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Prensa méd. argent ; 108(2): 87-93, 20220000.
Article in Spanish | LILACS | ID: biblio-1368441


La transferencia de huso permite evitar enfermedades de herencia mitocondria. El art. 57 del Código Civil y Comercial, que utiliza una redacción amplia para no quedar obsoleto, apuntaría la prohibición a la manipulación de embriones en busca de mejoras determinadas, pero no a aquellas prácticas que tienen un fin terapéutico. Sin embargo, hay que repensar los límites de la prohibición y la razonabilidad de este tratamiento.

Spindle transfer makes it possible to avoid diseases of mitochondrial inheritance. The art. 57 of the Civil and Commercial Code, which uses a broad wording so as not to become obsolete, would point the prohibition to the manipulation of embryos in search of certain improvements, but not to those practices that have a therapeutic purpose. However, it is necessary to rethink the limits of the prohibition and the reasonableness of this treatment.

Humans , Oocyte Donation , Public Attorneys , Embryo Transfer , In Vitro Oocyte Maturation Techniques/legislation & jurisprudence , Legislation as Topic/organization & administration , Spindle Apparatus/transplantation
Rev. Assoc. Med. Bras. (1992) ; 68(1): 100-105, Jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360701


SUMMARY OBJECTIVE: The aim of this study was to compare the use of micronized vaginal progesterone and oral dydrogesterone in the endometrial preparation for frozen-thawed embryo transfer. METHODS: This was a randomized, controlled, open, two-armed clinical trial, with women undergoing frozen-thawed embryo transfer along with hormone replacement therapy for endometrial preparation, between September 2019 and February 2021. A total of 73 patients were randomly selected and orally administered 40 mg/day dydrogesterone (dydrogesterone group, n=36) or 800 mg/day micronized vaginal progesterone (micronized vaginal progesterone group, n=37), after endometrial preparation with transdermal estradiol. The main outcome was a viable ongoing pregnancy with 12 weeks of gestation as evaluated by ultrasound. RESULTS: The reproductive outcomes in frozen-thawed embryo transfer cycles were similar, with pregnancy rates in the dydrogesterone and micronized vaginal progesterone treatment groups being, respectively, 33.3 and 32.4% at 12 weeks pregnancy (confidence interval= -22.4-20.6, p=0.196). CONCLUSIONS: The use of oral dydrogesterone may be a more patient-friendly approach to endometrial preparation in frozen-thawed embryo transfer cycles, avoiding undesirable side effects and discomfort resulting from vaginal administration, while also providing similar reproductive results.

Humans , Female , Pregnancy , Dydrogesterone/adverse effects , Luteal Phase , Progesterone , Pregnancy Rate , Embryo Transfer/methods
Rev. bras. ginecol. obstet ; 43(1): 28-34, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156078


Abstract Objective To determine embryo quality (mean graduated embryo score [GES]) in infertile patients with endometriosis undergoing in vitro fertilization with embryo transfer (IVF-ET) compared with infertile patients without endometriosis. Methods A case-control study was performed comparing 706 embryos (162 patients) divided into 2 groups: 472 embryos derived from patients without endometriosis (n= 109, infertile patients with tubal infertility) and 234 embryos from patients in the study group (n= 53, infertile patients with peritoneal endometriosis). All patients were subjected to IVF using an oestradiol-antagonist-recombinant follicle-stimulating hormone (FSH) protocol for ovarian stimulation. Themean GESwas performed to evaluate all embryos at 3 points in time: 16 to 18 hours, 25 to 27 hours, and 64 to 67 hours. Embryo evaluation was performed according to the following parameters: fragmentation, nucleolar alignment, polar body apposition, blastomere number/morphology, and symmetry. The primary outcomemeasure was the mean GES score.We also compared fertilization, implantation, and pregnancy rates. Results Although the number of embryos transferred was greater in patients with endometriosis than in the control group (2.38 ± 0.66 versus 2.15 ± 0.54; p= 0.001), the meanGESwas similar inbothgroups (71 ± 19.8 versus 71.9 ± 23.5; p= 0.881). Likewise, the fertilization ratewas similar in all groups, being 61% in patients with endometriosis and 59% in the control group (p= 0.511). No significant differences were observed in the implantation (21% versus 22%; [p= 0.989]) and pregnancy rates (26.4% versus 28.4%; p= 0.989). Conclusion Embryo quality measured by the mean GES was not influenced by peritoneal endometriosis. Likewise, the evaluated reproductive outcomes were similar between infertile patients with and without endometriosis.

