Summary:With delayed childbearing in women,preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma(EOC).Fertility-sparing surgery(FSS)can be considered in patien...Summary:With delayed childbearing in women,preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma(EOC).Fertility-sparing surgery(FSS)can be considered in patients with early-stage disease in order to preserve fertility and improve quality of life.In order to evaluate oncological safety,attitudes toward childbearing and reproductive outcomes in women with EOC who underwent FSS,this multicenter retrospective study was conducted.Between January 2005 and December 2014,total of 87 young women with FIGO stage I EOC were included,with their clinicopathologic parameters in relation to disease-free survival(DFS)and overall survival(OS)assessed.Attitudes toward childbearing,ovarian function and fertility were studied in women undergoing FSS(n=36).As a result,in contrast to radical sur ery,FSS did not affect prognosis by Kaplan-Meier curves(log-rank test;DFS:P=0.484;OS:P=0.125).However,two of the three recurrence cases and both death cases were in FSS group stage IC.All women undergoing FSS resumed regular menstrual periods after chemotherapy.Only 16(44.44%)had tried to conceive,and 17 pregnancies occurred in 15(93.75%)women.Among 20 women who did not attempt conception,the most common reason was not being married(70%),followed by already having children(15%).In summary,FSS is considered safe in young women with stage IA EOC.Regular menstruation and good obstetric outcomes can be achieved.This study also provides some insight into the attitudes and social factors regarding fertility in EOC patients.展开更多
At the end of 2022,the adjustment of the coronavirus disease 2019(COVID-19)pandemic control policy in China resulted in alarge-scale increase in public infection.To compare the fertility parameters of male patients be...At the end of 2022,the adjustment of the coronavirus disease 2019(COVID-19)pandemic control policy in China resulted in alarge-scale increase in public infection.To compare the fertility parameters of male patients before and after the adjustments ofthe COVID-19 pandemic control policy in China,we collected data on patients’medical histories and laboratory examinations ontheir first visits between June 2022 and March 2023 in five different hospitals.Data were divided into five groups according tothe timeline of the policy adjustment.The data we collected from male patients included semen quality and serum reproductivehormone levels,and intergroup comparisons were made using the Mann–Whitney U and Chi-square tests.In total,16784 casesunderwent regular semen analysis,11180 had sperm morphology assessments,and 7200 had reproductive hormone analyses.Thedata showed declining trends in semen volume,sperm motility,and the progressive sperm motility rate after the policy adjustment.Subgroup comparison revealed an initial decrease and gradual recovery in progressive motility rate.Sperm morphology analysisshowed increased neck and tail abnormalities after the policy adjustment.No significant change in hormone levels was observed.Following the adjustment of the COVID-19 prevention policy in China,a decline in sperm motility and morphology was observed.This trend may gradually recover over 2 months.After the policy adjustment,reproductive hormone levels were relatively stablethroughout,except for an increase in luteinizing hormone(LH).These changes in semen parameters suggest that the policyadjustment had a short-to medium-term impact on male reproductive function.展开更多
Objective To explore and quantify the association of hot night exposure during the sperm development period(0–90 lag days) with semen quality.Methods A total of 6,640 male sperm donors from 6 human sperm banks in Chi...Objective To explore and quantify the association of hot night exposure during the sperm development period(0–90 lag days) with semen quality.Methods A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014–2020were recruited in this multicenter study.Two indices(i.e.,hot night excess [HNE] and hot night duration[HND]) were used to estimate the heat intensity and duration during nighttime.Linear mixed models were used to examine the association between hot nights and semen quality parameters.Results The exposure-response relationship revealed that HNE and HND during 0–90 days before semen collection had a significantly inverse association with sperm motility.Specifically,a 1 ℃ increase in HNE was associated with decreased sperm progressive motility of 0.0090(95% confidence interval[CI]:–0.0147,–0.0033) and decreased total motility of 0.0094(95% CI:–0.0160,–0.0029).HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021(95% CI:–0.0040,–0.0003) and 0.0023(95% CI:–0.0043,–0.0002),respectively.Consistent results were observed at different temperature thresholds on hot nights.Conclusion Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.展开更多
Background:The National Chest Pain Center Program(NCPCP)is a nationwide,quality enhancement program aimed at raising the standard of care for patients experiencing acute chest pain in China.The benefits of chest pain ...Background:The National Chest Pain Center Program(NCPCP)is a nationwide,quality enhancement program aimed at raising the standard of care for patients experiencing acute chest pain in China.The benefits of chest pain center(CPC)accreditation on acute coronary syndrome have been demonstrated.However,there is no evidence to indicate whether CPC accreditation improves outcomes for patients with acute aortic dissection(AAD).Methods:We conducted a retrospective observational study of patients with AAD from 1671 hospitals in China,using data from the NCPCP spanning the period from January 1,2016 to December 31,2022.The patients were divided into 2 groups:pre-accreditation and post-accreditation admissions.The outcomes examined included in-hospital mortality,misdiagnosis,and Stanford type A AAD surgery.Multivariate logistic regression was employed to explore the relationship between CPC accreditation and in-hospital outcomes.Furthermore,we stratified the hospitals based on their geographical location(Eastern/Central/Western regions)or administrative status(provincial/non-provincial capital areas)to assess the impact of CPC accreditation on AAD patients across various regions.Results:The analysis encompassed a total of 40,848 patients diagnosed with AAD.The post-accreditation group exhibited significantly lower rates of in-hospital mortality and misdiagnosis(12.1%vs.16.3%,P<0.001 and 2.9%vs.5.4%,P<0.001,respectively)as well as a notably higher rate of Stanford type A AAD surgery(61.1%vs.42.1%,P<0.001)compared with the pre-accreditation group.After adjusting for potential covariates,CPC accreditation was associated with substantially reduced risks of in-hospital mortality(adjusted OR=0.644,95%CI 0.599-0.693)and misdiagnosis(adjusted OR=0.554,95%CI 0.493-0.624),along with an increase in the proportion of patients undergoing Stanford type A AAD surgery(adjusted OR=1.973,95%CI 1.797-2.165).Following CPC accreditation,there were significant reductions in in-hospital mortality across various regions,particularly in Western regions(from 21.5%to 14.1%).Moreover,CPC accreditation demonstrated a more pronounced impact on in-hospital mortality in non-provincial cities compared to provincial cities(adjusted OR:0.607 vs.0.713).Conclusion:CPC accreditation is correlated with improved management and in-hospital outcomes for patients with AAD.展开更多
