study to evaluate the effect of maternal age on the outcomes of in vitro fertilization and embryo transfer(IVF-ET).11830 IVF-ET cycles from 10268 women were included.Four groups of different maternal age periods were compared.The groups were 21 30 years old group(4549 cycles),31-35 years old group(4424 cycles),36-40 years old group(2429 cycles),and over 40 years old group(428 cycles).The mean starting dose of Gn and mean total dose of Gn in each cycle were significantly higher(P<0.01),while the mean retrieved oocyte number was significantly lower(P<0.01) in groups of higher maternal age period than those in each of the lower groups.The biochemical pregnancy rate and the clinical pregnancy rate were significantly lower(P<0.01),while the miscarriage rate was significantly higher(P<0.01) in groups of higher maternal age period than those in the lower groups.No difference was found in two-pronuclear zygotes(2PN) rate and good quality embryo rate among different groups.Birth defect rate was also comparable in the born babies in different groups.In the group with patients' age over 40 years old,the pregnancy rate was 26.87%,the clinical pregnancy rate was 19.39%,while the miscarriage rate after clinical pregnancy was 36.14%.To draw the conclusion,patients with higher maternal age had worse IVF outcomes.In women of fertile age,patients between 20 and 30 years old have the best IVF outcomes.Patients over 40 years old have poor IVF outcome and high miscarriage rate,which suggested the necessity of preimplantation genetic screening(PGS).展开更多
The aim of this study was to investigate whether the sperm chromatin structure assay (SCSA) results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilizati...The aim of this study was to investigate whether the sperm chromatin structure assay (SCSA) results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilization (IVF). A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index (DFI) subgroups and high DNA stainability (HDS) subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.展开更多
Homozygous human embryonic stem cells (hESCs) are thought to be better cell sources for hESC banking because their human leukocyte antigen (HLA) haplotype would strongly increase the degree of matching for certain...Homozygous human embryonic stem cells (hESCs) are thought to be better cell sources for hESC banking because their human leukocyte antigen (HLA) haplotype would strongly increase the degree of matching for certain populations with relatively smaller cohorts of cell lines. Homozygous hESCs can be generated from parthenogenetic embryos, but only heterozygous hESCs have been established using the current strategy to artificially activate the oocyte without second polar body extrusion. Here we report the first successful derivation of a human homozygous ESC line (chHES- 32) from a one-pronuclear oocyte following routine in vitro fertilization treatment, chHES-32 cells express common markers and genes with normal hESCs. They have been propagated in an undifferentiated state for more than a year (〉P50) and have maintained a stable karyotype of 46, XX. When differentiated in vivo and in vitro, chHES-32 cells can form derivatives from all three embryonic germ layers. The almost undetectable expression of five paternally expressed imprinted genes and their HLA genotype identical to the oocyte donor indicated their parthenogenetic origin. Using genome-wide single-nucleotide polymorphism analysis and DNA fingerprinting, the homozygosity of chHES-32 cells was further confirmed. The results indicated that ‘ unwanted' one-pronuclear oocytes might be a potential source for human homozygous and parthenogenetic ESCs, and suggested an alternative strategyfor obtaining homozygous hESC lines from parthenogenetic haploid oocytes.展开更多
Background: Estradiol, as an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization embryo transfer (IVF-ET) cycles. The aim of...Background: Estradiol, as an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization embryo transfer (IVF-ET) cycles. The aim of this retrospective study was to evaluate the association between elevated serum estradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and IVF-ET pregnancy and birth outcomes. Methods: A total of 1771 infertile patients with their first fresh IVF-ET cycles were analyzed retrospectively between January 2011 and January 2016 in Peking University First Hospital. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels < 1000 pg/mL, n = 205), group 2 (serum E2 levels 1001-2000 pg/mL, n = 457), group 3 (serum E2 levels 2001-3000 pg/mL, n = 425), group 4 (serum E2 levels 3001-4000 pg/mL, n = 310), group 5 (serum E2 levels 4001- 5000 pg/mL, n = 237), and group 6 (serum E2 levels > 5000 pg/mL, n — 137). The retrieved oocyte and Mil oocyte numbers and implantation and clinical pregnancy rates of the groups were compared as the first objective of the study. For the 360 women with singleton births among all patients, the area under the corresponding receiver operating characteristic curve (ROC curve) was calculated to assess the predictive value of the E2 change for the probability of low birth weight (LBW) infants as the second objective. Results: The retrieved oocyte and Mil oocyte numbers and implantation and clinical pregnancy rates gradually increased from groups 1 to 5 but decreased in group 6. The parameters of group 1 were statistically worse than those of the other groups, from group 2 to group 6 (the number of retrieved oocytes, t = 13.096, t = 23.307, t = 23.086, t = 26.376, t = 19.636, P < 0.003;the number of retrieved Mil oocytes, t = 10.856, t = 20.868, t = 21.874, t = 23.374, t = 19.092, P < 0.003;the implantation rate,χ^2= 12.179,χ^2= 22.239,χ^2= 23.993,χ^2= 23.344,χ^2= 16.758, P < 0.003;the cl展开更多