Resumo Objetivo Determinar a qualidade do embrião (média de escore embrionário graduado [EEG]) em pacientes inférteis com endometriose submetidas à fertilização in vitro com transferência de embrião (FIV-TE) em comparação com pacientes inférteis sem endometriose. Métodos Realizamos um estudo de caso-controle comparando 706 embriões (162 pacientes) divididos em dois grupos: 472 embriões derivados de pacientes sem endometriose (n = 109, pacientes inférteis com infertilidade tubária) e 234 embriões de pacientes do grupo de estudo (n= 53, inférteis pacientes com endometriose peritoneal). Todos os pacientes foram submetidos à fertilização in vitro usando um protocolo follicle-stimulating hormone (FSH) recombinante de estradiol-antagonista para estimulação ovariana. A média do EEGfoi realizada para avaliar todos osembriõesemtrêsmomentos: de 16 a 18 horas, 25 a 27 horas e 64 a 67 horas.A avaliaçãoembrionária foi realizada de acordo comos seguintes parâmetros: fragmentação, alinhamento nucleolar, aposição do corpo polar, número de blastômeros/morfologia e simetria. A medida de desfecho primário foi o escore médios embrionário (EEG). Também avaliamos como desfechos secundários as taxas de fertilização, implantação e gravidez. Resultados Embora o número de embriões transferidos tenha sido maior em pacientes com endometriose do que no grupo controle (2,38 ± 0,66 versus 2,15 ± 0,54; p = 0,001), o EEGmédio foi semelhante nos dois grupos (71 ± 19,8 versus 71,9 ± 23,5; p = 0,881). Da mesma forma, a taxa de fertilização foi semelhante em todos os grupos, sendo 61% nos pacientes com endometriose e 59% no grupo controle (p = 0,511). Não foram observadas diferenças significativas nas taxas de implantação (21% versus 22%; [p = 0,989]) e nas taxas de gravidez (26,4% versus 28,4%; p = 0,989). Conclusão A qualidade embrionária medida pelo EEGmédio não foi influenciada pela endometriose peritoneal. Da mesma forma, os resultados reprodutivos avaliados foram semelhantes entre pacientes inférteis com e sem endometriose.

Humans , Female , Pregnancy , Adult , Embryo, Mammalian , Embryo Transfer , Endometriosis , Infertility, Female , Ovulation Induction , Pregnancy Outcome , Fertilization in Vitro , Case-Control Studies , Prospective Studies
National Journal of Andrology ; (12): 825-832, 2021.
Article in Chinese | WPRIM | ID: wpr-922165


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. /.

Acupuncture Points , Embryo Transfer , Female , Fertilization in Vitro , Humans , Pregnancy , Pregnancy Outcome , Randomized Controlled Trials as Topic
Chinese Medical Journal ; (24): 2421-2429, 2021.
Article in English | WPRIM | ID: wpr-921176


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 undergone in 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.

Abortion, Habitual , Embryo Transfer , Female , Fertilization in Vitro , Humans , Pregnancy , Pregnancy Rate , Retrospective Studies
Chinese Medical Journal ; (24): 2306-2315, 2021.
Article in English | WPRIM | ID: wpr-921140


BACKGROUND@#Existing clinical prediction models for in vitro fertilization are based on the fresh oocyte cycle, and there is no prediction model to evaluate the probability of successful thawing of cryopreserved mature oocytes. This research aims to identify and study the characteristics of pre-oocyte-retrieval patients that can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles.@*METHODS@#Data were collected from the Reproductive Center, Peking University Third Hospital of China. Multivariable logistic regression model was used to derive the nomogram. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and calibration plots.@*RESULTS@#The predictors in the model of "no transferable embryo cycles" are female age (odds ratio [OR] = 1.099, 95% confidence interval [CI] = 1.003-1.205, P = 0.0440), duration of infertility (OR = 1.140, 95% CI = 1.018-1.276, P = 0.0240), basal follicle-stimulating hormone (FSH) level (OR = 1.205, 95% CI = 1.051-1.382, P = 0.0084), basal estradiol (E2) level (OR = 1.006, 95% CI = 1.001-1.010, P = 0.0120), and sperm from microdissection testicular sperm extraction (MESA) (OR = 7.741, 95% CI = 2.905-20.632, P 10 mm on the day of hCG administration.

