Dear Editor,I am Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diag...Dear Editor,I am Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagnosis of unsuspected retinoblastoma（RB）in an in vitro fertilisation（IVF）infant with retinopathy of prematurity.展开更多
Infertility is considered to be a growing problem worldwide. In sub-Saharan Africa, at least 20%-50% of couples of reproductive age experience a fertility problem and 30% are diagnosed with infertility. This study exp...Infertility is considered to be a growing problem worldwide. In sub-Saharan Africa, at least 20%-50% of couples of reproductive age experience a fertility problem and 30% are diagnosed with infertility. This study explores the experiences of women in South Africa who are involuntary childless and explores their psychological and emotional experiences of In Vitro Fertilisation and Embryo Transfer (IVF-ET). Utilising a qualitative methodology, a diverse group of 21 married women diagnosed with infertility and who had undergone at least two cycles of IVF-ET were recruited. Semi-structured, in-depth individual interviews were conducted and the data were analysed using thematic analysis. The results of the study indicated that the women perceived themselves as not conforming to a dominant belief system and as a result felt compelled to explore all the medical options available. They reported emotional turmoil characterised by primary binary emotions of anxiety-excitement and nervousness-optimistic. These emotions were experienced throughout the five stages of the IVF-ET treatment cycles. A synopsis of the psychological and emotional responses to the IVF-ET treatment is discussed. The findings of this study suggest the need for the incorporation of a mandatory psychosocial intervention as part of infertility management. Greater attention to the psychological and emotional repercussions of infertility treatment could lead to a more personalised client-approach which, in turn, would prepare infertile women and couples for the emotional demands of the treatment.展开更多
Objective:To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intr...Objective:To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intracytoplasmic sperm injection (ICSI) cycles with embryo transfer were carried out and 312 embryos were scored using a combined scoring system (CSS) of zygote and embryo morphology before transplantation. In a control group, a total of 420 IVF or ICSI cycles were carried out and 1176 embryos were scored using a cumulative embryo score (CES). The effects of the combined scoring system on the embryo implantation rate and pregnancy rate per cycle were analyzed. Results: Using the combined scoring system, the embryo implan-tation rate (27.6%) and the clinical pregnancy rate (48.7%) were significantly higher than those in the control group (20.8% and 38.6%, respectively). Also, the implantation rate of embryos scoring ≥70 (38.5%: 82 sacs/213 embryos) was significantly higher (P<0.001) than that of embryos scoring <70 (4%: 4 sacs/99 embryos). The pregnancy rate of patients with embryos scoring ≥70 using the combined scoring system (66.7%) was significantly higher (P<0.001) than that of patients with embryos scoring ≥20 using the cumulative embryo score (59.0%). Conclusion: The results suggest that selecting embryos with a high score (≥70) using the combined scoring system could increase the implantation rate and pregnancy rate, and that using a scoring system combining assessments of human zygotes and pre-implantation embryos might predict IVF outcomes more accurately than using a cumula-tive embryo score.展开更多
Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infert...Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1-3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B （P〈0.05） and group C （P〈0.01）. The implantation rate of group A was significantly lower than than of group C （P〈0.01）. There was no significant difference of the rate of pregnancy and implantation between group B and group C （P〉0.05）. Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.展开更多