Background:Ectopic pregnancy(EP)is a common complication in women undergoing assisted reproductive treatment,but the underlying causes for this remain unclear.This study aimed to explore factors affecting the incidenc...Background:Ectopic pregnancy(EP)is a common complication in women undergoing assisted reproductive treatment,but the underlying causes for this remain unclear.This study aimed to explore factors affecting the incidence of EP in in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI).Methods:This was a retrospective study on the incidence of EP in IVF/ICSI cycles between January 1,2013 and December 31,2017.Patient age,infertility diagnosis(tubal factor or not),primary or secondary infertility,type of cycle(frozen-thawed or fresh),type of embryo(s)transferred(cleavage embryo or blastocyst),number of embryos transferred(one,two,or three),previous history of EP,and endometrial combined thickness were analyzed to explore their relationships with the incidence of EP.Based on clinical typing results,the patients were divided into an EP group or a non-EP group.Categorical variables were analyzed using Chi-squared test or Fisher exact test.Logistic regression analysis was performed to explore their associations with the incidence of EP.Results:The percentage of patients with primary infertility in EP group was significantly lower than that in non-EP group(31.3%vs.46.7%,χ^2=26.032,P<0.001).The percentage of patients with tubal infertility in EP group was also significantly higher than that in non-EP group(89.2%vs.63.6%,χ^2=77.410,P<0.001).The percentages of patients with transfer of cleavage-stage embryo or blastocyst(91.4%vs.84.4%,χ^2=10.132,P=0.001)and different endometrial combined thickness(ECT)(χ^2=18.373,P<0.001)differed significantly between EP and non-EP groups.For patients who had a previous history of one to four EPs,the percentage of patients undergoing transfer of a cleavage-stage embryo was significantly higher in EP group than that in non-EP group(92.2%vs.77.6%,χ^2=13.737,P<0.001).In multivariate logistic regression analysis,tubal infertility was strongly associated with EP(adjusted odds ratio:3.995,95%confidence interval:2.706-5.897,P<0.001).Conclusions:In IVF/ICSI cycles,transfer of a blasto展开更多
Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patien...Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (〈40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration ofgonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (rs=0.46-0.61, P 0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (rs=-0.67--0.38, P=0.000 or P〈0.01) with total rFSH dose and total days ofrFSH stimulation. (2) No significant variation (P〉0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged 〉35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age 〈35 years was found; however, IVF pregnancy outcome is significantly lower in women of age 〉35 years.展开更多
Objective:To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intr...Objective:To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intracytoplasmic sperm injection (ICSI) cycles with embryo transfer were carried out and 312 embryos were scored using a combined scoring system (CSS) of zygote and embryo morphology before transplantation. In a control group, a total of 420 IVF or ICSI cycles were carried out and 1176 embryos were scored using a cumulative embryo score (CES). The effects of the combined scoring system on the embryo implantation rate and pregnancy rate per cycle were analyzed. Results: Using the combined scoring system, the embryo implan-tation rate (27.6%) and the clinical pregnancy rate (48.7%) were significantly higher than those in the control group (20.8% and 38.6%, respectively). Also, the implantation rate of embryos scoring ≥70 (38.5%: 82 sacs/213 embryos) was significantly higher (P<0.001) than that of embryos scoring <70 (4%: 4 sacs/99 embryos). The pregnancy rate of patients with embryos scoring ≥70 using the combined scoring system (66.7%) was significantly higher (P<0.001) than that of patients with embryos scoring ≥20 using the cumulative embryo score (59.0%). Conclusion: The results suggest that selecting embryos with a high score (≥70) using the combined scoring system could increase the implantation rate and pregnancy rate, and that using a scoring system combining assessments of human zygotes and pre-implantation embryos might predict IVF outcomes more accurately than using a cumula-tive embryo score.展开更多