OBJECTIVE: To evaluate the clinical efficacy and safety of Heyan Kuntai capsule(HYKT) in treating women with infertility caused by diminished ovarian reserve(DOR).METHODS: One hundred eight eligible patientsfrom three...OBJECTIVE: To evaluate the clinical efficacy and safety of Heyan Kuntai capsule(HYKT) in treating women with infertility caused by diminished ovarian reserve(DOR).METHODS: One hundred eight eligible patientsfrom three Chinese hospitals were randomly divided into an HYKT treatment group(n = 55) or a dehydroepiandrosterone(DHEA) treatment group(n =53). Patients in the HYKT group were treated orally with four 0.5 g HYKT three times a day; patients in the DHEA group were treated with one 25.0 mg DHEA capsule three times a day. All patients were treated for 3 months and followed up over a3-month period.RESULTS: Of 108 patients, 12 dropped out: six from the HYKT group, and six from the DHEA group. Eleven patients got pregnant during the treatment. Serum anti-Müllerian hormone levels and antral follicle counts increased significantly in both groups after treatment(P < 0.05) especially in the HYKT group(P < 0.05). Serum follicle stimulating hormone(FSH) levels and FSH/luteinizing hormone ratios decreased(P < 0.05) with no significant difference between the two groups. Estradiol levels in the HYKT group and DHEA-sulfate levels in the DHEA group both increased(P < 0.05). The spontaneous pregnancy rates were 12% and 11% in the HYKT and DHEA groups, respectively(not significant). During the follow-up period, 16 patients in the HYKT group underwent in vitro fertilization-embryo transfer(IVF-ET) and the number of retrieved oocytes was(5.1 ± 1.8). In DHEA group, 20 patients underwent IVF-ET and the number of retrieved oocyte was(4.2 ± 1.9)(not significant); clinical pregnancy rates were 38% in the HYKT group and 20%in DHEA group(not significant). No significant adverse reactions were observed.CONCLUSION: HYKT can improve the ovarian re-serve and hormone levels in patients with infertility caused by DOR. Pregnancy rates after HYKT treatment were similar to those of DHEA treatment.HYKT might be an alternative to the treatment of infertility caused by DOR.展开更多
Recent research indicates that the human infertility rate is increasing. Although various reasons have been hypothesized for the growing infertility rate, environmental contaminants are potentially important causal ag...Recent research indicates that the human infertility rate is increasing. Although various reasons have been hypothesized for the growing infertility rate, environmental contaminants are potentially important causal agents associated with this change.Chemical contaminants are widespread throughout our environment and human exposure is virtually unavoidable. The overall contribution of environmental exposure to infertility is unknown, but studies involving occupational exposure, together with results from animal experiments, suggest that environmental contaminants may adversely affect fertility. We reviewed the adverse effects of environmental exposure on fertility and related reproductive outcomes. Environmental contaminants covered in this review include heavy metals, organic solvents, pesticides and endocrine disrupting chemicals. It is hoped that this review will highlight the need for further research in this area.展开更多
The impact of prior cesarean section（CS） on the pregnancy and neonatal outcomes of in vitro fertilization and embryo transfer（IVF-ET） was investigated. A retrospective analysis was performed on 144 patients with p...The impact of prior cesarean section（CS） on the pregnancy and neonatal outcomes of in vitro fertilization and embryo transfer（IVF-ET） was investigated. A retrospective analysis was performed on 144 patients with prior CS between January 2013 and December 2015. The pregnancy, delivery, and neonatal outcomes of patients who had previous CS delivery and received IVF-ET were analyzed. The control group comprised 166 patients who had only previous vaginal delivery（VD） and received IVF-ET during the same period. The results showed that the basal follicle stimulating hormone level, estradiol level on human chorionic gonadotropin（h CG） day, gonadotrophin dosage, duration of stimulation, retrieved oocytes, fertilization rate, high-quality embryo rate, multiple birth rate, abortion rate and ectopic pregnancy rate had no significant difference between the two groups（P〉0.05）. The pregnancy rate（40.28% vs. 54.22%） and implantation rate（24.01% vs. 34.67%） were significantly lower（P〈0.05）, and the ratio of embryo difficulty transfer（9/144 vs. 0/166） was significantly higher in CS group than in VD group. The risk of pernicious placenta previa and postpartum hemorrhage in twin deliveries was significantly increased in CS group as compared with that in VD group（P〈0.05）, and gestational age and neonatal birth weight were significantly reduced in twin deliveries as compared with singleton deliveries in both groups（P〈0.05）. It was suggested that the existence of CS scar may impact embryo implantation and clinical pregnancy outcome, and increase the difficulty of ET. We should limit the number of transfer embryos to avoid multiple pregnancies and strengthen gestational supervision in patients with cesarean scar.展开更多
The expression of Attractin mRNA and protein in testis and semen of human and male mice was investigated. Human testis and semen samples were all collected from Reproductive Center of Reumin Hospital, Wuhan University...The expression of Attractin mRNA and protein in testis and semen of human and male mice was investigated. Human testis and semen samples were all collected from Reproductive Center of Reumin Hospital, Wuhan University in December, 2012. Testis samples were collected from 7 cases of obstructive azoospermias when they were subjected to diagnosed testis biopsy, and 30 nor- mal human semen samples were obtained from those cases of semen analysis. Adult mice testis tis- sues were obtained from 10 2-month-old male BALB/c mice, and 60 male mice at different ages were classified into 10 groups （day 1, 5, 10, 15, 21, 28, 35, 42, 56, and 120 respectively, n=6 each）. The expression of Attractin mRNA and protein in testis was detected by RT-PCR and Western blotting re- spectively. Human semen samples were centrifuged into sperm plasma （SP） and sperm extract （SE）, and mice sperm samples were collected from the epididymis of 10 adult male BALB/c mice. Western blotting was used to determine the Attractin protein expression level. Attractin mRNA and protein were expressed in the testis of both patients with obstructive azoospermias and adult Bcl/B mice. Quantitative RT-PCR revealed that no Attractin mRNA was detectable in day 1 male BALB/c mice group. The Attractin mRNA and protein levels were low on the day 10, and increased with age until day 56. On the day 120, the expression levels of Attractin were decreased. As for human semen sam- pies, Attractin protein was expressed in both SP and SE, but didn＇t exist in samples from the epidi- dymis of male BALB/c mice. It was suggested that Attractin acted as a novel active substance and was involved in male reproduction in both human and BALB/c mice, but it exerted a different ex- pression profile in different mammal species.展开更多
