Live Birth

活产
  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:描述并总结X染色体异常患者的体外受精(IVF)结果。
    方法:进行回顾性病例系列研究。根据正常X的数量,患者被分为两组:A组(仅X正常的患者,而其他X具有任何类型的异常)和B组(患者具有两个或多个正常X染色体)。临床数据,包括基本信息,生育信息,和IVF结果,被收集。
    结果:纳入14例X染色体异常患者,其中13例患者共接受了29个周期。B组患者有5例成功怀孕和3例活产,而A组没有患者有临床妊娠。此外,A组的囊胚形成率和妊娠发生率显着降低(Z=-3.135,p=.002;Z=-2.946,p=.003)。当受控协变量时,一个正常X的核型也是囊胚形成率和成功妊娠的危险因素(β=.820,95%置信区间[CI]=0.458-1.116,β=.333,95%CI=0.017-0.494).
    结论:我们的结果显示,只有一个正常X的女性可能会遭受更差的IVF结局。主要是囊胚形成率,与那些有两个或两个以上正常X的人相比,包括马赛克特纳综合征和47,XXX。
    BACKGROUND: To describe and conclude the in vitro fertilization (IVF) results of patients with X chromosome abnormality.
    METHODS: A retrospective case series was conducted. According to the number of normal X, patients were allocated into two groups: Group A (patients with only a normal X, while other X has any types of abnormalities) and Group B (patients have two or more normal X chromosomes). Clinical data, including basic information, fertility information, and IVF outcomes, were collected.
    RESULTS: Fourteen patients with X chromosome abnormality were included, among which 13 patients underwent a total of 29 cycles. Patients in Group B had five successful pregnancies and three live births, while no patient in Group A had a clinical pregnancy. Furthermore, the blastocyst formation rate and incidence of pregnancy were significantly lower in Group A (Z = -3.135, p = .002; Z = -2.946, p = .003, respectively). When controlled covariates, the karyotype of one normal X was also a risk factor for both blastocyst formation rate and success pregnancy (β = .820, 95% confidence interval [CI] = 0.458-1.116, β = .333, 95% CI = 0.017-0.494, respectively).
    CONCLUSIONS: Our results revealed that women with only one normal X might suffer from worse IVF outcomes, mainly blastocyst formation rate, compared with those who had two or more normal X, including mosaic Turner syndrome and 47,XXX.
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  • 文章类型: Case Reports
    我们报告了第一例成功的不育夫妇患有过早染色单体分离(PCS)综合征的遗传咨询。经过我们仔细的遗传咨询,这对夫妇决定继续治疗不孕症。因此,他们于2018年5月通过剖腹产生了一个婴儿(女孩:2,930g)。据我们所知,在PubMed之后,还没有任何关于患有PCS的不育夫妇的遗传咨询的公开报道,EMBASE,和WebofScience搜索到2024年3月。
    We report the first case of successful genetic counseling for an infertile couple with premature chromatid separation (PCS) syndrome. After our careful genetic counseling, the couple decided to continue infertility treatment. As a result, they gave birth to a baby (girl: 2,930 g) by caesarean section in May 2018. To our knowledge, there have not been any published reports regarding genetic counseling for an infertile couple with PCS after PubMed, EMBASE, and Web of Science searches until March 2024.
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  • 文章类型: Journal Article
    目的:取卵时未能收集卵母细胞是体外受精(IVF)周期的不利结果。在这些情况下,及时宫腔内人工授精(IUI)可能是一种选择(救援IUI),但是这种可能性研究得很少。
    方法:RescueIUI通常在我们的单位中提供,用于未能取回卵母细胞的女性,只要他们至少有一根专利管,正常男性精液分析,发育的卵泡总数≤3。因此,我们回顾了2006年至2022年在我们单位进行的所有卵母细胞检索,以识别这些病例。作为一个比较器,我们参考了在同一研究期间进行的预先计划的IUI.使用二项分布模型计算比例的95%置信区间(95%CI)。
    结果:在3531个卵母细胞中的96个中进行了拯救IUI(2.7%;95%CI2.2-3.3%)。获得了六个活产,对应于6.2%(95%CI2.3-13.1)。所有怀孕都是单身。
    结论:对于未能获取卵母细胞的女性,挽救IUI是一个可能的选择,在某些情况下可以考虑。疗效低,但是程序很简单,没有重大风险。然而,对常规IVF协议设置的通用化是有限的。
    OBJECTIVE: Failure to collect oocytes at the time of oocyte pick-up is an unfavorable outcome of in vitro fertilization (IVF) cycles. In these cases, prompt intrauterine insemination (IUI) could be an option (rescue IUI), but this possibility has been poorly studied.
