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Soh RCC, Chen BZ, Hartono S, Lee MS, Lee W, Lim SL, Gan J, Maréchal B, Chan LL, Lo YL. The hindbrain and cortico-reticular pathway in adolescent idiopathic scoliosis. Clin Radiol 2024; 79:e759-e766. [PMID: 38388254 DOI: 10.1016/j.crad.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024]
Abstract
AIM To characterise the corticoreticular pathway (CRP) in a case-control cohort of adolescent idiopathic scoliosis (AIS) patients using high-resolution slice-accelerated readout-segmented echo-planar diffusion tensor imaging (DTI) to enhance the discrimination of small brainstem nuclei in comparison to automated whole-brain volumetry and tractography and their clinical correlates. MATERIALS AND METHODS Thirty-four participants (16 AIS patients, 18 healthy controls) underwent clinical and orthopaedic assessments and brain magnetic resonance imaging (MRI) on a 3 T MRI machine. Automated whole-brain volume-based morphometry, tract-based spatial statistics analysis, and manual CRP tractography by two independent raters were performed. Intra-rater and inter-rater agreement of DTI metrics from CRP tractography were assessed by intraclass correlation coefficient. Normalised structural brain volumes and DTI metrics were compared between groups using Student's t-tests. Linear correlation analysis between imaging parameters and clinical scores was also performed. RESULTS AIS patients demonstrated a significantly larger pons volume compared to controls (p=0.006). Significant inter-side CRP differences in mean (p=0.02) and axial diffusivity (p=0.01) were found in patients only. Asymmetry in CRP fractional anisotropy significantly correlated with the Cobb angle (p=0.03). CONCLUSION Relative pontine hypertrophy and asymmetry in CRP DTI metrics suggest central supranuclear inter-hemispheric imbalance in AIS, and support the role of the CRP in axial muscle tone. Longitudinal evaluation of CRP DTI metrics in the prediction of AIS progression may be clinically relevant.
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Affiliation(s)
- R C C Soh
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - B Z Chen
- Singapore General Hospital, Singapore
| | - S Hartono
- Duke-NUS Medical School, Singapore; National Neuroscience Institute, Singapore
| | - M S Lee
- Singapore General Hospital, Singapore
| | - W Lee
- Singapore General Hospital, Singapore
| | - S L Lim
- Singapore General Hospital, Singapore
| | - J Gan
- Siemens Healthineers, Singapore
| | - B Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland; Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - L L Chan
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore.
| | - Y L Lo
- Duke-NUS Medical School, Singapore; National Neuroscience Institute, Singapore
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Wang XA, Li JP, Lee MS, Yang SF, Chang YS, Chen L, Li CW, Chao YH. A common trajectory of gut microbiome development during the first month in healthy neonates with limited inter-individual environmental variations. Sci Rep 2024; 14:3264. [PMID: 38332050 PMCID: PMC10853277 DOI: 10.1038/s41598-024-53949-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/07/2024] [Indexed: 02/10/2024] Open
Abstract
The early development of the gut microbiome is governed by multiple factors and has significantly long-term effects on later-in-life health. To minimize inter-individual variations in the environment, we determined developmental trajectories of the gut microbiome in 28 healthy neonates during their stay at a postpartum center. Stool samples were collected at three time points: the first-pass meconium within 24 h of life, and at 7 and 28 days of age. Illumina sequencing of the V3-V4 region of 16S rRNA was used to investigate microbiota profiles. We found that there was a distinct microbiota structure at each time point, with a significant shift during the first week. Proteobacteria was most abundant in the first-pass meconium; Firmicutes and Actinobacteria increased with age and were substituted as the major components. Except for a short-term influence of different delivery modes on the microbiota composition, early microbiome development was not remarkably affected by gravidity, maternal intrapartum antibiotic treatment, premature rupture of membranes, or postnatal phototherapy. Hence, our data showed a similar developmental trajectory of the gut microbiome during the first month in healthy neonates when limited in environmental variations. Environmental factors external to the host were crucial in the early microbiome development.
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Affiliation(s)
- Xing-An Wang
- Department of Pediatrics, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung, 402, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ju-Pi Li
- Department of Pediatrics, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung, 402, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Lee Women's Hospital, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Sheng Chang
- Department of Research and Development, AllBio Life Incorporation, Taichung, Taiwan
| | - Ling Chen
- Department of Research and Development, AllBio Life Incorporation, Taichung, Taiwan
| | - Chang-Wei Li
- Department of Research and Development, AllBio Life Incorporation, Taichung, Taiwan
| | - Yu-Hua Chao
- Department of Pediatrics, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Road, Taichung, 402, Taiwan.
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Clinical Pathology, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Lee CI, Huang CC, Lee TH, Chen HH, Cheng EH, Lin PY, Yu TN, Chen CI, Chen CH, Lee MS. Associations between the artificial intelligence scoring system and live birth outcomes in preimplantation genetic testing for aneuploidy cycles. Reprod Biol Endocrinol 2024; 22:12. [PMID: 38233926 PMCID: PMC10792866 DOI: 10.1186/s12958-024-01185-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/12/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Several studies have demonstrated that iDAScore is more accurate in predicting pregnancy outcomes in cycles without preimplantation genetic testing for aneuploidy (PGT-A) compared to KIDScore and the Gardner criteria. However, the effectiveness of iDAScore in cycles with PGT-A has not been thoroughly investigated. Therefore, this study aims to assess the association between artificial intelligence (AI)-based iDAScore (version 1.0) and pregnancy outcomes in single-embryo transfer (SET) cycles with PGT-A. METHODS This retrospective study was approved by the Institutional Review Board of Chung Sun Medical University, Taichung, Taiwan. Patients undergoing SET cycles (n = 482) following PGT-A at a single reproductive center between January 2017 and June 2021. The blastocyst morphology and morphokinetics of all embryos were evaluated using a time-lapse system. The blastocysts were ranked based on the scores generated by iDAScore, which were defined as AI scores, or by KIDScore D5 (version 3.2) following the manufacturer's protocols. A single blastocyst without aneuploidy was transferred after examining the embryonic ploidy status using a next-generation sequencing-based PGT-A platform. Logistic regression analysis with generalized estimating equations was conducted to assess whether AI scores are associated with the probability of live birth (LB) while considering confounding factors. RESULTS Logistic regression analysis revealed that AI score was significantly associated with LB probability (adjusted odds ratio [OR] = 2.037, 95% confidence interval [CI]: 1.632-2.542) when pulsatility index (PI) level and types of chromosomal abnormalities were controlled. Blastocysts were divided into quartiles in accordance with their AI score (group 1: 3.0-7.8; group 2: 7.9-8.6; group 3: 8.7-8.9; and group 4: 9.0-9.5). Group 1 had a lower LB rate (34.6% vs. 59.8-72.3%) and a higher rate of pregnancy loss (26% vs. 4.7-8.9%) compared with the other groups (p < 0.05). The receiver operating characteristic curve analysis verified that the iDAScore had a significant but limited ability to predict LB (area under the curve [AUC] = 0.64); this ability was significantly weaker than that of the combination of iDAScore, type of chromosomal abnormalities, and PI level (AUC = 0.67). In the comparison of the LB groups with the non-LB groups, the AI scores were significantly lower in the non-LB groups, both for euploid (median: 8.6 vs. 8.8) and mosaic (median: 8.0 vs. 8.6) SETs. CONCLUSIONS Although its predictive ability can be further enhanced, the AI score was significantly associated with LB probability in SET cycles. Euploid or mosaic blastocysts with low AI scores (≤ 7.8) were associated with a lower LB rate, indicating the potential of this annotation-free AI system as a decision-support tool for deselecting embryos with poor pregnancy outcomes following PGT-A.
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Affiliation(s)
- Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Tzu-Ning Yu
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
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Wu PJ, Tsai SCS, Huang JY, Lee MS, Wang PH, Lin FCF. From Infection to Malignancy: Tracing the Impact of Human Papillomavirus on Uterine Endometrial Cancer in a Nationwide Population-Based Cohort Study. Viruses 2023; 15:2314. [PMID: 38140555 PMCID: PMC10747305 DOI: 10.3390/v15122314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Uterine endometrial cancer (EC) is the most common gynecological malignancy in Taiwan. This study aimed to investigate the association between human papillomavirus (HPV) infection and the development of uterine EC among Taiwanese women. A nationwide population cohort research approach was employed, leveraging longitudinal health insurance databases (LHID 2007 and 2015) from the National Health Insurance Research Database alongside data from the Taiwan Cancer Registry datasets. A comparative analysis examined 472,420 female patients with HPV infection and 944,840 without HPV infection. The results demonstrated that the HPV cohort exhibited a significantly elevated risk of uterine EC, as evidenced by an adjusted hazard ratio (aHR) of 1.588 (95% CI: 1.335-1.888). Furthermore, this elevated risk extended to type 1 EC with an aHR of 1.671 (95% CI: 1.376-2.029), specifically the endometrioid adenocarcinoma subtype with an aHR 1.686 (95% CI: 1.377-2.065). Importantly, these findings were statistically significant (p < 0.001). In conclusion, this research unveils a potential association between HPV infection and an increased risk of uterine EC, particularly the type 1 endometrial cancer subtype, within the Taiwanese female population. These findings have implications for preventive measures and screening programs targeting HPV infection to reduce the risk of this prevalent gynecological malignancy in Taiwan.
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Affiliation(s)
- Pei-Ju Wu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (P.-J.W.); (J.-Y.H.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Stella Chin-Shaw Tsai
- Superintendent Office, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, Taiwan;
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (P.-J.W.); (J.-Y.H.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Maw-Sheng Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
- Lee Women’s Hospital, Taichung 40652, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (P.-J.W.); (J.-Y.H.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Frank Cheau-Feng Lin
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
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Wang TE, Lee CI, Huang CC, Tsao HM, Chang HC, Chang LS, Chang TA, Lee MS, Hsu CT. Innovative technology for evaluation of sperm DNA double-strand breaks diagnoses male factor infertility and prevents reproductive failures. Sci Rep 2023; 13:18996. [PMID: 37923811 PMCID: PMC10624885 DOI: 10.1038/s41598-023-46049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
Neutral comet assay has been available for two decades to evaluate sperm double-strand breaks (DSBs). However, its clinical usability is limited due to its complex and time-consuming procedure, as well as the lack of a standardized scoring system. The aim of this study was to: develop a rapid diagnostic method for DSBs, Sperm DNA Fragmentation Releasing Assay (SDFR), and explore the association between DSBs and reproductive outcomes. We pioneered the use of polyacrylamide (PA) for embedding sperm chromatin and optimized the porosity of PA to be between 10 and 13%. The refined PA network allowed the trapping of DSBs, which dispersed halo on an immunological slide; in contrast, intact chromatin failed to develop a halo. A strong correlation was showed between reproducible values obtained from SDFR and neutral comet assay. SDFR were responsive to dose-/time-dependent simulated DSBs, indicating high sensitivity and specificity. Furthermore, we conducted a retrospective study of couples with embryonic aneuploidy screening, and recording DSB profiles of the male partners. Our findings revealed that DSB enabled to predict embryonic aneuploidy whereas basic semen parameters did not. In conclusion, SDFR offers a rapid and user-friendly approach for evaluating DSBs, with potential implications for predictive healthcare in reproductive medicine.
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Affiliation(s)
- Tse-En Wang
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC
| | - Chun-I Lee
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan, ROC
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Chun-Chia Huang
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC
| | - Hui-Chen Chang
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC
| | - Li-Sheng Chang
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC
| | - T Arthur Chang
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Maw-Sheng Lee
- Division of Infertility Clinic, Lee Women's Hospital, No. 30-6, Sec. 1, Changping Rd., Beitun Dist., Taichung City, 406021, Taiwan, ROC.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan, ROC.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC.
| | - Cheng-Teng Hsu
- Center for Research and Development, Bonraybio Co., Ltd., 4F., No. 118, Gongye 9Th Rd., Dali Dist., Taichung City, 412037, Taiwan, ROC.
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Yu TN, Cheng EH, Lin YP, Chen YC, Huang CC, Lee TH, Lee MS. Significantly shortened telomere length and altered androgen receptor level in cumulus cells from women with polycystic ovary syndrome. Taiwan J Obstet Gynecol 2023; 62:845-851. [PMID: 38008503 DOI: 10.1016/j.tjog.2023.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 11/28/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the correlation between hormone receptor levels and telomere length (TL) in infertile women with and without polycystic ovary syndrome (PCOS). MATERIALS AND METHODS This prospective cohort study recruited a total of 431 cumulus oocyte complex (COC) from 88 infertile women between July 2012 and June 2014. The participants were divided into three groups: young age (<38 years, n = 42 and 227 COC), advanced age (≥38 years, n = 33 and 107 COC) and PCOS patients (n = 13 and 97 COC). Cumulus cells were collected from individual follicle during oocyte pick-up, and the mRNA levels of hormone receptors and TL were measured using real-time PCR. RESULTS The cumulus cells of PCOS patients demonstrated lower mRNA levels of LH receptor (75.57 ± 138.10 vs. 171.07 ± 317.68; p < 0.01) and androgen receptor (1.13 ± 1.52 vs. 4.08 ± 9.57; p < 0.01), as well as a shorter TL (2.39 ± 2.58 vs. 3.96 ± 4.72; p < 0.01) compared to those of the young age group. In the young age group, only androgen receptor mRNA level showed a significant association with TL (rho = 0.148, p = 0.026), while FSH receptor mRNA level was the only factor associated with TL (rho = 0.247, p = 0.015) in PCOS patients. For advanced-aged patients, no significant relationship was observed between hormone receptor mRNA levels and TL. Alternative splicing of androgen receptors was identified in some PCOS patients but not in young age controls. CONCLUSION The findings suggest that the androgen receptor level and function may be altered in the cumulus cells of PCOS patients, leading to a shorter TL in cumulus cells in PCOS patients.
