Pregnancy rate

妊娠率
  • 文章类型: Journal Article
    背景:非侵入性染色体筛查(NICS)和滋养外胚层活检植入前基因检测(TE-PGT)均用于胚胎倍性检测,然而,老年组NICS和TE-PGT的累积活产率(CLBR)尚未报告.这项研究旨在确定NICS和TE-PGT是否可以提高高龄产妇的累积活产率。
    方法:共招募384对35-40岁的夫妇。患者被分为三组:NICS,TE-PGT,和卵胞浆内单精子注射(ICSI)。所有患者均接受冷冻单囊胚移植。NICS和TE-PGT组患者接受非整倍体筛查。
    结果:与ICSI组相比,NICS和TE-PGT组的CLBR明显更高(27.9%vs.44.9%vs.51.0%,对于NICS和NICS,p=0.003ICSI,TE-PGT与ICSI)。NICS和TE-PGT组之间的临床结果没有显着差异。调整混杂因素,NICS和TE-PGT组的CLBR仍高于ICSI组(校正比值比(OR)3.847,95%置信区间(CI)1.939~7.634;校正OR3.795,95%CI1.981~7.270).此外,NICS组和TE-PGT组的累积妊娠损失率显著低于ICSI组(校正OR0.277,95%CI0.087~0.885;校正OR0.182,95%CI0.048~0.693).三组出生体质量差异无统计学意义(p=0.108)。
    结论:在35-40岁的女性中,可以通过使用NICS和TE-PGT选择整倍体胚胎来增加CLBR。对于胚胎非整倍体高风险的老年妇女,NICS,其特点是安全性和非侵入性,可能会成为植入前遗传检测的替代选择。
    BACKGROUND: Non-invasive chromosome screening (NICS) and trophectoderm biopsy preimplantation genetic testing for aneuploidy (TE-PGT) were both applied for embryo ploidy detection, However, the cumulative live birth rates (CLBR) of NICS and TE-PGT in older age groups have yet to be reported. This study aimed to ascertain whether NICS and TE-PGT could enhance the cumulative live birth rates among patients of advanced maternal age.
    METHODS: A total of 384 couples aged 35-40 years were recruited. The patients were assigned to three groups: NICS, TE-PGT, and intracytoplasmic sperm injection (ICSI). All patients received frozen single blastocyst transfer. Patients in the NICS and TE-PGT groups underwent aneuploidy screening.
    RESULTS: When compared to the ICSI group, the CLBR was significantly higher in the NICS and TE-PGT groups (27.9% vs. 44.9% vs. 51.0%, p = 0.003 for NICS vs. ICSI, p < 0.001 for TE-PGT vs. ICSI). There were no significant differences in the clinical outcomes between the NICS and TE-PGT groups. Adjusting for confounding factors, the NICS and TE-PGT groups still showed a higher CLBR than the ICSI group (adjusted odds ratio (OR) 3.847, 95% confidence interval (CI) 1.939 to 7.634; adjusted OR 3.795, 95% CI 1.981 to 7.270). Additionally, the cumulative pregnancy loss rates of the NICS and TE-PGT groups were significantly lower than that of the ICSI group (adjusted OR 0.277, 95% CI 0.087 to 0.885; adjusted OR 0.182, 95% CI 0.048 to 0.693). There was no significant difference in the birth weights of the three groups (p = 0.108).
    CONCLUSIONS: In women 35-40 years old, the CLBR can be increased by selecting euploid embryos using NICS and TE-PGT. For elderly women at high risk of embryonic aneuploidy, NICS, characterized by its safety and non-invasive nature, may emerge as an alternative option for preimplantation genetic testing.