The clinical effects of acupuncture on idio pathic male infertility in sperm parameter and on therapeutic results in assiste d reproductive technology were investigated. 22 patients failed in intracytoplas mic sperm i...The clinical effects of acupuncture on idio pathic male infertility in sperm parameter and on therapeutic results in assiste d reproductive technology were investigated. 22 patients failed in intracytoplas mic sperm injection (ICSI) with idiopathic male infertility were treated with ac upuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture(18.3 %±9.6 %) was significa ntly improved as compared with that before treatment (11.0 %±7.5 %, P <0.01) . The normal sperm ratio was increased after acupuncture (21.1 %±10.4 % vs 16.2 %± 8.2 %, P <0.05). The fertilization rates after acupuncture (66.2 %) were obviously higher than that before treatment (40.2 %, P <0.01). There was no significant difference in sperm concentration and general sperm motility between before and after acupuncture. The embryo quality after acupuncture was improved , but the difference between them was not significant ( P >0.05). Acupuncture can improve sperm quality and fertilization rates in assisted reproductive techn ology.展开更多
Melatonin,as a ubiquitous indoleamine hormone,is synthesized primarily by the pineal gland.It has diverse biological effects through quite complex mechanisms.More recently,studies have focused on the mechanism of mela...Melatonin,as a ubiquitous indoleamine hormone,is synthesized primarily by the pineal gland.It has diverse biological effects through quite complex mechanisms.More recently,studies have focused on the mechanism of melatonin in anti-reproductive toxicity/damage.Since melatonin possesses strong antioxidant and anti-apoptotic properties,researchers have examined its potential role in protecting against male reproductive toxicity/damage,which may be induced by chemotherapy or environmental toxicants and can lead to male infertility.In this article,recent progress regarding the protective effects of melatonin on male reproductive toxicity/damage is reviewed.展开更多
Advanced paternal age has been overlooked,and its effect on fertility remains controversial.Previous studies have focused mainly on intracytoplasmic sperm injection(ICSI)cycles in men with oligozoospermia.However,few ...Advanced paternal age has been overlooked,and its effect on fertility remains controversial.Previous studies have focused mainly on intracytoplasmic sperm injection(ICSI)cycles in men with oligozoospermia.However,few studies have reported on men with semen parameters within reference ranges.Therefore,we conducted a retrospective cohort study analyzing the reproductive outcomes of couples with non-male-factor infertility undergoing in vitro fertilization(IVF)cycles.In total,381 cycles included were subgrouped according to paternal age(<35-year-old,35–39-year-old,or≥40-year-old),and maternal age was limited to under 35 years.Data on embryo quality and clinical outcomes were analyzed.The results showed that fertilization and high-quality embryo rates were not significantly different(all P>0.05).The pregnancy rate was not significantly different in the 35–39-year-old group(42.0%;P>0.05),but was significantly lower in the≥40-year-old group(26.1%;P<0.05)than that in the<35-year-old group(40.3%).Similarly,the implantation rate significantly decreased in the≥40-year-old group(18.8%)compared with that in the<35-year-old group(31.1%)and 35–39-year-old group(30.0%)(both P<0.05).The live birth rate(30.6%,21.7%,and 19.6%)was not significantly different across the paternal age subgroups(<35-year-old,35–39-year-old,and≥40-year-old,respectively;all P>0.05),but showed a declining trend.The miscarriage rate significantly increased in the 35–39-year-old group(44.8%)compared with that in the<35-year-old group(21.0%;P<0.05).No abnormality in newborn birth weight was found.The results indicated that paternal age over 40 years is a key risk factor that influences the assisted reproductive technology success rate even with good semen parameters,although it has no impact on embryo development.展开更多
Assisted reproductive technology （ART） is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture o...Assisted reproductive technology （ART） is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.展开更多
BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread u...BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread use of assisted reproductive techniques(ART)such as ovulation promotion therapy.CASE SUMMARY Here,we describe a case of HP that occurred after ART with concurrent tubal and intrauterine singleton pregnancies.This was treated successfully with surgery to preserve the intrauterine pregnancy,resulting in the birth of a low-weight premature infant.This case report aims to increase awareness of the possibility of HP during routine first-trimester ultrasound examinations,especially in pregnancies resulting from ART and even if multiple intrauterine pregnancies are present.CONCLUSION This case alerts us to the importance of comprehensive data collection during regular consultations.It is important for us to remind ourselves of the possibility of HP in all patients presenting after ART,especially in women with an established and stable intrauterine pregnancy that complain of constant abdominal discomfort and also in women with an unusually raised human chorionic gonadotropin level compared with simplex intrauterine pregnancy.This will allow symptomatic and timeous treatment of patients with better results.展开更多
This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teachi...This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.展开更多
Anxiety is a common reaction of men undergoing assisted reproductive treatment.Our study aims to explore the risk factors of anxiety among men receiving assisted reproductive treatment.We found that the men who have p...Anxiety is a common reaction of men undergoing assisted reproductive treatment.Our study aims to explore the risk factors of anxiety among men receiving assisted reproductive treatment.We found that the men who have primary school education were more anxious than those who have higher level education including junior middle school(X^2=13.01,P<0.01),senior middle school(X^2=5.63,P=0.02),junior college(X^2=6.94,P=0.01)and higher education(X^2=13.78,P<0.01).Moreover,the men who have severe financial burden were more anxious than the men who have mild(X^2=9.54,P<0.01)or moderate(X^2=6.30,P=0.01)burden.For trait anxiety,the independent risk factor was financial burden of treatment.Therefore,we suggest that for men who prepare to receive assisted reproductive treatment,especially for men who had financial burden for treatment or only received primary education,pre-treatment counseling or psychological intervention should be provided.展开更多
Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases...Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases of singleton deliver by infertile patients under 35 years old who received IVF/ICSI-ET in our center were analyzed.According to different fertilization methods,they were divided into IVF group(2967 cases)and ICSI group(1262 cases).The general situation of birth,birth defects and the location of defects were compared between the two groups.Results:a total of 38 cases of neonatal birth defects were found,the incidence of birth defects was 0.89%,including 30 cases(1.01%)in IVF group and 8 cases(0.64%)in ICSI group.There was no significant difference in the incidence of birth defects between the two groups(P>0.05).There was also no significant difference in birth weight,gestational age and gender ratio between the two groups(P>0.05).Conclusion:Different fertilization methods in assisted reproductive technology do not increase the incidence of neonatal birth defects.展开更多
Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely ...Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely and effectively.Methods:Prospective,multicenter,randomized controlled trial;A total of 278 POR patients were randomized in DKD group or immediate treatment group.Both groups received IVF or ICSI as a standard treatment while in the DKD group,DKD was administrated for 3 months before the IVF/ICSI cycle.The primary outcome was the ongoing pregnancy rate.The secondary outcomes include clinical pregnancy rate,biochemical pregnancy rate,total gonadotropin(Gn)dosage and duration,estradiol(E2)and progesterone(P)levels on human chorionic gonadotropin(hCG)trigger day,cycle cancellation rate,number of oocytes retrieved,high-quality embryo rate and any adverse events.Results:Compared to the immediate IVF treatment group,oral administration of DKD for 3 months before IVF led to a significant increase in ongoing pregnancy rate(30.0%v.s.17.6%,P<0.05),biochemical pregnancy rate(39.2%vs.25.2%,P<0.05),clinical pregnancy rate(36.7%vs.22.7%,P<0.05)and high-quality embryo rate(40.8%vs.32.4%,P<0.05),and a significant decrease in Gn duration(P<0.05).However,no significant differences were found in total dosage of Gn,number of retrieved oocytes,cycle cancellation rate,E2 level and P level on hCG trigger days(P>0.05).No serious adverse events occurred during the intervention period in either group.Conclusion:DKD is a safe and effective intervention to improve the IVF/ICSI-ET outcomes in patients with POR.展开更多
Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four gro...Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four groups based on the dates of artificial insemination and transplantation:spring,summer,autumn,or winter.The main outcome measures were clinical pregnancy rates and live birth rates.Secondary outcomes included body mass index(BMI),oocyte number,two pronuclei(2PN)cleavage rate,total gonadotropin(Gn)dosage and days,age,2PN fertilization rate,sperm concentration,sperm PR rate,anti-Müllerian hormone(AMH),and endometrial thickness.Outpatient semen quality indicators included sperm PR rate,total sperm count,sperm concentration,and total sperm motility.Results:This retrospective cohort study analyzed 2,016 artificial insemination cycles and 1,783 ovarian retrieval cycles from January 2017 to October 2022,and assessed the semen quality of 6,651 outpatients from May 2017 to October 2022.In artificial insemination cycles,sperm PR rate and clinical pregnancy rate were highest in winter,with a statistically significant difference between groups(P<0.05).Clinical pregnancy rate was influenced by both age and sperm PR rate(P<0.05).In ovarian retrieval cycles,the winter group had significantly higher clinical pregnancy,2PN fertilization,and 2PN cleavage rates than the other groups.The autumn group had higher live birth rates,though not significantly different.Additionally,winter months showed higher total sperm concentration and total sperm number compared to other seasons.Conclusion:Seasonality affected clinical pregnancy and live birth rates in artificial insemination cycles but not in ovarian retrieval cycles in the Hainan region.These findings suggest that while there is no need to choose a specific season for ovarian retrieval cycles,artificial insemination in winter may be preferable for patients.展开更多
Research in stem cells is one of the most rapidly evolving fields of investigation in medicine today. Stem cells are defined as cells that have the capacity to both generate daughter cells identical to the cell of ori...Research in stem cells is one of the most rapidly evolving fields of investigation in medicine today. Stem cells are defined as cells that have the capacity to both generate daughter cells identical to the cell of origin (self-renewal) and to produce progeny with more restricted, specialized potential (differentiated cells). This dual ability to self-renew and differentiate offers great promise for expanding our understanding of organ systems, elucidating disease pathophysiology, and creating therapeutic approaches to difficult diseases. The goal of this review is to offer an overview of the different types of stem cells and to provide an introduction to the applications of stem cells to the field of obstetrics and gynecology.展开更多
Objective To evaluate the association of GGN repeat polymorphism of androgen receptor(AR)with ovarian reserve and ovarian response in controlled ovarian stimulation(COS).Methods This genetic association study was cond...Objective To evaluate the association of GGN repeat polymorphism of androgen receptor(AR)with ovarian reserve and ovarian response in controlled ovarian stimulation(COS).Methods This genetic association study was conducted among a total of 361 women aged≤40 years with basal FSH≤12 U/L undergoing the GnRH-agonist long protocol for COS in a university affiliated IVF center.GGN repeat in the AR gene was analyzed with Sanger sequencing.The primary endpoint was the number of antral follicle counts(AFCs),and the secondary endpoints were stimulation days,total dose of gonadotropin(Gn)used,total number of retrieved oocytes,ovarian sensitivity index,and follicular output rate.Results The GGN repeat in exon 1 of the AR gene ranged from 13 to 24,and the median repeat length was 22.Based on the genotypes(S for GGN repeats<22,L for GGN repeats≥22),the patients were divided into 3 groups:SS,SL,and LL.Generalized regression analysis indicated that the number of AFCs in group SS was significantly lower than those in group SL(adjusted β=1.8,95%CI:0.2-3.4,P=0.024)and group LL(adjusted β=1.5,95%CI:0.2-2.7,P=0.021).No significant difference was observed in the number of AFCs between group SL and group LL(P>0.05).Generalized regression analysis indicated no significant differences in ovarian stimulation parameters among the 3 groups,either before or after adjusting for confounding factors(P>0.05).Conclusion GGN repeat length on the AR gene is associated with AFC but not with ovarian response in Chinese women,indicating that AR gene polymorphisms may affect ovarian reserve.展开更多
基金This work was supported by National Key Technology Research and Development Program of China(No.2019YFC1005200,No.2019YFC1005202 and No.2018YFC1002103)National Natural Science Foundation of China(No.81802896)Hubei Province Health and Family Planning Scientific Research Project(No.WJ2019M127).
