According to features of current undergraduate curriculum design in the teaching of art and science, and combing exploration and the problems that exist during the process of teaching of basic theory of art and scienc...According to features of current undergraduate curriculum design in the teaching of art and science, and combing exploration and the problems that exist during the process of teaching of basic theory of art and science, this paper taking design courses of interactive introduction for example, it tries to innovate classroom teaching methods of exhibition of art and technology, interactive art and technology are principle theoretical classes of their major. Making good use of initiative of self- learning is the core element to help students in subjects learning, we constantly improve and perfect teaching concepts and classroom teaching mode to create the space for students to learn and explore actively, make personalized study according to their own characteristics, we make students experience the interest of freedom, autonomy, inquiry learning, enjoy the delight of appearance of personality and vitality of the burst of life vigor. Combining personal teaching experience, we should explore the way to led art students to learn with initiative in principle theoretical classes of their major.展开更多
Since 1992, assisted reproductive technology (ART) has been reported as a viable means of helping HIV-1 serodiscordant couples achieve pregnancy while theoretically reducing the risk for viral transmission. While th...Since 1992, assisted reproductive technology (ART) has been reported as a viable means of helping HIV-1 serodiscordant couples achieve pregnancy while theoretically reducing the risk for viral transmission. While the sum of the evidence suggests that ART is effective and safe, numerous controversies still exist, The follow- ing review addresses several of the important issues involved in the use of ART for HIV-serodiscordant couples, including patient selection, semen processing techniques, post-process HIV testing, the use of lUI vs IVF-ICSI.展开更多
At present, the reform of colleges and universities in our country is in full swing. In the course of teaching design of art in colleges and universities, it is necessary to change the teaching mode in time to adapt t...At present, the reform of colleges and universities in our country is in full swing. In the course of teaching design of art in colleges and universities, it is necessary to change the teaching mode in time to adapt to the new teaching development environment. In the era of digital development, we need to give full attention to the optimization of art design teaching in colleges and universities, and run new teaching techniques. This paper mainly analyzes the advantages and importance of the digital art design in colleges and universities, and then discusses the application of digital technology in the art design teaching and the concrete teaching optimiTatiun strategy in detail. Hoping to through this theoretical research, contribute to the improvement of the quality of art design teaching.展开更多
Reproduction technologies(RTs)can provide for the reliable reproduction of amphibians,as well as perpetuation of species genetic variation with the use of biobanks.In 1982,in anticipation of the biodiversity conservat...Reproduction technologies(RTs)can provide for the reliable reproduction of amphibians,as well as perpetuation of species genetic variation with the use of biobanks.In 1982,in anticipation of the biodiversity conservation crisis,major Russian institutions collaborated in a dynamic program to develop and implement RTs for the sustainable management of amphibian biodiversity.An initial primary focus was the captive breeding of threatened Russian endemic anuran and caudate species,using RTs that varied from environmental manipulation to the use of exogenous gonadotropic hormones to stimulate reproduction.These species were mostly from Palearctic or cool mountain regions,but also included a wide range of species from warm regions.Other early achievements included the successful cryopreservation of anuran spermatozoa and anuran diploid pluripotent cell nuclei,in order to store both the matrilineal and patrilineal genomes in biobanks,with their subsequent development to the blastula stage after implantation into enucleated oocytes.After the turn of the 21st Century,in support of the priorities of the Amphibian Conservation Action Plan(2007),we developed RTs for the refrigerated storage of testicular or urinary spermatozoa for days to weeks at 4℃,the cryopreservation of urinary spermatozoa using anovel cryoprotectant,the in vitro fertilisation of hormonally induced oocytes either fresh or after refrigerated ex situ or in situ storage,and the artificial insemination of salamanders with fresh spermatozoa.In this article,we describe previously unpublished techniques and techniques from obscure Russian sources.展开更多
Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein with a molecular weight of 140 kD, encoded by a gene on the short arm of chromosome and a member of the transforming growth factor-beta (TGF-<em>β</em&g...Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein with a molecular weight of 140 kD, encoded by a gene on the short arm of chromosome and a member of the transforming growth factor-beta (TGF-<em>β</em>) superfamily. The expression of AMH is markedly different in males and females, both in concentration and temporality. In males, Sertoli cells maintain a high concentration of AMH in utero which peaks shortly after birth and then drops precipitously at puberty. In females, granulosa cells produce very low levels of AMH in utero followed by a transient spike in the neonatal period. Concentrations of the hormone then rise steadily through adolescence to a peak in the mid-twenties and subsequently decline until becoming undetectable in menopause. The study aimed to understand how Clinicians and Clinical Embryologists used anti-mullerian hormone (AMH) test to assess ovarian reserve, direct patient selection and treatment regimens and guide in vitro fertilization (IVF) cycle management in all registered fertility hospitals in a West African country, Ghana. A web-based survey (questionnaire) using google forms was performed to solicit responses from all IVF hospitals that are registered with the Fertility Society of Ghana (FERSOG). This questionnaire consisted of fifteen (15) broader questions, ten (10) of which assessed the clinics’ use of AMH. Responses were screened for quality to verify that only one (1) survey was completed by each IVF centre. The study was conducted during May and June 2020 at the In Vitro Fertilization (IVF) Department of the Airport Women’s Hospital (AWH) in Accra, Ghana. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Survey responses were completed from 15 IVF centres, representing 2504 IVF cycles performed annually. A good majority (73.3%) [1835 IVF cycles] of the respondent IVF hospitals reported to use AMH as a first line test and 93.3% reported it as the best test for evaluating ovarian reserve. Another 66.7% reported that AMH results were extremely relevant to clinical practice. However, in contrast, for predicting live birth rate, 60% reported age as the best predictor in their practice. Overall, our results indicate that AMH is considered a first line test for assessing ovarian reserve and is relevant to the clinical practice of majority of Assisted Reproductive Technologies (ART) providers in Ghana.展开更多
The paper aims at indicating and demonstrating a kind of beautiful harmony in technology and art of excellent buildings of ancient China, through the analysis of cases of historic building up to the study of theoretic...The paper aims at indicating and demonstrating a kind of beautiful harmony in technology and art of excellent buildings of ancient China, through the analysis of cases of historic building up to the study of theoretical generalization. Any applicative, practical and durable building will conform to the simplicity of science and technology and harmony of design, and conform to the principle of beauty in the meantime. Architecture not only satisfies the need of functions, but represents the combination of skill and art, which is a sufficient integration of technology and art. The paper analyzes the relationship between technology and art of historic buildings in China by taking the typical examples of the Zhaozhou Bridge and the Hanging Temple of Hengshan, and clarifies the way of fusion between building and art, and indicates ways of fusion and reasons. In the last, the article proves the theory by the case of indoor decoration in modern building in order to defend mechanics and aesthetics in the modern buildings.展开更多
Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fer...Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fertility.An increasing number of infertile couples with chronic hepatitis B(CHB)virus infection choose assisted reproductive technology(ART)to meet their fertility needs.Despite the high prevalence of HBV,the effects of HBV infection on assisted reproduction treatment remain limited and contradictory.Objective:The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes,vertical transmission,pregnancy complications,and viral activity during ART treatment.Methods:We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022.Results:HBV infection negatively affected fertility in both males and females.Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment.The impact of HBV infection on the pregnancy outcomes of ART is still controversial.Current evidence does not support that ART increases the risk of vertical transmission of HBV,while relevant studies are limited.With the development of ART,the risk of HBV reactivation(HBVr)is increasing,especially due to the wide application of immunosuppressive therapy.Conclusions:Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART.The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.展开更多
Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks...Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced.展开更多
Assisted reproductive technology (ART) is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture o...Assisted reproductive technology (ART) is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.展开更多
Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify...Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART (IVF and for ICSI) compared with those spontaneously conceived and also compared birth defects between subgroups of lVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk (RR) estimated for these studies ranged from 0.44 to 5.51, a signifieantly increased risk of birth defects was observed (RR=l.36, 95%CI=1.25-1.47) in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects (RR=0.90, 95%CI=0.80 1.02), but ICSI had a higher risk in subgroups of clinical research (RR=O. 76, 95%CI=0.65-0.89) and crude RR value (RR=O. 78, 95%CI=0.67 0.91). Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or 1CS1 using a summative analysis, however, 1CS1 had a significant higher risk in birth defect risk comparing with 1VF when using subgroup analyses of sample size and RR value.展开更多
