Background: As regard to adjuvant supplementations, nowadays dehydroepiandrosterone (DHEA) is widely used all over the world and is considered to be a potential agent to ameliorate the assisted reproduction technologi...Background: As regard to adjuvant supplementations, nowadays dehydroepiandrosterone (DHEA) is widely used all over the world and is considered to be a potential agent to ameliorate the assisted reproduction technologies outcomes of infertile women with poor ovarian reserve. Objective: To find out the role of DHEA supplementation in improving intracytoplasmic sperm injection (ICSI) outcome for infertile women with expected poor ovarian response in controlled ovarian stimulation. Setting: Assisted reproduction unit of Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt. Duration: From April 2016 to May 2018. Study Design: A randomized double-blinded controlled trial. Methods: One hundred and forty infertile women with expected poor ovarian response prepared for ICSI procedure were included in this study. Patients were divided into two groups;group I (DHEA group) included 70 patients received 25 mg DHEA 12 weeks prior to ICSI cycle and group II (placebo group) included 70 patients received a placebo. Results: There was a highly statistically significant difference in basal AFC at start of ICSI cycle in group I (who received DHEA supplementation for 12 weeks prior to ICSI procedure) than in group II (13.8 ± 5.3 versus 10.7 ± 4.6 respectively) with P < 0.001. There were mildly statistically significant differences between group I and group II as regard to increase in the number and quality of retrieved oocytes, increased in endometrial thickness, fertilization rate and embryo quality with p value < 0.05 but there was no statistically significant difference between the 2 groups as regard to pregnancy (chemical and clinical) rates (p value > 0.05). Conclusions & Recommendations: DHEA supplementations improved basal AFC, increased the number & quality of oocytes and increased quality of embryos in infertile patients with expected poor ovarian response in ICSI procedure. So DHEA supplementations could be an important adjuvant for infertile women with expected poor ovarian response in ICSI procedure.展开更多
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...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.展开更多
Poor response to ovarian stimulation which results in low pregnancy rate has been a major challenging in assisted reproductive technology.Chinese herbal medicine(CHM)has been used as a supplementary or an alternative ...Poor response to ovarian stimulation which results in low pregnancy rate has been a major challenging in assisted reproductive technology.Chinese herbal medicine(CHM)has been used as a supplementary or an alternative intervention in improving pregnancy rate in women with poor ovarian response(POR).This systematic review was aimed to assess the clinical effectiveness of Chinese herbal medicine for the treatment of POR.We searched Embase,PubMed,China National Knowledge Infrastructure(CNKI),VIP Database,Chinese biomedical database(CBM),Wan Fang database and the Cochrane library from January 2011 to March 2018.Study quality assessment and metaanalyses were performed according to the Cochrane recommendations.16 trials including 1245 ovulation-promoting cycles were evaluated.The analysis showed that CHM can increase the pregnancy rate(RR=1.80,95%CI(1.41-2.29),P<0.001),while decrease cycle cancellation(RR=0.66,95%CI(0.45-0.97),P=0.04).Conclusion:CHM presented a promising effectiveness in women with POR as a supplementary or an alternative intervention in IVF/ICSI.展开更多
Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely ...Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely and effectively.Methods:Prospective,multicenter,randomized controlled trial;A total of 278 POR patients were randomized in DKD group or immediate treatment group.Both groups received IVF or ICSI as a standard treatment while in the DKD group,DKD was administrated for 3 months before the IVF/ICSI cycle.The primary outcome was the ongoing pregnancy rate.The secondary outcomes include clinical pregnancy rate,biochemical pregnancy rate,total gonadotropin(Gn)dosage and duration,estradiol(E2)and progesterone(P)levels on human chorionic gonadotropin(hCG)trigger day,cycle cancellation rate,number of oocytes retrieved,high-quality embryo rate and any adverse events.Results:Compared to the immediate IVF treatment group,oral administration of DKD for 3 months before IVF led to a significant increase in ongoing pregnancy rate(30.0%v.s.17.6%,P<0.05),biochemical pregnancy rate(39.2%vs.25.2%,P<0.05),clinical pregnancy rate(36.7%vs.22.7%,P<0.05)and high-quality embryo rate(40.8%vs.32.4%,P<0.05),and a significant decrease in Gn duration(P<0.05).However,no significant differences were found in total dosage of Gn,number of retrieved oocytes,cycle cancellation rate,E2 level and P level on hCG trigger days(P>0.05).No serious adverse events occurred during the intervention period in either group.Conclusion:DKD is a safe and effective intervention to improve the IVF/ICSI-ET outcomes in patients with POR.展开更多
Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to wo...Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to women’s age (years) during the treatment cycle: 1) 20 - 34 (n = 133), 2) 35 - 39 (n = 133), 3) 40 - 42 (n = 78), 4) 43 - 47 y (n = 42), and correlated with the characteristics of the population. The clinical pregnancy rates for groups 1, 2, 3, and 4 were: 23.3%, 12%, 2.6%, 4.8%, respectively. It was found to be significantly higher (p < 0.001) comparing group 1 with group 3 patients. The “take home baby” rate was much lower (p < 0.001) in group 3;there were no deliveries in group 4. Delivery rates for groups 1, 2, 3, and 4 were: 19.5%, 10.5%, 1.3% and 0%, respectively. Intraabdominal adhesions were more common (p = 0.005) as the cause of infertility in group 3 women compared to groups 2 and 1: 24.4% compared with 9% and 9.8%, respectively. According to multivariate regression analysis, the parameters that negatively reflect on the pregnancy rate in POR women are intraabdominal adhesions, POR in the past, and increased age. We suggest encouraging young POR patients to pursue IVF treatments since the “take home baby” rates are reasonably good.展开更多
In India</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the problem of infertility is growing and in the last 5 years</span><s...In India</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the problem of infertility is growing and in the last 5 years</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> it has gone up to 20%</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">30%. This ongoing prospective clinical study brings forth a novel, innovative, effective, simple, affordable, easily performed outpatient procedure (OP) and a promising therapeutic method in rejuvenating the Ageing Ovaries and Thin Endometrium, with autologous Platelet Rich Plasma (PRP). This clinical study proves to give a better result in rejuvenating Ovary and treating the Thin Endometrium. This pilot study include</span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> five women (28</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">44 years) with Poor Ovarian Response (POR), Premature Ovarian Insufficiency (POI) and Perimenopause and Thirty-nine women (22</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">43</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">years.) with recurrent implantation failure due to Thin Endometrium were subjected to autologous PRP instillation under Ultrasound Guidance, and Hysteroscopic guided PRP. After PRP</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> a significant output was obtained, with improved Anti Mullerian Hormone (AMH) and Antral Follicle Count (AFC) and out of five women three women conceived by Intra Cytoplasmic Sperm Injection (ICSI). PRP injected in women with Poor Ovarian Response found successful ovarian rejuvenation within 1</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">3 months and had a 60% of pregnancy rate, PRP into the endometrium had 53.8% successful pregnancies. We have not encountered any complications.展开更多
文摘Background: As regard to adjuvant supplementations, nowadays dehydroepiandrosterone (DHEA) is widely used all over the world and is considered to be a potential agent to ameliorate the assisted reproduction technologies outcomes of infertile women with poor ovarian reserve. Objective: To find out the role of DHEA supplementation in improving intracytoplasmic sperm injection (ICSI) outcome for infertile women with expected poor ovarian response in controlled ovarian stimulation. Setting: Assisted reproduction unit of Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt. Duration: From April 2016 to May 2018. Study Design: A randomized double-blinded controlled trial. Methods: One hundred and forty infertile women with expected poor ovarian response prepared for ICSI procedure were included in this study. Patients were divided into two groups;group I (DHEA group) included 70 patients received 25 mg DHEA 12 weeks prior to ICSI cycle and group II (placebo group) included 70 patients received a placebo. Results: There was a highly statistically significant difference in basal AFC at start of ICSI cycle in group I (who received DHEA supplementation for 12 weeks prior to ICSI procedure) than in group II (13.8 ± 5.3 versus 10.7 ± 4.6 respectively) with P < 0.001. There were mildly statistically significant differences between group I and group II as regard to increase in the number and quality of retrieved oocytes, increased in endometrial thickness, fertilization rate and embryo quality with p value < 0.05 but there was no statistically significant difference between the 2 groups as regard to pregnancy (chemical and clinical) rates (p value > 0.05). Conclusions & Recommendations: DHEA supplementations improved basal AFC, increased the number & quality of oocytes and increased quality of embryos in infertile patients with expected poor ovarian response in ICSI procedure. So DHEA supplementations could be an important adjuvant for infertile women with expected poor ovarian response in ICSI procedure.
文摘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.
文摘Poor response to ovarian stimulation which results in low pregnancy rate has been a major challenging in assisted reproductive technology.Chinese herbal medicine(CHM)has been used as a supplementary or an alternative intervention in improving pregnancy rate in women with poor ovarian response(POR).This systematic review was aimed to assess the clinical effectiveness of Chinese herbal medicine for the treatment of POR.We searched Embase,PubMed,China National Knowledge Infrastructure(CNKI),VIP Database,Chinese biomedical database(CBM),Wan Fang database and the Cochrane library from January 2011 to March 2018.Study quality assessment and metaanalyses were performed according to the Cochrane recommendations.16 trials including 1245 ovulation-promoting cycles were evaluated.The analysis showed that CHM can increase the pregnancy rate(RR=1.80,95%CI(1.41-2.29),P<0.001),while decrease cycle cancellation(RR=0.66,95%CI(0.45-0.97),P=0.04).Conclusion:CHM presented a promising effectiveness in women with POR as a supplementary or an alternative intervention in IVF/ICSI.
