Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activ...Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activation deficiency(OAD),in which fertilization is impeded due to the oocyte’s inability to initiate embryogenesis,commonly attributed to inadequate intracellular calcium(Ca^(2+))release following sperm injection.Patient concerns:The couple repeatedly experienced complete or near-complete fertilization failure in previous ICSI cycles,raising suspicion of an underlying oocyte activation defect.Diagnosis:Based on the repeated absence of fertilization post-ICSI and clinical history,a diagnosis of suspected OAD leading to recurrent ICSI fertilization failure was considered.Interventions:Artificial oocyte activation(AOA)using the calcium ionophore A23187 was performed.After ICSI,unfertilized oocytes were exposed to the ionophore to induce Ca^(2+)influx,simulating physiological calcium oscillations essential for oocyte activation.The efficacy of intervention was evaluated through subsequent embryonic development,morphological grading,and chromosomal integrity.Outcomes:Following AOA treatment,successful oocyte activation occurred,resulting in the formation of high-grade embryos with normal developmental progression.Chromosomal analysis revealed no detectable abnormalities,indicating genomic stability.Lessons:Calcium ionophore–mediated AOA may serve as an effective adjunct in cases of recurrent ICSI failure attributed to OAD.This case highlights the importance of individualized therapeutic strategies in assisted reproduction;however,further research is needed to refine protocols,validate broader clinical efficacy,and assess long-term safety,including potential epigenetic risks.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
The significance of the performance of conventional in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) using sibling oocytes from couples with subfertile male or unexplained infertility was evaluat...The significance of the performance of conventional in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) using sibling oocytes from couples with subfertile male or unexplained infertility was evaluated. A total of 410 sibling oocyte cumulus-corona complexes (OCCC) from 21 couples with subfertile male (group A) and 11 unexplained infertile couples (group B) were randomly divided, in order of retrieval, into two groups inseminated either by conventional IVF or by ICSI. The treatment outcomes and the influence of infertility factors on fertilization in each group were compared. The results showed that although the two pronuclear (2PN) fertilization rate per injected sibling oocytes was significantly higher after ICSI (group A: 68.2 %±28.8 %; group B: 66.2 %±24.9 %) than after conventional IVF (group A: 41.8 %±32.7 %; group B: 40.1 %±22.1 %), the other variables studied included: the fertilization rates of per allocated sibling oocytes IVF/ICSI, the fertilization rates of sibling oocytes IVF/ICSI after excluding failed IVF fertilization cycles, as well as the cleavage rates of normal fertilization were not statistically significant (P>0.05). Similarly, though the total fertilization failure rate in the IVF group (group A: 42.9 %; group B: 36.4 %) was significantly higher than in the ICSI group (group A: 4.8 %; group B: 0), we did not cancel cycles due to the normal fertilization of sibling oocytes. Embryo transfer was possible in all 32 couples. There were 10 clinical pregnancies in the two groups. We also discovered a possible association between some semen parameters and sperm functions of group A, and women age and duration of infertility of group B and fertilization. It is suggested that adoption of the split IVF/ICSI technology in the above cases may help eliminate fertilization failures. This is also a useful method to investigate the effect of single factor on the employment of assisted reproductive technology.展开更多
