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Zhu S, Jiang W, Liao X, Sun Y, Chen X, Zheng B. Effect of diminished ovarian reserve on the outcome of fresh embryo transfer in IVF/ICSI cycles among young women: A retrospective cohort study. BMC Womens Health 2024; 24:230. [PMID: 38594688 PMCID: PMC11003098 DOI: 10.1186/s12905-024-03039-6] [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: 10/29/2023] [Accepted: 03/21/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVE This study aims to investigate the effect of diminished ovarian reserve (DOR) on the clinical outcomes and maternal and infant safety of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) procedures in young women aged ≤ 35 years. METHODS A retrospective cohort study was performed to analyze the clinical data of 4,203 infertile women aged ≤ 35 years who underwent fresh embryo transfer (ET) in IVF/ICSI cycles. The data were collected from their initial visits to Fujian Maternity and Child Health Hospital between January 2015 and January 2022. Based on their ovarian reserve, the participants were categorized into two groups: DOR group (n = 1,027) and non-DOR group (n = 3,176). A propensity score matching (PSM) method was employed to ensure a relatively balanced distribution of covariates. The primary outcome assessed in this study was the live birth rate, while the secondary observation indicators included rates of high-quality embryo development, blastocyst formation, clinical pregnancy, and miscarriage, along with perinatal complications, neonatal birth weight, and the incidence of low birth weight (LBW). RESULTS The DOR group showed notably lowered rates of blastocyst formation (59.8% vs. 64.1%), embryo implantation (29.8% vs.33.3%), clinical pregnancy (47.9% vs. 53.6%), and live birth (40.6% vs. 45.7%) compared to the non-DOR group (all P < 0.05). However, no statistically significant differences were observed in the high-quality embryo rate, miscarriage rate, perinatal complications, neonatal birth weight, or LBW incidence in infants between both groups (all P > 0.05). CONCLUSION DOR has been found to reduce both clinical pregnancy and live birth rates in young females undergoing fresh ET in IVF/ICSI cycles. However, this reduction does not increase the risk of perinatal complications or LBW of infants through live birth cycles.
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Affiliation(s)
- Suqin Zhu
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China
- Fujian Maternal-Fetal Clinical Medicine Research Center, Fuzhou, 350001, China
| | - Wenwen Jiang
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Xiuhua Liao
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Yan Sun
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Xiaojing Chen
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China.
- Fujian Provincial Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, Fujian Province, 350001, China.
| | - Beihong Zheng
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350001, China.
- Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, 350001, China.
- Fujian Provincial Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Fuzhou City, Fujian Province, 350001, China.
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Zou W, Liu D, Peng J, Tang Z, Li Y, Zhang J, Liu Z. Sequential embryo transfer combined with intrauterine perfusion improved pregnancy outcomes in patients with recurrent implantation failure. BMC Womens Health 2024; 24:126. [PMID: 38365686 PMCID: PMC10873986 DOI: 10.1186/s12905-024-02966-8] [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: 03/02/2023] [Accepted: 02/11/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To compare the application of sequential embryo transfer, cleavage embryo transfer, and blastocyst transfer combined with intrauterine perfusion in frozen-thawed embryo transfer cycles in patients with recurrent implantation failure to provide a reference for reproductive clinicians. METHODS The 166 patients who underwent frozen-thawed embryo transfer due to recurrent implantation failure in the reproductive center from January 2021 to March 2022 were retrospectively analyzed. According to the different embryos transferred, they were divided into cleavage embryo transfer groups (72 cases in Group A), blastocyst transfer group (29 cases in Group B), and sequential transfer group (65 cases in Group C). All three groups were treated with intrauterine perfusion 5 days before embryo transfer. The general data and clinical pregnancy outcome indicators, such as embryo implantation rate, clinical pregnancy rate, ongoing pregnancy rate, live birth rate, twin rate, were compared among the three groups. RESULTS The embryo implantation rate (53.1%), clinical pregnancy rate (76.9%), ongoing pregnancy rate (67.7%) and live birth rate(66.15%) in the sequential transfer group were significantly higher than those in the other two groups (P < 0.05), and the ectopic pregnancy rate was lower in the sequential transfer group. CONCLUSION Sequential transfer combined with intrauterine perfusion partially improves clinical pregnancy outcomes and reduces the risk of ectopic pregnancy in frozen embryo cycle transfers in patients with recurrent implantation failure, which may be a favourable transfer reference strategy for patients with recurrent implantation failure.
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Affiliation(s)
- Wenda Zou
- Department of Reproductive Medicine Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, China
| | - Dan Liu
- Department of Reproductive Medicine Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, China
| | - Juan Peng
- Department of Reproductive Medicine Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, China
| | - Zhijing Tang
- Department of Reproductive Medicine Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, China
| | - Yukun Li
- Department of Reproductive Medicine Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, China
| | - Juan Zhang
- Department of Reproductive Medicine Center, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, China.
| | - Ziwei Liu
- Department of Urology, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, South Changjiang Road, Tianyuan District, ZhuZhou, 412007, China.
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Chen D, Wang A, Zhang W, Guo Y, Yao S, Chen X, Zhang J. Effectiveness of double ABCX-based psychotherapy for psychological distress among women undergoing in vitro fertilization-embryo transfer: a three-arm randomized controlled trial. J Psychosom Obstet Gynaecol 2023; 44:2278015. [PMID: 38056467 DOI: 10.1080/0167482x.2023.2278015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of double ABCX-based psychotherapy for psychological distress during in vitro fertilization-embryo transfer (IVF-ET) among a female group (FG), couple group (CoG) and control group (CG). METHODS A total of 201 women undergoing their first IVF-ET cycle were randomized into three groups. The 6-session intervention was delivered at each visit to the IVF clinic. The primary outcomes were depression and anxiety, and the secondary outcomes included sleep quality, serum cortisol (nmol/L) levels and the clinical pregnancy rate, which were assessed before and after the intervention. RESULTS The group-by-time effects were significant for depression, anxiety, sleep quality and serum cortisol levels, with larger effect sizes in the FG than in the CoG. There was no significant difference in the pregnancy rate among the three groups. CONCLUSION Psychotherapy effectively mitigated psychological distress, suggesting greater effectiveness for couples undergoing IVF couples than for women only. It is structured and easy to use during the IVF treatment cycle. TRIAL REGISTRATION NUMBER https://register.clinicaltrials.gov (NCT03931187, retrospectively registered on April 23, 2019).
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Affiliation(s)
- Dan Chen
- Nursing Department, Medical College, Hunan Normal University, Changsha, China
| | - Anni Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Yufang Guo
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Shuyu Yao
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxuan Chen
- School of Mathematics, Hunan Normal University, Changsha, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
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Zhou H, Zou Y, Guo Y, Lv X, Chen J, Guo X, Liu Q. Effect of COVID-19 inactivated vaccine on peripheral blood anti-β 2-GPI antibody and outcomes in vitro fertilization-embryo transplantation. Int Immunopharmacol 2023; 122:110596. [PMID: 37441812 DOI: 10.1016/j.intimp.2023.110596] [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: 04/01/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
Corona Virus Disease 2019 (COVID-19) is an acute respiratory infection and a global public health event. The level of aβ2GPI is significantly up-regulated in COVID-19 patients. The impact of inactivated vaccination against COVID-19 on aβ2GPI and in vitro fertilization and embryo transfer (IVF-ET) remains unknown amidst the universal administration of COVID-19 vaccines. We conducted a retrospective study to assess the impact of COVID-19 inactivated vaccination on aβ2GPI levels and its effect on superovulation and pregnancy outcomes. We found aβ2GPI level is significantly up-regulated after vaccination. There was no statistical difference in mature egg rate, 2PN fertilization rate, day 3 high-quality embryo rate, blastocyst formation rate, embryo implantation rate and miscarriage rate between the vaccine group and control group. Our findings showed vaccination with COVID-19 inactivated vaccine can elevate the level of aβ2GPI in peripheral blood but have no effect on the outcomes of controlled ovarian hyperstimulation and pregnancy in IVF-ET.
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Affiliation(s)
- Huiling Zhou
- Department of Reproductive Medicine Center, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China
| | - Yilu Zou
- Department of Reproductive Medicine Center, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China; Fujian Provincial Key Laboratory of Stem Cell Engineering and Regenerative Medicine, Fuzhou 350004, Fujian, China
| | - Yujia Guo
- Department of Reproductive Medicine Center, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China
| | - Xiaoting Lv
- Department of Respiratory and Critical Care Medicine, Research Laboratory of the Respiratory System Diseases, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China
| | - Jiajing Chen
- Department of Reproductive Medicine Center, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China
| | - Xinxin Guo
- Department of Reproductive Medicine Center, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China; Fujian Provincial Key Laboratory of Stem Cell Engineering and Regenerative Medicine, Fuzhou 350004, Fujian, China.
| | - Qicai Liu
- Department of Reproductive Medicine Center, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian, China.
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Ouyang Y, Peng Y, Zhang S, Gong F, Li X. A simple scoring system for the prediction of early pregnancy loss developed by following 13,977 infertile patients after in vitro fertilization. Eur J Med Res 2023; 28:237. [PMID: 37452358 PMCID: PMC10347825 DOI: 10.1186/s40001-023-01218-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/09/2023] [Indexed: 07/18/2023] Open
Abstract
A retrospective study was conducted to investigate a convenient simple scoring system for the prediction of early pregnancy loss (EPL) based on simple demographics. A total of 13,977 women undergoing transvaginal ultrasound scans on Days 27-29 after in vitro fertilization-embryo transfer (IVF-ET) from June 2016 and December 2017 were included. The first trimester pregnancy outcome was recorded at 12 weeks of gestation. The areas under the curve of this scoring system were 0.884 (95% confidence interval (CI) 0.870-0.899) and 0.890 (95% CI 0.878-0.903) in the training set and test set, respectively. The score totals ranged from -8 to 14 points. A score of 5 points, which offered the highest predictive accuracy (94.01%) and corresponded to a 30% miscarriage risk, was chosen as the cutoff value, with a sensitivity of 62.84%, specificity of 98.79%, positive predictive value (PPV) of 88.87% and negative predictive value (NPV) of 94.54% for the prediction of EPL in the training set. In the test set, a score of 5 points had a sensitivity of 64.69%, specificity of 98.78%, PPV of 89.87% and NPV of 93.62%, and 93.91% of the cases were correctly predicted. Therefore, the simple scoring system using conventionally collected data can be conveniently used to predict EPL after ET. However, considering the limitations, its predictive value needs to be further verified in future clinical practice.
