Is telephone follow-up reliable in maternal and neonatal outcomes surveys in in vitro fertilization?

BACKGROUND: Many studies that collect maternal and neonatal outcomes rely on patient self-report phone calls. It is unclear how reliable or accurate these phone call reports are. OBJECTIVE: To evaluate the reliability of telephone calls in information collection in IVF. STUDY DESIGN: The women were interviewed seven days after delivery by a nurse via telephone. The maternal and neonatal outcomes were recorded based on a self-report from one of the spouses. Meanwhile, the standardized electronic hospitalized discharge records were extracted from the hospital medical database. For each case, maternal and neonatal information obtained from telephone interviews and extracted from medical files were compared. RESULTS: Agreement was classified as "almost perfect, K = 0.81-1.00" for preterm birth, cesarean delivery, low birth weight baby, and macrosomia. The strength of agreement was classified as "moderate, K = 0.41-0.60" for some antepartum complications: gestational diabetes (K = 0.569); pregnancy-induced hypertension (K = 0.588); intrahepatic cholestasis of pregnancy (K = 0.597) and oligohydramnios (K = 0.432). The strength of agreement between telephone interviews and hospitalized discharge records can be classified as "slight (K = 0-0.20)" for some complications: thyroid diseases (K = 0.137), anemia (K = 0.047), postpartum hemorrhage (K = 0.016), and Fetal distress (K = 0.106). CONCLUSION: Some variables (preterm birth, cesarean delivery, birth weight) information collected by telephone follow-up were reliable. However, other complications (thyroid diseases, anemia, postpartum hemorrhage, and fetal distress) collected via self-report was non-reliable. Compared with complications during labor, antepartum complications have higher agreement between different follow-up methods. IVF records and hospitalized discharge records should be matched and collected simultaneously when discussing maternal and neonatal outcomes of IVF.

The chemical reprogramming of unipotent adult germ cells towards authentic pluripotency and de novo establishment of imprinting.

Although somatic cells can be reprogrammed to pluripotent stem cells (PSCs) with pure chemicals, authentic pluripotency of chemically induced pluripotent stem cells (CiPSCs) has never been achieved through tetraploid complementation assay. Spontaneous reprogramming of spermatogonial stem cells (SSCs) was another non-transgenic way to obtain PSCs, but this process lacks mechanistic explanation. Here, we reconstructed the trajectory of mouse SSC reprogramming and developed a five-chemical combination, boosting the reprogramming efficiency by nearly 80- to 100-folds. More importantly, chemical induced germline-derived PSCs (5C-gPSCs), but not gPSCs and chemical induced pluripotent stem cells, had authentic pluripotency, as determined by tetraploid complementation. Mechanistically, SSCs traversed through an inverted pathway of in vivo germ cell development, exhibiting the expression signatures and DNA methylation dynamics from spermatogonia to primordial germ cells and further to epiblasts. Besides, SSC-specific imprinting control regions switched from biallelic methylated states to monoallelic methylated states by imprinting demethylation and then re-methylation on one of the two alleles in 5C-gPSCs, which was apparently distinct with the imprinting reprogramming in vivo as DNA methylation simultaneously occurred on both alleles. Our work sheds light on the unique regulatory network underpinning SSC reprogramming, providing insights to understand generic mechanisms for cell-fate decision and epigenetic-related disorders in regenerative medicine.

Endometrial Preparation for Frozen-Thawed Embryo Transfer With or Without Pretreatment With GnRH Agonist: A Randomized Controlled Trial at Two Centers.

Objective: This prospective randomized controlled trial compared the reproductive outcomes of frozen embryo transfer (FET) with hormone replacement treatment (HRT) with or without gonadotropin-releasing hormone agonist (GnRHa) pretreatment. Methods: A total of 133 patients scheduled for HRT-FET mainly because of tubal and/or male factors who received two high-quality cleavage-stage embryos were enrolled at two participating centers. The GnRHa group (n = 65) received GnRHa pretreatment, while the control group (n = 68) did not. Analysis was based on the intention-to-treat (ITT) principle. Results: Among the 133 participants, 130 (97.7%) underwent embryo transfer and 127 (95.5%) completed the protocol. The clinical pregnancy rate according to ITT did not differ between the GnRHa and control groups [39/65 (60.0%) vs. 41/68 (60.3%), p = 0.887]. The implantation rate (47.6% vs. 45.3%, p = 0.713), early pregnancy loss rate (5.1% vs. 19.5%, p = 0.09), and live birth rate (49.2% vs. 50.0%, p = 0.920) were also comparable between groups. Conclusion: Pretreatment with GnRHa does not improve the reproductive outcomes for women receiving HRT-FET. Clinical Trial Registration: The study was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-17014170; http://www.chictr.org.cn).