Objective To investigate the reproduction-assisting effects of laparoscopic "corepulling" salpingectomy for patients with hydrosalpinx on ovarian reserve,responsiveness to stimuli and outcomes of in vitro fertilizat...Objective To investigate the reproduction-assisting effects of laparoscopic "corepulling" salpingectomy for patients with hydrosalpinx on ovarian reserve,responsiveness to stimuli and outcomes of in vitro fertilization and embryo transfer(IVF-ET).Methods Infertile females receiving treatment in Reproductive Medicine Center of Yantai Yuhuangding Hospital due to fallopian tube disorders(n=214) were enrolled from July 2006 to December 2007 and further divided into three groups."Core-pulling" procedure group(group A) consisted of patients receiving pretreatment with "corepulling" salpingectomy due to hydrosalpinx in our center(n=31),wherein 16 patients received IVF-ET.Conventional procedure group(group B) consisted of patients receiving conventional salpingectomy for hydrosalpinx or ectopic pregnancy in our center or other institutes prior to IVF-ET(n=59).Control group(group C) consisted of patients receiving IVF-ET without the history of previous hydrosalpinx or salpingectomy(n=124).Results At baseline,the antral follicle count of group B was significantly less than that of groups A and C(8.6±2.5 vs 8.3±2.0 vs 9.8±2.4).The mature oocytes retrieved numbered less than the other two groups,in a statistically significant manner compared with group C(13.1±5.7 vs 10.6±5.0 vs 12.0±6.2).Patients of groups A and B received more gonadotropin while the dosage of group B differed significantly from group C(31.0±17.7 vs 37.6±8.3 vs 30.0±4.6).E2 level on hCG injection day was slightly lower in group B than in the other two groups,statistically significant compared with that of group C,but not compared with that of group A.After receiving IVF-ET,patients of group A showed significantly higher conception rate than groups B and C(62.5% vs 43.6% vs 39.2%).Conclusion Compared with the conventional procedure,laparoscopic "core-pulling" salpingectomy should be recommended for patients with hydrosalpinx intending to receive IVF-ET,which did not interfere with the ov展开更多
Objective: To investigate the effects of body mass index(BMI) on the outcomes of in vitro fertilization(IVF) in Chinese patients with polycystic ovary syndrome(PCOS). Methods: In the retrospective cohort study, a tota...Objective: To investigate the effects of body mass index(BMI) on the outcomes of in vitro fertilization(IVF) in Chinese patients with polycystic ovary syndrome(PCOS). Methods: In the retrospective cohort study, a total of 1074 patients with PCOS undergoing IVF between April 2010 and May 2017 in two reproductive medicine centers, respectively in eastern China(Women's Hospital, School of Medicine, Zhejiang University, Zhejiang Province) and in southern China(Maternal and Child Health Care Hospital of Liuzhou, Guangxi Province), were included. The patients were divided into four groups according to the recommended Chinese BMI cut-off points: underweight(BMI<18.5kg/m^2), normal weight(18.5kg/m^2≤BMI<24.0kg/m^2), overweight(24.0kg/m^2≤BMI<28.0kg/m^2), and obese(BMI≥28.0kg/m2). The basic characteristics of the PCOS patients, the details of IVF treatment, and the pregnancy outcomes were collected. Main results: There were no significant differences among the normal weight, overweight, and obese PCOS patients undergoing IVF on the biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, or term delivery rate(P>0.05), although the overweight and obese PCOS patients required more gonadotropin(Gn)(P<0.001) as well as longer stimulation period(P<0.001), and got less retrieved oocytes(P<0.05) and fertilized oocytes(P<0.05). The underweight PCOS patients required less Gn(P<0.05) and achieved higher live birth rate and term delivery rate(P<0.05), compared with the normal weight PCOS patients. Conclusions: High BMI had no negative effects on the outcomes of IVF in Chinese patients with PCOS; however, the conclusion may seem a little limited due to the retrospective design and the potential bias.展开更多
Objective:To observe the effect of acupuncture on endometrium and pregnancy outcomes in patients with polycystic ovary syndrome(PCOS)infertility undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods:Eighty...Objective:To observe the effect of acupuncture on endometrium and pregnancy outcomes in patients with polycystic ovary syndrome(PCOS)infertility undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods:Eighty-three patients were randomly assigned to observation group(40 cases)and control group(43 cases)according to the random numbers generated by SPSS software.The patients of the two groups received GnRH agonist long protocol as a routine treatment.In the observation group,acupuncture was given at two acupoint groups for 30 min once every other day.Group 1 included Guanyuan(CV 4),Qihai(CV 6),Zhongji(CV 3),bilateral acupoints Zigong(EX-CA1).Group 2 included Mingmen(GV 4),Yaoyangguan(GV 3),bilateral Shenshu(BL 23)and Ciliao(BL 32).The two groups of acupoints were used alternately.The whole needling process was performed at the time of ovulation induction until the transplantation