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Affiliation(s)
- Yan Ouyang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China
| | - Yangqin Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Fei Gong
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China
| | - Xihong Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.
- Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China.
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De M, Chen L, Zeng L, Wang Y, Yang R, Li R, Chi H. Effects of two different types of luteal support on pregnancy outcomes following antagonist fresh embryo transfer: a retrospective study. BMC Pregnancy Childbirth 2023; 23:316. [PMID: 37142960 PMCID: PMC10158007 DOI: 10.1186/s12884-023-05570-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/03/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Only a small number of studies have reported the use of progesterone vaginal gel in combination with dydrogesterone as part of the antagonist protocol for fresh embryo transfer. Therefore, this study aimed to compare the effects of two types of luteal support on pregnancy outcomes following the antagonist protocol for fresh embryo transfer. METHODS We performed a retrospective analysis of clinical data from infertile patients who underwent fresh embryo transfer via the antagonist protocol (2785 cycles) between February and July 2019 and between February and July 2021 at the Peking University Third Hospital Reproductive Medicine Centre. According to the luteal support received, the cycle groups were divided into the progesterone vaginal gel group (single medication or VP group; 1170 cycles) and the progesterone vaginal gel plus dydrogesterone group (combination medication or DYD + VP group; 1615 cycles). After propensity score matching, the clinical pregnancy, ongoing pregnancy, early miscarriage, and ectopic pregnancy rates were compared between the two groups. RESULTS In total, 1057 pairs of cycles were successfully matched via propensity scores. The clinical and ongoing pregnancy rates in the combination medication group were significantly higher than those in the single medication group (P < 0.05), whereas no significant differences were noted in the early miscarriage and ectopic pregnancy rates between the two groups (both P > 0.05). CONCLUSIONS Combined luteal support after the antagonist protocol is preferred for patients undergoing fresh cycle embryo transfer.
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Affiliation(s)
- Minji De
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China
- Department of Obstetrics and Gynaecology, Ewenki People's Hospital, Hulunbuir, 021100, China
| | - Lixue Chen
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China
| | - Lin Zeng
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China
- Clinical Epidemiology Research Center, Peking University Third Hospital, No.49, North Garden Road, Haidian District, Beijing, 100191, China
| | - Yang Wang
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China
| | - Rui Yang
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China
| | - Rong Li
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China
| | - Hongbin Chi
- Reproductive Medicine Center, Peking University Third Hospital, No. 49, North Garden Road, Haidian District, Beijing, 100191, China.
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Zhong XF, Zong DK, Chi LK, Ren CX, Liu XR, Zhang WW, Yin P, Tong GQ, Xu LW. [Effects of electroacupuncture on pregnancy outcome in poor ovarian response patients of kidney essence deficiency and undergoing in vitro fertilization-embryo transfer]. Zhen Ci Yan Jiu 2023; 48:392-8. [PMID: 37186205 DOI: 10.13702/j.1000-0607.20220335] [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] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To observe the effects of electroacupuncture (EA) on ovarian reaction, egg and embryo quality, as well as pregnancy rate in poor ovarian response (POR) patients of kidney essence deficiency and undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS Ninety-six patients who met the inclusion criteria were randomly divided into an EA group and a control group, with 48 cases in each group. Before IVF-ET, the patients in the EA group received EA, once daily, 2 or 3 treatments a week for 12 weeks. Before and after the treatment, traditional Chinese medicine (TCM) syndrome score and clinical pregnancy rate were assessed in two groups. The concentrations of serum follicle-stimulating hormone (FSH), luteinsing hormone, estradiol, progesterone and anti-mullerian hormone were detected by chemiluminescence; the contents of serum insulin-like growth factor-1, serum inhibin B (INHB) and Kisspeptin in follicular fluid were determined by enzyme linked immunosorbent assay (ELISA); the antral follicle counting (AFC) was detected by color Doppler ultrasonography; and the egg and embryo conditions were observed under microscope. Fourteen days after embryo transfer, the positive rate of serum hemchoriconic gonadotropin (HCG) and clinical pregnancy rate were calculated. RESULTS After the treatment, the TCM syndrome score and level of serum FSH were reduced (P<0.05); the INHB in serum and AFC were increased (P<0.05) when compared with those before the treatment in the EA group. After the treatment, in comparison with the control group, the TCM syndrome score and level of serum FSH were lower (P<0.05); and the contents of serum INHB, AFC, the numbers of MⅡ eggs and high-quality embryos, as well as serum HCG positive rate were all increased (P<0.05) in the EA group. CONCLUSION EA can relieve the clinical symptoms of TCM in POR patients of kidney essence deficiency and undergoing IVF-ET, increase the ovarian reserve, reduce the serum FSH level, and improve the content of serum INHB, and the quality of eggs and embryos. This therapy tends to improve the clinical pregnancy rate and clinical pregnancy outcome.
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Affiliation(s)
- Xiu-Fang Zhong
- Longhua Clinical College of Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Dao-Kuan Zong
- Longhua Clinical College of Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Ling-Kan Chi
- Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Chun-Xia Ren
- Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Xi-Ru Liu
- Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Wu-Wen Zhang
- Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Ping Yin
- Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Guo-Qing Tong
- Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203
| | - Lian-Wei Xu
- Gynecology Department of Chinese Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032
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Yin J, Su Y, Siyuan L, Yin F, Wang W, Deng F, Wang T. Association between in vitro fertilization-embryo transfer and hearing loss: risk factors for hearing loss among twin infants in a cohort study. Eur J Pediatr 2023; 182:1289-1297. [PMID: 36637539 DOI: 10.1007/s00431-022-04767-3] [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: 06/22/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 01/14/2023]
Abstract
Assisted reproductive technologies (ART), including in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI), are known to contribute a higher risk of birth defects; however, studies have rarely evaluated the association between IVF-ET and diagnostic hearing loss (HL). This study aimed to evaluate the prevalence of and risk factors for HL and to clarify the association between IVF-ET and HL among twinborn infants. We enrolled 1860 live-born twin neonates born at a hospital in China from January 2017 to December 2020. After multi-step hearing screening, participants were diagnosed with HL by pediatric audiologists at 6 months of age. The prevalence of hearing loss and the adjusted odds ratios (AORs) for specific risk factors were estimated using generalized estimation equation (GEE) models in twin-born infants. Characteristics and prevalence of failure for hearing screening and HL were measured in IVF-ET twin infants. IVF-ET conception and preterm birth conferred a higher risk of hearing loss, with increased adjusted odds ratios (AOR [95% confidence intervals (CI)] IVF-ET: 2.82 [1.17-6.80], P = 0.021; preterm birth: 6.14 [2.30-16.40], P < 0.001) than the control group, respectively. Among the 1860 twin infants, more IVF-ET twins failed in dual-step hearing screening (3.26%) and were diagnosed with hearing loss (2.21%) than those conceived by spontaneous pregnancy. CONCLUSION IVF-ET conception and premature birth were associated with a higher risk of hearing impairment. Twin infants conceived by IVF-ET tended to fail in hearing screening and be diagnosed with hearing loss. These observations provide a more comprehensive approach for the prevention and management of deafness in twin-born children. WHAT IS KNOWN • IVF-ET technologies conferred a higher risk of birth defects. WHAT IS NEW • Premature birth and IVF-ET conception were associated with a higher risk of hearing loss among twin infants. • Twin infants conceived by IVF-ET tended to fail in hearing screening and diagnosed with hearing loss.
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Affiliation(s)
- Jinghua Yin
- Department of Pathophysiology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Su
- Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, No. 416 Chengnan Dong Rd, Yuhua District, Changsha, 410007, People's Republic of China
| | - Linpeng Siyuan
- Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, No. 416 Chengnan Dong Rd, Yuhua District, Changsha, 410007, People's Republic of China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Weidong Wang
- Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, No. 416 Chengnan Dong Rd, Yuhua District, Changsha, 410007, People's Republic of China
| | - Fengliang Deng
- Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, No. 416 Chengnan Dong Rd, Yuhua District, Changsha, 410007, People's Republic of China.
| | - Taosha Wang
- Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, No. 416 Chengnan Dong Rd, Yuhua District, Changsha, 410007, People's Republic of China.
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Zhou Y, Sun Z, Song J. Research progress on the impact of anxiety and depression on embryo transfer outcomes of in vitro fertilization. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:61-67. [PMID: 37283119 DOI: 10.3724/zdxbyxb-2022-0473] [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] [Indexed: 06/08/2023]
Abstract
Infertile women who receive in vitro fertilization-embryo transfer (IVF-ET) often present psychological distress such as anxiety, depression and perceived stress. This adverse psychological state can affect the immune homeostasis at the mother-fetus interface, the incubation of blastula and the receptivity of the maternal endometrium through the psycho-neuro-immuno-endocrine network, which in turns affect the proliferation, invasion and vascular remodeling of the embryo trophoblast, and reduces the success rate of embryo transfer. This adverse outcome of embryo transfer will further aggravate the psychological pain of patients, forming a vicious circle. The positive partner effect between husband and wife or the use of cognitive behavioral therapy, acupuncture, yoga and other measures for psychological intervention before and after IVF-ET, may break the vicious cycle and improve clinical pregnancy rate, continuous pregnancy rate and live birth rate after IVF-ET by alleviating anxiety and depression. This article reviews the research progress on anxiety and depression states in women receiving IVF-ET and the impact on outcome of IVF-ET and related mechanisms, as well as the application of psychological intervention for alleviating anxiety and depression, so as to provide insights in improving the outcome of IVF-ET.