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  • 文章类型: Journal Article
    在经典的体外受精程序(IVF)或胞质内单精子注射(ICSI)后的第18小时进行受精检查是辅助生殖的关键阶段。治疗的成功很大程度上取决于显示两个原核的受精卵的数量。因此,低受精率或完全受精失败对患者和生殖专家都是非常不希望的结果.ICSI后应用额外的钙离子载体进行卵母细胞激活可能会带来益处,并可能增强治疗效果。特别是对于在以前的治疗周期中经历过低受精率或无受精率(FR)的患者。该研究的目的是评估Ca2离子载体应用于卵母细胞活化的功效。
    回顾性分析从120例患者中获得的924个卵母细胞,这些患者因先前的治疗失败而经历了ICSI周期,具有低受精或无受精史。在下一个ART周期之后,在57例病例中应用了额外的卵母细胞Ca2离子载体激活,以优化治疗过程(第1组)。纳入63例患者,其结局作为对照组(第2组).我们对两组的结果进行了比较分析。该研究的主要结果包括受精,卵裂胚胎质量,囊胚率,并确定了临床妊娠。
    在第1天受精检查时,我们在第1组中有274/386个受精卵(71%FR),在第2组中有132/410个受精卵(32.2%FR),(P<0.0001)。第2组的22个(34.9%)周期导致总受精失败(TFF)。在卵裂阶段,与第2组相比,第1组的优质胚胎明显更高(P=0.0021)。第1组进行了48个胚胎移植(ET),导致41.67%的临床妊娠,而第2组只有33个ET,仅4个妊娠(12.12%)(P=0.0044)。
    结果证实了在先前受精失败周期的情况下,辅助卵母细胞激活作为附加方法的适当性。
    UNASSIGNED: Fertilization check performed at the 18th hour following classic in vitro fertilization procedure (IVF) or intracytoplasmic sperm injection (ICSI) is a critical stage in assisted reproduction. The success of the treatment is significantly reliant on the quantity of zygotes exhibiting two pronuclei. Consequently, low fertilization rates or complete fertilization failure are highly undesirable outcomes for both patients and reproductive specialists. Applying additional calcium ionophore for oocyte activation subsequent to ICSI may offer benefits and potentially enhance treatment outcomes, particularly for patients who have experienced low or absent fertilization rates (FR) in previous treatment cycles. The aim of the study is to evaluate the efficacy of Ca2+ ionophore application for oocyte activation.
    UNASSIGNED: A retrospective analysis of 924 oocytes obtained from 120 patients who underwent ICSI cycles with a history of low or no fertilization as a result of previous unsuccessful treatment rounds. The next ART cycle followed with additional oocyte Ca2+ ionophore activation applied in 57 of the cases in order to optimize the treatment process (Group 1), and 63 patients were included and their outcomes followed as a control group (Group 2).We conducted a comparative analysis of results in both groups. The study\'s primary outcomes encompassed fertilization, cleavage embryo quality, blastocyst rate, and established clinical pregnancies.
    UNASSIGNED: At day 1 fertilization check we had 274/386 zygotes (71%FR) in group 1 and 132/410 in group 2 (32.2%FR), (P < 0.0001). Twenty-two (34.9%) cycles in group 2 resulted in total fertilization failure (TFF). At the cleavage stage top-quality embryos from group 1 were significantly higher (P = 0.0021) in comparison to group 2. Forty-eight embryo transfers (ET) were performed in group 1 resulting in 41.67% clinical pregnancies versus 33 ET and only 4 pregnancies (12.12%) for group 2 (P = 0.0044).
    UNASSIGNED: The results confirm the appropriateness of assisted oocyte activation as an additional method in cases of previous fertilization failure cycles.
