Varicocele is the most common surgically treatable cause of male infertility, and often results in alterations in semen parameters, sperm DNA damage, and changes to the seminal milieu. Varicocele repair can result in ...Varicocele is the most common surgically treatable cause of male infertility, and often results in alterations in semen parameters, sperm DNA damage, and changes to the seminal milieu. Varicocele repair can result in improvement in these parameters in the majority of men with clinical varicocele; data supporting repair in men with subclinical varicocele are less definitive. In couples seeking fertility using assisted reproductive technologies （ARTs）, varicocele repair may offer improvement in semen parameters and sperm health that can increase the likelihood of successful fertilization using techniques such as in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）, or may decrease the level of ART needed to achieve successful pregnancy. Male infertility is an indicator of general male health, and evaluation of the infertile male with an eye toward future health can facilitate optimal screening and treatment of these men. Furthermore, varicocele may represent a progressive lesion, offering an argument for its repair, although this is currently unclear.展开更多
There were few studies of cumulative live birth rates(CLBRs) based on multicenter reproductive clinical data from the general Chinese population.Here we report a retrospective cohort study,including 14 311 women with1...There were few studies of cumulative live birth rates(CLBRs) based on multicenter reproductive clinical data from the general Chinese population.Here we report a retrospective cohort study,including 14 311 women with17 315 cycles,in three reproductive centers to evaluate two estimated parameters of CLBRs with multiple transfer cycles of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI) in a Chinese population.We found that CLBRs were related to female age and endometrial thickness.By the fourth transfer cycle,the conservative and optimal estimates of CLBRs were 52.95% and 77.30% in women under 30 years of age,and 18.17% and26.51% in those 37 years of age or older,respectively.The two estimates were 44.70% and 63.15% in women with endometrial thickness more than 7 mm,and 32.05% and 46.18% in those with less than 7 mm,respectively.In addition,body mass index(BMI),duration of infertility,and infertility diagnoses may also be related to CLBRs on certain conditions.The findings from this study on CLBRs after multiple transfer cycles of IVF/ICSI treatment on different conditions in the Chinese population should be beneficial to both infertile couples and clinicians.展开更多
Objective: To determine the effects of fasting of Ramadan in patients undergoing in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Design: A prospective cohort study conducted during Ramadan...Objective: To determine the effects of fasting of Ramadan in patients undergoing in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Design: A prospective cohort study conducted during Ramadan. Setting: Ain Shams University IVF centre. Population: Three hundred fasting, infertile women undergoing their first trial of IVF/ICSI and 300 non-fasting matched controls undergoing the same procedure during Ramadan. Methods: Anxiety and depression were measured by the Hospital Anxiety and Depression Scale, at the start of the induction protocol. All the successful pregnant women were followed up until delivery. Main Outcome Measures: The primary outcome measure was the live birth rate. Results: The live birth rate was higher in the fasting group than in the non-fasting group;this was not significant (43% vs. 40%, P = 0.46). The fasting group needed higher doses and durations of induction. Embryo quality did not differ between both groups. The pregnancy complication rate among successful cases was higher in the fasting group (52.9% vs. 40.4%, P = 0.03);however, the frequencies of anxiety and depression were significantly lower than those in the non-fasting group (18% vs. 38%, P P < 0.00001, respectively). Conclusion: Fasting during Ramadan does not seem to significantly affect the IVF/ICSI outcome;however, it significantly decreased the anxiety and depression usually associated with these procedures.展开更多
Objective:To study the effects of preconceptional thyroid-stimulating hormone(TSH)levels on antral follicle count(AFC)and pregnancy outcomes in a firstin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)...Objective:To study the effects of preconceptional thyroid-stimulating hormone(TSH)levels on antral follicle count(AFC)and pregnancy outcomes in a firstin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)cycle.Methods:A retrospective cohort study was conducted to explore the effects of preconceptional TSH levels on AFC and pregnancy outcomes in 1340 patients.The patients were divided into three groups:group 1,0.55≤TSH<2.5μIU/mL(n=868);group 2,2.5≤TSH<4.0μIU/mL(n=334);and group 3,TSH≥4.0μIU/mL(n=138).Results:There were significant differences in AFC(P=0.002),number of zygotes(P=0.008),and fertilization rate(P=0.015)among the three groups.Among the three groups,there were no obvious differences in live birth(P=0.559),high-quality embryo(P=0.108),or clinical pregnancy(P=0.939)rates.Binary logistics regression analysis showed that TSH correlated with AFC when TSH was≥4μIU/mL(P=0.033);however,TSH levels had no effect on live birth or clinical pregnancy rate.Conclusions:Although the preconceptional TSH level negatively related with AFC,number of zygotes,and fertility rate,especially when TSH was>4μIU/mL,TSH was not an independent factor on the live birth rate among fertile women undergoing their first IVF/ICSI-embryo transfer treatment.The effect of TSH levels on couples undergoing assisted reproductive technology requires further investigation.展开更多
Objective:This study aimed to compare the efficacy of clomiphene citrate(CC)with human menopausal gonadotropin(hMG)and that of medroxyprogesterone acetate(MPA)with hMG in poor responders defined according to the Bolog...Objective:This study aimed to compare the efficacy of clomiphene citrate(CC)with human menopausal gonadotropin(hMG)and that of medroxyprogesterone acetate(MPA)with hMG in poor responders defined according to the Bologna criteria.Methods:The data of patients with poor ovarian response(POR)according to the Bologna criteria from September 2016 to November 2017 were retrospectively reviewed.All participants received either CC+hMG or the progesterone-primed ovarian stimulation protocol(PPOS)protocol.Results:A total of 340 patients and 563 in vitro fertilization cycles were analyzed in this study.The incidence of spontaneous luteinizing hormone(LH)surge and the mean LH level on trigger day were significantly lower in the PPOS group than in the CC+HMG group(0.04%vs.3.49%and 4.26±3.59 vs.9.38±6.92 mIU/mL,respectively,P<0.05);however,the incidence of premature ovulation was similar between the two groups.The number of viable embryos harvested was not statistically different between the two groups(1.7±1.1 vs.1.5±0.8,P=0.06).The mean dose and duration of hMG were significantly higher in the PPOS group than in the CC+hMG group(908.7±556.6 vs.177.9±214.5 IU and 6.0±3.4 vs.1.2±1.5 days,respectively,P<0.05).However,the number of oocytes retrieved,number of metaphase II oocytes,and fertilization rate were comparable between the two groups.Conclusions:The CC with low-dose gonadotropin strategy was superior to the MPA with hMG protocol for POR.展开更多