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Affiliation(s)
- Tzu-Ning Yu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Yi-Ping Lin
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Yi-Chun Chen
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
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7
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Viotti M, Greco E, Grifo JA, Madjunkov M, Librach C, Cetinkaya M, Kahraman S, Yakovlev P, Kornilov N, Corti L, Biricik A, Cheng EH, Su CY, Lee MS, Bonifacio MD, Cooper AR, Griffin DK, Tran DY, Kaur P, Barnes FL, Zouves CG, Victor AR, Besser AG, Madjunkova S, Spinella F. Chromosomal, gestational, and neonatal outcomes of embryos classified as a mosaic by preimplantation genetic testing for aneuploidy. Fertil Steril 2023; 120:957-966. [PMID: 37532168 DOI: 10.1016/j.fertnstert.2023.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE To understand the clinical risks associated with the transfer of embryos classified as a mosaic using preimplantation genetic testing for aneuploidy. DESIGN Analysis of data collected between 2017 and 2023. SETTING Multicenter. PATIENTS Patients of infertility treatment. INTERVENTION Comparison of pregnancies resulting from embryos classified as euploid or mosaic using the 20%-80% interval in chromosomal intermediate copy numbers to define a mosaic result. MAIN OUTCOME MEASURES Rates of spontaneous abortion, birth weight, length of gestation, incidence of birth defects, and chromosomal status during gestation. RESULTS Implanted euploid embryos had a significantly lower risk of spontaneous abortion compared with mosaic embryos (8.9% [n = 8,672; 95% confidence interval {CI95} 8.3, 9.5] vs. 22.2% [n = 914; CI95 19.6, 25.0]). Embryos with mosaicism affecting whole chromosomes (not segmental) had the highest risk of spontaneous abortion (27.6% [n = 395; CI95 23.2, 32.3]). Infants born from euploid, mosaic, and whole chromosome mosaic embryos had average birth weights and lengths of gestation that were not statistically different (3,118 g and 267 days [n = 488; CI95 3,067, 3,169, and 266, 268], 3052 g and 265 days [n = 488; CI95 2,993, 3,112, and 264,267], 3,159 g and 268 days [n = 194; CI95 3,070, 3,249, and 266,270], respectively). Out of 488 infants from mosaic embryo transfers (ETs), one had overt gross abnormalities as defined by the Centers for Disease Control and Prevention. Most prenatal tests performed on pregnancies from mosaic ETs had normal results, and only three pregnancies produced prenatal test results reflecting the mosaicism detected at the embryonic stage (3 out of 250, 1.2%; CI95 0.25, 3.5). CONCLUSION Although embryos classified as mosaic experience higher rates of miscarriage than euploid embryos (with a particularly high frequency shortly after implantation), infants born of mosaic ETs are similar to infants of euploid ETs. Prenatal testing indicates that mosaicism resolves during most pregnancies, although this process is not perfectly efficient. In a small percentage of cases, the mosaicism persists through gestation. These findings can serve as risk-benefit considerations for mosaic ETs in the fertility clinic.
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Affiliation(s)
- Manuel Viotti
- Zouves Foundation for Reproductive Medicine, Foster City, California; Kindlabs, Kindbody, New York, New York.
| | - Ermanno Greco
- Villa Mafalda, Center For Reproductive Medicine, Rome, Italy
| | - James A Grifo
- New York University Langone Fertility Center, New York, New York
| | - Mitko Madjunkov
- CReATe Fertility Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
| | - Clifford Librach
- CReATe Fertility Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada; Institute of Medical Sciences and Department of Physiology, University of Toronto, Toronto, Canada
| | | | | | - Pavel Yakovlev
- Centre for Reproductive Medicine, Co.Ltd. "Next Generation Clinic," Moscow, Russia
| | - Nikolay Kornilov
- Centre for Reproductive Medicine, Co.Ltd. "Next Generation Clinic," Moscow, Russia; Centre for Reproductive Medicine, Co.Ltd. "Next Generation Clinic," St. Petersburg, Russia
| | - Laura Corti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anil Biricik
- Eurofins Genoma Group, Molecular Genetics Laboratories, Rome, Italy
| | | | | | - Maw-Sheng Lee
- Lee Women's Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | | | | | - Darren K Griffin
- School of Biosciences, University of Kent, Canterbury, United Kingdom
| | - Diane Y Tran
- Zouves Fertility Center, Foster City, California
| | - Purvi Kaur
- Zouves Fertility Center, Foster City, California
| | - Frank L Barnes
- Zouves Foundation for Reproductive Medicine, Foster City, California; Zouves Fertility Center, Foster City, California
| | - Christo G Zouves
- Zouves Foundation for Reproductive Medicine, Foster City, California; Zouves Fertility Center, Foster City, California
| | - Andrea R Victor
- School of Biosciences, University of Kent, Canterbury, United Kingdom; Zouves Fertility Center, Foster City, California; Reproductive Medicine Associates of Long Island, Melville, New York
| | - Andria G Besser
- New York University Langone Fertility Center, New York, New York
| | - Svetlana Madjunkova
- CReATe Fertility Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
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8
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Hsu CT, Lee CI, Huang CC, Wang TE, Chang HC, Chang LS, Lee MS. Development and integration of LensHooke ® R10 for automatic and standardized diagnosis for sperm DNA fragmentation. Andrology 2023; 11:1337-1344. [PMID: 36869577 DOI: 10.1111/andr.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND The sperm chromatin dispersion assay is commonly used to assess sperm DNA integrity. This approach is time-consuming, demonstrates poor chromatin preservation, and provides an ambiguous and unstandardized evaluation of fragmented chromatin. OBJECTIVES We aimed to (i) develop an optimized sperm chromatin dispersion assay with reduced operation time, (ii) validate R10 test accuracy by comparing it to a conventional sperm chromatin dispersion assay, and (iii) standardize the sperm DNA fragmentation analysis procedure by integrating artificial intelligence optical microscopic technology. MATERIALS AND METHODS This cross-section study included 620 semen samples. Aliquots were analyzed by a conventional Halosperm® G2 assay (G2) and LensHooke® R10 assay (R10). The DNA fragmentation index was scored manually, and R10 slides were automatically determined by a LensHooke® X12 PRO semen analysis system (X12). RESULTS We demonstrated significant improvements in total assay time (40 vs. 72 min, p < 0.001) and in the halo-cytological resolution using R10 compared to G2. Comparing the G2 and R10, DNA fragmentation index results demonstrated good agreement between the two methods (Spearman's rank correlation, rho = 0.8517, p < 0.0001). We introduced the integration of an auto-calculation system to diagnose sperm DNA fragmentation. X12 interpretation showed excellent agreement with manual interpretation (Spearman's rank correlation, rho = 0.9323, p < 0.0001), but had a low coefficient of variation compared to manual interpretation (4% for R10 by X12 vs. 19% for R10 by manual scoring vs. 25% for G2 by manual scoring). DNA fragmentation index was more correlated with total motility (coefficients = -0.3607, p < 0.0001) than sperm morphology and was positively associated with asthenozoospermic semen samples (p = 0.0001). CONCLUSION The R10 sperm chromatin dispersion assay combined with the X12 semen analysis system is faster, more objective, and provides standardization for sperm DNA fragmentation.
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Affiliation(s)
- Cheng-Teng Hsu
- Center for Research and Development, Bonraybio Co., Ltd., Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Tse-En Wang
- Center for Research and Development, Bonraybio Co., Ltd., Taichung, Taiwan
| | - Hui-Chen Chang
- Center for Research and Development, Bonraybio Co., Ltd., Taichung, Taiwan
| | - Li-Sheng Chang
- Center for Research and Development, Bonraybio Co., Ltd., Taichung, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Lin PY, Lee CI, Chen YC, Cheng EH, Huang CC, Chen CI, Lee TH, Lee YJ, Lee MS. Factors Affecting the Potential Efficacy of Intrauterine Platelet-Rich Plasma Infusion on Thin Endometrium in Women with Recurrent Implantation Failure. J Pers Med 2023; 13:1419. [PMID: 37763186 PMCID: PMC10532920 DOI: 10.3390/jpm13091419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Optimizing endometrial thickness (EMT) is crucial for successful embryo implantation, but enhancing thin endometrium remains a significant challenge. Platelet-rich plasma (PRP)-derived therapies have emerged as a promising approach in reproductive medicine due to their capacity to facilitate tissue repair and regeneration. This study aims to identify the risk factors associated with the failure of intrauterine PRP infusion for thin endometrium in women with recurrent implantation failure (RIF). We retrospectively reviewed data from 77 women with RIF, all exhibiting an EMT of <7 mm. These women underwent programmed hormone therapy for frozen embryo transfer (FET) and received two autologous intrauterine PRP infusions. Following intrauterine PRP-lysate (PL) infusions, the mean increase in EMT was 1.9 ± 1.2 mm, with EMT reaching 7 mm in 86% of the cases (66/77; average EMT, 8.3 mm). We identified an exceedingly thin EMT as a risk factor impacting the therapeutic efficacy in increasing EMT (p = 0.04, OR: 3.16; 95% CI: 1.03-9.67). Additionally, the number of previous uterine surgeries emerged as a prognostic factor for pregnancy failure following PL infusion (p = 0.02, OR: 2.02; 95% CI: 1.12-3.64). Our findings suggest that an extremely thin EMT and a history of numerous uterine surgeries can impede successful pregnancy, even when an optimal EMT is achieved following PRP infusion.
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Affiliation(s)
- Pin-Yao Lin
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
| | - Yi-Chun Chen
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - En-Hui Cheng
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Chun-Chia Huang
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Chung-I Chen
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
| | - Yu-Jen Lee
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
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Huang MC, Tzeng SL, Chen WJ, Chen SL, Ding YR, Lee CI, Lee MS, Lee TH. SUMO1 and Defective Spermatozoa Correlate with Endogenous Hydrogen Peroxide and Live Birth Outcome in Intrauterine Insemination Cycles for Unexplained Infertility. Int J Mol Sci 2023; 24:12775. [PMID: 37628954 PMCID: PMC10454912 DOI: 10.3390/ijms241612775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to investigate the correlation between hydrogen peroxide (H2O2), small ubiquitin-like modifier molecules (SUMO), and pregnancy outcomes in couples with unexplained infertility (UI) undergoing intrauterine insemination (IUI) treatment. We prospectively collected semen samples from 56 couples with UI and divided the spermatozoa into motile and immotile fractions by density gradient centrifugation (DSC). Immunofluorescence staining was used to examine the immunostaining and localization of nuclear pore complex (NPC), SUMO1, and SUMO2/3 in spermatozoa. We detected H2O2 levels by chemiluminescence methods. We found that H2O2 levels correlated with NPC (neck) (r = 0.400) and NPC (tail) (r = 0.473) in motile sperm fractions. In immotile fractions, H2O2 positively correlated with NPC (tail) (r = 0.431) and SUMO1 (neck) (r = 0.282). Furthermore, the positive NPC (tail) group had a significantly lower live birth rate than the negative NPC group (17.9% = 5/28 vs. 42.9% = 12/28). In conclusion, H2O2 positively correlated with SUMO1 (neck) and NPC (tail) in human spermatozoa. The DSC may partially eliminate defective spermatozoa (positive NPC staining); however, if defective spermatozoa remain in the motile fraction, this scenario is associated with a low live birth rate following IUI treatment.
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Affiliation(s)
- Ming-Chao Huang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Hsinchu 30071, Taiwan;
- MacKay Junior College of Medicine, Nursing, and Management, Taipei 23741, Taiwan
| | - Shu-Ling Tzeng
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan; (S.-L.T.); (Y.-R.D.); (M.-S.L.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
| | - Wen-Jung Chen
- Department of Urology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (W.-J.C.); (S.-L.C.)
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
| | - Sung-Lang Chen
- Department of Urology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (W.-J.C.); (S.-L.C.)
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
| | - You-Ren Ding
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan; (S.-L.T.); (Y.-R.D.); (M.-S.L.)
| | - Chun-I Lee
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan; (S.-L.T.); (Y.-R.D.); (M.-S.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan; (S.-L.T.); (Y.-R.D.); (M.-S.L.)
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
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11
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Chen CH, Lee CI, Huang CC, Chen HH, Chang CY, Cheng EH, Lin PY, Chen CI, Lee TH, Lee MS. Increased incidence of live births in implanted day 5 versus day 6 blastocysts following single embryo transfers with PGT-A. Sci Rep 2023; 13:12725. [PMID: 37543691 PMCID: PMC10404267 DOI: 10.1038/s41598-023-40052-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
Elective single-embryo transfers of euploid or low-level mosaic blastocysts were analyzed in this retrospective study to determine the correlations of live birth (LB) probability with embryonic developmental features of implanted day 5 (D5, n = 245) or day 6 (D6, n = 73) blastocysts using time-lapse (TL) monitoring. According to the logistic regression analyses (adjusted odds ratio [OR] = 0.341, 95% confidence interval [CI] = 0.169-0.685, P < 0.05), the LB probability was negatively associated with the D6 group. The LB rate of the D5 group was higher than the D6 group (88.2% vs. 75.3%; P < 0.05). Compared with the D5 blastocysts, the D6 blastocysts exhibited comparable dysmorphisms except for the multinucleation at the 4-cell stage (10.9% vs. 2.9%, P < 0.05). Moreover, D6 blastocysts had considerably slower developmental kinetics and poorer blastocyst morphologies. Further analysis confirmed that the LB rate was not associated with developmental kinetics or dysmorphisms but rather with blastocyst morphology (inner cell mass [ICM] grade ≤ C vs. ICM grade A, adjusted OR = 0.155, 95% CI = 0.04-0.596, P < 0.05; trophectoderm [TE] grade ≤ C vs. TE grade A, adjusted OR = 0.157, 95% CI = 0.032-0.760, P < 0.05). In conclusion, D6 implanted blastocysts have a considerably lower LB rate than D5 implanted blastocysts. As determined by TL monitoring, the diminished blastocyst morphology can be one of the primary reasons underlying the decreased likelihood of LB.
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Affiliation(s)
- Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Ying Chang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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12
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Chang YS, Li CW, Chen L, Wang XA, Lee MS, Chao YH. Early Gut Microbiota Profile in Healthy Neonates: Microbiome Analysis of the First-Pass Meconium Using Next-Generation Sequencing Technology. Children (Basel) 2023; 10:1260. [PMID: 37508757 PMCID: PMC10377966 DOI: 10.3390/children10071260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Gut microbiome development during early life has significant long-term effects on health later in life. The first-pass meconium is not sterile, and it is important to know the initial founder of the subsequent gut microbiome. However, there is limited data on the microbiota profile of the first-pass meconium in healthy neonates. To determine the early gut microbiota profile, we analyzed 39 samples of the first-pass meconium from healthy neonates using 16S rRNA sequencing. Our results showed a similar profile of the microbiota composition in the first-pass meconium samples. Pseudomonas was the most abundant genus in most samples. The evenness of the microbial communities in the first-pass meconium was extremely poor, and the average Shannon diversity index was 1.31. An analysis of the relationship between perinatal characteristics and the meconium microbiome revealed that primigravidae babies had a significantly higher Shannon diversity index (p = 0.041), and the Bacteroidales order was a biomarker for the first-pass meconium of these neonates. The Shannon diversity index was not affected by the mode of delivery, maternal intrapartum antibiotic treatment, prolonged rupture of membranes, or birth weight. Our study extends previous research with further characterization of the gut microbiome in very early life.