基金This study was supported by the National Natural Science Foundation of China Nos.81774351the Tianjin Health&Family Planning Commission(Tianjin scientific research project of priority area of traditional Chinese medicine,Nos.2018008)Shanxi Guangyuyuan TCM Co.,Ltd.
文摘Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely and effectively.Methods:Prospective,multicenter,randomized controlled trial;A total of 278 POR patients were randomized in DKD group or immediate treatment group.Both groups received IVF or ICSI as a standard treatment while in the DKD group,DKD was administrated for 3 months before the IVF/ICSI cycle.The primary outcome was the ongoing pregnancy rate.The secondary outcomes include clinical pregnancy rate,biochemical pregnancy rate,total gonadotropin(Gn)dosage and duration,estradiol(E2)and progesterone(P)levels on human chorionic gonadotropin(hCG)trigger day,cycle cancellation rate,number of oocytes retrieved,high-quality embryo rate and any adverse events.Results:Compared to the immediate IVF treatment group,oral administration of DKD for 3 months before IVF led to a significant increase in ongoing pregnancy rate(30.0%v.s.17.6%,P<0.05),biochemical pregnancy rate(39.2%vs.25.2%,P<0.05),clinical pregnancy rate(36.7%vs.22.7%,P<0.05)and high-quality embryo rate(40.8%vs.32.4%,P<0.05),and a significant decrease in Gn duration(P<0.05).However,no significant differences were found in total dosage of Gn,number of retrieved oocytes,cycle cancellation rate,E2 level and P level on hCG trigger days(P>0.05).No serious adverse events occurred during the intervention period in either group.Conclusion:DKD is a safe and effective intervention to improve the IVF/ICSI-ET outcomes in patients with POR.
文摘Poor ovarian response (POR)—retrieval of 3 or fewer eggs, is a challenging issue in IVF. A retrospective study included POR women who underwent 386 IVF cycles. The data were classified in four groups according to women’s age (years) during the treatment cycle: 1) 20 - 34 (n = 133), 2) 35 - 39 (n = 133), 3) 40 - 42 (n = 78), 4) 43 - 47 y (n = 42), and correlated with the characteristics of the population. The clinical pregnancy rates for groups 1, 2, 3, and 4 were: 23.3%, 12%, 2.6%, 4.8%, respectively. It was found to be significantly higher (p < 0.001) comparing group 1 with group 3 patients. The “take home baby” rate was much lower (p < 0.001) in group 3;there were no deliveries in group 4. Delivery rates for groups 1, 2, 3, and 4 were: 19.5%, 10.5%, 1.3% and 0%, respectively. Intraabdominal adhesions were more common (p = 0.005) as the cause of infertility in group 3 women compared to groups 2 and 1: 24.4% compared with 9% and 9.8%, respectively. According to multivariate regression analysis, the parameters that negatively reflect on the pregnancy rate in POR women are intraabdominal adhesions, POR in the past, and increased age. We suggest encouraging young POR patients to pursue IVF treatments since the “take home baby” rates are reasonably good.
文摘In India</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> the problem of infertility is growing and in the last 5 years</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> it has gone up to 20%</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">30%. This ongoing prospective clinical study brings forth a novel, innovative, effective, simple, affordable, easily performed outpatient procedure (OP) and a promising therapeutic method in rejuvenating the Ageing Ovaries and Thin Endometrium, with autologous Platelet Rich Plasma (PRP). This clinical study proves to give a better result in rejuvenating Ovary and treating the Thin Endometrium. This pilot study include</span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> five women (28</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">44 years) with Poor Ovarian Response (POR), Premature Ovarian Insufficiency (POI) and Perimenopause and Thirty-nine women (22</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">43</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">years.) with recurrent implantation failure due to Thin Endometrium were subjected to autologous PRP instillation under Ultrasound Guidance, and Hysteroscopic guided PRP. After PRP</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> a significant output was obtained, with improved Anti Mullerian Hormone (AMH) and Antral Follicle Count (AFC) and out of five women three women conceived by Intra Cytoplasmic Sperm Injection (ICSI). PRP injected in women with Poor Ovarian Response found successful ovarian rejuvenation within 1</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-size:10pt;font-family:""> </span><span style="font-family:Verdana;">3 months and had a 60% of pregnancy rate, PRP into the endometrium had 53.8% successful pregnancies. We have not encountered any complications.