Objective:Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome.The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pre...Objective:Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome.The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pregnancy outcomes of patients with high body mass index(BMI)undergoingin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI),compared to the long protocol(LP).Methods:We retrospectively analyzed the clinical data of 3,920 infertile patients at the Reproductive and Genetic Hospital of Citic-Xiangya from January 2012 to December 2017 by propensity score matching(PSM).Patients were divided into two groups:modified ultra-LP(MULP)(n=1,960)and LP(n=1,960).Results:In the MULP group,live birth rate(52.65%vs.46.79%,P<0.001,odds ratio[OR]:1.784,95%confidence interval[CI]:1.563-2.036),clinical pregnancy rate(62.50%vs.57.91%,P=0.003,OR:1.211,95%CI:1.066-1.377),and implantation rate(53.24%vs.49.65%,P=0.004,OR:1.155,95%CI:1.048-1.272)were statistically significantly higher than those of the LP group.Moreover,the cycle cancellation rates(12.70%vs.15.15%,P=0.027,OR:0.815,95%CI:0.68-0.977),abortion rates(12%vs.14.8%,P=0.046,OR:0.785,95%CI:0.619-0.996),and ectopic pregnancy rates(1.06%vs.2.11%,P=0.04,OR:0.497,95%CI:0.252-0.98)were lower than those in the LP group.Conclusion:The modified ultra-long downregulation protocol improved the pregnancy outcomes in patients with high BMI undergoing IVF/ICSI treatment,providing a potential option for physicians when deciding an optimized ovary stimulation protocol for high BMI patients.展开更多
Background:To analyze the clinical outcomes of in vitro fertilization(IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease(GTD).Methods:This retrospective study...Background:To analyze the clinical outcomes of in vitro fertilization(IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease(GTD).Methods:This retrospective study included 43 patients with a history of GTD as the study group and 43 matched patients as the control group.The patients in the study group were divided into two groups according to the therapy received.Patients in Subgroup A(n=32)underwent uterine curettage treatment only.Patients in Subgroup B(n=11)underwent uterine curettage combined with chemotherapy.The characteristics of ovarian stimulation and outcomes of embryos and pregnancy were compared.Results:In the first cycle,there was a higher number of retrieved oocytes and normal fertilized oocytes in the control group than those in the study group(9.2 vs.6.2 and 6.0 vs.4.0,respectively;P<0.05);however,a similar mature oocyte rate(83.5%vs.85.0%),normal fertilization rate(84.5%vs.80.1%),number of good-quality embryos(1 vs.2),and viable embryos(2 vs.2)were found between the two groups(P>0.05).There was no difference in the outcomes between Subgroup A and Subgroup B.There was a significant difference in thickness of the endometrium between the control group and study group(10.9 mm vs.9.2 mm,respectively;P<0.05).The biochemical pregnancy rate and ongoing pregnancy rate in the control group were significantly higher than those in the study group(51.4%vs.31.7%and 37.8%vs.18.3%,respectively;P<0.05).In the study group,28(93.3%)patients had intrauterine adhesion(IUA)and 23(76.7%)patients used an intrauterine device(IUD),which were both significantly higher than those in control group(P<0.05).In addition,the rate of IUA in second-look hysteroscopy was lower than that in the first surgery in the study group(P<0.05).Conclusions:Patients with a history of GTD can present with a similar normal fertilization rate and number of viable embryos.However,patients with a history of GTD may have a thinner endometrium and lower ongoing pregnancy rate.Hysteroscopy before frozen embryo transfer and usage of an IUD can improve the occurrence of IUA.展开更多
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
Panax species are globally recognized for their high medicinal and economic value,yet large-scale cultivation is constrained by high production costs,progressive soil acidification,and persistent soil-borne diseases.A...Panax species are globally recognized for their high medicinal and economic value,yet large-scale cultivation is constrained by high production costs,progressive soil acidification,and persistent soil-borne diseases.Although various soil improvement strategies have been tested,a comprehensive synthesis of their comparative effectiveness has been lacking.Here,we conducted a meta-analysis of 1381 observations from 54 independent studies to evaluate the effects of conventional fertilizers,microbial fertilizers,organic amendments,and inorganic amendments on Panax cultivation.Our results demonstrate that microbial fertilizers,organic amendments,and inorganic amendments significantly increased soil pH,thereby ameliorating soil acidification.Among them,organic amendments significantly enhanced the content of soil organic carbon,available nitrogen,and available phosphorus,alongside a notable increase in microbial diversity(Chao1 and ACE indices,which increased by 9%and 17%,respectively).Moreover,our analysis revealed that while microbial fertilizers,organic amendments,and inorganic amendments(except conventional fertilizers)reduced the disease index of Panax plants,organic amendments demonstrated absolute superiority in promoting plant height,root dry weight,root fresh weight,and root length.By quantitatively integrating multi-source evidence,this study provides novel mechanistic insights and practical recommendations that extend beyond local practices,offering guidance for sustainable ginseng cultivation and broader medicinal plant production systems worldwide.展开更多
Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as bioc...Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes.There are some crucial steps known to clearly explain the process of fertilization,starting with hyperactivation of spermatozoa,mutual recognition,and binding of gametes mediated by receptors located on the surface membranes of both gametes.The final step is followed by oocyte activation,which is primarily triggered via sperm-derived factors,inducing a sharp increase in intracellular calcium levels,eventually leading to polyspermy block.This review integrates current knowledge of the molecular and physiological events governing fertilization,emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation.Special attention is given to sperm-derived factors such as phospholipase C zeta(PLCζ)and post-acrosomal sheath WW domain-binding protein(PAWP),which play essential roles in triggering calcium release and supporting early embryonic development.展开更多