The in vitro maturation, fertilization and development of bovine ovary oocytes in two differentcultural systems A and B were studied under the conditions of 38.5℃,5%CO2,95%air and 100%humidity.The maturation rates we...The in vitro maturation, fertilization and development of bovine ovary oocytes in two differentcultural systems A and B were studied under the conditions of 38.5℃,5%CO2,95%air and 100%humidity.The maturation rates were 94.5%and 91.3%,respectively,and the difference wasextremely significant.Frozen semen were thawed and sperm were capacitated with three kinds ofcapacitation agents for fertilization.The pronucleus rates were 76%,65%-68%and 62%respectively.The rates of embryos developed to morula and blastocyst were 19%,16% and 17%respectively.The developmental rates of embryos cocultured with bovine oviductal epithelium cellsand bovine granulosa cells were 25% and 23.4% respectively,with no significant difference. Freshembryos were transplanted into 15 recipicns,and three of them were pregnant and calves were bornin 1990 and 1991.The pregnant rate was 20%.The emryos developed faster before 8-cell stage andslower after 8-cell stage,in vitro than in vivo.展开更多
Introduction: This prospective pilot study was done to get preliminary data about a new technique of inflecting endometrial injury in order to improve implantation rate in IVF cases. Patients and methods: 60 patients ...Introduction: This prospective pilot study was done to get preliminary data about a new technique of inflecting endometrial injury in order to improve implantation rate in IVF cases. Patients and methods: 60 patients were en-rolled and randomly distributed into 3 groups. Each group included 20 pa-tients. This study was conducted in the Egyptian consultants for infertility management and IVF center Tanta-Egypt, in the period from January 2015 to March 2016. In group A (study group 1), the 20 patients included in this group underwent endometrial scratching once at day 21 of menstrual cycle in the cycle prior to ET by a 4 mm disposable Karman’s cannula inserted through the cervical os. While in group B (study group 2), the 20 patients underwent the new technique of endometrial Ice bars application for 10 minutes at day 7 of the embryo transfer cycle to inflect the physical trauma required for the change in the endometrial receptivity. In Group C (control group), the 20 patients didn’t receive any extra action rather than the ordinary preparation for embryo transfer. The primary outcome measures of the study were the clinical pregnancy rate and the number of pregnancies that exceeded 14 weeks of gestation. The secondary outcome measures were multiple pregnancy and miscarriage ratios. Results: The results of this pilot study shows a (>14 weeks) pregnancy rate which is equal in the endometrial icing (30% n = 6/20) and endometrial scratching group (30% n = 6\20). The >14 weeks pregnancy rate in both groups is higher than the control group (25% n = 5/20). The small number of patients in the pilot study may explain the difference to be statistically non-significant. The abortion rate was 33.3% (n = 3/9) in the scratching group and 25% (n = 2/8) in the icing group and 16.6% (n = 1/5) in the control group. The multiple pregnancy rate was 16.6% (n = 1/6) in the scratching group and 33.3% (n = 2/6) in the icing group and 20% (n = 1/5) in the control group. Conclusion: Endometrial icing is a new technique of endometrial injury which deserves more studies to test its efficacy in improving embryo implantation and to test its safety.展开更多