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  • 文章类型: Journal Article
    这项研究比较了两种同步排卵方案中的生殖结果,这些方案提供了延长的发情期与目前用于定时AI(TAI)的基于雌二醇的常规方案。在一个位置的荷斯坦小母牛(13-15个月)被随机分配到三种TAI方案之一。7天雌二醇苯甲酸酯(EB)组中的母牛(n=150)在第0天接受了孕酮装置(Cue-Mate)和2mgEB;在第7天去除500μg的氯前列醇(PGF)和Cue-Mate;在第8天添加1mgEB,在第9天(Cue-Mate去除后54小时)。5天CO-Synch(CO)组中的小母牛(n=150)在第2天接受了Cue-Mate和100μg促性腺激素释放激素(GnRH);Cue-Mate去除和PGF(两次,间隔12小时)在第7天;以及GnRH和TAI在第10天(Cue-Mate去除后72小时)。J-Synch(JS)组中的小母牛(n=150)在第1天接受Cue-Mate和2mgEB;在第7天接受PGF和Cue-Mate去除;在第10天(Cue-Mate去除后72小时)接受GnRH和TAI。小母牛由一名技术人员用来自四个市售父亲之一的冻融常规精液进行授精。在Cue-Mate去除和TAI时测定血浆孕酮(P4)浓度(ng/mL)。在方案开始时,对217只母牛的一部分进行了卵巢超声检查,在Cue-Mate移除;TAI;和TAI后7天。大约,TAI后28天和50天通过超声检查确定妊娠状态。与EB母牛(4.53±0.2)相比,在CO(6.02±0.2)和JS(6.51±0.2)中,Cue-Mate去除时的平均(±SEM)血浆P4浓度更高(p<0.01)。平均(±SEM)血浆P4浓度在TAI最低的JS(0.28±0.05),中间CO(0.46±0.02),EB母牛中最大(0.66±0.05,p<0.01)。与CO和EB组相比,JS组的排卵卵泡直径(平均值±SEM)最小(15.8±0.5;13.9±0.5;EB为12.7±0.5mm,CO和JS,分别)。JS组中更多(p<.01)的母牛的发情周期同步(EB为50.0、78.8和82.4%,CO和JS组),并在28岁时怀孕(EB分别为40.3%、51.3%和63.3%,CO和JS组)和TAI后50天(EB为32.6、46.0和60.0%,CO和JS组)。总之,接受J-SynchTAI方案的母牛在TAI的P4较低,对荷尔蒙治疗的整体反应更好,与接受7天EB方案或5天CO同步方案的小母牛相比,导致TAI后28天和50天的P/AI增加。
    This study compared reproductive outcomes among two protocols for synchronization of ovulation that provide for a lengthened proestrus with the conventional oestradiol-based protocol currently used for timed-AI (TAI). Holstein heifers (13-15 months) at one location were assigned randomly to one of three TAI protocols. Heifers (n = 150) in the 7-day oestradiol benzoate (EB) group received a progesterone device (Cue-Mate) and 2 mg EB on Day 0; 500 μg of cloprostenol (PGF) and Cue-Mate removal on Day 7; 1 mg of EB on Day 8 and TAI on Day 9 (54 h after Cue-Mate removal). Heifers (n = 150) in the 5-day CO-Synch (CO) group received a Cue-Mate and 100 μg of gonadotropin-releasing hormone (GnRH) on Day 2; Cue-Mate removal and PGF (twice, 12 h apart) on Day 7; and GnRH along with TAI on Day 10 (72 h after Cue-Mate removal). Heifers (n = 150) in the J-Synch (JS) group received a Cue-Mate and 2 mg of EB on Day 1; PGF and Cue-Mate removal on Day 7; GnRH and TAI on Day 10 (72 h after Cue-Mate removal). Heifers were inseminated by one technician with frozen-thawed conventional semen from one of four commercially available sires. Plasma progesterone (P4) concentrations (ng/mL) were determined at Cue-Mate removal and TAI. Ovarian ultrasonography was done in a subset of 217 heifers at the initiation of protocols, at Cue-Mate removal; TAI; and 7 days after TAI. Approximately, 28 and 50 days after TAI pregnancy status was determined by ultrasonography. Mean (±SEM) plasma P4 concentration at Cue-Mate removal was greater (p < .01) in CO (6.02 ± 0.2) and JS (6.51 ± 0.2) compared to EB heifers (4.53 ± 0.2). Mean (±SEM) plasma P4 concentration at TAI was lowest in the JS (0.28 ± 0.05), intermediate in CO (0.46 ± 0.02), and greatest in EB heifers (0.66 ± 0.05, p < .01). The diameter of the ovulatory follicle (mean ± SEM) was the smallest in the JS group compared to that in the CO and EB groups (15.8 ± 0.5; 13.9 ± 0.5; and 12.7 ± 0.5 mm for EB, CO and JS, respectively). More (p < .01) heifers in the JS group had their oestrous cycle synchronized (50.0, 78.8 and 82.4% for EB, CO and JS groups), and were pregnant at 28 (40.3, 51.3 and 63.3% for EB, CO and JS groups) and 50 days after TAI (32.6, 46.0 and 60.0% for EB, CO and JS groups). In summary, heifers subjected to the J-Synch TAI protocol had lower P4 at TAI, and better overall response to hormonal treatments, which resulted in increased P/AI at 28 and 50 days after TAI compared to those heifers subjected to either a 7-day EB protocol or a 5-day CO-synch protocol.