文摘Summary:With delayed childbearing in women,preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma(EOC).Fertility-sparing surgery(FSS)can be considered in patients with early-stage disease in order to preserve fertility and improve quality of life.In order to evaluate oncological safety,attitudes toward childbearing and reproductive outcomes in women with EOC who underwent FSS,this multicenter retrospective study was conducted.Between January 2005 and December 2014,total of 87 young women with FIGO stage I EOC were included,with their clinicopathologic parameters in relation to disease-free survival(DFS)and overall survival(OS)assessed.Attitudes toward childbearing,ovarian function and fertility were studied in women undergoing FSS(n=36).As a result,in contrast to radical sur ery,FSS did not affect prognosis by Kaplan-Meier curves(log-rank test;DFS:P=0.484;OS:P=0.125).However,two of the three recurrence cases and both death cases were in FSS group stage IC.All women undergoing FSS resumed regular menstrual periods after chemotherapy.Only 16(44.44%)had tried to conceive,and 17 pregnancies occurred in 15(93.75%)women.Among 20 women who did not attempt conception,the most common reason was not being married(70%),followed by already having children(15%).In summary,FSS is considered safe in young women with stage IA EOC.Regular menstruation and good obstetric outcomes can be achieved.This study also provides some insight into the attitudes and social factors regarding fertility in EOC patients.
基金supported by a grant from the Beijing Municipal NaturalScience Foundation(No.7194332)the Shandong Province Natural ScienceFoundation(No.ZR2022ZD19).
文摘At the end of 2022,the adjustment of the coronavirus disease 2019(COVID-19)pandemic control policy in China resulted in alarge-scale increase in public infection.To compare the fertility parameters of male patients before and after the adjustments ofthe COVID-19 pandemic control policy in China,we collected data on patients’medical histories and laboratory examinations ontheir first visits between June 2022 and March 2023 in five different hospitals.Data were divided into five groups according tothe timeline of the policy adjustment.The data we collected from male patients included semen quality and serum reproductivehormone levels,and intergroup comparisons were made using the Mann–Whitney U and Chi-square tests.In total,16784 casesunderwent regular semen analysis,11180 had sperm morphology assessments,and 7200 had reproductive hormone analyses.Thedata showed declining trends in semen volume,sperm motility,and the progressive sperm motility rate after the policy adjustment.Subgroup comparison revealed an initial decrease and gradual recovery in progressive motility rate.Sperm morphology analysisshowed increased neck and tail abnormalities after the policy adjustment.No significant change in hormone levels was observed.Following the adjustment of the COVID-19 prevention policy in China,a decline in sperm motility and morphology was observed.This trend may gradually recover over 2 months.After the policy adjustment,reproductive hormone levels were relatively stablethroughout,except for an increase in luteinizing hormone(LH).These changes in semen parameters suggest that the policyadjustment had a short-to medium-term impact on male reproductive function.
基金funded by the Guangdong Provincial Natural Science Foundation of China(No.2022A1515011517).
文摘Objective To explore and quantify the association of hot night exposure during the sperm development period(0–90 lag days) with semen quality.Methods A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014–2020were recruited in this multicenter study.Two indices(i.e.,hot night excess [HNE] and hot night duration[HND]) were used to estimate the heat intensity and duration during nighttime.Linear mixed models were used to examine the association between hot nights and semen quality parameters.Results The exposure-response relationship revealed that HNE and HND during 0–90 days before semen collection had a significantly inverse association with sperm motility.Specifically,a 1 ℃ increase in HNE was associated with decreased sperm progressive motility of 0.0090(95% confidence interval[CI]:–0.0147,–0.0033) and decreased total motility of 0.0094(95% CI:–0.0160,–0.0029).HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021(95% CI:–0.0040,–0.0003) and 0.0023(95% CI:–0.0043,–0.0002),respectively.Consistent results were observed at different temperature thresholds on hot nights.Conclusion Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
基金supported by the National Key Research and Development Program of China(2023YFC2506500,2021YFC2500500)the Program of Shanghai Academic Research Leader(22XD1423300)the National Natural Science Foundation of China(T2288101,82370357,82100470)。
文摘Background:The National Chest Pain Center Program(NCPCP)is a nationwide,quality enhancement program aimed at raising the standard of care for patients experiencing acute chest pain in China.The benefits of chest pain center(CPC)accreditation on acute coronary syndrome have been demonstrated.However,there is no evidence to indicate whether CPC accreditation improves outcomes for patients with acute aortic dissection(AAD).Methods:We conducted a retrospective observational study of patients with AAD from 1671 hospitals in China,using data from the NCPCP spanning the period from January 1,2016 to December 31,2022.The patients were divided into 2 groups:pre-accreditation and post-accreditation admissions.The outcomes examined included in-hospital mortality,misdiagnosis,and Stanford type A AAD surgery.Multivariate logistic regression was employed to explore the relationship between CPC accreditation and in-hospital outcomes.Furthermore,we stratified the hospitals based on their geographical location(Eastern/Central/Western regions)or administrative status(provincial/non-provincial capital areas)to assess the impact of CPC accreditation on AAD patients across various regions.Results:The analysis encompassed a total of 40,848 patients diagnosed with AAD.The post-accreditation group exhibited significantly lower rates of in-hospital mortality and misdiagnosis(12.1%vs.16.3%,P<0.001 and 2.9%vs.5.4%,P<0.001,respectively)as well as a notably higher rate of Stanford type A AAD surgery(61.1%vs.42.1%,P<0.001)compared with the pre-accreditation group.After adjusting for potential covariates,CPC accreditation was associated with substantially reduced risks of in-hospital mortality(adjusted OR=0.644,95%CI 0.599-0.693)and misdiagnosis(adjusted OR=0.554,95%CI 0.493-0.624),along with an increase in the proportion of patients undergoing Stanford type A AAD surgery(adjusted OR=1.973,95%CI 1.797-2.165).Following CPC accreditation,there were significant reductions in in-hospital mortality across various regions,particularly in Western regions(from 21.5%to 14.1%).Moreover,CPC accreditation demonstrated a more pronounced impact on in-hospital mortality in non-provincial cities compared to provincial cities(adjusted OR:0.607 vs.0.713).Conclusion:CPC accreditation is correlated with improved management and in-hospital outcomes for patients with AAD.