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Affiliation(s)
- Yue Zhou
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
| | - Zhen'gao Sun
- Reproductive & Genetic Center of Integrated Chinese & Western Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
| | - Jingyan Song
- Reproductive & Genetic Center of Integrated Chinese & Western Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
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Li Q, Liu A, Shen H, Zhang X. Endometrial compaction after human chorionic gonadotrophin administration reduces ectopic pregnancy rate following fresh embryo transfer in vitro fertilization/intracytoplasmic sperm injection cycles in patients with non-thin endometrium: a retrospective cohort study. Reprod Biol Endocrinol 2022; 20:151. [PMID: 36271375 PMCID: PMC9585867 DOI: 10.1186/s12958-022-01020-2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aims to study whether the change of endometrial thickness between the day of human chorionic gonadotrophin (HCG) administration and the day of embryo transfer (ET) has any effect on ectopic pregnancy (EP) rate following fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. METHODS This study retrospectively analyzed 3134 patients who underwent fresh IVF/ICSI ET, including 3022 intrauterine, 112 ectopic cycles. Multiple logistic regression analysis and stratified analysis were used to study the effect of endometrial compaction after HCG administration on EP in patients with non-thin endometrium after adjusting for confounding factors. RESULTS After adjusting for confounders, multiple logistic regression analysis found that the risk of EP in the compaction group was significantly lower than that in the non-compaction group (OR = 0.49; 95% CI: 0.31-0.78; P = 0.0023). The results of the stratified analysis demonstrated the EP rate in patients with an endometrial thickness ≥ 8 mm on the day of ET; the compaction group significantly reduced the incidence of EP (OR = 0.49; 95% CI: 0.31-0.79; P = 0.0036). In patients with an endometrial thickness ≥ 8 mm on the day of ET, the incidence of EP had no statistical significance in two group (OR = 1.02; 95% CI: 0.18-5.88; P = 9790). CONCLUSION(S) In patients with non-thin endometrium, endometrial thickness compaction from the day of HCG to the ET day reduced the risk of EP significantly.
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Affiliation(s)
- Qiuyuan Li
- grid.32566.340000 0000 8571 0482Lanzhou University, No. 222 Tian Shui South Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
- grid.32566.340000 0000 8571 0482The First School of Clinical Medicine Lanzhou University, No. 1, Dong Gang Xi Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
| | - Ahui Liu
- grid.32566.340000 0000 8571 0482Lanzhou University, No. 222 Tian Shui South Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
- grid.32566.340000 0000 8571 0482The First School of Clinical Medicine Lanzhou University, No. 1, Dong Gang Xi Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
| | - Haofei Shen
- grid.32566.340000 0000 8571 0482Lanzhou University, No. 222 Tian Shui South Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
- grid.32566.340000 0000 8571 0482The First School of Clinical Medicine Lanzhou University, No. 1, Dong Gang Xi Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
| | - Xuehong Zhang
- grid.412643.60000 0004 1757 2902The First Hospital of Lanzhou University, No. 1 Dong Gang Xi Road, Chengguan District, Lanzhou, Gansu 730000 People’s Republic of China
- Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu Province People’s Republic of China
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Liu J, Zhu Y, Zhu D, Shi Y, Lu L, Li W, Li L, Zhou X, Zhang P, Yang H, Li M, Wang B, Sun M. GDF15 negatively regulates RGS16 to impair hepatic lipid metabolism in male mice offspring conceived by in vitro fertilization. Am J Transl Res 2022; 14:7535-7551. [PMID: 36398249 PMCID: PMC9641458] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES We generated an in vitro fertilization and embryo transfer (IVF-ET) mouse model to investigate the molecular mechanism underlying the abnormal lipid metabolism found in IVF-ET offspring. METHODS The glucose metabolism levels of offspring were assessed by glucose tolerance test (GTT), insulin tolerance test (ITT), and pyruvate tolerance test (PTT). The lipid metabolism levels were assessed by triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). RNA-seq was performed on liver tissues. mRNA and protein expression of relevant genes was verified by the quantitative real-time PCR and protein immunoblotting. HepG2 cells were transfected with either interfering RNA or overexpression plasmids to investigate the gene functions. RESULTS Compared to the control, male IVF-ET offspring showed: 1) higher body, liver, and epididymal white adipose tissue weight; 2) disrupted glucolipid metabolism with abnormal GTT, ITT, and PTT; 3) significantly decreased GDF15 along with increased RGS16. Furthermore, phosphorylation of ERK1/2 and AKT was significantly reduced. In HepG2 cells, knockdown of GDF15 caused an abnormally increased RGS16 and decreased phosphorylation of ERK1/2 and AKT, accompanied by increased lipid deposition. In contrast, overexpression of GDF15 reduced expression of RGS16. Simultaneous knockdown of both GDF15 and RGS16 reversed lipid deposition. CONCLUSIONS Down-regulation of GDF15 results in elevated RGS16, which causes the weakening of the downstream ERK1/2 and AKT phosphorylation, leading to abnormal lipid metabolism in the livers of IVF-ET male offspring. This suggests that the GDF15-RGS16-p-ERK1/2/p-AKT pathway plays a crucial role in liver lipid deposition in IVF-ET male offspring and could be a therapeutic target.
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Affiliation(s)
- Jingliu Liu
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Yichen Zhu
- Cambridge-Suda Genomic Resource Center, Jiangsu Key Laboratory of Neuropsychiatric Diseases Research, Suzhou Medical College of Soochow UniversitySuzhou, Jiangsu, China
| | - Dan Zhu
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Yajun Shi
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Likui Lu
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Weisheng Li
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Lingjun Li
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Xiuwen Zhou
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Pengjie Zhang
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Hao Yang
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Min Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Bin Wang
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Miao Sun
- Institute for Fetology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
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12
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Feng X, Zhu N, Yang S, Wang L, Sun W, Li R, Gong F, Han S, Zhang R, Han J. Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial. Reprod Biol Endocrinol 2022; 20:127. [PMID: 35996188 PMCID: PMC9396882 DOI: 10.1186/s12958-022-00997-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/29/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine the effects and mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization (IVF)-embryo transfer (ET). DESIGN, SETTING, AND PARTICIPANTS This efficacy study was a multicenter, randomized, controlled clinical trial (RCT) in women receiving IVF-ET. The mechanistic study was a single-center RCT. INTERVENTIONS The participants received TEAS vs. no TEAS treatment. MAIN OUTCOME MEASURES In the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined. RESULTS Ultimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, P = 0.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all P > 0.05) in the study population. In women > 35 years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (P = 0.004),30.8 vs. 13.9% (P = 0.001) and 34.0% vs. 19.7% (P = 0.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin α1β1/αVβ3, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls. CONCLUSION TEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity. TRIAL REGISTRATION ChiCTR-TRC-13003950.
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Affiliation(s)
- Xiaojun Feng
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Na Zhu
- Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, 410000, China
| | - Shuo Yang
- Center of Reproductive Medicine, Department of Obstetrics and GynecologyKey Laboratory of Assisted Reproduction, Ministry of EducationBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, 100191, China
| | - Li Wang
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Wei Sun
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Rong Li
- Center of Reproductive Medicine, Department of Obstetrics and GynecologyKey Laboratory of Assisted Reproduction, Ministry of EducationBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, 100191, China
| | - Fei Gong
- Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, 410000, China
| | - Songping Han
- Wuxi Shengpingxintai Medical Technology Co., Ltd, Wuxi, 214091, China
| | - Rong Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Key Lab for Neuroscience, Neuroscience Research Institute, Peking UniversityPeking University Health Science CenterThe Ministry of EducationThe Ministry of Health, Beijing, 100191, China.
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.
| | - Jisheng Han
- Department of Neurobiology, School of Basic Medical Sciences, Key Lab for Neuroscience, Neuroscience Research Institute, Peking UniversityPeking University Health Science CenterThe Ministry of EducationThe Ministry of Health, Beijing, 100191, China.
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13
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张 春, 杨 蕊, 李 蓉, 乔 杰, 王 海, 王 颖. [Successful assisted reproductive technology treatment for a woman with 46XX-17α-hydroxylase deficiency: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2022; 54:751-755. [PMID: 35950403 PMCID: PMC9385507 DOI: 10.19723/j.issn.1671-167x.2022.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Indexed: 06/15/2023]
Abstract
Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder, and 17α-hydroxylase deficiency (17α-OHD) is a rare type of CAH. 17α-OHD is caused by CYP17 gene mutation, resulting in partial or complete deficiency of 17α-hydroxylase, which in turn leads to the lack of cortisol and sex hormone production. The disease is manifested by excessive secretion of adrenocorticotropic hormone (ACTH), decreased levels of estradiol (E2) and androgen, elevated levels of proges-terone (P), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Most of the patients are female in gender. According to the chromosome karyotype, 17α-OHD can be divided into 46XX and 46XY, of which 46XX is rarer. The clinical manifestations are hypokalemia and hypertension. Patients with 46XX-karyotype may have irregular menstruation, amenorrhea, and infertility. The severity of symptoms varies according to the degree of 17α-hydroxylase deficiency. Due to its untypical manifestation, the patients with partial 17α-OHD are more likely to be missed or misdiagnosed. Some 17α-OHD patients with 46, XX karyotypes have different degrees of development of internal and external reproductive organ and spontaneous menstrual cycle, so they may have the potential ovulation and fertility opportunities. However, due to the adverse effects of high serum P level on the endometrium, the patients would have infertility problems. To date, four cases from foreign countries have been reported about the infertility treatments among 46XX-17α-OHD patients, and two cases were mentioned in China without describing the process of treatments. Here, one case with partial 46XX-17α-OHD was diagnosed and successfully conceived and delivered after in vitro fertilization-embryo transfer (IVF-ET) in the Center for Reproductive Medicine, Peking University Third Hospital. Controlled ovarian stimulation with ultra-long protocol was initiated after glucocorticoid therapy was given to reduce P level. Ten oocytes were obtained and 6 embryos were cryopreserved. Frozen-thawed embryo transfer under hormonal replacement after gonadotropin releasing hormone agonist (GnRH-a) was carried out in an artificial cycle, and then the patient was successfully pregnant and delivered a healthy boy after 37 weeks of gestation by cesarean section. The treatment of this case suggests that patients with partial 46XX-17α-OHD can obtain oocytes and embryos with good quality. IVF combined with frozen-thawed embryo transfer under artificial cycle is an effective method for patients with partial 46XX-17α-OHD with infertility.