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  • 文章类型: Journal Article
    背景:许多癌症治疗对患者的生育能力构成威胁。癌症治疗前精液冷冻保存是保存生育能力的有效方法。关于加拿大肿瘤精子库样本使用情况的长期数据很少。
    方法:对加拿大学术生育中心2001年至2020年的所有肿瘤精子库样本进行回顾性图表回顾。
    结果:从2001年到2020年,有2504名患者收集了4521个样本。这些患者中最常见的诊断是睾丸癌(29.5%)和淋巴瘤(26.9%)。在这些病人中,只有81例(3.2%)患者通过宫腔内授精(IUI)或体外受精(IVF)治疗返回使用他们的样本,62例(2.5%)患者将他们的样本转移到另一家诊所.银行和使用精子之间的时间从1到131个月不等,银行后的中位数为18个月。回顾了67例患者的66个IVF周期(104个胚胎移植)和101个IUI周期。在使用样本的67对夫妇中,53.7%实现了临床妊娠。IUI每个周期的临床妊娠率为6.6%,IVF每个胚胎移植的临床妊娠率为30.8%。较高的精子浓度或总运动量与较高的怀孕机会无关。受孕的患者每个周期的可用胚胎平均比没有受孕的患者多1.9±0.8(p=0.02)。
    结论:精子冷冻保存为癌症患者在潜在的性腺毒性癌症治疗后获得父母身份提供了一个有价值的选择。然而,库存肿瘤精子样本的总体使用率很低。
    BACKGROUND: Many cancer treatments pose a threat to fertility for patients. Semen cryopreservation before cancer treatment is an effective method to preserve fertility. There are sparse long-term data on the usage of samples from Canadian oncology sperm banks.
    METHODS: A retrospective chart review of all oncology sperm banking samples at a Canadian academic fertility centre from 2001 to 2020 was conducted.
    RESULTS: From 2001 to 2020, 4521 samples were banked by 2504 patients. The most frequent diagnoses among these patients were testicular cancer (29.5%) and lymphoma (26.9%). Of these patients, only 81 (3.2%) patients returned to use their samples with intrauterine insemination (IUI) or in vitro fertilisation (IVF) treatment and 62 (2.5%) patients transferred their samples to another clinic. The time between banking and return for usage of the sperm ranged from 1 to 131 months with a median of 18 months after banking. A total of 66 IVF cycles (104 embryo transfers) and 101 IUI cycles from 67 patients were reviewed. Of the 67 couples who used their samples, 53.7% achieved a clinical pregnancy. The clinical pregnancy rate was 6.6% per cycle for IUI and 30.8% per embryo transfer for IVF. Higher sperm concentration or total motile count was not associated with a higher chance of pregnancy. Patients who conceived had on average 1.9 ± 0.8 (p=0.02) more usable embryos per cycle than those who did not conceive.
    CONCLUSIONS: Sperm cryopreservation provides a valuable option for patients with cancer to achieve parenthood after potentially gonadotoxic cancer treatment. However, the overall usage of banked oncology sperm samples is very low.