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Affiliation(s)
- Yi-Sheng Chang
- Department of Research and Development, AllBio Life Incorporation, Taichung 402, Taiwan
| | - Chang-Wei Li
- Department of Research and Development, AllBio Life Incorporation, Taichung 402, Taiwan
| | - Ling Chen
- Department of Research and Development, AllBio Life Incorporation, Taichung 402, Taiwan
| | - Xing-An Wang
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Maw-Sheng Lee
- Department of Obstetrics and Gynecology, Lee Women's Hospital, Taichung 406, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Yu-Hua Chao
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Clinical Pathology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
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13
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Hsu CT, Lee CI, Lin FS, Wang FZ, Chang HC, Wang TE, Huang CC, Tsao HM, Lee MS, Agarwal A. Live motile sperm sorting device for enhanced sperm-fertilization competency: comparative analysis with density-gradient centrifugation and microfluidic sperm sorting. J Assist Reprod Genet 2023:10.1007/s10815-023-02838-4. [PMID: 37300647 PMCID: PMC10371955 DOI: 10.1007/s10815-023-02838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE A live motile sperm sorting device (LensHooke® CA0) developed to prevent the deleterious effects of centrifugation was evaluated comparatively with conventional density-gradient centrifugation (DGC) and microfluidic-based device (Zymot) in sperm selection. METHODS Semen samples from 239 men were collected. CA0 under different incubation intervals (5, 10, 30, and 60 min) and temperatures (20, 25, and 37℃) was conducted. The sperm quality in CA0-, DGC-, and Zymot-processed samples was then comparatively evaluated. Semen parameters included concentration, motility, morphology, motion kinematics, DNA fragmentation index (DFI), and the rate of acrosome-reacted sperm (AR). RESULTS Total motility and motile sperm concentration increased in a time- and temperature-dependent manner and the total motility peaked for 30 min at 37℃. In paired analysis, CA0 showed significantly higher total motility (94.0%), progressive motility (90.8%), rapid progressive motility (83.6%), normal morphology (10.3%), and lower DFI (2.4%) and AR (4.7%) than the other two methods in normozoospermic samples (all p < 0.05). For non-normozoospermic samples, CA0 had significantly better results than the other two methods (total motility 89.2%, progressive motility 80.4%, rapid progressive motility 74.2%, normal morphology 8.5%, DFI 4.0%, and AR 4.0%; all p < 0.05). CONCLUSION CA0 yielded spermatozoa with enhanced sperm fertilization potentials; DFI was minimized in samples processed by CA0. CA0 was effective for both normal and abnormal semen samples due to its consistent selection efficiency.
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Affiliation(s)
- Cheng-Teng Hsu
- Center for Research and Development, Bonraybio Co., Ltd, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Fong-Sian Lin
- Center for Research and Development, Bonraybio Co., Ltd, Taichung, Taiwan
| | - Fang-Zong Wang
- Center for Research and Development, Bonraybio Co., Ltd, Taichung, Taiwan
| | - Hui-Chen Chang
- Center for Research and Development, Bonraybio Co., Ltd, Taichung, Taiwan
| | - Tse-En Wang
- Center for Research and Development, Bonraybio Co., Ltd, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility Clinic, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ashok Agarwal
- Global Andrology Forum, American Center for Reproductive Medicine, OH, 44022, Moreland Hills, USA.
- Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.
- Global Andrology Forum, 130 West Juniper Lane, Moreland Hills, OH, 44022, USA.
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Wu TF, Chen MJ, Lee MS, Huang CC, Ho ST, Cheng EH, Lee TH. Comparison of clinical outcome between day 5 and day 6 single blastocyst transfers in cycles undergoing preimplantation genetic testing for aneuploidy. Taiwan J Obstet Gynecol 2023; 62:429-433. [PMID: 37188448 DOI: 10.1016/j.tjog.2023.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE In vitro fertilization (IVF) treatment has gradually adopted the practice of culturing embryos until the blastocyst stage on the D5 or D6 as the standard approach. PGT-A is commonly used in vitro fertilization (IVF). This study aimed to evaluate the clinical outcomes of frozen embryo transfers (FETs) using single blastocyst transfers (SBTs) on the fifth (D5) or sixth (D6) day of development in cycles that underwent preimplantation genetic testing for aneuploidy (PGT-A). MATERIALS AND METHODS The patients who had at least one euploid or mosaic blastocyst of good quality determined by PGT-A results and received single embryo transfer (SET) cycles were included in the study. In this study, the live birth rate (LBR) and neonatal outcomes were compared after the transfer of single biopsied D5 and D6 blastocysts in frozen embryo transfer (FET) cycles. RESULTS A total of 527 frozen-thawed blastocyst transfer (FET) cycles (8449 biopsied embryos were analyzed). No significant difference in the implantation rate (IR), clinical pregnancy rate (CPR), and live birth rate (LBR) between the transfers of D5 and D6 blastocysts. Birth weight was the only perinatal outcome that showed a significant difference between the D5 and D6 groups. CONCLUSION The study confirmed that the transfer of a single euploid or mosaic blastocyst, regardless of whether it was on the fifth (D5) or sixth (D6) day of development, can lead to promising clinical results.
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Affiliation(s)
- Ting-Feng Wu
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan; Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Jer Chen
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Shu-Ting Ho
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
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15
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Lee YJ, Lin YP, Cheng EH, Chen CH, Huang CC, Lin PY, Lee TH, Lee MS. Presence of vacuoles in blastocysts is negatively associated with euploidy and live birth rates. Fertil Steril 2023:S0015-0282(23)00308-4. [PMID: 37086831 DOI: 10.1016/j.fertnstert.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE To investigate whether the presence of vacuoles in biopsied blastocysts is associated with the likelihood of aneuploidy and clinical outcomes. DESIGN Retrospective observational study. SUBJECTS This study retrospectively analyzed data obtained through preimplantation genetic testing for aneuploidy (PGT-A) performed on 3351 blastocysts from 826 patients at a single reproductive center between August 2018 and July 2020. Ultimately, 167 single euploid blastocyst transfers were performed in these patients. Vacuoles existing in the trophectoderm or inner cell mass were observed using blastocyst biopsy. After biopsy, all blastocysts were vitrified, and embryo transfer was performed in a subsequent treatment cycle. EXPOSURE Presence versus absence of vacuoles. MAIN OUTCOME MEASURES The associations between vacuoles and euploidy or live birth rates were assessed using logistic regression models and estimated adjusted odds ratios [ORs] and 95% confidence intervals (CIs). RESULTS Of the 3351 blastocysts from 826 patients, 903 (26.9%) were discovered to have vacuoles. The vacuole-positive group had a significantly lower percentage of euploid blastocysts after TE biopsy than did the vacuole-negative group (28.8% vs. 35.5%; p < 0.001). Embryos with vacuoles were significantly more likely to be poor quality (30.6% vs. 18.2%, p < 0.001). Logistic regression analyses revealed that euploid blastocysts were positively associated with the absence of vacuoles, maternal age, and good embryo quality (vacuole-negative group: adjusted OR= 1.291, 95% CI = 1.089-1.530; age < 38 years: adjusted OR= 1.989, 95% CI = 1.692-2.337; good embryo quality: adjusted OR = 1.703, 95% CI = 1.405-2.064). The implantation rate and live birth rate were significantly lower for the transferred single euploid blastocysts with vacuoles than for the blastocysts without vacuoles (35.5% vs. 56.6%, p = 0.033; 29.0% vs. 52.2%, p = 0.020, respectively). The live birth rate was positively associated with the absence of vacuoles (adjusted OR = 2.792, 95% CI = 1.180-6.608). CONCLUSION The formation of vacuoles in blastocysts is associated with lower rates of euploidy and live birth. Blastocysts without vacuoles should thus be prioritized for embryo transfer in in vitro fertilization cycles.
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Affiliation(s)
- Yu-Jen Lee
- Genetic Diagnosis Laboratory, Lee Women's Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Yi-Ping Lin
- Genetic Diagnosis Laboratory, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Genetic Diagnosis Laboratory, Lee Women's Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chien-Hong Chen
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan; Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chun-Chia Huang
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan; Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Pin-Yao Lin
- Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan; Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Chen HH, Lee CI, Huang CC, Cheng EH, Lee TH, Lin PY, Chen CH, Lee MS. Biphasic oxygen tension promotes the formation of transferable blastocysts in patients without euploid embryos in previous monophasic oxygen cycles. Sci Rep 2023; 13:4330. [PMID: 36922540 PMCID: PMC10017668 DOI: 10.1038/s41598-023-31472-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
This study evaluated whether the concentration of biphasic O2 (5-2%) promotes the formation of qualified blastocysts (QBs) and euploid blastocysts and the probability of cycles with transferable blastocysts. The paired experimental design included a total 90 patients (180 cycles) without euploid blastocysts in previous monophasic O2 (5%) cycles were enrolled for an additional cycle of biphasic O2 (5-2%). In the biphasic O2 (5-2%) group, the QB rate (35.8%, 225/628) was significantly higher than that in the monophasic O2 (5%) group (23.5%, 137/582; p < 0.001). In addition, the euploid blastocyst number (0.5 ± 0.8) and the percentage of cycles with transferable blastocysts were significantly higher in the biphasic O2 (5-2%) group (57.8%, 52/90) than those in the monophasic O2 (5%) group (0 and 35.6%, 32/90, respectively; p < 0.01). Multivariable regression analysis also indicated that the QB rate and the probability of cycles with transferable blastocysts correlated with O2 tension (OR 1.535, 95% CI 1.325-1.777, and OR 3.191, 95% CI 1.638-5.679, respectively; p < 0.001). Biphasic O2 culture can be used as an alternative strategy to increase the euploid QBs and the probability of cycles with transferable blastocysts in patients with a poor prognosis.
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Affiliation(s)
- Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Pin Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan. .,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan. .,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. .,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan. .,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan. .,Post Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan.
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Liu YL, Lee CI, Liu CH, Cheng EH, Yang SF, Tsai HY, Lee MS, Lee TH. Association between Leukemia Inhibitory Factor Gene Polymorphism and Clinical Outcomes among Young Women with Poor Ovarian Response to Assisted Reproductive Technology. J Clin Med 2023; 12:jcm12030796. [PMID: 36769444 PMCID: PMC9917712 DOI: 10.3390/jcm12030796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Does the presence of single-nucleotide polymorphisms (SNPs) in the leukemia inhibitory factor (LIF) gene affect ovarian response in infertile young women? METHODS This was a case-control study recruiting 1744 infertile women between January 2014 to December 2015. The 1084 eligible patients were stratified into four groups using the POSEIDON criteria. The gonadotropin-releasing hormone receptor (GnRHR), follicle-stimulating hormone receptor (FSHR), anti-Müllerian hormone (AMH), and LIF SNP genotypes were compared among the groups. The distributions of LIF and FSHR among younger and older patients were compared. Clinical outcomes were also compared. RESULTS The four groups of poor responders had different distributions of SNP in LIF. The prevalence of LIF genotypes among young poor ovarian responders differed from those of normal responders. Genetic model analyses in infertile young women revealed that the TG or GG genotype in the LIF resulted in fewer oocytes retrieved and fewer mature oocytes relative to the TT genotypes. In older women, the FSHR SNP genotype contributed to fewer numbers of mature oocytes. CONCLUSIONS LIF and FSHR SNP genotypes were associated with a statistically significant reduction in ovarian response to controlled ovarian hyperstimulation in younger and older women with an adequate ovarian reserve, respectively.
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Affiliation(s)
- Yung-Liang Liu
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei 11490, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Chun-I Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
| | - Chung-Hsien Liu
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - En-Hui Cheng
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Hsueh-Yu Tsai
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
| | - Maw-Sheng Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Division of Infertility Clinic, Lee Women’s Hospital, Taichung 40602, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Tsung-Hsien Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
- Correspondence:
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Lee JH, Kwon J, Lee MS, Cho Y, Oh IY, Park J, Jeon KH. Prediction of atrial fibrillation in patients with embolic stroke with undetermined source using electrocardiogram deep learning algorithm and clinical risk factors. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Combining the artificial intelligence algorithm with the known clinical risk factors may provide enhanced accuracy for prediction of the hidden atrial fibrillation (AF) in patients with embolic stroke with undetermined source (ESUS).
Purpose
We aimed to develop enhanced prediction models for AF with deep learning algorithm (DLA) and clinical predictors in patients with ESUS. The DLA was created to identify the patients with paroxysmal AF based on their electrocardiograms (ECG) during sinus rhythm.
Methods
We analyzed the 221 patients who underwent insertable cardiac monitor (ICM) for AF detection following ESUS. The DLA was previously developed with sinus rhythm ECGs of 10,605 paroxysmal AF patients and 50,522 non-AF patients. The convolutional neural network was used for the DLA. The primary endpoint was defined as any AF episode lasting over 5 min by ICM. The atrial ectopic burden (AEB) was calculated as the percentage of the number of conducted QRS by atrial ectopy on Holter monitoring.
