Factors associated with the incidence of ectopic pregnancy in women undergoing assisted reproductive treatment / 中华医学杂志(英文版)

BACKGROUND@#Ectopic pregnancy (EP) is a common complication in women undergoing assisted reproductive treatment, but the underlying causes for this remain unclear. This study aimed to explore factors affecting the incidence of EP in in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).@*METHODS@#This was a retrospective study on the incidence of EP in IVF/ICSI cycles between January 1, 2013 and December 31, 2017. Patient age, infertility diagnosis (tubal factor or not), primary or secondary infertility, type of cycle (frozen-thawed or fresh), type of embryo(s) transferred (cleavage embryo or blastocyst), number of embryos transferred (one, two, or three), previous history of EP, and endometrial combined thickness were analyzed to explore their relationships with the incidence of EP. Based on clinical typing results, the patients were divided into an EP group or a non-EP group. Categorical variables were analyzed using Chi-squared test or Fisher exact test. Logistic regression analysis was performed to explore their associations with the incidence of EP.@*RESULTS@#The percentage of patients with primary infertility in EP group was significantly lower than that in non-EP group (31.3% vs. 46.7%, χ = 26.032, P < 0.001). The percentage of patients with tubal infertility in EP group was also significantly higher than that in non-EP group (89.2% vs. 63.6%, χ = 77.410, P < 0.001). The percentages of patients with transfer of cleavage-stage embryo or blastocyst (91.4% vs. 84.4%, χ = 10.132, P = 0.001) and different endometrial combined thickness (ECT) (χ = 18.373, P < 0.001) differed significantly between EP and non-EP groups. For patients who had a previous history of one to four EPs, the percentage of patients undergoing transfer of a cleavage-stage embryo was significantly higher in EP group than that in non-EP group (92.2% vs. 77.6%, χ = 13.737, P < 0.001). In multivariate logistic regression analysis, tubal infertility was strongly associated with EP (adjusted odds ratio: 3.995, 95% confidence interval: 2.706-5.897, P < 0.001).@*CONCLUSIONS@#In IVF/ICSI cycles, transfer of a blastocyst-stage embryo, especially for patients with a previous history of EP, reduced the rate of EP. Tubal infertility was strongly associated with EP.

A frozen-thawed embryo transfer program improves the embryo utilization rate / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Frozen-thawed embryo transfer (FET) is the most common way to prevent serious late ovarian hyperstimulation syndrome and increase the cumulative pregnancy rate. We evaluated the effectiveness of an FET program for improving the embryo implantation and clinical pregnancy rates, and ultimate embryo utilization rate in infertility treatment.</p><p><b>METHODS</b>Patients undergoing in vitro fertilisation (IVF) cycles from January 2006 to June 2008 were enrolled, including 179 patients who had undergone the first FET cycle after controlled ovarian hyperstimulation (COH) in which all embryos were frozen (group C1) and 1306 patients who had COH with fresh embryo transfer (ET) (group T1). Logistic regression was used to model the embryo implantation and clinical pregnancy rates based on the mother's age, numbers of oocytes retrieved, embryos transferred and high-quality embryos transferred. The embryo implantation and clinical pregnancy rates were also compared between two groups after adjusting for age, the numbers of oocytes retrieved and the numbers of embryos transferred.</p><p><b>RESULTS</b>Logistic regression analysis confirmed that embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than those in group T1 after adjusting for confounding factors (43.6% vs 29.0%, 63.1% vs 47.0%, respectively; P < 0.01). The embryo implantation and clinical pregnancy rates were consistently higher in group C1 by comparing the age groups >or= 35 or < 35 years. The clinical pregnancy rates for the numbers of oocytes retrieved per cycle being >or= 15 or < 15 were higher in group C1, as was the embryo implantation rate. These differences were statistically significant for oocyte numbers >or= 15 (P < 0.05). The embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than in group T1 when two or three embryos were transferred (P < 0.05).</p><p><b>CONCLUSION</b>A program of freezing all embryos and performing FET improved the rates of embryo implantation and clinical pregnancy, and ultimately enhanced the embryo utilization rate.</p>

