Serum β-hCG level on day 7 of frozen-thawed embryo transfer: association with the clinical pregnancy outcomes in artificial cycles

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.

Buildings and civil engineering works-Sealants-Determination of changes in cohesion and appearance of elastic weatherproofing sealants after exposure of statically cured specimens to artificial weathering and mechanical cycling

Foreword ISO(the International Organization for Standardization)is a worldwide federation of national standards bodies(ISO member bodies).The work of preparing International Standards is normally carried out through ISO technical committees.Each member body interested in a subject for which a technical committee has been established has the right to be represented on that committee.

Intermittent spontaneous ovulation in patients with premature ovarian failure:Three case reports and review of literature

BACKGROUND Premature ovarian failure(POF)is the end-stage of a decline in ovarian function prior to the age of 40 years that involves symptoms associated with low estradiol(E2)levels and a minimal probability of pregnancy.This increases the physical and psychological burden experienced by young women of reproductive age,particularly with regards to over-diagnosis.CASE SUMMARY Here,we report three cases(29,22,and 33 years-of-age)diagnosed with POF after experiencing secondary amenorrhea for more than one year,serum levels of follicle-stimulating hormone(FSH)>40 IU/L on two occasions with an interval of more than 4 wk,and negative progesterone withdrawal tests.All three patients were intermittently administered with drugs to create an artificial cycle.During the subsequent discontinuation period,the patients experienced intermittent follicular growth and spontaneous ovulation.One patient experienced two natural pregnancies(both with embryo arrest).CONCLUSION Our findings suggest that young patients with POF can experience unpredictable and intermittent spontaneous follicular development,ovulation,and even natural pregnancy.Clinicians should provide appropriate medical guidance and individualized treatments according to fertility requirements,genetic risks and hypoestrogenic symptoms as soon as possible.

Acupuncture and moxibustion for functional hypothalamic amenorrhea by establishing artificial cycle:a controlled trial

Objective To observe the clinical efficacy of acupuncture and moxibustion in treatment of functional amenorrhea by establishing artificial cycle.Method One hundred and twelve eligible patients with functional amenorrhea were divided into an acupuncture-moxibustion group（64 cases） and a western medication group（48 cases） by adopting random method.According to the pattern differentiation of amenorrhea of traditional Chinese medicine,the patients in the acupuncture-moxibustion group were classified into two types：amenorrhea due to blood depletion and amenorrhea due to stagnation of blood.For patients with amenorrhea due to blood depletion,Guanyuan（关元 CV4）,Zhongji（中极CV 3）,GuiTlai（归来ST 29）,Geshu（膈俞 BL 17）,Ganshu（肝俞BL 18）,Pishu（脾俞 BL 20） and Shenshu（肾俞 BL 23） were selected.At first,BL 17,BL 18,BL 20 and BL 23 were needled;after deqi,reinforcing method was applied,and the needles were not retained.Then,warmingneedle moxibustion was applied at CV 4,CV 3 and ST 29,and the needles were retained for 30 min.For patients with amenorrhea due to stagnation of blood,CV 3,Qihai（气海CV 6）,Xuehai（血海 SP 10）,Sanyinjiao（三阴交 SP 6）and Xingjian（行间 LR 2） were selected,reducing method was applied,and the needles were retained for 30 min.The treatment was performed once a day,and treatment for 15 consecutive days were the 1st cycle.The 2nd and3 rd cycles started from the 5th day of menstruation（for the patients still not menstruating,the 2nd and 3rd cycles started from the 29 th and 57 th days since the 1st day of treatment）,and the treatment lasted for 15 days.Three cycles were needed.In the western medicine group,estrogen-progestogen was taken orally for 21 days（one cycle） to establish a artificial cycle.The levels of FSH and LH were tested and compared on the 3rd day of menstruation before treatment and after the 3rd cycle of treatment,and the adverse effects were analyzed statistically.Follow-up visit was conducted for the patients after treatment for three cycles,and the recurrence rate was calculated.Result The levels of FSH and LH of patients with functional amenorrhea were enhanced significantly through establishing artificial cycle by acupuncture and moxibustion.There was no significant difference between the acupuncture-moxibustion group and the western medication group in effective rate（P〉0.05）;but the adverse effect rate（1.49%） and recurrence rate（25.0%） of the acupuncture-moxibustion group were lower than that of the western medication group（with the adverse effect rate of 4.14%,and recurrence rate of 69.8%）（both P〈0.05）.Conclusion The levels of FSH and LH of patients with functional amenorrhea can be enhanced significantly through establishing artificial cycle by acupuncture and moxibustion.The efficacy of acupuncture and moxibustion in treatment of functional amenorrhea by establishing artificial cycle is equivalent to that of oral administration of estrogen-progestogen in treatment of functional amenorrhea by establishing artificial cycle,but the adverse effect rate and recurrence rate of acupuncture and moxibustion group are lower.