基金Supported by The Scientific research project of Administration of Traditional Chinese Medicine of Hebei Province:The Clinical Study of Kuntai Capsule in the Treatment of Infertility Women with Diminished Ovarian Reserve Diagnosed Liver-kidney Yin Deficiency and Heart-kidney Imbalance Syndrome(No.2016068)
文摘OBJECTIVE: To evaluate the clinical efficacy and safety of Heyan Kuntai capsule(HYKT) in treating women with infertility caused by diminished ovarian reserve(DOR).METHODS: One hundred eight eligible patientsfrom three Chinese hospitals were randomly divided into an HYKT treatment group(n = 55) or a dehydroepiandrosterone(DHEA) treatment group(n =53). Patients in the HYKT group were treated orally with four 0.5 g HYKT three times a day; patients in the DHEA group were treated with one 25.0 mg DHEA capsule three times a day. All patients were treated for 3 months and followed up over a3-month period.RESULTS: Of 108 patients, 12 dropped out: six from the HYKT group, and six from the DHEA group. Eleven patients got pregnant during the treatment. Serum anti-Müllerian hormone levels and antral follicle counts increased significantly in both groups after treatment(P < 0.05) especially in the HYKT group(P < 0.05). Serum follicle stimulating hormone(FSH) levels and FSH/luteinizing hormone ratios decreased(P < 0.05) with no significant difference between the two groups. Estradiol levels in the HYKT group and DHEA-sulfate levels in the DHEA group both increased(P < 0.05). The spontaneous pregnancy rates were 12% and 11% in the HYKT and DHEA groups, respectively(not significant). During the follow-up period, 16 patients in the HYKT group underwent in vitro fertilization-embryo transfer(IVF-ET) and the number of retrieved oocytes was(5.1 ± 1.8). In DHEA group, 20 patients underwent IVF-ET and the number of retrieved oocyte was(4.2 ± 1.9)(not significant); clinical pregnancy rates were 38% in the HYKT group and 20%in DHEA group(not significant). No significant adverse reactions were observed.CONCLUSION: HYKT can improve the ovarian re-serve and hormone levels in patients with infertility caused by DOR. Pregnancy rates after HYKT treatment were similar to those of DHEA treatment.HYKT might be an alternative to the treatment of infertility caused by DOR.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB14010300)the Beijing Municipal Science and Technology Commission(No.Z151100004015167)+1 种基金the Beijing Municipal Health Technology High-level Talent Project(No.2014-3-076)the Open fund of State Key Laboratory of Environmental Chemistry and Ecotoxicology(No.KF-2017-13)
文摘Recent research indicates that the human infertility rate is increasing. Although various reasons have been hypothesized for the growing infertility rate, environmental contaminants are potentially important causal agents associated with this change.Chemical contaminants are widespread throughout our environment and human exposure is virtually unavoidable. The overall contribution of environmental exposure to infertility is unknown, but studies involving occupational exposure, together with results from animal experiments, suggest that environmental contaminants may adversely affect fertility. We reviewed the adverse effects of environmental exposure on fertility and related reproductive outcomes. Environmental contaminants covered in this review include heavy metals, organic solvents, pesticides and endocrine disrupting chemicals. It is hoped that this review will highlight the need for further research in this area.
文摘The impact of prior cesarean section（CS） on the pregnancy and neonatal outcomes of in vitro fertilization and embryo transfer（IVF-ET） was investigated. A retrospective analysis was performed on 144 patients with prior CS between January 2013 and December 2015. The pregnancy, delivery, and neonatal outcomes of patients who had previous CS delivery and received IVF-ET were analyzed. The control group comprised 166 patients who had only previous vaginal delivery（VD） and received IVF-ET during the same period. The results showed that the basal follicle stimulating hormone level, estradiol level on human chorionic gonadotropin（h CG） day, gonadotrophin dosage, duration of stimulation, retrieved oocytes, fertilization rate, high-quality embryo rate, multiple birth rate, abortion rate and ectopic pregnancy rate had no significant difference between the two groups（P〉0.05）. The pregnancy rate（40.28% vs. 54.22%） and implantation rate（24.01% vs. 34.67%） were significantly lower（P〈0.05）, and the ratio of embryo difficulty transfer（9/144 vs. 0/166） was significantly higher in CS group than in VD group. The risk of pernicious placenta previa and postpartum hemorrhage in twin deliveries was significantly increased in CS group as compared with that in VD group（P〈0.05）, and gestational age and neonatal birth weight were significantly reduced in twin deliveries as compared with singleton deliveries in both groups（P〈0.05）. It was suggested that the existence of CS scar may impact embryo implantation and clinical pregnancy outcome, and increase the difficulty of ET. We should limit the number of transfer embryos to avoid multiple pregnancies and strengthen gestational supervision in patients with cesarean scar.
基金supported by the National Natural Science Foundation of China(No.30570769)Funds of Health and Family Planning Commission of Hubei Province(No.JS2013009)the Fundamental Research Funds for Central Universities(No.2042014kf0120)
文摘The expression of Attractin mRNA and protein in testis and semen of human and male mice was investigated. Human testis and semen samples were all collected from Reproductive Center of Reumin Hospital, Wuhan University in December, 2012. Testis samples were collected from 7 cases of obstructive azoospermias when they were subjected to diagnosed testis biopsy, and 30 nor- mal human semen samples were obtained from those cases of semen analysis. Adult mice testis tis- sues were obtained from 10 2-month-old male BALB/c mice, and 60 male mice at different ages were classified into 10 groups （day 1, 5, 10, 15, 21, 28, 35, 42, 56, and 120 respectively, n=6 each）. The expression of Attractin mRNA and protein in testis was detected by RT-PCR and Western blotting re- spectively. Human semen samples were centrifuged into sperm plasma （SP） and sperm extract （SE）, and mice sperm samples were collected from the epididymis of 10 adult male BALB/c mice. Western blotting was used to determine the Attractin protein expression level. Attractin mRNA and protein were expressed in the testis of both patients with obstructive azoospermias and adult Bcl/B mice. Quantitative RT-PCR revealed that no Attractin mRNA was detectable in day 1 male BALB/c mice group. The Attractin mRNA and protein levels were low on the day 10, and increased with age until day 56. On the day 120, the expression levels of Attractin were decreased. As for human semen sam- pies, Attractin protein was expressed in both SP and SE, but didn＇t exist in samples from the epidi- dymis of male BALB/c mice. It was suggested that Attractin acted as a novel active substance and was involved in male reproduction in both human and BALB/c mice, but it exerted a different ex- pression profile in different mammal species.
