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
Purpose: To evaluate age related ovarian response to controlled ovarian hyperstimulation, clinical pregnancy and ongoing pregnancy rates beyond 20 weeks in women undergoing assisted reproduction treatment (ART) with a...Purpose: To evaluate age related ovarian response to controlled ovarian hyperstimulation, clinical pregnancy and ongoing pregnancy rates beyond 20 weeks in women undergoing assisted reproduction treatment (ART) with antimullerian hormone (AMH) levels of <5 pmol/l. Methods: Retrospective analysis of data from 63 women with AMH of In-vitro?fertilization, IVF and intracytoplasmic sperm injection, ICSI) cycle. Results were analyzed after dividing patients in two groups, group 1 included women of ≤38 years and group 2 > 38 years of age. Non parametric variables were expressed as median (Interquartile range) and compared by Kruskal-Wallis test. Categorical variables were expressed as numbers with proportions (%) and compared by Fisher’s exact test. Results: There was no statistical difference in body max index, level of antimullerian hormone (AMH), follicle stimulating hormone (FSH), dose of gonadotrophins used and cycles cancellation rate in two groups. Although number of oocytes retrieved (median 5), clinical pregnancy (18.4%) and ongoing pregnancy rate beyond 20 weeks (18.4%) was higher in group 1, there was no statistical difference between the two groups. There was one miscarriage in group 2. Conclusion: Women with extremely low-serum AMH levels can still have clinical pregnancy and ongoing pregnancies beyond 20 weeks after ART, though chances will be lower than women with normal ovarian reserve.展开更多
目的评价孕激素在先兆流产患者中的治疗效果,并探索不同制剂、用药途径是否存在差异。方法检索数据库MEDLINE、EMBASE、Cochrane Database of Clinical Trials、ClinicalTrials.gov,检索时间为建库至2020年5月,比较了先兆流产患者中孕...目的评价孕激素在先兆流产患者中的治疗效果,并探索不同制剂、用药途径是否存在差异。方法检索数据库MEDLINE、EMBASE、Cochrane Database of Clinical Trials、ClinicalTrials.gov,检索时间为建库至2020年5月,比较了先兆流产患者中孕激素组与对照组(安慰剂或未治疗组)妊娠结局指标的所有随机对照试验(RCT)。两位研究者独立进行数据提取及分析,应用RevMan5.3软件对孕激素组和对照组患者的妊娠结局进行Meta分析。结果共检索到85篇文章,其中符合纳入标准的有11篇,共计5076例先兆流产患者被纳入Meta分析。(1)与对照组相比,孕激素组先兆流产患者的流产率显著降低(P<0.05)。不同孕激素制剂亚组分析显示,地屈孕酮和黄体酮均显著降低了先兆流产患者的流产率(P<0.05);不同给药途径亚组分析显示,口服孕激素在降低流产率方面显著优于对照组(P<0.05),而经阴道应用孕激素与对照组无统计学差异(P>0.05)。不同地区和不同研究规模的亚组分析显示,孕激素组与对照组相比,先兆流产患者的流产率均显著降低(P<0.05)。(2)与对照组相比,孕激素组的活产率显著提高(P<0.05)。不同孕激素制剂亚组分析显示,与对照组相比,地屈孕酮亚组的活产率显著提高(P<0.05),而黄体酮亚组无统计学差异(P>0.05);不同给药途径亚组分析显示,与对照组相比,口服孕激素显著提高活产率(P<0.05),而经阴道应用孕激素与对照组无统计学差异(P>0.05)。(3)孕激素组与对照组在新生儿先天性异常及低体重的发生率方面均无统计学差异(P>0.05)。结论孕激素可以降低先兆流产患者的流产率,提高活产率,且未增加新生儿相关不良结局的发生;但不同孕激素制剂和给药途径的治疗效果存在差异。口服地屈孕酮治疗可降低先兆流产患者的流产率并提高活产率,值得临床推荐应用。展开更多
Background： The effect of ovarian hyperstimulation syndrome （OH SS） on pregnancy outcomes of in vitro fertilization （IVF） patients is still ambiguous. Tbis study aimed to analyze pregnancy outcomes of IVF with or...Background： The effect of ovarian hyperstimulation syndrome （OH SS） on pregnancy outcomes of in vitro fertilization （IVF） patients is still ambiguous. Tbis study aimed to analyze pregnancy outcomes of IVF with or without OHSS in Chinese patients. Methods： A retrospective cohort study was undertaken to compare pregnancy outcomes between 190 women with OHSS and 197 women without OHSS. We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth, preterm deliver）,, preterm birth before 34 weeks＇ gestation, cesarean delivery, low birth weight （LBW）, and small-for-gestational age （SGA） between the two groups. Odds ratios （ORs） and 95% confidence intervals （Cls） of measure of clinical pregnancy were also analyzed. Results： The clinical pregnancy rate of OHSS patients was significantly higher than that of non-OHSS patients （91.8% vs. 43.5%, P 〈 0.001）. After controlling for drug protocol and causes of infertility, the adjusted ORs of moderate OHSS and severe/critical OHSS for clinical pregnancy were 4.65 （95% CI, 1.86-11.61 ） and 5.83 （95% CI, 3.45-9.86）, respectively. There were no significant differences in rates of muhiple pregnancy （4.0% vs. 3.7%） and miscarriage （16.1% vs. 17.5%） between the two groups. With regard to ongoing clinical pregnancy, we also found no significant differences in the rates of live birth （82.1% vs. 78.8%）, preterm delivery （20.9% vs. 17.5%）, preterm birth before 34 weeks＇ gestation （8.6% vs. 7.9%）, cesarean delivery （84.9% vs. 66.3%）, LBW （30.2% vs. 23.5%）, and SGA （21.9% vs. 17.6%） between the two groups. Conclusion： OHSS, which occurs in the luteal phase or early pregnancy in IVF patients and represents abnormal transient hemodynamics, does not exert any obviously adverse effect on the subsequent pregnancy.展开更多