Results
AF (≥5 min) was detected by ICM in 32 patients (14.5%) during follow-up period of 15.1±8.6 months. AF patients had higher AEB (0.199% vs 0.023%, p<0.001), larger left atrial diameters (LAD, 41.2 mm vs 35.7 mm, p<0.001), and larger left atrial volume index (LAVI, 46.4 ml/m2 vs 32.3 ml/m2, p<0.001) than those without AF. The means of calculated probabilities of AF by DLA were higher in patients with AF than those without AF (63.8% vs 40.2%, p<0.001). In the receiver operating characteristic curve analysis, the areas under the curve (AUC) were the highest in DLA (0.824) followed by AEB (0.784), LAVI (0.780), and LAD (0.768). The multivariable model with AEB, LAVI, and DLA demonstrated excellent prediction accuracy for paroxysmal AF (AUC: 0.902, Figure 1)
Conclusions
In patients with ESUS, the DLA outperformed other clinical risk factors for prediction of AF. Combining DLA with AEB, LAD and LAVI could is a potential useful tool to predict AF in ESUS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J H Lee
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J Kwon
- Medical AI Inc, Medical research team , California , United States of America
| | - M S Lee
- Medical AI Inc, Medical research team , California , United States of America
| | - Y Cho
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - I Y Oh
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J Park
- Mediplex Sejong Hospital, Critical Care and Emergency Medicine , Incheon , Korea (Republic of)
| | - K H Jeon
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
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Jeon KH, Kwon JM, Lee MS, Cho YJ, Oh IY, Lee JH. Deep learning-based electrocardiogram analysis detecting paroxysmal atrial fibrillation during sinus rhythm in patients with cryptogenic stroke: validation study using implantable cardiac monitoring. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most cause of cardioembolic source causing cryptogenic stroke. In these, anticoagulation therapy could reduce recurrence of stroke. However, paroxysmal AF would not be detected even by 24 hours Holter monitoring. Deep learning-based electrocardiogram (ECG) analysis models were recently developed to detect AF during sinus rhythm.
Purpose
We aimed to develop a deep learning algorithm (DLA) to detect AF during sinus rhythm and validate the model in patients with cryptogenic stroke who underwent implantable cardiac monitoring (ICM) to diagnose paroxysmal AF.
Methods
This cohort study involved three hospitals (A, B, and C). We developed a DLA to detect AF using sinus rhythm 10 s 12-lead ECG. We included adult patients aged ≥18 years from hospital A and B. We used development data from AF adult patients who had at least one atrial fibrillation rhythm in the study period (Jan 2016 to Dec 2021) and non-AF patients who had no reference to AF in the ECG and electronic medical record. DLA was based on convolutional neural network (CNN) using 10 s 12-lead. For external validation, the ECGs from 217 patients (hospital C) with cryptogenic stroke who underwent ICM were analyzed by using the DLA for validating the accuracy in the real-world clinical situations.
Results
We included 10,605 AF adult patients and 50,522 non-AF patients as development data. During the internal validation, the area under the curve (AUC) of the final DLA based on CNN was 0.793 (95% Confidence interval 0.778–0.807). In external validation data from cryptogenic stroke patients, the mean ICM duration was 15.1 months, and AF >5 mins was detected in 32 patients (14.5%). The diagnostic accuracy of DLA was 0.793 to detect AF during sinus rhythm, and AUC was 0.824. The sensitivity, specificity, positive predictive value, and negative predictive value of the model were 0.844, 0.784, 0.403, and 0.967, respectively, which outperformed other conventional predictive methods based on clinical factors, such as CHARGE-AF, C2hest, and HATCH.
Conclusions
In this study, DLA accurately detected paroxysmal AF using 12-leads normal sinus rhythm ECG in patients with cryptogenic stroke and outperformed the conventional models. The DLA could be used as a screening tool to identify the cause of stroke in the future.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K H Jeon
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J M Kwon
- Incheon Sejong Hospital, Department of Critical Care and Emergency Medicine , Incheon , Korea (Republic of)
| | - M S Lee
- Medical research team, Medical AI Inc , San Francisco , United States of America
| | - Y J Cho
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - I Y Oh
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
| | - J H Lee
- Seoul National University Bundang Hospital , Seongnam , Korea (Republic of)
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Cheng EH, Shih HH, Lin PY, Lee TH, Huang CC, Lee MS. SEGMENTAL ANEUPLOIDY IN PGT-A HAS THE POTENTIAL WITH EUPLOIDY IN INNER CELL MASS. Fertil Steril 2022. [DOI: 10.1016/j.fertnstert.2022.09.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wu PJ, Hsin IL, Hung WL, Lee MS, Wang PH, Ko JL. Combination treatment with cyclosporin A and arsenic trioxide induce synergistic cell death via non-apoptotic pathway in uterine cervical cancer cells. Chem Biol Interact 2022; 368:110177. [PMID: 36100036 DOI: 10.1016/j.cbi.2022.110177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022]
Abstract
Cyclosporin A is an immunosuppressive drug with anti-cancer effect. Arsenic trioxide (As2O3), a well-known cancer-inhibiting drug, induced cytotoxicity via apoptosis and autophagy. The aim of this study is to evaluate the effect of combinational treatment with cyclosporin A and arsenic trioxide on cell viability inhibition in cervical cancer cells. Using MTT assay and combination index, combinational treatment with cyclosporin A and arsenic trioxide induced a synergistic cytotoxic effect in Caski and SiHa cells. Cyclosporin A and arsenic trioxide triggered cell death via non-apoptotic pathway by using annexin V/propidium iodide (PI) assay. Cyclosporin A and arsenic trioxide combined treatment decreased mitochondrial membrane potential and increase reactive oxygen species (ROS) generation. This co-treatment increased LC3B-II expression and autophagosome formation in cervical cancer cells. This study first demonstrated that combinational treatment with cyclosporin A and As2O3 trigger synergistic cytotoxic effect via autophagy in cervical cancer cells.
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Affiliation(s)
- Pei-Ju Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan.
| | - I-Lun Hsin
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Wei-Li Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan; Neurosurgery Department, Everan Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Jiunn-Liang Ko
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan; Division of Medical Oncology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
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22
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Yu TN, Cheng EH, Tsai HN, Lin PY, Chen CH, Huang CC, Lee TH, Lee MS. Assessment of Telomere Length and Mitochondrial DNA Copy Number in Granulosa Cells as Predictors of Aneuploidy Rate in Young Patients. J Clin Med 2022; 11:jcm11071824. [PMID: 35407431 PMCID: PMC9000104 DOI: 10.3390/jcm11071824] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/13/2022] [Accepted: 03/23/2022] [Indexed: 01/10/2023] Open
Abstract
Background: To identify the correlation among female age, cellular aging markers, and aneuploidy rate in in vitro fertilization (IVF) and the preimplantation genetic test for aneuploidy (PGT-A) cycles. Methods: This is a prospective cohort study recruiting 110 infertile women between August 2017 and July 2018. They were divided into young-age (<38 years, n = 60) and advanced-age (≥38 years, n = 50) groups. Peripheral leukocytes were assessed, and the granulosa cells were pooled during oocyte pickup. Mitochondrial DNA (mtDNA) copy number and telomere length (TL) were measured using real-time polymerase chain reaction. PGT-A was performed on the NGS platform. Results: mtDNA copy number and TL were positively correlated in both leukocytes (rho = 0.477, p < 0.001) and granulosa cells (rho = 0.361, p < 0.001), but the two parameters in leukocytes were not correlated with those in granulosa cells. In the young-age group, TL in the granulosa cells was the only factor correlated with the aneuploidy rate (rho = −0.283, p = 0.044), whereas in the advanced-age group, age was the main factor (rho = 0.358, p = 0.018). Conclusions: TL in the granulosa cells was negatively correlated with the aneuploidy rate in the young-age group, supporting the application of PGT-A in younger women.
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Affiliation(s)
- Tzu-Ning Yu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
| | - En-Hui Cheng
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
| | - Han-Ni Tsai
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
| | - Pin-Yao Lin
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
| | - Chien-Hong Chen
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
| | - Chun-Chia Huang
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Correspondence: (T.-H.L.); (M.-S.L.)
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Division of Infertility, Lee Women’s Hospital, Taichung 40652, Taiwan; (E.-H.C.); (H.-N.T.); (P.-Y.L.); (C.-H.C.); (C.-C.H.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Correspondence: (T.-H.L.); (M.-S.L.)
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Huang CY, Chuang HL, Tsai LY, Lu YC, Liou CF, Lee MS, Kuo CP, Lee SH. Differences in sexual activities and information seeking behaviors between women who underwent in vitro fertilization (IVF) and who conceived without IVF. Sexual and Relationship Therapy 2022. [DOI: 10.1080/14681994.2021.2023736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Cheng-Yi Huang
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiao-Ling Chuang
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Li-Ya Tsai
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Yen-Chiao Lu
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiou-Fang Liou
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Lee Women’s Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ching-Pyng Kuo
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shu-Hsin Lee
- Department of Nursing, Chung Shan Medical University, Taichung, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Chen CH, Lee CI, Huang CC, Chen HH, Ho ST, Cheng EH, Lin PY, Chen CI, Lee TH, Lee MS. Blastocyst Morphology Based on Uniform Time-Point Assessments is Correlated With Mosaic Levels in Embryos. Front Genet 2022; 12:783826. [PMID: 35003219 PMCID: PMC8727871 DOI: 10.3389/fgene.2021.783826] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022] Open
Abstract
Avoiding aneuploid embryo transfers has been shown to improve pregnancy outcomes in patients with implantation failure and pregnancy loss. This retrospective cohort study aims to analyze the correlation of time-lapse (TL)-based variables and numeric blastocyst morphological scores (TLBMSs) with different mosaic levels. In total, 918 biopsied blastocysts with time-lapse assessments at a uniform time-point were subjected to next-generation sequencing–based preimplantation genetic testing for aneuploidy. In consideration of patient- and cycle-related confounding factors, all redefined blastocyst morphology components of low-grade blastocysts, that is, expansion levels (odds ratio [OR] = 0.388, 95% confidence interval [CI] = 0.217–0.695; OR = 0.328, 95% CI = 0.181–0.596; OR = 0.343, 95% CI = 0.179–0.657), inner cell mass grades (OR = 0.563, 95% CI = 0.333–0.962; OR = 0.35, 95% CI = 0.211–0.58; OR = 0.497, 95% CI = 0.274–0.9), and trophectoderm grades (OR = 0.29, 95% CI = 0.178–0.473; OR = 0.242, 95% CI = 0.143–0.411; OR = 0.3, 95% CI = 0.162–0.554), were less correlated with mosaic levels ≤20%, <50%, and ≤80% as compared with those of top-grade blastocysts (p < 0.05). After converting blastocyst morphology grades into scores, high TLBMSs were associated with greater probabilities of mosaic levels ≤20% (OR = 1.326, 95% CI = 1.187–1.481), <50% (OR = 1.425, 95% CI = 1.262–1.608), and ≤80% (OR = 1.351, 95% CI = 1.186–1.539) (p < 0.001). The prediction abilities of TLBMSs were similar for mosaic levels ≤20% (AUC = 0.604, 95% CI = 0.565–0.642), <50% (AUC = 0.634, 95% CI = 0.598–0.671), and ≤80% (AUC = 0.617, 95% CI = 0.576–0.658). In conclusion, detailed evaluation with TL monitoring at the specific time window reveals that redefined blastocyst morphology components and converted numeric TLBMSs are significantly correlated with all of the threshold levels of mosaicism. However, the performance of TLBMSs to differentiate blastocysts with aberrant ploidy risk remains perfectible.
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Affiliation(s)
- Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chun-I Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Shu-Ting Ho
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chung-I Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Kuo CP, Li PC, Chuang HL, Lee SH, Liao WC, Lee MS. The effect of multimedia health education on pain and anxiety in women undergoing mammography in Taiwan. Taiwan J Obstet Gynecol 2021; 60:1084-1089. [PMID: 34794742 DOI: 10.1016/j.tjog.2021.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Breast cancer is the most common cancer among women in Taiwan. However, the discomfort of receiving mammograms reduces the willingness to screen. MATERIALS AND METHODS This study using a quasi-experimental design and recruited 150 participants in a medical center, Taiwan. In the control group, only provided traditional health education sheets, the experimental group has joined the intervention of multimedia health education. State-Trait Anxiety Inventory and Visual Analogue Scale, respectively, were used to compare the differences in anxiety and pain between the two groups before and after receiving mammography. RESULTS After the intervention, the experimental group's state anxiety score was significantly lower than that of the control group (30.63 ± 8.43 vs. 33.77 ± 10.74, p < .05). However, there was no significant difference in pain scores (4.13 ± 2.37 vs. 4.57 ± 2.31; p = .25). CONCLUSIONS Younger, prior experience with mammography, and high trait anxiety affect pain and state anxiety of women undergoing mammography. The multimedia health education intervention could reduce anxiety effectively, but it does not significantly relieve the pain undergoing mammography.
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Affiliation(s)
- Ching-Pyng Kuo
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Pei-Ching Li
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan.
| | - Hsiao-Ling Chuang
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Shu-Hsin Lee
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Wen-Chun Liao
- School of Nursing and Graduate Institute of Nursing, China Medical University, Department of Nursing, China Medical University Hospital, Taichung, Taiwan; Department of Nursing, Asian University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Gyurjian K, Chiu S, Hammershaimb B, Nadadur M, Phan P, Shen YJ, Lin B, Lee MS. The association between diabetes and mortality in young adults presenting with myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The incidence of diabetes mellitus and coronary artery disease continue to rise and collectively comprise two of the most prevalent and costly diseases worldwide. The goal of this study is to report the prognosis of young patients with diabetes presented with acute myocardial infarction (AMI).
Methods
This is a retrospective observational cohort study that included consecutive patients aged 18–45 years who underwent cardiac catheterization for AMI between 2006 and 2016 in an integrated healthcare system in Southern California. The prognosis of patients with diabetes were compared to those without diabetes.
Results
A total of 1,560 patients (average age 40.2±5.3 years, 25.6% female) presenting with AMI were included. Of these 272 (17.4%) had diabetes. Diabetics were older (41.1±4.4 vs 40.0±5.4 years), more likely to be female (32.4% vs 24.1%, p=0.006), Hispanic (51.5% vs 40.5%, p<0.001), have a higher body mass index (BMI) (33.6±7.1 vs 31.2±6.8kg/m2, p<0.001), have hypertension (HTN) (67.6% vs 23.8%, p<0.001), hyperlipidemia (HLD) (78.3% vs 24.1%, p<0.001), peripheral vascular disease (9.9% vs 1.9%, p<0.001), chronic kidney disease (CKD) (23.2% vs 2.7%, p<0.001), hypothyroidism (7% vs 4%, p=0.034), and prior strokes (4.4% vs 2.2%, p=0.034).