Embryo Transfer , Female , Fertilization in Vitro , Humans , Nomograms , Oocytes , Ovulation Induction , Pregnancy , Pregnancy Outcome , Pregnancy Rate , Retrospective Studies
Chinese Acupuncture & Moxibustion ; (12): 1338-1342, 2021.
Article in Chinese | WPRIM | ID: wpr-921056


OBJECTIVE@#To compare the effect of @*METHODS@#A total of 74 patients with RIF of thin endometrium type undergoing freeze-thaw embryo transfer were randomly divided into an observation group (37 cases) and a control group (37 cases). The patients in the control group were treated with freeze-thaw embryo transfer in hormone replacement cycle, and the estradiol valerate tablets were taken orally from the fifth day of menstruation, 2 mg per day. On the basis of the control group, the observation group was additionally treated with @*RESULTS@#The clinical pregnancy rate was 37.8% (14/37) in the observation group, which was higher than 16.2% (6/37) in the control group (@*CONCLUSION@#On the basis of conventional medication,

Acupuncture Therapy , Embryo Transfer , Endometrium , Female , Humans , Pregnancy , Pregnancy Outcome , Pregnancy Rate
Article in English | WPRIM | ID: wpr-878330


Objective@#Prior pulmonary tuberculosis (PTB) on chest X-ray (CXR) was commonly found in infertile patients receiving examinations before @*Method@#We conducted a retrospective cohort study of 14,254 infertile patients who had received IVF-ET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth, clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.@*Results@#The untreated PTB group had significantly lower clinical pregnancy (31.7% @*Conclusions@#Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.

Abortion, Spontaneous/epidemiology , Adult , China/epidemiology , Embryo Transfer/statistics & numerical data , Female , Fertilization in Vitro/statistics & numerical data , Humans , Infertility, Female/etiology , Live Birth/epidemiology , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Radiography, Thoracic , Retrospective Studies , Tuberculosis, Pulmonary/epidemiology , Young Adult
Rev. bras. ginecol. obstet ; 43(8): 608-615, 2021. tab, graf
Article in English | LILACS | ID: biblio-1351769


Abstract Objective To establish a relationship between serum progesterone values on the day of frozen blastocyst transfer in hormone-replaced cycles with the probability of pregnancy, miscarriage or delivery. Methods This was an ambispective observational study including all frozen-thawed embryo transfer cycles performed at our department following in vitro fecundation from May 2018 to June 2019. The outcomes evaluated were β human chorionic gonadotropin (β-hCG)-positive pregnancy and delivery. Groups were compared according to the level of serum progesterone on the day of embryo transfer: the 1st quartile of progesterone was compared against the other quartiles and then the 2nd and 3rd quartiles against the 4th quartile. Results A total of 140 transfers were included in the analysis: 87 with β-HCG>10 IU/L (62%), of which 50 (36%) delivered and 37 had a miscarriage (42%).Women with lower progesterone levels (< 10.7ng/mL) had a trend toward higher β-HCG-positive (72 versus 59%; p>0.05), lower delivery (26 versus 39%; p>0.05) and higher miscarriage rates (64 versus 33%; p<0.01). Comparing the middle quartiles (P25-50) with those above percentiles 75, the rate of pregnancy was similar (60 versus 57%; p>0.05), although there was a trend toward a higher number of deliveries (43 versus 31%; p>0.05) and a lower number of miscarriages (28 versus 45%; p>0.05). These differences were not statistically significant. Conclusion There were no differences in pregnancy and delivery rates related with the progesterone level when measured in the transfer day. The miscarriage rate was higher in the 1st quartile group.