day and consisted of3 courses,while the control group did not receive acupuncture interventions.The Gn dosage and Gn stimulation time,endometrial thickness and type(A,B,and C),serum oestradiol(E2)and progesterone(P)levels on the day of injection of human chorionic gonadotropin(hCG),clinical pregnancy rate,as well as live birth rate were observed.Adverse reactions were also be recorded.All patients were followed up for the pregnant rate 14 days after IVF-ET and live birth rate after pregnancy.All adverse reactions(AEs)of acupuncture were recorded during the trial.Ressults:The Gn dosage and Gn stimulation time in the observation group were lower in the observation group than in the control group(P<0.01).The proportion of type A endometrium in the observation group were higher than that in the control group(P<0.05).The serum E2 and P levels on the day of hCG injection was lower and the clinical pregnancy rate was higher in the observation group compared to those in the control group(P<0.05).There was no serious AEs during this trial.Conclusion:Acupuncture can improve the proportion of type A endometrium,regulate the levelse of serum 展开更多
This study aimed to investigate the effect of different gonadotropin-releasing hormone agonist (GnRH-a) administration methods on pregnancy outcomes of patients undergoing in-vitro fertilization-embryo transfer (IVF-E...This study aimed to investigate the effect of different gonadotropin-releasing hormone agonist (GnRH-a) administration methods on pregnancy outcomes of patients undergoing in-vitro fertilization-embryo transfer (IVF-ET). Clinical data of 5217 patients who underwent IVF-ET were retrospectively analyzed. Patients were divided into the long-acting GnRH-a group (n=1330) and the short-acting GnRH-a group (w=3887) based on their various treatment plans. The clinical and laboratory embryo data and clinical pregnancy outcomes were compared between the two groups. The results showed that there were no significant differences in the age, infertility, primary/secondary infertility rate, IVF rate, body mass index (BMI), antral follicle counting (AFC), folliclestimulating hormone (FSH) level, and the number of transplanted embryos between the two groups (P>0.05). There were no significant differences in the oocyte numbers, M II rate, fertilization rate, cleavage rate and blastocyst formation rate (P>0.05) between the two groups. The gonadotropin (Gn) using days, Gn dose and endometrial thickness were significantly greater in the long-acting GnRH-a group than those in the short-acting GnRH-a group (P<0.01). Additionally, the estradiol (E2) levels, blastocyst freezing rate, embryo utilization rate, transplant cancellation rate and abortion rate were significantly lower in the long-acting GnRH-a group than those in the shortacting GnRH-a group (P<0.01). The clinical pregnancy rate and embryo implantation rate were significantly higher in the long-acting GnRH-a group than in the short-acting GnRH-a group (P<O.Ol). It was concluded that use of long-acting GnRH-a can effectively reduce the transplant cancellation rate and improve the clinical pregnancy rate of the fresh cycle.展开更多
Background:Very few studies have been conducted regarding the optimal time interval between hysteroscopic adhesiolysis and the embryo transfer(ET).Investigation of this optimal time may be helpful for assisted reprodu...Background:Very few studies have been conducted regarding the optimal time interval between hysteroscopic adhesiolysis and the embryo transfer(ET).Investigation of this optimal time may be helpful for assisted reproductive technology.Therefore,we investigated effects of the interval between hysteroscopic adhesiolysis and ET upon in vitro fertilization(IVF)cycle outcomes.Methods:Patients were recruited between January 2014 and September 2017 at the Reproductive Hospital Affiliated to Shandong University.Patients who were diagnosed with intra-uterine adhesion(IUA)and underwent hysteroscopic adhesiolysis before fresh IVF-ET or intra-cytoplasmic sperm injection cycles were classified into three groups according to the interval between hysteroscopic adhesiolysis and ET:less than 90 days(Group 1),90 to 180 days(Group 2),and greater than 180 days(Group 3).Baseline characteristics,controlled ovarian stimulation(COS)response,and pregnancy outcomes after ET were compared.Analysis of variance or non-parametric tests were used to test numerical data.The Pearson’s Chi-squared test was used to test categorical data.Results:A total of 312 patients were recruited as follows:112 in Group 1,137 in Group 2,and 63 in Group 3.There were no differences in baseline and COS characteristics among the three groups.The live-birth rate in Group 2(40.1%)was significantly higher than that in Group 1(17.9%;χ^2=14.545,P<0.001).There were no significant differences in the rates of biochemical,ongoing,and clinical pregnancy,and biochemical and clinical pregnancy abortion,as well as stillbirth among the groups.In the mild IUA patients,the live-birth rate was significantly higher in Group 2(42.6%)compared with Group 1(22%;χ^2=8.413,P=0.004).In the moderate IUA patients,Group 2(35.7%)had a higher frequency of live births than Group 1(6.7%;χ^2=8.187,P=0.004).Conclusions:The optimal waiting period for fresh ET after hysteroscopic adhesiolysis was 90 to 180 days in the current study.展开更多
