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
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
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
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
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
Objective To describe two clinical cases involving patients who were administered 800 IU of hCG to trigger oocyte maturation and who underwent a frozen-thawed embryo transfer （FET） cycle. Methods Two infertile patie...Objective To describe two clinical cases involving patients who were administered 800 IU of hCG to trigger oocyte maturation and who underwent a frozen-thawed embryo transfer （FET） cycle. Methods Two infertile patients with high ovarian response undergoing stimulation for IVF,, in which 800 IU of hCG was injected by mistake. IVF patients treated under a short protocol with 800 IU of hCG triggering ovulation. Live birth, clinical pregnancy outcomes and ovarian hyperstimulation syndrome （OHSS） were observed. Results Neither cycle of the two patients was canceled for oocyte retrieval failure and no OHSS was observed. Both patients gave birth to live twins after FET. Conclusion Triggering oocyte maturation in two hyper-responders by employing 800 IU of hCG could produce a good quantity of good-quality oocytes and an excellent clinical pregnancy and retain the opportunity for conception and live birth. Broader studies are needed.展开更多
Objective To compare the clinical characteristics in a gonadotropin （Gn） and medroxyprogestrone acetate （MPA） protocol using three types of Gn in normal ovulatory women undergoing IVF/ICSI treatments. Methods A to...Objective To compare the clinical characteristics in a gonadotropin （Gn） and medroxyprogestrone acetate （MPA） protocol using three types of Gn in normal ovulatory women undergoing IVF/ICSI treatments. Methods A total of 258 normal ovulatory IVF/ICSI patients undergoing ovarian stimulation in a Gn and MPA protocol were analyzed in this retrospective study and allocated into three groups according to the Gn used： group A, hMG-A （brand name： Fengyuan, n=105）; group B, hMG-B （brand name： Lebaode, n=90）; group C： u-FSH （brand name： Lishenbao, n=63）. The hormone profile, embryological characteristics, and the pregnant results after frozen-thawed embryo transfer （FET） were compared among the three groups. Results There was no significant difference in the number of oocytes retrieved among the three groups （12.1± 6.9 vs 12.1±5.6 vs 13.1 ±8.8, P〉0.05）. Other indicators such as the number of mature oocyte, fertilization, cleavage and viable embryo were similar （P〉0.05）. No premature LH surges were detected, with a range of 0.04-7.38 IU/L. No differences were found in the clinical pregnancy rate per transfer （43.48% vs 37.93% vs 40. 74%, P〉0.05） and the implantation rate （34.88% vs 22.22% vs 26.42%, P〉O.05）. Conclusion MPA is an effective oral alternative for the prevention of premature LH surges. Progestin-primed ovarian stimulation （PPOS） is a novel regimen of ovarian stimulation in combination with embryo cryopreservation, in which the two types of hMG are as effective as u-FSH.展开更多
文摘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.
基金supported by the grants from Natural Science Foundation of Chongqing(Nos:cstc2019jcyj-msxmX0749,cstc2019jxjl130030,cstc2018jxjl130065)Intelligent Medicine Research Project of Chongqing Medical University(YJSZHYX202010)Sichuan Provincial Science and Technology Plan Project(2019YFSY0047)and Applied Basic Research Project in Sichuan Province(2018JY0357).
文摘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.
基金supported in part by grants from the National Natural Science Foundation of China(No.81270749 and No.81470064)the Natural Science Foundation of Shanghai,China(No.15411953000,No.15411964500 and No.14ZR1423900)
文摘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.
基金supported by National Natural Science Foundation of China (No. 31071275, No. 81270749 and No. 31101070)
文摘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.
基金supported by National Natural Science Foundation of China(No.31071275)Natural Science Foundation of Shanghai of China(No.09411962900)
文摘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
文摘Objective To describe two clinical cases involving patients who were administered 800 IU of hCG to trigger oocyte maturation and who underwent a frozen-thawed embryo transfer （FET） cycle. Methods Two infertile patients with high ovarian response undergoing stimulation for IVF,, in which 800 IU of hCG was injected by mistake. IVF patients treated under a short protocol with 800 IU of hCG triggering ovulation. Live birth, clinical pregnancy outcomes and ovarian hyperstimulation syndrome （OHSS） were observed. Results Neither cycle of the two patients was canceled for oocyte retrieval failure and no OHSS was observed. Both patients gave birth to live twins after FET. Conclusion Triggering oocyte maturation in two hyper-responders by employing 800 IU of hCG could produce a good quantity of good-quality oocytes and an excellent clinical pregnancy and retain the opportunity for conception and live birth. Broader studies are needed.
文摘Objective To compare the clinical characteristics in a gonadotropin （Gn） and medroxyprogestrone acetate （MPA） protocol using three types of Gn in normal ovulatory women undergoing IVF/ICSI treatments. Methods A total of 258 normal ovulatory IVF/ICSI patients undergoing ovarian stimulation in a Gn and MPA protocol were analyzed in this retrospective study and allocated into three groups according to the Gn used： group A, hMG-A （brand name： Fengyuan, n=105）; group B, hMG-B （brand name： Lebaode, n=90）; group C： u-FSH （brand name： Lishenbao, n=63）. The hormone profile, embryological characteristics, and the pregnant results after frozen-thawed embryo transfer （FET） were compared among the three groups. Results There was no significant difference in the number of oocytes retrieved among the three groups （12.1± 6.9 vs 12.1±5.6 vs 13.1 ±8.8, P〉0.05）. Other indicators such as the number of mature oocyte, fertilization, cleavage and viable embryo were similar （P〉0.05）. No premature LH surges were detected, with a range of 0.04-7.38 IU/L. No differences were found in the clinical pregnancy rate per transfer （43.48% vs 37.93% vs 40. 74%, P〉0.05） and the implantation rate （34.88% vs 22.22% vs 26.42%, P〉O.05）. Conclusion MPA is an effective oral alternative for the prevention of premature LH surges. Progestin-primed ovarian stimulation （PPOS） is a novel regimen of ovarian stimulation in combination with embryo cryopreservation, in which the two types of hMG are as effective as u-FSH.