    METHODS: Rescue IUI is routinely offered in our unit in women failing to retrieve oocytes, provided that they have at least one patent tube, normal male semen analysis, and the total number of developed follicles is ≤ 3. We therefore reviewed all oocyte retrievals performed from 2006 to 2022 in our unit to identify these cases. As a comparator, we referred to preplanned IUI performed during the same study period. The 95% confidence interval (95% CI) of proportions was calculated using a binomial distribution model.
    RESULTS: Rescue IUI was performed in 96 out of 3531 oocyte retrievals (2.7%; 95% CI 2.2-3.3%). Six live births were obtained, corresponding to 6.2% (95% CI 2.3-13.1). All pregnancies were singletons.
    CONCLUSIONS: Rescue IUI in women failing to retrieve oocytes is a possible option that may be considered in selected cases. The efficacy is low, but the procedure is simple, and without significant risks. Generalizability to a conventional IVF protocol setting is however limited.
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  • 文章类型: Case Reports
    第一极体(PB1)过大的卵母细胞通常发生在辅助生殖程序中。很多时候,这些卵母细胞在没有授精的情况下被丢弃,因此,该部分卵母细胞的应用至今几乎没有报道。很少有研究检查不育妇女的大型PB1卵母细胞,并且几乎完全研究了大型PB1卵母细胞异常的遗传变异。这里,我们描述了在冷冻胚胎移植(FET)周期中,一个非常大的PB1卵母细胞活产的不寻常情况。这是由PB1卵母细胞产生的成功活产的第一个实例,该卵母细胞的极体大小为80μM×40μM。大的PB1卵母细胞通过早期拯救胞浆内单精子注射(r-ICSI)进行,并在第5天形成胚泡。在FET之后,在受孕后37周和5天,一个体重3100克的健康男婴最终通过剖腹产分娩。此外,足月分娩后的整个产前或围产期均未出现并发症.在这项研究中,首次揭示了巨大的PB1卵母细胞可以受精,导致胚泡的生长,随后的怀孕,和活产。这些新信息促使我们重新考虑使用大型PB1卵母细胞。应该注意更多有见地的讨论,以防止胚胎的浪费,因为并非所有形态异常的卵母细胞都不可用。
    Oocytes with excessively large first polar bodies (PB1) often occur in assisted reproductive procedures. Many times these oocytes are discarded without insemination and, as a result, the application of this portion of oocytes has scarcely been reported to date. Few studies have examined large PB1 oocytes in infertile women and have virtually entirely studied genetic variations for large PB1 oocyte abnormalities. Here, we describe an unusual case of a live birth from a remarkably large PB1 oocyte in a frozen embryo transfer (FET) cycle. This is the first instance of a successful live birth resulting from a PB1 oocyte with an extremely large polar body measuring 80 μM × 40 μM in size. The large PB1 oocyte was performed by an early rescue intracytoplasmic sperm injection (r-ICSI) and was formed into a blastocyst on day 5. Following FET, a healthy boy baby weighing 3100 g was finally delivered by caesarean section at 37 weeks and 5 days after conception. Additionally, there were no complications throughout the antenatal period or the perinatal phase of this following full-term delivery. In this study, it is revealed for the first time that a huge PB1 oocyte can be fertilized, resulting in the growth of a blastocyst, a subsequent pregnancy, and a live birth. This new information prompts us to reconsider the use of large PB1 oocytes. More insightful talks should be given attention to prevent the waste of embryos because not all oocytes with aberrant morphology are unavailable.
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  • 文章类型: Case Reports
    我们报告了一名32岁女性难治性不孕症患者的子宫内膜容受性阵列(ERA)测试临床疗效的成功案例。经过我们的精心治疗,该患者于2021年11月生下了一名男婴(3390克)。据我们所知,尽管直到2024年3月ERA测试的临床疗效仍存在争议,但我们认为患者的年龄,试管婴儿周期的数量,种族差异可能会影响ERA测试的临床疗效。
    We report a successful case for the clinical efficacy of the endometrial receptivity array (ERA) test for a 32-year-old female patient with refractory infertility. After our careful treatment, the patient gave birth to a male baby (3390 g) in November 2021. To our knowledge, though the clinical efficacy of the ERA test is controversial until March 2024, we think that the age of the patients, the number of IVF cycles, and the racial differences may have an impact on the clinical efficacy of the ERA test.