The combined effects of macronutrients(Nitrogen,Phosphorus,and Potassium-N,P,K)and micronutrient fertilization on turmeric yield,soil enzymatic activity,microbial biomass,and nutrient dynamics remains poorly understoo...The combined effects of macronutrients(Nitrogen,Phosphorus,and Potassium-N,P,K)and micronutrient fertilization on turmeric yield,soil enzymatic activity,microbial biomass,and nutrient dynamics remains poorly understood,despite their significance for sustainable soil fertility management and optimizing crop productivity across diverse agroecosystems.To investigate,a net house experiment on sandy loam Haplic Chernozem was conducted to 03 fertilizer regimes,viz.N_(75)P_(50)K_(50)kg ha^(−1)(T-2),N_(12)5P_(100)K_(100)kg ha^(−1)(T-3),and N_(100)P_(75)K_(75)+B_(3)Zn_(6)Fe_(6)kg ha^(−1)(T-4).Furthermore,the influence of these treatments was systematically assessed on soil nutrient status(N,P,K),enzymatic activities(alkaline phosphomonoesterase,dehydrogenase,fluorescein diacetate hydrolysis),microbial biomass carbon(MBC)and soil organic carbon(SOC).Balanced fertilization significantly turmeric productivity and soil health.All three fertilizer treatments showed a clear yield increase compared to the unfertilized control.Compared to the control,N_(75)P_(50)K_(50)kg/ha T-2 increased rhizome number and biomass per plant by 44.7%and 16.3%,respectively,while N_(100)P_(75)K_(75)+B_(3)Zn_(6)Fe_(6)kg/ha T-4 further enhanced them by 86.6%and 27.7%.T-3 produced the most significant yield response by increasing the rhizome biomass by 38.0%and rhizome number per plant by 100%compared to the control.The nutrient availability was also substantially improved.T-2 enhanced the soil nitrogen contents by 83.3%with maximum N levels observed in T-3&T-4.Phosphorus increased by 61.5%in T-3 and 37.3%in T-4,while potassium was enhanced by 12.9%in T-3 relative to the control,respectively.Enzymatic activities were markedly enhanced as T-3 was recorded to improve alkaline phosphomonoesterase(APA),dehydrogenase(DHA)and fluorescein diacetate hydrolysis(FDA)by 50.6%,37.4%,and 43.4%,where T-4 increased by 32.2%,30.9%,and 35.9%,respectively compared to control.MBC and SOC also rose significantly,with SOC increased by 13.8%(T-2),41.6%(T-3),and 47.2%(T-3)relative to control.The result of this study demonstrates that the integrated macroµnutrient fertilization,particularly T-37 T-4 treatments,sustainably enhanced turmeric yield,soil nutrient availability,enzyme activity,microbial biomass,and organic carbon.These findings highlight the critical role of balanced nutrient management in sustaining soil fertility and crop productivity across agroecosystems.展开更多
<abstract>Aim: To evaluate the effect of intracytoplasmic sperm injection (ICSI) in the management of cases with a history of conventional in vitro fertilization (IVF) failure. Methods: Two groups of patients, 1...<abstract>Aim: To evaluate the effect of intracytoplasmic sperm injection (ICSI) in the management of cases with a history of conventional in vitro fertilization (IVF) failure. Methods: Two groups of patients, 19 with normal semen parameters and a history of IVF failure (metaphase Ⅱ oocytes: 0~30 %) and 28 with severe male factor infertility received ICSI technology during the same period. Ovarian stimulation was achieved by conventional procedure. Transvaginal ultrasound-guided oocyte collection was done 35~37 h after human chorionic gonadotrophin (hCG) injection. Only metaphase Ⅱ oocytes were selected for microinjection. Results: Fertilization was achieved with ICSI in all the patients. The fertilization rate (75.6 %±21.1 % vs. 73.9 %±19.2 %), cleavage rate (85.1 %±19.3 % vs. 82.7 %±22.1 %), clinical pregnancy rate per embryo transfer cycle (31.6 % vs. 28.6 %) and implantation rate per embryo (15.3 % vs. 14.4 %) did not differ significantly between the two groups. Conclusion: ICSI is a valuable method for couples with a history of IVF failure. These patients may have a similar ICSI result as in severe male infertility.展开更多
Antisperm antibodies(ASAs)are assumed to be a possible causative factor for male infertility,with ASAs detected in 5%-15%of infertile men but in only l%-2%of fertile ones.It remains unclear whether ASAs have an advers...Antisperm antibodies(ASAs)are assumed to be a possible causative factor for male infertility,with ASAs detected in 5%-15%of infertile men but in only l%-2%of fertile ones.It remains unclear whether ASAs have an adverse effect on the outcome of in v/tro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).This study investigated differences in the rates of fertilization,pregnancy,and live births associated with serum ASA-positive and ASA-negative men following IVF or ICSI.Five hundred and fifty-four consecutive infertile couples undergoing IVF(n=399)or ICSI(n=155)were included.The two-sample two-sided t-test and Chi-square or Fisher's exact test was used for statistical analysis.Lower rates of fertilization(41.7%vs 54.8%,P=0.03),good embryos(18.9%vs 35.2%,P=0.00),pregnancy(38.5%vs 59.4%,P=0.00),and live births(25.8%vs 42.5%,P=0.00)were observed in men of the IVF group with a positive serum ASA than in those with a negative ASA.ASA positivity/negativity correlated with pregnancy rates(P=0.021,odds ratio[OR]:0.630,95%confidence interval[Cl]:0.425-0.932)and live birth rates(P=0.010,OR:1.409,95%Cl:1.084-1.831)after controlling for the female serum follicle-stimulating hormone level and the couple's ages at IVF.Women coupled with ASA-positive men had lower live birth rates with IVF than with ICSI(25.8%and 47.4%,respectively;P=0.07).Women coupled with ASA-positive men had lower rates of pregnancy and live births following IVF than those coupled with ASA-negative men but had a similar outcome with ICSI.展开更多
Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology(ART).However,the impact of teratozoospermia on in vitro fertilization(IVF)/intracyto...Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology(ART).However,the impact of teratozoospermia on in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)outcomes and its offspring remains inconclusive.In order to evaluate the influence of teratozoospermia on pregnancy outcome and newborn status after IVF and ICSI,a retrospective study was conducted.This was a matched case-control study that included 2202 IVF cycles and 2574 ICSI cycles and was conducted at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha,China,from June 2013 to June 2018.Patients were divided into two groups based on sperm morphology:teratozoospermia and normal sperm group.The pregnancy outcome and newborn outcome were analyzed.The results indicated that couples with teratozoospermia had a significantly lower optimal embryo rate compared to those with normal sperm morphology in IVF(P=0.007),while there were no statistically significant differences between the two groups in terms of the fertilization rate,cleavage rate,implantation rate,and pregnancy rate(all P>0.05).Additionally,teratozoospermia was associated with lower infant birth weight in multiple births after IVF.With regard to ICSI,there was no significant difference in both pregnancy outcome and newborn outcome between the teratozoospermia and normal groups(both P>0.05).Furthermore,no increase in the risk of birth defects occurred in the teratozoospermia group after IVF/ICSI.Consequently,we believe that teratozoospermia has limited predictive value for pregnancy outcomes in IVF/ICSI,and has little impact on the resulting offspring if multiple pregnancy is avoided.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
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
