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Embryo Transfer Strategies for Women with Recurrent Implantation Failure During the Frozen-thawed Embryo Transfer Cycles:Sequential Embryo Transfer or Double-blastocyst Transfer?
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作者 Qiao-hang ZHAO Yu-wei SONG +8 位作者 Jian CHEN Xiang ZHOU Ji-lai XIE Qiu-ping YAO Qi-yin DONG Chun FENG Li-ming ZHOU Wei-ping FU Min JIN 《Current Medical Science》 SCIE CAS 2024年第1期212-222,共11页
Objective Both sequential embryo transfer(SeET)and double-blastocyst transfer(DBT)can serve as embryo transfer strategies for women with recurrent implantation failure(RIF).This study aims to compare the effects of Se... Objective Both sequential embryo transfer(SeET)and double-blastocyst transfer(DBT)can serve as embryo transfer strategies for women with recurrent implantation failure(RIF).This study aims to compare the effects of SeET and DBT on pregnancy outcomes.Methods Totally,261 frozen-thawed embryo transfer cycles of 243 RIF women were included in this multicenter retrospective analysis.According to different embryo quality and transfer strategies,they were divided into four groups:group A,good-quality SeET(GQ-SeET,n=38 cycles);group B,poor-quality or mixed-quality SeET(PQ/MQ-SeET,n=31 cycles);group C,good-quality DBT(GQ-DBT,n=121 cycles);and group D,poor-quality or mixed-quality DBT(PQ/MQ-DBT,n=71 cycles).The main outcome,clinical pregnancy rate,was compared,and the generalized estimating equation(GEE)model was used to correct potential confounders that might impact pregnancy outcomes.Results GQ-DBT achieved a significantly higher clinical pregnancy rate(aOR 2.588,95%CI 1.267–5.284,P=0.009)and live birth rate(aOR 3.082,95%CI 1.482–6.412,P=0.003)than PQ/MQ-DBT.Similarly,the clinical pregnancy rate was significantly higher in GQ-SeET than in PQ/MQ-SeET(aOR 4.047,95%CI 1.218–13.450,P=0.023).The pregnancy outcomes of GQ-SeET were not significantly different from those of GQ-DBT,and the same results were found between PQ/MQ-SeET and PQ/MQ-DBT.Conclusion SeET relative to DBT did not seem to improve pregnancy outcomes for RIF patients if the embryo quality was comparable between the two groups.Better clinical pregnancy outcomes could be obtained by transferring good-quality embryos,no matter whether in SeET or DBT.Embryo quality plays a more important role in pregnancy outcomes for RIF patients. 展开更多
关键词 recurrent implantation failure sequential embryo transfer frozen-thawed embryo transfer embryo transfer strategies
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Artificial Cycle with or without a Depot Gonadotropin-releasing Hormone Agonist for Frozen-thawed Embryo Transfer: An Assessment of Infertility Type that Is Most Suitable 被引量:5
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作者 Di XIE Fan CHEN +4 位作者 Shou-zhen XIE Zhi-lan CHEN Ping TUO Rong ZHOU Juan ZHANG 《Current Medical Science》 SCIE CAS 2018年第4期626-631,共6页
The clinical outcomes of five groups of infertility patients receiving frozen- thawed, cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) a... The clinical outcomes of five groups of infertility patients receiving frozen- thawed, cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed. A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed, cleavage-stage embryo transfers from January 1, 2012 to June 31, 2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region. Based on the infertility etiologies of the patients, the 1003 cycles were divided into five groups: tubal infertility, polycystic ovary syndrome (PCOS), endometriosis, male infertility, and unexplained infertility. The main outcome was the live birth rate. Two groups were set up based on the intervention: group A was given a GnRH agonist with exogenous estrogen and progesterone, and group B (control group) was given exogenous estrogen and progesterone only. The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B. The live birth rates in groups A and B were 41.67% and 29.29%, respectively (P〈0.05). The live birth rates in patients with PCOS in groups A and B were 56.25% and 30.61%, respectively (P〈0.05). The clinical pregnancy, implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B. The ectopic pregnancy rate was significantly lower in group A than in group B. We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist co- treatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer. The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested, especially for women with PCOS. 展开更多
关键词 frozen-thawed embryo transfer gonadotropin-releasing hormone agonist polycystic ovary syndrome
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Serum β-hCG level on day 7 of frozen-thawed embryo transfer: association with the clinical pregnancy outcomes in artificial cycles
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作者 Na Sun Shu-Yi Dong +1 位作者 Ping-Ping Sun Hua-Gang Ma 《Clinical Research Communications》 2022年第3期29-33,共5页