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  • 文章类型: Journal Article
    在体外受精/卵胞浆内单精子注射和胚胎移植的控制性卵巢刺激(COS)期间,重组人黄体生成素(r-hLH)的最佳剂量及其对子宫内膜厚度(EMT)的影响尚不确定,形成了本系统综述和荟萃分析的目标。
    在PubMed中进行了搜索,科克伦图书馆,WebofScience,EMBASE,CNKI,和万方从成立到2023年7月10日。纳入了27项随机对照试验,比较了在体外受精/卵胞浆内单精子注射和胚胎移植(IVF/ICSI-ET)期间r-hFSH/r-hLH联合治疗与r-hFSH单独治疗。二分数据的汇总优势比(OR)和连续数据的平均差(MD),他们各自的95%置信区间(CI),产生了。Meta分析采用基于异质性的固定效应或随机效应模型,使用Q检验和I2指数计算。主要结果包括触发日的EMT,临床妊娠率(CPR)和活产率(LBR)。
    r-hFSH/r-hLH在触发日显著增加EMT(MD=0.27;95%CI,0.11-0.42;I2=13%),但卵母细胞数量(MD=-0.60;95%CI,-1.07至-0.14;I2=72%)和高质量胚胎(MD=-0.76;95%CI,-1.41至-0.10;I2=94%)比单独的r-hFSH减少,更明显与促性腺激素释放激素激动剂长方案。亚组分析显示,r-hLH在75IU/天增加了CPR(OR=1.23;95%CI,1.02-1.49;I2=16%)和触发日的EMT(MD=0.40;95%CI,0.19-0.61;I2=0%)。年龄≥35岁的参与者表现出恢复的卵母细胞减少(MD=-1.26;95%CI,-1.78至-0.74;I2=29%),但在触发日EMT增加(MD=0.26;95%CI,0.11-0.42;I2=29%)。
    与单独的r-hFSH相比,COS期间的r-hFSH/r-hLH显着改善了EMT。75IU/天的r-hLH剂量可以被认为是最佳的妊娠结局。这仍然需要进一步的临床研究来支持这种给药方案。
    [www.crd.约克。AC.uk/PROSPERO],标识符[CRD42023454584]。
    UNASSIGNED: The optimal dosage of recombinant human luteinizing hormone (r-hLH) and its impact on endometrial thickness (EMT) when administered alongside recombinant human follicle-stimulating hormone (r-hFSH) during controlled ovarian stimulation (COS) for in vitro fertilization/intracytoplasmic sperm injection and embryo transfer are uncertain, which formed the aims of this systematic review and meta-analysis.
    UNASSIGNED: A search was performed in PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, and Wanfang from its inception to 10 July 2023. Twenty-seven Randomized controlled trials comparing r-hFSH/r-hLH co-treatment with r-hFSH alone during in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) were included. Pooled odds ratios (OR) for dichotomous data and mean differences (MD) for continuous data, with their respective 95% confidence intervals (CI), were generated. Meta-analysis employed fixed-effect or random-effect models based on heterogeneity, using Q-test and I2-index calculations. The main outcomes included EMT on trigger day, clinical pregnancy rate (CPR) and live birth rate (LBR).
    UNASSIGNED: r-hFSH/r-hLH significantly increased EMT on trigger day (MD = 0.27; 95% CI, 0.11-0.42; I2 = 13%), but reduced oocyte number (MD = -0.60; 95% CI, -1.07 to -0.14; I2 = 72%) and high-quality embryos (MD = -0.76; 95% CI, -1.41 to -0.10; I2 = 94%) than r-hFSH alone, more pronounced with the gonadotrophin-releasing hormone agonist long protocol. A subgroup analysis showed r-hLH at 75 IU/day increased CPR (OR = 1.23; 95% CI, 1.02-1.49; I2 = 16%) and EMT on trigger day (MD = 0.40; 95% CI, 0.19-0.61; I2 = 0%). Participants ≥35 years of age exhibited decreased retrieved oocytes (MD = -1.26; 95% CI, -1.78 to -0.74; I2 = 29%), but an increase in EMT on trigger day (MD = 0.26; 95% CI, 0.11-0.42; I2 = 29%).
    UNASSIGNED: r-hFSH/r-hLH during COS significantly improved EMT compared to r-hFSH alone. An r-hLH dose of 75 IU/day may be considered for optimal pregnancy outcomes, which still require further clinical studies to support this dosing regime.
    UNASSIGNED: [www.crd.york.ac.uk/PROSPERO], identifier [CRD42023454584].
