Objective To analyse the effects of controlled ovarian hyperstimulation （ COH） on the endometrial expression of collagen fibril （CF） during the peri-implantation period in patients undergoing IVF, and its relation...Objective To analyse the effects of controlled ovarian hyperstimulation （ COH） on the endometrial expression of collagen fibril （CF） during the peri-implantation period in patients undergoing IVF, and its relation to endometrial receptivity （ER） in repeated implantation failure（RIF）. Methods Peripheral blood and endometrial biopsies were obtained from 45 infertile women on days 5, 7 or 9 after oocytes retrieval or ovulation in a stimulated cycle （SC） and natural cycle （NC） respectively. CF was assayed by transmission electron microscope and quantified by modified Masson dyeing. The outcome of subsequent embryo transfer（ET） was observed. Results Levels of both E2 and progesterone were higher in the peripheral blood in SC than in NC. Also the expression of CF in the stroma in each secretory phase was increased significantly in SC （P 〈O.05）. After embryo transferring, expression levels of CF in the pregnancy group dropped between the mid- and late-secretory phase, but no change in the non-pregnancy group. In the same term, all patients undergone endometrial curettage had higher pregnancy rate than those without. Conclusion Imbalance of production and degradation of endometrial CF in the secretory phase resulting from COH may be the cause of defective ER and implantation failure in some RIF patients. Endometrial curettage may improve implantation rate by inducing appropriate CF hyperplasia and degradation.展开更多
From October 2006,we began to investigate two kinds of mild stimulation protocols which were CC+HMG and L+HMG.Our preliminary results show:(1)119 patients were stimulated with CC+HMG,143 oocyte pick-up(OPU) cycles hav...From October 2006,we began to investigate two kinds of mild stimulation protocols which were CC+HMG and L+HMG.Our preliminary results show:(1)119 patients were stimulated with CC+HMG,143 oocyte pick-up(OPU) cycles have been finished.The average age of patient was 33.9 years old.5.64 eggs were retrieved per patient averagely.Fertilization rate was 63.4%.The 143 OPU cycles resulted in 59 fresh embryo transfer cycles(11 clinical pregnancies),55 whole embryo frozen cycles and 29 cycles without available embryo(15 cycles were due to un-fertilization or un-cleavage,14 cycles were due to blastocyst culture failure).In 85 frozen embryo transfer cycles,the clinical pregnancy rate was 20%(17/85).Until now,3 patients of whole embryo frozen cycle still haven’t carried out frozen embryo transfer.After transfer,3 patients without pregnancy still have frozen embryos.We anticipate that there will be one pregnancy at most in these 3 patients.Therefore,the cumulative pregnancy rate will achieve 20.7%(29/440) in 140 finished OPU cycles.No moderate or severe OHSS happened.(2)From July 2007 to April 2008,we had finished 284 OPU cycles with L+HMG protocols.The 284 OPU cycles resulted in 261 fresh embryo transfer cycles(64 clinical pregnancies),10 whole embryo frozen cycles and 13 cycles without available embryo.Clinical pregnancy rate was 24.5% for fresh embryo transfer cycles.Excluding 10 whole embryo frozen cycles,the clinical pregnancy rate for OPU cycles was 23.4(64/274).No moderate or severe OHSS happened in those 284 OPU cycles.Until 10,April 2008,72 thawed transfer cycles had been finished for above cases,20 pregnancies were produced and the pregnancy rate was 27.8%.The experiences of 427 mild stimulation cycles demonstrate that CC+HMG or L+HMG protocol show unique benefits,especially for patients with repeated IVF-ET failure,empty follicle syndrome,fertilization failure in COH cycles,poor-respond and hyper-respond to COH.展开更多
基金supported by a research grant from Science and Technology Commission of Shanghai Pudong District (PKJ2005-33)
文摘Objective To analyse the effects of controlled ovarian hyperstimulation （ COH） on the endometrial expression of collagen fibril （CF） during the peri-implantation period in patients undergoing IVF, and its relation to endometrial receptivity （ER） in repeated implantation failure（RIF）. Methods Peripheral blood and endometrial biopsies were obtained from 45 infertile women on days 5, 7 or 9 after oocytes retrieval or ovulation in a stimulated cycle （SC） and natural cycle （NC） respectively. CF was assayed by transmission electron microscope and quantified by modified Masson dyeing. The outcome of subsequent embryo transfer（ET） was observed. Results Levels of both E2 and progesterone were higher in the peripheral blood in SC than in NC. Also the expression of CF in the stroma in each secretory phase was increased significantly in SC （P 〈O.05）. After embryo transferring, expression levels of CF in the pregnancy group dropped between the mid- and late-secretory phase, but no change in the non-pregnancy group. In the same term, all patients undergone endometrial curettage had higher pregnancy rate than those without. Conclusion Imbalance of production and degradation of endometrial CF in the secretory phase resulting from COH may be the cause of defective ER and implantation failure in some RIF patients. Endometrial curettage may improve implantation rate by inducing appropriate CF hyperplasia and degradation.
文摘From October 2006,we began to investigate two kinds of mild stimulation protocols which were CC+HMG and L+HMG.Our preliminary results show:(1)119 patients were stimulated with CC+HMG,143 oocyte pick-up(OPU) cycles have been finished.The average age of patient was 33.9 years old.5.64 eggs were retrieved per patient averagely.Fertilization rate was 63.4%.The 143 OPU cycles resulted in 59 fresh embryo transfer cycles(11 clinical pregnancies),55 whole embryo frozen cycles and 29 cycles without available embryo(15 cycles were due to un-fertilization or un-cleavage,14 cycles were due to blastocyst culture failure).In 85 frozen embryo transfer cycles,the clinical pregnancy rate was 20%(17/85).Until now,3 patients of whole embryo frozen cycle still haven’t carried out frozen embryo transfer.After transfer,3 patients without pregnancy still have frozen embryos.We anticipate that there will be one pregnancy at most in these 3 patients.Therefore,the cumulative pregnancy rate will achieve 20.7%(29/440) in 140 finished OPU cycles.No moderate or severe OHSS happened.(2)From July 2007 to April 2008,we had finished 284 OPU cycles with L+HMG protocols.The 284 OPU cycles resulted in 261 fresh embryo transfer cycles(64 clinical pregnancies),10 whole embryo frozen cycles and 13 cycles without available embryo.Clinical pregnancy rate was 24.5% for fresh embryo transfer cycles.Excluding 10 whole embryo frozen cycles,the clinical pregnancy rate for OPU cycles was 23.4(64/274).No moderate or severe OHSS happened in those 284 OPU cycles.Until 10,April 2008,72 thawed transfer cycles had been finished for above cases,20 pregnancies were produced and the pregnancy rate was 27.8%.The experiences of 427 mild stimulation cycles demonstrate that CC+HMG or L+HMG protocol show unique benefits,especially for patients with repeated IVF-ET failure,empty follicle syndrome,fertilization failure in COH cycles,poor-respond and hyper-respond to COH.