Objective:The relationship between serum beta human chorionic gonadotropin(β-hCG)levels of patients(7 days after the transplantation of frozen-thawed embryos)and the pregnancy outcomes was investigated.Methods:This s... Objective:The relationship between serum beta human chorionic gonadotropin(β-hCG)levels of patients(7 days after the transplantation of frozen-thawed embryos)and the pregnancy outcomes was investigated.Methods:This study was designed as a retrospective clinical trial of 366 women who underwent frozen-thawed embryo transfers(FETs)in artificial cycles.Patients were divided into three groups:clinical pregnancy group,biochemical pregnancy group,and non-pregnant group according to their pregnancy outcomes.Serumβ-hCG levels were tested on day 4,7,9,11 and 14 after FET.Results:In the clinical pregnancy group,the serumβ-hCG levels after 7-day post-transplantation were significantly elevated(16.20 IU/L vs.3.07 vs.0.1 IU/L;P<0.05)compared with the other two groups.Furthermore,it was found that Area Under Curve(AUC=0.96)was significant with cut-off value higher than 4.26 IU/L(sensitivity=92.3%,specificity=90.2%)to predict the clinical pregnancy outcomes in the receiver operating characteristic(ROC)analysis ofβ-hCG concentrations on day 7 of post-transplantation.Conclusion:Our results suggested that the elevated serumβ-hCG levels on day 7 of post-transplantation could predict the positive clinical pregnancy outcomes in artificial FET cycles. 展开更多
关键词 frozen-thawed embryo transfer pregnancy outcomes artificial cycle human chorionic gonadotrophin INFERTILITY
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Pregnancy Outcomes for Day 5 Versus Day 6 Single Frozen-thawed Blastocyst Transfer with Different Qualities of Embryos: A Large Matched-cohort Study
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作者 Qiong YU Hui HE +2 位作者 Xin-ling REN Shi-fu HU Lei JIN 《Current Medical Science》 SCIE CAS 2023年第2期297-303,共7页
Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patie... Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patients who underwent blastocyst transfer in frozen-thawed cycles at day 5 or 6 were matched for potential confounding factors.A total of 2207 matched pairs of FBT cycles were included from January 2016 to December 2019 in our Reproductive Medicine Center.Results The clinical pregnancy rate(CPR)and live birth rate(LBR)were significantly increased in day 5 blastocyst transfers when compared to day 6 blastocyst transfers,in terms of the same embryo quality.For FBT cycles with good-quality embryo,the CPR at day 5 and 6 was 61.30%and 57.56%,respectively(P=0.045),and the LBR was 44.79%and 36.16%,respectively(P<0.001).For FBT cycles with poor-quality embryo,the CPR at day 5 and 6 was 48.61%and 40.89%,respectively(P=0.006),and the LBR was 31.71%and 25.74%,respectively(P=0.019).The CPR for FBT cycles with good-quality embryo was statistically higher at day 6 than that at day 5 with poor-quality embryo transferred(57.56%vs.48.61%,P=0.001).Maternal age,anti-Müllerian hormone(AMH),endometrial thickness,embryo quality,and the day of blastocyst expansion were independently correlated with the CPR and LBR.The FBT cycles at day 5 had significantly higher CPR(adjusted odds ratio[OR]=1.246,95%confidence intervals[CI]:1.097–1.415,P=0.001)and LBR(adjusted OR=1.435,95%CI:1.258–1.637,P<0.001)than those at day 6.Conclusion The embryo quality is the primary indicator for FBT cycles.Day 5 blastocysts should be preferred when the quality of embryo at day 5 is the same as that at day 6. 展开更多
关键词 frozen-thawed blastocyst transfer day 5 versus day 6 embryo quality clinical pregnancy rate live birth rate
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Live births from in vitro fertilization-embryo transfer following the administration of gonadotropin-releasing hormone agonist without gonadotropins:Two case reports
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作者 Mai Li Ping Su Li-Ming Zhou 《World Journal of Clinical Cases》 SCIE 2023年第9期2067-2073,共7页
BACKGROUND The prevalence of female infertility between the ages of 25 and 44 is 3.5%to 16.7%in developed countries and 6.9%to 9.3%in developing countries.This means that infertility affects one in six couples and is ... BACKGROUND The prevalence of female infertility between the ages of 25 and 44 is 3.5%to 16.7%in developed countries and 6.9%to 9.3%in developing countries.This means that infertility affects one in six couples and is recognized by the World Health Organization as the fifth most serious global disability.The International Committee for Monitoring Assisted Reproductive Technology reported that the global total of babies born as a result of assisted reproductive technology procedures and other advanced fertility treatments is more than 8 million.Advancements in controlled ovarian hyperstimulation procedures led to crucial accomplishments in human fertility treatments.The European Society for Human