The cumulative live birth rates of 18 593 women with progestin-primed ovarian stimulation-related protocols and frozen-thawed transfer cycles.

STUDY QUESTION: What are the odds of achieving pregnancy when adopting progestin-primed ovarian stimulation (PPOS)-related protocols combined with repetitive frozen-thawed transfer (FET) cycles in patients with different clinical characteristics? SUMMARY ANSWER: The cumulative live birth rates (CLBRs) of women undergoing different PPOS-related protocols can be significantly and consistently enhanced within six FET cycles when the female age is <40 years (or even <45 years) and when >5 oocytes are retrieved, regardless of antral follicle count (AFC). WHAT IS KNOWN ALREADY: There have been numerous studies on the live birth rate of the first FET cycle in patients with PPOS-related protocols. These studies have focused mainly on comparing pregnancy outcomes with those of other stimulation protocols. However, owing to the unique features of the PPOS-related strategy, such as its flexible timing of oocyte retrieval and repeated transfer of frozen embryos, studies using the CLBR as an overall indicator of success and investigating which types of patients would benefit from this protocol are lacking. STUDY DESIGN SIZE DURATION: This retrospective cohort study included 18 593 women who underwent PPOS-related protocols (dydrogesterone + hMG, medroxyprogesterone acetate + hMG, micronized progesterone + hMG treatment, and luteal-phase ovarian stimulation protocol) from 1 March 2011 to 31 September 2022 in our centre. PARTICIPANTS/MATERIALS SETTING METHODS: The population was categorized by female age, number of oocytes retrieved, and AFC in the analysis of CLBR within six FET cycles. The age groups (Groups 1-5, respectively) were <30, 30-34, 35-39, 40-44, and ≥45 years. The number of oocytes retrieved was grouped as 1-5, 6-10, 11-15, 16-20, and >20. AFC was grouped as <5, 5-10, 11-15, and >15. The Kaplan-Meier analysis (optimistic method), which hypothesized that patients who did not continue treatment had the same chance of achieving a live birth as those who continued, and the competing risk method (conservative method) which hypothesized they had no chance of achieving a live birth, were applied. In further analyses, the Cox model and Fine-Gray model were adopted: the former corresponds to the optimistic scenario, and the latter corresponds to the pessimistic scenario. MAIN RESULTS AND THE ROLE OF CHANCE: CLBR had a declining trend with female age over six FET cycles (Groups 1-5, respectively: optimistic: 96.9%, 96.6%, 91.4%, 67.3%, and 11.7%; conservative: 87.3%, 85.0%, 74.0%, 41.3%, and 7.5%), requiring more FET cycles to achieve a success rate of at least 50% (Groups 1-5, respectively: optimistic: 2, 2, 2, 4, and >6 cycles; conservative: 2, 2, 2, >,6 and >6 cycles). CLBR showed an increasing trend with the number of oocytes retrieved (Groups 1-5, respectively: optimistic: 93.8%, 94.3%, 95.8%, 96.0%, and 95.6%; conservative: 66.2%, 78.3%, 85.6%, 88.9%, and 91.0%). All groups needed the same number of FET cycles to achieve a success rate of at least 50% (Groups 1-5, respectively: optimistic: 2, 2, 2, 2, and 2 cycles; conservative: 2, 2, 2, 2, and 2 cycles). Furthermore, the CLBR within six FET cycles had an increasing trend with AFC number (Groups 1-4, respectively: optimistic: 89.2%, 94.8%, 95.9%, and 96.3%; conservative: 67.4%, 78.2%, 83.9%, and 88.1%), with all four groups achieving a success rate of at least 50% by the second FET cycle. LIMITATIONS REASONS FOR CAUTION: The current research is limited by its retrospective design and single-centre nature, which may restrict the generalizability of our findings. WIDER IMPLICATIONS OF THE FINDINGS: This work describes two models (the Kaplan-Meier analysis and the competing risk method) to evaluate the clinical outcome of patients using PPOS-related protocols, which are especially useful for patients of advanced age or those with diminished ovarian reserve. Our findings encourage patients below 45 years old, especially younger than 40 years, and patients with lower AFCs and fewer retrieved oocytes to try this new protocol. Moreover, this study demonstrates the degree of improvement in the CLBR within six FET cycles for patients with different clinical characteristics, providing a valuable point of reference to determine whether to continue ART after a transfer failure. STUDY FUNDING/COMPETING INTERESTS: The study was supported by grants from the National Natural Science Foundation of China (82071603 to L.W., 82001502 to Y.L.). There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: N/A.