Objective： To explore whether there exist differences in cognitive development between singletons and twins born after in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）. Methods： A total of...Objective： To explore whether there exist differences in cognitive development between singletons and twins born after in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）. Methods： A total of 566 children were recruited for the study, including 388 children （singletons, n=175; twins, n=213） born after IVF and 178 children （singletons, n=87; twins, n=91 ） born after ICSI. The cognitive development was assessed using the Chinese-Wechsler Intelligence Scale for Children （C-WISC）. Results： For all pre-term offspring, all the intelligence quotient （IQ） items between singletons and twins showed no significant differences no matter if they were born after IVF or ICSI. There was a significant difference in the cognitive development of IVF-conceived full-term singletons and twins. The twins born after IVF obtained significantly lower scores than the singletons in verbal IQ （containing information, picture ＆ vocabulary, arithmetic, picture completion, comprehension, and language）, performance IQ （containing maze, visual analysis, object assembly, and performance）, and full scale IQ （P〈0.05）. The cognitive development of full-term sin- gletons and twins born after ICSI did not show any significant differences. There was no significant difference between the parents of the singletons and twins in their characteristics where data were collected, including the age of the mothers, the current employment status, the educational backgrounds, and areas of residence. There were also no consistent differences in the duration of pregnancy, sex composition of the children, age, and height between sin- gletons and twins at the time of our study although there existed significant differences between the two groups in the sex composition of the full-term children born after ICSI （P〈0.05）. Conclusions： Compared to the full-term singletons born after IVF, the full-term twins have lower cognitive development. The cognitive development of full-term singletons and twins born after ICSI did not show any significant differences. For all pre-term offspring, singletons and twins born after IVF or ICSI, the results of the cognitive development showed no significant differences.展开更多
This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were pe...This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.展开更多
Aim: To evaluate the fertilization competence of spermatozoa from ejaculates and testicle when the oocytes were matured in vitro following intracytoplasmic sperm injection (ICSI). Methods: Fifty-six completed cycles i...Aim: To evaluate the fertilization competence of spermatozoa from ejaculates and testicle when the oocytes were matured in vitro following intracytoplasmic sperm injection (ICSI). Methods: Fifty-six completed cycles in 46 women with polycystic ovarian syndrome were grouped according to the semen parameters of their male partners. Group 1 was 47 cycles that presented motile and normal morphology spermatozoa in ejaculates and Group 2 was the other nine cycles where male partners were diagnosed as obstructive azoospermia and spermatozoa could only be found in testicular tissue fragment. All female patients received minimal stimulation with gonadotropin. Immature oocytes were matured in vitro and inseminated by ICSI. The spermatozoa from testes were retrieved by testicular fine needle aspiration. Results: A total of 449 and 78 immature oocytes were collected and cultured for 48 hours, 75.5 % (339/449) and 84.6 % (66/78) oocytes were matured in Groups 1 and 2, respectively. The percentage of oocytes achieving normal fertilization was significantly higher in Group 1 than that in Group 2 (72.9 % vs. 54.5 %, P < 0.05). There were no significant differences in the rates of oocytes cleavage and clinical pregnancies in these two groups [87.4 % (216/247) vs. 88.9 % (32/36); 21.3 % (10/47) vs. 44.4 % (4/9)]. A total of 15 babies in the two groups were healthy delivered at term. Conclusion: It appears that IVM combined with ICSI using testicular spermatozoa can produce healthy infants, while the normal fertilization rate of in vitro matured oocytes after ICSI using testicular spermatozoa was significantly lower than using the ejaculated spermatozoa.展开更多
Background For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy.Surgery is one of the treatment options; however, i...Background For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy.Surgery is one of the treatment options; however, if patients failed to conceive after surgery, in vitro fertilization （IVF） is effective.The objective of this retrospective study was to determine the clinical characteristics of IVF/intracytoplasmic sperm injection （ICSI） in patients with stage Ⅲ/Ⅳ endometriosis, and to determine the impact of the interval from surgery to IVF/ICSI on outcome.Methods One hundred and sixty patients who were diagnosed with stage Ⅲ/Ⅳ endometriosis underwent IVF/ICSI cycles between February 2004 and June 2009 were enrolled.The mean interval from surgery to IVF, number of oocytes retrieved, fertilization rate, implantation rate, embryos transferred, and good embryos transferred were compared between two age groups （≤35 years and 〉 35 years）.Results The mean interval from surgery to IVF was （37.9±28.9） months for the group ≤ 35 years of age and （57.6±39.7）months for the group 〉35 years of age.Twenty-five IVF/ICSI cycles （12.8%） were performed during the first year after surgery, and 34.9% IVF/ICSI cycles were performed 2 years after surgery.No significant differences existed between the two groups with respect to the fertilization rate, implantation rate, number of embryos transferred, number of good embryos,clinical pregnancy rates, live birth rates, and cumulative clinical pregnancy rates （P 〉0.05）.The probability of cumulative clinical pregnancies was 75%, 50%, and 25% （（29.0±4.8）, （61.0±7.6）, and （120.0±16.9） months after surgery, respectively）.Conclusions For infertile patients with stage Ⅲ/Ⅳ endometriosis, the optimal time to conceive by IVF/ICSI is 〈2 years after surgery; nevertheless, most of the patients took a longer time to conceive.展开更多
文摘Varicocele is the most common surgically treatable cause of male infertility, and often results in alterations in semen parameters, sperm DNA damage, and changes to the seminal milieu. Varicocele repair can result in improvement in these parameters in the majority of men with clinical varicocele; data supporting repair in men with subclinical varicocele are less definitive. In couples seeking fertility using assisted reproductive technologies （ARTs）, varicocele repair may offer improvement in semen parameters and sperm health that can increase the likelihood of successful fertilization using techniques such as in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）, or may decrease the level of ART needed to achieve successful pregnancy. Male infertility is an indicator of general male health, and evaluation of the infertile male with an eye toward future health can facilitate optimal screening and treatment of these men. Furthermore, varicocele may represent a progressive lesion, offering an argument for its repair, although this is currently unclear.
