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ObjectiveTo compare the effects of single sperm cryopreservation and conventional cryopreservation on embryo culture and pregnancy in patients undergoing microdissection testicular sperm extraction （micro-TESE）. MethodsA retrospective analysis was done on the patients who underwent micro-TESE at the Reproductive Medicine Center in the Sixth Affiliated Hospital of Sun Yat-Sen University between January 2018 and December 2021. The single sperm cryopreservation group included 39 patients undergoing single sperm cryopreservation and 307 MII oocytes. The conventional cryopreservation group included 39 patients undergoing conventional cryopreservation and 410 MII oocytes. Propensity score matching （PSM） was performed to balance the selection bias. The fertility rate， embryo culture and pregnancy of these two groups were compared. ResultsThere was no statistical difference in age， body mass index （BMI）， years of infertility， basal FSH， basal LH， basal E2， AMH， AFC， number of oocytes retrieved and number of transferred embryos between the two groups （P>0.05）. No significant difference was found in fertilization rate （65.8% vs. 60.49%）， available embryo rate （67.82% vs. 58.87%） and high-quality embryo rate （70.80% vs. 75.34%）. The single sperm cryopreservation group had significantly lower clinical pregnancy rate than conventional cryopreservation group （45.45% vs. 70.0%， P=0.049）. ConclusionIf the patients undergoing micro-TESE have very few sperms， single sperm cryopreservation could be an effective choice to increase the utilization of each sperm and ensure the subsequent sperm retrieval after thawing， but the clinical pregnancy rate is decreased. Due to the limited number of cases， we need a large additional number of cases to observe and analyze.
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ObjectiveTo compare the effects of two different insemination methods， conventional in vitro fertilization （IVF） and intracytoplasmic sperm injection （ICSI）， on pregnancy outcomes in patients with frozen-thawed D6（day 6） blastocyst transfer. MethodsA retrospective cohort study was conducted to analyze the clinical data of patients with thawed D6 blastocyst transfer between January 2018 and April 2020 at the Fertility Center of the Third Hospital of Sun Yat-sen University， divided into conventional IVF group （446 cycles ） and ICSI fertilization group （200 cycles） according to the fertilization method. Patients were divided into those with a history of D5（day 5） blastocyst transfer and those without. The patients’ general characteristics， blastocyst quality， and pregnancy outcomes of the two groups were compared. ResultsBMI， years of infertility， and basal FSH were not statistically significant in the IVF and ICSI groups （P > 0.05）. Regardless of the history of D5 transfer， patients in the ICSI group were younger than those in the IVF group （P < 0.001）， the proportion of primary infertility was significantly higher in the ICSI group （P < 0.001）， and the number of oocytes obtained and the number of normally fertilized oocytes in the ICSI group were higher than those in the conventional IVF fertilization group （P < 0.001）. The proportion of stage V and Ⅵ blastocysts was significantly higher in the conventional IVF group than in the ICSI group （21.6 % vs. 3.14 %， P < 0.001）. High-quality blastocysts with an ICM score of A were significantly higher in the ICSI group than in the IVF group （23.8 % vs. 14.3 %， P = 0.01）. The HCG-positive and clinical pregnancy rates were significantly higher in the ICSI group than in the IVF group （65.5 % vs. 48.4 %， P < 0.001； 56 % vs. 41.3 %， P = 0.001）， and embryo implantation and live birth rates were also higher in the ICSI group than in the conventional IVF group （43.8 % vs. 30.9 %， P < 0.001； 43.0 % vs. 31.8 %， P = 0.006）. After correcting for age and number of oocytes obtained between the two groups， the clinical pregnancy rate was still significantly higher in the ICSI group than in the conventional IVF group （OR： 1.590， 95 % CI： 1.030， 2.455， P = 0.036）. Infant birth weight was lower in the ICSI group than in the IVF group （P = 0.016）， and the differences in preterm birth rate， sex ratio， and mode of delivery were not statistically significant between the two groups. ConclusionsClinical pregnancy and live birth rates after thawing and transfer of D6 blastocysts fertilized by ICSI are higher than those of D6 blastocysts fertilized by conventional IVF， which may be related to the different factors contributing to the slow development of blastocysts in patients who received different fertilization methods. The relatively good pregnancy outcome after the transfer of thawed D6 blastocysts fertilized by ICSI may compensate to some extent for the difference in pregnancy outcome due to the relatively slow blastocyst development and a relatively higher proportion of D6 blastocysts after ICSI fertilization in male infertility patients.