Background Reduced endometrial receptivity in hyperstimulated cycles may lead to a lower implantation rate and a lower clinical pregnancy rate,but it is unclear if it is also associated with an increase in pregnancy l...Background Reduced endometrial receptivity in hyperstimulated cycles may lead to a lower implantation rate and a lower clinical pregnancy rate,but it is unclear if it is also associated with an increase in pregnancy loss rate.The aim of this study was to compare the implantation,miscarriage,and pregnancy rates between fresh and frozen thawed transfer of one or two day-3 embryos,with a view to understanding whether or not reduced endometrial receptivity encountered in hyperstimulated cycles is associated with an increase in miscarriage rate.Methods This study involved a consecutive series of 1 551 single day-3 embryo transfer cycles and consecutive 5 919 double day-3 embryo transfer cycles in the Assisted Reproductive Unit of the Sir Run Run Shaw Hospital,Hangzhou,China,between January 2010 and December 2012.Results The implantation and clinical pregnancy rates （single embryo 30.7％ and double embryos 33.4％ and 51.4％）using fresh cycle were both significantly lower than that of frozen-thawed cycles （single embryo 35.8％ and double embryos 38.1％ and 57.8％）.There was no difference in biochemical loss or clinical miscarriage rates between the two groups.Conclusions Impairment of endometrial receptivity associated with ovarian hyperstimulation leads to implantation failure at a very early stage,resulting in an increased number of non-pregnancy.It does not lead to increase in biochemical or clinical losses.The significantly reduced ongoing pregnancy rates in both fresh single and double embryo transfer are therefore due to failure to achieve a pregnancy,rather than pregnancy loss after conception.展开更多
With the clinical development and application of intracytoplasmic sperm injection(ICSI)technology in human assisted reproduction,the influence of oocyte quality on embryo development has been paid more and more attent...With the clinical development and application of intracytoplasmic sperm injection(ICSI)technology in human assisted reproduction,the influence of oocyte quality on embryo development has been paid more and more attention.So far,there have been many reports on oocyte morphology affecting embryo development.It has been found in some works that the appearance of smooth endoplasmic reticulum clusters(SERC)in oocytes may affect the fertilization and embryo development of oocytes.However,with the increasing reports of SERC-containing oocytes obtained by in vitro fertilization and healthy offspring in recent years,there is still some controversy on whether to continue to use SERC-containing oocytes for the following assisted reproductive therapy in clinical practice.Based on this,this review aims to review the research progress of SERC in oocytes in recent years.展开更多
Background: The objective of this study was to determine the effects of acupuncture treatment as an adjunctive therapy on the outcome of in vitro fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI). Material/M...Background: The objective of this study was to determine the effects of acupuncture treatment as an adjunctive therapy on the outcome of in vitro fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI). Material/Methods: We conducted a retrospective study of 238 patients who underwent conventional IVF/ ICSI alone or in conjunction with acupuncture over a course of 2 years. Patients in the two treatment groups were matched in terms of age and diagnosis. Acupuncture was administered in two sessions 5 to 7 days prior to and on the day of embryo transfer. Results: There were no differences between the two groups in terms of fertilization rate, pregnancy or implantation rates, and endometrial thickness. The number of oocytes retrieved (P < 0.005) and the number of first trimester miscarriages were significantly lower in the group receiving acupuncture (P < 0.001). Conclusions: Acupuncture reduces miscar-riage rates in patients undergoing IVF/ICSI possibly secondary to stress relief.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).
