Comparison of Pregnancy Outcomes of High-Quality D5- and D6-Blastocyst Transfer in Hormone-Replacement Frozen-Thawed Cycles

This study aimed to assess pregnancy outcomes after high-quality D5- and D6-blastocyst transfer in frozen cycles of in vitro fertilization and embryo transfer and to further evaluate whether there was a difference in blastocyst development potentials with different developmental speeds and in pregnancy outcomes. A retrospective analysis was conducted to analyze 247 frozen cycles in our center from September 2015 to July 2017, which were divided into two groups: a D5-FET group with 193 cycles of D5-blastocyst transfer, and a D6-FET group with 54 cycles of D6-blastocyst transfer. Hormone replacement method was utilized to prepare frozen-cycle endometria. Pregnancy outcomes were analyzed and compared between these two groups. The mean ages of the two groups were 31.45 ± 4.43 years and 31.98 ± 4.84 years, respectively, with no statistically significant differences (P > 0.05). The difference in the endometrial thickness during transfer was also not statistically significant. The implantation rate in the D5-FET group was 60.13%, significantly higher than that in the D6-FET group (31.58%, P P < 0.05). No statistically significant differences were found in the abortion rate and ectopic pregnancy rate between the two groups. The implantation, biochemical pregnancy, and clinical pregnancy rates of the blastocyst D5 were all superior to those of the blastocyst D6. In clinics, therefore, D5-blastocyst transfer could be prioritized for embryo transfer.

Case Report of Ectopic Pregnancy during Controlled Ovarian Stimulation without Oocytes Harvested and Late Ovarian Hyperstimulation Syndrome

Here we reported a rare case of misdiagnosed ectopic pregnancy (EP) due to unintended ovulation during controlled ovarian stimulation (COS) in GnRH agonist cycle, resulting in no oocytes harvested and late hyper-stimulation syndrome (OHSS). The patient was a 33-year old primary infertile woman due to male’s factors and underwent her second in vitro fertilization (IVF) cycle using GnRH agonist protocol, and no oocytes harvested on ovum picked-up (OPU) day. The start of gonadotropin usage was on day 8th of her period, and the P level increased rapidly and strangely high from day 8th after gonadotropin usage. The E2 level and follicles grew normally but finally no oocytes harvested. She was diagnosed as late ovarian hyper-stimulation syndrome (OHSS) 7 days after OPU. 20 days after OPU, no menstruation come and a positive urine test of hCG were reported. And the patient was diagnosed as EP by laparoscopy. In conclusion, rapidly increased P level, no oocyte retrieval and late onset of OHSS should be very important clues to diagnose this misdiagnosed EP.

Double-Lumen Needle Follicular Flushing System versus Single-Lumen Aspiration Needle in IVF/ICSI Patients with Poor Ovarian Response: A Meta-Analysis

Background: The present study performed a meta-analysis to comprehensively analyze existing randomized controlled trials (RCT) involving the use of double-lumen needle in patients with poor ovarian response to explore whether double-lumen needle was good for specific patients. Methods: The PubMed, EMBASE, Cochrane Library databases and two randomized controlled trials registration centers were thoroughly searched until April 2017. The clinical outcomes of IVF/ICSI cycles were compared between two groups with double-lumen needle and single-lumen needle. Results: Four RCT studies were included in this present meta-analysis. The oocytes yield was similar in two groups (OR 0.88, 95%CI 0.66 - 1.16;I2 = 4%). The procedure time with double-lumen needle was significantly longer than that with single-lumen needle (IV = 1.98, 95%CI 0.95 - 3.00;I2 = 86%). The fertilization rate with double-lumen needle was lower than that with single-lumen needle (OR 0.66, 95%CI 0.44 - 0.97;I2 = 0%). There was no significant difference of live birth rate in two groups (OR 0.76, 95%CI 0.32 - 1.76;I2 = 41%). Conclusion: Double-lumen needle could not benefit patients with a POR in terms of the number of oocytes retrieved, oocyte recovery rate, normal fertilization rate, clinical pregnancy rate, and live birth rate, compared with single-lumen needle.

Frozen Blastocyst Transfer during <i>in Vitro</i>Fertilization/Intracytoplasmic Sperm Injection Cycle Lowers the Rate of Ectopic Pregnancy

This study aimed to determine whether frozen blastocyst transfer can lower the incidence rate of ectopic pregnancy. A total of 1577 in vitro fertilization/ intra-cytoplasmic cycles were analyzed, including 757 fresh D3-ET cycles, 429 frozen D3-ET cycles, and 391 frozen D5-ET cycles. The differences of ages, the proportion of IVF cycles, the proportion of primary infertility, and the proportion of tubal factor between three groups were not significant. The clinical pregnancy rate in Frozen D5-ET Group was 62.15%, which was significantly higher than other two groups (46.10%;38.93%;P < 0.05). The miscarriage rates of three groups were similar. The ectopic pregnancy rate in Frozen D5-ET Group was 0.41%, which was significantly lower than that in Frozen D3-ET Group (2.99%, P < 0.05) and slightly lower than that in Fresh D3-ET Group (2.29%, P = 0.089). Results from this study show that the transfer of frozen D5 blastocysts can significantly decrease the incidence rate of ectopic pregnancy.

Current therapies for osteoarthritis and prospects of CRISPR-based genome,epigenome,and RNA editing in osteoarthritis treatment

Osteoarthritis(OA)is one of the most common degenerative joint diseases worldwide,causing pain,disability,and decreased quality of life.The balance between regeneration and inflammation-induced degradation results in multiple etiologies and complex pathogenesis of OA.Currently,there is a lack of effective therapeutic strategies for OA treatment.With the development of CRISPR-based genome,epigenome,and RNA editing tools,OA treatment has been improved by targeting genetic risk factors,activating chondrogenic elements,and modulating inflammatory regulators.Supported by cell therapy and in vivo delivery vectors,genome,epigenome,and RNA editing tools may provide a promising approach for personalized OA therapy.This review summarizes CRISPR-based genome,epigenome,and RNA editing tools that can be applied to the treatment of OA and provides insights into the development of CRISPR-based therapeutics for OA treatment.Moreover,in-depth evaluations of the efficacy and safety of these tools in human OA treatment are needed.

Homology-based repair induced by CRISPR-Cas nucleases in mammalian embryo genome editing

Recent advances in genome editing,especially CRISPR-Cas nucleases,have revolutionized both laboratory research and clinical therapeutics.CRISPR-Cas nucleases,together with the DNA damage repair pathway in cells,enable both genetic diversification by classical non-homologous end joining(c-NHEJ)and precise genome modification by homology-based repair(HBR).Genome editing in zygotes is a convenient way to edit the germline,paving the way for animal disease model generation,as well as human embryo genome editing therapy for some life-threatening and incurable diseases.HBR efficiency is highly dependent on the DNA donor that is utilized as a repair template.Here,we review recent progress in improving CRISPR-Cas nuclease-induced HBR in mammalian embryos by designing a suitable DNA donor.Moreover,we want to provide a guide for producing animal disease models and correcting genetic mutations through CRISPR-Cas nuclease-induced HBR in mammalian embryos.Finally,we discuss recent developments in precise genome-modification technology based on the CRISPR-Cas system.

ON q-WIENER INDEX OF UNICYCLIC GRAPHS

The q-Wiener index of unicyclic graphs are determined in this work. As an example of its applications, an explicit expression of q-Wiener index of caterpillar cycles is presented.