Objective To analyze the effect of the numbers of transferred good-quality embryos on pregnancy outcomes in in vitro fertilization-embryo transfer （IVF-ET）, supplying a reference for selection of transferred embryos...Objective To analyze the effect of the numbers of transferred good-quality embryos on pregnancy outcomes in in vitro fertilization-embryo transfer （IVF-ET）, supplying a reference for selection of transferred embryos.Methods Five hundreds and one infertile patients who underwent IVF-ET were retrospectively analyzed. All cycles were divided into 3 groups by the number of transferred good-quality embryos （group A： two good-quality embryos, group B： one good-quality embryo, group C： no good-quality embryo）, with no significant difference in general condition such as age, infertility duration and infertility types. The pregnancy outcomes were compared and analyzed among the three groups.Results 1） Live-birth rate was improved with increasing good-quality transferred embryo numbers. Groups A （70.3%） and B （69.8%） had no significant difference （P=0. 409）, whereas it was significantly greater in groups A and B than in group C （57. 7%） （P=0.009, P=0.036）. 2） The loss of single gestational sacs rate, which have no significant difference among 3 groups （P=0.221, P=0.539, P=0.226）, reduced with increasing good-quality transferred embryos numbers. 3） Biochemical pregnancy abortion rate in groups A （10.9%） and B （10.1%） was significantly lower than that in group C （18.3%）（P=0.049, P=0.049）. 4） There was no significant difference among 3 groups in ectopic pregnancy rate （P=0.174, P=0.129, P=0.404）. 5）Multiple-birth rate was improved with increasing good-quality transferred embryos numbers, it was significantly greater in group A （31.6%） than in group C （15.0%）（P=0.020）, while groups B and A had no significant difference （P=0.489, P=0.126）.Conclusion Two good-quality transferred embryos have no significantly difference to 1 good-quality embryo in all pregnancy outcomes. In clinic treatment, we can select 1 good-quality embryo and 1 poor-quality embryo when patients only have few goodquality embryos. Meanwhile, a good-quality embryo can improve live-birth rate and multiple pregnancy rate simultaneously. In order to meet a better assisted reproductive technology （ART） outcome, we need to seek a balance between pregnancy rate and multiple pregnancy rate.展开更多
Objective To analyze the fertilization rate, embryo development and clinical outcome of oocytes with abnormal zona pellucida after in vitro fertilization （IVF） or intracytoplasmic sperm injection （1CS1）. Methods ...Objective To analyze the fertilization rate, embryo development and clinical outcome of oocytes with abnormal zona pellucida after in vitro fertilization （IVF） or intracytoplasmic sperm injection （1CS1）. Methods A retrospective analysis included a total of 43 cycles （27 IVF cycles and 16 ICSI cycles） in which oocytes displaying abnormal zona pellucida were retrieved between January 2006 and December 2011. The fertilization rate, embryo quality, and the cumulative clinical pregnancy rate were analyzed. Results Rescue ICSI was applied in 2 7 IVF cycles in which failed extrusion of the second polar body after conventional IVF was observed, and of them, complete failure to fertilize occurred in 23 IVF cycles. The fertilization rate and the normal fertilization rate for IVF （64.83% and 59.32%, respectively） were significantly lower than those for ICS1 （85.19% and 79.01%, respectively）, whereas the cleavage rate （94.12%） with IVF did not differ significantly from that with ICSI （95.65%, P〉0. 05）. The percentages of good-quality embryos in 1VF group （52. 67%） and 1CSl group （43.75%） also did not differ significantly （P〉0.05）. Although the rates of implantation and pregnancy appeared to be greater in IVF group （33.33% and 40.00%, respectively） compared with those in ICSI group （25.00% and 35. 71%, respectively）, the differences were not significant （P〉0.05）.Conclusions ICSI should be carried out for oocytes with abnormal zona pellucida, for which the risk of lVF failure is high. Rescue ICSI improves the likelihood of fertilization of oocytes with abnormal zona pellucida, but cannot improve the clinical outcome.展开更多
Objective To study the hepatitis B virus （HBV） vertical transmission via infected spermatozoa. Methods Eighteen male patients with HBV infection who underwent in vitro fertilization （IVF） were studied, 5 HBV negat...Objective To study the hepatitis B virus （HBV） vertical transmission via infected spermatozoa. Methods Eighteen male patients with HBV infection who underwent in vitro fertilization （IVF） were studied, 5 HBV negative patients were selected as the control. Fluorescence in situ hybridization （FISH） analysis using the partial-length HBV DNA as the hybridization probe was performed to explore the existence of HBV DNA in the sperm and in the host embryonic genome. Results FISH showed that 5 of 18 patients＇ sperm presented positive signals and 2 of 18 embryos presented positive signals, while no positive signals were found in control group. Conclusion The HBV DNA was found in human sperm and embryos of HBV patients. These results provide direct evidence that HBV DNA could transmit to foetus via human infected spermatozoa.展开更多