基金supported by National Key Research&Development Program(Grant No.2016YFC1000200,No.2016YFC1000204,and No.2018YFC1004200)the State Key Program of National Natural Science of China(Grant No.31530047)+2 种基金National Natural Science Foundation of China(Grant No.81602927)Innovation Fund of State Key Laboratory of Reproductive Medicine(Grant No.SKLRMGC201802)Top-notch Academic Programs Project of Jiangsu Higher Education Institutions(Grant No.PPZY2015A067)。
文摘There were few studies of cumulative live birth rates(CLBRs) based on multicenter reproductive clinical data from the general Chinese population.Here we report a retrospective cohort study,including 14 311 women with17 315 cycles,in three reproductive centers to evaluate two estimated parameters of CLBRs with multiple transfer cycles of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI) in a Chinese population.We found that CLBRs were related to female age and endometrial thickness.By the fourth transfer cycle,the conservative and optimal estimates of CLBRs were 52.95% and 77.30% in women under 30 years of age,and 18.17% and26.51% in those 37 years of age or older,respectively.The two estimates were 44.70% and 63.15% in women with endometrial thickness more than 7 mm,and 32.05% and 46.18% in those with less than 7 mm,respectively.In addition,body mass index(BMI),duration of infertility,and infertility diagnoses may also be related to CLBRs on certain conditions.The findings from this study on CLBRs after multiple transfer cycles of IVF/ICSI treatment on different conditions in the Chinese population should be beneficial to both infertile couples and clinicians.
文摘Objective: To determine the effects of fasting of Ramadan in patients undergoing in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Design: A prospective cohort study conducted during Ramadan. Setting: Ain Shams University IVF centre. Population: Three hundred fasting, infertile women undergoing their first trial of IVF/ICSI and 300 non-fasting matched controls undergoing the same procedure during Ramadan. Methods: Anxiety and depression were measured by the Hospital Anxiety and Depression Scale, at the start of the induction protocol. All the successful pregnant women were followed up until delivery. Main Outcome Measures: The primary outcome measure was the live birth rate. Results: The live birth rate was higher in the fasting group than in the non-fasting group;this was not significant (43% vs. 40%, P = 0.46). The fasting group needed higher doses and durations of induction. Embryo quality did not differ between both groups. The pregnancy complication rate among successful cases was higher in the fasting group (52.9% vs. 40.4%, P = 0.03);however, the frequencies of anxiety and depression were significantly lower than those in the non-fasting group (18% vs. 38%, P P < 0.00001, respectively). Conclusion: Fasting during Ramadan does not seem to significantly affect the IVF/ICSI outcome;however, it significantly decreased the anxiety and depression usually associated with these procedures.
基金Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(YGLX202311)Clinical Incubation Project of Beijing Chao-Yang Hospital(CYFH202307)。
文摘Objective:To study the effects of preconceptional thyroid-stimulating hormone(TSH)levels on antral follicle count(AFC)and pregnancy outcomes in a firstin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)cycle.Methods:A retrospective cohort study was conducted to explore the effects of preconceptional TSH levels on AFC and pregnancy outcomes in 1340 patients.The patients were divided into three groups:group 1,0.55≤TSH<2.5μIU/mL(n=868);group 2,2.5≤TSH<4.0μIU/mL(n=334);and group 3,TSH≥4.0μIU/mL(n=138).Results:There were significant differences in AFC(P=0.002),number of zygotes(P=0.008),and fertilization rate(P=0.015)among the three groups.Among the three groups,there were no obvious differences in live birth(P=0.559),high-quality embryo(P=0.108),or clinical pregnancy(P=0.939)rates.Binary logistics regression analysis showed that TSH correlated with AFC when TSH was≥4μIU/mL(P=0.033);however,TSH levels had no effect on live birth or clinical pregnancy rate.Conclusions:Although the preconceptional TSH level negatively related with AFC,number of zygotes,and fertility rate,especially when TSH was>4μIU/mL,TSH was not an independent factor on the live birth rate among fertile women undergoing their first IVF/ICSI-embryo transfer treatment.The effect of TSH levels on couples undergoing assisted reproductive technology requires further investigation.
文摘Objective:This study aimed to compare the efficacy of clomiphene citrate(CC)with human menopausal gonadotropin(hMG)and that of medroxyprogesterone acetate(MPA)with hMG in poor responders defined according to the Bologna criteria.Methods:The data of patients with poor ovarian response(POR)according to the Bologna criteria from September 2016 to November 2017 were retrospectively reviewed.All participants received either CC+hMG or the progesterone-primed ovarian stimulation protocol(PPOS)protocol.Results:A total of 340 patients and 563 in vitro fertilization cycles were analyzed in this study.The incidence of spontaneous luteinizing hormone(LH)surge and the mean LH level on trigger day were significantly lower in the PPOS group than in the CC+HMG group(0.04%vs.3.49%and 4.26±3.59 vs.9.38±6.92 mIU/mL,respectively,P<0.05);however,the incidence of premature ovulation was similar between the two groups.The number of viable embryos harvested was not statistically different between the two groups(1.7±1.1 vs.1.5±0.8,P=0.06).The mean dose and duration of hMG were significantly higher in the PPOS group than in the CC+hMG group(908.7±556.6 vs.177.9±214.5 IU and 6.0±3.4 vs.1.2±1.5 days,respectively,P<0.05).However,the number of oocytes retrieved,number of metaphase II oocytes,and fertilization rate were comparable between the two groups.Conclusions:The CC with low-dose gonadotropin strategy was superior to the MPA with hMG protocol for POR.
