目的:研究行体外受精的U4b型单角子宫不孕症患者与正常子宫不孕症患者的实验室及临床结局的差异及早产的相关因素分析。方法:选取2015年6月至2017年6月在郑州大学第一附属医院生殖医学中心行体外受精-胚胎移植的U4b型单角子宫不孕症患者...目的:研究行体外受精的U4b型单角子宫不孕症患者与正常子宫不孕症患者的实验室及临床结局的差异及早产的相关因素分析。方法:选取2015年6月至2017年6月在郑州大学第一附属医院生殖医学中心行体外受精-胚胎移植的U4b型单角子宫不孕症患者134例,根据年龄、不孕类型、不孕年限、基础卵泡刺激素水平和受精方式行1∶1倾向性评分匹配同时期正常形态子宫不孕症患者134例作为对照组,比较两组患者的基本资料、促排卵后临床和实验室指标及临床结局。结果:两组患者的基本资料、扳机日激素水平、获卵数、卵母细胞成熟率、受精率、优胚率、新鲜周期临床妊娠率、流产率、活产率和累积活产率差异均无统计学意义(P>0.05)。与对照组相比,U4b型单角子宫组促性腺激素的总用量[(2014.27±671.85)IU vs(1825.56±616.76)IU]扳机日子宫内膜厚度[(10.87±2.43)mm vs(11.97±2.36)mm]、新鲜周期胚胎着床率(40.34%vs 55.10%)、活产单胎新生儿平均出生体重(3147.22 g vs 3405.69 g)差异均有统计学意义(P<0.05)。结论:U4b型单角子宫患者通过体外受精技术能够获得与正常形态子宫患者相似的累积活产率。增加早产风险的主要因素是双胎妊娠。展开更多
To compare the efficacy of human chorionic gonadotrophin （hCG） at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IV...To compare the efficacy of human chorionic gonadotrophin （hCG） at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IVF/ICSI and the subsequent pregnancy outcome in frozen-thawed embryo transfer （FET）. Methods In the retrospective cohort study, 2 166patients undergoing IVF/ICSI with moderate or high response were recruited and classified into three groups according to the trigger dose of hCG： 2 000 IU （group A, n=722）, 3 000 IU （group B, n=722） and 5 000 IU （group C, n= 722）. The main outcome was the proportion of mature oocytes retrieved, fertilization rates, clinical pregnancy rates, cumulative pregnancy rates and incidence of ovarian hyperstimulation syndrome （OHSS）. Results No evidence of statistically difference was found in the proportion of mature oocytes retrieved （89.92%, 91.40%, 90.20%, respectively） and fertilization rate （79.8%, 80.07%, 80.51%, respectively） among groups A, B and C. Serum E2 level on the day of hCG injection, the number of mature oocytes retrieved and good-quality embryos in group A were significantly higher than those in group B and group C. Clinical pregnancy rates per transfer cycle （45.95%, 43.97% and 44.25%）, ongoing pregnancy rates （43.17%, 40.91% and 42,53%）, implantation rates （30, 74%, 2Z 78% and 29.86%） and cumulative pregnancy rates per patient （58.31%, 53.6% and 54.85%）A reduced hCG dose of 2 000 IUfor moderate or high responders leads展开更多
Background:Empiric therapy for patients with unexplained recurrent pregnancy loss(URPL)is not precise.Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age.T...Background:Empiric therapy for patients with unexplained recurrent pregnancy loss(URPL)is not precise.Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age.The clinical outcomes of URPL patients who have undergonein vitro fertilization-embryo transfer(IVF-ET)require elucidation.The IVF outcome and influencing factors of URPL patients need further study.Methods:A retrospective cohort study was designed,and 312 infertile patients with URPL who had been treated during January 2012 to December 2015 in the Reproduction Center of Peking University Third Hospital were included.By comparing clinical outcomes between these patients and those with tubal factor infertility(TFI),the factors affecting the clinical outcomes of URPL patients were analyzed.Results:The clinical pregnancy rate(35.18%vs.34.52%in fresh ET cycles,P=0.877;34.48%vs.40.27%in frozen-thawed ET cycles,P=0.283)and live birth rate(LBR)in fresh ET cycles(27.67%vs.26.59%,P=0.785)were not significantly different between URPL group and TFI group.URPL group had lower LBR in frozen-thawed ET cycles than that of TFI group(23.56%vs.33.56%,P=0.047),but the cumulative LBRs(34.69%vs.38.26%,P=0.368)were not significantly different between the two groups.The increased endometrial thickness(EMT)on the human chorionic gonadotropin day(odds ratio[OR]:0.848,95%confidence interval[CI]:0.748-0.962,P=0.010)and the increased number of eggs retrieved(OR:0.928,95%CI:0.887-0.970,P=0.001)were protective factors for clinical pregnancy in stimulated cycles.The increased number of eggs retrieved(OR:0.875,95%CI:0.846-0.906,P<0.001),the increased two-pronucleus rate(OR:0.151,95%CI:0.052-0.437,P<0.001),and increased EMT(OR:0.876,95%CI:0.770-0.997,P=0.045)in ET day were protective factors for the cumulative live birth outcome.Conclusion:After matching ages,no significant differences in clinical outcomes were found between the patients with URPL and the patients with TFI.A thicker endometrium and more retrieved oocytes increase the probability of pregnancy in fresh transfer cycles,but a better normal fertilization potential will increase the possibility of a live birth.展开更多