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  • 文章类型: Journal Article
    根据现有的随机对照试验(RCT),定量评估辅酶Q10(CoQ10)预处理对卵巢储备功能减退(DOR)女性IVF或ICSI结局的影响。
    从数据库开始到2023年11月1日,对9个数据库进行了全面搜索,以确定合格的RCT。感兴趣的生殖结局包括三个主要结局和六个次要结局。采用敏感性分析验证了合并结果的稳健性。
    总共有六个RCT,共有1529名接受IVF/ICSI不孕症治疗的DOR参与者。现有证据的回顾表明,辅酶Q10预处理与临床妊娠率升高显著相关(OR=1.84,95CI[1.33,2.53],p=0.0002),最佳胚胎数量(OR=0.59,95CI[0.21,0.96],p=0.002),检索到的卵母细胞数(MD=1.30,95CI[1.21,1.40],p<0.00001),HCG当天的E2水平(SMD=0.37,95CI[0.07,0.66],p=0.01),随着周期取消率的降低(OR=0.60,95CI[0.44,0.83],p=0.002),流产率(OR=0.38,95CI[0.15,0.98],p=0.05),Gn应用的总天数(MD=-0.89,95CI[-1.37,-0.41],p=0.0003),和使用的Gn总剂量(MD=-330.44,95CI[-373.93,-286.96],p<0.00001)。敏感性分析表明,我们的合并结果是稳健的。
    这些研究结果表明,辅酶Q10预处理是改善DOR妇女IVF/ICSI结局的有效干预措施。尽管如此,这项荟萃分析纳入的样本量相对有限,但方法学描述较差.今后需要进行严格的试验。
    UNASSIGNED: To quantitatively evaluate the effect of coenzyme Q10 (CoQ10) pretreatment on outcomes of IVF or ICSI in women with diminished ovarian reserve (DOR) based on the existing randomized controlled trials (RCTs).
    UNASSIGNED: Nine databases were comprehensively searched from database inception to November 01, 2023, to identify eligible RCTs. Reproductive outcomes of interest consisted of three primary outcomes and six secondary outcomes. The sensitivity analysis was adopted to verify the robustness of pooled results.
    UNASSIGNED: There were six RCTs in total, which collectively involved 1529 participants with DOR receiving infertility treatment with IVF/ICSI. The review of available evidence suggested that CoQ10 pretreatment was significantly correlated with elevated clinical pregnancy rate (OR = 1.84, 95%CI [1.33, 2.53], p = 0.0002), number of optimal embryos (OR = 0.59, 95%CI [0.21, 0.96], p = 0.002), number of oocytes retrieved (MD = 1.30, 95%CI [1.21, 1.40], p < 0.00001), and E2 levels on the day of hCG (SMD = 0.37, 95%CI [0.07, 0.66], p = 0.01), along with a reduction in cycle cancellation rate (OR = 0.60, 95%CI [0.44, 0.83], p = 0.002), miscarriage rate (OR = 0.38, 95%CI [0.15, 0.98], p = 0.05), total days of Gn applied (MD = -0.89, 95%CI [-1.37, -0.41], p = 0.0003), and total dose of Gn used (MD = -330.44, 95%CI [-373.93, -286.96], p < 0.00001). The sensitivity analysis indicated that our pooled results were robust.
    UNASSIGNED: These findings suggested that CoQ10 pretreatment is an effective intervention in improving IVF/ICSI outcomes for women with DOR. Still, this meta-analysis included relatively limited sample sizes with poor descriptions of their methodologies. Rigorously conducted trials are needed in the future.
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  • 文章类型: Journal Article
    目的:研究辅助生殖技术(ART)在妇科癌症患者中的生殖结局,并评估母婴并发症。
    方法:本研究包括2013年至2021年在上海集爱遗传和IVF研究所接受首次体外受精/卵胞浆内单精子注射(IVF/ICSI)治疗的被诊断为妇科癌症的女性。无任何癌症史的不孕妇女与癌症组相匹配。主要结果是累积活产率。使用正态分布变量的Student\'st检验和分类变量的卡方检验比较各组之间的基线和随访数据。采用基于倾向评分的患者匹配方法,以确保有和没有特定癌症类型的个体之间的可比性。
    结果:本研究共纳入了136例有妇科癌症史的患者和241例健康不孕对照。子宫内膜癌占病例的50.70%,宫颈癌占病例的34.60%。癌症组表现出明显更短的刺激持续时间,较低水平的雌二醇,回收的卵母细胞数量较少,第3天的胚胎,囊胚与对照组比较(P<0.05)。妇科癌症组的累积活产率明显低于对照组(36.10%vs.60.50%,P<0.001)。母婴并发症组间差异无统计学意义(P>0.05)。子宫内膜癌和宫颈癌组的累积活产率显着低于其匹配的对照组(38.60%vs.64.50%,P=0.011和24.20%vs.68.60%,分别为P<0.001)。
    结论:这些发现强调了接受ART的女性妇科癌症患者的妊娠和活产发生率下降,特别是子宫内膜癌和宫颈癌。这些发现对于接受ART的妇科癌症患者的咨询和管理具有重要意义。
    OBJECTIVE: To examine the reproductive outcomes of assisted reproductive technology (ART) in gynecologic cancer patients and to assess maternal and neonatal complications.
