ABSTRACT
Objective The study compared the clinical outcomes among cleavage stage embryo transfer,two-step embryo transfer and blastocyst transfer in frozen-thawed cycles.To provide the clinical guidance for the patients with repeated implantation failure(RIF) to make a appropriate embryo transfer protocol.Methods In this retrospective study,a total of 252 patients with RIF were undergoing the frozenthawed embryo transfer (FET) treatment.They were divided into cleavage stage embryo transfer group (group A),two-step embryo transfer group (group B) and blastocyst transfer group (group C) according to the transfer protocols.Groups were compared including implantation rate,clinical pregnancy rate,live birth rate,miscarriage rate,multiple pregnancy rate and ectopic pregnancy rate.Results (1) There were no significant differences among three groups in age,infertility duration,infertility type,endometrial preparation protocols and embryo resuscitation rate.The rate of optimal embryo after resuscitation of group B was lower than that of group A (72.46％ vs 81.50％),showing significant differences (P'＜ 0.0125),but no significant difference were found between group B and C (72.46％ vs 77.42％),A and C (81.50％ vs 77.42％) (P'＞ 0.0125).(2) The implantation rate of embryos in group C was significantly higher than that in group A (38.46％ vs 21.61％) (P'＜0.0125),and there were no significant difference between group B and C (26.85％ vs 38.46％),A and B (21.61％ vs 26.85％).The clinical pregnancy rate of group B was significantly higher than that of group A (62.50％ vs 45.09％) (P'＜0.0125),and there were no significant differences between the others.No statistically differences existed in regard to the live birth rate among three groups,but the group B than the group A (50.00％ vs 35.71％),the group B than the group C (50.00％ vs 34.62％) showed an increasing trend.(3) No statistically differences existed in regard to abortion and multiple pregnancy rate among three groups (P ＞ 0.05).No case of ectopic pregnancy occurred in group B and group C,while in the group A,there were 7 cases of ectopic pregnancy.Conclusions For RIF patients,two-step embryo transfer and blastocyst transfer are relatively safe and effective transplants in frozen-thawed cycles compared to cleavage embryo transfer.
ABSTRACT
<p><b>OBJECTIVE</b>This study investigated the effect of catheter-based renal sympathetic denervation (RDN) in pigs with rapid pacing induced heart failure.</p><p><b>METHODS</b>Heart failure was induced by rapid right ventricular pacing in 12 pigs and pigs were randomly divided into RDN group (n = 6): pacing+RDN at 7 days post pacing; control group (n = 6): pacing only. Echocardiography examination (LVEF, LVEDD and LVESD) was performed before pacing and at 1 and 2 weeks post pacing. Serum biochemical markers including renin, aldosterone and creatinine were also measured at baseline, 1 and 2 weeks after pacing. Repeated renal artery angiography was performed at 1 week after RDN. All pigs were sacrificed to examine the heart and renal pathology and renal artery sympathetic nerve staining at 2 weeks post pacing.</p><p><b>RESULTS</b>LVEF decreased 1 week after rapid pacing from (60.5 ± 6.0)% to (35.3 ± 9.8)%. LVEF was significantly higher [(42.8 ± 5.9) % vs. (33.4 ± 9.7)%, P = 0.001 8] while LVESD was significantly lower [(28.4 ± 3.7) mm vs. (33.0 ± 2.0) mm, P = 0.001 6] in the RDN group than in the control group at 2 weeks post pacing. At 2 weeks after pacing, plasma concentrations of renin and aldosterone were significantly lower in RDN group compared to the control group (all P < 0.05) . Kidney function and blood pressure were comparable between the two groups at 2 weeks post pacing. There were no signs of renal damages such as renal artery stenosis, dissection and thrombus in all pigs after 2 weeks pacing. Sympathetic neurons of adventitia were injured in RND group.</p><p><b>CONCLUSION</b>RDN could significantly improve cardiac function and attenuate left ventricular remodeling via inhibiting renin-angiotensin-aldosterone system in this pacing induced pig heart failure model.</p>