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【Objective】 To observe the effects of paternal age on the pregnancy outcomes in frozen embryo transfer (FET) cycles. 【Methods】 The clinical data of two groups after propensity score matching (PSM) were retrospectively analyzed, including 738 cycles in the 0.05). The clinical pregnancy rate (52.2%vs. 67.2%) and live birth rate (41.1% vs. 57.2%) decreased in the 40-60 year group compared with those in the 0.05). 【Conclusion】 Advanced paternal age decreases clinical pregnancy rate and live birth rate.
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ObjectiveTo evaluate the effect of Wenshen Yangxue prescription （WSYX） on the outcome of in vitro fertilization-embryo transfer （IVF-ET） in poor ovarian responders and the safety. MethodA total of 116 eligible patients who were admitted to Beijing Obstetrics and Gynecology Hospital in June 2016-June 2019 were randomized into the experimental group and the control group with random number table method （58 in either group）. Conventional controlled ovarian hyperstimulation （COH） was directly implemented in the control group， while the experimental group was intervened with WSYX for 3 menstrual cycles before the COH. The pregnant patients were observed till childbirth and the non-pregnant patients for 12 months. Gonadotropins （Gn） dosage and the days of use were recorded. Serum levels of follicle-stimulating hormone （FSH）， basal FSH （bFSH）， basal luteinizing hormone （bLH）， and basal estrogen （bE2）， endometrial thickness， and antral follicle count （AFC） before and after treatment were measured. The serum levels of estrogen （E2）， progesterone （P）， and luteinizing hormone （LH） on the day of human chorionic gonadotropin （HCG） injection， and levels of FSH， LH， E2， testosterone （T）， and P in follicular fluid 36 h after HCG injection were determined. Number of fertilization， rate of fertilization， number of high-quality embryos， cycle cancellation rate， clinical pregnancy rate， and live birth rate were evaluated. The traditional Chinese medicine （TCM） syndrome scores before and after treatment were recorded. Liver and kidney functions were detected before and after treatment， and adverse reactions during treatment were recorded. ResultCompared with the control group， the experimental group showed the decrease in the days of Gn use and dosage of Gn （P<0.05）， endometrium thickening （P<0.05）， and increase in oocytes obtained， levels of E2 and LH on the day of HCG injection， and ovarian reserve function. Moreover， in follicular fluid 36 h after HCG injection， the reduction in level of FSH （P<0.05）， rise of levels of LH and E2 （P<0.05）， and insignificant changes in levels of T and P in the experimental group were observed as compared with those in the control group. In addition， larger number of fertilization， more available embryos， and higher rate of high-quality embryos were observed in the experimental group than in the control group （P<0.05）. The experimental group demonstrated improvement in quality of oocytes， decrease in cycle cancellation rate ， and increase in clinical pregnancy rate and live birth rate compared with the control group. The TCM syndrome score in experimental group was decreased after treatment compared with that before treatment （P<0.05）. No serious adverse reactions occurred in two groups during treatment and the safety indexes before and after treatment were all within the normal ranges. ConclusionWSYX can reduce the use duration and dosage of Gn in infertile patients receiving IVF-ET， improve the quality of oocytes， increase the rate of high-quality embryos， and improve the pregnancy outcome of IVF-ET patients.
