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ObjectiveTo evaluate the effect of women's body mass index （BMI） on pregnancy outcomes of ovulation induction intrauterine insemination （OI-IUI） in patients with unexplained primary infertility. MethodsThe study included 764 OI-IUI cycles from January 2016 to December 2022 in reproductive center of Sun Yat-sen Memorial Hospital. According to BMI，patients were divided into three groups：low BMI （BMI<18.5 kg/m2）， normal BMI （18.5 kg/m2 ≤BMI＜23.0 kg/m2）， and high BMI （BMI≥23.0 kg/m2）. Comparison of clinical data and pregnancy outcomes was performed between the groups. Logistic regression was used to analyze the association between BMI and live birth rate. ResultsFrom the low BMI group to the high BMI group， the HCG positive rate （7.08%，9.74%， 13.19%）， clinical pregnancy rate（5.51%， 7.91%， 13.19%）， and live birth rate （4.72%， 6.90%， 12.50%） increased. Among them， the live birth rate of the high BMI group was significantly higher than that of the low BMI group and the normal BMI group， with a statistically significant difference （P=0.034）. While the early miscarriage rate （14.28%， 10.26%， 5.26%） decreased from the low BMI group to the high BMI group. The binary logistic regression analysis revealed that BMI was an independent factor in live birth， and high BMI resulted in a better live birth rate than low BMI （OR=3.15，95%CI=1.191-8.329，P=0.021）. ConclusionLow BMI is associated with poor OI-IUI outcomes in patients with unexplained primary infertility. These patients are encouraged to gain weight in a healthy manner.
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Objective:To figure out the development status of group psychotherapy and its problems and trends in China.Methods:Properties and contents,intervention programs and methods of 386 chosen articles from key journals of psychology and Doctor & Master Thesis in the group psychotherapy area were examined with bibliometric analyses and content analysis.Result:It showed a fast increase in properties and contents for the last 15 years.The proportion of clinical and sub-clinical study was 1 ∶ 4.Totally 53.9％ of studies focused on anxiety and depression,89.4％ were quantitative studies and 86.9％ were effect studies.As for the intervention programs,36.5％ were CBT,90.0％ were short-term treatment group below 12 times,35.6％ were lack of details in introductions and 67.8％ had other missing descriptions of group leader.As for the methods,34.9％ of participants were undergraduates,experimental (34.9％) and comprehensive (44.6％) methods were dominant,and difference test (58.3％) was most widely used statistical analysis.The self-report effect evaluation accounted for about 91.4％,and the follow-up studies were less than 22％.Totally 42.9％ of studies were lack of ethical consideration.Conclusion:The status of group psychotherapy in China is still in its early developmental phase,which need further standardization and improvement.
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Objective To evaluate the effect of the difficult embryo transfer on the clinical pregnancy outcome of in vitro fertili-zation-embryo transfer(IVF-ET) .Methods There were 209 fresh cycles of difficultly transferring and 2 489 fresh cycles of easily embryo transferring between January 2011 and December 2012 .The clinical outcome was compared .Results There were statistical-ly significant differences in the catheter blood staining rates (51 .20% vs 27 .68% ,P0 .05) .Conclusion Difficulty ET will in-fluence the clinical pregnancy .Therefore ,all efforts should be made to avoid the difficult transfer in order to increase the pregnant rate .
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ObjectiveTo compare the neonatal outcomes between infants of assisted conception (AC) and natural conception (NC). Methods A prospective case-control study was conducted.Eligible mothers were invited to this study at 28 weeks of gestation and were followed up to delivery.All newborns were examined by pediatricians right after birth.Data including gestational age,birth weight,admission to neonatal intensive care unit (NICU),and presence of any major malformation were collected.Statistical analysis was performed with SPSS 13.0.Difference between two groups was compared by x2 test. ResultsSix hundred and seventy-three newborns were enrolled into this study,including 325 in AC group and 348 in NC group.There were no differences between the demographic characteristics of the two groups,including maternal age,parents' education,family income and proportion of primipara (P＞0.05).The incidences of twins (32.62％ vs 3.45％,x2 =98.88),preterm birth (30.46％ vs 7.76％,x2=56.92),low birth weight infant (32.31％ vs 8.91％,x2 =57.07)and admission to neonatal intensive care unit (27.38％ vs 8.91％,x2 =39.16) and proportion of cesarean birth (62.77％ vs 21.55％,x2=117.64) in AC group were significantly higher than in NC group (all P＜0.01),except for the incidence of birth defect (4.62％ vs 2.59％,x2=2.01,P＞ 0.05).However,no significant differences was found in the above items when only singletons were compared between the two groups (P＞0.05),except for the cesarean section rate (61.18％ vs 22.03％,x2 =100.93,P＜0.01).There were no difference in any of the above neonatal outcomes when different assisted reproductive technologies applied were compared(in vitro fertilization-embryo transfer,intracytoplasmic sperm injection and frozen embryo transfer) (P＞0.05).Conclusions Neonatal outcome after assisted conception is a bit worse than natural conception,which might mainly due to the large proportion of multiple pregnancy after assisted conception.In order to improve neonatal outcome after assisted conception,the number of embryos transferred should be limited.
