为探讨心理压力对不孕女性行体外受精-胚胎移植(IVF-ET)后妊娠结局的影响,本研究采用Fertility Problem Inventory量表对318例不孕女性进行心理压力测评,并根据总分由高到低分为A、B、C三组,比较各组的实验室指标及妊娠结局。结果显示,...为探讨心理压力对不孕女性行体外受精-胚胎移植(IVF-ET)后妊娠结局的影响,本研究采用Fertility Problem Inventory量表对318例不孕女性进行心理压力测评,并根据总分由高到低分为A、B、C三组,比较各组的实验室指标及妊娠结局。结果显示,3组获卵数、可移植胚胎形成率及优质胚胎率均随心理压力的降低而增加,C组临床妊娠率及活产率最高,流产率最低。因此,心理压力可通过影响卵巢对促性腺激素刺激的敏感性、卵子-胚胎质量等对IVF-ET妊娠结局造成不利影响,应重视心理护理,从而提高成功率。展开更多
目的:观察认知行为干预联合肌肉放松训练对行体外授精-胚胎移植(in-vitro fertilization and embryo transfer,IVF-ET)病人心理应激水平及幸福感的影响。方法:选择2017年5月至2018年7月行IVF-ET治疗的116例病人为研究对象,按照随机表法...目的:观察认知行为干预联合肌肉放松训练对行体外授精-胚胎移植(in-vitro fertilization and embryo transfer,IVF-ET)病人心理应激水平及幸福感的影响。方法:选择2017年5月至2018年7月行IVF-ET治疗的116例病人为研究对象,按照随机表法将病人分为对照组和观察组2组,各58例;对照组入院后给予常规治疗以及护理,观察组在对照组的基础上给予认知行为干预联合肌肉放松训练。在治疗前和治疗后(完成胚胎移植)使用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价病人焦虑抑郁情绪,使用睡眠状况自评量表(SRSS)评估病人睡眠状况,采集病人静脉血使用化学发光法检测病人皮质醇水平;治疗后使用纽芬兰纪念大学幸福度量表(MUNSH)对病人幸福感进行评估,在治疗后1个月行超声检查,确认病人妊娠情况。结果:治疗前,2组SDS和SAS评分差异无统计学意义(P>0.05),治疗后,2组SDS和SAS评分均明显低于治疗前,且观察组SDS和SAS评分明显低于对照组(P<0.01)。治疗前2组睡眠质量比较差异无统计学意义(P>0.05),治疗后观察组睡眠质量明显优于对照组(P<0.01)。治疗前2组皮质醇水平比较差异无统计学意义(P>0.05),治疗后观察组皮质醇水平明显低于对照组(P<0.01)。观察组妊娠率高于对照组(P<0.05)。治疗后观察组MUNSH量表负性评分明显低于对照组,且正性评分以及总分均明显高于对照组(P<0.01)。结论:认知行为干预联合肌肉放松训练可有效减轻IVF-ET病人病人焦虑抑郁情绪,提升病人睡眠质量以及幸福感,有效降低心理应激水平,提高妊娠成功率。展开更多
Background Some studies suggested that human papillomavirus （HPV） infection could reduce the clinical pregnancy rate and double the spontaneous abortion rate compared with non-infected women after in-vitro fertiliza...Background Some studies suggested that human papillomavirus （HPV） infection could reduce the clinical pregnancy rate and double the spontaneous abortion rate compared with non-infected women after in-vitro fertilization and embryo transfer （IVF-ET）. But some other studies showed there was no difference between HPV infected and non-infected groups of ART outcomes. The role of HPV infection in infertile women undergoing IVF treatments has been a controversial issue which this article attempts to investigate. Methods This is a retrospective analysis of 3880 infertile women undergoing IVF treatment at Peking University Third hospital reproductive medical center in 2008. Patients with abnormal thin-layer preparation cytologic test （TCT） results who underwent fresh cycle embryo transfer were divided into an HPV positive group （n=56） and an HPV negative group （n=56）. The clinical parameters were compared （using Student＇s t-test and chi-squared test）. Univariate and multivariate analyses were taken to see if HPV infection affects the clinical pregnancy rate. Results Of the 3880 cases 157 had TCT abnormality （4.0%）. Of the 149 patients who had HPV test results, 112 women （81.2%） received a fresh cycle embryo transfer. Each group had 56 cases. The patients were of similar age and BMI, basic hormone levels, and infertile factors were similar. The gonadotropin use, oocyte retrieval number, clinical pregnancy rate, abortion rate and newborn condition were all similar between groups. Analyses showed neither HPV infection nor HPV hybrid capture （HC） II results affected clinical pregnancy rate after IVF treatments, but the FSH level did. Conclusion HPV positivity did not appear to impact assisted reproductive technology （ART） success. ＂Extensive treatment＂ for HPV before IVF was not recommended because treatment time will increase age and reduce ovarian function, which will lead to inferior IVF outcomes.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
