The interaction effect between advanced paternal age and paternal obesity is associated with the low implantation rate in couples with unexplained recurrent pregnancy loss

Objective:To explore the roles of advanced paternal age(APA)and abnormal paternal weight on embryo quality and pregnancy outcomes for unexplained recurrent pregnancy loss(uRPL)couples who underwent preimplantation genetic testing for aneuploidies(PGT-A).Methods:This study included 779 uRPL couples who underwent their first PGT-A cycles between 2014 and 2018.Male patients’aging and nutritional status were quantified by paternal age and body mass index(BMI).Routine semen parameters and sperm DNA fragmentation index(DFI)were used to reflect the seminal quality.Blastocyst formation rate and aneuploidy rate were used to reflect the embryo quality.Cycle cancellation rate,implantation rate,pregnancy loss rate,and live birth rate were measured to evaluate the treatment efficiency from IVF.To remove the interference of maternal age,only the women younger than 38 years old were included.After univariate screening,interaction tests were performed in a generalized linear model(GLM)to further examine the effects of paternal age and BMI on each outcome indicator.Results:In the total population(779 cycles),there were no statistical differences in aneuploidy rate,cycle cancellation rate,implantation rate,pregnancy loss rate,and live birth rate,whether stratified by paternal age or paternal BMI.Similar results occurred in the younger men(<40 y.o.,633 cycles).Conversely,among the men with advanced age(≥40 y.o.,146 cycles),there were statistical differences between the three BMI groups in four semen parameters(total sperm number,total motility,progressive motility,and total motile sperm count),implantation rate,and live birth rate.After interaction testing,the results of GLM suggested that the interaction effect between APA and paternal obesity was associated with the low implantation rate of uRPL couples.Conclusions:For the uRPL couples seeking for PGT-A treatment,if the male patients have both advanced age and obesity,their spouses are at higher risks for embryo implantation failure.

A comparison of implantation, miscarriage and pregnancy rates of single and double day 3 embryo transfer between fresh and frozen thawed transfer cycles： a retrospective study

Background Reduced endometrial receptivity in hyperstimulated cycles may lead to a lower implantation rate and a lower clinical pregnancy rate,but it is unclear if it is also associated with an increase in pregnancy loss rate.The aim of this study was to compare the implantation,miscarriage,and pregnancy rates between fresh and frozen thawed transfer of one or two day-3 embryos,with a view to understanding whether or not reduced endometrial receptivity encountered in hyperstimulated cycles is associated with an increase in miscarriage rate.Methods This study involved a consecutive series of 1 551 single day-3 embryo transfer cycles and consecutive 5 919 double day-3 embryo transfer cycles in the Assisted Reproductive Unit of the Sir Run Run Shaw Hospital,Hangzhou,China,between January 2010 and December 2012.Results The implantation and clinical pregnancy rates （single embryo 30.7％ and double embryos 33.4％ and 51.4％）using fresh cycle were both significantly lower than that of frozen-thawed cycles （single embryo 35.8％ and double embryos 38.1％ and 57.8％）.There was no difference in biochemical loss or clinical miscarriage rates between the two groups.Conclusions Impairment of endometrial receptivity associated with ovarian hyperstimulation leads to implantation failure at a very early stage,resulting in an increased number of non-pregnancy.It does not lead to increase in biochemical or clinical losses.The significantly reduced ongoing pregnancy rates in both fresh single and double embryo transfer are therefore due to failure to achieve a pregnancy,rather than pregnancy loss after conception.

Molecular Dynamics Simulation on Hydrogen Ion Implantation Process in Smart-Cut Technology

The hydrogen ion implantation process in Smart-Cut technology is investigated in the present paper using molecular dynamics（MD） simulations.This work focuses on the effects of the implantation energy,dose of hydrogen ions and implantation temperature on the distribution of hydrogen ions and defect rate induced by ion implantation.Numerical analysis shows that implanted hydrogen ions follow an approximate Gaussian distribution which mainly depends on the implantation energy and is independent of the hydrogen ion dose and implantation temperature.By introducing a new parameter of defect rate,the influence of the processing parameters on defect rate is also quantitatively examined.