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Affiliation(s)
- 春梅 张
- 北京大学第三医院妇产科,生殖医学中心,北京 100191Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - 蕊 杨
- 北京大学第三医院妇产科,生殖医学中心,北京 100191Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - 蓉 李
- 北京大学第三医院妇产科,生殖医学中心,北京 100191Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - 杰 乔
- 北京大学第三医院妇产科,生殖医学中心,北京 100191Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - 海宁 王
- 北京大学第三医院内分泌科,北京 100191Department of Endocrinology, Peking University Third Hospital, Beijing 100191, China
| | - 颖 王
- 北京大学第三医院妇产科,生殖医学中心,北京 100191Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
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14
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Sun X, Xiong W, Liu L, Xiong J, Liao C, Lan Y, Li F, Tao S, Meng M, Sun C, Mao X. Comparison of the predictive capability of antral follicle count vs. the anti-Müllerian hormone for ovarian response in infertile women. Front Endocrinol (Lausanne) 2022; 13:862733. [PMID: 36387919 PMCID: PMC9659916 DOI: 10.3389/fendo.2022.862733] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the predictive capability of antral follicle count (AFC) and the anti-Müllerian hormone (AMH) on ovarian response in infertile women and to identify potential factors influencing retrieved oocytes. METHODS A total of 2585 infertile women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles had been enrolled in this study. Spearman correlation was used to investigate the correlation between retrieved oocytes and AFC. Multiple linear regression analysis was used to study the parameters affecting the number of retrieved oocytes. RESULTS Spearman correlation and multiple linear regression analysis revealed that the oocyte retrieval number was positively correlated with AFC (r = 0.651, p < 0.001) and AMH (r = 0.566, p < 0.001) and negatively correlated with age (r = -0.425, p < 0.001) and regimen selection (r = -0.233 p < 0.001). There was no significant correlation between retrieved oocytes and BMI (p = 0.913). ROC analysis revealed that AFC was a better predictor of adverse effects than AMH, BMI, and age (AUC: 0.916 VS 0.791, 0.575, 0.752). Meanwhile, AFC and AMH were comparable in predicting high response (AUC = 0.731 and AUC = 0.733, respectively). CONCLUSIONS This study showed that retrieved oocytes were positively correlated with serum AMH and AFC and negatively correlated with age and BMI. AFC had an ideal predictive performance in ovarian response prediction. The mechanism of the effect of AFC on ovarian response during controlled ovarian hyperstimulation (COH) needs to be further investigated.
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Affiliation(s)
- Xingyu Sun
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Wang Xiong
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Liting Liu
- Department of Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Junjun Xiong
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Chenlu Liao
- Department of Ophthalmology, The First People’s Hospital of Neijiang, Neijiang, China
| | - Yunzhu Lan
- Department of Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Feifei Li
- Department of Gynecology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shufei Tao
- Family Medicine, Carle Foundation Hospital, Urbana, IL, United States
| | - Muzi Meng
- American University of the Caribbean School of Medicine, Preston, United Kingdom
- Bronxcare Health System, The Bronx, NY, United States
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, United States
| | - Xiguang Mao
- Department of Gynecology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Xiguang Mao,
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15
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Yang L, Zhang H, Zhou L, Gao Y, Yang L, Hu Y, Xu L, Huang D. Effect of electro-acupuncture on ovarian function of women with diminished ovarian reserve: study protocol for a randomized controlled trial. Trials 2021; 22:921. [PMID: 34906206 PMCID: PMC8670117 DOI: 10.1186/s13063-021-05894-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Background Diminished ovarian reserve (DOR) is the precursor state of ovarian failure and can cause the decline of women’s reproductive function. DOR also leads to poor outcome of in vitro fertilization and embryo transfer (IVF-ET) by affecting the oocytes, high qualified embryo rate, pregnancy rate, etc. Some studies have demonstrated that acupuncture can improve ovarian function. But to date, there is limited evidence indicating that acupuncture or electro-acupuncture is efficient to DOR. This trial aims to evaluate the efficiency and safety of electro-acupuncture for the ovarian function and the following outcome of IVF-ET in DOR patients. Methods This will be a multicenter randomized controlled clinical trial. A total of more than 338 women with DOR will be randomly allocated to treatment and control groups in 1:1 ratio receiving acupuncture before undergoing IVF-ET. The primary outcome will be the clinical pregnancy rate per cycle of IVF-ET after acupuncture. The secondary outcomes will be ovarian reserve function, outcomes of IVT-ET, blood biochemical index, Massachusetts General Hospital Acupuncture Sensation Scale (MASS), scores from the self-rating anxiety and depression scale, quality of life, and pregnancy outcomes. The safety of acupuncture will also be assessed. Discussion The results of this trial may provide high-quality evidence regarding the effectiveness of electro-acupuncture in the treatment of DOR and following outcomes of IVF-ET. This will also help patients with DOR and their physicians by offering a new treatment option. Trial registration Chinese Clinical Trial Registry ChiCTR1900024626. Registered on 19 July 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05894-2.
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Affiliation(s)
- Le Yang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Hanwang Zhang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Li Zhou
- First Hospital of Wuhan, 215 Zhongshan Avenue, Wuhan, Hubei, China
| | - Ying Gao
- Union Hospital, 1277 Jiefang Avenue, Wuhan, Hubei, China
| | - Lijuan Yang
- Reproductive Hospital, Jiangxi University of Traditional Chinese Medicine, 597 Shuangmashi Road, Nanchang, Jiangxi, China
| | - Yajun Hu
- First Hospital of Wuhan, 215 Zhongshan Avenue, Wuhan, Hubei, China
| | - Lu Xu
- Reproductive Hospital, Jiangxi University of Traditional Chinese Medicine, 597 Shuangmashi Road, Nanchang, Jiangxi, China
| | - Dongmei Huang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
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16
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Wang B, Fu J, Gao K, Liu Q, Zhuang L, Zhang G, Long M, Na J, Ren M, Wang A, Liang R, Shen G, Li Z, Lu Q. Early pregnancy loss: Do Per- and polyfluoroalkyl substances matter? Environ Int 2021; 157:106837. [PMID: 34454360 DOI: 10.1016/j.envint.2021.106837] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
Per- and poly-fluorinated substances (PFASs) with endocrine disrupting effect can efficiently transfer across the blood-follicle barrier. However, it is still controversial and attracting extensive public concern that whether PFASs can affect the human fertility potential. Therefore, we aimed to analyze the associations of women's exposure to PFASs with pregnancy loss, the relevant processes of fertilization, zygote implantation, and embryo development by using a prospective cohort study. The women undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment were recruited in Beijing City (Beijing Center) and Yantai City (Yantai Center) in China during 2015-2017. A total of 305 women were recruited before the IVF-ET treatment. Twelve PFASs were measured in their serum samples collected in the day before the IVF-ET treatment, as well as in the human chorionic gonadotropin (hCG) day. The three IVF-ET outcomes were included, i.e. hCG test negative, clinical pregnancy failure (CPF), and preclinical spontaneous abortion. Nine serum PFASs had detection rate of >70% in Beijing and Yantai centers. The exposure patterns to PFASs between these two centers were overall different. For Beijing Center, we only found a positive association of perflurodecanoic acid (PFDA) with the risk of CPF [RR = 2.28 (95 %CI: 1.02-5.11)], but there is a reverse trend in Yantai Center with [RR = 0.45 (95 %CI: 0.23-0.85)]. However, the serum concentration of PFDA in Beijing Center was relatively lower than that of Yantai Center. Other significant associations of the detected PFASs with the IVF-ET outcomes, or with the relevant clinical processes, were not found. The multi-pollutant regression model of the Bayesian kernel machine regression suggested that there were no joint effects between various PFASs on the concerned outcomes. Overall, we suggest that most PFAS were not associated with early pregnancy loss at the current exposure levels. As for the PFDA, there may exist susceptibility of different populations.
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Affiliation(s)
- Bin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health Peking University Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China.
| | - Jianjie Fu
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
| | - Ke Gao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Qian Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
| | - Lili Zhuang
- Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, Yantai 264000, China
| | - Guohuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health Peking University Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Manman Long
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health Peking University Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Jigen Na
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health Peking University Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Mengyuan Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health Peking University Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Anni Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| | - Rong Liang
- Reproductive Medical Center, Peking University People's Hospital, Beijing 100044, China
| | - Guofeng Shen
- College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Zhiwen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health Peking University Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Qun Lu
- Reproductive Medical Center, Peking University People's Hospital, Beijing 100044, China
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17
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Ni Y, Huang L, Tong C, Qian W, Fang Q. Analysis of the levels of hope and influencing factors in infertile women with first-time and repeated IVF-ET cycles. Reprod Health 2021; 18:200. [PMID: 34627302 PMCID: PMC8502316 DOI: 10.1186/s12978-021-01248-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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/25/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose To explore the hope levels and influencing factors in infertile women undergoing first-time and repeated in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods This study was a cross-sectional and convenient sampling study conducted among patients undergoing IVF-ET from January to June 2019. Patients were divided into first-time and repeated groups by the number of IVF-ET cycles, and then a questionnaire survey was administered. The questionnaire included demographic information, Herth hope index (HHI) scale, Locke-Wallace short marital-adjustment test scale and social support rating scale. Multiple linear regression was used to analyse the influencing factors associated with hope levels. Results A total of 298 IVF-ET patients were recruited for the study, including 150 (50.3%) in the first-time cycle group and 148 (49.7%) in the repeated cycle group. The HHI score of the repeated cycle group was significantly lower than that of the first-time cycle group (34.4 ± 3.5 vs. 37.5 ± 3.7, P < 0.001). Multiple linear regression analysis indicated that repeated IVF-ET and age were independently negatively correlated with HHI, with standardized coefficient β values of − 0.895 and − 0.223, respectively (both P < 0.001). High education level (P = 0.002), high monthly income (P = 0.020), high degree of short marital-adjustment test (P < 0.001) and social support rating (P < 0.001) were independently positively correlated with HHI. Conclusion Infertile women undergoing repeated IVF-ET have low hope levels. Maintaining a good marriage adjustment and establishing a good social support and relationship network could effectively improve their hope levels. Hope level is closely related to patients' mental health and emotional state. Therefore, improving the hope level of infertile women with IVF-ET could contribute to relieving the psychological pressure of patients and improving the success rate of pregnancy. This study aimed to evaluate the hope level of infertile women with different IVF-ET cycles and analyse its influencing factors to provide guidance for clinical nurses to clarify the intervention objects, select reasonable intervention measures and improve the hope levels of patients. A total of 298 IVF-ET patients were recruited in the study, including 150 in the first-time cycle group and 148 in the repeated cycle group. The results showed that the hope level of patients with repeated IVF-ET cycles was significantly lower than that of patients undergoing first-time treatment. We also analysed its influencing factors and found that repeated IVF-ET cycles and age were independent negative correlation factors in hope levels. High monthly income, living in the city, high marital adjustment and social support score were independent positive correlation factors in hope levels. Therefore, maintaining a good marriage adjustment and establishing a good social support and relationship network could effectively improve their hope levels.