Objective To analyze the effects of growth hormone (GH) supplementation during IVF/ ICSI-ET in Chinese patients who had prior IVF cycle with poor response to gonadot- ropin (Gn). Methods Ovulation was stimulated i...Objective To analyze the effects of growth hormone (GH) supplementation during IVF/ ICSI-ET in Chinese patients who had prior IVF cycle with poor response to gonadot- ropin (Gn). Methods Ovulation was stimulated in 389 consecutive patients who all had poor ovarian response, among them, 102 patients (GH cycle) received 4 IU GH and the other 287 patients (non-GH cycle) underwent IVF without GH. Fisher's exact test, Chi square test and Student's t-test were used to analyze IVF/ICSI-ET outcomes. Results After GH treatment, 102 patients had significantly more large- and medium- sized follicles, oocytes retrieved, 2 pronucleus oocytes, metaphase H stage (M^I) oocytes, and high-quality embryos than in previous cycles without GH. However, the number of embryos transferred, clinical pregnancy rate, transfer rate and biochemical pregnancy rate were not significantly different. Furthermore, the 102 patients given GH had significantly lower luteinizing hormone levels and biochemical pregnancy rates; thicker endometrium and more Gn administration days; and more large- and medium-sized follicles and M^I oocytes than 287 other patients undergoing IVF/ICSI-ET without GH. However, these groups did not differ significantly in clinical pregnancies, high-quality embryos, Mn oocytes, and embryo implantation rates. Conclusion GH may improve some IVF/ICSI-ET outcomes for women with poor ovarian response.展开更多
文摘According to features of current undergraduate curriculum design in the teaching of art and science, and combing exploration and the problems that exist during the process of teaching of basic theory of art and science, this paper taking design courses of interactive introduction for example, it tries to innovate classroom teaching methods of exhibition of art and technology, interactive art and technology are principle theoretical classes of their major. Making good use of initiative of self- learning is the core element to help students in subjects learning, we constantly improve and perfect teaching concepts and classroom teaching mode to create the space for students to learn and explore actively, make personalized study according to their own characteristics, we make students experience the interest of freedom, autonomy, inquiry learning, enjoy the delight of appearance of personality and vitality of the burst of life vigor. Combining personal teaching experience, we should explore the way to led art students to learn with initiative in principle theoretical classes of their major.
文摘Since 1992, assisted reproductive technology (ART) has been reported as a viable means of helping HIV-1 serodiscordant couples achieve pregnancy while theoretically reducing the risk for viral transmission. While the sum of the evidence suggests that ART is effective and safe, numerous controversies still exist, The follow- ing review addresses several of the important issues involved in the use of ART for HIV-serodiscordant couples, including patient selection, semen processing techniques, post-process HIV testing, the use of lUI vs IVF-ICSI.
文摘At present, the reform of colleges and universities in our country is in full swing. In the course of teaching design of art in colleges and universities, it is necessary to change the teaching mode in time to adapt to the new teaching development environment. In the era of digital development, we need to give full attention to the optimization of art design teaching in colleges and universities, and run new teaching techniques. This paper mainly analyzes the advantages and importance of the digital art design in colleges and universities, and then discusses the application of digital technology in the art design teaching and the concrete teaching optimiTatiun strategy in detail. Hoping to through this theoretical research, contribute to the improvement of the quality of art design teaching.
基金performed within the framework of State projects 122041100276-0 and 075-01027-2200。
文摘Reproduction technologies(RTs)can provide for the reliable reproduction of amphibians,as well as perpetuation of species genetic variation with the use of biobanks.In 1982,in anticipation of the biodiversity conservation crisis,major Russian institutions collaborated in a dynamic program to develop and implement RTs for the sustainable management of amphibian biodiversity.An initial primary focus was the captive breeding of threatened Russian endemic anuran and caudate species,using RTs that varied from environmental manipulation to the use of exogenous gonadotropic hormones to stimulate reproduction.These species were mostly from Palearctic or cool mountain regions,but also included a wide range of species from warm regions.Other early achievements included the successful cryopreservation of anuran spermatozoa and anuran diploid pluripotent cell nuclei,in order to store both the matrilineal and patrilineal genomes in biobanks,with their subsequent development to the blastula stage after implantation into enucleated oocytes.After the turn of the 21st Century,in support of the priorities of the Amphibian Conservation Action Plan(2007),we developed RTs for the refrigerated storage of testicular or urinary spermatozoa for days to weeks at 4℃,the cryopreservation of urinary spermatozoa using anovel cryoprotectant,the in vitro fertilisation of hormonally induced oocytes either fresh or after refrigerated ex situ or in situ storage,and the artificial insemination of salamanders with fresh spermatozoa.In this article,we describe previously unpublished techniques and techniques from obscure Russian sources.