Variable sediment methane production in response to different source-associated sewer sediment types and hydrological patterns: Role of the sediment microbiome.

Production of methane (CH4), an essential anthropogenic greenhouse gas, from municipal sewer sediment is a problem deserving intensive attention. Based on long-term laboratory batch tests in conjunction with 16 s rRNA gene sequencing and metagenomics, this study provides the first detailed assessment of the variable sediment CH4 production in response to different pollution source-associated sewer sediment types and hydrological patterns, while addressing the role of the sediment microbiome. The high CH4-production capability of sanitary sewer sediment is shaped by enriched biologically active substrate and dominated by acetoclastic methanogenesis (genus Methanosaeta). Moreover, it involves syntrophic interactions among fermentation bacteria, hydrogen-producing acetogens and methanogens. Distinct source-associated microbial species, denitrifying bacteria and sulfate-reducing bacteria occur in storm sewer and illicit discharge-associated (IDA) storm sewer sediments. This reveals their insufficient microbial function capabilities to support efficient methanogenesis. Hydrogenotrophic methanogenesis (genus Methanobacterium) prevails in both these sediments. In this context, storm sewer sediment has an extremely low CH4-production capability, while IDA storm sewer sediment still shows significant carbon emission through a possibly unique mechanism. Hydrological connections promote the sewer sediment biodegradability and CH4-production capability. In contrast, hydrological disconnection facilitates the prevalence of acetoclastic methanogenesis, sulfate-reducing enzymes, denitrification enzymes and the sulfur-utilizing chemolithoautotrophic denitrifier, which drastically decreases CH4 production. Turbulent suspension of sediments results in relative stagnation of methanogenesis. This work bridges the knowledge gap and will help to stimulate and guide the resolution of 'bottom-up' system-scale carbon budgets and GHG sources, as well as the target CH4 abatement interventions.

[Pollution Status and Pollution Behavior of Microplastic in Surface Water and Sediment of Urban Rivers].

Rivers have been a subject of great concern in recent years as they have been found to be the critical path for the transmission of microplastics from terrestrial land to the ocean. However, the pollution status of microplastics and their behavior in the surface waters and sediments of urban rivers located in different urban areas remain unclear. In this study, 16 samples of surface water and sediment from eight rivers in the central and suburban areas of Shanghai Megacity were obtained and analyzed. High-speed cameras and Fourier transform infrared spectrometers were used to identify the abundance, size, color, shape, type, and other characteristics of microplastics in these samples. The results showed that the average abundance of microplastics in the surface waters of urban rivers in Shanghai Megacity was (7.5±2.8) pieces·L-1, while the corresponding average abundance in the sediment reached (1575.5±758.4)pieces·kg-1 (wet weight). The abundance of microplastics was found to increase with the decreasing particle diameter. Among which, microplastics with a size of less than 500 µm, as well as the fibrous shape, transparent color, and Polyester composition, have always dominated in the urban rivers in Shanghai megacity. Comparably, microplastics in the sediments were more diverse in their morphology features and polymer compositions. Microplastic pollution in the urban rivers in Shanghai megacity was severe in comparison to that in other urban rivers worldwide. Among various urban rivers, the distribution of microplastics with different morphology features and polymer compositions is greatly influenced by a number of factors including the source (e.g., mainly laundry wastewater, personal care products, and refuse plastic waste), hydrodynamic conditions, and the physical and chemical properties of plastics. Furthermore, the pollution behavior (i.e., source, transmission, and fate) of microplastics occurring in urban rivers is discussed, and the potential impacts of various environmental factors are explained.

[Molecular Chemo-diversity of the Dissolved Organic Matter Occurring in Urban Stormwater Runoff].