文摘目的:研究行体外受精的U4b型单角子宫不孕症患者与正常子宫不孕症患者的实验室及临床结局的差异及早产的相关因素分析。方法:选取2015年6月至2017年6月在郑州大学第一附属医院生殖医学中心行体外受精-胚胎移植的U4b型单角子宫不孕症患者134例,根据年龄、不孕类型、不孕年限、基础卵泡刺激素水平和受精方式行1∶1倾向性评分匹配同时期正常形态子宫不孕症患者134例作为对照组,比较两组患者的基本资料、促排卵后临床和实验室指标及临床结局。结果:两组患者的基本资料、扳机日激素水平、获卵数、卵母细胞成熟率、受精率、优胚率、新鲜周期临床妊娠率、流产率、活产率和累积活产率差异均无统计学意义(P>0.05)。与对照组相比,U4b型单角子宫组促性腺激素的总用量[(2014.27±671.85)IU vs(1825.56±616.76)IU]扳机日子宫内膜厚度[(10.87±2.43)mm vs(11.97±2.36)mm]、新鲜周期胚胎着床率(40.34%vs 55.10%)、活产单胎新生儿平均出生体重(3147.22 g vs 3405.69 g)差异均有统计学意义(P<0.05)。结论:U4b型单角子宫患者通过体外受精技术能够获得与正常形态子宫患者相似的累积活产率。增加早产风险的主要因素是双胎妊娠。
基金supported by National Natural Science Foundation of China(No.31071275)Natural Science Foundation of Shanghai of China(No.09411962900)
文摘To compare the efficacy of human chorionic gonadotrophin （hCG） at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IVF/ICSI and the subsequent pregnancy outcome in frozen-thawed embryo transfer （FET）. Methods In the retrospective cohort study, 2 166patients undergoing IVF/ICSI with moderate or high response were recruited and classified into three groups according to the trigger dose of hCG： 2 000 IU （group A, n=722）, 3 000 IU （group B, n=722） and 5 000 IU （group C, n= 722）. The main outcome was the proportion of mature oocytes retrieved, fertilization rates, clinical pregnancy rates, cumulative pregnancy rates and incidence of ovarian hyperstimulation syndrome （OHSS）. Results No evidence of statistically difference was found in the proportion of mature oocytes retrieved （89.92%, 91.40%, 90.20%, respectively） and fertilization rate （79.8%, 80.07%, 80.51%, respectively） among groups A, B and C. Serum E2 level on the day of hCG injection, the number of mature oocytes retrieved and good-quality embryos in group A were significantly higher than those in group B and group C. Clinical pregnancy rates per transfer cycle （45.95%, 43.97% and 44.25%）, ongoing pregnancy rates （43.17%, 40.91% and 42,53%）, implantation rates （30, 74%, 2Z 78% and 29.86%） and cumulative pregnancy rates per patient （58.31%, 53.6% and 54.85%）A reduced hCG dose of 2 000 IUfor moderate or high responders leads
基金supported by a grant from the National Science and Technology Major Project of China(No.2017ZX09304012-012)。
文摘Background:Empiric therapy for patients with unexplained recurrent pregnancy loss(URPL)is not precise.Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age.The clinical outcomes of URPL patients who have undergonein vitro fertilization-embryo transfer(IVF-ET)require elucidation.The IVF outcome and influencing factors of URPL patients need further study.Methods:A retrospective cohort study was designed,and 312 infertile patients with URPL who had been treated during January 2012 to December 2015 in the Reproduction Center of Peking University Third Hospital were included.By comparing clinical outcomes between these patients and those with tubal factor infertility(TFI),the factors affecting the clinical outcomes of URPL patients were analyzed.Results:The clinical pregnancy rate(35.18%vs.34.52%in fresh ET cycles,P=0.877;34.48%vs.40.27%in frozen-thawed ET cycles,P=0.283)and live birth rate(LBR)in fresh ET cycles(27.67%vs.26.59%,P=0.785)were not significantly different between URPL group and TFI group.URPL group had lower LBR in frozen-thawed ET cycles than that of TFI group(23.56%vs.33.56%,P=0.047),but the cumulative LBRs(34.69%vs.38.26%,P=0.368)were not significantly different between the two groups.The increased endometrial thickness(EMT)on the human chorionic gonadotropin day(odds ratio[OR]:0.848,95%confidence interval[CI]:0.748-0.962,P=0.010)and the increased number of eggs retrieved(OR:0.928,95%CI:0.887-0.970,P=0.001)were protective factors for clinical pregnancy in stimulated cycles.The increased number of eggs retrieved(OR:0.875,95%CI:0.846-0.906,P<0.001),the increased two-pronucleus rate(OR:0.151,95%CI:0.052-0.437,P<0.001),and increased EMT(OR:0.876,95%CI:0.770-0.997,P=0.045)in ET day were protective factors for the cumulative live birth outcome.Conclusion:After matching ages,no significant differences in clinical outcomes were found between the patients with URPL and the patients with TFI.A thicker endometrium and more retrieved oocytes increase the probability of pregnancy in fresh transfer cycles,but a better normal fertilization potential will increase the possibility of a live birth.