文摘This is a retrospective,observational study to evaluate the effect of maternal age on the outcomes of in vitro fertilization and embryo transfer(IVF-ET).11830 IVF-ET cycles from 10268 women were included.Four groups of different maternal age periods were compared.The groups were 21 30 years old group(4549 cycles),31-35 years old group(4424 cycles),36-40 years old group(2429 cycles),and over 40 years old group(428 cycles).The mean starting dose of Gn and mean total dose of Gn in each cycle were significantly higher(P<0.01),while the mean retrieved oocyte number was significantly lower(P<0.01) in groups of higher maternal age period than those in each of the lower groups.The biochemical pregnancy rate and the clinical pregnancy rate were significantly lower(P<0.01),while the miscarriage rate was significantly higher(P<0.01) in groups of higher maternal age period than those in the lower groups.No difference was found in two-pronuclear zygotes(2PN) rate and good quality embryo rate among different groups.Birth defect rate was also comparable in the born babies in different groups.In the group with patients' age over 40 years old,the pregnancy rate was 26.87%,the clinical pregnancy rate was 19.39%,while the miscarriage rate after clinical pregnancy was 36.14%.To draw the conclusion,patients with higher maternal age had worse IVF outcomes.In women of fertile age,patients between 20 and 30 years old have the best IVF outcomes.Patients over 40 years old have poor IVF outcome and high miscarriage rate,which suggested the necessity of preimplantation genetic screening(PGS).
基金ACKNOWLEDGMENTS This study was supported by grants from the Natural Science Foundation of Shanghai (No. 10JC1410800). The support of Jian-Bin Liu in collecting the patient data is gratefully acknowledged.
文摘The aim of this study was to investigate whether the sperm chromatin structure assay (SCSA) results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilization (IVF). A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index (DFI) subgroups and high DNA stainability (HDS) subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.
文摘Homozygous human embryonic stem cells (hESCs) are thought to be better cell sources for hESC banking because their human leukocyte antigen (HLA) haplotype would strongly increase the degree of matching for certain populations with relatively smaller cohorts of cell lines. Homozygous hESCs can be generated from parthenogenetic embryos, but only heterozygous hESCs have been established using the current strategy to artificially activate the oocyte without second polar body extrusion. Here we report the first successful derivation of a human homozygous ESC line (chHES- 32) from a one-pronuclear oocyte following routine in vitro fertilization treatment, chHES-32 cells express common markers and genes with normal hESCs. They have been propagated in an undifferentiated state for more than a year (〉P50) and have maintained a stable karyotype of 46, XX. When differentiated in vivo and in vitro, chHES-32 cells can form derivatives from all three embryonic germ layers. The almost undetectable expression of five paternally expressed imprinted genes and their HLA genotype identical to the oocyte donor indicated their parthenogenetic origin. Using genome-wide single-nucleotide polymorphism analysis and DNA fingerprinting, the homozygosity of chHES-32 cells was further confirmed. The results indicated that ‘ unwanted' one-pronuclear oocytes might be a potential source for human homozygous and parthenogenetic ESCs, and suggested an alternative strategyfor obtaining homozygous hESC lines from parthenogenetic haploid oocytes.
文摘Background: Estradiol, as an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization embryo transfer (IVF-ET) cycles. The aim of this retrospective study was to evaluate the association between elevated serum estradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and IVF-ET pregnancy and birth outcomes. Methods: A total of 1771 infertile patients with their first fresh IVF-ET cycles were analyzed retrospectively between January 2011 and January 2016 in Peking University First Hospital. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels < 1000 pg/mL, n = 205), group 2 (serum E2 levels 1001-2000 pg/mL, n = 457), group 3 (serum E2 levels 2001-3000 pg/mL, n = 425), group 4 (serum E2 levels 3001-4000 pg/mL, n = 310), group 5 (serum E2 levels 4001- 5000 pg/mL, n = 237), and group 6 (serum E2 levels > 5000 pg/mL, n — 137). The retrieved oocyte and Mil oocyte numbers and implantation and clinical pregnancy rates of the groups were compared as the first objective of the study. For the 360 women with singleton births among all patients, the area under the corresponding receiver operating characteristic curve (ROC curve) was calculated to assess the predictive value of the E2 change for the probability of low birth weight (LBW) infants as the second objective. Results: The retrieved oocyte and Mil oocyte numbers and implantation and clinical pregnancy rates gradually increased from groups 1 to 5 but decreased in group 6. The parameters of group 1 were statistically worse than those of the other groups, from group 2 to group 6 (the number of retrieved oocytes, t = 13.096, t = 23.307, t = 23.086, t = 26.376, t = 19.636, P < 0.003;the number of retrieved Mil oocytes, t = 10.856, t = 20.868, t = 21.874, t = 23.374, t = 19.092, P < 0.003;the implantation rate,χ^2= 12.179,χ^2= 22.239,χ^2= 23.993,χ^2= 23.344,χ^2= 16.758, P < 0.003;the cl