文摘The clinical effects of acupuncture on idio pathic male infertility in sperm parameter and on therapeutic results in assiste d reproductive technology were investigated. 22 patients failed in intracytoplas mic sperm injection (ICSI) with idiopathic male infertility were treated with ac upuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture(18.3 %±9.6 %) was significa ntly improved as compared with that before treatment (11.0 %±7.5 %, P <0.01) . The normal sperm ratio was increased after acupuncture (21.1 %±10.4 % vs 16.2 %± 8.2 %, P <0.05). The fertilization rates after acupuncture (66.2 %) were obviously higher than that before treatment (40.2 %, P <0.01). There was no significant difference in sperm concentration and general sperm motility between before and after acupuncture. The embryo quality after acupuncture was improved , but the difference between them was not significant ( P >0.05). Acupuncture can improve sperm quality and fertilization rates in assisted reproductive techn ology.
基金from NHC Key Laboratory of Family Planning and Healthy/key laboratory of reproductive medicine of Hebei provincial(SZ-202006)Peking University International Hospital Research Funds(No.YN2019QN13).
文摘Melatonin,as a ubiquitous indoleamine hormone,is synthesized primarily by the pineal gland.It has diverse biological effects through quite complex mechanisms.More recently,studies have focused on the mechanism of melatonin in anti-reproductive toxicity/damage.Since melatonin possesses strong antioxidant and anti-apoptotic properties,researchers have examined its potential role in protecting against male reproductive toxicity/damage,which may be induced by chemotherapy or environmental toxicants and can lead to male infertility.In this article,recent progress regarding the protective effects of melatonin on male reproductive toxicity/damage is reviewed.
基金This work was supported by the National Key R&D Program of China(No.2018YFC1005001)the Zhongshan Hospital Youth Fund(No.2019ZSQN57)the National Natural Science Foundation of China(No.81971345).
文摘Advanced paternal age has been overlooked,and its effect on fertility remains controversial.Previous studies have focused mainly on intracytoplasmic sperm injection(ICSI)cycles in men with oligozoospermia.However,few studies have reported on men with semen parameters within reference ranges.Therefore,we conducted a retrospective cohort study analyzing the reproductive outcomes of couples with non-male-factor infertility undergoing in vitro fertilization(IVF)cycles.In total,381 cycles included were subgrouped according to paternal age(<35-year-old,35–39-year-old,or≥40-year-old),and maternal age was limited to under 35 years.Data on embryo quality and clinical outcomes were analyzed.The results showed that fertilization and high-quality embryo rates were not significantly different(all P>0.05).The pregnancy rate was not significantly different in the 35–39-year-old group(42.0%;P>0.05),but was significantly lower in the≥40-year-old group(26.1%;P<0.05)than that in the<35-year-old group(40.3%).Similarly,the implantation rate significantly decreased in the≥40-year-old group(18.8%)compared with that in the<35-year-old group(31.1%)and 35–39-year-old group(30.0%)(both P<0.05).The live birth rate(30.6%,21.7%,and 19.6%)was not significantly different across the paternal age subgroups(<35-year-old,35–39-year-old,and≥40-year-old,respectively;all P>0.05),but showed a declining trend.The miscarriage rate significantly increased in the 35–39-year-old group(44.8%)compared with that in the<35-year-old group(21.0%;P<0.05).No abnormality in newborn birth weight was found.The results indicated that paternal age over 40 years is a key risk factor that influences the assisted reproductive technology success rate even with good semen parameters,although it has no impact on embryo development.
基金supported by Cultivating Youth Training Programme Fund in the First Affiliated Hospital of Anhui Medical University(2015KJ03)Reserve talented person fund in the First Affiliated Hospital of Anhui Medical University(310100J001165)
文摘Assisted reproductive technology （ART） is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.
基金Supported by Science and Technology Development Project of Jilin Province,No.YDZJ202201ZYTS060。
文摘BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread use of assisted reproductive techniques(ART)such as ovulation promotion therapy.CASE SUMMARY Here,we describe a case of HP that occurred after ART with concurrent tubal and intrauterine singleton pregnancies.This was treated successfully with surgery to preserve the intrauterine pregnancy,resulting in the birth of a low-weight premature infant.This case report aims to increase awareness of the possibility of HP during routine first-trimester ultrasound examinations,especially in pregnancies resulting from ART and even if multiple intrauterine pregnancies are present.CONCLUSION This case alerts us to the importance of comprehensive data collection during regular consultations.It is important for us to remind ourselves of the possibility of HP in all patients presenting after ART,especially in women with an established and stable intrauterine pregnancy that complain of constant abdominal discomfort and also in women with an unusually raised human chorionic gonadotropin level compared with simplex intrauterine pregnancy.This will allow symptomatic and timeous treatment of patients with better results.
文摘This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.
基金Hubei Provincial Health Research Fund(WJ2019Q048)Hubei Provincial Health and Family Planning Research Fund(WJ2018H0007)。
文摘Anxiety is a common reaction of men undergoing assisted reproductive treatment.Our study aims to explore the risk factors of anxiety among men receiving assisted reproductive treatment.We found that the men who have primary school education were more anxious than those who have higher level education including junior middle school(X^2=13.01,P<0.01),senior middle school(X^2=5.63,P=0.02),junior college(X^2=6.94,P=0.01)and higher education(X^2=13.78,P<0.01).Moreover,the men who have severe financial burden were more anxious than the men who have mild(X^2=9.54,P<0.01)or moderate(X^2=6.30,P=0.01)burden.For trait anxiety,the independent risk factor was financial burden of treatment.Therefore,we suggest that for men who prepare to receive assisted reproductive treatment,especially for men who had financial burden for treatment or only received primary education,pre-treatment counseling or psychological intervention should be provided.