Clinical Analysis on IVF-ET Treatment of 9 Cases of Post-cesarean Section Uterine Diverticulum

Objective To evaluate the influence of uterine diverticulum patients who have a history of cesarean section on IVF-ET process and pregnancy outcome. Methods Nine patients with uterine diverticulum after cesarean were retrospectively analyzed, who have received IVF-ET treatment. Clinical pregnancy rate and embryo implantation rate were measured. Results There were 9 infertility patients in all, 7 cases with tubal factor, 2 with unexplained factor; 3 cases were associated with prolonged menstruation period, including 1 patient was misdiagnosed as dysfunctioned uterine bleeding. There were a total of 16 transplantation cycles, including14 fresh cycles and 2 thawing cycles. Each cycle had at least one high-quality embryo available for transfer. Five cases were difficult to transfer. Two were clinical pregnancie, the implantation rate was 5.13% （2/39）. Conclusion In this study, 14 fresh cycles all had high-quality embryo transfer, uterine diverticulum had no effect on the development of ovums and the formation of high- quality embryos. But forming uterine diverticulum after cesarean section may lead to secondary infertility or patients with prolonged menstruation period, it also may lead it difficult to transfer during the treatment of IVF-ET and affect embryo implantation. So the patients with a history of cesarean section shall receive ultrasonic examination or hysteroscopy routinely before IVF treatment. If necessary surgical treatment is required.

Influence of Gynaecologic Adnexal Surgeries on Subsequent Ovarian Function and In Vitro Fertilization Treatment Outcome

Objective To investigate the correlation between gynaecologic adnexal surgery history and pregnancy outcome of in vitro fertilization （IVF） treatment. Methods A total of 810 women who were proceeded 810 IVF; treatment cycles from October 2009 to March 2011 were recruited to this retrospective study, based on whether they had history of gynaecologic adnexal surgeries or not. Among 810 women, 587 women had no gynaecologic adnexal surgeries （group A）, 223 women had gynaecologic adnexal surgeries （group B）. Additionally, the group B was further divided into 4 subgroups based on their different gynaecologic adnexal surgery histories, such as tubal conservative surgery （group Bal）, unilateral salpingectomy （group Ba2）, ovarian cyst ablation （group Bbl） and unilateral adnexal resection （group Bb2）. The basal levels of FSH, antral follicle count （AFC）, clinical pregnancy rate （CPR）, embryos implantation rates （IR） and live birth rates （LBR） were compared.Results The levels of FSH and AFC were significantly different between groups A and B, respectively. Therefore, CPR, IR and LBR were significantly lower （P 〈0.05） in group B （30.9%, 17.8% and 25.1%） compared with group A （39.9%, 22.8% and 32.4%）. Meanwhile, there was no significant difference between the patients who had tubal conservation surgery （group Bal） and who had unilateral salpingectomy （group Ba2）. However, in contrast to unilateral adnexectomy, ovarian cystectomy surgery influenced FSH and AFC significant, even for the number of oocyte retrieved, but did not affect the IVF treatment outcome. Conclusion The previous history of gynaecologic adnexal surgeries may affect the subsequent ovarian function and also IVF outcomes. As for different operation methods, between tubal conservation surgery and unilateral salpingectomy, the IVF outcomes were not significantly different. The same result we found in different ovarian operation groups.

Clinical Outcomes of Transfer Vitrified-Thawed Day 4,8-Cell Embryos into Endometrium Prepared for Day 3 Embryos

Objective:To determine the clinical outcomes of transfer of day 3,8-cell embryos into endometrium prepared for day 3 embryos.Methods:This study performed a retrospective analysis of 1,190 retarded embryos.These embryos underwent extended culture in vitro to select and vitrify day 4,8-cell embryos,followed by 176 frozen embryo transfer cycles(study group),matching 660 transfer cycles with single frozen day 3,8-cell embryos as the control(control group).Results:The study group achieved successful implantation rates,clinical pregnancy rate,and live-birth rates(20.45%,15.91%,14.20%,respectively),although these were lower than that in the control group(30.45%,27.42%,and 20.91%;P=0.009,0.002,and 0.046,respectively).The miscarriage rate was similar to that in the control group(4.55%vs.3.33%,P>0.05),and the mean birth weight of the study group was higher than that in the control group(3,556±381 g vs.3,311±570 g,P=0.012).Conclusions:Transfer of frozen day 4,8-cell embryos into endometrial prepared for day 3 embryos can be a new and safe alternative for patients with delayed embryos.