On multivariate analysis accounting for other cardiovascular risk factors, the association remained significant (OR 1.82, 95% CI 1.04–3.19, p=0.036). At a median follow-up of 5.8 years (interquartile range 3.7–8.7 years), diabetes was independently associated with increased all-cause mortality (Hazard ratio [HR] 3.10, 95% CI 1.68–5.69, p<0.001) when adjusting for age, sex, race, BMI, HTN, HLD, CKD, hypothyroidism, prior stroke, and ACS etiology. In a propensity score matched cohort, diabetes remained significantly associated with all-cause mortality (HR 5.29, 95% CI 2.34–12.02, p<0.001).
Conclusion
Diabetes is an independent predictor of increased mortality in young adults <45 years old presenting with AMI.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): KAISER PERMANENTE LOS ANGELES MEDICAL CENTER
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Affiliation(s)
- K Gyurjian
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - S Chiu
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - B Hammershaimb
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - M Nadadur
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - P Phan
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - Y J Shen
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - B Lin
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - M S Lee
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
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27
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Hsieh HC, Lee CI, Lai EY, Su JY, Huang YT, Zheng WL, Chen CH, Huang CC, Lin PY, Lee MS, Liu M, Huang YT. Estimating the causal effect of embryo transfer day on clinical in vitro fertilization outcomes using propensity score matching. BMC Pregnancy Childbirth 2021; 21:554. [PMID: 34388966 PMCID: PMC8364091 DOI: 10.1186/s12884-021-04013-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For women undergoing in vitro fertilization (IVF), the clinical benefit of embryo transfer at the blastocyst stage (Day 5) versus cleavage stage (Day 3) remains controversial. The purpose of this study is to compare the implantation rate, clinical pregnancy rate and odds of live birth of Day 3 and Day 5 embryo transfer, and more importantly, to address the issue that patients were chosen to receive either transfer protocol due to their underlying clinical characteristics, i.e., confounding by indication. METHODS We conducted a retrospective cohort study of 9,090 IVF cycles collected by Lee Women's Hospital in Taichung, Taiwan from 1998 to 2014. We utilized the method of propensity score matching to mimic a randomized controlled trial (RCT) where each patient with Day 5 transfer was matched by another patient with Day 3 transfer with respect to other clinical characteristics. Implantation rate, clinical pregnancy rate, and odds of live birth were compared for women underwent Day 5 transfer and Day 3 transfer to estimate the causal effects. We further investigated the causal effects in subgroups by stratifying age and anti-Mullerian hormone (AMH). RESULTS Our analyses uncovered an evidence of a significant difference in implantation rate (p=0.04) favoring Day 5 transfer, and showed that Day 3 and Day 5 transfers made no difference in both odds of live birth (p=0.27) and clinical pregnancy rate (p=0.11). With the increase of gestational age, the trend toward non-significance of embryo transfer day in our result appeared to be consistent for subgroups stratified by age and AMH, while all analyses stratified by age and AMH were not statistically significant. CONCLUSIONS We conclude that for women without strong indications for Day 3 or Day 5 transfer, there is a small significant difference in implantation rate in favor of Day 5 transfer. However, the two protocols have indistinguishable outcomes on odds of live birth and clinical pregnancy rate.
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Affiliation(s)
- Han-Chih Hsieh
- Institute of Statistical Science, Academia Sinica, No. 128 Academia Road, Taipei, 11529, Taiwan
| | - Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, No.110,Sec.1,Jianguo N.Rd., Taichung, 40201, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University, No.110,Sec.1,Jianguo N.Rd., Taichung, 40201, Taiwan.,Division of Infertility, Lee Women's Hospital, No. 30-6, Section 1, Changping Road, Taichung, 406, Taiwan
| | - En-Yu Lai
- Institute of Statistical Science, Academia Sinica, No. 128 Academia Road, Taipei, 11529, Taiwan
| | - Jia-Ying Su
- Institute of Statistical Science, Academia Sinica, No. 128 Academia Road, Taipei, 11529, Taiwan
| | - Yi-Ting Huang
- Institute of Statistical Science, Academia Sinica, No. 128 Academia Road, Taipei, 11529, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 501, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan
| | - Wei-Lin Zheng
- Binflux Inc, 4F.-1, No. 9, Dehui St., Taipei, 104, Taiwan
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, No. 30-6, Section 1, Changping Road, Taichung, 406, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, No. 30-6, Section 1, Changping Road, Taichung, 406, Taiwan
| | - Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, No. 30-6, Section 1, Changping Road, Taichung, 406, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, No.110,Sec.1,Jianguo N.Rd., Taichung, 40201, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University, No.110,Sec.1,Jianguo N.Rd., Taichung, 40201, Taiwan.,Division of Infertility, Lee Women's Hospital, No. 30-6, Section 1, Changping Road, Taichung, 406, Taiwan
| | - Mark Liu
- Binflux Inc, 4F.-1, No. 9, Dehui St., Taipei, 104, Taiwan
| | - Yen-Tsung Huang
- Institute of Statistical Science, Academia Sinica, No. 128 Academia Road, Taipei, 11529, Taiwan.
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28
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Lee CI, Su YR, Chen CH, Chang TA, Kuo EES, Hsieh WT, Huang CC, Lee MS, Liu M. O-086 End-to-end deep learning for recognition of ploidy status using time-lapse videos. Hum Reprod 2021. [DOI: 10.1093/humrep/deab125.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Our Retrospective study is to investigate an end-to-end deep learning model in identifying ploidy status through raw time-lapse video.
Summary answer
Our deep learning model demonstrates a proof of concept and potential in recognizing the ploidy status.
What is known already
Since the time-lapse system has been introduced into the IVF lab, the relationship between morphogenetic and ploidy status has been often discussed. However, the result has not yet reached a united conclusion due to some limitations such as human labeling. Besides the statistical approach, deep learning models have been utilized for ploidy prediction. As such approaches are single image-based, the performance remains unpromising as previous statistical-based research. Therefore, in order to move further toward clinical application, better research design and approach are needed.
Study design, size, duration
A retrospective analysis of the time-lapse videos and chromosomal status from 690 biopsied blastocysts cultured in a time-lapse incubator (EmbryoScope+, Vitrolife) between January 2017 and August 2018 in the Lee Women’s Hospital were assessed. The ploidy status of the blastocyst was derived from the PGT-A using high-resolution next-generation sequencing (hr-NGS). Embryo videos were obtained after normal fertilization through the intracytoplasmic sperm injection or conventional insemination.
Participants/materials, setting, methods
By randomly dividing the data into 80% and 20%, we developed our deep learning model based on Two-Stream Inflated 3D ConvNets(I3D) network. This model was trained by the 80% time-lapse videos and the PGT-A result. The remaining 20% has been tested by feeding the time-lapse video as input and the PGT-A prediction as output. Ploidy status was classified as Group 1 (aneuploidy) and Group 2 (euploidy and mosaicism).
Main results and the role of chance
Time-lapse videos were divided into 3-time partitions: day 1, day 1 to 3, and day 1 to 5. Deep learning models have been fed by RGB and optical flow. Combining 3 different time partitions with RGB, optical flow, and fused result from RGB and optical flow, we received nine sets of test results. According to the results, the longest time partition with the fusion method has the highest AUC result as 0.74, which appeared higher than the other eight experimental settings with a maximum increase of 0.17.
Limitations, reasons for caution
The present study is retrospective and future prospective research would help us to identify more key factors and improve this model. In addition, expanding sample size combined with cross-centered validation will also be considered in our future approach.
Wider implications of the findings
Group 1 and Group 2 approach provided deselection of aneuploidy embryos, while future deep learning approaches toward high mosaicism, low mosaicism, and euploidy will be needed, in order to provide a better clinical application.
Trial registration number
CS18082
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Affiliation(s)
- C I Lee
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - Y R Su
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - C H Chen
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - T A Chang
- University of Texas Health Science Center, Department of Obstetrics and Gynecology, San Antonio, USA
| | - E E S Kuo
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - W T Hsieh
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - C C Huang
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - M S Lee
- Lee Women’s Hospital, Division of Infertility, Taichung, Taiwan R.O.C
| | - M Liu
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
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Chang LS, Lee HC, Hsu CT, Tsao HM, Huang CC, Lee MS. P–009 A modified sperm chromatin dispersion test, LensHooke® R10, for quick and accurate determination of human sperm DNA fragmentation. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
The performance and efficiency of the LensHooke® R10 test kit were evaluated by the clinical examination for precision, accuracy, and time.
Summary answer
The LensHooke® R10 based on sperm chromatin dispersion test offers not only quick testing for sperm DNA fragmentation but also reliable and accurate test results.
What is known already
Sperm chromatin dispersion (SCD) test, one of the most commonly used testing for sperm DNA fragmentation (SDF), can be conducted promptly and without the need for expensive laboratory instruments. However, the main disadvantage of the SCD test is inter-observer variability in categorizing the size of characteristics halos surrounding the core of sperm. Moreover, it takes more than one hour to accomplish whole assay procedures making this testing an inefficient diagnostic tool. These may hinder its broad availability among andrology laboratories or prevent it from being routinely used for the evaluation of male infertility.
Study design, size, duration
A total of 108 participants was included in this prospective study. Data was collected from the reproductive medicine center between June and December 2020.
Participants/materials, setting, methods
This study included 108 consecutive male partners of couples attending for assisted reproductive treatment. SDF was simultaneously tested by using LensHooke® R10 (R10) and Halosperm® G2 (G2) respectively. We evaluated the correlation and agreement between two SCD-based test kits. The repeatability and reproducibility of the SCD kits were assessed by intra-and inter-observer agreement experiments. The sensitivity, specificity, positive predictive value, negative predictive value for the R10 was determined by receiver operator characteristics (ROC) curve analysis.
Main results and the role of chance
The R10 produced more clear sperm core and dispersed chromatin, therefore highly recognizable images can be easily and accurately categorized when scoring of SDF. It took 50% less time for SDF testing by the R10 compared to the G2 (38.26 ± 9.85 minutes vs. 76.52 ± 19.7 minutes, P < 0.0001). The SDF% results showed a strong correlation for the R10 and G2 with Spearman’s coefficients of rank correlation (rho) above 0.8 (P < 0.0001, N = 108). The R10 showed 89.8% accuracy with 87.9% sensitivity, 90.8% specificity, 82.9% PPV, and 93.7% NPV on the measurement of SDF% at the threshold value of 22%. Intraclass correlation coefficients (ICC) >0.9 showed a strong agreement between two observers on the testing of SDF using the R10. ICC >0.9 showed a high intra-observer agreement within 4 repeated testing on SDF using the R10. The R10 showed an intra-observer’s precision of coefficient variation, CV < 10% for SDF%. In addition, SDF% test results obtained by the R10 for asthenospermic (31.8% ± 16.7%), teratospermic (22.9% ± 14.4%), and oligoasthenoteratozoospermic samples (36.6% ± 14.4%) were significantly higher than that observed in normozoospermic samples (15.3% ± 10.2%, p < 0.05), was comparable with the G2.
Limitations, reasons for caution
The sample size of 4 semen specimens used to evaluate the intra-and inter-observer agreement was a limitation. Besides, evaluating the relationship between the SDF and clinical outcome of ART is necessary for further study.
Wider implications of the findings: The new in vitro diagnostics reagent, LensHooke® R10, is a simple and quick test kit that offers reliable and accurate test results of sperm DNA fragmentation, can be routinely used in male infertility evaluation.
Trial registration number
CS2–20012
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Affiliation(s)
- L S Chang
- Bonraybio Co.- Ltd, Clinical Medicine Dept., Taichung, Taiwan R.O.C
| | - H C Lee
- Bonraybio Co.- Ltd, Clinical Medicine Dept., Taichung, Taiwan R.O.C
| | - C T Hsu
- Bonraybio Co.- Ltd, Executive Office, Taichung, Taiwan R.O.C
| | - H M Tsao
- Lee Women’s Hospital, IVF Center, Taichung, Taiwan R.O.C
| | - C C Huang
- Lee Women’s Hospital, IVF Center, Taichung, Taiwan R.O.C
| | - M S Lee
- Lee Women’s Hospital, IVF Center, Taichung, Taiwan R.O.C
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30
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Lee CI, Su YR, Chen CH, Chang TA, Kuo EES, Zheng WL, Hsieh WT, Huang CC, Lee MS, Liu M. End-to-end deep learning for recognition of ploidy status using time-lapse videos. J Assist Reprod Genet 2021; 38:1655-1663. [PMID: 34021832 PMCID: PMC8324635 DOI: 10.1007/s10815-021-02228-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/11/2021] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Our retrospective study is to investigate an end-to-end deep learning model in identifying ploidy status through raw time-lapse video. METHODS By randomly dividing the dataset of time-lapse videos with known outcome of preimplantation genetic testing for aneuploidy (PGT-A), a deep learning model on raw videos was trained by the 80% dataset, and used to test the remaining 20%, by feeding time-lapse videos as input and the PGT-A prediction as output. The performance was measured by an average area under the curve (AUC) of the receiver operating characteristic curve. RESULT(S) With 690 sets of time-lapse video image, combined with PGT-A results, our deep learning model has achieved an AUC of 0.74 from the test dataset (138 videos), in discriminating between aneuploid embryos (group 1) and others (group 2, including euploid and mosaic embryos). CONCLUSION Our model demonstrated a proof of concept and potential in recognizing the ploidy status of tested embryos. A larger scale and further optimization on the exclusion criteria would be included in our future investigation, as well as prospective approach.