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OBJECTIVES@#To identify, examine and summarize the available evidence on the effectiveness and safety of acupuncture for in vitro fertilisation (IVF) outcomes.@*METHODS@#Eight electronic databases, including PubMed, EMBASE, Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Database and VIP Database, were searched, supplemented by manual searches. Two researchers independently conducted the literature screening, data extraction, and methodological quality assessments. A narrative description was provided to show the general information and specific characteristics of the included studies. A bubble plot was used to visually display the overall effects of acupuncture on IVF outcomes.@*RESULTS@#Eighty-two studies were identified, including 64 primary studies and 18 systematic reviews. Transcutaneous electrical acupoint stimulation, electric acupuncture and manual acupuncture were applied in most studies and compared with no acupuncture, sham acupuncture and placebo acupuncture control groups. Sixty-three (98.4%) primary studies reported clinical pregnancy rate, and positive effects of acupuncture were found in 34 studies (54.0%). Live birth rate was reported in only 18 (28.1%) primary studies, of which 10 (55.6%) showed positive results. In addition, only 8 and 2 systematic reviews showed that acupuncture could increase clinical pregnancy events and live birth events, respectively. However, none of these reviews was of high methodological quality.@*CONCLUSIONS@#Available evidence suggests that acupuncture therapy could improve clinical pregnancy rates. However, whether acupuncture could increase live birth events was difficult to determine based on the few studies that have reported this outcome indicator. Furthermore, the methodological quality of most systematic reviews was assessed as critically low or low. Studies with a rigorous design and standardized implementation should be performed to refine the available evidence.
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Female , Humans , Pregnancy , Acupuncture Therapy/methods , China , Fertilization in Vitro , Pregnancy RateABSTRACT
Objective@#To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) based on the available clinical evidence.@*METHODS@#We searched PubMed, MEDLINE, EMBASE, Cochrane Library, CNKI, VIP, CBM and Wanfang Database up to February 2021 for published randomized controlled trials (RCT) relevant to TEAS for the improvement of the pregnancy outcomes of IVF-ET. We performed literature screening, data extraction and quality evaluation according to the inclusion and exclusion criteria, followed by a meta-analysis with the RevMan 5.3 software.@*RESULTS@#A total of 2 206 cases of IVF-ET from 9 RCTs were included, 1 018 in the TEAS group and 1 188 in the control. The clinical pregnancy rate was significantly higher in the TEAS than in the mock TEAS and non-TEAS control groups (RR = 1.85, 95% CI: 1.42－2.42, P < 0.001; RR = 1.23, 95% CI: 1.10－1.39, P = 0.0004), and so was it before and after oocyte retrieval (RR = 1.50, 95% CI: 1.03－2.17, P = 0.03; RR = 1.47, 95% CI: 1.12－1.92, P = 0.005). The TEAS group also showed dramatically improved embryo implantation rate (RR = 1.49, 95% CI: 1.24－1.79, P < 0.0001) and live birth rate (RR = 1.44, 95% CI: 1.04－1.98, P = 0.03) compared with the control.@*CONCLUSIONS@#As a safe and non-invasive treatment, TEAS can significantly improve the pregnancy outcomes of IVF-ET, with definite effectiveness. /.