基金support from the National Natural Science Foundation of China(grant No.81501328)。
文摘Objective:Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome.The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pregnancy outcomes of patients with high body mass index(BMI)undergoingin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI),compared to the long protocol(LP).Methods:We retrospectively analyzed the clinical data of 3,920 infertile patients at the Reproductive and Genetic Hospital of Citic-Xiangya from January 2012 to December 2017 by propensity score matching(PSM).Patients were divided into two groups:modified ultra-LP(MULP)(n=1,960)and LP(n=1,960).Results:In the MULP group,live birth rate(52.65%vs.46.79%,P<0.001,odds ratio[OR]:1.784,95%confidence interval[CI]:1.563-2.036),clinical pregnancy rate(62.50%vs.57.91%,P=0.003,OR:1.211,95%CI:1.066-1.377),and implantation rate(53.24%vs.49.65%,P=0.004,OR:1.155,95%CI:1.048-1.272)were statistically significantly higher than those of the LP group.Moreover,the cycle cancellation rates(12.70%vs.15.15%,P=0.027,OR:0.815,95%CI:0.68-0.977),abortion rates(12%vs.14.8%,P=0.046,OR:0.785,95%CI:0.619-0.996),and ectopic pregnancy rates(1.06%vs.2.11%,P=0.04,OR:0.497,95%CI:0.252-0.98)were lower than those in the LP group.Conclusion:The modified ultra-long downregulation protocol improved the pregnancy outcomes in patients with high BMI undergoing IVF/ICSI treatment,providing a potential option for physicians when deciding an optimized ovary stimulation protocol for high BMI patients.
文摘Background:To analyze the clinical outcomes of in vitro fertilization(IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease(GTD).Methods:This retrospective study included 43 patients with a history of GTD as the study group and 43 matched patients as the control group.The patients in the study group were divided into two groups according to the therapy received.Patients in Subgroup A(n=32)underwent uterine curettage treatment only.Patients in Subgroup B(n=11)underwent uterine curettage combined with chemotherapy.The characteristics of ovarian stimulation and outcomes of embryos and pregnancy were compared.Results:In the first cycle,there was a higher number of retrieved oocytes and normal fertilized oocytes in the control group than those in the study group(9.2 vs.6.2 and 6.0 vs.4.0,respectively;P<0.05);however,a similar mature oocyte rate(83.5%vs.85.0%),normal fertilization rate(84.5%vs.80.1%),number of good-quality embryos(1 vs.2),and viable embryos(2 vs.2)were found between the two groups(P>0.05).There was no difference in the outcomes between Subgroup A and Subgroup B.There was a significant difference in thickness of the endometrium between the control group and study group(10.9 mm vs.9.2 mm,respectively;P<0.05).The biochemical pregnancy rate and ongoing pregnancy rate in the control group were significantly higher than those in the study group(51.4%vs.31.7%and 37.8%vs.18.3%,respectively;P<0.05).In the study group,28(93.3%)patients had intrauterine adhesion(IUA)and 23(76.7%)patients used an intrauterine device(IUD),which were both significantly higher than those in control group(P<0.05).In addition,the rate of IUA in second-look hysteroscopy was lower than that in the first surgery in the study group(P<0.05).Conclusions:Patients with a history of GTD can present with a similar normal fertilization rate and number of viable embryos.However,patients with a history of GTD may have a thinner endometrium and lower ongoing pregnancy rate.Hysteroscopy before frozen embryo transfer and usage of an IUD can improve the occurrence of IUA.
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supported by the National Natural Science Foundation of China(Nos.42388101,82403271)Natural Science Foundation of Ningbo Municipality(No.2024J420)Ningbo Top Talent Project(No.215-432094250).
文摘Panax species are globally recognized for their high medicinal and economic value,yet large-scale cultivation is constrained by high production costs,progressive soil acidification,and persistent soil-borne diseases.Although various soil improvement strategies have been tested,a comprehensive synthesis of their comparative effectiveness has been lacking.Here,we conducted a meta-analysis of 1381 observations from 54 independent studies to evaluate the effects of conventional fertilizers,microbial fertilizers,organic amendments,and inorganic amendments on Panax cultivation.Our results demonstrate that microbial fertilizers,organic amendments,and inorganic amendments significantly increased soil pH,thereby ameliorating soil acidification.Among them,organic amendments significantly enhanced the content of soil organic carbon,available nitrogen,and available phosphorus,alongside a notable increase in microbial diversity(Chao1 and ACE indices,which increased by 9%and 17%,respectively).Moreover,our analysis revealed that while microbial fertilizers,organic amendments,and inorganic amendments(except conventional fertilizers)reduced the disease index of Panax plants,organic amendments demonstrated absolute superiority in promoting plant height,root dry weight,root fresh weight,and root length.By quantitatively integrating multi-source evidence,this study provides novel mechanistic insights and practical recommendations that extend beyond local practices,offering guidance for sustainable ginseng cultivation and broader medicinal plant production systems worldwide.
文摘Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes.There are some crucial steps known to clearly explain the process of fertilization,starting with hyperactivation of spermatozoa,mutual recognition,and binding of gametes mediated by receptors located on the surface membranes of both gametes.The final step is followed by oocyte activation,which is primarily triggered via sperm-derived factors,inducing a sharp increase in intracellular calcium levels,eventually leading to polyspermy block.This review integrates current knowledge of the molecular and physiological events governing fertilization,emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation.Special attention is given to sperm-derived factors such as phospholipase C zeta(PLCζ)and post-acrosomal sheath WW domain-binding protein(PAWP),which play essential roles in triggering calcium release and supporting early embryonic development.