Resumo Objetivo Avaliar se existe alguma relação entre os valores plasmáticos de progesterona no dia da transferência de um blastocisto desvitrificado em ciclos hormonalmente substituídos e a taxa de gravidez, aborto ou nascido vivo. Métodos Estudo observacional, ambispectivo, incluindo todos os ciclos de transferência de blastocistos congelados no nosso departamento, entre maio de 2018 e junho de 2019. Avaliou-se a taxa de gravidez e de nascidos vivos após 24 semanas de gestação. Os grupos foram comparados de acordo com os valores de progesterona plasmáticos dosados no dia da transferência do blastocisto: comparou-se o 1° quartil com os outros e depois os 2° e 3° quartis com o 4°. Resultados Avaliaram-se 140 transferências: 87 com β gonadotrofina coriônica humana (β-HCG)>10 IU/L (62%), 50 das quais terminaram em nascido vivo (36% do total), enquanto 37 tiveram um aborto (42% das gravidezes). Verificou-se uma tendência para menor número de recém-nascidos nas transferências com níveis de progesterona no 1° quartil (<10.7ng/mL) (26 versus 39%; p>0.05) e ummaior número de abortos (64 versus 33%; p<0.01). Comparando o 2° e 3° quartis com o 4°, verificouse que nos casos em que a progesterona estava acima do percentil 75, apesar de uma taxa de gravidez semelhante (60 versus 57%; p>0.05), houve uma tendência para uma maior taxa de nascidos vivos (43 versus 31%; p>0.05) emenor número de abortos (28 versus 45%; p>0.05) abaixo do percentil 75. Estas diferenças não foram estatisticamente significativas. Conclusão Não se verificaram diferenças estatisticamente significativas para taxa de gravidez e de nascido vivo. A taxa de aborto foi maior no primeiro quartil.

Humans , Female , Pregnancy , Progesterone , Chorionic Gonadotropin, beta Subunit, Human , Fertilization in Vitro , Retrospective Studies , Pregnancy Rate , Embryo Transfer
Rev. chil. obstet. ginecol. (En línea) ; 85(supl.1): S122-S130, set. 2020. graf
Article in Spanish | LILACS | ID: biblio-1138657


La pandemia de SARS-CoV-2 es una emergencia sanitaria sin precedentes, que ha implicado un reordenamiento en la priorización de procedimientos médicos electivos, frente a un potencial colapso del sistema de salud a nivel mundial y riesgo de contagio del personal y pacientes. Al igual que en el resto del mundo, en Chile la mayoría de los centros de medicina reproductiva han debido suspender sus diferentes terapias de reproducción asistida (TRA). Sin embargo, a raiz de la disminución del número de contagios y mayor evidencia científica disponible, la Sociedad Europea de Reproducción Humana y Embriología (ESHRE) ha recomendado reiniciar los ciclos de medicina reproductiva de forma gradual, a través de sistemas de triage, priorizando pacientes por medio de la generación de distintos escenarios. Considerando esta recomendación, se realizó una revisión sobre la evidencia existente respecto a SARS-CoV-2 / COVID-19 en medicina reproductiva recopilando diferentes directrices de las principales sociedades internacionales, con el objetivo de generar una recomendación ajustada a la realidad nacional.

SARS-CoV-2 pandemic is an unprecedented health emergency, which involves a reorganization of elective procedures, facing a potential global health system collapse. In Chile, as in the rest of the world. most reproductive medicine centers have suspended their different assisted reproduction therapies (ART). However, due to the decrease in the number of infections and due to a greater collection of scientific evidence, the European Society for Human Reproduction and Embryology (ESHRE) have recommended restarting cycles gradually through triage systems, prioritizing patients through the generation of different scenarios. With this in mind, we carried out a review of the existing evidence so far regarding SARS-CoV-2 and reproductive medicine, and we tried to compile the different guidelines of the main international societies, to generate a recommendation adjusted to our local scenario.