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Female , Humans , Pregnancy , Acupuncture Points , Embryo Transfer , Fertilization in Vitro , Pregnancy Outcome , Randomized Controlled Trials as TopicABSTRACT
Background: Elective frozen embryo transfer (FET), has recently increased significantly with improvements in cryopreservation techniques. Observational studies and randomized controlled trials suggested that the endometrium in stimulated cycles is not optimally prepared for implantation; risk of ovarian hyperstimulation syndrome reduced and pregnancy rates increased following FET and perinatal outcomes are less affected after FET. However, the evidence is not unequivocal and recent randomised control trials challenge the use of elective FET for the general IVF population. Pregnancy rates were analysed in a cohort of patients undergoing embryo transfers.Methods: This was a retrospective cohort study of patients who underwent embryo transfers from April 2018 to March 2019 at study centre in Surat.175 cycles of embryo transfers (119 fresh and 56 frozen) were included in the study. Outcomes measured were positive pregnancy, clinical pregnancy and ongoing clinical pregnancy rates achieved in the IVF-ET cycles.Results: There were no statistically significant differences between positive pregnancy rate (54.6% versus 60.7%, Odds ratio (OR) 0.78; 95% Confidence Interval (CI) 0.41-1.49), clinical pregnancy rate (48.73% versus 57.14%, OR 0.52; 95% CI 0.1- 2.64) and ongoing clinical pregnancy rate (45.38% versus 51.78% OR 1.4; 95% CI 0.29 - 6.67) in fresh ET and FET cycles, respectively, p < 0.05 was considered statistically significant for all measures.Conclusions: Despite the observed higher rates of positive biochemical, clinical and ongoing clinical pregnancy per transfer in the FET cohort, these did not reach statistical significance. Thus, both transfer strategies are reasonable options, although there is a trend favouring the freeze-all strategy.
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Objective:To explore the clinical efficacy of Yangjing Zhongyu Tang in treating kidney-Yin deficiency due to repeated implantation failure (RIF). Method:Totally 70 patients with kidney yin deficiency due to repeated implantation failure (RIF) who received the periodic Frozen thawed embyo (FET) after in vitro fertilization (IVF) embryo cryopreservation were selected from the Integrative Medicine Reproductive and Genetics Center of Affiliated Hospital of Shandong University of Traditional Chinese Medicine(TCM). They were randomly divided into observation group and control group, with 35 cases in each group. All patients were received long protocol controlled ovarian hyperstimulation. Observation group was given Yangjing Zhongyu Tang from the 5th day to the 14th day of the menstrual cycle 1 month before transplantation, and continued to take it on the 5th day of the menstrual cycle in the month of the transplantation. Control group did not given TCM. After treatment, TCM syndrome scores, endometrial thickness, typing, uterine artery pulsation index (PI) and resistance index (RI) of HCG, endometrial secretion leukemia inhibitory factor (LIF), blood vessels endothelial growth factor (VEGF), interleukin-1β (IL-1β) and monocyte chemoattractant protein-1 (MCP-1), number of eggs obtained, fertilization rate and embryo transfer results were observed. Result:After treatment, the scores of TCM syndromes in observation group were significantly improved, with statistically significant difference (PPPβ and LIF of observation group were higher than those of control group, and the MCP-1 was lower than that of control group (PPConclusion:Yangjing Zhongyu Tang can significantly alleviate the clinical symptoms of patients with kidney-Yin deficiency due to RIF, effectively improve the type A endometrial morphology of RIF patients, reduce the uterine artery blood flow resistance, optimize endometrial implantation, and significantly improve the clinical pregnancy rate.
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Background:@#Estradiol, as an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization embryo transfer (IVF-ET) cycles. The aim of this retrospective study was to evaluate the association between elevated serum estradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and IVF-ET pregnancy and birth outcomes.@*Methods:@#A total of 1771 infertile patients with their first fresh IVF-ET cycles were analyzed retrospectively between January 2011 and January 2016 in Peking University First Hospital. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 205), group 2 (serum E2 levels 1001–2000 pg/mL, n = 457), group 3 (serum E2 levels 2001–3000 pg/mL, n = 425), group 4 (serum E2 levels 3001–4000 pg/mL, n = 310), group 5 (serum E2 levels 4001–5000 pg/mL, n = 237), and group 6 (serum E2 levels > 5000 pg/mL, n = 137). The retrieved oocyte and MII oocyte numbers and implantation and clinical pregnancy rates of the groups were compared as the first objective of the study. For the 360 women with singleton births among all patients, the area under the corresponding receiver operating characteristic curve (ROC curve) was calculated to assess the predictive value of the E2 change for the probability of low birth weight (LBW) infants as the second objective.@*Results:@#The retrieved oocyte and MII oocyte numbers and implantation and clinical pregnancy rates gradually increased from groups 1 to 5 but decreased in group 6. The parameters of group 1 were statistically worse than those of the other groups, from group 2 to group 6 (the number of retrieved oocytes, t = 13.096, t = 23.307, t = 23.086, t = 26.376, t = 19.636, P < 0.003; the number of retrieved MII oocytes, t = 10.856, t = 20.868, t = 21.874, t = 23.374, t = 19.092, P < 0.003; the implantation rate, χ2 = 12.179, χ2 = 22.239, χ2 = 23.993, χ2 = 23.344, χ2 = 16.758, P < 0.003; the clinical pregnancy rate, χ2 = 16.415, χ2 = 28.074, χ2 = 35.387, χ2 = 37.025, χ2 = 24.590, P < 0.003). ROC analysis revealed that when a serum peak E2 of 3148 pg/mL was used to predict LBW.@*Conclusions:@#The results indicate that serum E2 levels have a concentration-dependent effect on clinical outcomes. The optimal range of the E2 level during a fresh IVF-ET cycle is 1000 to 3148 pg/mL.