The extent to which factors affect the probability of clinical pregnancy in the first fresh embryo transfer after assisted conception is unknown.In order to examine the predictors of clinical pregnancy,a retrospective...The extent to which factors affect the probability of clinical pregnancy in the first fresh embryo transfer after assisted conception is unknown.In order to examine the predictors of clinical pregnancy,a retrospective cohort study was launched between January 1,2013 and December 31,2016 in four infertility clinics including 19837 in vitro fertilization and intracytoplasmic sperm injection(IVF/ICSI)fresh cycles with known outcomes and relevant records.A multivariable logistic regression was used to select the most significant predictors in the final nomogram for predicting clinical pregnancy.Furthermore,the model was validated by an independent validation set and the performance of the model was evaluated by the receiver operating characteristic(ROC)curves along with the area under the ROC curve(AUC)and calibration plots.In a training set including 17854 participants,we identified that female age,tubal factor,number of embryos transferred,endometrial thickness and number of good-quality embryos were independent predictors for clinical pregnancy.We developed a nomogram using these five factors and the predictive ability was 0.66 for AUC(95%CI=0.64−0.68),which was independently validated in the validation set(AUC=0.66,95%CI=0.65−0.68).Our results show that some specific factors can be used to provide infertile couples with an accurate assessment of clinical pregnancy following assisted conception and facilitate to guide couples and clinicians.展开更多
For infertility treatment,the selection of in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)is decided by multiplying indicators(including fallopian tube factors,semen count,and semen motility),exce...For infertility treatment,the selection of in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)is decided by multiplying indicators(including fallopian tube factors,semen count,and semen motility),except for sperm morphology.In this study,we conducted a retrospective analysis,from implantation to birth,over a period of 5 years.A total of 1873 couples with primary or secondary fallopian tube factors and an increased defective sperm morphology rate(DSMR)were divided into different groups to receive IVF or ICSI cycles.By comparing the outcomes,we found that the F1 group(DSMR<96%,IVF group 1)had higher cleavage rate,biochemical pregnancy rate,clinical pregnancy rate,and live birth rate than the F3 group(DSMR>98%,IVF group 3;P<0.05).In contrast,there was no significant difference in the ICSI subgroups.Furthermore,a comparison of the outcomes between IVF and ICSI showed that the S3 group(DSMR>98%,ICSI group 3)had higher cleavage rate(P<0.001),biochemical pregnancy rate(P<0.05),clinical pregnancy rate(P<0.05)and live birth rate(P<0.05)than the F3 group.However,the ICSI subgroup had a lower two pronuclei fertilization rate than the IVF subgroup(P<0.05).Our data suggest that the sperm morphology should also be considered when selecting IVF or ICSI combined with other semen parameters before the first assisted reproductive technologies(ART)cycle,especially for males with severe sperm defects.展开更多
Objective To explore the predictive factors for clinical pregnancies of poor responders diagnosed according to the Bologna criteria in ovarian stimulation in vitro fertilization （IVF） .Methods The present study incl...Objective To explore the predictive factors for clinical pregnancies of poor responders diagnosed according to the Bologna criteria in ovarian stimulation in vitro fertilization （IVF） .Methods The present study included 392 poor responders diagnosed according to the Bologna criteria （392 first poor response cycles and 247 subsequent conventional stimulation cycles） in our IVF center. Binary Logistic regression analysis was used to study the association between possible predictive factors and clinical pregnancy of poor