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Affiliation(s)
- Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | | | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - T Arthur Chang
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX, USA
| | | | | | | | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
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31
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Viotti M, Victor AR, Barnes FL, Zouves CG, Besser AG, Grifo JA, Cheng EH, Lee MS, Horcajadas JA, Corti L, Fiorentino F, Spinella F, Minasi MG, Greco E, Munné S. Using outcome data from one thousand mosaic embryo transfers to formulate an embryo ranking system for clinical use. Fertil Steril 2021; 115:1212-1224. [PMID: 33685629 DOI: 10.1016/j.fertnstert.2020.11.041] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To study how the attributes of mosaicism identified during preimplantation genetic testing for aneuploidy relate to clinical outcomes, in order to formulate a ranking system of mosaic embryos for intrauterine transfer. DESIGN Compiled analysis. SETTING Multi-center. PATIENT(S) A total of 5,561 euploid blastocysts and 1,000 mosaic blastocysts used in clinical transfers in patients undergoing fertility treatment. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Implantation (gestational sac), ongoing pregnancy, birth, and spontaneous abortion (miscarriage before 20 weeks of gestation). RESULT(S) The euploid group had significantly more favorable rates of implantation and ongoing pregnancy/birth (OP/B) compared with the combined mosaic group or the mosaic group affecting only whole chromosomes (implantation: 57.2% vs. 46.5% vs. 41.8%; OP/B: 52.3% vs. 37.0% vs. 31.3%), as well as lower likelihood of spontaneous abortion (8.6% vs. 20.4% vs. 25%). Whole-chromosome mosaic embryos with level (percent aneuploid cells) <50% had significantly more favorable outcomes than the ≥50% group (implantation: 44.5% vs. 30.4%; OP/B: 36.1% vs. 19.3%). Mosaic type (nature of the aneuploidy implicated in mosaicism) affected outcomes, with a significant correlation between number of affected chromosomes and unfavorable outcomes. This ranged from mosaicism involving segmental abnormalities to complex aneuploidies affecting three or more chromosomes (implantation: 51.6% vs. 30.4%; OP/B: 43.1% vs. 20.8%). Combining mosaic level, type, and embryo morphology revealed the order of subcategories regarding likelihood of positive outcome. CONCLUSION(S) This compiled analysis revealed traits of mosaicism identified with preimplantation genetic testing for aneuploidy that affected outcomes in a statistically significant manner, enabling the formulation of an evidence-based prioritization scheme for mosaic embryos in the clinic.
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Affiliation(s)
- Manuel Viotti
- Zouves Foundation for Reproductive Medicine, Foster City, California; Zouves Fertility Center, Foster City, California.
| | - Andrea R Victor
- Zouves Foundation for Reproductive Medicine, Foster City, California
| | - Frank L Barnes
- Zouves Foundation for Reproductive Medicine, Foster City, California; Zouves Fertility Center, Foster City, California
| | - Christo G Zouves
- Zouves Foundation for Reproductive Medicine, Foster City, California; Zouves Fertility Center, Foster City, California
| | - Andria G Besser
- New York University Langone Fertility Center, New York, New York
| | - James A Grifo
- New York University Langone Fertility Center, New York, New York
| | | | - Maw-Sheng Lee
- Lee Women's Hospital, Taichung, Taiwan; Chung Shan Medical University, Institute of Medicine, Taichung, Taiwan
| | | | - Laura Corti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Maria Giulia Minasi
- European Hospital, Centre For Reproductive Medicine, Rome, Italy; Villa Mafalda, Center For Reproductive Medicine, Rome, Italy
| | - Ermanno Greco
- European Hospital, Centre For Reproductive Medicine, Rome, Italy; Villa Mafalda, Center For Reproductive Medicine, Rome, Italy
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Huang LH, Lee TH, Huang JY, Ng SC, Lee MS, Lee SH. Erratum to Effect of postpartum care institutions on postpartum depression in women' [Midwifery 82C (2020) 102600]. Midwifery 2021; 97:102954. [PMID: 33685743 DOI: 10.1016/j.midw.2021.102954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Li-Hua Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Maternity Care Centre, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynaecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Soo-Cheen Ng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynaecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynaecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Division of Infertility, Lee Women's Hospital, Taichung, Taiwan.
| | - Shu-Hsin Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Nursing, Chung Shan Medical University, Taichung, Taiwan.
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Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021; 9:100325. [PMID: 33662705 PMCID: PMC8072144 DOI: 10.1016/j.esxm.2021.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION The pelvic floor muscle (PFM) could affect female sexual functions. The hip muscles are morphologically and functionally linked to PFM and are important elements of female sexual attraction. AIM To determine the relationship between female sexual function and hip muscle strength and PFM functions in women with stress urinary incontinence (SUI). METHODS A total of 42 women with SUI were recruited in this study. Female sexual function was measured using the pelvic organ prolapse urinary incontinence sexual function questionnaire (PISQ). PFM functions were measured using a perineometer. Hip muscle strength was measured using a Smart KEMA tension sensor. The relationship between female sexual function and PFM function and hip muscle strength was assessed using Pearson correlation coefficients and multiple regression analyses with forward selection. MAIN OUTCOME MEASURES PISQ score, PFM functions (strength and endurance), and strength of hip extensor, abductor, and adductor were the main outcome measures. RESULTS For the behavioral/emotive domain in the PISQ, hip extensor strength (r = 0.452), PFM strength (r = 0.441), PFM endurance (r = 0.362), and hip adductor strength (r = 0.324) were significantly correlated and hip extensor strength emerged in multiple regression. For the physical domain in the PISQ, hip abductor strength (r = 0.417), PFM endurance (r = 0.356), hip adductor strength (r = 0.332), and PFM strength (r = 0.322) were significantly correlated and hip abductor strength entered in multiple regression. For partner-related domain in the PISQ, hip adductor (r = 0.386) and abductor strength (r = 0.314) were significantly correlated and hip adductor strength appeared in multiple regression. For the PISQ total score, hip extensor strength (r = 0.484), PFM endurance (r = 0.470), hip adductor strength (r = 0.424), hip abductor strength (r = 0.393), and PFM strength (r = 0.387) were significantly correlated and hip extensor strength and PFM endurance emerged in multiple regression. CONCLUSION The female sexual function could be related to not only PFM functions but also hip muscle strength in women with SUI. Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Relationship Between Sexual Function and Pelvic Floor and Hip Muscle Strength in Women With Stress Urinary Incontinence. Sex Med 2021;9:100325.
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Affiliation(s)
- U J Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - M S Lee
- Sophie-Marceau Women's Clinic, Daegu, South Korea
| | - S H Jung
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - S H Ahn
- Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea
| | - O Y Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, Wonju, South Korea.
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Wu PJ, Wang CH, Hsieh MH, Lee CY, Wang PH, Lin CW, Yang SF, Lee MS. The impact of Aurora kinase A genetic polymorphisms on cervical cancer progression and clinicopathologic characteristics. Int J Med Sci 2021; 18:2457-2465. [PMID: 33967624 PMCID: PMC8100634 DOI: 10.7150/ijms.58516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/04/2021] [Indexed: 02/03/2023] Open
Abstract
The aims of this study were to explore the involvement of Aurora kinase A (AURKA) gene single nucleotide polymorphisms (SNPs) in uterine cervical cancer that has not yet been investigated. One hundred and six patients with cervical invasive cancer and 94 patients with precancerous lesions, and 302 Taiwanese female individuals were included. AURKA SNPs rs2273535, rs6024836, rs2064863 and rs1047972 were analyzed for genotypic distributions using real-time polymerase chain reaction. There were no statistically significant differences in the genetic frequencies of AURKA SNPs among patients with invasive cancer and those with precancerous lesions of uterine cervix and control women. There were no associations among AURKA SNPs and clinicopathologcal variables and recurrence and survival events. However, in a multivariate analysis, cervical cancer patients with adenocarcinoma (HR: 3.18, 95% CI: 1.23-8.23; p=0.017) and larger tumor (HR: 5.61, 95% CI: 2.10-14.95; p=0.001) had poorer recurrence-free survival. In conclusion, tumor size and pelvic lymph node status rather than AURKA SNPs were the most obvious independent parameter that could significantly predict 5 years survival rate in Taiwanese women with cervical cancer.
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Affiliation(s)
- Pei-Ju Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Hao Wang
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Hong Hsieh
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chung-Yuan Lee
- Department of Obstetrics and Gynecology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Wu CH, Chiu LT, Chang YJ, Lee CI, Lee MS, Lee TH, Wei JCC. Hypertension Risk in Young Women With Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study. Front Med (Lausanne) 2020; 7:574651. [PMID: 33072787 PMCID: PMC7538684 DOI: 10.3389/fmed.2020.574651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/18/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: A number of publications have assessed the prevalence of hypertension in polycystic ovary syndrome (PCOS) patients with inconclusive results. Since in general populations the occurrence of hypertension is related to age and comorbidities, we investigated the incidence rate and hazard ratios (HRs) of hypertension between healthy subjects and young women with PCOS as well as comorbidities. Methods: We conducted a population-based retrospective cohort study by using the National Health Insurance Research Database in Taiwan. The cohort included women with the diagnosis of PCOS between 2000 and 2012. Those without PCOS were selected as the control group at a ratio of 4:1 by an age-matched systematic random-sampling method. Cox proportional hazard regression analysis was used to determine the effects of PCOS on the risks of developing hypertension. Stratification analysis was performed to elucidate the interaction among PCOS and the comorbidities, which affect the incidence of hypertension. Results: The PCOS cohort consisted of 20,652 patients with PCOS and the comparison cohort consisted of 82,608 matched patients without PCOS. There was no difference in the distribution of age between the PCOS cohort and the comparison cohort (29.1 ± 6.8 vs. 29.0 ± 6.5, p = 0.32). The incidence rates of hypertension were 7.85 and 4.23 per 1,000 person-years in the PCOS and comparison groups, respectively. A statistically significant higher risk of hypertension was found in the PCOS cohort (adjusted HR = 1.62, 95% confidence interval = 1.48–1.76) than in the comparison cohort. After a joint analysis of comorbidities, the adjusted HR of hypertension was 9.44 (95% confidence interval = 7.27–12.24) for PCOS patients with comorbidities of diabetes mellitus (DM) and hyperlipidemia compared with women with neither PCOS nor DM and hyperlipidemia. Conclusion: The risk of developing hypertension in young women with PCOS was higher than in controls in this cohort study. The comorbidities of DM and hyperlipidemia could interact with PCOS patients and further increase the risk of hypertension. An earlier screening for hypertension and comorbidities in patients with PCOS may be warranted, even in young women.
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Affiliation(s)
- Cheng-Hsuan Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Women's Health Research Laboratory, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lu-Ting Chiu
- Management Office for Health Data, Clinical Trial Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Huang YY, Wu CH, Liu CH, Yang SF, Wang PH, Lin LY, Lee TH, Lee MS. Association between the Genetic Variants of Glutathione Peroxidase 4 and Severity of Endometriosis. Int J Environ Res Public Health 2020; 17:ijerph17145089. [PMID: 32679649 PMCID: PMC7400372 DOI: 10.3390/ijerph17145089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/10/2020] [Accepted: 07/12/2020] [Indexed: 01/10/2023]
Abstract
It has been reported that oxidative and nitrative stress might be the pathogenesis of endometriosis. This prospective case-control study attempted to check the connection between single nucleotide polymorphism (SNP) of three antioxidant enzymes (glutathione peroxidase 4 (GPX4), thioredoxin 2 (TXN2), thioredoxin reductase 1 (TXNRD1)) and endometriosis. We recruited 90 patients with histology-approved endometriosis as the case group and 130 age-matched women for an annual pap smear examination as the control group. The stage of endometriosis was evaluated with revised ASRM score. Both groups were genotyped in the peripheral leukocytes for the SNP of GPX4 (rs713041), TXN2 (rs4821494) and TXNRD1 (rs1128446) by PCR-based methods. An X2 test was used to analysis of the difference of allele frequency and SNP distribution between two groups. The results revealed GPX4 (rs713041) has a significantly different distribution between two groups (C:T = 116 (44.6%):144 (55.4%) in control and C:T = 104 (57.8%): 76 (42.2%) in endometriosis groups, p = 0.007). The SNP in TXN2 (rs4821494) also showed a difference in allele frequency (G:T = 180 (69.2%):80 (30.8%) in control and G:T = 141 (78.3%):39 (21.6%) in endometriosis group, p = 0.030). In addition, the SNP GPX4 (rs713041) was associated with the severity of the endometriosis. Women who have advanced stage endometriosis were different from mild endometriosis in genetic variants of GPX4 gene (p = 0.001). In conclusion, the relationship between endometriosis and SNP of antioxidant enzymes, GPX4 and TXN2, was confirmed by the present study. According to the result, we suggested that the GPX4 might contribute to the pathogenesis of endometriosis.
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Affiliation(s)
- Yun-Yao Huang
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (Y.-Y.H.); (C.-H.L.); (P.-H.W.); (L.-Y.L.); (M.-S.L.)
| | - Cheng-Hsuan Wu
- Women’s Health Research Laboratory, Changhua Christian Hospital, Changhua 50006, Taiwan;
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Chung-Hsien Liu
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (Y.-Y.H.); (C.-H.L.); (P.-H.W.); (L.-Y.L.); (M.-S.L.)
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40203, Taiwan
| | - Po-Hui Wang
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (Y.-Y.H.); (C.-H.L.); (P.-H.W.); (L.-Y.L.); (M.-S.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
| | - Long-Yao Lin
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (Y.-Y.H.); (C.-H.L.); (P.-H.W.); (L.-Y.L.); (M.-S.L.)
- School of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
| | - Tsung-Hsien Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (Y.-Y.H.); (C.-H.L.); (P.-H.W.); (L.-Y.L.); (M.-S.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
- Division of Infertility, Lee Women’s Hospital, Taichung 40602, Taiwan
- Correspondence:
| | - Maw-Sheng Lee
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; (Y.-Y.H.); (C.-H.L.); (P.-H.W.); (L.-Y.L.); (M.-S.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan;
- Division of Infertility, Lee Women’s Hospital, Taichung 40602, Taiwan
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Park KH, Jung M, Kim DY, Lee YM, Lee MS, Ryu BH, Hong SI, Hong KW, Bae IG, Cho OH. Effects of subinhibitory concentrations of chlorhexidine and mupirocin on biofilm formation in clinical meticillin-resistant Staphylococcus aureus. J Hosp Infect 2020; 106:295-302. [PMID: 32679053 DOI: 10.1016/j.jhin.2020.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The effects of subinhibitory concentrations (sub-MICs) of antibacterial agents on the biofilm-forming ability of Staphylococcus aureus require further study. AIM To investigate the effects of sub-MICs of chlorhexidine and mupirocin on biofilm formation in clinical meticillin-resistant Staphylococcus aureus (MRSA) isolates. METHODS MRSA isolates were collected from patients with bloodstream infections at a tertiary care hospital. The basal level of biofilm formation and biofilm induction by sub-MICs of chlorhexidine and mupirocin were evaluated by measuring biofilm mass stained with Crystal Violet. FINDINGS Of the 112 MRSA isolates tested, 63 (56.3%) and 44 (39.3%) belonged to sequence type (ST)5 and ST72 lineages, respectively, which are the predominant healthcare- and community-associated clones in South Korea. ST5 isolates were more likely to have chlorhexidine MIC ≥4 (73.0% vs 29.5%), resistance to mupirocin (23.8% vs 0%), agr dysfunction (73.0% vs 9.1%), and qacA/B gene (58.7% vs 2.3%) compared to ST72 isolates. The basal level of biofilm formation ability was frequently stronger in ST72 isolates compared to ST5 isolates (77.3% vs 12.7%). Sub-MICs of chlorhexidine and mupirocin promoted biofilm formation in 56.3% and 53.6%, respectively, of all isolates. Biofilm induction was more prevalent in ST5 isolates (85.7% for chlorhexidine, 69.8% for mupirocin) than in ST72 isolates (15.9% for chlorhexidine, 27.3% for mupirocin). CONCLUSION Sub-MICs of chlorhexidine and mupirocin promoted biofilm formation in half of the clinical MRSA isolates. Our results suggest that ST5 MRSA biofilm can be induced together with some other bacterial virulent factors following exposure to chlorhexidine, which might confer a survival advantage to this clone in the healthcare environment.