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Objective The embryonic development is usually observed for 5-6 days during the process of embryo culture in most embryonic laboratories.The article aimed to explore the application of D 6+D7 frozen-thawed blastocyst transfer in patients with di -minished ovarian reserve(DOR). Methods Retrospective analysis was conducted on 285 patients with DOR who were treated with in-vitro fertilization and embryo transfer (IVF-ET) in our center from 2015 to 2017.Frozen embryos were harvested from the natural cycle , mini-stimulation protocol, ovulation induction during the luteal phase , followed by frozen-thawed embryo transfer with a total of 442 cycles. The frozen embryos were divided into cleavage embryo group and blas -tocyst group according to different life stages , and comparison was made in general data and pregnancy outcome between the two groups .The blastocyst transfer group was subdivided into Day 5 group and Day6+Day7 group followed by the comparison of different pregnancy outcome between the two groups . Results Patients with DOR were treated with frozen-thawed blastocyst transfer with 291 cycles in cleavage embryo group and 151 cycles in blastocyst group.The implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of blastocyst group were significantly higher than those of cleavage embryo group ( 44.62％ vs 22.46％, 50.33％ vs 33.33％, 37.75％ vs 21.65％, P<0.05) and the abortion rate of blastocyst group was significantly lower than that of cleavage embryo group (35.05％ vs 25％, P<0.05).As to the frozen blastocyst transplantation cycle , the number of D5 blastocysts was 69, and D6+D7 blastocyst was 76. The embryo planting rate, clinical pregnancy rate, continued pregnancy rate and abortion rate of D 6+D7 group were higher than those of D5 group(39.74％ vs 50％, 44.93％ vs 55.26％, 34.78％ vs 39.47％, 22.58％ vs 28.57％), but the difference was of no statistical significance(P>0.05). Conclusion In patients with DOR, the transplanted blastocyst can significantly improve the pregnancy out -come, increase the clinical pregnancy rate and reduce the abortion rate .The embryo planting rate and clinical pregnancy rate of the transplanted D6+D7 blastocyst were higher than those of D 5 blastocyst, but the difference was not statistically significant .The abortion rate was also increased.Therefore, when the number of embryos is limited, patients with DOR may consider transplanting D 6+D7 high-quality blastocysts in order to get a certain clinical pregnancy rate .
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Objective To estimate the effect of blastocysts morphological score on pregnancy outcomes and neonate′s condition in vitrified-warmed single-blastocyst transfer cycles. Methods A retrospective analysis of 586 cycles of vitrified-warmed single-blastocyst transfer from Mar. 2010 to Feb.2016 was performed and the influ-ence of day of vitrification,inner cell mass(ICM)and trophectoderm(TE)scores on pregnancy outcomes and neo-nate′s condition were observed. Results There were no significant differences in clinical pregnancy rate,birth weight and sex ration of newborn between different vitrification day,ICM score and TE score.The day of vitrifica-tion and ICM score can significantly influence pregnancy loss rate,and were the two primary predictors of pregnan-cy loss rate. Vitrification day,ICM score and TE score exerted significant influence on live birth rate(P < 0.05) and TE score was the primary factor of live birth rate. Conclusions Day 5 vitrified blastocysts with higher quality of ICM and TE can provide high live birth rate and low pregnancy loss rate,but it could not predict the weight and gender of the newborn.