responders in ovarian stimulation IVF.Results The significant predictive factors for clinical pregnancies of poor responders in ovarian stimulation IVF were female age, number of embryos transferred and ovarian stimulation protocol. Female age had the best predictive value for clinical pregnancy of poor ovarian responders.Conclusion Poor responders should be encouraged to attempt Jurther ovarian stimulation IVF treatment as soon as possible because the pregnancy rate decreases with advancing female age. Growth hormone supplementation, intracytoplasmic sperm injection （ICSI） procedure or assisted hatching seem not be able to prominently improve the pregnancy outcomes of poor responders diagnosed according to the Bologna criteria in ovarian stimulation IVF.展开更多
文摘Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activation deficiency(OAD),in which fertilization is impeded due to the oocyte’s inability to initiate embryogenesis,commonly attributed to inadequate intracellular calcium(Ca^(2+))release following sperm injection.Patient concerns:The couple repeatedly experienced complete or near-complete fertilization failure in previous ICSI cycles,raising suspicion of an underlying oocyte activation defect.Diagnosis:Based on the repeated absence of fertilization post-ICSI and clinical history,a diagnosis of suspected OAD leading to recurrent ICSI fertilization failure was considered.Interventions:Artificial oocyte activation(AOA)using the calcium ionophore A23187 was performed.After ICSI,unfertilized oocytes were exposed to the ionophore to induce Ca^(2+)influx,simulating physiological calcium oscillations essential for oocyte activation.The efficacy of intervention was evaluated through subsequent embryonic development,morphological grading,and chromosomal integrity.Outcomes:Following AOA treatment,successful oocyte activation occurred,resulting in the formation of high-grade embryos with normal developmental progression.Chromosomal analysis revealed no detectable abnormalities,indicating genomic stability.Lessons:Calcium ionophore–mediated AOA may serve as an effective adjunct in cases of recurrent ICSI failure attributed to OAD.This case highlights the importance of individualized therapeutic strategies in assisted reproduction;however,further research is needed to refine protocols,validate broader clinical efficacy,and assess long-term safety,including potential epigenetic risks.
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The significance of the performance of conventional in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) using sibling oocytes from couples with subfertile male or unexplained infertility was evaluated. A total of 410 sibling oocyte cumulus-corona complexes (OCCC) from 21 couples with subfertile male (group A) and 11 unexplained infertile couples (group B) were randomly divided, in order of retrieval, into two groups inseminated either by conventional IVF or by ICSI. The treatment outcomes and the influence of infertility factors on fertilization in each group were compared. The results showed that although the two pronuclear (2PN) fertilization rate per injected sibling oocytes was significantly higher after ICSI (group A: 68.2 %±28.8 %; group B: 66.2 %±24.9 %) than after conventional IVF (group A: 41.8 %±32.7 %; group B: 40.1 %±22.1 %), the other variables studied included: the fertilization rates of per allocated sibling oocytes IVF/ICSI, the fertilization rates of sibling oocytes IVF/ICSI after excluding failed IVF fertilization cycles, as well as the cleavage rates of normal fertilization were not statistically significant (P>0.05). Similarly, though the total fertilization failure rate in the IVF group (group A: 42.9 %; group B: 36.4 %) was significantly higher than in the ICSI group (group A: 4.8 %; group B: 0), we did not cancel cycles due to the normal fertilization of sibling oocytes. Embryo transfer was possible in all 32 couples. There were 10 clinical pregnancies in the two groups. We also discovered a possible association between some semen parameters and sperm functions of group A, and women age and duration of infertility of group B and fertilization. It is suggested that adoption of the split IVF/ICSI technology in the above cases may help eliminate fertilization failures. This is also a useful method to investigate the effect of single factor on the employment of assisted reproductive technology.