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Affiliation(s)
- K-H Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M Jung
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Y-M Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M S Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - B-H Ryu
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - S I Hong
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea
| | - K-W Hong
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - I-G Bae
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - O-H Cho
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Republic of Korea; Gyeongsang Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Lin PY, Lee CI, Cheng EH, Huang CC, Lee TH, Shih HH, Pai YP, Chen YC, Lee MS. Clinical Outcomes of Single Mosaic Embryo Transfer: High-Level or Low-Level Mosaic Embryo, Does it Matter? J Clin Med 2020; 9:E1695. [PMID: 32498291 PMCID: PMC7356018 DOI: 10.3390/jcm9061695] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/15/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022] Open
Abstract
Recently, reports showed that embryos identified as mosaic after preimplantation genetic testing for aneuploid (PGT-A) could result in live birth with lower pregnancy and higher pregnancy loss rates compared with euploid embryos. However, the effects of mosaicism level on reproductive outcomes remain controversial. This study aimed to examine the level of mosaicism on pregnancy outcomes. Single mosaic embryo transfer was offered to 108 women who only had mosaic embryos. Mosaic embryos were labeled by utilizing next generation sequencing (NGS) based PGT-A for day 5/6 trophectoderm (TE)biopsies. TE biopsies containing < 50% abnormal cells were classified as low-level mosaicism and ≥ 50% as high-level mosaicism. To further confirm the concordance of chromosome constitution between TE and inner cell mass (ICM), 41 remaining embryos designated as mosaic blastocysts donated for research were also analyzed. Comparable live birth rate (LBR) but higher miscarriage rate (MR) was found in the high-level group. (LBR: low vs. high: 44.5% vs. 36%; p = 0.45, MR: low vs. high: 5.1% vs. 30.7%; p = 0.012). Analyses of TE and ICM from the remaining mosaic blastocysts show a poor concordance. This preliminary study demonstrated that high-level mosaic embryos could result in comparable LBR but higher MR.
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Affiliation(s)
- Pin-Yao Lin
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.); (C.-I.L.); (T.-H.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
| | - Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.); (C.-I.L.); (T.-H.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
| | - Chun-Chia Huang
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.); (C.-I.L.); (T.-H.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
| | - Hui-Hsin Shih
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
| | - Yi-Ping Pai
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
| | - Yi-Chun Chen
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.); (C.-I.L.); (T.-H.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan; (E.-H.C.); (C.-C.H.); (H.-H.S.); (Y.-P.P.); (Y.-C.C.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
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Lee CI, Chen HH, Huang CC, Chen CH, Cheng EH, Huang JY, Lee MS, Lee TH. Effect of Interval between Human Chorionic Gonadotropin Priming and Ovum Pick-up on the Euploid Probabilities of Blastocyst. J Clin Med 2020; 9:jcm9061685. [PMID: 32498244 PMCID: PMC7356224 DOI: 10.3390/jcm9061685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 11/25/2022] Open
Abstract
This retrospective study attempts to elucidate the relevance of the interval between human chorionic gonadotropin priming and oocyte pick-up (hCG-OPU) to the euploidy probability of biopsied blastocysts in preimplantation genetic tests for aneuploidy (PGT-A) cycles. A total of 1889 blastocysts from 511 patients undergoing PGT- A cycles were used. An analysis of generalized estimating equations (GEE) was used to identify whether the hCG–OPU interval is associated with euploidy probabilities of blastocysts. Accordingly, maternal age (OR: 0.925, 95% CI: 0.903–0.948, p < 0.001) and the hCG–OPU interval (OR: 1.138, 95% CI: 1.028–1.260, p = 0.013) were the two significant factors associated with the euploidy probabilities. The Cochran-Armitage trend test demonstrated that the blastocyst euploidy percentage increased progressively with the increasing hCG-OPU interval in normal responders (p = 0.006) and advanced maternal age (age ≥38 years; p = 0.020) groups. In normal responders, the euploidy rate was highest in the 38–39 h interval (43.1%, 47/109). In contrast, the euploidy rate was lowest in the 34–35 h interval (28.7%, 29/105). In conclusion, the present study demonstrated that at an hCG-OPU interval between 34–39 h, the longer the hCG-OPU interval, the higher the probability of euploidy for blastocysts.
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Affiliation(s)
- Chun-I Lee
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
| | - Chun-Chia Huang
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
| | - Chien-Hong Chen
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
| | - En-Hui Cheng
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
| | - Jing Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Tsung-Hsien Lee
- Division of Infertility, Lee Women’s Hospital, Taichung 406, Taiwan; (C.-IL.); (H.-H.C.); (C.-C.H.); (C.-H.C.); (E.-H.C.); (M.-S.L.)
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: ; Tel.: +886-9-20823519
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Webster G, Draelos ZD, Graber E, Lee MS, Dhawan S, Salman M, Magrath GN. A multicentre, randomized, double-masked, parallel group, vehicle-controlled phase IIb study to evaluate the safety and efficacy of 1% and 3% topical minocycline gel in patients with papulopustular rosacea. Br J Dermatol 2020; 183:471-479. [PMID: 31907924 PMCID: PMC7496252 DOI: 10.1111/bjd.18857] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2020] [Indexed: 01/21/2023]
Abstract
Background Papulopustular rosacea is characterized by chronic facial erythema and inflammatory facial lesions. Minocycline has anti‐inflammatory properties which may be effective in the treatment of rosacea inflammatory lesions. Objectives To assess the safety and efficacy of once‐daily topical minocycline gel 1% and 3% in patients with papulopustular rosacea. Methods This was a prospective, 12‐week, double‐blinded study conducted at 26 sites in the United States; 270 patients with papulopustular rosacea and 12–40 inflammatory lesions were randomized to minocycline 1%, minocycline 3% or vehicle. The primary endpoint was the mean change in inflammatory lesions at week 12. Key secondary endpoints included success on an Investigator's Global Assessment (IGA). Results Baseline mean lesion counts were 24·6, 25·1 and 24·3 in the minocycline 1%, minocycline 3% and vehicle groups, respectively; at week 12, the counts had decreased by 12·6, 13·1 and 7·9, respectively. Minocycline significantly decreased lesions, compared with the vehicle [P = 0·01, 95% confidence interval (CI) 7·9 to 0·9, for minocycline 1%; P = 0·007, 95% CI 8·3 to 1·3, for minocycline 3%]. The proportion of patients achieving IGA success was 39% in the minocycline 1% arm [P = 0·34, odds ratio (OR) 1·396 and OR 95% CI 0·71 to 2·75 vs. vehicle], 46% in the minocycline 3% arm (P = 0·04, OR 2·03 and OR 95% CI 1·04 to 3·95 vs. vehicle) and 31% in the vehicle arm. Conclusions Minocycline topical gel appears to be safe and tolerable at concentrations of 1% and 3%, and both concentrations significantly decreased inflammatory lesion counts, with a significantly larger proportion of patients achieving IGA success at week 12 in the minocycline 3% arm. These findings support further evaluation of minocycline gel for treating inflammatory lesions associated with papulopustular rosacea. Linked Comment: Hampton. Br J Dermatol 2020; 183:412–413. What is already known about this topic? Papulopustular rosacea is characterized by inflammatory facial lesions and chronic erythema of the face. Oral minocycline has been reported to have efficacy in the treatment of inflammatory lesions of papulopustular rosacea.
What does this study add? The study shows that a topical gel preparation of minocycline significantly decreased the number of inflammatory lesions and significantly improved the Investigator's Global Assessment score in patients with papulopustular rosacea. This may offer a topical therapeutic alternative to oral doxycycline or oral minocycline for the treatment of inflammatory lesions in papulopustular rosacea, with potentially fewer systemic side‐effects, owing to lower systemic drug exposure.
Linked Comment: Hampton. Br J Dermatol 2020; 183:412–413. Plain language summary available online
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Affiliation(s)
- G Webster
- Department of Dermatology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Z D Draelos
- Dermatology Consulting Services, High Point, NC, USA
| | - E Graber
- Northeastern University and The Dermatology Institute of Boston, Boston, MA, USA
| | - M S Lee
- Lee Medical Associates, San Antonio, TX, USA
| | - S Dhawan
- Center for Dermatology, Cosmetic, and Laser Surgery, Freemont, CA, USA
| | - M Salman
- Hovione Scientia Ltd., Loughbeg, Ringaskiddy, Cork, Ireland
| | - G N Magrath
- Hovione Scientia Ltd., Loughbeg, Ringaskiddy, Cork, Ireland.,Medical University of South Carolina, Charleston, SC, USA
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Huang LH, Lee TH, Huang JY, Ng SC, Lee MS, Lee SH. Effect of stay in a postpartum care institution on postpartum depression in women. Midwifery 2020; 82:102600. [DOI: 10.1016/j.midw.2019.102600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/09/2019] [Indexed: 11/28/2022]
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Lee CI, Chen HH, Huang CC, Lin PY, Lee TH, Lee MS. Early Progesterone Change Associated With Pregnancy Outcome After Fresh Embryo Transfer in Assisted Reproduction Technology Cycles With Progesterone Level of >1.5 ng/ml on Human Chorionic Gonadotropin Trigger Day. Front Endocrinol (Lausanne) 2020; 11:653. [PMID: 33042015 PMCID: PMC7522275 DOI: 10.3389/fendo.2020.00653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
Several studies have reported a poor implantation rate for assisted reproduction technology (ART) cycles with elevated progesterone (P4) at the end of the follicular phase. Whether all women with increased P4 on the human chorionic gonadotropin(hCG) trigger day should undergo fresh or frozen embryo transfer (ET) remains to be explored. This study attempted to determine that the P4 level on 2 days before hCG administration and P4 ratio can serve as indicators for fresh ET in normal responders with an elevated P4 level of >1.5 ng/ml on the hCG administration day. This was a retrospective cohort study involving 337 ART cycles with fresh ET for normal responders. Serum P4 levels were measured 2 days prior to hCG day (P4 level I) and on the hCG administration day (P4 level II). The P4 ratio was calculated as follows: P4 ratio = P4 level II / P4 level I. The primary outcome is live birth rate of fresh ET cycles. The ROC curves established that the optimal P4 level I and P4 ratio for pregnancy in ART cycles with high P4 level II were 0.975 ng/ml and 1.62, respectively. Patients with a P4 level I of ≤0.975 ng/ml and P4 ratio of >1.62 were associated with a significantly higher implantation (30.8%, 61/198 vs. 10.3%, 19/184, p < 0.001) and live birth rates (51.6%, 33/64 vs. 15.0%, 9/60, p < 0.001) compared with those with a P4 level I of >0.975 ng/ml and P4 ratio of ≤1.62. A combination of P4 level I and P4 ratio cutoff values of 0.975 ng/ml and 1.62, respectively, had a positive predictive value (PPV) of 82.5% for pregnancy. In conclusion, fresh ET can be an option for women with an early P4 level I under 0.975 ng/ml and a P4 ratio higher than 1.62, especially for those normal responders with an elevated P4 level II >1.5 ng/ml on the hCG administration day. This approach may shorten the time to pregnancy and reduce the cost of ART cycles.
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Affiliation(s)
- Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Pin-Yao Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- *Correspondence: Tsung-Hsien Lee
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Friedman N, Pancer Z, Savic R, Tseng F, Lee MS, Mclean L, Bagli DJ, Tessaro MO. Accuracy of point-of-care ultrasound by pediatric emergency physicians for testicular torsion. J Pediatr Urol 2019; 15:608.e1-608.e6. [PMID: 31455581 DOI: 10.1016/j.jpurol.2019.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/05/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Acute scrotum is a common presentation to the pediatric emergency department, and ultrasound is frequently used to narrow the differential diagnosis. Point-of-care ultrasound (POCUS) is increasingly used by urologists and emergency physicians and could potentially be used to detect pediatric testicular torsion. OBJECTIVES This study aimed to determine the accuracy of POCUS by pediatric emergency physicians in diagnosing testicular torsion and the agreement between point-of-care ultrasound and final diagnosis for other causes of acute scrotum. STUDY DESIGN A chart review of patients presenting to the study emergency department who received POCUS by a pediatric emergency physician, as well as radiology department ultrasound and/or surgery, was performed. Charts were reviewed for POCUS diagnoses, final diagnoses, and imaging time metrics. RESULTS A total of 120 patients met study criteria, with 12 cases of testicular torsion. The diagnostic accuracy of POCUS for testicular torsion is described in the summary table. For all causes of acute scrotum, point-of-care ultrasound agreed with final diagnosis in 70% (95% confidence interval [CI] 62-78%) of cases, and more experienced point-of-care ultrasound users displayed higher agreement with final diagnosis. Point-of-care ultrasound results were generated a median of 73 min (Q1 = 51, Q3 = 112) before radiology department ultrasound results. DISCUSSION Scrotal POCUS performed by pediatric emergency physicians appears to be an accurate tool to detect testicular torsion in children with acute scrotum and saves time compared with radiology ultrasound. The study results may not be generalizable to hospitals without a multidisciplinary POCUS system for quality assurance and image sharing. Future work on POCUS for acute scrotum should investigate its impact on patient outcomes, cost-effectiveness, and family satisfaction. CONCLUSION Point-of-care ultrasound by pediatric emergency physicians is accurate for detecting testicular torsion in children with acute scrotum and could expedite diagnosis of this time-sensitive condition.