Humans , Female , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Reproductive Medicine/standards , Reproductive Techniques, Assisted/standards , Betacoronavirus , Ovulation Induction , Fertilization in Vitro , Triage , Practice Guidelines as Topic , Patient Selection , Embryo Transfer , Pandemics/prevention & control
Rev. chil. obstet. ginecol. (En línea) ; 85(4): 400-407, ago. 2020.
Article in Spanish | LILACS | ID: biblio-1138638


La utilización de técnicas de reproducción asistida (TRA) ha aumentado en todo el mundo, incluyendo procedimientos como la donación de gametos, la subrogación y el diagnóstico genético preimplantacional. Creciente evidencia confirma que los embarazos de pacientes sometidas a estos tratamientos tienen un mayor riesgo de complicaciones perinatales. No queda claro si la causa de estos hallazgos se debe a la infertilidad subyacente o los tratamientos en sí. Esta revisión tiene como objetivo resumir la evidencia actual acerca de los efectos sobre los resultados maternos y perinatales tanto de los diferentes procedimientos propios de la fecundación in vitro como de algunos tipos de TRA especiales.

The use of assisted reproduction techniques (ART) has increased worldwide, including procedures such as gamete donation, subrogation and preimplantation genetic diagnosis. Growing evidence confirms that pregnancies following these treatments have an increased risk of adverse perinatal outcomes. It is not clear whether the cause of these findings is due to the underlying infertility or the treatments themselves. This review aims to summarize the current evidence regarding the effects of both the different ART procedures and some special types of ART on maternal and perinatal outcomes.

Humans , Female , Pregnancy , Reproductive Techniques, Assisted/adverse effects , Ovulation Induction/adverse effects , Infant, Low Birth Weight , Pregnancy Outcome , Fertilization in Vitro/adverse effects , Risk , Premature Birth/etiology , Embryo Transfer/adverse effects
Rev. bras. ginecol. obstet ; 42(3): 165-168, Mar. 2020. graf
Article in English | LILACS | ID: biblio-1098856


Abstract Bilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.

Humans , Female , Pregnancy , Adult , Pregnancy, Tubal/diagnosis , Prenatal Diagnosis , Sperm Injections, Intracytoplasmic , Embryo Transfer , Pregnancy, Tubal/blood , Pregnancy, Tubal/diagnostic imaging , Ultrasonography, Prenatal , Diagnosis, Differential
Article in Chinese | WPRIM | ID: wpr-826705


OBJECTIVE@#To observe the effect of warming acupuncture on uterine blood perfusion in the patients with failed high-quality freeze-thawed embryo transfer (FET) and explore its effect mechanism on the improvement of clinical pregnancy rate after re-tranfer.@*METHODS@#A total of 72 patients of failed high-quality FET were randomized into an observation group and a control group, 36 cases in each one. In the observation group, after the menstrual period ended, warming acupuncture started at the acupoints located on the abdomen, e.g. Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3) and Qugu (CV 2) and those on the lumbar sacral region, e.g. Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3), 50 min in each treatment, once daily, at the interval of 1 day after 4-day treatment. The treatment was discontinued till the patients were at the ovulatory stage. In the control group, capsules were taken orally and continuously after the end of menstrual period, 3 capsules each time, three times a day and stopped at the ovulatory stage. The treatment of one menstrual cycle was taken as one course and the treatment for 3 menstrual cycles was required. Before and after treatment, the uterine artery pulsation index (PI), endometrial thickness, endometrial type, uterine blood perfusion, the recovery time of sufficient uterine blood flow, the endomentrial receptivity (ER) during the implantation window period and the clinical pregnancy rate were observed in the two groups.@*RESULTS@#After treatment, the endometrial thickness was increased and PI decreased obviously in the two groups (<0.05) and PI in the observation group was lower than that in the control group (<0.05). After treatment, the proportion of type a and type A of endometrium was increased markedly in the two groups (<0.05) and the proportion in the observation group was higher than the control group (<0.05). After treatment, the case proportion of sufficient uterine blood flow was increased obviously in the two groups (<0.05) and the value in the observation group was higher than the control group [83.3% (30/36) vs 69.4% (25/36), <0.05]. After treatment, the proportion of ER during the implantation window period was increased remarkably in the two groups (<0.05) and the value in the observation group was higher than the control group [72.2% (26/36) vs 50.0% (18/36), <0.05]. The recovery time of sufficient uterine blood flow in the observation group was shorter than the control group (<0.05) and the clinical pregnancy rate was higher than the control group [47.2% (17/36) vs 33.3% (12/36), <0.05].@*CONCLUSION@#Warming acupuncture enhances uterine blood perfusion and improves uterine endometrial receptivity so that the clinical pregnancy rate is increased after re-transfer in the patients with failed high-quality freeze-thawed embryo transfer.

