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Zhang S, Xu H, Chen J, Zhang Y, Sun Z, Luo L, Wang X, Jiang X, Jiang C, Deng K, Zhang C. Higher baseline alanine aminotransferase level is associated with lower live birth rate after freeze-thawed embryo transfer. Gynecol Endocrinol 2022; 38:949-953. [PMID: 36097348 DOI: 10.1080/09513590.2022.2122430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The aim of this retrospective analysis was to explore whether an elevated ALT level before pregnancy is associated with a reduction in live birth rate after IVF-FET. DESIGN Retrospective observational study. SETTING Shiyan People's Hospital, China between January 2019 and December 2019. PATIENTS Women aged ≤ 40 years. INTERVENTION(S) Freeze-thawed embryo transfer (FET). MAIN OUTCOME MEASURE(S) The live birth rate, which was defined as the delivery of a live baby after 24 weeks of gestation. RESULTS The analysis included 365 FET cycles. There was a significant difference between groups in the live birth rate (p < .05), which was highest for the low ALT tertile and lowest for the high ALT tertile. Multiple regression analysis with adjustment for multiple potential confounders revealed that the odds of live birth were decreased for each one standard deviation increase in ALT (OR = 0.56, 95%CI = 0.42-0.75, p < .0001) and lower for the high ALT tertile than for the low ALT tertile (OR = 0.38, 95%CI = 0.19-0.75, p = .0055). Smooth curve fitting showed an inverse relationship between ALT and live birth rate. CONCLUSION Our findings indicate that relatively small elevations in baseline serum ALT level can have a clinically relevant impact on the success of FET.
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Affiliation(s)
- Shuping Zhang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Hongyi Xu
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Juan Chen
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Ying Zhang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Zhifeng Sun
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Lijuan Luo
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Xiaoning Wang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Xing Jiang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Chenglong Jiang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Kai Deng
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
| | - Changjun Zhang
- Reproductive Medicine Center, Shiyan Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, P. R. China
- Hubei University of Medicine Biomedical Engineering College, Shiyan, Hubei, P. R. China
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Mattsson K, Nilsson-Condori E, Elmerstig E, Vassard D, Schmidt L, Ziebe S, Jöud A. Fertility outcomes in women with pre-existing type 2 diabetes-a prospective cohort study. Fertil Steril 2021; 116:505-513. [PMID: 34353572 DOI: 10.1016/j.fertnstert.2021.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/12/2021] [Accepted: 02/05/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To study childbirth and the risk of miscarriage and infertility among women who have received a diagnosis of type 2 diabetes before the start of their reproductive journey. DESIGN Register-based cohort study using the Skåne Healthcare Register SETTING: All healthcare visits for the whole population of the southernmost region in Sweden over the past 20 years PATIENT(S): All women who were aged 18-45 years between January 1, 1998 and December 31, 2019 and who received a clinical diagnosis of type 2 diabetes before their first childbirth, miscarriage, or infertility diagnosis (n = 230) were compared with a healthcare-seeking population of women without any type of diabetes, matched for calendar year and age (n = 179,434). INTERVENTION(S) None MAIN OUTCOME MEASURE(S): Childbirth, miscarriage, and infertility diagnosis RESULT(S): The birthrate was lower among women with type 2 diabetes (62.6% vs. 83.8%), and they were less likely to give birth (crude risk ratio [RR] = 0.73, 95% confidence interval [CI]: 0.66-0.81). They had a higher risk of experiencing a miscarriage (RR = 1.88, 95% CI: 1.50-2.36). The risk of infertility was increased (RR = 3.44, 95% CI: 2.88-4.10) as was the risk of having infertility and not giving birth (RR = 4.47, 95% CI: 3.44-5.82). All results remained the same after adjustment for polycystic ovary syndrome and obesity. CONCLUSION(S) Women with type 2 diabetes with onset before their reproductive journey were more often childless compared with women without diabetes and had a higher risk of experiencing both miscarriage and infertility. This patient group may be in need of targeted information regarding potential fertility issues as part of their clinical treatment.
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Affiliation(s)
- Kristina Mattsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden; Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden.
| | | | - Eva Elmerstig
- Center for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Ditte Vassard
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Søren Ziebe
- The Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anna Jöud
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
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Nørgård BM, Catalini L, Jølving LR, Larsen MD, Friedman S, Fedder J. The Efficacy of Assisted Reproduction in Women with a Wide Spectrum of Chronic Diseases - A Review. Clin Epidemiol 2021; 13:477-500. [PMID: 34194244 PMCID: PMC8236837 DOI: 10.2147/clep.s310795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/07/2021] [Indexed: 01/11/2023] Open
Abstract
Assisted reproductive technology (ART) treatments in women with underlying chronic diseases have become increasingly frequent. The objective of this review is to provide an overview of the literature examining the chance of having a live born child after ART in women with chronic diseases, compared to other women receiving ART. We focused on some of the most prevalent chronic diseases in women during their reproductive years, ie ulcerative colitis, Crohn’s disease, rheumatoid arthritis, multiple sclerosis, epilepsy, hyperthyroidism, hypothyroidism, and diabetes mellitus. Secondly, we studied the chance of successful implantation. The literature search was performed in the database Pubmed.gov. including all studies published before October 2020. Title and abstracts of 58 papers were reviewed, 37 papers were excluded and other 8 studies were excluded after full-text evaluation. Only 13 papers were eligible for review. Results indicate that women with ulcerative colitis, Crohn’s disease, rheumatoid arthritis, hyperthyroidism, and diabetes mellitus type 2 might have problems with low implantation rate or early embryo development during ART. On the contrary, the few studies on women with hypothyroidism, diabetes mellitus type 1, and epilepsy suggest an equivalent chance of a live birth compared to other women undergoing ART. A possible explanation behind these differences could reside in the disease-specific dysregulation of the innate or adaptive immune system. To our knowledge, this is the first review on ART in women with chronic diseases, and it has disclosed that the evidence in this area is indeed sparse. We encourage others to examine live birth after ART in women with chronic diseases.
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Affiliation(s)
- Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.,Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Laura Catalini
- Centre of Andrology and Fertility Clinic, Odense University Hospital, Odense, Denmark.,Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Line Riis Jølving
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.,Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Michael Due Larsen
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sonia Friedman
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.,Center for Crohn's and Colitis, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jens Fedder
- Centre of Andrology and Fertility Clinic, Odense University Hospital, Odense, Denmark.,Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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