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Affiliation(s)
- Ying Ni
- Department of Nursing, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,School of Nursing, Shanghai Jiaotong University, Shanghai, China
| | - Limin Huang
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chenye Tong
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Qian
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiong Fang
- Department of Nursing, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. .,School of Nursing, Shanghai Jiaotong University, Shanghai, China.
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18
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Diao J, Gao G, Zhang Y, Wang X, Zhang Y, Han Y, Du A, Luo H. Caesarean section defects may affect pregnancy outcomes after in vitro fertilization-embryo transfer: a retrospective study. BMC Pregnancy Childbirth 2021; 21:487. [PMID: 34229640 DOI: 10.1186/s12884-021-03955-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Caesarean section rates are rising worldwide. One adverse effect of caesarean section reported in some studies is an increased risk of subfertility. Only a few studies have assessed the relationship between the previous mode of delivery and in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) reproductive outcomes. In this study, we primarily investigated the impact of a history of caesarean section with or without defects on IVF/ICSI-ET outcomes compared to a vaginal delivery history. Methods This retrospective study included 834 women who had a IVF or ICSI treatment at our centre between 2015 and 2019 with a delivery history. In total, 401 women with a previous vaginal delivery (VD) were assigned to the VD group, and 433 women with a history of delivery by caesarean section were included, among whom 359 had a caesarean scar (CS) without a defect and were assigned to the CS group and 74 had a caesarean section defect (CSD) and were assigned to the CSD group. Baseline characteristics of the three groups were compared and analysed. Binary logistic regression analyses were performed to explore the association between clinical outcomes and different delivery modes. Results There were no significant differences in the live birth rate, biochemical pregnancy rate, clinical pregnancy rate, mean implantation rate or abnormal pregnancy rate between the CS and VD groups However, the live birth rate and mean implantation rate in the CSD group were significantly lower than those in the VD group (21.6 vs 36.4%, adjusted OR 0.50 [0.27–0.9]; 0.25 ± 0.39 vs 0.35 ± 0.41, adjusted OR 0.90 [0.81–0.99]). Among women aged ≤ 35 years, the subgroup analyses showed that the live birth rate, biochemical pregnancy rate, clinical pregnancy rate, and mean implantation rate in the CSD group were all significantly lower than those in the VD group (21.4 vs 45.8%, adjusted OR 0.35[0.15 ~ 0.85]; 38.1 vs 59.8%, adjusted OR 0.52[0.24–0.82]; 31.0 vs 55.6%, adjusted OR 0.43[0.19–0.92]; 0.27 ± 0.43 vs 0.43 ± 0.43, adjusted OR 0.85[0.43 ± 0.43]). For women older than 35 years, there was no statistically significant difference in any pregnancy outcome among the three groups. Conclusions This study suggested that the existence of a CS without a defect does not decrease the live birth rate after IVF or ICSI compared with a previous VD. However, the presence of a CSD in women, especially young women (age ≤ 35 years), significantly impaired the chances of subsequent pregnancy.
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Song YF, Hu RN, Zheng CH, Zhang MM. [Clinical studies on acupuncture assisting in vitro fertilization-embryo transfer: a review and thoughts]. Zhen Ci Yan Jiu 2021; 46:342-7. [PMID: 33932002 DOI: 10.13702/j.1000-0607.200427] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Acupuncture has a long history of application in the field of reproduction, and in the past 20 years, numerous clinical studies have been conducted to explore the value of acupuncture in assisted reproductive technology. However, due to inconsistent research findings, there are still controversies over the clinical safety and efficacy of acupuncture in assisting in vitro fertilization-embryo transfer (IVF-ET), which may be closely associated with lacking of standardized treatment regimen in clinical trials of acupuncture. For that reason, this article reviews 16 representative clinical trials of acupuncture assisting IVF-ET published worldwide in 1999-2020, summarizes the grouping design, acupuncture method (acupuncture timing, acupuncture frequency, acupoints, and acupuncture types), and pregnancy outcome (pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate), and discusses several key links in clinical protocol design, so as to provide references for future clinical research.
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Affiliation(s)
- Yu-Fan Song
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ru-Nan Hu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Cui-Hong Zheng
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ming-Min Zhang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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20
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Kirca N, Ongen M. Perceived stress and sleep quality before oocyte pick-up, embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. Sleep Breath 2021; 25:1977-1985. [PMID: 33624218 DOI: 10.1007/s11325-021-02328-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/16/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infertility is a major health problem that affects both the family and the community. Women receiving infertility treatment may suffer from stress and even experience sleep disturbance. Sleep quality is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during in vitro fertilization treatment. Many studies have focused on the stress and sleep quality associated with their treatment in infertile women. However, few studies have investigated factors linked to their sleep disturbances. OBJECTIVE This study investigated the relationship between perceived stress and sleep quality before oocyte pick-up, in vitro fertilization-embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. MATERIAL AND METHODS This prospective, longitudinal study was conducted between January and May 2020. One hundred fifty-seven women receiving infertility treatment were included in the study. A personal information form, the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. RESULTS The relationship between the Perceived Stress Scale scores and the Pittsburgh Sleep Quality Index scores in all stages of infertility treatment was found to be positively significant at the p < .001 significance level. CONCLUSION Perceived stress level was high in women throughout the infertility treatment. Our study suggested that sleep quality was impaired as stress increased. TRIAL REGISTRATION 70904504/38.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey.
| | - Meryem Ongen
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey
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21
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Wang C, Yao Y, Zheng DL, Li R, Qiao J. [Incidence and management of cesarean scar pregnancies after in vitro fertilization-embryo transfer]. Zhonghua Yi Xue Za Zhi 2021; 100:3759-3763. [PMID: 33379839 DOI: 10.3760/cma.j.cn112137-20200518-01573] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the incidence, clinical characteristics, management strategies and reproductive outcomes of cesarean scar pregnancies (CSP) after in vitro fertilization-embryo transfer (IVF-ET). Methods: The patients who were diagnosed with CSP followed IVF/ET in the Center for Reproductive Medicine of Peking University Third Hospital between April 1, 2010 and March 31, 2020 were included. The clinical data of each patient were analyzed retrospectively. Results: There were a total of 1 441 patients with secondary infertility complicated with a history of cesarean section and achieved clinical pregnancy after IVF-ET treatments, of which CSP accounted for 1.94% (28/1 441). The average age of CSP patients was (34±3) years old, and 50.0% (14/28) of the patients had a history of artificial abortion. The incidence of CSP in embryo transfers at the cleavage stage had no significantly difference from transfers at the blastocyst stage (1.74% vs 2.20%, χ(2)=0.408, P=0.523), and the incidence of CSP in fresh embryo transfers had no significantly difference from frozen-thawed embryo transfers (1.77% vs 2.23%, χ(2)=0.372, P=0.542). The average gestational age at diagnosis was (47±6) days. According to the classification based on imaging examination during early pregnancy, a case of type Ⅰ CSP received expectant treatment and achieved live birth at third trimester of pregnancy. Two cases of heterotopic cesarean scar pregnancy underwent transvaginal selective reduction of CSP, and intrauterine pregnancies were followed by live births at third trimester of pregnancy. One case of type Ⅲ CSP underwent laparoscopic CSP excision and uterine repair, and 24 patients with type Ⅰ or type Ⅱ CSP underwent hysteroscopic CSP excision with/without uterine artery embolization. After CSP treatment, 5 patients achieved clinical pregnancy through embryo transfer, all of which were normal intrauterine pregnancy followed by term live birth. Conclusions: Color ultrasonography should be performed during early pregnancy to confirm the occurrence of CSP in patients receiving IVF-ET after previous cesarean section. Treatment of CSP should be individualized, and patients with Type Ⅰ CSP who are strictly selected have the opportunity for expectant treatment.
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Affiliation(s)
- C Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Y Yao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - D L Zheng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - R Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - J Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
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22
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Liu L, Jiao Y, Li X, Ouyang Y, Shi D. Machine learning algorithms to predict early pregnancy loss after in vitro fertilization-embryo transfer with fetal heart rate as a strong predictor. Comput Methods Programs Biomed 2020; 196:105624. [PMID: 32623348 DOI: 10.1016/j.cmpb.2020.105624] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 06/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE According to previous studies, after in vitro fertilization-embryo transfer (IVF-ET) there exist a high early pregnancy loss (EPL) rate. The objectives of this study were to construct a prediction model of embryonic development by using machine learning algorithms based on historical case data, in this way doctors can make more accurate suggestions on the number of patient follow-ups, and provide decision support for doctors who are relatively inexperienced in clinical practice. METHODS We analyzed the significance of the same type of features between ongoing pregnancy samples and EPL samples. At the same time, by analyzing the correlation between days after embryo transfer (ETD) and fetal heart rate (FHR) of those normal embryo samples, a regression model between the two was established to obtain FHR model of normal development, and the residual analysis was used to further clarify the importance of FHR in predicting pregnancy outcome. Finally we applied six representative machine learning algorithms including Logistic Regression (LR), Support Vector Machine (SVM), Decision Tree (DT), Back Propagation Neural Network (BNN), XGBoost and Random Forest (RF) to build prediction models. Sensitivity was selected to evaluate prediction results, and accuracy of what each algorithm above predicted under both the conditions with and without FHR was compared as well. RESULTS There were statically significant differences in the same type of features between ongoing pregnancy samples and EPL samples, which could serve as predictors. FHR, of which the normal development showed a strong correlation with ETD, had great predictive value for embryonic development. Among the six predictive models the one predicted with the highest accuracy was Random Forest, of which recall ratio and F1 could reach 97%, and AUC could reach 0.97, FHR taken into account as a feature. In addition, Random Forest had a higher prediction accuracy rate for samples with longer ETD-its accuracy rate could reach 99% when predicting those at 10 weeks after embryo transfer. CONCLUSION In this study, we established and compared six classification models to accurately predict EPL after the appearance of embryonic cardiac activity undergoing IVF-ET. Finally, Random Forest model outperformed the others. The implementation of Random Forest model in clinical environment can assist doctors to make clinical decisions.