    METHODS: Women diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student\'s t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.
    RESULTS: A total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).
    CONCLUSIONS: These findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.
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  • 文章类型: Journal Article
    本研究旨在确定生育和生长性状,生存能力,在土耳其潮湿地区的饲养员条件下对罗曼诺夫绵羊进行身体测量。该研究的动物材料包括2019年从乌克兰进口的绵羊。在研究中,第一年有两个农场,有31只和44只母羊,第二年有三个农场,有45只、34只和32只母羊。对三个不同养殖场的186只绵羊和羔羊的繁殖性能进行了检查,和九只公羊,每20只绵羊一只公羊,是用来交配的.纯罗曼诺夫母羊繁殖性能的两年(2020年和2021年)数据,母羊和羔羊的生存能力,本研究采用羔羊的发育特征。构思率(88.17%),出生时(1.42)和断奶时(1.29)的繁殖力,出生时产仔数(1.76)和断奶时产仔数(1.56),单身(50.98%),双胞胎(41.83%),三胎出生率(6.54%),平均2年确定流产率(6.71%)。羔羊的出生和断奶重量受性别和出生类型的影响(p<0.01)。罗曼诺夫绵羊及其羔羊在繁殖性能和羔羊发育方面不满意饲养员。
    This study aimed to determine the fertility and growth traits, viability, and body measurements of the Romanov sheep under breeder conditions in the humid region of Turkey. The animal material of the research consisted of sheep imported from Ukraine in 2019. In the study, there are two farms with 31 and 44 ewes in the first year and three farms with 45, 34, and 32 ewes in the second year. The reproductive performances of 186 sheep and lambs in three different farms were examined, and nine rams, one ram per 20 sheep, were used for mating. Two-year (2020 and 2021) data on the reproductive performance of pure Romanov ewes, survivability in ewes and lambs, and development characteristics in lambs were used in the present study. The conceived rate (88.17%), fecundity at birth (1.42) and at weaning (1.29), litter size at birth (1.76) and weaning (1.56), single (50.98%), twin (41.83%), and triplet birth rate (6.54%), and abortion rate (6.71%) were determined for 2 years average. Birth and weaning weights of lambs were affected by sex and birth type (p < 0.01). The Romanov sheep and their lambs did not satisfy the breeder regarding reproductive performance and lamb development.
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  • 文章类型: Journal Article
    不孕症的全球患病率为9%,男性因素可能占病例的40%至60%。常规治疗可能无效,侵入性,昂贵的,并与不利影响和高风险有关。以前的研究表明,中草药(CHM)可以调节下丘脑-垂体-睾丸轴,改善精子异常和质量,缓解氧化应激,降低DNA片段化指数(DFI)。然而,由于研究设计的局限性,支持使用中草药(CHM)治疗男性因素不育症的证据缺乏说服力,对于男性因素不育症的CHM治疗后的活产率的研究仍然很少。这里,我们描述了一项随机等待名单对照试验的基本原理和设计,以评估CHM对男性不育症患者活产率的影响.
    这项研究是一个单中心,随机化,等待名单对照研究。总共250对被诊断为男性因素不育症的夫妇将被纳入这项研究,然后以1:1的比例随机分为两组。CHM组(治疗组)的男性参与者将每天接受一次CHM,持续3个月。等待组(对照组)的男性参与者将在3个月内不接受任何治疗。三个月后,两组参与者需要再随访12个月.主要结果将是活产率;次要结果包括精液质量参数,DFI与妊娠相关结局。安全性也将被评估。
    该试验的目的是探讨CHM对处理男性因素不育症的夫妇中活产率的影响和安全性。该试验的结果可能为男性因素不育症提供可行的治疗选择。
    中国临床试验注册中心:ChiCTR2200064416.2022年10月7日注册,https://www。chictr.org.cn.