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  • 文章类型: Journal Article
    目的:评估第二次活检是否,在进行单基因疾病植入前遗传学检测(PGT-M)的胚泡首次诊断失败后,允许获得遗传诊断,以及与从第一次活检成功进行遗传诊断的PGT-M过程相比,该过程在多大程度上可以影响临床妊娠和活产率。
    方法:在不孕症中心接受PGT-M并在两次活检进行遗传分析后转移的女性(n=27)的胚胎以1:1的比例与女性的年龄(±1岁)和生育状况(可育与不育)进行匹配。以及学习期间,在第一次活检后直接获得决定性的PGT结果后转移的胚胎(n=27)。主要评估的结果是胚胎移植后的临床妊娠率,其中健康胚胎仅在一次活检后转移,而胚胎在重新活检后转移。活产率是次要结果。
    结果:单活检胚泡转移后的临床妊娠率为52%(95%CI:34-69),再活检胚泡转移后的临床妊娠率为30%(95%CI:16-48)。一次活检的胚泡转移后,有健康婴儿的可能性为33%(95%CI:19-52),再次活检的胚泡转移后为22%(95%CI:11-41)。
    结论:再次活检干预似乎大大降低了胚泡的妊娠潜能。然而,需要更大的样本量来明确澄清这个问题。
    OBJECTIVE: To evaluate whether a second biopsy, following a first diagnostic failure on blastocysts tested for preimplantation genetic testing for monogenic diseases (PGT-M), allows to obtain genetic diagnosis and to what extent this procedure can influence clinical pregnancy and live birth rates compared to the PGT-M process with a successful genetic diagnosis from the first biopsy.
    METHODS: Embryos from women who underwent PGT-M in an infertility centre and who had been transferred after two biopsies for genetic analysis (n = 27) were matched in a 1:1 ratio accordingly to women\'s age (± 1 year) and fertility status (fertile vs infertile), as well as with the study period, with embryos who were transferred after receiving a conclusive PGT result straight after the first biopsy (n = 27). The main evaluated outcome was clinical pregnancy rate following embryo transfers in which healthy embryos were transferred after only one biopsy and those in which an embryo was transferred after being re-biopsied. Live birth rate was the secondary outcome.
    RESULTS: Clinical pregnancy rate was 52% (95% CI: 34-69) following the transfer of a single-biopsy blastocyst and 30% (95% CI: 16-48) following the transfer of a re-biopsied blastocyst. The likelihood to have a healthy baby was 33% (95% CI: 19-52) following the transfer of a blastocyst biopsied once and 22% (95% CI: 11-41) following the transfer of a re-biopsied blastocyst.
    CONCLUSIONS: The re-biopsy intervention seems to considerably reduce the pregnancy potential of a blastocyst. However, a greater sample size is necessary to clarify this issue definitively.
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  • 文章类型: Case Reports
    腹痛是妊娠早期非常常见的表现。其原因可能是妇科或完全与妊娠无关。虽然急性阑尾炎是孕妇疼痛最常见的非产科原因,与其他原因的诊断和鉴别,包括异位妊娠,保持挑战。在不确定的临床情况下,腹腔镜检查是一种有用的诊断工具,但是如果有可能宫内妊娠,应避免子宫操作。在这份报告中,我们描述了一例妊娠早期并发阑尾炎的病例,尽管患者接受了诊断性腹腔镜检查并无意中进行了子宫操作,但最终还是获得了足月健康妊娠.
    Abdominal pain is a very common presentation in early pregnancy. Its cause may be gynecological or totally nonpregnancy related. While acute appendicitis is the most common nonobstetric cause of pain in pregnant women, diagnosis and differentiation from other causes, including ectopic pregnancy, remain challenging. In clinical situations of uncertainty, laparoscopy is a useful diagnostic tool, but uterine manipulation should be avoided if an intrauterine pregnancy is a possibility. In this report, we describe a case of complicated appendicitis in very early pregnancy where the patient ended with a full-term healthy pregnancy despite undergoing a diagnostic laparoscopy with inadvertent uterine manipulation.
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  • 文章类型: Case Reports
    背景:怀孕的成功取决于各种因素,子宫内膜容受性是至关重要的组成部分。子宫内膜厚度(EMT)是评估子宫内膜容受性的直接指标。以前的研究表明,子宫内膜薄与较低的妊娠率有关,尤其是EMT小于4毫米的患者。即使在辅助生殖技术周期中成功率很高,据报道,子宫内膜薄的患者的临床妊娠病例很少,更不用说自然概念循环了。因此,薄薄的子宫内膜对不孕症患者构成重大挑战。在这项研究中,子宫内膜极薄的患者能够通过自然受孕实现临床妊娠和成功活产,强调成功的可能性,即使在具有挑战性的情况下。
    方法:患者表现为多囊卵巢综合征和排卵障碍。她经历了来曲唑诱导排卵的自然周期。在人类绒毛膜促性腺激素触发的那天,她的EMT为3.8毫米.
    方法:多囊卵巢综合征,排卵障碍,薄薄的子宫内膜。
    方法:患者接受了包括Progynova在内的药物治疗,阿司匹林,和地屈孕酮.