Affected-embryo-based SNP haplotyping with NGS for the preimplantation genetic testing of Marfan syndrome.

Marfan syndrome (MFS), an autosomal dominant heritable disease of the connective tissue, is characterized by broad clinical manifestations in the musculoskeletal, cardiovascular, pulmonary, and ocular systems. In this study, a male patient with MFS caused by a heterozygous mutation NM_000138.5(FBN1):c.6037 + 2 T > C in the fibrillin 1 gene (FBN1) underwent preimplantation genetic testing (PGT) by using affected-embryo-based single nucleotide polymorphism (SNP) haplotyping. Multiple displacement amplification was used for whole genome amplification of biopsied trophectoderm cells after controlled ovarian stimulation. Sanger sequencing and next-generation sequencing (NGS) were used to detect the state of FBN1 mutation. A total of 14 blastocysts formed after intracytoplasmic sperm injection were biopsied. After NGS, 60 informative polymorphic SNP markers located upstream and downstream of the FBN1 gene and its pathogenic mutation site were linked to individual alleles. Sanger sequencing further confirmed that 8 blastocysts carried the mutation NM_000138.5(FBN1):c.6037 + 2 T > C, while 6 did not. Four of the non-carriers were euploid verified by copy number variation results. A female infant without MFS was born at 37 weeks gestation after a subsequent frozen embryo transfer. In conclusion, the successful case indicates that SNP haplotyping using sibling embryos as a reference is applicable to PGT in monogenetic diseases.Abbreviations MFS: Marfan syndrome; PGT: preimplantation genetic testing; FBN1: fibrillin 1 gene; NGS: next-generation sequencing; SNP: single nucleotide polymorphism.

Dietary protein intake and subsequent risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies.

AIMS: Dietary proteins, including those obtained from animal and plant sources, have inconsistently been correlated with type 2 diabetes mellitus (T2DM) risk. Therefore, a meta-analysis was conducted to evaluate the association between dietary proteins and the risk of T2DM. METHODS: Prospective cohort studies published until November 2018 were systematically searched in PubMed, Embase, and the Cochrane library. The pooled relative risks (RRs) were calculated with 95% confidence intervals (CIs) using the random-effects model. RESULTS: Ten articles involving a total of 21 cohorts were included in the final meta-analysis. A total of 487,956 individuals were recruited in these studies and 38,350 T2DM cases were reported. Analysis of the pooled RRs indicated that high total protein intake was associated with an increased risk of T2DM (RR 1.10; P = 0.006), whereas moderate total protein intake was not significantly associated with T2DM risk (RR 1.00; P = 0.917). Moreover, a higher risk of T2DM was observed with high animal protein intake (RR 1.13; P = 0.013), whereas moderate animal protein intake had little or no effect on T2DM risk (RR 1.06; P = 0.058). Finally, high intake of plant protein did not affect T2DM risk (RR 0.93; P = 0.074), whereas moderate intake was associated with a reduced risk of T2DM (RR 0.94; P < 0.001). CONCLUSIONS: The results of this study indicate that high total protein and animal protein intakes are associated with an increased risk of T2DM, whereas moderate plant protein intake is associated with a decreased risk of T2DM.

Correction to: Dietary protein intake and subsequent risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies.

The article Dietary protein intake and subsequent risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies written by Jianhong Ye, Qixin Yu, Weihua Mai, Peiling Liang, Xiaoxia Liu, Yunnan Wang was originally published electronically on the publisher's internet portal (currently SpringerLink) on 30 March 2019 with open access. With the author(s)' decision to step back from Open Choice, the copyright of the article changed on 30 May 2019 to © Springer-Verlag Italia S.r.l., part of Springer Nature 2019 and the article is forthwith distributed under the terms of copyright.

Longitudinal Changes of PAI-1, MMP-2, and VEGF in Peritoneal Effluents and Their Associations with Peritoneal Small-Solute Transfer Rate in New Peritoneal Dialysis Patients.

Patients on peritoneal dialysis (PD) encounter peritoneal functional and structural alterations. It is still unknown whether levels of plasminogen activator inhibitor type 1 (PAI-1), matrix metalloproteinases- (MMP-) 2, and vascular endothelial growth factor (VEGF) exhibit dynamic changes in peritoneal effluents. The aim of the present study was to investigate the longitudinal changes in these biomarkers in PD patients and their association with peritoneal small-solute transfer rate (PSTR). This prospective, single-center cohort study included 70 new PD patients. The presence of PAI-1, MMP-2, and VEGF in peritoneal effluents was measured regularly after PD initiation. The association between those biomarkers and 4-hour effluent:plasma creatinine ratio (PSTR) was analyzed. Longitudinal follow-up showed a tendency for PAI-1 (p < 0.001) and VEGF (p = 0.04) to increase with the duration of PD. Both PSTR at baseline and PSTR at 2 years significantly associated with PAI-1, MMP-2, and VEGF levels at baseline. PSTR at 2 years also associated with the MMP-2 level at 6 months and PAI-1 level at baseline. The present study illustrated a positive association of PSTR with selected biomarkers in peritoneal effluents observed over a 2-year period.