Acupuncture Points , Acupuncture Therapy , Embryo Transfer , Endometrium , Female , Humans , Pregnancy , Pregnancy Rate , Uterus
Arq. bras. med. vet. zootec. (Online) ; 71(6): 1909-1916, Nov.-Dec. 2019. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1055110


The study evaluated sonographic and serologic exams performed for early (20 to 30d) diagnosis of pregnancy. One hundred-twenty (n= 120) bovine recipients were synchronized (estrous=D0) and timed embryo transferred (TET, D7) with fresh in vitro produced embryos. In the first trial (n= 46), diagnosis of pregnancy was performed on day 20 (D20) by detecting CL blood flow (BF) and by Pregnancy-Associated Glycoproteins (PAGs) serology. In the second trial (n= 30), pregnancy diagnosis was performed on D25 by ultrasound visualization of uterine contents and by PAGs serology. In the last trial, PAG's serology was performed on D30. Ultrasonographic detection of the uterine contents and embryo viability performed on D30 (DG30) was considered the gold standard. The PROC FREQ procedure was used to test the agreement between diagnostic methods. On D20, the Doppler ultrasonography of the CL had showed high sensitivity (100%), but only moderate specificity (53.3%). On the same day, serologic diagnostic had no agreement (k= -0.08, P< 0.46) with the gold standard, with very low sensitivity (6.3%). However, the sensitivity of the serologic exam increased dramatically (from 6.3 to 100%) from D20 to D25, and it contributed to detect false negatives from the ultrasound diagnosis, improving the overall accuracy from 90% to 96.7%.(AU)

O estudo foi planejado para correlacionar exames ultrassonográficos e sorológicos realizados para o diagnóstico precoce (20 a 30d) de gestação. Cento e vinte (n= 120) receptoras bovinas foram sincronizadas (estro=D0), e embriões frescos produzidos in vitro foram transferidos em tempo fixo (TETF, D7). No experimento 1 (n= 46), o diagnóstico de gestação foi realizado no D20, pela detecção do fluxo sanguíneo do CL e pela sorologia de glicoproteínas associadas à gestação (PAGs). No experimento 2 (n= 30), a detecção da gestação foi realizada por meio da visualização do conteúdo do útero e também pela sorologia para PAGs. No experimento 3, a sorologia para PAGs foi realizada no D30. Em todos os experimentos, a visualização ultrassonográfica da vesícula e da viabilidade embrionária, realizada no D30, foi considerada padrão-ouro. O procedimento PROC FREQ testou o nível de concordância dos métodos diagnósticos. No D20, o diagnóstico baseado na vascularização do CL mostrou alta sensibilidade (100%) e apenas moderada especificidade (53,3%). Nesse mesmo dia, o diagnóstico sorológico não apresentou concordância (k=-0,08, P<0,46) com o padrão-ouro, além de baixa sensibilidade (6,3%). No entanto, a sensibilidade do exame sorológico aumentou drasticamente (6,3 para 100%) do D20 para o D25, contribuindo para detectar falsos negativos diagnosticados pela ultrassonografia, melhorando a acurácia (90 para 96,7%).(AU)

Animals , Female , Pregnancy , Cattle , Pregnancy, Animal/blood , Serologic Tests/veterinary , Glycoproteins/analysis , Ultrasonography, Doppler, Color/veterinary , Embryo Transfer/veterinary
Electron. j. biotechnol ; 39: 74-81, may. 2019. tab, ilus, graf
Article in English | LILACS | ID: biblio-1052041


Background: CPEB is considered as an RNA-binding protein first identified in Xenopus oocytes. Although CPEB1 was involved in the growth of oocyte, its role in goat follicular granulosa cell has not been fully elucidated. To clarify the functions of this gene in goat follicular granulosa cells, CPEB1-overexpressing vector and interference vector were structured and transfected into follicular granulosa cells from Jiangsu native white goats of Nantong city, Jiangsu Province, China. The expression levels of differentiation-related genes including CDK1, Cyclin B1, and C-mos were determined 24 h after administration of CPEB1 by quantitative real-time polymerase chain reaction and Western blotting methods. Results: The expression levels of CDK1, Cyclin B1, and C-mos were significantly upregulated after overexpression and significantly downregulated after interference with CPEB1. Conclusions: The CPEB1 gene expression could affect the transcription of genes related to early cleavage divisions, which provided a reference for further research on its role in the growth and maturation of oocytes.