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Affiliation(s)
- Lijue Liu
- School of Automation, Central South University, Changsha, Hunan, 410083, China; Hunan Zixing Intelligent Medical Technology Co., Ltd, Changsha, Hunan, 410000, China
| | - Yongxia Jiao
- School of Automation, Central South University, Changsha, Hunan, 410083, China
| | - Xihong Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, No. 84, Xiangya road, Changsha city, Hunan, 410078, China.
| | - Yan Ouyang
- Reproductive and Genetic Hospital of CITIC-Xiangya, No. 84, Xiangya road, Changsha city, Hunan, 410078, China; Institute of Reproductive and Stem Cell Engineering, Central South University, No. 84, Xiangya road, Changsha city, Hunan, 410078, China
| | - Danni Shi
- School of Automation, Central South University, Changsha, Hunan, 410083, China
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23
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Ouyang Y, Qin J, Lin G, Xiang S, Li X. Reference intervals of gestational sac, yolk sac, embryonic length, embryonic heart rate at 6-10 weeks after in vitro fertilization-embryo transfer. BMC Pregnancy Childbirth 2020; 20:533. [PMID: 32928137 PMCID: PMC7488996 DOI: 10.1186/s12884-020-03186-2] [Citation(s) in RCA: 4] [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: 01/17/2020] [Accepted: 08/17/2020] [Indexed: 11/18/2022] Open
Abstract
Background Accurately determining the normal range of early pregnancy markers can help to predict adverse pregnancy outcomes. The variance in ovulation days leads to uncertain accuracy of reference intervals for natural pregnancies. While the gestational age (GA) is accurate estimation during in vitro fertilization-embryo transfer (IVF-ET). Thus, the objective of this research is to construct reference intervals for gestational sac diameter (GSD), yolk sac diameter (YSD), embryonic length (or crown–rump length, CRL) and embryonic heart rate (HR) at 6–10 gestational weeks (GW) after IVF-ET. Methods From January 2010 to December 2016, 30,416 eligible singleton pregnancies were retrospectively recruited. All included participants had full records of early ultrasound measurements and phenotypically normal live neonates after 37 GW, with birth weights > the 5th percentile for gestational age. The curve-fitting method was used to screen the optimal models to predict GSD, CRL, YSD and HR based on gestational days (GD) and GW. Additionally, the percentile method was used to calculate the 5th, 50th, and 95th percentiles. Results There were significant associations among GSD, CRL, YSD, HR and GD and GW, the models were GSD = − 29.180 + 1.070 GD (coefficient of determination [R2] = 0.796), CRL = − 11.960 - 0.147 GD + 0.011 GD2 (R2 = 0.976), YSD = − 2.304 + 0.184 GD - 0.011 GD2 (R2 = 0.500), HR = − 350.410 + 15.398 GD - 0.112 GD2 (R2 = 0.911); and GSD = − 29.180 + 7.492 GW (R2 = 0.796), CRL = − 11.960 - 1.028 GW + 0.535 GW2 (R2 = 0.976), YSD = − 2.304 + 1.288 GW - 0.054 GW2 (R2 = 0.500), HR = − 350.410 + 107.788 GW - 5.488 GW2 (R2 = 0.911), (p < 0.001). Conclusions Reference intervals for GSD, YSD, HR and CRL at 6–10 gestational weeks after IVF-ET were established.
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Affiliation(s)
- Yan Ouyang
- College of Life Science, Hunan Normal University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ge Lin
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China.,Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China
| | - Shuanglin Xiang
- College of Life Science, Hunan Normal University, Changsha, China
| | - Xihong Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China. .,Clinical Research Center For Reproduction and Genetics in Hunan Province, Changsha, China.
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Xu H, Zheng C, He L, Su T, Wang H, Li Y, Zhao C, Zhang C, Bai Y, Tong G, Chen L, Zhao F, Yang H, Hao M, Yin Y, Yang L, Fang Y, Liu B. Effect of acupuncture on women with poor ovarian response: a study protocol for a multicenter randomized controlled trial. Trials 2020; 21:775. [PMID: 32912298 PMCID: PMC7488258 DOI: 10.1186/s13063-020-04690-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 08/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Poor ovarian response (POR), a manifestation of low ovarian reserve and ovarian aging, leads to a significant reduction in the pregnancy rate after in vitro fertilization-embryo transfer. Acupuncture has increasingly been used to improve the ovarian reserve. The purpose of this study will be to evaluate the effect of acupuncture on increasing the number of retrieved oocytes after controlled ovarian hyperstimulation in women with POR. Methods This will be a multicenter randomized controlled trial. A total of 140 women with POR will be randomly assigned to receive acupuncture or nontreatment for 12 weeks before controlled ovarian hyperstimulation. The primary outcome will be the number of retrieved oocytes. The secondary outcomes will be antral follicle counts, serum levels of anti-Müllerian hormone, basal serum levels of follicle stimulating hormone, luteinizing hormone and estradiol levels, scores from the self-rating anxiety scale, fertilization rates, cleavage rates, available embryo rates, and high-quality embryo rates. The safety of acupuncture will also be assessed. Discussion The results of this trial will help to determine the effectiveness of acupuncture in the treatment of POR. This may provide a new treatment option for patients with POR and their physicians. Trial registration AMCTR-IPR-18000198. Registered on 10 August 2018.
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Affiliation(s)
- Huanfang Xu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chensi Zheng
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liyun He
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tongsheng Su
- Shanxi Provincial Hospital of Chinese Medicine, Taiyuan, Shanxi, China
| | - Huidan Wang
- Shandong University Reproductive Hospital, Jinan, Shandong, China
| | - Yu Li
- Sun Yat-sen Memorial Hospital of the Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cui Zhao
- Lanzhou University First Hospital, Lanzhou, Gansu, China
| | - Cuilian Zhang
- Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Yang Bai
- Huazhong University of Science and Technology Reproductive Medicine Center of Tongji Medical College, Wuhan, Hubei, China
| | | | - Li Chen
- East Region Military Command General Hospital, Nanjing, Jiangsu, China
| | - Fang Zhao
- Luoyang Women and Children Health Care Center, Luoyang, Henan, China
| | - Huisheng Yang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mingzhao Hao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yaqian Yin
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Li Yang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yigong Fang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Baoyan Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
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Chen T, Zhao F, Wang Q, Liu C, Lan Y, Wang S, Xin Z, Yang X. Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35-39 years: a retrospective study. J Ovarian Res 2020; 13:80. [PMID: 32684158 PMCID: PMC7370502 DOI: 10.1186/s13048-020-00678-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/29/2020] [Indexed: 01/26/2023] Open
Abstract
Purpose Problems with fallopian tubes are one of the main reasons for women to undergo in vitro fertilization-embryo transfer (IVF-ET). A large proportion of women with ectopic pregnancy, fallopian tube obstruction and hydrosalpinx have had one or both fallopian tubes removed by salpingectomy. With increasing age, ovarian reserve deteriorates, the numbers of retrieved oocytes, available embryos and high-quality embryos are reduced, and the live birth rate for women treated with IVF treatment is affected. Thus, it is important to understand how salpingectomy affects live birth rates for IVF patients of different ages. This study analyzed how patients’ age and salpingectomy influenced ovarian reserve, ovarian response and pregnancy outcomes for infertile women undergoing IVF-ET. Methods A total of 1922 patients that underwent IVF-ET treatment from January 1, 2012, to December 31, 2018, were included in this retrospective study. The patients were divided into two groups according to whether or not they had a previous history of salpingectomy. The salpingectomy (group A, 534 patients) and control groups (group B, 1388 patients) were then further divided into two subgroups according to patient age (age<35 years, and age 35–39 years). Ovarian reserve, ovarian response, and IVF outcomes were investigated for each subgroup. Logistic regression model was used to estimate the relationship between clinical pregnancy and live births and patients’ baseline characteristics. Results In the salpingectomy group, antral follicle counts (AFC) were significantly lower for the subgroup aged 35 to 39 years compared with the control group. But this difference did not appear in women younger than 35 years. In addition, there were no significant differences in levels of basal follicle stimulation hormone (FSH), basal luteinizing hormone (LH), basal estradiol (E2), total gonadotropins (Gn) dose, duration of Gn, numbers of retrieved oocytes, fertilization rates, numbers of available embryos, live birth rates, clinical pregnancy rates, miscarriage rates, ectopic pregnancy rates, or multiple pregnancy rates between the salpingectomy group and the control group (P > 0.05). Age is a risk factor for the clinical pregnancy and live birth. Conclusion Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35–39 years. The increased female age was negative related with clinical pregnancy and live birth.
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Affiliation(s)
- Tong Chen
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Feiyan Zhao
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Qin Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Chang Liu
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Yonglian Lan
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Shuyu Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Zhimin Xin
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China.
| | - Xiaokui Yang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China.