Objectives To evaluate the impact of cryopreservation on early cleavage stage (d 2) embryos Methods This was a retrospective study. Embryo survival rate, implantation rates and clinical pregnancy rates per transfer...Objectives To evaluate the impact of cryopreservation on early cleavage stage (d 2) embryos Methods This was a retrospective study. Embryo survival rate, implantation rates and clinical pregnancy rates per transfer from fresh and cryopreserved cycles were analyzed. Results From January to December, 2002, in a total of 628 thawing cycles in which 1 876 embryos were thawed, the embryo survival rate was similar between the IVF and ICSI group (88.09% and 88.95%, respectively). There was no significant difference in implantation rates both between the frozen and fresh IVF groups (19.19% and 21.07%, respectively) and between the frozen and fresh ICSI groups (15.22% and 15.64%, respectively), but there were significant differences either between frozen IVF and frozen ICSI groups (P<0.05) or between fresh IVF and fresh ICSI groups (P<0.01). The clinical preg- nancy rates in the frozen and fresh IVF groups were 45.86% and 43.43%, respec- tively (P>0.05). The clinical pregnancy rate of the frozen ICSI group was 42.07%, slightly higher than that of fresh ICSI (35.43%), but the difference was not significant (P>0.05). The clinical pregnancy rate between fresh IVF and fresh ICSI was signifi- cantly different (P<0.05). Conclusion The present study indicated that frozen-thawed embryos at early cleavage stage had equivalent pregnancy rates as that of fresh embryos.展开更多
[目的]研究牛活体采卵-体外受精(ovum pick-up and in vitro fertilization,OPU/IVF)体系,建立高效的牛体外胚胎生产系统。[方法]以从屠宰场采集的健康牛新鲜卵巢为试验材料,进行卵母细胞体外成熟、体外受精、体外胚胎培养相关条件的摸...[目的]研究牛活体采卵-体外受精(ovum pick-up and in vitro fertilization,OPU/IVF)体系,建立高效的牛体外胚胎生产系统。[方法]以从屠宰场采集的健康牛新鲜卵巢为试验材料,进行卵母细胞体外成熟、体外受精、体外胚胎培养相关条件的摸索,重点考查体外胚胎培养液中添加瘦素(leptin)对囊胚率的影响。选取13~15月龄健康荷斯坦奶牛及和牛各10头作为供体,进行活体采卵、卵母细胞体外成熟、体外胚胎生产,记录可用卵数及可用囊胚数,统计卵裂率、囊胚率;2个品种牛的体外冷冻胚胎解冻后,以荷斯坦奶牛为受体进行胚胎移植,移植后45 d统计妊娠率。[结果]添加30 U/mL的leptin可以显著(P<0.05)提高屠宰场来源牛体外胚胎的囊胚率。随机选择供体牛活体采卵,平均每头荷斯坦奶牛获得可用卵7.5枚,平均每头和牛获得可用卵8.1枚;荷斯坦奶牛及和牛的卵裂率分别为84.00%、82.71%,二者差异不显著(P>0.05)。体外培养条件下,平均每头荷斯坦奶牛获得可用囊胚4.3枚,平均每头和牛获得可用囊胚3.7枚;荷斯坦奶牛的囊胚率(57.33%)显著(P<0.05)高于和牛(45.68%)。体外胚胎解冻后移植,荷斯坦奶牛胚胎组的妊娠率为54.17%,和牛胚胎组的妊娠率为55.79%,二者差异不显著(P>0.05)。[结论]该研究建立的OPU/IVF体系可以有效提高优质母牛的利用效率,降低生产成本,为牛体外胚胎生产系统的优化提供了参考。展开更多
Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications which affect the mother and offspring. In addition to adverse perinatal outcomes, it may lead to permanent health problems for the ...Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications which affect the mother and offspring. In addition to adverse perinatal outcomes, it may lead to permanent health problems for the mother, such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), while increasing the risk of future obesity, CVD, T2DM and GDM in the child. Approximately 15% of women seek fertility treatment. Over the last decade, it has come to attention that patients with an infertility history are more prone to having GDM during their pregnancies, and this review examines the relationship between GDM and infertility. The elevated estrogen, progesterone, leptin, placental lactogen and growth hormone are the main reasons for increased insulin resistance during pregnancy. Despite some confounding factors in the mechanism of GDM in patients with an infertility history, infertility treatment increases the risk, according to numerous studies. The obesity epidemic and associated disorders have become a significant public health concern worldwide. Lifestyle modification for weight loss before pregnancy is encouraged, but there is no strong evidence for improvement in perinatal results. GDM, infertility and infertility treatment have a potential risk of alteration in the embryo’s environment and cause epigenetic reprogramming, which may be inherited to the next generation. The fertility treatment impacts the patient’s and offspring’s health. Patients should be informed about the risks so that they consent and get involved in the decision. Infertility treatment may be accepted as a reason for high-risk pregnancy, and patients can be screened for GDM in early pregnancy.展开更多
文摘Dear Editor,I am Dr.Tian Tian,from the Department of Ophthalmology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China.I write to present a rare case report of a delayed diagnosis of unsuspected retinoblastoma（RB）in an in vitro fertilisation（IVF）infant with retinopathy of prematurity.