Animals , Female , Oocytes , Transcription Factors/genetics , Goats/genetics , Transfection , Fertilization in Vitro , Gene Expression , Blotting, Western , Polymerase Chain Reaction/methods , RNA-Binding Proteins , Embryo Transfer , Livestock , Fluorescence , Granulosa Cells
Article in Chinese | WPRIM | ID: wpr-776240


OBJECTIVE@#To observe the clinical effect of warm acupuncture on endometrial cavity fluid (ECF) from in vitro fertilization-embryo transfer (IVF-ET), and to explore the mechanism of warm acupuncture on ECF.@*METHODS@#Twenty-nine patients who were prepared for IVF-ET from 2016 to 2019 and whose transplantation was cancelled due to ECF found by vaginal B-ultrasound examination were divided into an observation group (14 cases) and a control group (15 cases) according to random number table method. The warm acupuncture was applied at Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), Guilai (ST 29), Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6) after the end of menstruation in the observation group, the treatment lasted for 60 min, once a day, 5 times as a course, with 2 days interval between the courses and 3 consecutive courses of treatment were given, until the embryo transfer was performed in the IVF assisted pregnancy cycle. After the end of menstruation, fresh leonurus japonicus capsule was given in the control group, 3 times a day, 0.8 g each time, 7 days as a course, and 3 courses of continuous treatment were received, until the embryo transfer was performed in the IVF assisted pregnancy cycle. The changes of ECF before and after treatment, the time required to prepare for embryo transfer during IVF assisted pregnancy cycle, and the clinical outcome of embryo transfer were observed in the two groups.@*RESULTS@#The decrease of ECF in the observation group was more significant than that in the control group (<0.05). The time required for the embryo transfer in the IVF assisted pregnancy cycle in the observation group was shorter than that in the control group (<0.05). The clinical pregnancy rate in the observation group was 42.9% (6/14), which was significantly higher than 26.7% (4/15) in the control group (<0.05).@*CONCLUSION@#Warm acupuncture may improve the clinical pregnancy rate by raising the local temperature of the lower abdomen, accelerating the blood circulation around the uterus and appendages, promoting the absorption of ECF, improving the uterine environment and endometrial receptivity.

Acupuncture Therapy , Embryo Transfer , Endometrium , Female , Fertilization in Vitro , Humans , Pregnancy , Pregnancy Rate
Article in Chinese | WPRIM | ID: wpr-775844


OBJECTIVE@#To observe the effects of acupoint catgut embedding on miscarriage prevention and pregnancy outcome in patients with threatened abortion after in vitro fertilization-embryo transfer (IVF-ET).@*METHODS@#Sixty cases of patients with threatened abortion after IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with intramuscular injection of progesterone (40 mg) once every day, while the patients in the observation group, on the basis of the treatment of control group, were treated with catgut embedding at Geshu (BL 17), Ganshu (BL 18), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21), Xuehai (SP 10), Diji (SP 8) and Fuliu (KI 7), once every two weeks, six times as a course of treatment. The treatment was given until 12 weeks into pregnancy. The level of serum human chorionic gonadotropin (HCG), estradiol (E) and progesterone (P) before and after treatment was recorded; the TCM syndrome score before and after treatment was compared; the successful pregnancy rate and spontaneous abortion rate after treatment were observed in the two groups.@*RESULTS@#Compared before treatment, the scores of TCM syndrome in both groups were reduced after treatment (both <0.01), and score in the observation group was superior to that in the control group (<0.05). After treatment, the clinical efficacy in the observation group was superior to that in the control group (<0.05). After treatment, the hormone levels (β-HCG, E, P) in both groups were increased steadily; the hormone levels in 6-week pregnancy, 8-week pregnancy and 10-week pregnancy were significantly higher than those in 4-week pregnancy (all <0.05); except the levels of P and β-HCG in 10-week pregnancy, the hormone levels in the observation group were superior to those in the control group (all <0.05). After treatment, the early abortion rate was 16.7% (5/30) in the observation group, which was lower than 33.3% (10/30) in the control group (<0.01); the pregnancy rate was 96.0% (24/25) in the observation group, which was higher than 80.0% (16/20) in the control group (<0.01).@*CONCLUSION@#Acupoint catgut embedding is effective for preventing threatened abortion, which could significantly reduce the spontaneous abortion rate, improve the pregnancy success rate, regulate hormone levels in patients after IVF-ET.