文摘Purpose: To evaluate age related ovarian response to controlled ovarian hyperstimulation, clinical pregnancy and ongoing pregnancy rates beyond 20 weeks in women undergoing assisted reproduction treatment (ART) with antimullerian hormone (AMH) levels of <5 pmol/l. Methods: Retrospective analysis of data from 63 women with AMH of In-vitro?fertilization, IVF and intracytoplasmic sperm injection, ICSI) cycle. Results were analyzed after dividing patients in two groups, group 1 included women of ≤38 years and group 2 > 38 years of age. Non parametric variables were expressed as median (Interquartile range) and compared by Kruskal-Wallis test. Categorical variables were expressed as numbers with proportions (%) and compared by Fisher’s exact test. Results: There was no statistical difference in body max index, level of antimullerian hormone (AMH), follicle stimulating hormone (FSH), dose of gonadotrophins used and cycles cancellation rate in two groups. Although number of oocytes retrieved (median 5), clinical pregnancy (18.4%) and ongoing pregnancy rate beyond 20 weeks (18.4%) was higher in group 1, there was no statistical difference between the two groups. There was one miscarriage in group 2. Conclusion: Women with extremely low-serum AMH levels can still have clinical pregnancy and ongoing pregnancies beyond 20 weeks after ART, though chances will be lower than women with normal ovarian reserve.
文摘目的评价孕激素在先兆流产患者中的治疗效果,并探索不同制剂、用药途径是否存在差异。方法检索数据库MEDLINE、EMBASE、Cochrane Database of Clinical Trials、ClinicalTrials.gov,检索时间为建库至2020年5月,比较了先兆流产患者中孕激素组与对照组(安慰剂或未治疗组)妊娠结局指标的所有随机对照试验(RCT)。两位研究者独立进行数据提取及分析,应用RevMan5.3软件对孕激素组和对照组患者的妊娠结局进行Meta分析。结果共检索到85篇文章,其中符合纳入标准的有11篇,共计5076例先兆流产患者被纳入Meta分析。(1)与对照组相比,孕激素组先兆流产患者的流产率显著降低(P<0.05)。不同孕激素制剂亚组分析显示,地屈孕酮和黄体酮均显著降低了先兆流产患者的流产率(P<0.05);不同给药途径亚组分析显示,口服孕激素在降低流产率方面显著优于对照组(P<0.05),而经阴道应用孕激素与对照组无统计学差异(P>0.05)。不同地区和不同研究规模的亚组分析显示,孕激素组与对照组相比,先兆流产患者的流产率均显著降低(P<0.05)。(2)与对照组相比,孕激素组的活产率显著提高(P<0.05)。不同孕激素制剂亚组分析显示,与对照组相比,地屈孕酮亚组的活产率显著提高(P<0.05),而黄体酮亚组无统计学差异(P>0.05);不同给药途径亚组分析显示,与对照组相比,口服孕激素显著提高活产率(P<0.05),而经阴道应用孕激素与对照组无统计学差异(P>0.05)。(3)孕激素组与对照组在新生儿先天性异常及低体重的发生率方面均无统计学差异(P>0.05)。结论孕激素可以降低先兆流产患者的流产率,提高活产率,且未增加新生儿相关不良结局的发生;但不同孕激素制剂和给药途径的治疗效果存在差异。口服地屈孕酮治疗可降低先兆流产患者的流产率并提高活产率,值得临床推荐应用。
文摘Background： The effect of ovarian hyperstimulation syndrome （OH SS） on pregnancy outcomes of in vitro fertilization （IVF） patients is still ambiguous. Tbis study aimed to analyze pregnancy outcomes of IVF with or without OHSS in Chinese patients. Methods： A retrospective cohort study was undertaken to compare pregnancy outcomes between 190 women with OHSS and 197 women without OHSS. We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth, preterm deliver）,, preterm birth before 34 weeks＇ gestation, cesarean delivery, low birth weight （LBW）, and small-for-gestational age （SGA） between the two groups. Odds ratios （ORs） and 95% confidence intervals （Cls） of measure of clinical pregnancy were also analyzed. Results： The clinical pregnancy rate of OHSS patients was significantly higher than that of non-OHSS patients （91.8% vs. 43.5%, P 〈 0.001）. After controlling for drug protocol and causes of infertility, the adjusted ORs of moderate OHSS and severe/critical OHSS for clinical pregnancy were 4.65 （95% CI, 1.86-11.61 ） and 5.83 （95% CI, 3.45-9.86）, respectively. There were no significant differences in rates of muhiple pregnancy （4.0% vs. 3.7%） and miscarriage （16.1% vs. 17.5%） between the two groups. With regard to ongoing clinical pregnancy, we also found no significant differences in the rates of live birth （82.1% vs. 78.8%）, preterm delivery （20.9% vs. 17.5%）, preterm birth before 34 weeks＇ gestation （8.6% vs. 7.9%）, cesarean delivery （84.9% vs. 66.3%）, LBW （30.2% vs. 23.5%）, and SGA （21.9% vs. 17.6%） between the two groups. Conclusion： OHSS, which occurs in the luteal phase or early pregnancy in IVF patients and represents abnormal transient hemodynamics, does not exert any obviously adverse effect on the subsequent pregnancy.