基金This study was supported by grants from the National Key Research and Development Program of China(No.2018YFC1004800)the National Natural Science Foundation of China(No.81701514)+1 种基金the Natural Science Program of Zhejiang(No.LY20C080002,No.LQ19H040014)the Medical&Health Program of Zhejiang(No.2019KY411)。
文摘Background:Ectopic pregnancy(EP)is a common complication in women undergoing assisted reproductive treatment,but the underlying causes for this remain unclear.This study aimed to explore factors affecting the incidence of EP in in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI).Methods:This was a retrospective study on the incidence of EP in IVF/ICSI cycles between January 1,2013 and December 31,2017.Patient age,infertility diagnosis(tubal factor or not),primary or secondary infertility,type of cycle(frozen-thawed or fresh),type of embryo(s)transferred(cleavage embryo or blastocyst),number of embryos transferred(one,two,or three),previous history of EP,and endometrial combined thickness were analyzed to explore their relationships with the incidence of EP.Based on clinical typing results,the patients were divided into an EP group or a non-EP group.Categorical variables were analyzed using Chi-squared test or Fisher exact test.Logistic regression analysis was performed to explore their associations with the incidence of EP.Results:The percentage of patients with primary infertility in EP group was significantly lower than that in non-EP group(31.3%vs.46.7%,χ^2=26.032,P<0.001).The percentage of patients with tubal infertility in EP group was also significantly higher than that in non-EP group(89.2%vs.63.6%,χ^2=77.410,P<0.001).The percentages of patients with transfer of cleavage-stage embryo or blastocyst(91.4%vs.84.4%,χ^2=10.132,P=0.001)and different endometrial combined thickness(ECT)(χ^2=18.373,P<0.001)differed significantly between EP and non-EP groups.For patients who had a previous history of one to four EPs,the percentage of patients undergoing transfer of a cleavage-stage embryo was significantly higher in EP group than that in non-EP group(92.2%vs.77.6%,χ^2=13.737,P<0.001).In multivariate logistic regression analysis,tubal infertility was strongly associated with EP(adjusted odds ratio:3.995,95%confidence interval:2.706-5.897,P<0.001).Conclusions:In IVF/ICSI cycles,transfer of a blasto
文摘Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (〈40 years of age) who underwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (1) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration ofgonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (rs=0.46-0.61, P 0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (rs=-0.67--0.38, P=0.000 or P〈0.01) with total rFSH dose and total days ofrFSH stimulation. (2) No significant variation (P〉0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged 〉35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age 〈35 years was found; however, IVF pregnancy outcome is significantly lower in women of age 〉35 years.
基金Project (No. 021107137) supported by the Department of Scienceand Technology of Zhejiang Province, China
文摘Objective:To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intracytoplasmic sperm injection (ICSI) cycles with embryo transfer were carried out and 312 embryos were scored using a combined scoring system (CSS) of zygote and embryo morphology before transplantation. In a control group, a total of 420 IVF or ICSI cycles were carried out and 1176 embryos were scored using a cumulative embryo score (CES). The effects of the combined scoring system on the embryo implantation rate and pregnancy rate per cycle were analyzed. Results: Using the combined scoring system, the embryo implan-tation rate (27.6%) and the clinical pregnancy rate (48.7%) were significantly higher than those in the control group (20.8% and 38.6%, respectively). Also, the implantation rate of embryos scoring ≥70 (38.5%: 82 sacs/213 embryos) was significantly higher (P<0.001) than that of embryos scoring <70 (4%: 4 sacs/99 embryos). The pregnancy rate of patients with embryos scoring ≥70 using the combined scoring system (66.7%) was significantly higher (P<0.001) than that of patients with embryos scoring ≥20 using the cumulative embryo score (59.0%). Conclusion: The results suggest that selecting embryos with a high score (≥70) using the combined scoring system could increase the implantation rate and pregnancy rate, and that using a scoring system combining assessments of human zygotes and pre-implantation embryos might predict IVF outcomes more accurately than using a cumula-tive embryo score.
