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Objective To investigate the premature spontaneous ovulation rates in in vitro fertilization-embryo transfer (IVF-ET) cycles using gonadotropin-releasing hormone antagonist (GnRH-ant) and gonadotropin-releasing hormone agonist (GnRH-a), as well as the risk factors for premature spontaneous ovulation. Methods The rates of premature spontaneous ovulation in a total of 10 612 cycles using GnRH-ant or GnRH-a were compared. Matched case-controlled study and binary logistic regression model were conducted to analyze the risk factors for premature spontaneous ovulation. Results The spontaneous ovulation rate in the whole for GnRH-a cycles was 0.15%(13/8 514), compared with a 1.62%(34/2 098) in GnRH-ant cycles (P<0.01). Further matched controlled study and regression analyze found out that higher basal FSH level was a predominant risk and prediction factor for spontaneous ovulation (OR=1.20, P=0.009). Conclusions In GnRH-ant cycles, spontaneous ovulation rate is about 10 times than which in GnRH-a cycles. Diminished ovarian function is a predominate risk factor for premature spontaneous ovulation.
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Objective To investigate the impact of previous cystectomy for ovary benign cyst on ovarian reserve and pregnancy outcome in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles. Methods Totally 622 infertility patients were retrospectively investigated who underwent first IVF/ICSI-ET cycle in Reproductive Hospital Affiliated to Shandong University from January 2013 to June 2014. There were 153 cases who had been removed ovarian cyst by cystectomy surgeries recruited as study group, in which 44 cases of ovarian endometriosis cyst, 35 cases of benign ovarian teratomas, 67 cases of simple ovarian cyst and 7 cases of ovarian mucinous cystadenoma. In contrast, 469 infertility patients with tubal-factor infertility or male factor were included as control group. The age-matched women in the control group had no ovarian surgery previously. The indicators of ovarian reserve and pregnancy outcome were analyzed between two groups. The influence of different types of ovarian cysts on ovarian reserve and pregnancy outcome in IVF/ICSI-ET cycles were also studied, ovarian endometriosis cyst was studied as Group A, and Group B consisted of benign ovarian teratomas, simple ovarian cyst and mucinous cystadenoma. Results (1) The significantly lower serum antimullerian hormone (AMH) level (median: 1.92 versus 2.90 mg/L), antral follicle count (AFC; median: 12.0 versus 13.0), retrieved oocytes (12 ± 5 versus 13 ± 6) and the number of embryo cryopreserved (median:1.0 versus 3.0) were found in study group compared with control group (all P0.05). A better clinical pregnancy rate was achieved in control group (61.6%, 241/391) than that in study group (61.4%, 81/132), but no significant difference was existed (P=0.96). (2) Compared to Group B, Group A had fewer AFC, lower serum AMH level, retrieved oocytes and the number of embryo cryopreserved (11±4 versus 13±5;1.65 versus 2.15 mg/L;9±4 versus 13±5;0 versus 2.0;all P0.05). Conclusions Ovarian reserve declines after the cystectomy for ovarian benign cysts and the cystectomy has a negative impact on IVF/ICSI-ET cycle, resulting in a decrease of the number of retrieved oocytes and the number of embryo cryopreserved, but do not influence clinical pregnancy outcome. Ovarian reserve is impaired more seriously by cystectomy for ovarian endometriosis cyst than other ovarian benign cyst.
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The in-vitro fertilization and embryo transfer technique has been widely applied in human insemination. The rate of successful insemination is gradual y rising, and the in-vitro fertilization directly determine the insemination outcome. OBJECTIVE:To evaluate the difference between the two common using insemination methods, microdrop and open, in in-vitro fertilization and embryo development. METHODS:A randomized study was conducted to compare microdrop and open insemination methods among non-male factor patients undergoing in-vitro fertilization and embryo transfer. A total of 1 175 cases were enrol ed in the research. There were 573 cases in the microdrop group, and 602 cases in open insemination group. The fertilization rate and embryo development in the two groups were compared. RESULTS AND CONCLUSION:The fertilization failure rate [total fertilization failure rate+low fertilization rate (0.05). The open insemination method is a simple insemination method with a lower fertilization failure rate. As the fertilization is a highly complicated process involving many extrinsic and intrinsic factors, further study is needed to confirm the effects of the two insemination methods on in-vitro fertilization outcome.
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BACKGROUND:With the improvement of in vitro fertilization-embryo transfer technology, patients with in vitro fertilization-embryo transfer are facing more and more psychological stress. To completely understand their mental features and to explore effective mental intervention are important problems faced workers of reproductive medicine. OBJECTIVE:To investigate the psychological condition of in vitro fertilization-embryo transfer patients. METHODS:A total of 92 in vitro fertilization-embryo transfer patients, who entered the cycle from October to November 2012, were enrol ed in this study. The psychological conditions of these patients were evaluated using Symptom Checklist-90. RESULTS AND CONCLUSION:Al the factor scores of the Symptom Checklist-90 in patients with in vitro fertilization-embryo transfer achieved significantly higher levels than national adult norm on their first day of in vitro fertilization-embryo transfer cycles (P<0.05), with the exception of Psychiatric state factor. Meanwhile, in addition to Psychiatric state, differences of al the factors of Symptom Checklist-90 in patients with in vitro fertilization-embryo transfer were statistical y significant in different stages of in vitro fertilization-embryo transfer cycles at the first day of entering cycle, the day of obtaining ovum, and the seventh day of embryo transfer, (P<0.05). Interpersonal relationship, Depression and Anxiety scores were increased at the first day of entering cycle, the day of obtaining ovum, and the seventh day of embryo transfer (P<0.05). These results showed that patients with in vitro fertilization-embryo transfer tend to have poor psychological status, which is a problem in patients during the different stages of in vitro fertilization-embryo transfer cycles and becomes aggravated during egg retrieval and waiting for the outcome. Interventional measures should be taken in different stages to improve patients’ mental health.