Reproduction and Embryology guideline on ovarian stimulation gave us valuable evidence-based recommendations to optimize ovarian stimulation in assisted reproductive technology.Conventional ovarian stimulation protocols for in vitro fertilization(IVF)–embryo transfer are based upon the administration of gonadotropins combined with gonadotropin-releasing hormone(GnRH)analogues,either GnRH agonists(GnRHa)or antagonists.The development of ovarian cysts requires the combination of GnRHa and gonadotropins for controlled ovarian hyperstimulation.However,in rare cases patients may develop an ovarian hyper response after administration of GnRHa alone.CASE SUMMARY Here,two case studies were conducted.In the first case,a 33-year-old female diagnosed with polycystic ovary syndrome presented for her first IVF cycle at our reproductive center.Fourteen days after triptorelin acetate was administrated(day 18 of her menstrual cycle),bilateral ovaries presented polycystic manifestations.The patient was given 5000 IU of human chorionic gonadotropin.Twenty-two oocytes were obtained,and eight embryos formed.Two blastospheres were transferred in the frozen-thawed embryo transfer cycle,and the patient was impregnated.In the second case,a 37-year-old woman presented to the reproductive center for her first donor IVF cycle.Fourteen days after GnRHa administration,the transvaginal ultrasound revealed six follicles measuring 17-26 mm in the bilateral ovaries.The patient was given 10000 IU of human chorionic gonadotropin.Three oocytes were obtained,and three embryos formed.Two high-grade embryos were transferred in the frozen-thawed embryo transfer cycle,and the patient was impregnated.CONCLUSION These two special cases provide valuable knowledge through our experience.We hypothesize that oocyte retrieval can be an alternative to cycle cancellation in these conditions.Considering the high progesterone level in most cases of this situation,we advocate freezing embryos after oocyte retrieval rather than fresh embryo transfer. 展开更多
关键词 Gonadotropin-releasing hormone agonist Ovarian hyperstimulation In vitro fertilization Live birth INFERTILITY frozen-thawed embryo transfer Human chorionic gonadotropin Case report
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Impact of gonadotropin-releasing hormone agonist and hormone replacement therapy on pregnancy outcomes in single euploid frozen-thawed embryo transfer for patients with endometrial polyps
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作者 Qing Zhao Jie Li +6 位作者 Wei-Lin Wang Ying-Bo Liu Jing Li Tian-Xiang Ni Wei Zhou Qian Zhang Jun-Hao Yan 《Reproductive and Developmental Medicine》 CAS CSCD 2024年第1期1-7,共7页
Objective:Although consensus on the optimal endometrial preparation protocol for frozen-thawed embryo transfer(FET)is lacking,this is particularly true for patients with infertility and a history of endometrial polyps... Objective:Although consensus on the optimal endometrial preparation protocol for frozen-thawed embryo transfer(FET)is lacking,this is particularly true for patients with infertility and a history of endometrial polyps(EPs).In this study,we aimed to investigate whether a gonadotropin-releasing hormone agonist combined with hormone replacement therapy(GnRHa-HRT)could improve pregnancy outcomes in single euploid FET for patients with a history of EPs.Methods:In this retrospective cohort study,395 women who underwent their first single euploid FET cycle were divided into groups according to endometrial preparation protocols as follows:natural cycle(NC)(n=220),hormone replacement therapy(HRT)(n=122),and GnRHa-HRT groups(n=53).Subsequently,the FET cycles in the three groups were subdivided according to maternal age.All patients underwent hysteroscopic polypectomy before FET,and their EPs were confirmed by pathology.Results:No statistically significant differences were observed in live birth rates among the three groups(58.64%vs.58.20%vs.56.60%,P=0.964).Furthermore,the rates of miscarriage,ectopic pregnancy,premature live birth,and pregnancy complications were comparable among the three groups(P>0.05).After adjusting for potential confounding factors,no significant differences in pregnancy outcomes were reported between the groups(adjusted odds ratios[OR]and 95%credible intervals[CI]for live birth rate,HRTvs.NC:1.119,0.660–1.896,P=0.677;GnRHa-HRTvs.NC:1.165,0.610–2.226,P=0.643).Additionally,the pregnancy outcomes of the FET cycle were not influenced by the endometrial preparation protocols in the subgroups when stratified by maternal age(P>0.05).Conclusion:GnRHa-HRT did not improve the pregnancy outcomes of the single euploid FET in patients with a history of EPs. 展开更多
关键词 Endometrial polyps frozen-thawed embryo transfer GNRHA Hormone replacement therapy Preimplantation genetic testing
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Perinatal outcomes of frozen-thawed embryo transfer following blastocyst-stage embryo transfer compared to those of cleavage-stage embryo transfer:analysis of 9408 singleton newborns using propensity score analysis