[Catgut implantation at stellate ganglion for postmenopausal osteoporosis].

OBJECTIVE: To compare the efficacy differences between catgut implantation at stellate ganglion combined with oral administration of alendronate sodium and oral administration of alendronate sodium alone on postmenopausal osteoporosis (PO). METHODS: Sixty patients of PO were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with oral administration of alendronate sodium. Based on the treatment of control group, the patients in the observation group were treated with catgut implantation at stellate ganglion. The treatment was given once a week in the two groups; the consecution treatment of four weeks constituted one session, and totally six sessions were given. The changes of total syndrome score, bone mineral density of lumbar vertebra (L1 to L4) and femeral neck (FN) and estradiol were observed before and after treatment; the clinical efficacy was compared between the two groups. RESULTS: Compared before treatment, the total syndrome score, bone mineral density of lumbar vertebra (L1 to L4) and FN and estradiol were significantly improved after treatment (all P<0.05); which were more significant in the observation group (all P<0.05). Compared before treatment, the level of estradiol in the control group was not significantly changed after treatment (P>0.05), while that in the observation group was significantly changed after treatment (P<0.05). After treatment, the level of estradiol in the observation group was higher than that in the control group (P<0.05). The total effective rate was 93.3% (28/30) in the observation group, which was significantly higher than 83.3% (25/30) in the control group (P<0.05). CONCLUSION: Catgut implantation at stellate ganglion combined with oral administration of alendronate sodium are superior to oral administration of alendronate sodium alone for postmenopausal osteoporosis, which improve the clinical symptoms, regulate the hormone level and increase bone mineral density.

[Moxibustion at Geshu (BL 17) for diabetic limb arterial obliteration at early stage].

OBJECTIVE: To compare the efficacy differences between moxibustion at Geshu (BL 17) and oral administration of cilostazol on diabetic limb arterial obliteration (DLAO) at early stage as well as the impacts on hemorheology and arterial inner dimension of lower extremity. METHODS: Seventy patients of DLAO at early stage were randomly divided into an observation group and a control group, 35 cases in each one. The two groups were treated with regular treatment of blood glucose and blood lipid. The patients in the control group was treated with oral administration of cilostazol, 50 mg, twice a day; the patients in the observation group were treated with moxibustion at Geshu (BL 17), once a day. The consecution treatment of two weeks constituted one session, and totally 4 sessions were given. The total syndrome score, hemorheology index (including low and high shear viscosity of blood, plasma viscosity, hematocrit and erythrocyte aggregation index) and arterial inner dimension of lower extremity (including popliteal artery, posterior tibial artery and dorsalis pedis artery) were compared before and after treatment. RESULTS: Compared with those before treatment, the total syndrome score, hemorheology index and arterial inner dimension of lower extremity were significantly improved after treatment in the two groups (all P<0.05). The total syndrome score, hemorheology index in the observation group were superior to those in the control group (all P<0.05), but the improvement of arterial inner dimension of lower extremity was not significantly different between the two groups (P>0.05). After treatment, the total effective rate was 91.4% (32/35) in the observation group, which was significantly superior to 85.7% (30/35) in the control group (P<0.05). CONCLUSION: Moxibustion at Geshu (BL 17) is superior to oral administration of cilostazol for DLAO at early stage, which could effectively improve the clinical symptoms, blood flow and blood vessel and increase the blood flow of lower limb.

[Effects of luteinizing hormone supplementation on outcomes of in vitro fertilization and embryo transfer in patients undergoing GnRH-agonist long protocol].