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Objective To explore ICSI treatment process in the different proportion of oocytes maturation and dosage of gonadotropin affecting embryo quality and clinical outcome. Methods From Jan. to Dec. 2015,we retrospectively analyzed the patients from the center line of ICSI cycle ,divided them into three groups according to the maturity of oocytes. The 3 groups were due to maturity rate of oocytes in 50% in group A(n = 19),50% 0.05). Group A had the best egg rate,high quality embryo rate,clinical pregnancy rate than the other two groups (P < 0.05). In pregnancy and non-pregnancy groups ,the dosage of gonadotropin in the non-pregnancy group was obviously higher than that in the pregnancy group in oocyte maturation in the same proportion interval(P<0.05). Conclusion In ICSI treatment process,the high dose of gonadotropin and rising rates of oocytes maturation are not conducive to the development potential of the egg and clinical outcome,so the dose of gonadotropin and oocyte maturation ratio should be controlled in a certain range to collect and protect the best dominant egg which matches to the state of the patient.
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Objective To investigate the influence of atosiban on the pregnancy outcome in patients with repeated implantation failure(RIF)in blastcyst thawed embryo transfer(bTET) Methods From January 2014 to December 2015,a total of 262 RIF patients undergoing bTET were retrospectively studied. They were divided into study group with a single bolus dose (6.75 mg/0.9 mL,iv) of atosiban before bTET (n = 94),and control groupwithout atosiban(n = 168). Results The clinical pregnancy rate(57.41%),implantation rate(38.41%) and living-birth rate(46.81%) of study group were significantly higher than those of control group (41.12%, 28.32% and 33.93% respectively;P 0.05). Conclusion Atosiban treatment before embryo transfer may improve pregnancy outcomes of RIF patients in bTET.
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[Objective]To determine whether all-blastocyst-culture can benefit elderly infertile patients with low ovarian reserve.[Methods]To retrospectively analyze elderly patients with low ovarian reserve undergoing IVF/ICSI in Reproductive Medicine Re?search Center of the Sixth Affiliated Hospital of Sun Yat-sen University from May 2016 to April 2017.We divide them into group A (All-blastocyst-culture)and group B(None-blastocyst-culture)based on different culture approach of D3 transferrable embryo. To compare the cumulative biochemical pregnancy rate ,cumulative clinical pregnancy rate between them.[Results]A total of 231 eligi?ble patients are included,with130 in group A and 101 in group B. The basic conditions of the two groups show no difference. Cumula?tive biochemical pregnancy rate/clinical pregnancy rate in group A is higher than that of group B ,though the difference is not statisti?cally significant(P>0.05). After removing patients who did not undergo embryo transfer due to failure in blastocyst culture ,the cumu?lative biochemical pregnancy rate/clinical pregnancy rate in group A is significantly higher than group B(P<0.05). Multivariate analy?sis of the patient′s basic condition and the outcome of blastocyst culture showed that the number of D3 transferrable embryo was a risk factor for the failure of blastocyst culture(OR=0.277,95%CI:0.103~0.744,P<0.05).[Conclusion]All-blastocyst-culture will not adversely affect the pregnancy outcome of elderly infertile patients with low ovarian reserve. On the contrary ,once they obtain transfer?rable embryos, pregnancy outcome in All-Blastocyst-Culture group are better than None-Blastocyst-Culture group. A small number of D3 transferrable embryo is a risk factor for failure to culture blastocyst. If the patients were fully informed consent ,we can consider implementing all-blastocyst-culture for elderly infertile patients with low ovarian reserve.