文摘目的探讨行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)助孕的多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清中补体C1q/肿瘤坏死因子相关蛋白9(complement C1q/tumour necrosis factor-related protein 9,CTRP9)、抗苗勒管激素(anti-mullerian hormone,AMH)对治疗结果的预测价值。方法选取2022年3月—2023年7月于重庆医科大学附属第一医院生殖中心行IVF-ET的85例PCOS患者。根据妊娠结局分为临床妊娠组43例与临床未妊娠组42例。记录2组患者的一般资料,测定血清CTRP9和AMH水平,分析其与妊娠结局的关系。结果临床未妊娠组血清CTRP9为(290.19±58.97)ng/mL,AMH为3.39(2.09,5.42)ng/mL,均低于临床妊娠组的(413.63±89.56)ng/mL、7.42(5.45,9.90)ng/mL(P<0.05)。血清CTRP9、AMH水平、优胚数是PCOS患者IVF-ET妊娠成功的保护因素(P<0.05)。血清CTRP9预测行IVF-ET的PCOS患者妊娠成功的敏感度与特异度为74.40%和90.50%,曲线下面积(area under the curve,AUC)值为0.836;血清AMH预测敏感度与特异度为83.70%和73.80%,AUC值为0.859;血清CTRP9和AMH联合预测的敏感度和特异度分别为88.40%和92.90%,AUC值为0.924,高于单独使用CTRP9或AMH预测的价值。结论血清CTRP9、AMH与PCOS患者IVF-ET治疗结局密切相关,且与单一指标检测比较,两者联合检测可提高预测价值。
文摘Infertility is considered to be a growing problem worldwide. In sub-Saharan Africa, at least 20%-50% of couples of reproductive age experience a fertility problem and 30% are diagnosed with infertility. This study explores the experiences of women in South Africa who are involuntary childless and explores their psychological and emotional experiences of In Vitro Fertilisation and Embryo Transfer (IVF-ET). Utilising a qualitative methodology, a diverse group of 21 married women diagnosed with infertility and who had undergone at least two cycles of IVF-ET were recruited. Semi-structured, in-depth individual interviews were conducted and the data were analysed using thematic analysis. The results of the study indicated that the women perceived themselves as not conforming to a dominant belief system and as a result felt compelled to explore all the medical options available. They reported emotional turmoil characterised by primary binary emotions of anxiety-excitement and nervousness-optimistic. These emotions were experienced throughout the five stages of the IVF-ET treatment cycles. A synopsis of the psychological and emotional responses to the IVF-ET treatment is discussed. The findings of this study suggest the need for the incorporation of a mandatory psychosocial intervention as part of infertility management. Greater attention to the psychological and emotional repercussions of infertility treatment could lead to a more personalised client-approach which, in turn, would prepare infertile women and couples for the emotional demands of the treatment.
基金Project (No. 021107137) supported by the Department of Scienceand Technology of Zhejiang Province, China
文摘Objective:To evaluate the accuracy of a scoring system combining zygote and embryo morphology in predicting the outcome of in vitro fertilization (IVF) treatment. Methods: In a study group, 117 consecutive IVF or intracytoplasmic sperm injection (ICSI) cycles with embryo transfer were carried out and 312 embryos were scored using a combined scoring system (CSS) of zygote and embryo morphology before transplantation. In a control group, a total of 420 IVF or ICSI cycles were carried out and 1176 embryos were scored using a cumulative embryo score (CES). The effects of the combined scoring system on the embryo implantation rate and pregnancy rate per cycle were analyzed. Results: Using the combined scoring system, the embryo implan-tation rate (27.6%) and the clinical pregnancy rate (48.7%) were significantly higher than those in the control group (20.8% and 38.6%, respectively). Also, the implantation rate of embryos scoring ≥70 (38.5%: 82 sacs/213 embryos) was significantly higher (P<0.001) than that of embryos scoring <70 (4%: 4 sacs/99 embryos). The pregnancy rate of patients with embryos scoring ≥70 using the combined scoring system (66.7%) was significantly higher (P<0.001) than that of patients with embryos scoring ≥20 using the cumulative embryo score (59.0%). Conclusion: The results suggest that selecting embryos with a high score (≥70) using the combined scoring system could increase the implantation rate and pregnancy rate, and that using a scoring system combining assessments of human zygotes and pre-implantation embryos might predict IVF outcomes more accurately than using a cumula-tive embryo score.