OBJECTIVE: To compare the clinical outcomes of in vitro fertilization and embryo transfer (IVF-ET) among patients in different conditions receiving luteinizing hormone supplementation in GnRH-agonist long protocol. METHODS: Between June, 2010 and December, 2015, 671 IVF-ET cycles with GnRH-agonist long protocol were performed at our center. These cycles were divided into group A with FSH only and group B with FSH and recombinant luteinizing hormone (r-LH) supplementation, and each group was divided into 4 subgroups according to age (<35 or ≥35) and the LH level on the initial day (<1.0 U/L or ≥1.0 U/L). The effects of LH supplementation on the clinical pregnancy rate and implantation rate were compared among different subgroups. RESULTS: No statistical significances were found between groups A and B in age, body mass index (BMI), basal FSH, basal LH, basal E2, Gn dosage, Gn day, LH on HCG day, E2 on HCG day, P on HCG day, number of oocytes, fertilization rate, available embryo rate or good quality embryo rate per oocyte, but the endometrium thickness on HCG day differed significantly between the two groups. In women below 35 years of age with a LH level on HCG day over 1.0 U/L, r-LH supplementation resulted in a clinical pregnancy rate of 60%, significantly lower than the rate of 79.55% in women without r-LH supplementation (P<0.05). In women over 35 years with a LH level below 1.0 U/L, r-LH supplementation resulted in an implantation rate of 44.74%, as compared with 24.74% in women without r-LH supplementation (P<0.05). CONCLUSION: In the long protocol, LH supplementation does not improve the oocyte number, fertilization rate, or good quality embryo per oocyte, and does not bring benefits to women below 35 years with a low LH level (<1.0 U/L) or those over 35 years with normal LH level (≥1.0 U/L) after GnRH-agonist administration. But for women over 35 years with low LH levels, r-LH supplementation may improve the clinical pregnancy rate and implantation rate of IVF-ET cycles.

Factors associated with the disposition of frozen embryos after a live birth through IVF treatment in China.

OBJECTIVE: To investigate infertility patients' attitudes towards frozen embryos and the factors that influence patients' decisions. STUDY DESIGN: This is a cross-sectional quantitative observational study conducted between 1 April 2010 and 1 April 2015. Patients underwent IVF with embryo cryopreservation and successfully delivered at least one baby were called to complete a questionnaire regarding decisions about embryo disposition and reasons for their preferred option. The chi-square test was used to compare the attitudes about embryo disposition between subgroups. A multinomial logistic regression was performed to examine the effects of various individual characteristics on the decision. The effects were presented by adjusted odds ratios (OR) and their 95% confidence interval (95% CI). SETTING: Guangzhou Women and Children's Hospital. RESULTS: Among 769 interviewed couples, 718 couples (93.4%) completed the questionnaire. A total of 462 couples (64.3%) continued to store embryos. Among the participants who discontinued storage, 214 couples (83.6%) chose to discard embryos, and 42 couples (16.4%) agreed to donate embryos for research. Having no college education and longer storage duration were associated with an increase in the likelihood of discontinuing storage. The couples having twins from IVF were more likely to discontinue storage (OR=6.33, 95%CI: 4.37-9.39) compared to those having only one child. Regarding the choice of discarding or donation for research among those who decided to discontinue frozen embryos, females aged 30 or above were more willing to donate their embryos for research (OR=2.85, 95%CI:1.12-7.23). CONCLUSION: The preference for embryo disposition was associated with the number of children, storage duration, and the couple's education. Chinese patients generally chose to store cryopreserved embryos and were less receptive to the concept of embryo research compared with patients in other developed countries.

[Effects of acupuncture at stellate ganglion on lower limb atherosclerosis of early diabetes mellitus].

OBJECTIVE: To compare the efficacy between acupuncture at stellate ganglion combined with intravenous administration of alprostadil and simple intravenous administration of alprostadil on lower limb atherosclerosis of early diabetes mellitus. METHODS: Sixty patients of lower limb atherosclerosis of early diabetes mellitus were randomly divided into an observation group and a control group, 30 cases in each one. Patients in the two groups were treated with basic treatment to control blood glucose and lipid. In addition, patients in the control group were treated with intravenous administration of alprostadil (10 µg) and sodium chloride solution (100 mL); based on this, patients in the observation group were treated with acupuncture at stellate ganglion. The treatment was given once a day; the consecutive treatment of two weeks constituted one session, and totally 4 sessions were given. The total syndrome score, glycosylated hemoglobin (HbA1c), blood flow of posterior tibial artery and dorsal artery of foot were observed before and after treatment; the clinical efficacy was compared between the two groups. RESULTS: Compared before treatment, the total syndrome score, HbA1c, blood flow of posterior tibial artery and dorsal artery of foot were significantly improved after treatment (all P < 0.05), which were more obvious in the observation group (all P < 0.05). After treatment, the total effective rate was 93.3% (28/30) in the observation group, which was significantly superior to 86.7% (26/30) in the control group (P < 0.05). CONCLUSION Acupuncture at stellate ganglion combined with intravenous administration of alprostadil achieve better effect than simple intravenous administration of alprostadil for lower limb atherosclerosis of early diabetes mellitus, which improve the clinical symptoms, regulate blood sugar and increase the blood flow of lower limb.