    结果:患者实现了自发受孕,随后进行了活产。
    结论:该病例报告强调了在来曲唑诱导排卵期间管理薄型子宫内膜的重要性。虽然EMT传统上是预测胚胎植入成功的关键,我们的研究结果表明,子宫内膜容受性超出了单独的厚度.子宫内膜形态学等因素,type,血液供应起着至关重要的作用。3.8毫米EMT成功怀孕很少见,使这个案子成为这些病人的希望灯塔。它强调,通过适当的干预,成功的怀孕仍然可以实现。对于那些子宫内膜薄的人来说,重点应该超越厚度,解决方法,以提高子宫内膜的血液供应和形态,提高妊娠率。
    BACKGROUND: The success of pregnancy depends on various factors, with the endometrial receptivity being a crucial component. Endometrial thickness (EMT) serves as a direct indicator for assessing endometrial receptivity. Previous studies have suggested that a thin endometrium is associated with lower pregnancy rates, especially in patients with an EMT of less than 4 mm. Even in assisted reproductive technology cycles with high success rates, clinical pregnancy cases in patients with such thin endometrium are reported to be very few, let alone in natural conception cycles. Therefore, a thin endometrium poses significant challenges for infertility patients. In this study, patients with an extremely thin endometrium were able to achieve clinical pregnancy and successful live births through natural conception, highlighting the possibility of success even in challenging cases.
    METHODS: The patient presented with polycystic ovary syndrome and ovulation disorders. She underwent a natural cycle of letrozole-induced ovulation. On the day of the human chorionic gonadotropin trigger, she had an EMT of 3.8 mm.
    METHODS: Polycystic ovary syndrome, ovulation disorders, thin endometrium.
    METHODS: The patient received medications including Progynova, Aspirin, and Dydrogesterone.
    RESULTS: The patient achieved spontaneous conception and subsequently had a live birth.
    CONCLUSIONS: This case report underscores the significance of managing a thin endometrium during letrozole-induced ovulation. While EMT is traditionally pivotal for predicting embryo implantation success, our findings indicate that endometrial receptivity extends beyond thickness alone. Factors such as endometrial morphology, type, and blood supply play crucial roles. Successful pregnancies with a 3.8 mm EMT are rare, making this case a beacon of hope for such patients. It highlights that, with appropriate interventions, successful pregnancies remain attainable. For those with a thin endometrium, emphasis should extend beyond thickness, addressing ways to enhance both endometrial blood supply and morphology for improved pregnancy rates.
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  • 文章类型: Case Reports
    目的:报告一名双侧卵巢癌患者体外回收成熟卵母细胞的胞浆内单精子注射导致的妊娠和活产。
    方法:病例报告。
    方法:一名34岁的双侧卵巢肿瘤未产妇女,根据IOTA-ADNEX,恶性肿瘤的风险为96.1%,谁希望在明确的手术治疗之前保留生育能力。
    方法:冷冻保存离体回收的成熟(MII)卵母细胞,然后用供体精子受精,并将胚胎移植到妊娠携带者身上.
    方法:生育力保存。
    结果:控制性卵巢刺激后,从卵巢切除的标本中取出12个MII卵母细胞,和玻璃化。使用供体精子进行ICSI缓解,产生9个卵裂期胚胎,其中两个被转移到妊娠携带者身上,导致正常健康的单胎怀孕,和一个健康婴儿的活产。
    结论:(s):卵巢切除术后离体取卵可能是卵巢恶性肿瘤女性保留生育能力标准取卵的安全替代方法。
    OBJECTIVE: To report pregnancy and live birth resulting from intracytoplasmic sperm injection of ex vivo-retrieved mature oocytes from a woman with bilateral ovarian carcinoma.
    METHODS: Case report.
    METHODS: Fertility clinic.
    METHODS: A 34-year-old nulliparous woman with bilateral ovarian tumor, with a risk of malignancy of 96.1% according to International Ovarian Tumor Analysis Group recommendations for adnexal tumors, who desired fertility preservation before definitive surgical treatment.
    METHODS: Cryopreservation of ex vivo-retrieved mature metaphase II oocytes is followed by fertilization with donor sperm and embryo transfer to a gestational carrier.
    METHODS: Fertility preservation.
    RESULTS: After controlled ovarian stimulation, 12 metaphase II oocytes were retrieved from oophorectomized specimens and vitrified. Intracytoplasmic sperm injection with donor sperm was performed in remission, resulting in 9 cleavage-stage embryos, 2 of which were transferred to a gestational carrier, resulting in a normal, healthy singleton pregnancy, and the live birth of a healthy infant.
    CONCLUSIONS: Ex vivo oocyte retrieval after oophorectomy may be a safe alternative to standard oocyte retrieval for fertility preservation in women with ovarian malignancies.
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