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A total of 1 107 Chinese women were retrospectively investigated for the effects of overweight and underweight on ovarian stimulation, as well as the outcomes of in vitro fertilization and embryo transfer (IVF-ET)treatment. It showed that overweight women required more ampoules of gonadotrophin [ (36. 87 ±11. 18 vs 33.57±10.96)/ampoule,P<0.01]and had lower peak of estradiol concentration [ (1 846.6±1 390.3 vs 2 337.2± 1 490.6)pg/ml,P<0.01].increased cycle cancellation due to insufficient follicle development(6. 5% vs 2. 8% , P<0.05) ,and a higher miscarriage rate( 10.5% vs 5.4% ,P<0.05)compared with normal weight women. But no differences were found in clinical pregnancy and live birth rates. Compared with normal weight women, underweight women showed no differences in ovarian stimulation and IVF outcome.
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Objective To perform a follow-up study on psychomotor development in children conceived with assisted reproductive technology. Methods A control-matched study was done including 63 infants born after assisted conception (study group)and 65 natural conception infants(control group). The pregnant women agreed to participate in the study when they were at 28 weeks of gestation and were followed-up in a predefine schedule till delivery. The regular developmental assessment was done with the CDCC Scales of Infant Development for the children of two groups till they were 24 months old. Results The mean birth weight and length were lower in the study group than those of the control group. The incidences of preterm birth,low birth weight,and NICU admission were significantly higher in the study group than those of control group. However,these differences were not significant when only singletons were compared between two groups. No statistical differences were found in the mental development index(MDI)and psychomotor development index(PDI)between two groups. Conclusions Psychomotor development of children born after assisted conception is normal at 24 months of age. Since the incidences of preterm birth,low birth weight,and multifetation are significantly higher in children born after assisted conception,their general health and development should be followed up for a longer time.
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Objective This study was designed to investigate the correlationship between plasma metastin and pathogenesis of adolescent women with polycystic ovary syndrome(PCOS).MethodsFrom Jan 2006 to Jun.2006.42 PCOS patients including 19 adolescent women and 23 adults with syndrome were treated in Second Affiliated Hospital of Sun Yat-Sen University.According to the range of age,those patients were divided into 19 cases in adolascent group(≤19 years)and 23 cases in aduh group(＞19 years).Meanwhile,20 adolescent women were matched as controls.Blood samples were collected between day 1 and day 5 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls.The Jevels of luteinizing hormone(LH)，follicle-stimulating hormone(FSH)，testosterone(T)，free T(FT)，dehydroepiandrosterone sulfate(DHEAS)，sex hormone-binding globulin(SHBG)，insulin，glucose，and metastin were detected from day 1 to day 5 of spontaneous bleeding or withdrawal bleeding by progesterone.On the next day,oral glucose tolerance test(75 g)and insulin release test were performed on those above patients and controls.The area under carve(AUC),the ratio of fasting blood glucose to insulin(GIR)and homeostasis model assessment insulin resistance jndex ( HOMA-IR)were calculated.Results(1)The level of hormone:the level of LH was in(12±7)U/L in adult group and(12±8)U/L in adolescent PCOS group，which were significantly higher than(6±4)U/L in controls(P＜0.05).The level of FT was(2.3±1.2)pmol/L in adult group，which was significantly higher than(1.3±0.8)pmol/L in adolescent group and(1.1±0.5)pmol/L in control roup(P＜0.05).It was observed that the level of(3.1±2.7)μmol/L in adolescent group was significantly lower than(6.3±2.7)μmol/L in control group(P＜0.05).Meanwhile,the level of FAI of 5.6±4.1 in adult group was significantly higher than 3.0±1.3 in control group(P＜0.05).No significant difference in FSH，T and SHBG levels among three groups were observed (P＞0.05).(2)Metastin and metabolism:Both the levels of fasting blood insulin,2-hour insulin and AUC of insulin were(13±7)mU/L，(88±59)mU/L and(133±80)mU·L-1·min-1 in adolescent group，which were significantly higher than(7±3)mU/L，(57±29)mU/L and(82±34)mU·L-1·min-1 in control group.The fasting blood insulin of(13±7)mU/L in adolescent group was significantly higher than (9±5)mU/L in adult group.The level of fasting blood glucose and 2-hour glucose were(5.01±0.44)mmol/L and(6.48±1.16)mmol/L in adult group，which were significantly higher than(4.68±0.29)mmol/L and(5.44±0.83)mmol/L in control group and(4.67±0.30)mmol/L and(5.93±1.44)mmol/L in adolescent group.The glucose AUC of(9.99±1.85)mmol·L-1·min-1 in adult group was significantly higher than(8.42±1.53)mmol·L-1·min-1 in control group(P＜0.05).HOMA-IR of 2.6±2.0 in adolescent group was significantly higher than 1.4±0.7 in control group.GIR of 10±8 in adolescent group was significantly lower than 16±10 in control group(P＜0.05).The metastin level of (0.25±0.19)pmol/L in adolescent group and(0.29±0.29)pmol/L in adult group were all significantly higher than(0.18±0.23)pmol/L in control group(PPh glucose were observed(r=0.256，0.286 and 0.267.P=0.044.0.025 and 0.043).Conclusions The expression of metastin in adolescent PCOS women was significantly higher that of normal adolescent women The increased level of metastin might be associated with pathogenesis of adolescent women with PCOS.