Stormwater runoff pollution occurring in urban areas can be a notable threat to the ecological environments of receiving water bodies. Dissolved organic matter (DOM) constitutes the primary type of pollutant in stormwater runoff, and tracking of its components and sources can provide valuable scientific bases for the future abatement of stormwater runoff pollution. In this study, aiming to demonstrate the characteristics and sources of the contained DOM in both pavement runoff (PR) and greenland runoff (GR), we applied ultra-high-resolution Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR-MS) to analyze the molecular chemo-diversity of their DOM, as well as Spearman rank correlations between the molecular chemo-diversity and water quality indicators including suspended solids (SS), total nitrogen (TN), dissolved organic carbon (DOC), and dissolved lead (Pb). The results show:① When the molecular accumulation reaches a saturated state, the cumulative number of molecules of PR-DOM (12498) is much larger than that of GR-DOM (7015). The molecular distribution of PR-DOM (150-750) is smaller yet more concentrated than that of GR-DOM (150-850). ② According to the molecular composition characterization and Spearman rank correlation analysis, the sources of the components of PR-DOM and GR-DOM are remarkably different. PR-DOM can be greatly influenced by human activities, and its primary element component (CHOS) contains a large number of substances that were recognized to be from the surfactant sulfonic acid. Additionally, the significant aliphatic components that emerged were from traffic pollution. In contrast, GR-DOM is less affected by human activities, and its primary element component (CHO) gives priority to natural organic matter (NOM). The most abundant substance component that occurred in GR-DOM, i.e., the highly unsaturated and phenolic compound that generally originates in the degraded humus, is initially formed by the plant residue and flushed by rainfall runoff.

[Relationship Between CO2 and CH4 Emissions in Urban Rivers and Sewage Discharging from a Municipal Drainage Network].

The increasing carbon emission of polluted rivers in urban areas is an environmental problem commonly faced by many cities in China, especially the megacities with vast populations. In this study, two typical rivers located in the megacity of Shanghai, including the suburban river network R1 and urban river R2 (in the central city), were investigated for their emission characteristics of CO2 and CH4 in dry and wet weather. We also analyzed the relationship between the state and type of river pollution and CO2 and CH4 emissions, and further explained the mechanisms of CO2 and CH4 emissions in urban rivers impacted by sewage discharged from the municipal drainage network. The results show that:① In dry weather, the average fluxes of CO2 and CH4 emitted from the river in the central city (R2) were (2.48±1.02) mmol·(m2·h)-1 and (1.21×10-2±0.71×10-2) mmol·(m2·h)-1, respectively. The average fluxes of CO2 and CH4 from the suburban river (R1) network were (1.53±0.39) mmol·(m2·h)-1 and (9.26×10-3±9.18×10-3) mmol·(m2·h)-1, respectively. In wet weather, affected by sewage from the municipal drainage network, CH4 flux emitted from the surface water of the R2 river downstream of the pump station P increased by up to 119 times that in dry weather. ② Global carbon emission statistics, involving the data from our study and from other rivers around the world, seemed to imply a relationship between the carbon emission flux and the pollution state of an urban river, i.e., the rivers with high pollution showed significant carbon emission intensity. ③ According to the results of PCA, organic matter can be an essential factor in driving the variation of carbon emissions, and this trend is evident in all the rivers in urban and suburban areas. The relationship between carbon emissions and nitrogen pollution in a river varies with different types of underlying riparian surface. In the less polluted urban rivers, the aquatic physical factor can also be an essential factor. ④ In the short term, with massive quantities of sewage discharged into urban rivers, a large amount of CH4 flux can be emitted. In contrast, in the long run, the carbon cycle can be strengthened when the carbon storage is increased, and thus the emission potential of CO2 and CH4 is improved.

The occurrence of microplastics in water bodies in urban agglomerations: Impacts of drainage system overflow in wet weather, catchment land-uses, and environmental management practices.