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作者 Hu-Cen Zhong Qi Wan +6 位作者 Yu-Ling Hu Tian Li Li-Juan Huang Mao Wang Xin-Yue Hu Meng-Di Wang Zhao-Hui Zhong 《Reproductive and Developmental Medicine》 CAS CSCD 2024年第2期67-74,共8页
Objective:Regarding frozen-thawed embryo transfer(FET),there is limited consensus on whether extending embryo culture from the cleavage stage to the blastocyst stage affects perinatal outcomes.This study aimed to comp... Objective:Regarding frozen-thawed embryo transfer(FET),there is limited consensus on whether extending embryo culture from the cleavage stage to the blastocyst stage affects perinatal outcomes.This study aimed to compare perinatal outcomes of singletons between blastocyst-stage embryo transfer(BT)and cleavage-stage embryo transfer(CT)in FET.Methods:A total of 9408 FET cycles that met the inclusion criteria were included in this retrospective cohort study between 2019 and 2022.Blastocyst-stage embryo transfers were performed in the BT group,and cleavage-stage embryo transfers were performed in the CT group.Multivariate logistic regression analyses were performed,as well as propensity score matching(PSM)to adjust for confounders.Results:After PSM,a higher risk of pre-term birth(PTB;odds ratio[OR]:1.23,95%confidence interval[CI]:1.00-1.50,P=0.048)and being large for gestational age(LGA;OR:1.16,95%CI:1.00-1.35,P=0.050)was observed in the BT group compared to that in the CT group.After stratified PSM,in the subgroup under 35 years of age,only an increased risk of LGA was observed in the BT group compared to the CT group.Perinatal outcomes in the double-embryo transfer subgroup were similar to those in the unstratified group.However,in the subgroup beyond 35 years of age and the single embryo transfer subgroup,perinatal outcomes were not statistically different between the BT and CT groups(P>0.05).Conclusions:In FET,prolonged embryo culture to the blastocyst stage increased the risk of PTB and LGA in single fetuses.However,stratified analysis based on age and the number of transferred embryos yielded different results,necessitating further mechanistic studies. 展开更多
关键词 frozen-thawed embryo transfer BLASTOCYST Cleavage stage Perinatal outcomes Pre-term birth Large for gestational age Small for gestational age
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A frozen-thawed embryo transfer program improves the embryo utilization rate 被引量:11
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作者 ZHOU Feng LIN Xiao-na TONG Xiao-mei LI Chao LIU Liu JIN Xiao-ying ZHU Hai-yan ZHANG Song-ying 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第17期1974-1978,共5页
Background Frozen-thawed embryo transfer (FET) is the most common way to prevent serious late ovarian hyperstimulation syndrome and increase the cumulative pregnancy rate. We evaluated the effectiveness of an FET pr... Background Frozen-thawed embryo transfer (FET) is the most common way to prevent serious late ovarian hyperstimulation syndrome and increase the cumulative pregnancy rate. We evaluated the effectiveness of an FET program for improving the embryo implantation and clinical pregnancy rates, and ultimate embryo utilization rate in infertility treatment. Methods Patients undergoing in vitro fertilisation (IVF) cycles from January 2006 to June 2008 were enrolled, including 179 patients who had undergone the first FET cycle after controlled ovarian hyperstimulation (COH) in which all embryos were frozen (group C1) and 1306 patients who had COH with fresh embryo transfer (ET) (group T1). Logistic regression was used to model the embryo implantation and clinical pregnancy rates based on the mother's age, numbers of oocytes retrieved, embryos transferred and high-quality embryos transferred. The embryo implantation and clinical pregnancy rates were also compared between two groups after adjusting for age, the numbers of oocytes retrieved and the numbers of embryos transferred. Results Logistic regression analysis confirmed that embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than those in group T1 after adjusting for confounding factors (43.6% vs 29.0%, 63.1% vs 47.0%, respectively; P 〈0.01). The embryo implantation and clinical pregnancy rates were consistently higher in group C1 by comparing the age groups ≥35 or 〈35 years. The clinical pregnancy rates for the numbers of oocytes retrieved per cycle being ≥15 or 〈15 were higher in group C1, as was the embryo implantation rate. These differences were statistically significant for oocyte numbers 〉15 (P 〈0.05). The embryo implantation and clinical pregnancy rates in group C1 were both significantly higher than in group T1 when two or three embryos were transferred (P 〈0.05). Conclusion A program of freezing all embryos and performing FET improved the rates of embryo implantation and clinical pregnancy, and ultimately enhanced the embryo utilization rate. 展开更多