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Background: The objective of this retrospective study was to compare the efficacy of slow freezing and Vitrification for the cryopreservation of supernumerary cleavage stage embryos on day 3 after IVF and its impact on clinical outcome. Methods: 485 supernumerary embryos of IVF cycles (from Oct 2011 to Dec 2012) were cryopreserved by slow freezing method while 502 embryos (from Jan 2013 to April 2014) by Vitrification method. 362/485 and 230/502 embryos were thawed for FET cycles (65 patients in each group).After warming the survival rate, post warmed embryo morphology, clinical pregnancy and implantation rates were evaluated and compared between the two groups. Results: There were 65 frozen thawed cycles in each group. The percentage of excellent and good morphology embryos before cryopreservation were same in both the groups, but after thawing the results were significantly in favour of Vitrification as compared to Slow freezing. In Vitrification group versus Slow freezing group, the different outcomes were survival rate (96.95% vs. 69.06%, p-0.000), post warmed excellent morphology embryos (94.17% vs. 60.8%, p-0.000) clinical pregnancy rate (41.53% vs. 21.53%, p-0.043) and the implantation rate (14.41% vs. 7.01%, p-0.024). Conclusions: Vitrification is a promising alternate to the conventional slow freezing method in terms of not only excellent survival and post warmed excellent morphology embryo rate but also higher clinical pregnancy and implantation rate.
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Objective To analyze the influential factors of clinical pregnancy rate of the frozen-thawed embryo transplantation. Methods The data of 3 192 FET patients in the reproductive medicine center of our hospital up to May 2014 were analyzed retrospectively. According to ages, reasons of infertility, types of infertility, duration of infertility, drug regimen, the number and the time of embryo transplantation, we divided these patients into six groups for comparing the clinical pregnancy rate. Results The FET clinical pregnancy rate of the under 35 years group was higher than the 35~39 years group and the over 39 years group (33.96%vs. 27.58%and 19.35%; P<0.05, respectively). The duration of infertility in the clinical pregnancy group was significantly shorter than the non-pregnancy group (P<0.05). The clinical pregnancy rate in the group with three embryos transplanted was higher than the group with only two embryos transplanted (41.01% vs. 28.75%; P < 0.05). Among the group with the age of over 40 years, those with three embryos transplanted had a higher clinical pregnancy rate than those with only one embryo transplanted (25.49% vs. 0.00%; P < 0.05). The clinical pregnancy rate of the frozen blastocyst transplantation group was higher than that of the cleavage-stage transplantation group (40.00%vs. 26.27%;P<0.05). Conclusion Age, infertility duration, the number and the time of frozen embryo transplantation may affect the clinical pregnancy rate among the FET patients. An individualized transplantation program based on age may improve the patient′s clinical pregnancy rate.
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Objective To estimate the clinical value of 4 methods of endometrium preparation for frozen‐thawed embryo transfer(FET ) cycle .Methods Total 320 FET cycles completed in center of reproductive medicine of Qingyuan people′s hospital from March 2013 to March 2015 were retrospectively analyzed ,and divided into 4 groups :natural cycle group(group A ,n=70) ,o‐vulation‐inducing cycle group(group B ,n=152) ,hormone replacement treatment(HRT) cycle group (group C ,n=74) ,down‐regu‐lated HRT cycle (group D ,n=24) .The pregnancy outcomes were followed and compared among these different 4 groups .Results In FET cycles ,the clinical pregnancy rates and implantation rates of group B ,group C and group D were significantly higher than that of group A (P0 .05) .However ,the rank of the FET cycle of group D was significantly higher than those of the other three groups(P<0 .05) .Conclusion In FET cycles ,the methods of ovulation‐inducing ,HRT and down‐reg‐ulated HRT all have favorable clinical outcomes ,and the method of down‐regulated HRT is more suitable for patients with previous implantation failure .