文摘Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1-3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B （P〈0.05） and group C （P〈0.01）. The implantation rate of group A was significantly lower than than of group C （P〈0.01）. There was no significant difference of the rate of pregnancy and implantation between group B and group C （P〉0.05）. Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.
文摘The in vitro maturation, fertilization and development of bovine ovary oocytes in two differentcultural systems A and B were studied under the conditions of 38.5℃,5%CO2,95%air and 100%humidity.The maturation rates were 94.5%and 91.3%,respectively,and the difference wasextremely significant.Frozen semen were thawed and sperm were capacitated with three kinds ofcapacitation agents for fertilization.The pronucleus rates were 76%,65%-68%and 62%respectively.The rates of embryos developed to morula and blastocyst were 19%,16% and 17%respectively.The developmental rates of embryos cocultured with bovine oviductal epithelium cellsand bovine granulosa cells were 25% and 23.4% respectively,with no significant difference. Freshembryos were transplanted into 15 recipicns,and three of them were pregnant and calves were bornin 1990 and 1991.The pregnant rate was 20%.The emryos developed faster before 8-cell stage andslower after 8-cell stage,in vitro than in vivo.
文摘Introduction: This prospective pilot study was done to get preliminary data about a new technique of inflecting endometrial injury in order to improve implantation rate in IVF cases. Patients and methods: 60 patients were en-rolled and randomly distributed into 3 groups. Each group included 20 pa-tients. This study was conducted in the Egyptian consultants for infertility management and IVF center Tanta-Egypt, in the period from January 2015 to March 2016. In group A (study group 1), the 20 patients included in this group underwent endometrial scratching once at day 21 of menstrual cycle in the cycle prior to ET by a 4 mm disposable Karman’s cannula inserted through the cervical os. While in group B (study group 2), the 20 patients underwent the new technique of endometrial Ice bars application for 10 minutes at day 7 of the embryo transfer cycle to inflect the physical trauma required for the change in the endometrial receptivity. In Group C (control group), the 20 patients didn’t receive any extra action rather than the ordinary preparation for embryo transfer. The primary outcome measures of the study were the clinical pregnancy rate and the number of pregnancies that exceeded 14 weeks of gestation. The secondary outcome measures were multiple pregnancy and miscarriage ratios. Results: The results of this pilot study shows a (>14 weeks) pregnancy rate which is equal in the endometrial icing (30% n = 6/20) and endometrial scratching group (30% n = 6\20). The >14 weeks pregnancy rate in both groups is higher than the control group (25% n = 5/20). The small number of patients in the pilot study may explain the difference to be statistically non-significant. The abortion rate was 33.3% (n = 3/9) in the scratching group and 25% (n = 2/8) in the icing group and 16.6% (n = 1/5) in the control group. The multiple pregnancy rate was 16.6% (n = 1/6) in the scratching group and 33.3% (n = 2/6) in the icing group and 20% (n = 1/5) in the control group. Conclusion: Endometrial icing is a new technique of endometrial injury which deserves more studies to test its efficacy in improving embryo implantation and to test its safety.