关键词 embryo frozen-thawed embryo transfer pregnancy rate endometrial receptivity
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Different endometrial preparation protocols yield similar pregnancy outcomes for frozen-thawed embryo transfer in patients with advanced endometriosis 被引量:3
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作者 Hai-yan GUO Yun WANG +6 位作者 Qiu-ju CHEN Wei-ran CHAI Li-hua SUN Ai AI Yong-lun FU Qi-feng LYU Yan-ping KUANG 《Journal of Reproduction and Contraception》 CSCD 2016年第1期1-11,共11页
Objective To explore the different endometrial preparation for frozen-thawed embryo transfer (FET) in women with advanced endometriosis (EMS). Methods The pregnancy outcomes of patients with advanced EMS (542 cyc... Objective To explore the different endometrial preparation for frozen-thawed embryo transfer (FET) in women with advanced endometriosis (EMS). Methods The pregnancy outcomes of patients with advanced EMS (542 cycles), who were prepared for FET, were retrospectively assessed. Included patients underwent a total of 233 FET cycles (180 patients) using natural cycle (NC), a total of 142 FET cycles (115 patients) using letrozole (LE) ovulation induction, and a total of 167 FET cycles (137 patients) using hormonal replacement treatment (HRT) for endometrial preparation.Results There were no significant diffenences in the clinical pregnancy rate (LE: 49.30%, NC: 50.21%, and HRT: 43.11~/o, P=0.343), the implantation rate (LE: 29.26%, NC: 36.03%, and HRT: 29.55%, P=0.084), and the live birth rate (LE: 38.02%, NC: 39.11%, and HR T." 35.33 %, P=O. 648) among the three groups. No statistically signifi- cant differences were observed in the ongoing pregnancy rate, the miscarriage rate, and the pregnancy complication rate. The single birth weight in patients using NC- FET was lower than that in patients using HRT-FET (P=0.044) and a higher twin birth weight in patients using LE-FET were observed compared with other groups (P=O. 022). The rate of birth weight 〈2 500 g was also higher in the NC-FET group than in other groups. No congenital birth defects were found in the three groups. Conclusion Different endometrial preparation protocols without ultra-long GnRH-a down-regulation for FET yield similar pregnancy outcomes in patients with EMS. A tailored endometrial preparation protocol should be recommended according to different patients' situation. 展开更多
关键词 clinical pregnancy outcomes endometrial preparation endometriosis (EMS) frozen-thawed embryo transfer (FET)
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Clomiphene Citrate as An Adjuvant to hMG Stimulation of the Ovaries in Mid-to-late Follicular Phase and Subsequently Pregnancy Outcome of Frozen-thawed Embryo Transfers 被引量:2
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作者 Yan KANG Qing-qing HONG +4 位作者 Wei-ran CHAI Yong-lun FU Ai AI Qiu-ju CHEN Yan-ping KUANG 《Journal of Reproduction and Contraception》 CAS 2013年第1期10-20,共11页
Objective To compare the results of a novel regimen of human menopausal gonadotrophin (hMG) in combination with clomiphene citrate (CC) in mid-to-late follicular phase with those of a short protocol of GnRH agoni... Objective To compare the results of a novel regimen of human menopausal gonadotrophin (hMG) in combination with clomiphene citrate (CC) in mid-to-late follicular phase with those of a short protocol of GnRH agonist (GnRHa) and hMG used for IVF. Methods In the retrospective study, 842 patients undergoing IVF were collected and classified into two groups: hMG in combination with CC in mid-to-late follicular phase (group A, n=319) and short protocol of GnRHa-hMG (group B, n=523). The main outcome measures were ovarian responses in stimulation cycles and pregnancy outcomes in subsequent frozen-thawed embryo transfer (FET) cycles. Results In group A, the serum LH concentration on day 8 -10 was similar with that on the day of hCG administration (2.43 ± 1.92 IU vs 2.51 ±2.05 IU). The number of mature follicles and oocytes retrieved was significantly lower in group A than in group B while the fertilization rate and the cleavage rate were comparable. The clinical pregnancy rate (47. 79% vs 48.04%), the implantation rate (32.49% vs 33.11%) and the cumulative pregnancy rate (58.09% vs 60.22%) were respectively similar in group A and group B. Conclusion hMG in combination with CC in mid-to-late follicular phase results in the same pregnancy outcome as short protocol. The novel protocol may take the advantage of eliminating the occurrehce of a premature endogenous LH Surge. 展开更多
关键词 clomiphene citrate (CC) human menopausal gonadotrophin (hMG) frozen-thawed embryo transfer (FET) short protocol
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Analysis of factors related to early miscarriage after in vitro fertilization embryo transfer
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作者 Liying Zuo Yuan Fan +1 位作者 Jiajia Ai Li Tian 《Gynecology and Obstetrics Clinical Medicine》 2022年第4期171-174,共4页