文摘Background Reduced endometrial receptivity in hyperstimulated cycles may lead to a lower implantation rate and a lower clinical pregnancy rate,but it is unclear if it is also associated with an increase in pregnancy loss rate.The aim of this study was to compare the implantation,miscarriage,and pregnancy rates between fresh and frozen thawed transfer of one or two day-3 embryos,with a view to understanding whether or not reduced endometrial receptivity encountered in hyperstimulated cycles is associated with an increase in miscarriage rate.Methods This study involved a consecutive series of 1 551 single day-3 embryo transfer cycles and consecutive 5 919 double day-3 embryo transfer cycles in the Assisted Reproductive Unit of the Sir Run Run Shaw Hospital,Hangzhou,China,between January 2010 and December 2012.Results The implantation and clinical pregnancy rates （single embryo 30.7％ and double embryos 33.4％ and 51.4％）using fresh cycle were both significantly lower than that of frozen-thawed cycles （single embryo 35.8％ and double embryos 38.1％ and 57.8％）.There was no difference in biochemical loss or clinical miscarriage rates between the two groups.Conclusions Impairment of endometrial receptivity associated with ovarian hyperstimulation leads to implantation failure at a very early stage,resulting in an increased number of non-pregnancy.It does not lead to increase in biochemical or clinical losses.The significantly reduced ongoing pregnancy rates in both fresh single and double embryo transfer are therefore due to failure to achieve a pregnancy,rather than pregnancy loss after conception.
基金National Natural Science Foundation of China (No.82072880,81960283)Science and Technology Project of Hainan Province (No.LCYX202102)Key Science and Technology Project of Hainan Province (No.ZDKJ2017007)。
文摘With the clinical development and application of intracytoplasmic sperm injection(ICSI)technology in human assisted reproduction,the influence of oocyte quality on embryo development has been paid more and more attention.So far,there have been many reports on oocyte morphology affecting embryo development.It has been found in some works that the appearance of smooth endoplasmic reticulum clusters(SERC)in oocytes may affect the fertilization and embryo development of oocytes.However,with the increasing reports of SERC-containing oocytes obtained by in vitro fertilization and healthy offspring in recent years,there is still some controversy on whether to continue to use SERC-containing oocytes for the following assisted reproductive therapy in clinical practice.Based on this,this review aims to review the research progress of SERC in oocytes in recent years.
文摘Background: The objective of this study was to determine the effects of acupuncture treatment as an adjunctive therapy on the outcome of in vitro fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI). Material/Methods: We conducted a retrospective study of 238 patients who underwent conventional IVF/ ICSI alone or in conjunction with acupuncture over a course of 2 years. Patients in the two treatment groups were matched in terms of age and diagnosis. Acupuncture was administered in two sessions 5 to 7 days prior to and on the day of embryo transfer. Results: There were no differences between the two groups in terms of fertilization rate, pregnancy or implantation rates, and endometrial thickness. The number of oocytes retrieved (P < 0.005) and the number of first trimester miscarriages were significantly lower in the group receiving acupuncture (P < 0.001). Conclusions: Acupuncture reduces miscar-riage rates in patients undergoing IVF/ICSI possibly secondary to stress relief.