文摘Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein with a molecular weight of 140 kD, encoded by a gene on the short arm of chromosome and a member of the transforming growth factor-beta (TGF-<em>β</em>) superfamily. The expression of AMH is markedly different in males and females, both in concentration and temporality. In males, Sertoli cells maintain a high concentration of AMH in utero which peaks shortly after birth and then drops precipitously at puberty. In females, granulosa cells produce very low levels of AMH in utero followed by a transient spike in the neonatal period. Concentrations of the hormone then rise steadily through adolescence to a peak in the mid-twenties and subsequently decline until becoming undetectable in menopause. The study aimed to understand how Clinicians and Clinical Embryologists used anti-mullerian hormone (AMH) test to assess ovarian reserve, direct patient selection and treatment regimens and guide in vitro fertilization (IVF) cycle management in all registered fertility hospitals in a West African country, Ghana. A web-based survey (questionnaire) using google forms was performed to solicit responses from all IVF hospitals that are registered with the Fertility Society of Ghana (FERSOG). This questionnaire consisted of fifteen (15) broader questions, ten (10) of which assessed the clinics’ use of AMH. Responses were screened for quality to verify that only one (1) survey was completed by each IVF centre. The study was conducted during May and June 2020 at the In Vitro Fertilization (IVF) Department of the Airport Women’s Hospital (AWH) in Accra, Ghana. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Survey responses were completed from 15 IVF centres, representing 2504 IVF cycles performed annually. A good majority (73.3%) [1835 IVF cycles] of the respondent IVF hospitals reported to use AMH as a first line test and 93.3% reported it as the best test for evaluating ovarian reserve. Another 66.7% reported that AMH results were extremely relevant to clinical practice. However, in contrast, for predicting live birth rate, 60% reported age as the best predictor in their practice. Overall, our results indicate that AMH is considered a first line test for assessing ovarian reserve and is relevant to the clinical practice of majority of Assisted Reproductive Technologies (ART) providers in Ghana.
文摘The paper aims at indicating and demonstrating a kind of beautiful harmony in technology and art of excellent buildings of ancient China, through the analysis of cases of historic building up to the study of theoretical generalization. Any applicative, practical and durable building will conform to the simplicity of science and technology and harmony of design, and conform to the principle of beauty in the meantime. Architecture not only satisfies the need of functions, but represents the combination of skill and art, which is a sufficient integration of technology and art. The paper analyzes the relationship between technology and art of historic buildings in China by taking the typical examples of the Zhaozhou Bridge and the Hanging Temple of Hengshan, and clarifies the way of fusion between building and art, and indicates ways of fusion and reasons. In the last, the article proves the theory by the case of indoor decoration in modern building in order to defend mechanics and aesthetics in the modern buildings.
基金supported by the Key Laboratory of Clinical Cancer Pharmacology,the Zhejiang Provincial Natural Science Foundation of China(No.LY21H310001)the Zhejiang Province Medical Health Science and Technology Plan Project(Nos.2020RC028 and 2018KY566)the Clinical Research Fund Project of Zhejiang Medical Association(No.2018ZYC-A30),China.
文摘Background:Hepatitis B virus(HBV)is one of the most widespread viruses worldwide and a major cause of hepatitis,cirrhosis,and hepatocellular carcinoma.Previous studies have revealed the impacts of HBV infection on fertility.An increasing number of infertile couples with chronic hepatitis B(CHB)virus infection choose assisted reproductive technology(ART)to meet their fertility needs.Despite the high prevalence of HBV,the effects of HBV infection on assisted reproduction treatment remain limited and contradictory.Objective:The aim of this study was to provide a comprehensive overview of the effect of HBV infection on fertility and discuss its effects on pregnancy outcomes,vertical transmission,pregnancy complications,and viral activity during ART treatment.Methods:We conducted a literature search in PubMed for studies on HBV infection and ART published from 1996 to 2022.Results:HBV infection negatively affected fertility in both males and females.Existing research shows that HBV infection may increase the risk of pregnancy complications in couples undergoing assisted reproduction treatment.The impact of HBV infection on the pregnancy outcomes of ART is still controversial.Current evidence does not support that ART increases the risk of vertical transmission of HBV,while relevant studies are limited.With the development of ART,the risk of HBV reactivation(HBVr)is increasing,especially due to the wide application of immunosuppressive therapy.Conclusions:Regular HBV infection screening and HBVr risk stratification and management are essential to prevent HBVr during ART.The determination of optimal strategy and timing of prophylactic anti-HBV therapy during ART still needs further investigation.
