[Correlation of sperm DNA fragmentation index with age and semen parameters and its influence on the outcomes of IVF-ET].

OBJECTIVE: To explore the correlation of the sperm DNA fragmentation index (DFI) with age and other semen parameters in infertile men and its influence on the outcomes of in vitro fertilization and embryo transplantation (IVF-ET). METHODS: Semen samples were obtained from 6 162 infertile males in our hospital between July 2017 and December 2018. Sperm concentration, the percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS) and sperm DFI were determined by computer-assisted semen analysis, modified Papanicolaou staining and sperm chromatin structure assay, respectively. According to the sperm DFI, the samples were divided into three groups: DFI≤15%, 15%30%. Comparisons were made among different groups in the rates of fertilization, embryo cleavage, embryo formation and pregnancy. RESULTS: Spearman correlation analysis showed that DFI was correlated positively with age (r = 0.508, P < 0.05), but negatively with sperm concentration (r = －0.155, P < 0.05) and the percentages of PMS (r = －0.111, P < 0.05) and MNS (r = －0.315, P < 0.05). With sperm DFI >20%, the clinical pregnancy rate of IVF-ET was significantly reduced, while with sperm DFI >30%, the rate of available embryos markedly decreased and that of biochemical pregnancy remarkably increased. No correlation was found between sperm DFI and the rates of fertilization, embryo cleavage and high-quality embryos in IVF-ET. CONCLUSIONS: In infertile males, sperm DFI is correlated positively with age but negatively with sperm concentration and the percentages of PMS and MNS, and it significantly affects the outcomes of IVF-ET.

Learning from POSTAL study: can levothyroxine improve pregnancy outcomes in women with thyroid autoimmunity? / 中华内分泌代谢杂志

Whether levothyroxine ( LT4 ) treatment improves outcomes following in vitro fertilization and embryo transfer ( IVF-ET) in euthyroid women who have tested positive for thyroid autoantibodies remains unclear. In Pregnancy Outcome Study in enthyroid women with Thyroid Autoimmunity after Levothyroxine ( POSTAL) trial, which was a randomized controlled study involving 600 euthyroid women undergoing IVF-ET who were tested positive for thyroperoxidase antibodies, the miscarriage rate, clinical pregnancy rate and live-birth rate were not significantly different between the LT4 intervention group and control group. Therefore, LT4 treatment did not appear to improve pregnancy outcomes among women with thyroid autoantibodies undergoing IVF-ET.

[Application time-point and effect observation of fire needling therapy in IVF-ET].

OBJECTIVE: To observe the effects of the intervention with fire needling therapy on the uterine microenvironment at the specific time points of menstrual cycle and evaluate the effects on the assisted reproduction. METHODS: Sixty-eight patients of in vitro fertilization and embryo transplantation (IVF-ET) were randomized into an observation group (35 cases) and a control group (33 cases). The patients in the two groups all received post-IVF-ET corpus luteum support of the microstimulation scheme in the Clinical Reproduction Center of Jiangsu People's Hospital. In the control group, the regular sequential therapy of acupuncture was used. In the observation group, on the basis of the treatment as the control group, the intervention of fire needling therapy was applied after ovulation (the 1st time point, on the 1st day after ovulation) and at the end of premenstrual stage (the 2nd time point, 3 days before the menstruation). At the 1st time point, Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3) were selected and at the 2nd time point, Shenshu (BL 23) and Ciliao (BL 32) were selected. The acupoints were stimulated from up to down and from the left to the right. The changes in TCM syndrome during the preparation, the endometrial thickness and types on the day of transplantation, the biochemical pregnant rate after transplantation and clinical pregnant rate were observed and compared in the patients of the two groups. RESULTS: After treatment, TCM syndrome scores were all reduced in the two groups (both P<0.05). In the observation group, the biochemical pregnant rate and clinical pregnant rate were slightly higher than those in the control group, without significant difference in comparison (both P>0.05). In the observation group, the endo-metrial thickness on the day of transplantation was higher than that in the control group (P<0.05). After treatment, the differences in TCM syndrome score and endometrial type were not significant statistically between the two groups (all P>0.05). CONCLUSIONS: The intervention of fire needling therapy at the specific time points of menstrual cycle relieves menstrual symptoms and increases endometrial thickness so as to assist embryo implantation in the patients of infertility.

Application time-point and effect observation of fire needling therapy in IVF-ET / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of the intervention with fire needling therapy on the uterine microenvironment at the specific time points of menstrual cycle and evaluate the effects on the assisted reproduction.</p><p><b>METHODS</b>Sixty-eight patients of in vitro fertilization and embryo transplantation (IVF-ET) were randomized into an observation group (35 cases) and a control group (33 cases). The patients in the two groups all received post-IVF-ET corpus luteum support of the microstimulation scheme in the Clinical Reproduction Center of Jiangsu People's Hospital. In the control group, the regular sequential therapy of acupuncture was used. In the observation group, on the basis of the treatment as the control group, the intervention of fire needling therapy was applied after ovulation (the 1st time point, on the 1st day after ovulation) and at the end of premenstrual stage (the 2nd time point, 3 days before the menstruation). At the 1st time point, Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3) were selected and at the 2nd time point, Shenshu (BL 23) and Ciliao (BL 32) were selected. The acupoints were stimulated from up to down and from the left to the right. The changes in TCM syndrome during the preparation, the endometrial thickness and types on the day of transplantation, the biochemical pregnant rate after transplantation and clinical pregnant rate were observed and compared in the patients of the two groups.</p><p><b>RESULTS</b>After treatment, TCM syndrome scores were all reduced in the two groups (both<0.05). In the observation group, the biochemical pregnant rate and clinical pregnant rate were slightly higher than those in the control group, without significant difference in comparison (both>0.05). In the observation group, the endo-metrial thickness on the day of transplantation was higher than that in the control group (<0.05). After treatment, the differences in TCM syndrome score and endometrial type were not significant statistically between the two groups (all>0.05).</p><p><b>CONCLUSIONS</b>The intervention of fire needling therapy at the specific time points of menstrual cycle relieves menstrual symptoms and increases endometrial thickness so as to assist embryo implantation in the patients of infertility.</p>

Miliary tuberculosis after in vitro fertilization and embryo transplantation.

BACKGROUND: With the development of assisted reproductive technology, more patients with infertility prefer to get pregnant by in vitro fertilization and embryo transplantation (IVF-ET). But the indications of IVF-ET must be strictly controlled by the clinicians. CASE REPORT: We described a case of a 29-year-old pregnant Chinese woman with military tuberculosis. She was admitted to the hospital with complaints of fever and shortness of breath. She received IVF-ET 83 days ago, because of infertility with bilateraltubal occlusion, and was in pregnancy status. We presented the clinical, laboratory and two chest CT scan features of the patient. The second chest CT scan showed randomly distributed, innumerable tiny, military nodules throughout the lungs. The fluorescence quantitative PCR of the bronchoalveolar lavage fluid (BALF) was positive for Mycobacterium tuberculosis. The M. tuberculosis was cultured from BALF on Day 29. So we made the diagnosis of military tuberculosis. CONCLUSION: It is important to rule out tuberculosis for the infertility patients especially with bilateraltubal occlusion before IVF-ET in order to avoid tuberculosis disseminate during pregnancy.