Study on the function of decoction for invigorating the kidney and improving blood circulation to thrombosis on rabbit blood stasis model / 中国中药杂志

<p><b>OBJECTIVE</b>To evaluate the effect of decoction for invigorating the kidney and improving blood circulation to thrombosis and pathology on rabbit blood stasis model.</p><p><b>METHOD</b>Thirty rabbits were ramdomly divided into normal group, model group, high dose group, low dose group and Xue Shuan Ning group. Tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI), fibrinogen (Fbg) and D-dimer (DD) were investigated after those rabbits had been treated. One rot was solected randomly from each group to observe pathological changes.</p><p><b>RESULT</b>There were significant differences in t-PA, PAI, Fbg and DD between normal group and other groups is very obvious (P < 0.01) . Between groups of high dose low dose Xue Shuan Ning and model, the statistical differeces were significant, as well as between groups of high dose, low dose and Xue Shuan Ning groups (P < 0.05). However, there was no statistical difference between high dose group and high dose group (P > 0.05). The pathological changes in model group were most serious, those in Xue Shuan Ning were less serious. There were slight pathological changes in high dose group and low dose group.</p><p><b>CONCLUSION</b>Models ware made successfully. High dose group and low dose group have stronger effect on thrombosis than Xue Shuan Ning group.</p>

Study on function of decoction for invigorating the kidney and improving blood circulation on rabbits blood stasis model / 中国中药杂志

<p><b>OBJECTIVE</b>To evaluate the effect of decoction for invigorating the kidney and improving blood circulation to thrombosis on rabbits blood stasis model.</p><p><b>METHOD</b>Thirty rabbits were randomly divided into normal group, model group, heavy dose group, slight dose group and xue shuan ning group. Tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI), fibrinogen (Fbg) and D-dimer (DD) were investigated after those rabbits had been treated. One was selected randomly from each group to observe pathological changes.</p><p><b>RESULT</b>There was significant difference in t-PA, PAI, Fbg and DD between normal group and other groups (P < 0.01). Among groups of heavy dose, slight dose, xue shuan ning and model, the statistical differences were significant, as well as among groups of heavy dose, slight dose and xue shuan ning (P < 0.05). However, there was no statistical difference between heavy dose group and slight dose group (P > 0.05). The pathological changes in model group were most serious, and those in xue shuan ning were less serious. There were slight pathological change in heavy dose group and light dose group.</p><p><b>CONCLUSION</b>Models were made successfully. Heavy dose group and slight dose group have stronger effect on thrombosis than xue shuan ning group.</p>

The study of yi-shen-huo-xue fang's effects on expression of GMP-140 and cleaning out the oxygenic free radicle on rabbits blood stasis model / 中国中药杂志

<p><b>OBJECTIVE</b>To evaluate the effects of Yi-Shen-Huo-Xue Fang on expression of GMP-140 and cleaning out the oxygenic free radicle on rabbits blood stasis model.</p><p><b>METHOD</b>Thirty rabbits were divided randomly into five groups as the normal group, model group, large dose of "Yi-Shen-Huo-Xue Fang" group, small dose of "Yi-Shen-Huo-Xue Fang" group and "Xue-Shuan-Xin-Mai-Ning" group. After being treated respectively, granule membrane protein 140(GMP-140), erythrocyte sueroxide dismutase (E-SOD), erythrocyte lipid peroxide(E-LPO), plasma lipid peroxide(P-LPO) were checked up.</p><p><b>RESULT</b>The GMP-140, E-SOD, E-LPO, P-LPO in normal control were compared with those in model groups, With the difference(P < 0.01), model control group was compared with large dose group and small dose group (P < 0.01), with "Xue-Shuan-Xin-Mai-Ning" group(P < 0.05), large dose group was compared with "Xue-Shuan-Xin-Mai-Ning" group(P < 0.05), and large dose group were compared with small dose group (P > 0.05).</p><p><b>CONCLUSION</b>The model was made successfully. Large dose group, small dose group and "xue-shuan-xin-mai-ning" group can inhibit expression of GMP-140, enhence SOD activity and decrease LPO content on blood stasis rabbit model. Large dose group and small dose group have stronger effect than "xue-shuan-xin-mai-ning" group.</p>