Aims:This research aims to explore the factors related to early spontaneous miscarriage after in vitro fertilization and embryo transfer(IVF-ET)pregnancy,and to provide guidance for improving pregnancy outcomes.Method... Aims:This research aims to explore the factors related to early spontaneous miscarriage after in vitro fertilization and embryo transfer(IVF-ET)pregnancy,and to provide guidance for improving pregnancy outcomes.Methods:We retrospectively analyzed the data for clinical pregnant women(2591 cycles)undergoing IVF-ET at the reproductive center of Peking University People’s Hospital from January 2017 to December 2018;This included 544 ET cycles and 2047 frozen embryo transfer cycles.The analysis of factors associated with early miscarriage in the overall population of IVF/intracytoplasmic sperm injection(ICSI)pregnancies(including fresh and thawing cycles)was performed.Results:The risk of early miscarriage in the 35–39 age group was 1.35 times higher than that in the<35 age group(OR=1.35[1.05,1.73],p=0.02).In addition,the risk of early miscarriage was 3.88 times higher in the group40 years old than in the group<35 years old(OR=3.88[2.68,5.62],p<0.001).Endometrial thickness also affected the miscarriage rate;the early miscarriage risk with endometrial thickness8.5 mm was 0.78 times than that of the<8.5 mm group(OR=0.78[0.62,0.98],p=0.03).The early miscarriage rate during frozen embryo transfer was 1.48 times higher than that during fresh embryo transfer(OR=1.48[1.08,2.02],p=0.01),while in the fresh cycle,the risk of early miscarriage with high-quality embryos was 0.5 times lower than that with nonhigh quality embryos(OR=0.5[0.27,0.9],p=0.02).In the frozen cycle,the risk of early miscarriage in natural cycle transplantation was 0.73 times that in hormone replacement treatment(HRT)cycle transplantation(OR=0.73[0.54,0.97],p=0.03).Conclusions:Advanced age is an independent risk factor for early miscarriage,while endometrial thickness at the date of transplantation is an independent protective factor.The risk of early miscarriage in fresh-cycle transplanted embryos is significantly lower than that in frozen embryos,and the number of high-quality embryos in the fresh cycle lowers the miscarriage rate significantly.Natural cycle transplantation has a lower rate of early miscarriage than hormone replacement therapy. 展开更多
关键词 In vitro fertilization and embryo transfer Early spontaneous miscarriage Fresh cycle Frozen cycle
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Pregnancy outcomes of four different cycle protocols for frozen embryo transfer: a large retrospective cohort study
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作者 Yue Qian Qi Wan +11 位作者 Xiao-Qing Bu Tian Li Xiao-Jun Tang Yan Jia Qian Feng Xing-Yu Lv Xiang-Qian Meng Yin Yang Yu-Bin Ding Li-Hong Geng Min Xia Zhao-Hui Zhong 《Reproductive and Developmental Medicine》 CAS CSCD 2023年第3期135-141,共7页
Objective:To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer(FET),including natural cycle(NC),hormone replacement therapy cycle(HRT),go... Objective:To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer(FET),including natural cycle(NC),hormone replacement therapy cycle(HRT),gonadotropin-releasing hormone agonist artificial cycle(GAC),and ovarian stimulation cycle(OC).Methods:This retrospective cohort study enrolled 10,333 cycles of frozen embryo transfer performed at Xinan Gynecological Hospital in Sichuan,China,from January 2018 to December 2018.The patient's baseline characteristics and pregnancy outcomes were extracted from the medical record system.Pregnancy outcomes were compared among the four groups and multiple logistic regression models were used to adjust for the confounding factors.Results:After adjusting for covariates,multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT group,GAC group,and OC group compared to the NC group in the entire population.The adjusted odds ratio of live birth was 0.976(95%)confidence interval[Cl](0.837-1.138)for the HRT group,0.959(95%confidence interval 0.797-1.152)for the GAC group,and 0.909(95%confidence interval 0.763-1.083)for the OC group.Conclusions:The natural protocol had comparable pregnancy outcomes compared to the other three endometrial preparation protocols in the overall FET population.More high-quality prospective randomized controlled trials are required to assess the efficacy of the four protocols and explore the optimal one. 展开更多
关键词 Clinical pregnancy rate Endometrial preparation protocols frozen-thawed embryo transfer Live birth rate Natural cycle
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Effect of Traditional Chinese Herbs Combined with Low Dose Human Menopausal Gonadotropin Applied in Frozen-thawed Embryo Transfer
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作者 张慧琴 赵洪鑫 +5 位作者 顾敦瑜 贾晓峰 闫蓓 曹霖 王蕾 施惠娟 《Chinese Journal of Integrative Medicine》 SCIE CAS 2006年第4期244-249,共6页