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Objective To evaluate the factors associated with clinical pregnancy rate of in-vitro fertilization (IVF) in endometriosis related infertility.Methods Total of 326 patients with endometriosis related infertility undergoing IVF between January 2007 and December 2011 were studied in Department of Reproductive Medicine,First Affiliated Hospital,Nanjing Medical University,retrospectively,which were divided into 141 cases in clinical pregnancy group and 185 cases in non-pregnancy group.Those factors including age,body mass index (BMI),basic FSH,antral follicle count (AFC),CA125 and CA199,endometriotic stage and history of surgery,stimulation scheme were analyzed by bivariate analysis and multivariable logistic regression.Results (1) Pregnancy rate:total of 141 pregnant cases and 185 nonpregnant cases treated by IVF were observed,pregnancy rate was 43.2％ (141/326).(2) Basic parameters:there was no statistical difference in age,BMI,basic FSH,AFC,CA125 and CA199 between clinical pregnancy group and non-pregnancy group (P ＞ 0.05).(3) Bivariate analysis:clinical pregnancy rate of 50.0％ (87/174) among patients with infertility year less than five years was significantly higher than 35.5％ (54/152) in patients with more than five years.Pregnancy rate of 56.1％ (46/82) in stage Ⅰ-Ⅱ was significantly higher than 42.5％ (79/186) in stage Ⅲ-Ⅳ.Pregnancy rate of 46.6％(125/268) with history of surgery was significantly higher than 27.6％ (16/58) with no history of surgery (P ＜ 0.05).Pregnancy rate of 48.2％ (79/164) in long-term scheme was higher than 38.3％ (62/162) in short-term scheme,but there was no significant difference (P =0.075).(4) Multivariable logistic regression:clinical pregnancy rate of infertility year with less than 5 years,stage Ⅰ-Ⅱ,history of surgery proved stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ was significantly higher compared with infertility year more than 5 years,stage Ⅲ-Ⅳ and no history of surgery respectively (adjusted OR and 95％ CI:2.003,1.263-3.175; 1.899,1.110-3.248; 3.769,1.802-7.887,P＜0.05).Conclusion Factors affecting clinical pregnancy rate of IVF in endometriosis related infertility were infertility year,stage and surgery.
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14mm.Results Group thick cycles had significantly lower implantation and pregnancy rates compared with group normal cycles(9.1% versus 13.5% and 18.8% versus 27.0%,respectively).Group thick cycles had significantly higher miscarriage rates compared with group normal cycles(50.0% versus 19.0%,respectively).Conclusion Increased endometrial thickness is associated with the decreased implantation or pregnancy rates and the increased miscarriage rates in IVF-ET.
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8 oocytes) according to the number of oocytes collected in one ovary. On day of human chorionic gonadotrophin injection, PSV, EDV, PI, RI, S/D of ovarian stromal artery in the ovarian were detected and perifollicular vascularity were graded with color Doppler ultrasonography. Results Not only PSV and EDV of stromal artery but also perifollicular vascularity in low-response group was significantly lower than that of normal-response and high-response groups. PSV and EDV of ovarian stromal artery and perifollicular vascularity were highly interrelated with ovarian response. Conclusions The increase of PSV and EDV of ovarian stromal artery and perifollicular vascilarity indicate the improvement of perfusion in ovary and ovarian response.
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【Objective】To observe the effect of therapy of artificial menstrual cycle induction by Chinese medicine combined with assisted reproductive techniques(ART)on embryo implantation rate in in-vitro fertilization.【Methods】Sixtynine infertility patients were randomized into groups A(n=30)and B(n=39).Group B was treated with simple ART and group A received ART treatment after artificial menstrual cycle induction by Chinese medicine for 2～3 treatment courses.The therapy of artificial menstrual cycle induced by Chinese medicine respectivdy was carried out by applying Chinese medicine respectively with the actions of tonifying kidney,activating blood and removing stasis,tonifying kidney,and activating blood and regulating menstruation according to the ovarian cyclic changes of maturation of follicle,ovulation,formation of corpus luteum and atrophy of corpus luteum.After treatment,the medication time and dosage of gonadotropin,the number of retrieved oocytes,fertilization rate,cleavage rate,the number of fine quality embryo,embryo implantation rate and pregnancy rate were compared between the two groups.【Results】In group A,the embryo implantation rate was 27.0%,higher than 15.0% in group B(P0.05).【Conclusion】Therapy of artificial menstrual cycle induction by Chinese medicine combined with ART is helpful for the improvement and coordination of organic function,and thus increase embryo implantation rate in infertility patients.
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Objective:To study on effect of Gutai Decoction on the abortion rate of in vitro fertilization and embryo transplantation(IVF-ET).Methods:237 cases with ?-human chorionic gonadotropin(B-HCG) ≥25IU/L 14 days after the transplantation were divided into Treatment group A (TCM administration after the transplantation),Treatment group B(TCM administration after pregnancy) and western medicine control group.Their abortion rates were observed.Results:The abortion rate was 13.08%,15% and 24% in treatment group A,B and the control group respectively,with significant difference between the treatment groups and the control group(P