文摘为探讨心理压力对不孕女性行体外受精-胚胎移植(IVF-ET)后妊娠结局的影响,本研究采用Fertility Problem Inventory量表对318例不孕女性进行心理压力测评,并根据总分由高到低分为A、B、C三组,比较各组的实验室指标及妊娠结局。结果显示,3组获卵数、可移植胚胎形成率及优质胚胎率均随心理压力的降低而增加,C组临床妊娠率及活产率最高,流产率最低。因此,心理压力可通过影响卵巢对促性腺激素刺激的敏感性、卵子-胚胎质量等对IVF-ET妊娠结局造成不利影响,应重视心理护理,从而提高成功率。
文摘目的:观察认知行为干预联合肌肉放松训练对行体外授精-胚胎移植(in-vitro fertilization and embryo transfer,IVF-ET)病人心理应激水平及幸福感的影响。方法:选择2017年5月至2018年7月行IVF-ET治疗的116例病人为研究对象,按照随机表法将病人分为对照组和观察组2组,各58例;对照组入院后给予常规治疗以及护理,观察组在对照组的基础上给予认知行为干预联合肌肉放松训练。在治疗前和治疗后(完成胚胎移植)使用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价病人焦虑抑郁情绪,使用睡眠状况自评量表(SRSS)评估病人睡眠状况,采集病人静脉血使用化学发光法检测病人皮质醇水平;治疗后使用纽芬兰纪念大学幸福度量表(MUNSH)对病人幸福感进行评估,在治疗后1个月行超声检查,确认病人妊娠情况。结果:治疗前,2组SDS和SAS评分差异无统计学意义(P>0.05),治疗后,2组SDS和SAS评分均明显低于治疗前,且观察组SDS和SAS评分明显低于对照组(P<0.01)。治疗前2组睡眠质量比较差异无统计学意义(P>0.05),治疗后观察组睡眠质量明显优于对照组(P<0.01)。治疗前2组皮质醇水平比较差异无统计学意义(P>0.05),治疗后观察组皮质醇水平明显低于对照组(P<0.01)。观察组妊娠率高于对照组(P<0.05)。治疗后观察组MUNSH量表负性评分明显低于对照组,且正性评分以及总分均明显高于对照组(P<0.01)。结论:认知行为干预联合肌肉放松训练可有效减轻IVF-ET病人病人焦虑抑郁情绪,提升病人睡眠质量以及幸福感,有效降低心理应激水平,提高妊娠成功率。
文摘Background Some studies suggested that human papillomavirus （HPV） infection could reduce the clinical pregnancy rate and double the spontaneous abortion rate compared with non-infected women after in-vitro fertilization and embryo transfer （IVF-ET）. But some other studies showed there was no difference between HPV infected and non-infected groups of ART outcomes. The role of HPV infection in infertile women undergoing IVF treatments has been a controversial issue which this article attempts to investigate. Methods This is a retrospective analysis of 3880 infertile women undergoing IVF treatment at Peking University Third hospital reproductive medical center in 2008. Patients with abnormal thin-layer preparation cytologic test （TCT） results who underwent fresh cycle embryo transfer were divided into an HPV positive group （n=56） and an HPV negative group （n=56）. The clinical parameters were compared （using Student＇s t-test and chi-squared test）. Univariate and multivariate analyses were taken to see if HPV infection affects the clinical pregnancy rate. Results Of the 3880 cases 157 had TCT abnormality （4.0%）. Of the 149 patients who had HPV test results, 112 women （81.2%） received a fresh cycle embryo transfer. Each group had 56 cases. The patients were of similar age and BMI, basic hormone levels, and infertile factors were similar. The gonadotropin use, oocyte retrieval number, clinical pregnancy rate, abortion rate and newborn condition were all similar between groups. Analyses showed neither HPV infection nor HPV hybrid capture （HC） II results affected clinical pregnancy rate after IVF treatments, but the FSH level did. Conclusion HPV positivity did not appear to impact assisted reproductive technology （ART） success. ＂Extensive treatment＂ for HPV before IVF was not recommended because treatment time will increase age and reduce ovarian function, which will lead to inferior IVF outcomes.
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.