Abortion, Threatened , Acupuncture Points , Catgut , Embryo Transfer , Female , Fertilization in Vitro , Humans , Pregnancy
Article in Chinese | WPRIM | ID: wpr-775239


OBJECTIVE@#To compare laboratory and clinical outcomes of fertilization-embryo transfer (IVF-ET) in patients with endometriosis using antagonist protocol, long agonist protocol or prolonged agonist protocol.@*METHODS@#Totally 313 patients with endometriosis were recruited in Reproductive Centers of the Second Affiliated Hospital of Zhejiang University School of Medicine,Jiaxing Women and Children's Hospital,and Ningbo Women and Children's Hospital from April 2017 to October 2018, including 81 patients treated with antagonist protocol (antagonist group), 148 treated with long agonist protocol (long agonist group) and 84 treated with prolonged agonist protocol (prolonged agonist group). The clinical and laboratory data of the patients were retrospectively analyzed to investigate the effect of ovarian stimulation protocols on the IVF-ET outcomes of patients with endometriosis.@*RESULTS@#The average age in the antagonist group patients was significantly higher than those in the other two groups (all 0.05). Fertilization rate and available embryo rate were comparable among the three groups (all >0.05). Considering analysis per cycle with embryo transfer, the human chorionic gonadotrophin (HCG) positive rate, clinical pregnancy rate and total implantation rate showed no significant difference among the three groups (all >0.05). The implantation rate after fresh embryo transfer in the antagonist group was lower than that in the long agonist group (0.05). While the implantation rate of freeze-thaw embryo transfer showed a higher trend in the antagonist group, but there was no significant difference (>0.05). The patients were further divided into diminished and normal ovarian reserve subgroups, the per cycle with embryo transfer, the HCG positive rate, clinical pregnancy rate and total implantation rate still showed no significant difference between two subgroups (all >0.05), no matter in which ovarian stimulation protocol groups. Besides, in women with diminished ovarian reserve, the available embryo rate in antagonist group was significantly higher than that in the long agonist group (<0.05). The amount and duration of Gn application in antagonist group were significantly lower than those in long and prolonged agonist groups (all <0.05).@*CONCLUSIONS@#Patients with endometriosis who used the antagonist protocol in IVF procedure could reduce the cost and time of Gn treatment, when combined with frozen-embryo transfer strategy the antagonist protocol has comparable clinical pregnancy outcome with long or prolonged agonist protocol, especially in those with diminished ovarian reserve, the higher available embryo rate can be achieved.

Embryo Transfer , Endometriosis , Therapeutics , Female , Fertilization in Vitro , Humans , Ovulation Induction , Methods , Pregnancy , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-819043


fertilization and embryo transplantation (IVF-ET) technology is one of the main treatments for infertility. But IVF-ET is expensive and has not be covered by health insurance in most developing countries. Therefore, how to obtain the maximum success rate with the minimum cost is a common concern of clinicians and patients. At present, the economic studies on IVF-ET mainly focus on different ovulation stimulating drugs, different ovulation stimulating protocols, different transplantation methods and the number of transplants. But the process of IVF-ET is complex, the relevant methods of economic study are diverse, and there are no unified standard for outcome indicators, so there is no unified conclusion for more economical and effective protocol by now. Therefore, to analyze the economic studies of IVF-ET, and to explore appropriate evaluation methods and cost-effective protocols will be helpful for reasonable allocation of medical resources and guidance of clinical selection. It would provide policy reference to include the costs of IVF-ET treatment in health insurance in the future.

Economics, Medical , Embryo Transfer , Economics , Female , Fertilization in Vitro , Economics , Humans , Infertility , Economics , Insurance, Health , Economics , Ovulation Induction