文摘Objective To investigate the reproduction-assisting effects of laparoscopic "corepulling" salpingectomy for patients with hydrosalpinx on ovarian reserve,responsiveness to stimuli and outcomes of in vitro fertilization and embryo transfer(IVF-ET).Methods Infertile females receiving treatment in Reproductive Medicine Center of Yantai Yuhuangding Hospital due to fallopian tube disorders(n=214) were enrolled from July 2006 to December 2007 and further divided into three groups."Core-pulling" procedure group(group A) consisted of patients receiving pretreatment with "corepulling" salpingectomy due to hydrosalpinx in our center(n=31),wherein 16 patients received IVF-ET.Conventional procedure group(group B) consisted of patients receiving conventional salpingectomy for hydrosalpinx or ectopic pregnancy in our center or other institutes prior to IVF-ET(n=59).Control group(group C) consisted of patients receiving IVF-ET without the history of previous hydrosalpinx or salpingectomy(n=124).Results At baseline,the antral follicle count of group B was significantly less than that of groups A and C(8.6±2.5 vs 8.3±2.0 vs 9.8±2.4).The mature oocytes retrieved numbered less than the other two groups,in a statistically significant manner compared with group C(13.1±5.7 vs 10.6±5.0 vs 12.0±6.2).Patients of groups A and B received more gonadotropin while the dosage of group B differed significantly from group C(31.0±17.7 vs 37.6±8.3 vs 30.0±4.6).E2 level on hCG injection day was slightly lower in group B than in the other two groups,statistically significant compared with that of group C,but not compared with that of group A.After receiving IVF-ET,patients of group A showed significantly higher conception rate than groups B and C(62.5% vs 43.6% vs 39.2%).Conclusion Compared with the conventional procedure,laparoscopic "core-pulling" salpingectomy should be recommended for patients with hydrosalpinx intending to receive IVF-ET,which did not interfere with the ov
基金Project supported by the Zhejiang Provincial Natural Science Foundation for Distinguished Young Scholars(No.LR16H040001)the Key Project of Science and Technology Department of Zhejiang Province(No.2018C03010)+2 种基金the Zhejiang Provincial&Ministry of Health Research Fund for Medical Sciences(Nos.WKJ-ZJ-1522 and WKJ-ZJ-1722)the National Key Technology R&D Program of China(No.2014BAI05B04)the Guangxi Natural Science Foundation(Nos.2015GXNSFBA139177,2017GXNSFAA198199,and 2017GXNSFAA198193),China
文摘Objective: To investigate the effects of body mass index(BMI) on the outcomes of in vitro fertilization(IVF) in Chinese patients with polycystic ovary syndrome(PCOS). Methods: In the retrospective cohort study, a total of 1074 patients with PCOS undergoing IVF between April 2010 and May 2017 in two reproductive medicine centers, respectively in eastern China(Women's Hospital, School of Medicine, Zhejiang University, Zhejiang Province) and in southern China(Maternal and Child Health Care Hospital of Liuzhou, Guangxi Province), were included. The patients were divided into four groups according to the recommended Chinese BMI cut-off points: underweight(BMI<18.5kg/m^2), normal weight(18.5kg/m^2≤BMI<24.0kg/m^2), overweight(24.0kg/m^2≤BMI<28.0kg/m^2), and obese(BMI≥28.0kg/m2). The basic characteristics of the PCOS patients, the details of IVF treatment, and the pregnancy outcomes were collected. Main results: There were no significant differences among the normal weight, overweight, and obese PCOS patients undergoing IVF on the biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, or term delivery rate(P>0.05), although the overweight and obese PCOS patients required more gonadotropin(Gn)(P<0.001) as well as longer stimulation period(P<0.001), and got less retrieved oocytes(P<0.05) and fertilized oocytes(P<0.05). The underweight PCOS patients required less Gn(P<0.05) and achieved higher live birth rate and term delivery rate(P<0.05), compared with the normal weight PCOS patients. Conclusions: High BMI had no negative effects on the outcomes of IVF in Chinese patients with PCOS; however, the conclusion may seem a little limited due to the retrospective design and the potential bias.