文摘Objective To analyze the effect of the numbers of transferred good-quality embryos on pregnancy outcomes in in vitro fertilization-embryo transfer （IVF-ET）, supplying a reference for selection of transferred embryos.Methods Five hundreds and one infertile patients who underwent IVF-ET were retrospectively analyzed. All cycles were divided into 3 groups by the number of transferred good-quality embryos （group A： two good-quality embryos, group B： one good-quality embryo, group C： no good-quality embryo）, with no significant difference in general condition such as age, infertility duration and infertility types. The pregnancy outcomes were compared and analyzed among the three groups.Results 1） Live-birth rate was improved with increasing good-quality transferred embryo numbers. Groups A （70.3%） and B （69.8%） had no significant difference （P=0. 409）, whereas it was significantly greater in groups A and B than in group C （57. 7%） （P=0.009, P=0.036）. 2） The loss of single gestational sacs rate, which have no significant difference among 3 groups （P=0.221, P=0.539, P=0.226）, reduced with increasing good-quality transferred embryos numbers. 3） Biochemical pregnancy abortion rate in groups A （10.9%） and B （10.1%） was significantly lower than that in group C （18.3%）（P=0.049, P=0.049）. 4） There was no significant difference among 3 groups in ectopic pregnancy rate （P=0.174, P=0.129, P=0.404）. 5）Multiple-birth rate was improved with increasing good-quality transferred embryos numbers, it was significantly greater in group A （31.6%） than in group C （15.0%）（P=0.020）, while groups B and A had no significant difference （P=0.489, P=0.126）.Conclusion Two good-quality transferred embryos have no significantly difference to 1 good-quality embryo in all pregnancy outcomes. In clinic treatment, we can select 1 good-quality embryo and 1 poor-quality embryo when patients only have few goodquality embryos. Meanwhile, a good-quality embryo can improve live-birth rate and multiple pregnancy rate simultaneously. In order to meet a better assisted reproductive technology （ART） outcome, we need to seek a balance between pregnancy rate and multiple pregnancy rate.
基金supported by Jiangsu Province’s Outstanding Medical Academic Leader program,Jiangsu Health Department,No.LJ201102
文摘Objective To analyze the fertilization rate, embryo development and clinical outcome of oocytes with abnormal zona pellucida after in vitro fertilization （IVF） or intracytoplasmic sperm injection （1CS1）. Methods A retrospective analysis included a total of 43 cycles （27 IVF cycles and 16 ICSI cycles） in which oocytes displaying abnormal zona pellucida were retrieved between January 2006 and December 2011. The fertilization rate, embryo quality, and the cumulative clinical pregnancy rate were analyzed. Results Rescue ICSI was applied in 2 7 IVF cycles in which failed extrusion of the second polar body after conventional IVF was observed, and of them, complete failure to fertilize occurred in 23 IVF cycles. The fertilization rate and the normal fertilization rate for IVF （64.83% and 59.32%, respectively） were significantly lower than those for ICS1 （85.19% and 79.01%, respectively）, whereas the cleavage rate （94.12%） with IVF did not differ significantly from that with ICSI （95.65%, P〉0. 05）. The percentages of good-quality embryos in 1VF group （52. 67%） and 1CSl group （43.75%） also did not differ significantly （P〉0.05）. Although the rates of implantation and pregnancy appeared to be greater in IVF group （33.33% and 40.00%, respectively） compared with those in ICSI group （25.00% and 35. 71%, respectively）, the differences were not significant （P〉0.05）.Conclusions ICSI should be carried out for oocytes with abnormal zona pellucida, for which the risk of lVF failure is high. Rescue ICSI improves the likelihood of fertilization of oocytes with abnormal zona pellucida, but cannot improve the clinical outcome.
基金funded by a grant from the Natural Science Foundation of Hubei Province (No. 2001AA310B06)from the Bureau of Science and Technology of Shiyan City (No. 2001D19)
文摘Objective To study the hepatitis B virus （HBV） vertical transmission via infected spermatozoa. Methods Eighteen male patients with HBV infection who underwent in vitro fertilization （IVF） were studied, 5 HBV negative patients were selected as the control. Fluorescence in situ hybridization （FISH） analysis using the partial-length HBV DNA as the hybridization probe was performed to explore the existence of HBV DNA in the sperm and in the host embryonic genome. Results FISH showed that 5 of 18 patients＇ sperm presented positive signals and 2 of 18 embryos presented positive signals, while no positive signals were found in control group. Conclusion The HBV DNA was found in human sperm and embryos of HBV patients. These results provide direct evidence that HBV DNA could transmit to foetus via human infected spermatozoa.