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26
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Cai P, Ouyang Y, Gong F, Li X. Pregnancy outcomes of dichorionic triamniotic triplet pregnancies after in vitro fertilization-embryo transfer: multifoetal pregnancy reduction versus expectant management. BMC Pregnancy Childbirth 2020; 20:165. [PMID: 32178634 PMCID: PMC7077126 DOI: 10.1186/s12884-020-2815-4] [Citation(s) in RCA: 4] [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: 07/23/2019] [Accepted: 02/17/2020] [Indexed: 11/25/2022] Open
Abstract
Background Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not with a lower risk of miscarriage. However, data on dichorionic triamniotic (DCTA) triplet pregnancy outcomes are lacking. This study aimed to compare the pregnancy outcomes of DCTA triplets conceived via in vitro fertilization-embryo transfer (IVF-ET) managed expectantly or reduced to a monochorionic (MC) singleton or monochorionic diamniotic (MCDA) twins at 11–13+ 6 gestational weeks. Methods Two hundred ninety-eight patients with DCTA triplets conceived via IVF-ET between 2012 and 2016 were retrospectively analysed. DCTA triplets with three live foetuses were reduced to a MC singleton (group A) or MCDA twins (group B) or underwent expectant management (group C). Each multifoetal pregnancy reduction (MFPR) was performed at 11–13+ 6 gestational weeks. Pregnancy outcomes in the 3 groups were compared. Results Eighty-four DCTA pregnancies were reduced to MC singleton pregnancies, 149 were reduced to MCDA pregnancies, and 65 were managed expectantly. There were no significant differences among groups A, B, and C in miscarriage rate (8.3 vs. 7.4 vs. 10.8%, respectively) and live birth rate (90.5 vs. 85.2 vs. 83.1%, respectively) (P > 0.05). Group A had significantly lower rates of preterm birth (8.3 vs. 84.6%; odds ratio (OR) 0.017, 95% confidence interval (CI) 0.006–0.046) and low birth weight (LBW; 9.2 vs. 93.2%; OR 0.007, 95% CI 0.003–0.020) than group C (P < 0.001). Group B had significantly lower preterm birth (47.0 vs. 84.6%; OR 0.161, 95% CI 0.076–0.340) and LBW rates (58.7 vs. 93.2%; OR 0.103, 95% CI 0.053–0.200) than group C (P < 0.001). Group A had significantly lower preterm birth (8.3 vs. 47.0%; OR 0.103, 95% CI 0.044–0.237; P < 0.001), LBW (9.2 vs. 58.7%; OR 0.071, 95% CI 0.032–0.162; P < 0.001) and perinatal death rates (1.3 vs. 9.1%; OR 0.132, 95% CI 0.018–0.991; P = 0.021) than group B. Conclusion The MFPR of DCTA triplets to singleton or MCDA pregnancies was associated with better pregnancy outcomes compared to expectant management. DCTA triplets reduced to singleton pregnancies had better perinatal outcomes than DCTA triplets reduced to MCDA pregnancies.
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Affiliation(s)
- Pei Cai
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha City, 410078, Hunan, China
| | - Yan Ouyang
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha City, 410078, Hunan, China
| | - Fei Gong
- Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha City, 410078, Hunan, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha City, 410078, Hunan, China
| | - Xihong Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha City, 410078, Hunan, China.
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Zhao F, Lan Y, Chen T, Xin Z, Liang Y, Li Y, Wang S, Zhang J, Yang X. Live birth rate comparison of three controlled ovarian stimulation protocols for in vitro fertilization-embryo transfer in patients with diminished ovarian reserve after endometrioma cystectomy: a retrospective study. J Ovarian Res 2020; 13:23. [PMID: 32113477 PMCID: PMC7049193 DOI: 10.1186/s13048-020-00622-x] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 02/10/2020] [Indexed: 12/31/2022] Open
Abstract
Background Women with endometriosis and previous cystectomy may respond less well to gonadotropin stimulation, which results in fewer oocytes retrieved and poor pregnancy outcomes. Choosing an appropriate protocol for such populations is essential. This study involved an analysis of the effect of different controlled ovarian stimulation (COS) protocols on the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) in women with diminished ovarian reserve (DOR) who underwent ovarian endometrioma cystectomy. Methods A total of 342 patients that underwent IVF-ET treatment at the Beijing Obstetrics and Gynecology Hospital from January 1, 2013 to April 30, 2018 were included in this retrospective study. The patients were distributed into three groups according to the COS protocols, namely prolonged GnRH-agonist (Group A, n = 113), GnRH-antagonist (Group B, n = 121), and long GnRH-agonist (Group C, n = 108). The clinical and laboratory parameters of the three protocols were analyzed and a logistic regression of clinical pregnancy and live births was conducted. Results There were no significant differences in the age, infertility duration, basic follicle stimulation hormone (FSH), luteinizing hormone (LH), or estradiol (E2) levels as well as other baseline characteristics among groups (P > 0.05). The total gonadotrophin (Gn) dosage and duration tended to be less in the GnRH-antagonist group than in the others (P < 0.05). No significant differences were found in the implantation rate and clinical pregnancy rate among the groups, but the prolonged GnRH-agonist group showed the highest rates. In addition, no significant differences were present in the number of retrieved oocytes, oocyte fertilization rate, embryo utilization rate, live birth rate, abortion rate, ectopic pregnancy rate, or multiple pregnancy rate in the three groups (P > 0.05). Age had a significant effect on both clinical pregnancy and live birth. Conclusion For those DOR patients who had undergone ovarian endometriosis cystectomy, the prolonged GnRH-agonist protocol may achieve better clinical IVF-ET outcomes, but there were no significant differences from the other groups. The GnRH-antagonist protocol may reduce the cost and time of drug treatment. Age should be considered for its influence on pregnancy outcome. However, a larger sample size may be needed for further study.
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Affiliation(s)
- Feiyan Zhao
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Yonglian Lan
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Tong Chen
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Zhimin Xin
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Yu Liang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Ying Li
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Shuyu Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China
| | - Jun Zhang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China.
| | - Xiaokui Yang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yao jia yuan Road, Chaoyang District, Beijing, 100026, China.
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Zhang M, Lu L, Zhang Y, Li X, Fan X, Chen X, Tang J, Han B, Li M, Tao J, Gao Q, Xu Z, Sun M. Methylation-reprogrammed AGTR1 results in increased vasoconstriction by angiotensin II in human umbilical cord vessel following in vitro fertilization-embryo transfer. Life Sci 2019; 234:116792. [PMID: 31465733 DOI: 10.1016/j.lfs.2019.116792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 11/24/2022]
Abstract
AIMS Assisted reproductive technologies (ART) have been widely used to treat infertility, which may impact on fetuses and offspring. This study investigated the effects of in vitro fertilization-embryo transfer (IVF-ET) on angiotensin II (AII)-mediated vasoconstrictions in umbilical cord vein, and explored possible reprogrammed methylation mechanism. MATERIALS AND METHODS Human umbilical cords were randomly divided into ordinary pregnancy and IVF-ET pregnancy. Vascular studies with AII as well as its specific receptor antagonists losartan and PD123,319 were conducted. Real-time quantitative PCR, Western blotting, and methylation analysis by bisulfite sequencing were performed with the cord vessel samples. KEY FINDINGS In IVF-ET group, the maximal response to AII in umbilical vessels was significantly greater than that in the ordinary pregnancy. Using losartan and PD123,319, angiotensin receptor subtype 1 (AT1R) was found mainly responsible for the enhanced contraction in the umbilical vein of IVF-ET pregnancy. Decreased mRNA expression of DNMT3A was found in umbilical vein of IVF-ET group. Hypomethylation of the AGTR1 gene (gene encoding AT1R) in the umbilical veins of the IVF group was found. The data suggested that the IVF-ET treatments altered AII-mediated vasoconstrictions in umbilical veins, which could be partially attributed to the increased expression of AT1R. SIGNIFICANCE The hypo-methylation of the AGTR1 gene caused by IVF-ET might play important roles in altered vasoconstrictions, impacting on cardiovascular systems in the long run.
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Li Y, Deng B, Ouyang N, Yuan P, Zheng L, Wang W. Telomere length is short in PCOS and oral contraceptive does not affect the telomerase activity in granulosa cells of patients with PCOS. J Assist Reprod Genet 2017; 34:849-59. [PMID: 28477298 DOI: 10.1007/s10815-017-0929-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Our study aimed to investigate the association of telomerase activity (TA) and telomere length (TL) in granulosa cells (GCs) with IVF outcomes of polycystic ovary syndrome (PCOS) patients, and the effects of oral contraceptive pill (OCP) pretreatment on these two parameters. METHODS One hundred sixty-three infertile women were enrolled and divided into a PCOS group (n = 65) and a non-PCOS group (n = 98). The PCOS group was further divided into an OCP pretreatment group (n = 35) and a non-OCP pretreatment group (n = 30), a TA <0.070 group (n = 34) and a TA ≥0.070 group (n = 31), and a TL <1 group (n = 41) and a TL ≥1 group (n = 24), respectively. RESULTS No obvious differences were observed in TA between these groups. The TL was 0.971 in PCOS group and 1.118 in non-PCOS group (P = 0.005). The patients with TL ≥1 accounted for 36.9% in PCOS group and 54.1% in non-PCOS group (P = 0.032). The average duration of infertility for PCOS patients was 5 years in TA <0.070 group and 4 years in TA ≥0.070 group (P = 0.038), and 5 years in TL <1 group and 3 years in TL ≥1 group (P = 0.006), respectively. No obvious differences were observed in IVF outcomes between these groups. No obvious differences were observed in TA, TL, or IVF outcomes between OCP pretreatment group and non-OCP pretreatment group in PCOS patients. CONCLUSIONS Shorter TL was found in PCOS patients. The TA levels did not change significantly in PCOS patients. PCOS patients with a lower TA level and shorter telomeres had an earlier onset of infertility symptoms. No predictive value was found for TA and TL in terms of embryo quality or IVF outcomes in PCOS patients, and no effect OCP pretreatment was observed on either TA and TL.