基金Supported by the Sanming Project of Medicine in Shenzhen(No.SZSM201612046)the Guangdong Provincial Administration of Traditional Chinese Medicine(No.20181229)the Guangdong Provincial Administration of Traditional Chinese Medicine(No.20201294)。
文摘Objective:To observe the effect of acupuncture on endometrium and pregnancy outcomes in patients with polycystic ovary syndrome(PCOS)infertility undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods:Eighty-three patients were randomly assigned to observation group(40 cases)and control group(43 cases)according to the random numbers generated by SPSS software.The patients of the two groups received GnRH agonist long protocol as a routine treatment.In the observation group,acupuncture was given at two acupoint groups for 30 min once every other day.Group 1 included Guanyuan(CV 4),Qihai(CV 6),Zhongji(CV 3),bilateral acupoints Zigong(EX-CA1).Group 2 included Mingmen(GV 4),Yaoyangguan(GV 3),bilateral Shenshu(BL 23)and Ciliao(BL 32).The two groups of acupoints were used alternately.The whole needling process was performed at the time of ovulation induction until the transplantation day and consisted of3 courses,while the control group did not receive acupuncture interventions.The Gn dosage and Gn stimulation time,endometrial thickness and type(A,B,and C),serum oestradiol(E2)and progesterone(P)levels on the day of injection of human chorionic gonadotropin(hCG),clinical pregnancy rate,as well as live birth rate were observed.Adverse reactions were also be recorded.All patients were followed up for the pregnant rate 14 days after IVF-ET and live birth rate after pregnancy.All adverse reactions(AEs)of acupuncture were recorded during the trial.Ressults:The Gn dosage and Gn stimulation time in the observation group were lower in the observation group than in the control group(P<0.01).The proportion of type A endometrium in the observation group were higher than that in the control group(P<0.05).The serum E2 and P levels on the day of hCG injection was lower and the clinical pregnancy rate was higher in the observation group compared to those in the control group(P<0.05).There was no serious AEs during this trial.Conclusion:Acupuncture can improve the proportion of type A endometrium,regulate the levelse of serum
基金This work was supported by the Natural Science Foundation of Hubei Province (No.2017CFB262).
文摘This study aimed to investigate the effect of different gonadotropin-releasing hormone agonist (GnRH-a) administration methods on pregnancy outcomes of patients undergoing in-vitro fertilization-embryo transfer (IVF-ET). Clinical data of 5217 patients who underwent IVF-ET were retrospectively analyzed. Patients were divided into the long-acting GnRH-a group (n=1330) and the short-acting GnRH-a group (w=3887) based on their various treatment plans. The clinical and laboratory embryo data and clinical pregnancy outcomes were compared between the two groups. The results showed that there were no significant differences in the age, infertility, primary/secondary infertility rate, IVF rate, body mass index (BMI), antral follicle counting (AFC), folliclestimulating hormone (FSH) level, and the number of transplanted embryos between the two groups (P>0.05). There were no significant differences in the oocyte numbers, M II rate, fertilization rate, cleavage rate and blastocyst formation rate (P>0.05) between the two groups. The gonadotropin (Gn) using days, Gn dose and endometrial thickness were significantly greater in the long-acting GnRH-a group than those in the short-acting GnRH-a group (P<0.01). Additionally, the estradiol (E2) levels, blastocyst freezing rate, embryo utilization rate, transplant cancellation rate and abortion rate were significantly lower in the long-acting GnRH-a group than those in the shortacting GnRH-a group (P<0.01). The clinical pregnancy rate and embryo implantation rate were significantly higher in the long-acting GnRH-a group than in the short-acting GnRH-a group (P<O.Ol). It was concluded that use of long-acting GnRH-a can effectively reduce the transplant cancellation rate and improve the clinical pregnancy rate of the fresh cycle.
文摘Background:Very few studies have been conducted regarding the optimal time interval between hysteroscopic adhesiolysis and the embryo transfer(ET).Investigation of this optimal time may be helpful for assisted reproductive technology.Therefore,we investigated effects of the interval between hysteroscopic adhesiolysis and ET upon in vitro fertilization(IVF)cycle outcomes.Methods:Patients were recruited between January 2014 and September 2017 at the Reproductive Hospital Affiliated to Shandong University.Patients who were diagnosed with intra-uterine adhesion(IUA)and underwent hysteroscopic adhesiolysis before fresh IVF-ET or intra-cytoplasmic sperm injection cycles were classified into three groups according to the interval between hysteroscopic adhesiolysis and ET:less than 90 days(Group 1),90 to 180 days(Group 2),and greater than 180 days(Group 3).Baseline characteristics,controlled ovarian stimulation(COS)response,and pregnancy outcomes after ET were compared.Analysis of variance or non-parametric tests were used to test numerical data.The Pearson’s Chi-squared test was used to test categorical data.Results:A total of 312 patients were recruited as follows:112 in Group 1,137 in Group 2,and 63 in Group 3.There were no differences in baseline and COS characteristics among the three groups.The live-birth rate in Group 2(40.1%)was significantly higher than that in Group 1(17.9%;χ^2=14.545,P<0.001).There were no significant differences in the rates of biochemical,ongoing,and clinical pregnancy,and biochemical and clinical pregnancy abortion,as well as stillbirth among the groups.In the mild IUA patients,the live-birth rate was significantly higher in Group 2(42.6%)compared with Group 1(22%;χ^2=8.413,P=0.004).In the moderate IUA patients,Group 2(35.7%)had a higher frequency of live births than Group 1(6.7%;χ^2=8.187,P=0.004).Conclusions:The optimal waiting period for fresh ET after hysteroscopic adhesiolysis was 90 to 180 days in the current study.