基金Major Science and Technology Project of Hainan Province(No.ZDKJ2017007)Key Research and Development Project of Hainan Provincial Science and Technology Department(No.ZDYF2019158)Scientific Research Project of Health and Family Planning Industry in Hainan Province(No.19A200124)。
文摘Objective:To investigate the incidence of neonatal birth defects in assisted reproductive technology(ART)by in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods:The clinical data of 4229 cases of singleton deliver by infertile patients under 35 years old who received IVF/ICSI-ET in our center were analyzed.According to different fertilization methods,they were divided into IVF group(2967 cases)and ICSI group(1262 cases).The general situation of birth,birth defects and the location of defects were compared between the two groups.Results:a total of 38 cases of neonatal birth defects were found,the incidence of birth defects was 0.89%,including 30 cases(1.01%)in IVF group and 8 cases(0.64%)in ICSI group.There was no significant difference in the incidence of birth defects between the two groups(P>0.05).There was also no significant difference in birth weight,gestational age and gender ratio between the two groups(P>0.05).Conclusion:Different fertilization methods in assisted reproductive technology do not increase the incidence of neonatal birth defects.
基金This study was supported by the National Natural Science Foundation of China Nos.81774351the Tianjin Health&Family Planning Commission(Tianjin scientific research project of priority area of traditional Chinese medicine,Nos.2018008)Shanxi Guangyuyuan TCM Co.,Ltd.
文摘Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely and effectively.Methods:Prospective,multicenter,randomized controlled trial;A total of 278 POR patients were randomized in DKD group or immediate treatment group.Both groups received IVF or ICSI as a standard treatment while in the DKD group,DKD was administrated for 3 months before the IVF/ICSI cycle.The primary outcome was the ongoing pregnancy rate.The secondary outcomes include clinical pregnancy rate,biochemical pregnancy rate,total gonadotropin(Gn)dosage and duration,estradiol(E2)and progesterone(P)levels on human chorionic gonadotropin(hCG)trigger day,cycle cancellation rate,number of oocytes retrieved,high-quality embryo rate and any adverse events.Results:Compared to the immediate IVF treatment group,oral administration of DKD for 3 months before IVF led to a significant increase in ongoing pregnancy rate(30.0%v.s.17.6%,P<0.05),biochemical pregnancy rate(39.2%vs.25.2%,P<0.05),clinical pregnancy rate(36.7%vs.22.7%,P<0.05)and high-quality embryo rate(40.8%vs.32.4%,P<0.05),and a significant decrease in Gn duration(P<0.05).However,no significant differences were found in total dosage of Gn,number of retrieved oocytes,cycle cancellation rate,E2 level and P level on hCG trigger days(P>0.05).No serious adverse events occurred during the intervention period in either group.Conclusion:DKD is a safe and effective intervention to improve the IVF/ICSI-ET outcomes in patients with POR.
文摘Objective:To investigate the influence of season on live birth and clinical pregnancy rates,as well as assisted reproductive technology(ART)outcomes,in the Hainan region.Methods:Patients were categorized into four groups based on the dates of artificial insemination and transplantation:spring,summer,autumn,or winter.The main outcome measures were clinical pregnancy rates and live birth rates.Secondary outcomes included body mass index(BMI),oocyte number,two pronuclei(2PN)cleavage rate,total gonadotropin(Gn)dosage and days,age,2PN fertilization rate,sperm concentration,sperm PR rate,anti-Müllerian hormone(AMH),and endometrial thickness.Outpatient semen quality indicators included sperm PR rate,total sperm count,sperm concentration,and total sperm motility.Results:This retrospective cohort study analyzed 2,016 artificial insemination cycles and 1,783 ovarian retrieval cycles from January 2017 to October 2022,and assessed the semen quality of 6,651 outpatients from May 2017 to October 2022.In artificial insemination cycles,sperm PR rate and clinical pregnancy rate were highest in winter,with a statistically significant difference between groups(P<0.05).Clinical pregnancy rate was influenced by both age and sperm PR rate(P<0.05).In ovarian retrieval cycles,the winter group had significantly higher clinical pregnancy,2PN fertilization,and 2PN cleavage rates than the other groups.The autumn group had higher live birth rates,though not significantly different.Additionally,winter months showed higher total sperm concentration and total sperm number compared to other seasons.Conclusion:Seasonality affected clinical pregnancy and live birth rates in artificial insemination cycles but not in ovarian retrieval cycles in the Hainan region.These findings suggest that while there is no need to choose a specific season for ovarian retrieval cycles,artificial insemination in winter may be preferable for patients.
文摘Research in stem cells is one of the most rapidly evolving fields of investigation in medicine today. Stem cells are defined as cells that have the capacity to both generate daughter cells identical to the cell of origin (self-renewal) and to produce progeny with more restricted, specialized potential (differentiated cells). This dual ability to self-renew and differentiate offers great promise for expanding our understanding of organ systems, elucidating disease pathophysiology, and creating therapeutic approaches to difficult diseases. The goal of this review is to offer an overview of the different types of stem cells and to provide an introduction to the applications of stem cells to the field of obstetrics and gynecology.
文摘Objective To evaluate the association of GGN repeat polymorphism of androgen receptor(AR)with ovarian reserve and ovarian response in controlled ovarian stimulation(COS).Methods This genetic association study was conducted among a total of 361 women aged≤40 years with basal FSH≤12 U/L undergoing the GnRH-agonist long protocol for COS in a university affiliated IVF center.GGN repeat in the AR gene was analyzed with Sanger sequencing.The primary endpoint was the number of antral follicle counts(AFCs),and the secondary endpoints were stimulation days,total dose of gonadotropin(Gn)used,total number of retrieved oocytes,ovarian sensitivity index,and follicular output rate.Results The GGN repeat in exon 1 of the AR gene ranged from 13 to 24,and the median repeat length was 22.Based on the genotypes(S for GGN repeats<22,L for GGN repeats≥22),the patients were divided into 3 groups:SS,SL,and LL.Generalized regression analysis indicated that the number of AFCs in group SS was significantly lower than those in group SL(adjusted β=1.8,95%CI:0.2-3.4,P=0.024)and group LL(adjusted β=1.5,95%CI:0.2-2.7,P=0.021).No significant difference was observed in the number of AFCs between group SL and group LL(P>0.05).Generalized regression analysis indicated no significant differences in ovarian stimulation parameters among the 3 groups,either before or after adjusting for confounding factors(P>0.05).Conclusion GGN repeat length on the AR gene is associated with AFC but not with ovarian response in Chinese women,indicating that AR gene polymorphisms may affect ovarian reserve.