基金supported by the Department of Biotechnology,Government of India(DBT),TWAS,and the Ministry of Innovative Development of Uzbekistan。
文摘The combined effects of macronutrients(Nitrogen,Phosphorus,and Potassium-N,P,K)and micronutrient fertilization on turmeric yield,soil enzymatic activity,microbial biomass,and nutrient dynamics remains poorly understood,despite their significance for sustainable soil fertility management and optimizing crop productivity across diverse agroecosystems.To investigate,a net house experiment on sandy loam Haplic Chernozem was conducted to 03 fertilizer regimes,viz.N_(75)P_(50)K_(50)kg ha^(−1)(T-2),N_(12)5P_(100)K_(100)kg ha^(−1)(T-3),and N_(100)P_(75)K_(75)+B_(3)Zn_(6)Fe_(6)kg ha^(−1)(T-4).Furthermore,the influence of these treatments was systematically assessed on soil nutrient status(N,P,K),enzymatic activities(alkaline phosphomonoesterase,dehydrogenase,fluorescein diacetate hydrolysis),microbial biomass carbon(MBC)and soil organic carbon(SOC).Balanced fertilization significantly turmeric productivity and soil health.All three fertilizer treatments showed a clear yield increase compared to the unfertilized control.Compared to the control,N_(75)P_(50)K_(50)kg/ha T-2 increased rhizome number and biomass per plant by 44.7%and 16.3%,respectively,while N_(100)P_(75)K_(75)+B_(3)Zn_(6)Fe_(6)kg/ha T-4 further enhanced them by 86.6%and 27.7%.T-3 produced the most significant yield response by increasing the rhizome biomass by 38.0%and rhizome number per plant by 100%compared to the control.The nutrient availability was also substantially improved.T-2 enhanced the soil nitrogen contents by 83.3%with maximum N levels observed in T-3&T-4.Phosphorus increased by 61.5%in T-3 and 37.3%in T-4,while potassium was enhanced by 12.9%in T-3 relative to the control,respectively.Enzymatic activities were markedly enhanced as T-3 was recorded to improve alkaline phosphomonoesterase(APA),dehydrogenase(DHA)and fluorescein diacetate hydrolysis(FDA)by 50.6%,37.4%,and 43.4%,where T-4 increased by 32.2%,30.9%,and 35.9%,respectively compared to control.MBC and SOC also rose significantly,with SOC increased by 13.8%(T-2),41.6%(T-3),and 47.2%(T-3)relative to control.The result of this study demonstrates that the integrated macroµnutrient fertilization,particularly T-37 T-4 treatments,sustainably enhanced turmeric yield,soil nutrient availability,enzyme activity,microbial biomass,and organic carbon.These findings highlight the critical role of balanced nutrient management in sustaining soil fertility and crop productivity across agroecosystems.
文摘<abstract>Aim: To evaluate the effect of intracytoplasmic sperm injection (ICSI) in the management of cases with a history of conventional in vitro fertilization (IVF) failure. Methods: Two groups of patients, 19 with normal semen parameters and a history of IVF failure (metaphase Ⅱ oocytes: 0~30 %) and 28 with severe male factor infertility received ICSI technology during the same period. Ovarian stimulation was achieved by conventional procedure. Transvaginal ultrasound-guided oocyte collection was done 35~37 h after human chorionic gonadotrophin (hCG) injection. Only metaphase Ⅱ oocytes were selected for microinjection. Results: Fertilization was achieved with ICSI in all the patients. The fertilization rate (75.6 %±21.1 % vs. 73.9 %±19.2 %), cleavage rate (85.1 %±19.3 % vs. 82.7 %±22.1 %), clinical pregnancy rate per embryo transfer cycle (31.6 % vs. 28.6 %) and implantation rate per embryo (15.3 % vs. 14.4 %) did not differ significantly between the two groups. Conclusion: ICSI is a valuable method for couples with a history of IVF failure. These patients may have a similar ICSI result as in severe male infertility.
基金This work was supported by the National Natural Science Foundation of China(No.81471498 and 81760272)the Shandong Scientific Research and Technology Development project(No.2014GSF118129)+1 种基金the Guangxi Natural Science Foundation(No.2016GXNSFDA380010)the Guangxi Scientific Research and Technology Development project(No.Guikegong 1355005-5-7).
文摘Antisperm antibodies(ASAs)are assumed to be a possible causative factor for male infertility,with ASAs detected in 5%-15%of infertile men but in only l%-2%of fertile ones.It remains unclear whether ASAs have an adverse effect on the outcome of in v/tro fertilization(IVF)or intracytoplasmic sperm injection(ICSI).This study investigated differences in the rates of fertilization,pregnancy,and live births associated with serum ASA-positive and ASA-negative men following IVF or ICSI.Five hundred and fifty-four consecutive infertile couples undergoing IVF(n=399)or ICSI(n=155)were included.The two-sample two-sided t-test and Chi-square or Fisher's exact test was used for statistical analysis.Lower rates of fertilization(41.7%vs 54.8%,P=0.03),good embryos(18.9%vs 35.2%,P=0.00),pregnancy(38.5%vs 59.4%,P=0.00),and live births(25.8%vs 42.5%,P=0.00)were observed in men of the IVF group with a positive serum ASA than in those with a negative ASA.ASA positivity/negativity correlated with pregnancy rates(P=0.021,odds ratio[OR]:0.630,95%confidence interval[Cl]:0.425-0.932)and live birth rates(P=0.010,OR:1.409,95%Cl:1.084-1.831)after controlling for the female serum follicle-stimulating hormone level and the couple's ages at IVF.Women coupled with ASA-positive men had lower live birth rates with IVF than with ICSI(25.8%and 47.4%,respectively;P=0.07).Women coupled with ASA-positive men had lower rates of pregnancy and live births following IVF than those coupled with ASA-negative men but had a similar outcome with ICSI.
基金The work was supported by Graduate Independent Innovation Project Fund of Central South University(2020zzts229).