文摘The extent to which factors affect the probability of clinical pregnancy in the first fresh embryo transfer after assisted conception is unknown.In order to examine the predictors of clinical pregnancy,a retrospective cohort study was launched between January 1,2013 and December 31,2016 in four infertility clinics including 19837 in vitro fertilization and intracytoplasmic sperm injection(IVF/ICSI)fresh cycles with known outcomes and relevant records.A multivariable logistic regression was used to select the most significant predictors in the final nomogram for predicting clinical pregnancy.Furthermore,the model was validated by an independent validation set and the performance of the model was evaluated by the receiver operating characteristic(ROC)curves along with the area under the ROC curve(AUC)and calibration plots.In a training set including 17854 participants,we identified that female age,tubal factor,number of embryos transferred,endometrial thickness and number of good-quality embryos were independent predictors for clinical pregnancy.We developed a nomogram using these five factors and the predictive ability was 0.66 for AUC(95%CI=0.64−0.68),which was independently validated in the validation set(AUC=0.66,95%CI=0.65−0.68).Our results show that some specific factors can be used to provide infertile couples with an accurate assessment of clinical pregnancy following assisted conception and facilitate to guide couples and clinicians.
基金This project was supported by the Shanghai Municipal Science and Technology Major Project(2017SHZDZX01)State Key Laboratory of Reproductive Medicine(SKLRM-K202002).
文摘For infertility treatment,the selection of in vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)is decided by multiplying indicators(including fallopian tube factors,semen count,and semen motility),except for sperm morphology.In this study,we conducted a retrospective analysis,from implantation to birth,over a period of 5 years.A total of 1873 couples with primary or secondary fallopian tube factors and an increased defective sperm morphology rate(DSMR)were divided into different groups to receive IVF or ICSI cycles.By comparing the outcomes,we found that the F1 group(DSMR<96%,IVF group 1)had higher cleavage rate,biochemical pregnancy rate,clinical pregnancy rate,and live birth rate than the F3 group(DSMR>98%,IVF group 3;P<0.05).In contrast,there was no significant difference in the ICSI subgroups.Furthermore,a comparison of the outcomes between IVF and ICSI showed that the S3 group(DSMR>98%,ICSI group 3)had higher cleavage rate(P<0.001),biochemical pregnancy rate(P<0.05),clinical pregnancy rate(P<0.05)and live birth rate(P<0.05)than the F3 group.However,the ICSI subgroup had a lower two pronuclei fertilization rate than the IVF subgroup(P<0.05).Our data suggest that the sperm morphology should also be considered when selecting IVF or ICSI combined with other semen parameters before the first assisted reproductive technologies(ART)cycle,especially for males with severe sperm defects.
文摘Objective To explore the predictive factors for clinical pregnancies of poor responders diagnosed according to the Bologna criteria in ovarian stimulation in vitro fertilization （IVF） .Methods The present study included 392 poor responders diagnosed according to the Bologna criteria （392 first poor response cycles and 247 subsequent conventional stimulation cycles） in our IVF center. Binary Logistic regression analysis was used to study the association between possible predictive factors and clinical pregnancy of poor responders in ovarian stimulation IVF.Results The significant predictive factors for clinical pregnancies of poor responders in ovarian stimulation IVF were female age, number of embryos transferred and ovarian stimulation protocol. Female age had the best predictive value for clinical pregnancy of poor ovarian responders.Conclusion Poor responders should be encouraged to attempt Jurther ovarian stimulation IVF treatment as soon as possible because the pregnancy rate decreases with advancing female age. Growth hormone supplementation, intracytoplasmic sperm injection （ICSI） procedure or assisted hatching seem not be able to prominently improve the pregnancy outcomes of poor responders diagnosed according to the Bologna criteria in ovarian stimulation IVF.