基金Project supported by the National Basic Research Program (973) of China (No. 2012CB944901)the National Natural Science Foundation of China (Nos. 81070532 and 81200475)
文摘Children conceived via assisted reproductive technologies (ART) are nowadays a substantial proportion of the population. It is important to follow up these children and evaluate whether they have elevated health risks compared to naturally conceived (NC) children. In recent years there has been a lot of work in this field. This review will summarize what is known about the health of ART-conceived children, encompassing neonatal outcomes, birth defects, growth and gonadal developments, physical health, neurological and neurodevelopmental outcomes, psychosocial developments, risk for cancer, and epigenetic abnormalities. Most of the children conceived after ART are normal. However, there is increasing evidence that ART-conceived children are at higher risk of poor perinatal outcome, birth defects, and epigenetic disorders, and the mechanism(s) leading to these changes have not been elucidated. Continuous follow-up of children after ART is of great importance as they progress through adolescence into adulthood, and new ART techniques are constantly being introduced.
基金supported by Cultivating Youth Training Programme Fund in the First Affiliated Hospital of Anhui Medical University(2015KJ03)Reserve talented person fund in the First Affiliated Hospital of Anhui Medical University(310100J001165)
文摘Assisted reproductive technology (ART) is an important treatment for infertile people of reproductive age and is also known as fertility treatment. The processes of ART involves the isolation, handling and culture of early embryos, which may result in alterations in genomic methylation at specific loci and influence the proper establishment and maintenance of genomic imprints. Recent studies have identified an increased incidence of imprinting disorders via ART. In this article, we reviewed that the ART may be prone to induction of imprinting methylation errors during embryonic development. Further studies are necessary to elucidate the safety of ART in this field.
文摘Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART (IVF and for ICSI) compared with those spontaneously conceived and also compared birth defects between subgroups of lVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk (RR) estimated for these studies ranged from 0.44 to 5.51, a signifieantly increased risk of birth defects was observed (RR=l.36, 95%CI=1.25-1.47) in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects (RR=0.90, 95%CI=0.80 1.02), but ICSI had a higher risk in subgroups of clinical research (RR=O. 76, 95%CI=0.65-0.89) and crude RR value (RR=O. 78, 95%CI=0.67 0.91). Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or 1CS1 using a summative analysis, however, 1CS1 had a significant higher risk in birth defect risk comparing with 1VF when using subgroup analyses of sample size and RR value.
文摘Objective To analyze the effects of growth hormone (GH) supplementation during IVF/ ICSI-ET in Chinese patients who had prior IVF cycle with poor response to gonadot- ropin (Gn). Methods Ovulation was stimulated in 389 consecutive patients who all had poor ovarian response, among them, 102 patients (GH cycle) received 4 IU GH and the other 287 patients (non-GH cycle) underwent IVF without GH. Fisher's exact test, Chi square test and Student's t-test were used to analyze IVF/ICSI-ET outcomes. Results After GH treatment, 102 patients had significantly more large- and medium- sized follicles, oocytes retrieved, 2 pronucleus oocytes, metaphase H stage (M^I) oocytes, and high-quality embryos than in previous cycles without GH. However, the number of embryos transferred, clinical pregnancy rate, transfer rate and biochemical pregnancy rate were not significantly different. Furthermore, the 102 patients given GH had significantly lower luteinizing hormone levels and biochemical pregnancy rates; thicker endometrium and more Gn administration days; and more large- and medium-sized follicles and M^I oocytes than 287 other patients undergoing IVF/ICSI-ET without GH. However, these groups did not differ significantly in clinical pregnancies, high-quality embryos, Mn oocytes, and embryo implantation rates. Conclusion GH may improve some IVF/ICSI-ET outcomes for women with poor ovarian response.