文摘Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology(ART).However,the impact of teratozoospermia on in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)outcomes and its offspring remains inconclusive.In order to evaluate the influence of teratozoospermia on pregnancy outcome and newborn status after IVF and ICSI,a retrospective study was conducted.This was a matched case-control study that included 2202 IVF cycles and 2574 ICSI cycles and was conducted at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha,China,from June 2013 to June 2018.Patients were divided into two groups based on sperm morphology:teratozoospermia and normal sperm group.The pregnancy outcome and newborn outcome were analyzed.The results indicated that couples with teratozoospermia had a significantly lower optimal embryo rate compared to those with normal sperm morphology in IVF(P=0.007),while there were no statistically significant differences between the two groups in terms of the fertilization rate,cleavage rate,implantation rate,and pregnancy rate(all P>0.05).Additionally,teratozoospermia was associated with lower infant birth weight in multiple births after IVF.With regard to ICSI,there was no significant difference in both pregnancy outcome and newborn outcome between the teratozoospermia and normal groups(both P>0.05).Furthermore,no increase in the risk of birth defects occurred in the teratozoospermia group after IVF/ICSI.Consequently,we believe that teratozoospermia has limited predictive value for pregnancy outcomes in IVF/ICSI,and has little impact on the resulting offspring if multiple pregnancy is avoided.
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Project supported by the Program for Zhejiang Leading Team of S&T Innovation(No.2011R50013-14)the National Basic Research Program(973)of China(No.2014CB943302)+1 种基金the Major Science and Technology Programs of the Department of Science and Technology of Zhejiang Province(No.2010C13028)the National Science & Technology Pillar Program during the 12th Five-Year Plan Period(No.2012BAI32B01),China
文摘Objective： To explore whether there exist differences in cognitive development between singletons and twins born after in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）. Methods： A total of 566 children were recruited for the study, including 388 children （singletons, n=175; twins, n=213） born after IVF and 178 children （singletons, n=87; twins, n=91 ） born after ICSI. The cognitive development was assessed using the Chinese-Wechsler Intelligence Scale for Children （C-WISC）. Results： For all pre-term offspring, all the intelligence quotient （IQ） items between singletons and twins showed no significant differences no matter if they were born after IVF or ICSI. There was a significant difference in the cognitive development of IVF-conceived full-term singletons and twins. The twins born after IVF obtained significantly lower scores than the singletons in verbal IQ （containing information, picture ＆ vocabulary, arithmetic, picture completion, comprehension, and language）, performance IQ （containing maze, visual analysis, object assembly, and performance）, and full scale IQ （P〈0.05）. The cognitive development of full-term sin- gletons and twins born after ICSI did not show any significant differences. There was no significant difference between the parents of the singletons and twins in their characteristics where data were collected, including the age of the mothers, the current employment status, the educational backgrounds, and areas of residence. There were also no consistent differences in the duration of pregnancy, sex composition of the children, age, and height between sin- gletons and twins at the time of our study although there existed significant differences between the two groups in the sex composition of the full-term children born after ICSI （P〈0.05）. Conclusions： Compared to the full-term singletons born after IVF, the full-term twins have lower cognitive development. The cognitive development of full-term singletons and twins born after ICSI did not show any significant differences. For all pre-term offspring, singletons and twins born after IVF or ICSI, the results of the cognitive development showed no significant differences.
文摘This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.
文摘Aim: To evaluate the fertilization competence of spermatozoa from ejaculates and testicle when the oocytes were matured in vitro following intracytoplasmic sperm injection (ICSI). Methods: Fifty-six completed cycles in 46 women with polycystic ovarian syndrome were grouped according to the semen parameters of their male partners. Group 1 was 47 cycles that presented motile and normal morphology spermatozoa in ejaculates and Group 2 was the other nine cycles where male partners were diagnosed as obstructive azoospermia and spermatozoa could only be found in testicular tissue fragment. All female patients received minimal stimulation with gonadotropin. Immature oocytes were matured in vitro and inseminated by ICSI. The spermatozoa from testes were retrieved by testicular fine needle aspiration. Results: A total of 449 and 78 immature oocytes were collected and cultured for 48 hours, 75.5 % (339/449) and 84.6 % (66/78) oocytes were matured in Groups 1 and 2, respectively. The percentage of oocytes achieving normal fertilization was significantly higher in Group 1 than that in Group 2 (72.9 % vs. 54.5 %, P < 0.05). There were no significant differences in the rates of oocytes cleavage and clinical pregnancies in these two groups [87.4 % (216/247) vs. 88.9 % (32/36); 21.3 % (10/47) vs. 44.4 % (4/9)]. A total of 15 babies in the two groups were healthy delivered at term. Conclusion: It appears that IVM combined with ICSI using testicular spermatozoa can produce healthy infants, while the normal fertilization rate of in vitro matured oocytes after ICSI using testicular spermatozoa was significantly lower than using the ejaculated spermatozoa.
文摘Background For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy.Surgery is one of the treatment options; however, if patients failed to conceive after surgery, in vitro fertilization （IVF） is effective.The objective of this retrospective study was to determine the clinical characteristics of IVF/intracytoplasmic sperm injection （ICSI） in patients with stage Ⅲ/Ⅳ endometriosis, and to determine the impact of the interval from surgery to IVF/ICSI on outcome.Methods One hundred and sixty patients who were diagnosed with stage Ⅲ/Ⅳ endometriosis underwent IVF/ICSI cycles between February 2004 and June 2009 were enrolled.The mean interval from surgery to IVF, number of oocytes retrieved, fertilization rate, implantation rate, embryos transferred, and good embryos transferred were compared between two age groups （≤35 years and 〉 35 years）.Results The mean interval from surgery to IVF was （37.9±28.9） months for the group ≤ 35 years of age and （57.6±39.7）months for the group 〉35 years of age.Twenty-five IVF/ICSI cycles （12.8%） were performed during the first year after surgery, and 34.9% IVF/ICSI cycles were performed 2 years after surgery.No significant differences existed between the two groups with respect to the fertilization rate, implantation rate, number of embryos transferred, number of good embryos,clinical pregnancy rates, live birth rates, and cumulative clinical pregnancy rates （P 〉0.05）.The probability of cumulative clinical pregnancies was 75%, 50%, and 25% （（29.0±4.8）, （61.0±7.6）, and （120.0±16.9） months after surgery, respectively）.Conclusions For infertile patients with stage Ⅲ/Ⅳ endometriosis, the optimal time to conceive by IVF/ICSI is 〈2 years after surgery; nevertheless, most of the patients took a longer time to conceive.