Objective: To assess embryo implantation rate (IR) and pregnancy rate (PR) in women who received Bushen Wengong Decoction (补肾温宫汤, BSWGD), a Chinese herbal formula, combined with low dose of human menopausa... Objective: To assess embryo implantation rate (IR) and pregnancy rate (PR) in women who received Bushen Wengong Decoction (补肾温宫汤, BSWGD), a Chinese herbal formula, combined with low dose of human menopausal gonadotropin (hMG) prior to frozen-thawed embryo transfer (FET). Methods: A total of 262 subjects (674 transferred embryos) who received FET were analyzed retrospectively. In them, 122 women were under 30 years old, 106 between 30-35 years and 32 over 35 years. The 85 subjects with normal ovulation were assigned to Group A, the natural menstruation cycling group, on whom no pre-transfer treatment was applied. The other 177 subjects with abnormal ovulation were assigned to Group B, and subdivided, according to the pre-transfer treatment they received, into three groups, Group B1 (50 cases) received BSWGD, Group B2 (58 cases) received hMG and Group B3 (69 cases) received both BSWGD and low dose hMG. The IR and PR of FET in the four groups were compared time on PR of FET were compared also. Besides, the influencing factors and the effect of the embryo cryoto FET were analyzed. Results: IR and PR were significantly higher in all age sects of Group B3 than those in Group A, showing significant difference ( P〈0.05). IR and PR in subjects in age sects of 〈30 years and 〉 35 years in group B3 were significantly higher than those in Group B1 ( P〈0.05), but no significant difference was shown in the two parameters between Group B 2 and Group B3 (P〉0.05). PR in the subjects who received embryos with cryo-time of 〉 200 days was significantly lower than that in those with cryo-time of ~ 100 days (P〈0.05). Embryo cryo-time, endometrial thickness, use of BSWGD and use of hMG were of significance in FET ( P〈 0.05). Conclusion: A programmed cycle of BSWGD combined with low dose of hMG could improve the embryo IR and PR of FET. Embryo cryo-time, endometrial thickness, and the use of BSWGD and hMG are of significance for FET. 展开更多
关键词 frozen-thawed embryo transfer Bushen Wengong Decoction human menopausal gonadotropin ENDOMETRIUM
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THE FIRST SUCCESSFUL CLINICAL PREGNANCY AFTER FROZEN-THAWED EMBRYOS TRANSFER IN China's Mainland
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《Chinese Medical Journal》 SCIE CAS CSCD 1994年第12期40-40,共1页
In the afternoon of July 8,1994,at the In Vitro Fertilization Center of the Third Hospital of Beijing Medical University,
关键词 THE FIRST SUCCESSFUL CLINICAL PREGNANCY AFTER frozen-thawed embryoS transfer IN MAINLAND CHINA In
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Reducing the Trigger Dose of Human Chorionic Gonadotrophin Does Not Affect Final Oocyte Maturation and Subsequently Pregnancy Outcome of Frozen-thawed Embryo Transfer
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作者 Yun WANG Yong-lun FU +4 位作者 Shao-feng CAO Qiu-ju CHEN Song-guo XUE Qi-feng LYU Yan-ping KUANG 《Journal of Reproduction and Contraception》 CAS 2013年第3期151-158,共8页
To compare the efficacy of human chorionic gonadotrophin (hCG) at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IV... To compare the efficacy of human chorionic gonadotrophin (hCG) at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IVF/ICSI and the subsequent pregnancy outcome in frozen-thawed embryo transfer (FET). Methods In the retrospective cohort study, 2 166patients undergoing IVF/ICSI with moderate or high response were recruited and classified into three groups according to the trigger dose of hCG: 2 000 IU (group A, n=722), 3 000 IU (group B, n=722) and 5 000 IU (group C, n= 722). The main outcome was the proportion of mature oocytes retrieved, fertilization rates, clinical pregnancy rates, cumulative pregnancy rates and incidence of ovarian hyperstimulation syndrome (OHSS). Results No evidence of statistically difference was found in the proportion of mature oocytes retrieved (89.92%, 91.40%, 90.20%, respectively) and fertilization rate (79.8%, 80.07%, 80.51%, respectively) among groups A, B and C. Serum E2 level on the day of hCG injection, the number of mature oocytes retrieved and good-quality embryos in group A were significantly higher than those in group B and group C. Clinical pregnancy rates per transfer cycle (45.95%, 43.97% and 44.25%), ongoing pregnancy rates (43.17%, 40.91% and 42,53%), implantation rates (30, 74%, 2Z 78% and 29.86%) and cumulative pregnancy rates per patient (58.31%, 53.6% and 54.85%)A reduced hCG dose of 2 000 IUfor moderate or high responders leads 展开更多
关键词 human chorionic gonadotropin (hCG) controlled ovarian hyperstimulation (COH) ovarian hyperstimulation syndrome (OHSS) frozen-thawed embryo transfer (FET) cumulative pregnancy rate (CPR)
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冻融优质单囊胚移植失败后重复周期胚胎移植策略的探讨