    UNASSIGNED: The global prevalence of infertility is 9%, with male factors potentially accounting for 40% to 60% of cases. Conventional treatments can be ineffective, invasive, costly, and linked to adverse effects and high risks. Previous studies have shown that, Chinese herbal medicine (CHM) can regulate the hypothalamus-pituitary-testis axis, improve sperm abnormalities and quality, mitigate oxidative stress, and decrease DNA fragmentation index (DFI). Yet, the evidence backing the use of Chinese herbal medicine (CHM) for treating male factor infertility lacks conviction due to study design limitations, and there remains a scarcity of studies on the live birth rate following CHM treatment for male factor infertility. Here, we describe the rationale and design of a randomized waitlist-controlled trial to evaluate the effect of CHM on the live birth rate among males with infertility.
    UNASSIGNED: This study is a single-center, randomized, waitlist-controlled study. A total of 250 couples diagnosed with male factor infertility will be enrolled in this study and then randomly allocated into two groups in a 1:1 ratio. Male participants in CHM group (treatment group) will receive CHM once a day for 3 months. Male participants in the waitlist group (control group) will not receive any treatment for 3 months. After 3 months, participants in both groups need to be followed up for another 12 months. The primary outcome will be the live birth rate; secondary outcomes include semen quality parameters, DFI and pregnancy related outcomes. Safety will also be assessed.
    UNASSIGNED: The purpose of this trial is to explore the effects and safety of CHM on the live birth rate among couples dealing with male factor infertility. The outcome of this trial may provide a viable treatment option for male factor infertility.
    UNASSIGNED: Chinese Clinical Trial Registry: ChiCTR2200064416. Registered on 7 October 2022, https://www.chictr.org.cn.
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  • 文章类型: Systematic Review
    研究与期待治疗相比,切开隔膜是否有利于子宫纵隔患者的生殖结局。
    研究是从三个电子数据库中检索的:PubMed,Embase,还有Cochrane图书馆,没有时间或语言限制。两位作者独立选择了文章,并提取了有关研究特征的数据,质量,和结果。采用了随机效应模型,计算总风险比(RR)和95%置信区间(CI)。
    两项随机对照试验和一项队列研究的468例患者被纳入系统评价和荟萃分析。汇总结果显示,中隔切除术并不能提高中隔子宫患者的活产率(RR=0.84,95%CI=0.56-1.25,P=0.39)。此外,在临床妊娠方面,隔膜切除组和期待管理组之间没有发现显着差异(RR=1.08,95%CI0.81-1.44,P=0.60),流产(RR=1.99,95%CI0.80-4.98,P=0.14),和早产率(RR=0.99,95%CI0.42-2.31,P=0.98)。
    我们的数据提供了明确的证据,表明隔膜切除术不能改善纵隔子宫患者的生殖结局。这些发现可能有助于修订当前的临床指南。
    UNASSIGNED: To investigate whether incising the septum facilitates reproductive outcomes for patients with a septate uterus compared to expectant management.
    UNASSIGNED: Research was retrieved from three electronic databases: PubMed, Embase, and the Cochrane Library, with no time or language restrictions. Two authors independently selected the articles and extracted data regarding study characteristics, quality, and results. A random-effects model was employed, and summary risk ratios (RR) with 95% confidence intervals (CI) were calculated.
    UNASSIGNED: A total of 468 patients from two randomized controlled trials and one cohort study were included in the systematic review and meta-analysis. Pooled results showed that septum resection did not improve the live birth rate for patients with a septate uterus (RR = 0.84, 95% CI = 0.56 - 1.25, P = 0.39). Additionally, no significant differences were found between the septum resection and expectant management groups in terms of clinical pregnancy (RR = 1.08, 95% CI 0.81 - 1.44, P = 0.60), abortion (RR = 1.99, 95% CI 0.80 - 4.98, P = 0.14), and preterm delivery rates (RR = 0.99, 95% CI 0.42 - 2.31, P = 0.98).
    UNASSIGNED: Our data provide clear evidence that septum resection does not improve the reproductive outcomes of patients with a septate uterus. These findings might be useful for revising current clinical guidelines.
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