The footprints of microplastics in the water bodies of urban agglomerations are largely dominated by superimposed anthropogenic influences. Understanding these influences and how they are correlated is essential to better understand the occurrence and variability of microplastics in different ecosystems. This study longitudinally assessed the abundance and distribution of microplastics in the water bodies of urban agglomerations at the watershed-scale in Shanghai Megacity. Particularly, the behavior of microplastics with the impacts of drainage system overflow in wet weather (WWF), land uses, and environmental management practices were explored. WWF can greatly aggravate microplastic pollution in aquatic environments. A systemic estimation based on detailed data was used to show that the annual load of microplastics discharged via WWF in the watershed area was 8.50 × 1014 p/year, which was approximately six times larger than that discharged via the local Wastewater Treatment Plant effluent. Findings here contribute to research concerning the spatial variability of aquatic microplastics and the extent to which they are affected by land use. In descending order, the highest microplastic concentrations were found in heavy industrial > commercial/public/recreational > agricultural/light industrial > agricultural > and residential areas. The longitudinal pattern of microplastics observed in the water bodies suggested that there were superimposed effects of land use and hydrodynamics. This paper is the first to provide an integrated framework that demonstrates the significant role of environmental management practices in controlling the production and transmission of microplastics to receiving waters at a city-scale. Improved management of WWF might be a tangible solution that would help achieve an immediate and large-scale reduction of microplastics in sewage. Determining the optimized management practices for different weather or hydrological conditions could be an essential factor in decreasing microplastic concentrations and altering their flow-path pattern in a given region.

Variations in CH4 and CO2 productions and emissions driven by pollution sources in municipal sewers: An assessment of the role of dissolved organic matter components and microbiota.

Variations in methane (CH4) and carbon dioxide (CO2) emissions in municipal sewer driven by pollution sources are complex and multifaceted. It is important to investigate the role of dissolved organic matter (DOM) components and microbiota to better understand what and how those variations occurred. For this purpose, this study provides a systematic assessment based on short-term in-sewer conditioned cultivations, in conjunction with a field survey in four typical sewers in Shanghai Megacity. The results are as follows: (1) Sediment plays a main role in driving the sewer carbon emission behavior owing to its strong associations with the utilized substrates and predominant microbes that significantly promoted the gas fluxes (genera Bacteroidete_vadinHA17, Candidatus_competibacter, and Methanospirillum). (2) Aquatic DOM in overlying water is an indispensable factor in promoting total carbon emissions, yet the dominant microbes present there inversely correlated with gas fluxes (genera Methanothermobacter and Bacteroides). (3) The total fluxes of both CH4 and CO2 enhanced by pavement runoff were limited. Its high COD-CH4/CO2 conversion efficiencies can be ascribed to its dominant anthropogenic humic-like components and the emerged aquatic tyrosine-like components. (4) Domestic sewage can significantly enhance the total fluxes because of its high concentration of bioavailable DOM. However, these substrates, which were more suitable for supporting microbial growth, as well as the substrate competition caused by sulfate reduction and the nitrogen cycle (revealed by the dominant functional microbes genera Acinetobacter, Pseudomonas, Dechloromona, and Candidatus_competibacter and their correlations with indicators), seemed to be responsible for the low COD-CH4/CO2 conversion efficiencies of domestic sewage. (5) A field survey indicated the distinct features of carbon emissions of sewer sewage discharged from different catchments. An extreme hydraulic condition in a sewer in the absence of influent showed unexpectedly high levels of CO2, while a small amount of CH4 emissions.

[Removal of Microplastics by Different Treatment Processes in Shanghai Large Municipal Wastewater Treatment Plants].

Wastewater treatment plants are important sources of microplastics (MPs) in aquatic environments. The present study was conducted to investigate the number concentration, removal rate, and fate of MPs in two large municipal treatment plants in Shanghai. The MPs number concentration in the influent water of WWTP1 and WWTP2 were (226.27±83.00) piece·L-1 and (171.89±62.98) piece·L-1, respectively. WWTP1 had a MPs removal efficiency of 63.25%, which is slightly higher than that of WWTP2, at 59.84%. The removal efficiency during the primary treatment process of the two sewage treatment plants on MPs accounted for 70%-80% of the whole treatment process. The primary treatment process and secondary treatment process transferred (48.10%±1.62%) and (12.97%±0.05%) of MPs in the sewage to the sludge, respectively. As a whole, (38.82%±1.55%) of MPs in the sewage treatment plants were finally discharged into natural waters, and the remaining (61.18%±1.55%) entered the sludge. This study shows that the removal rate of MPs in Shanghai's municipal treatment plants is low and that after treatment, large amounts still enter the natural waters with the final effluent, which causes significant ecological risks. This study provides basic data of MPs removal and trends of large urban sewage treatment plants in a plain river network area, which can provide reference for further design of MPs removal processes.