文摘Objectives To evaluate the impact of cryopreservation on early cleavage stage (d 2) embryos Methods This was a retrospective study. Embryo survival rate, implantation rates and clinical pregnancy rates per transfer from fresh and cryopreserved cycles were analyzed. Results From January to December, 2002, in a total of 628 thawing cycles in which 1 876 embryos were thawed, the embryo survival rate was similar between the IVF and ICSI group (88.09% and 88.95%, respectively). There was no significant difference in implantation rates both between the frozen and fresh IVF groups (19.19% and 21.07%, respectively) and between the frozen and fresh ICSI groups (15.22% and 15.64%, respectively), but there were significant differences either between frozen IVF and frozen ICSI groups (P<0.05) or between fresh IVF and fresh ICSI groups (P<0.01). The clinical preg- nancy rates in the frozen and fresh IVF groups were 45.86% and 43.43%, respec- tively (P>0.05). The clinical pregnancy rate of the frozen ICSI group was 42.07%, slightly higher than that of fresh ICSI (35.43%), but the difference was not significant (P>0.05). The clinical pregnancy rate between fresh IVF and fresh ICSI was signifi- cantly different (P<0.05). Conclusion The present study indicated that frozen-thawed embryos at early cleavage stage had equivalent pregnancy rates as that of fresh embryos.
文摘[目的]研究牛活体采卵-体外受精(ovum pick-up and in vitro fertilization,OPU/IVF)体系,建立高效的牛体外胚胎生产系统。[方法]以从屠宰场采集的健康牛新鲜卵巢为试验材料,进行卵母细胞体外成熟、体外受精、体外胚胎培养相关条件的摸索,重点考查体外胚胎培养液中添加瘦素(leptin)对囊胚率的影响。选取13~15月龄健康荷斯坦奶牛及和牛各10头作为供体,进行活体采卵、卵母细胞体外成熟、体外胚胎生产,记录可用卵数及可用囊胚数,统计卵裂率、囊胚率;2个品种牛的体外冷冻胚胎解冻后,以荷斯坦奶牛为受体进行胚胎移植,移植后45 d统计妊娠率。[结果]添加30 U/mL的leptin可以显著(P<0.05)提高屠宰场来源牛体外胚胎的囊胚率。随机选择供体牛活体采卵,平均每头荷斯坦奶牛获得可用卵7.5枚,平均每头和牛获得可用卵8.1枚;荷斯坦奶牛及和牛的卵裂率分别为84.00%、82.71%,二者差异不显著(P>0.05)。体外培养条件下,平均每头荷斯坦奶牛获得可用囊胚4.3枚,平均每头和牛获得可用囊胚3.7枚;荷斯坦奶牛的囊胚率(57.33%)显著(P<0.05)高于和牛(45.68%)。体外胚胎解冻后移植,荷斯坦奶牛胚胎组的妊娠率为54.17%,和牛胚胎组的妊娠率为55.79%,二者差异不显著(P>0.05)。[结论]该研究建立的OPU/IVF体系可以有效提高优质母牛的利用效率,降低生产成本,为牛体外胚胎生产系统的优化提供了参考。
文摘Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications which affect the mother and offspring. In addition to adverse perinatal outcomes, it may lead to permanent health problems for the mother, such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), while increasing the risk of future obesity, CVD, T2DM and GDM in the child. Approximately 15% of women seek fertility treatment. Over the last decade, it has come to attention that patients with an infertility history are more prone to having GDM during their pregnancies, and this review examines the relationship between GDM and infertility. The elevated estrogen, progesterone, leptin, placental lactogen and growth hormone are the main reasons for increased insulin resistance during pregnancy. Despite some confounding factors in the mechanism of GDM in patients with an infertility history, infertility treatment increases the risk, according to numerous studies. The obesity epidemic and associated disorders have become a significant public health concern worldwide. Lifestyle modification for weight loss before pregnancy is encouraged, but there is no strong evidence for improvement in perinatal results. GDM, infertility and infertility treatment have a potential risk of alteration in the embryo’s environment and cause epigenetic reprogramming, which may be inherited to the next generation. The fertility treatment impacts the patient’s and offspring’s health. Patients should be informed about the risks so that they consent and get involved in the decision. Infertility treatment may be accepted as a reason for high-risk pregnancy, and patients can be screened for GDM in early pregnancy.