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Li X, Ouyang Y, Yi Y, Tan Y, Lu G. Correlation analysis between ultrasound findings and abnormal karyotypes in the embryos from early pregnancy loss after in vitro fertilization-embryo transfer. J Assist Reprod Genet 2016; 34:43-50. [PMID: 27796806 DOI: 10.1007/s10815-016-0821-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 06/28/2016] [Accepted: 09/22/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of the study is to evaluate the correlation between ultrasound findings and abnormal karyotypes in early pregnancy losses (EPLs) after in vitro fertilization-embryo transfer (IVF-ET). METHODS This retrospective analysis assessed 2172 cases of EPL after IVF-ET occurring between January 2008 and December 2013. The cases were examined via transvaginal ultrasonography (TVS). Embryonic tissue karyotyping following miscarriage was performed using a comparative genomic hybridization (CGH) analysis with fluorescence in situ hybridization (FISH). The correlations between the ultrasound findings and the karyotypes were evaluated. RESULTS Six categories of ultrasound findings were observed: normal ultrasound, empty sac, yolk sac only, small gestational sac, small embryonic pole, and early symmetrical arrested growth. The overall rate of abnormal karyotypes was 44.9 % (976/2172), and the rate of abnormal karyotypes associated with a normal ultrasound, empty sac, yolk sac only, small gestational sac, small embryonic pole, and early symmetrical arrested growth was 49.5 % (218/440), 28.1 % (138/491), 43.4 % (197/454), 50.0 % (43/86), 49.8 % (155/311), and 57.7 % (225/390), respectively. Compared with the other groups, the prevalence of chromosomal abnormalities was significantly higher in the early symmetrical arrested growth group but was markedly lower in the empty sac group in all cases and when cases of 46,XX were excluded (p < 0.05). Trisomy 16 was the most common chromosomal abnormality in the yolk sac only, small embryonic pole and early symmetrical arrested growth groups. In the empty sac, small gestational sac and normal ultrasound groups, monosomy X was the most frequent abnormality. CONCLUSIONS Chromosomal anomalies may be associated with specific types of ultrasound findings in EPLs after IVF-ET.
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Affiliation(s)
- Xihong Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, No. 84, Xiangya road, Changsha city, Hunan, 410078, China
| | - Yan Ouyang
- Reproductive and Genetic Hospital of CITIC-Xiangya, No. 84, Xiangya road, Changsha city, Hunan, 410078, China.,Institute of Reproductive and Stem Cell Engineering, Central South University, No. 84, Xiangya road, Changsha city, Hunan, 410078, China
| | - Yan Yi
- Institute of Reproductive and Stem Cell Engineering, Central South University, No. 84, Xiangya road, Changsha city, Hunan, 410078, China
| | - Yueqiu Tan
- Reproductive and Genetic Hospital of CITIC-Xiangya, No. 84, Xiangya road, Changsha city, Hunan, 410078, China. .,Institute of Reproductive and Stem Cell Engineering, Central South University, No. 84, Xiangya road, Changsha city, Hunan, 410078, China.
| | - Guangxiu Lu
- Reproductive and Genetic Hospital of CITIC-Xiangya, No. 84, Xiangya road, Changsha city, Hunan, 410078, China.
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Koo HS, Cha SH, Kim HO, Song IO, Min EG, Yang KM, Park CW. A high response to controlled ovarian stimulation induces premature luteinization with a negative impact on pregnancy outcomes in a gonadotropin-releasing hormone antagonist cycle. Clin Exp Reprod Med 2016; 42:149-55. [PMID: 26816874 PMCID: PMC4724599 DOI: 10.5653/cerm.2015.42.4.149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 09/24/2015] [Revised: 10/29/2015] [Accepted: 11/11/2015] [Indexed: 11/17/2022] Open
Abstract
Objective The goal of this study was to investigate the relationship between serum progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration and the pregnancy rate among women undergoing controlled ovarian stimulation for in vitro fertilization (IVF) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET) using a flexible antagonist protocol. Methods This prospective study included 200 IVF and ICSI-ET cycles in which a flexible antagonist protocol was used. The patients were divided into five distinct groups according to their serum P4 levels at the time of hCG administration (0.80, 0.85, 0.90, 0.95, and 1.00 ng/mL). The clinical pregnancy rate (CPR) was calculated for each P4 interval. Statistically significant differences were observed at a serum P4 level of 0.9 ng/mL. These data suggest that a serum P4 concentration of 0.9 ng/mL may represent the optimal threshold level for defining premature luteinization (PL) based on the presence of a significant negative impact on the CPR. Results The CPR for each round of ET was significantly lower in the PL group defined using this threshold (25.8% vs. 41.8%; p=0.019), and the number of oocytes retrieved was significantly higher than in the non-PL group (17.3±7.2 vs. 11.0±7.2; p=0.001). Elevated serum P4 levels on the day of hCG administration were associated with a reduced CPR, despite the retrieval of many oocytes. Conclusion Measuring serum P4 values at the time of hCG administration is necessary in order to determine the optimal strategy for embryo transfer.
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Affiliation(s)
- Hwa Seon Koo
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Sun Hwa Cha
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Hye Ok Kim
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - In Ok Song
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Eung Gi Min
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Kwang Moon Yang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Chan Woo Park
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
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Li PF, Zhu H, Tan L, Zhao DM, Ma LY, Xiang YG, Zhang D, Dou Q, Lu N. Effects of high progesterone on outcomes of in vitro fertilization-embryo transfer in patients with different ovarian responses. Syst Biol Reprod Med 2015; 61:161-7. [PMID: 25915151 DOI: 10.3109/19396368.2015.1033779] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Indexed: 11/13/2022]
Abstract
The data of 3,841 cycles undergoing in vitro fertilization-embryo transfer (IVF-ET) in our reproductive Center between January 2003 and December 2013 were retrospectively analyzed. According to the number of oocytes retrieved, this study was divided into the high ovarian response group (oocyte retrieval≥20, 842 cycles), the moderate ovarian response group (5<oocyte retrieval<20, 2008 cycles), and the low ovarian response group (oocyte retrieval≤5, 991 cycles). The treatment outcomes were compared between the patients with an increased progesterone (P) level and the patients where the P level did not increase. With increase in ovarian response, the cut-off values of serum P on the day of human chorionic gonadotrophin (hCG) rose, and respectively were 2.5 ng/ml in the high ovarian response group, 2.25 ng/ml in the moderate ovarian response group, and 1.5 ng/ml in the low ovarian response group. In each group, the clinical pregnancy rate and embryo implantation rate were lower in the patients with an increased P level compared to those where the P level did not increase (all p<0.05). However, there were no significant difference in the fertilization rate, cleavage rate, and high-quality embryo rate (all p>0.05). The increased level of P on the day of hCG may affect the treatment outcomes of IVF-ET. The cut-off values of serum P seem to be associated with ovarian response. Increased ovarian response causes the cut-off values of serum P to rise.
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Affiliation(s)
- Peng-fen Li
- Reproductive Medical Center, Second Affiliated Hospital of Zhengzhou University , Zhengzhou , China
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Yoon J, Yoon HJ, Juhn KM, Ko JK, Yoon SH, Ko Y, Lim JH. Application of two different synthetic sequential media for the human IVF-ET program: a prospective, randomized, and comparative study. Clin Exp Reprod Med 2011; 38:186-92. [PMID: 22384441 PMCID: PMC3283082 DOI: 10.5653/cerm.2011.38.4.186] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 10/19/2011] [Revised: 11/18/2011] [Accepted: 11/28/2011] [Indexed: 11/06/2022] Open
Abstract
Objective Since IVF program was first established, various types of media and culture systems have been developed either in-house or commercially. The aim of this study was to compare the efficacy of in-house Maria Research Center (MRC) media to that of commercially available Sydney IVF media in human day 3 embryo transfer cycles. Methods Three hundred sixty nine couples were included in this prospective, randomized, and comparative study. All couples undergoing IVF treatment at the Maria Fertility Hospital were randomly assigned to either Sydney IVF (n=178) or MRC (n=191) media. Results No difference was observed between the MRC media and Sydney IVF media groups with respect to fertilization rate (74.4% vs. 75.5%). The clinical pregnancy and implantation rates of MRC media (47.1% and 20.0%, respectively) were also similar to those of Sydney IVF media (44.4% and 19.4%, respectively). However, the proportion of embryos with good quality on day 3 was significantly higher in the MRC media group than the Sydney IVF media group (50.2% vs. 43.2%) (p<0.05). Conclusion MRC media were as effective as Sydney IVF media for sustaining embryo development and pregnancy rates. The present study implies that MRC media can be a suitable alternative to commercially available media for human IVF-ET program.
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Choi KW, Lee CY, Lee YK, Kim YH, Kim KH. The Photosensitivity Localized in a Vitiliginous Lesion Was Associated with the Intramuscular Injections of Synthetic Progesterone during an In Vitro Fertilization-embryo Transfer. Ann Dermatol 2009; 21:88-91. [PMID: 20548867 DOI: 10.5021/ad.2009.21.1.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 06/19/2008] [Accepted: 09/08/2008] [Indexed: 11/08/2022] Open
Abstract
The cutaneous diseases associated with progesterone are autoimmune progesterone dermatitis, erythema multiforme-like eruption, drug-induced progesterone dermatitis and solar urticaria. Estrogen and progesterone are widely used in oral contraceptives and hormone replacement therapies, and they are rarely known to cause a photosensitive reaction. The mechanism of contraceptive-induced photosensitivity is uncertain. Estrogen, rather than progesterone, in the combined oral contraceptive pill has been most frequently implicated in the induction of photosensitivity. A 32-year-old woman presented with an erythematous patch with an itching sensation on the centrofacial area of a residual vitiligious lesion. She had a history of being previously treated with narrow band UVB for 1 year. Her skin lesions had mostly subsided, but some lesions continued. She underwent an in vitro fertilization-embryo transfer 3 months previously, and she then took synthetic progesterone for 3 weeks starting at the 4th week of pregnancy. She was in good health with neither a family history of photosensitivity nor a personal history of any other drug ingestion or topical agent such as sunscreen in association with the beginning of her lesions. Phototesting revealed her to be markedly photosensitive in the UVB and UVA ranges. The intradermal skin reactions to progesterone combined with irradiation with UVA or UVB were positive. We report here on an unusual case of photosensitivity that was localized in a vitiliginous lesion, and this was associated with the intramuscular injections of synthetic progesterone that she had received during an in vitro fertilization-embryo transfer.
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Affiliation(s)
- Kyu-Won Choi
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
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