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作者 李苏萍 刘海鹏 +2 位作者 彭姝明 杨帆 段丽 《生殖医学杂志》 CAS 2024年第9期1147-1152,共6页
目的探讨冻融优质单囊胚移植失败后重复周期的胚胎移植策略。方法回顾性分析2018年7月至2022年10月在我中心进行冻融优质单囊胚移植后重复周期治疗患者的临床资料,共887个周期。根据患者年龄不同分为<35岁组(568个周期)和≥35岁组(31... 目的探讨冻融优质单囊胚移植失败后重复周期的胚胎移植策略。方法回顾性分析2018年7月至2022年10月在我中心进行冻融优质单囊胚移植后重复周期治疗患者的临床资料,共887个周期。根据患者年龄不同分为<35岁组(568个周期)和≥35岁组(319个周期),每组又根据胚胎移植情况分为5个亚组:单优囊组(移植冻融优质单囊胚)、双优囊组(移植冻融优质双囊胚)、优+非优囊组(移植冻融优质+非优质双囊胚)、双非优囊组(移植冻融非优质双囊胚)及双优卵裂组(移植冻融双卵裂胚)。比较各组患者的基础资料及妊娠结局。结果<35岁组中单优囊组、双优囊组、优+非优囊组、双非优囊组及双优卵裂组患者的年龄、基础FSH、移植日内膜厚度等基础资料比较均无显著性差异(P>0.05);单优囊组的临床妊娠率显著低于其他4组(60.41%vs.77.08%、72.73%、69.74%、70.83%,P<0.05),活产率亦显著低于其他4组(49.80%vs.68.75%、61.82%、59.21%、61.11%,P<0.05),双优卵裂组的多胎妊娠率显著高于单优囊组(38.24%vs.1.35%,P<0.05),但显著低于双优囊组(67.57%)、优+非优囊组(57.50%)及双非优囊组(56.60%)(P<0.05)。≥35岁组中各亚组的基础资料亦无显著性差异(P>0.05);各亚组间的临床妊娠率、活产率、流产率比较均无显著性差异(P>0.05),但单优囊组的多胎妊娠率显著低于其他4组(0.00%vs.33.33%、29.17%、20.59%、15.00%,P<0.05)。结论对于接受冻融优质单囊胚移植后行重复周期治疗的不孕患者,冻融胚胎移植策略的选择需要综合权衡。年龄≥35岁的患者,5种胚胎移植策略获得的临床结局相近,可以根据患者实际情况进行选择;而年龄<35岁的患者,在没有条件进行冻融优质单囊胚移植时,也可以考虑冻融优质双卵裂胚移植策略,但其后续多胎妊娠率风险较高,仍需要关注。 展开更多
关键词 冻融胚胎移植 单囊胚移植 重复周期 胚胎移植策略
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不同孕激素给药方式对激素替代方案准备内膜冻胚移植后妊娠及分娩结局的影响
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作者 杨敏 王云 +3 位作者 王泽 尹梦菲 邹嘉琳 魏代敏 《山东医药》 CAS 2024年第28期22-26,共5页
目的探讨激素替代方案准备子宫内膜的冷冻胚胎移植(FET)周期中不同孕激素给药方式对妊娠及分娩结局的影响。方法选取接受第1周期冷冻单囊胚移植并使用激素替代方案准备内膜患者3357例,根据孕激素给药方式分为肌内注射黄体酮组(IMP组)74... 目的探讨激素替代方案准备子宫内膜的冷冻胚胎移植(FET)周期中不同孕激素给药方式对妊娠及分娩结局的影响。方法选取接受第1周期冷冻单囊胚移植并使用激素替代方案准备内膜患者3357例,根据孕激素给药方式分为肌内注射黄体酮组(IMP组)749例、口服地屈孕酮联合阴道微粒化黄体酮胶囊组(DYD-VPC组)2249例及口服地屈孕酮联合阴道黄体酮凝胶组(DYD-VPG组)359例。比较三组基本临床特征、孕产期并发症及妊娠分娩结局的差异。结果三组年龄、BMI、不孕年限、未生育、患有原发性不孕症、窦卵泡数、获卵数、FET前子宫内膜厚度、PCOS患者比例、剖宫产史、移植胚胎发育时间等基线资料比较均无统计学差异(P均>0.05)。三组活产率、生化妊娠率、生化妊娠流产率、临床妊娠丢失率等均无统计学差异(P均>0.05);IMP组剖宫产率高于DYD-VPC组和DYD-VPG组(83.42%vs 76.88%vs 73.41%,P<0.05)。三组妊娠期和新生儿并发症如早产、巨大儿、低出生体质量儿、大于胎龄儿、小于胎龄儿、妊娠期高血压疾病和妊娠期糖尿病发生率均无统计学差异(P均>0.05)。多因素Logistic回归分析校正混杂因素后显示,肌内注射黄体酮与剖宫产风险增加相关。结论在激素替代方案准备子宫内膜的冻胚移植周期中,口服地屈孕酮联合阴道用黄体酮的临床妊娠率和活产率与肌内注射黄体酮相同,但剖宫产率降低。 展开更多
关键词 冷冻胚胎移植 激素替代周期 肌内注射黄体酮 阴道黄体酮 口服地屈孕酮
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卵巢功能减退患者多周期累积与非累积胚胎移植临床结局比较
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作者 王宇维 王聪 +1 位作者 方颖 杨晓葵 《武警医学》 CAS 2024年第4期307-311,共5页
目的探讨卵巢功能减退(DOR)患者多周期累积与非累积胚胎移植体外受精-胚胎移植(IVF-ET)临床结局的差异。方法回顾性分析2019-01至2022-12于首都医科大学附属北京妇产医院生殖医学科进行IVF-ET治疗的卵巢储备功能减退的不孕患者174例的... 目的探讨卵巢功能减退(DOR)患者多周期累积与非累积胚胎移植体外受精-胚胎移植(IVF-ET)临床结局的差异。方法回顾性分析2019-01至2022-12于首都医科大学附属北京妇产医院生殖医学科进行IVF-ET治疗的卵巢储备功能减退的不孕患者174例的临床资料,纳入患者均已完成所有胚胎移植及最终随访。收集患者的基础内分泌、抗苗勒管激素水平及窦卵泡计数,记录促排卵治疗后的卵巢反应参数及妊娠结局等相关临床资料,比较多周期累积胚胎移植(累积组)与非累积胚胎移植(非累积组)两种IVF-ET治疗的临床结局。结果DOR患者多周期累积胚胎移植与非累积胚胎移植两组间的累积妊娠率(35.24%vs.27.54%)、早期流产率(32.43%vs.26.32%)及累积活产率(21.90%vs.18.84%)差异无统计学意义(P>0.05);纳入移植策略、BMI、首次取卵年龄、AMH、胚胎移植数、优质胚胎移植数、累积获卵数等多个因素后进行logistic回归分析,两种不同的胚胎移植策略(OR=1.522,95%CI 0.608~3.814)对活产无明显影响(P>0.05)。结论对于DOR患者,进行多周期重复取卵后的累积胚胎移植并不能提高患者的累积妊娠率及活产率。 展开更多
关键词 卵巢功能减退 累积胚胎移植 多周期累积活产率
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经皮雌二醇凝胶在血栓前状态患者冻融胚胎移植中的应用
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作者 杨华清 王亚芹 +2 位作者 谭丽 张洁 赵冬梅 《生殖医学杂志》 CAS 2024年第4期441-445,共5页
目的探讨经皮雌二醇凝胶在血栓前状态患者激素替代周期(HRT)冻融胚胎移植(FET)中的应用价值。方法选取2021年2月至2023年2月在郑州大学第二附属医院生殖医院行HRT-FET助孕的血栓前状态患者68例为研究对象,其中采用经皮雌二醇凝胶进行内... 目的探讨经皮雌二醇凝胶在血栓前状态患者激素替代周期(HRT)冻融胚胎移植(FET)中的应用价值。方法选取2021年2月至2023年2月在郑州大学第二附属医院生殖医院行HRT-FET助孕的血栓前状态患者68例为研究对象,其中采用经皮雌二醇凝胶进行内膜准备者为研究组(n=32),采用口服芬吗通进行内膜准备者为对照组(n=36),两组均在胚胎移植后给予低分子肝素治疗。比较两组HRT情况和FET妊娠结局,并比较同组胚胎移植前、移植后14 d以及组间移植后14 d的纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)及D-二聚体(D-D)水平。结果研究组孕酮转化日子宫内膜厚度及A型子宫内膜比例显著高于对照组(P<0.05)。两组患者间移植胚胎数、移植优胚率、HCG阳性率比较均无显著差异(P>0.05),研究组临床妊娠率显著高于对照组(65.63%vs.41.67%,P<0.05),研究组早期流产率较对照组有所减低(9.38%vs.16.67%)但无显著差异(P>0.05)。两组患者胚胎移植后14 d的FIB及D-D水平均显著低于移植前(P<0.01),且胚胎移植后14 d研究组D-D及FIB水平显著低于对照组(P<0.01)。结论在血栓前状态患者HRT-FET周期中,与口服芬吗通比较,采用经皮给药的方式更能降低血栓前状态风险,提高子宫内膜容受性,改善助孕结局。因此针对这类患者,建议选择经皮雌激素进行内膜准备,并辅以肝素对症处理。 展开更多
关键词 经皮雌二醇凝胶 冻融胚胎移植 血栓前状态 激素替代周期 妊娠结局
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GnRH激动剂在人工周期冻融胚胎移植黄体支持中作用的荟萃分析
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作者 覃金春 韦娉嫔 覃捷 《现代妇产科进展》 2024年第8期590-595,共6页
目的:评价GnRH激动剂(GnRH-a)在人工周期冻融胚胎移植(AC-FET)黄体期支持(LPS)中的作用。方法:纳入PubMed、EMBASE和Cochrane数据库中符合纳入标准的研究。检索期限为建库至2023年10月31日。观察指标为种植率、HCG阳性率、临床妊娠率、... 目的:评价GnRH激动剂(GnRH-a)在人工周期冻融胚胎移植(AC-FET)黄体期支持(LPS)中的作用。方法:纳入PubMed、EMBASE和Cochrane数据库中符合纳入标准的研究。检索期限为建库至2023年10月31日。观察指标为种植率、HCG阳性率、临床妊娠率、持续妊娠率、活产率、流产率、宫外妊娠率、多胎妊娠率。采用RevMan5.4软件分析。结果:纳入9项随机对照试验(RCT),共2451例患者,其中GnRH-a LPS组1252例,常规LPS组1199例。黄体期给予GnRH-a可提高种植率(OR=1.29,95%CI为1.12~1.49,P=0.0005)、临床妊娠率(OR=1.32,95%CI为1.12~1.57,P=0.001)和多胎妊娠率(OR=1.82,95%CI为1.29~2.58,P=0.0007),同时降低流产率(OR=0.57,95%CI为0.41~0.79,P=0.0008)。两组的HCG阳性率、持续妊娠率、活产率、宫外妊娠率比较,差异均无统计学意义。结论:AC-FET黄体期添加GnRH-a可提高患者的种植率和临床妊娠率,提示GnRH-a可能是AC-FET黄体支持的新选择。然而,需开展多中心、大样本的RCT,以获得GnRH-a有效黄体支持的统一标准,进一步明确其LPS的安全性和有效性。 展开更多
关键词 GNRH激动剂 黄体期支持 人工周期 冻融胚胎移植
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