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Objective To confirm the correlation between pre or post processing semen parameters and clinical pregnancy rate in infertile couples with male factors undergoing intrauterine insemination (IUI) .Methods The pregnancy rate based on ovulation in‐ducing agent in infertile couples with male factors infertility per the 2010 world health organization criteria treated with IUI was e‐valuated .One hundred and twenty eight cycles were divided into pregnant group (16 cycles) and non‐pregnant group(112 cycles) . The pre or post processing semen parameters were retrospectively evaluated .Results The overall pregnancy rate was 12 .5% .All parameters in this study has no statistically significant difference between the two groups (P>0 .05) .Logistic multivariate analysis showed that there was no significant correlation between semen parameters and clinical pregnancy rate (P> 0 .05) .Conclusion There are no significant correlations between semen parameters and clinical pregnancy rate when the normal forms of patients with male infertility was 4% or higher .No semen parameters could predict results of clinical pregnancy .
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Objective To understand the clinical outcomes of frozen embryo transfer and fresh embryo transfer.Methods A retrospective analysis was conducted on the clinical data of 870 cases receiving embryo transfer at the Reproductive Medical Center of Sun Yat-Sen Memorial Hospital from January 2013 to March 2014,including 577 cases of in vitro fertilization and fresh embryo transfer,118 cases of intracytoplasmic sperm injection and fresh embryo transfer and 175 cases of frozen thawed embryo transfer,to compare the clinical characteristics and outcomes between fresh embryo transfer group and frozen embryo transfer group (the patients who had received unsuccessful fresh embryo transfer).The frozen embryo transfer group was divided into pregnant subgroup and non pregnant subgroup to further comparison.Binary logistic regression analyses was performed to identify the influencing factors of pregnancy.Results The implantation rate and clinical pregnancy rate were significantly lower in frozen embryo transfer group than in fresh embryo transfer group (26.27％ vs.31.98％,P=0.01 and 47.43％ vs.65.18％,P＜0.001).The differences in abortion rate,biochemical pregnancy rate and fetal birth weight had no statistical significance between the two groups (P=0.63,P=0.17 and P=0.33).The difference in age between pregnant subgroup and non pregnant subgroup was statistical significant (30.69 ± 3.37 years vs.32.00 ± 5.09 years,P=0.03),but no significant differences were found in BMI,duration of infertility and basic endocrine between the two subgroups.Binary logistic regression analysis showed that receiving frozen embryo transfer or not (P＜0.001),wife's age (P＜0.001),BMI (P=0.011) and number of top quality embryos (P＜0.001) were influencing factors of pregnancy.Conclusion Lower implantation rate and clinical pregnancy rate was observed in the patients in frozen embryo transfer group,who had received unsuccessful fresh embryo transfer,but no increase of abortion rate,influence on fetal birth weight and adverse pregnancy outcome were observed.
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Objective: To evaluate the effect of endometrial thickness, pattern and E2 level on the day of human chorionic gonadotropin (hCG) administration on clinical outcome in patients undergoing in vitro fertilization and embryo transfer (IVF-ET). Method: A total number of 112 cycles of IVF-ET conducted at Jaipur Fertility Centre, an Infertility Unit of Mahatma Gandhi University of Medical Sciences and Technology, Jaipur were observed prospectively. Endometrial ultrasonographic characteristics and E2 levels were recorded on the day of hCG administration. Clinical pregnancy rates were analyzed with different endometrial thickness and E2 levels. Results: Overall 37.5% patients conceived and in these women endometrial thickness was between 6-14 mm. Only 2.38% patients conceived with an ET of <6 mm. Maximum patients (52.33%) who conceived were with an ET of 8-10 mm. It was observed that endometrial thickness pattern did not have significant effect on clinical pregnancy rate in these cases. Clinical pregnancy rate was significantly higher in patients with serum E2 levels between 1,000-2,500 pg/mL as compared to other two groups. Conclusion: When thin endometrium ≤6 mm with no triple-line coexist and serum E2 level is >2,500 pg/mL in IVF/ICSI-ET, candidate cryopreservation should be recommended.