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Affiliation(s)
- N Friedman
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada.
| | - Z Pancer
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - R Savic
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - F Tseng
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - M S Lee
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - L Mclean
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - D J Bagli
- Division of Urology, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - M O Tessaro
- Emergency Point-of-Care Ultrasound Program, Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
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Lin PY, Huang CC, Chen HH, Huang BX, Lee MS. Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy. PLoS One 2019; 14:e0224919. [PMID: 31738801 PMCID: PMC6860430 DOI: 10.1371/journal.pone.0224919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 10/24/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose Unexpected sperm retrieval failure on the day of oocyte retrieval is not common but frequently happened in patients with severe oligospermia or non-obstructive azoospermia(NOA). Oocyte cryopreservation is a common strategy after failed collection of sperm when concurrent ovarian stimulation is underwent. However, the use of oocyte vitrification in such male-infertility cases remains unclear. Objective To investigate the outcomes of emergent oocyte cryopreservation after failed sperm retrieval from severe oligospermic or non-obstructive azoospermic (NOA) patients on oocyte retrieval day. Methods Design: Retrospective cohort study Setting: Academic fertility center at Lee Women's Hospital, Taiwan, between March 2015 and August 2017. Patients: For 203 couples with NOA(n = 200) or severe oligospermia(n = 3), testicular spermatozoa (n = 67 cycles) or frozen donor sperm (n = 209 cycles) were injected into fresh or frozen-thawed oocytes via 276 intracytoplasmic sperm injection (ICSI) cycles. Main Outcome Measures: Clinical pregnancy and live-birth rates (LBRs). Results In the 67 cycles involving the use of fresh testicular spermatozoa, no significant differences were observed between fresh and warmed oocytes with respect to the fertilization rates (69.2% vs. 74.1%; p = 0.27), number of Day-3 embryos (8.6±4.4 vs. 6.4±3.4; p = 0.08), number of good-quality Day-3 embryos (4.5±3.9vs. 4.7±3.0; p = 0.45), implantation rates (29.1% vs. 17.8%; p = 0.21), clinical pregnancy rates (36.4% vs. 26.8.0%; p = 0.81), live birth rates (36.4% vs. 14.3%; p = 0.46), or perinatal outcomes. In the 209 cycles involving the use of frozen donor sperm, no significant differences were seen between the two groups, except that the mean birth weights were significantly lower with fresh oocyte pregnancies than with warmed oocytes (2952±196 gm vs 2643±700 gm; p = 0.006). Conclusions Emergent oocyte cryopreservation is a feasible strategy to manage unexpected sperm retrieval failure from severe oligospermic or NOA patients on the oocyte retrieval day. There is no detrimental effect on the live birth rate when testicular spermatozoa or frozen donor sperm are injected into the thawed oocytes compared with fresh oocytes.
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Affiliation(s)
- Pin-Yao Lin
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
| | - Bo-Xuan Huang
- Department of Urology, Puli Christian Hospital, Nantou, Taiwan
| | - Maw-Sheng Lee
- Division of Infertility, Lee Women's Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail:
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Lee YM, Kim DY, Kim YJ, Park KH, Lee MS. Clinical impacts of delayed central venous catheter removal according to the severity of comorbidities in patients with candidaemia. J Hosp Infect 2019; 103:420-427. [PMID: 31493475 DOI: 10.1016/j.jhin.2019.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/28/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The effects of early central venous catheter (CVC) removal on the clinical outcomes of patients with candidaemia remain controversial. This study evaluated the impact of delayed CVC removal on mortality according to the severity of comorbidities in patients with candidaemia. METHODS Patients with candidaemia in a tertiary care hospital between January 2010 and December 2017 were included retrospectively. The severity of comorbidities was classified as low [Charlson Comorbidity Index (CCI) score ≤3] or high (CCI score ≥4). Cases with removal of CVC >2 days after the onset of candidaemia or without CVC removal were classified as having delayed CVC removal. RESULTS In total, 239 patients with candidaemia were included, excluding 18 who died within 2 days of onset of candidaemia. Of these, 149 had low CCI scores and 90 had high CCI scores. Septic shock [adjusted odds ratio (aOR)=9.5] and delayed CVC removal (aOR=4.7) were significantly associated with increased 30-day mortality, whereas Candida parapsilosis infection (aOR=0.2) and cerebrovascular disease (aOR=0.3) were associated with decreased 30-day mortality, in patients with low CCI scores. Septic shock (aOR=13.0) was the only risk factor for 30-day mortality in those with high CCI scores. Delayed CVC removal was associated with increased 30-day mortality in patients with low CCI scores (50.0% vs 20.3%; P=0.001), but not in those with high CCI scores (50.0% vs 47.9%; P=0.87). CONCLUSION Early CVC removal may improve the survival of patients with candidaemia and low CCI scores, but no such protective effect was evident in those with high CCI scores.
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Affiliation(s)
- Y-M Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - D Y Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Y J Kim
- Department of Laboratory Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - K-H Park
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - M S Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
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Lin PY, Lee MS, Cheng EH. Clinical outcomes of single embryo transfer with mosaic embryo: high-grade mosaic or low-grade mosaic embryo, does it matter ? Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.1362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lee CI, Chen CH, Huang CC, Cheng EH, Chen HH, Ho ST, Lin PY, Lee MS, Lee TH. Embryo morphokinetics is potentially associated with clinical outcomes of single-embryo transfers in preimplantation genetic testing for aneuploidy cycles. Reprod Biomed Online 2019; 39:569-579. [PMID: 31395516 DOI: 10.1016/j.rbmo.2019.05.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/23/2019] [Accepted: 05/29/2019] [Indexed: 12/14/2022]
Abstract
RESEARCH QUESTION Are the morphokinetics of euploid blastocysts evaluated by a generally applicable algorithm associated with the clinical outcomes of single-embryo transfer (SET)? DESIGN Time-lapse microscopy was used to compare morphokinetic variables between expanded blastocysts derived from preimplantation genetic testing for aneuploidy cycles using high-resolution next-generation sequencing (hr-NGS). The clinical efficacy of the morphokinetic algorithm KIDScore D5 was evaluated after euploid SET. RESULTS Compared with euploid blastocysts, low-level mosaic blastocysts presented comparable morphokinetic and morphological features. However, high-level mosaic blastocysts exhibited significant delays in t5 (median 51.9 h post insemination (hpi), P = 0.034) (where t is the time for the embryo to reach the specific stage in hours after ICSI or conventional IVF) and t8 (median 58.6 hpi, P = 0.032) accompanied by a prolonged time period for the third cell cycle (median 14.7 h, P = 0.012). A significantly higher incidence (P = 0.011) of multinucleation indicated a susceptibility of high-level mosaic blastocysts to mitotic errors. Only a delay in the time for the embryo to reach the full blastocyst stage (median 106.0 hpi, P = 0.039) was revealed in aneuploid blastocysts, reflecting the reduced formation of good-quality blastocysts (42.6% versus 65.7%, P < 0.001). Euploid blastocysts with specific morphokinetic characteristics were graded using the KIDScore D5 algorithm. Grade C embryos achieved significantly lower rates of clinical pregnancy, implantation and ongoing pregnancy (25%, 25% and 10%, respectively) compared with the grade A (76.2%, 79.4% and 68.3%, respectively) or grade B (62.5%, 66.7% and 62.5%, respectively) embryos (P = 0.0171 to <0.0001). CONCLUSIONS Although morphokinetic features appear dissimilar in embryos with different diploid-aneuploid mosaic levels, predicting chromosomal abnormalities using morphokinetics alone is still insufficient. When combined with hr-NGS, use of the generally applicable KIDScore D5 algorithm has the potential to discriminate euploid blastocysts with different developmental competence.
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Affiliation(s)
- Chun-I Lee
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Chien-Hong Chen
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Chun-Chia Huang
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - En-Hui Cheng
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Hsiu-Hui Chen
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Su-Ting Ho
- Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Pin-Yao Lin
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Taipei, Taiwan.
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Lee CI, Wu CH, Pai YP, Chang YJ, Chen CI, Lee TH, Lee MS. Performance of preimplantation genetic testing for aneuploidy in IVF cycles for patients with advanced maternal age, repeat implantation failure, and idiopathic recurrent miscarriage. Taiwan J Obstet Gynecol 2019; 58:239-243. [PMID: 30910146 DOI: 10.1016/j.tjog.2019.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE The primary objective of this study was to investigate whether preimplantation genetic testing for aneuploidy (PGT-A) of blastocysts through array comparative genomic hybridization (aCGH) improves live birth rates (LBR) in IVF cycles for patients with high prevalence of aneuploidy. MATERIALS AND METHODS This study included 1389 blastocysts with aCGH results derived from 296 PGT-A cycles in IVF patients with advanced maternal age (AMA) (n = 87, group A), those with repeated implantation failure (RIF) (n = 82, group B), those with recurrent miscarriage (RM) (n = 82, group C), and oocyte donors (OD) (n = 45, young age, as a control group). Another 61 AMA patients without PGT-A procedures were used as a control group for group A. Vitrification was performed after blastocyst biopsy, and thawed euploid embryos were transferred in a nonstimulated cycle. RESULTS For the AMA group, a significant increase in LBRs was found in the PGT-A group compared with the non-PGT-A group (54.1% vs. 32.8%, p = 0.018). Consistent LBRs (54.1%, 51.6%, 55.9%, and 57.1%, respectively, in group A, B, C, and young age group) were obtained for all the indications. CONCLUSIONS LBRs can be improved using PGT-A of blastocysts with aCGH in IVF cycles for patients with a high rate of aneuploidy, especially for patients with AMA.
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Affiliation(s)
- Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Lee Womens' Hospital, Taichung, Taiwan
| | - Cheng-Hsuan Wu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ping Pai
- Lee Womens' Hospital, Taichung, Taiwan; Institute of Biomedical Sciences, Chung Shan Medical University Taichung, Taiwan
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, Taiwan
| | | | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Lee Womens' Hospital, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Lee Womens' Hospital, Taichung, Taiwan
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Wu CH, Lee TH, Yang SF, Tsao HM, Chang YJ, Chou CH, Lee MS. Interleukin-3 Polymorphism is Associated with Miscarriage of Fresh in Vitro Fertilization Cycles. Int J Environ Res Public Health 2019; 16:ijerph16060995. [PMID: 30893922 PMCID: PMC6466610 DOI: 10.3390/ijerph16060995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/05/2019] [Accepted: 03/17/2019] [Indexed: 11/21/2022]
Abstract
The aim of this study was to examine the association between interleukin (IL) genes polymorphisms and in vitro fertilization (IVF) outcome. A prospective cohort analysis was performed at a Women’s Hospital IVF centre of 1015 female patients undergoing fresh non-donor IVF cycles. The effects of the following six single nucleotide polymorphisms (SNPs) in five IL genes on IVF outcomes were explored: IL-1α (rs1800587 C/T), IL-3 (rs40401 C/T), IL-6 (rs1800795 C/G), IL-15 (rs3806798 A/T), IL-18 (rs187238 C/G) and IL-18 (rs1946518 G/T). The main outcome measures included clinical pregnancy, embryo implantation, abortion and live birth rates. There were no statistically significant differences in clinical pregnancy, embryo implantation and live birth rates in the analysis of 1015 patients attempting their first cycle of IVF. Infertile women with IL-3 homozygous major genotype had a higher abortion rate than those with heterozygous and homozygous minor genotype (16.5% vs. 7.9%, P = 0.025). In conclusion, our results indicated that the IL-3 rs40401 polymorphism is associated with increased risk of abortion of IVF patients. Future studies with inclusion of other ethnic populations must be conducted to confirm the findings of this study.
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Affiliation(s)
- Cheng-Hsuan Wu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Women's Health Research Laboratory, Changhua Christian Hospital, Changhua 50006, Taiwan.
- School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Hui-Mei Tsao
- Division of Infertility Clinic, Lee Womens' Hospital, Taichung 406, Taiwan.
| | - Yu-Jun Chang
- Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua 50006, Taiwan.
| | - Chia-Hsuan Chou
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
- Division of Infertility Clinic, Lee Womens' Hospital, Taichung 406, Taiwan.
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Huang LH, Kuo CP, Lu YC, Lee MS, Lee SH. Association of emotional distress and quality of sleep among women receiving in-vitro fertilization treatment. Taiwan J Obstet Gynecol 2019; 58:168-172. [PMID: 30638474 DOI: 10.1016/j.tjog.2018.11.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Sleep disturbance is a common issue that can arise from emotional distress. Women who received the complicated invasive in-vitro fertilization (IVF) procedures can be stressful. The purpose of this study is to understanding the association between emotional distress (measured as anxiety and depression) and sleep quality for women undergoing IVF treatment. MATERIALS AND METHODS This research was of a cross-sectional questionnaire design. Questionnaires were completed during the controlled ovarian hyperstimulation of IVF treatment. A total of 97 participants complete the survey. The questionnaires included basic personal information, The Chinese Traditional Childbearing Attitude Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and the Beck depression and anxiety scales. RESULTS A total of 42.9% and 30% of the participants were determined to be anxious and depressed, respectively. Some participants (18.8%) required more than 30 min to fall asleep, and 56.2% of the participants had less than 7 h of sleep, 43.6% of the participants had less than 85% of sleep efficiency, and 43.3% of the participants were determined with poor sleep quality (PSQI>5). The linear regression analysis indicated that the score of the Beck anxiety index was significantly associated with sleep quality (F = 44.85, p = .000, adjust R2 = 49.4%). CONCLUSION This study revealed that some women when receiving early stage IVF treatments were anxious, depressed, and have sleep disturbance. Anxiety was significantly associated with sleep quality. It is suggested that medical care professional should understand these common issues when assisting women undergoing these complicated reproductive treatments.
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Affiliation(s)
- Li-Hua Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Maternity Care Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ching-Pyng Kuo
- Department of Nursing Chung Shan Medical University Hospital, Taichung, Taiwan; School of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Yen-Chiao Lu
- Department of Nursing Chung Shan Medical University Hospital, Taichung, Taiwan; School of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Lee Women's Hospital, Taichung, Taiwan.
| | - Shu-Hsin Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing Chung Shan Medical University Hospital, Taichung, Taiwan; School of Nursing, Chung Shan Medical University, Taichung, Taiwan.
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