Excessive Exogenous Gonadotropins and Genetic and Pregnancy Outcomes After Euploidy Embryo Transfer: A Secondary Analysis of a Randomized Clinical Trial.

Importance: The safety of exogenous gonadotropin treatment, based on its effect on embryos and pregnancy outcomes, remains inconclusive. Objective: To evaluate the associations of different doses and durations of gonadotropins with embryonic genetic status and pregnancy outcomes after euploid embryo transfer in couples with infertility. Design, Setting, and Participants: This study was a post hoc analysis of a multicenter randomized clinical trial (RCT) conducted at 14 reproductive centers throughout China from July 2017 to June 2018 that evaluated the cumulative live birth rate with or without preimplantation genetic testing for aneuploidy (PGT-A) among couples with infertility and good prognosis. The PGT-A group from the original RCT was selected for secondary analysis. Patients were divided into 4 groups according to the total dosage of exogenous gonadotropins and treatment duration: group 1 (≤1500 IU and <10 days), group 2 (≤1500 IU and ≥10 days), group 3 (>1500 IU and <10 days), and group 4 (>1 500 IU and ≥10 days). Group 1 served as the control group. Data were analyzed from June through August 2023. Interventions: Blastocyst biopsy and PGT-A. Main outcomes and measures: The primary outcomes were embryonic aneuploidy, embryonic mosaicism, and cumulative live birth rates after euploid embryo transfer. Results: A total of 603 couples (mean [SD] age of prospective mothers, 29.13 [3.61] years) who underwent PGT-A were included, and 1809 embryos were screened using next-generation sequencing. The embryo mosaicism rate was significantly higher in groups 2 (44 of 339 embryos [13.0%]; adjusted odds ratio [aOR], 1.69 [95% CI, 1.09-2.64]), 3 (27 of 186 embryos [14.5%]; aOR, 1.98 [95% CI, 1.15-3.40]), and 4 (82 of 651 embryos [12.6%]; aOR, 1.60 [95% CI, 1.07-2.38]) than in group 1 (56 of 633 embryos [8.8%]). There were no associations between gonadotropin dosage or duration and the embryo aneuploidy rate. The cumulative live birth rate was significantly lower in groups 2 (83 of 113 couples [73.5%]; aOR, 0.49 [95% CI, 0.27-0.88]), 3 (42 of 62 couples [67.7%]; aOR, 0.41 [95% CI, 0.21-0.82]), and 4 (161 of 217 couples [74.2%]; aOR, 0.53 [95% CI, 0.31-0.89]) than in group 1 (180 of 211 couples [85.3%]). Conclusions and relevance: In this study, excessive exogenous gonadotropin administration was associated with increased embryonic mosaicism and decreased cumulative live birth rate after euploid embryo transfer in couples with a good prognosis. These findings suggest that consideration should be given to minimizing exogenous gonadotropin dosage and limiting treatment duration to improve embryo outcomes and increase the live birth rate. Trial Registration: ClinicalTrials.gov Identifier: NCT03118141.

Maternal hypercholesterolemia would increase the incidence of embryo aneuploidy in couples with recurrent implantation failure.

BACKGROUND: The association of dyslipidemia with embryo development and pregnancy outcomes is largely unknown, especially in unexplained recurrent implantation failure (uRIF) patients. Here, this study aimed to explore the impact of abnormal blood lipid levels on embryo genetic status and pregnancy outcomes after preimplantation genetic testing for aneuploidy (PGT-A) from a clinical perspective. METHODS: This study retrospectively analyzed 502 patients diagnosed as uRIF. They were divided into four groups according to the levels of cholesterol and triglyceride: nonhyperlipidemia group (NonH group), simple hypercholesterolemia group (SHC group), simple hypertriglyceridemia group (SHC group) and mixed hyperlipidemia group (MixH group). At the same time, patients were divided into non-low HDL-C group and low HDL-C group according to their HDL-C level. The outcomes of embryos genetic testing and pregnancy outcomes after PGT-A was analyzed between groups. Binary logistic regression and/or generalized estimating equation (GEE) model were conducted to investigate the association of different types of dyslipidemia with embryonic aneuploidy rate and cumulative live-birth rate. RESULTS: 474 women who met the inclusion criteria were divided into four groups: NonH group (N = 349), SHC group (N = 55), SHT group (N = 52) and MixH group (N = 18). Compared with the NonH group, SHC group had a significantly increased rate of embryo aneuploidy [48.3% vs. 36.7%, P = 0.006; adjusted OR (95% confidence interval) = 1.52(1.04-2.22), P = 0.029], as well as a reduced number of good-quality embryos on day 5 or 6 [3.00 ± 2.29 vs. 3.74 ± 2.77, P = 0.033]. The SHC group showed a tendency of a lower cumulative live birth rate (47.0% vs. 40.0%), a lower incidence of good birth outcome (37.2% vs. 34.5%) and a higher risk of clinical pregnancy loss (11.1% vs. 17.9%), but did not reach statistical significance (P > 0.05). The incidences of obstetric or neonatal complications and other adverse events were similar in the four groups. Whether patients have low HDL-C did not differ in pregnancy outcomes. CONCLUSIONS: We found that uRIF women with hypercholesterolemia had an increased proportion of aneuploid embryos and a reduced proportion of high-quality embryos, while different types of hyperlipidemia had no correlation with cumulative live birth rate as well as pregnancy and neonatal outcomes.

Dealloying fabrication of hierarchical porous Nickel-Iron foams for efficient oxygen evolution reaction.

Designing and preparing highly active oxygen evolution reaction (OER) electrodes are essential for improving the overall efficiency of water splitting. Increasing the number of active sites is the simplest way to enhance OER performance. Herein, we present a dealloy-etched Ni-Fe foam with a hierarchical nanoporous structure as integrated electrodes with excellent performance for OER. Using the dealloying method on the Ni-Fe foam framework, a nanoporous structure is produced, which is named nanoporous Ni-Fe@Ni-Fe foam (NP-NF@NFF). Because of the peculiarities of the dealloying method, the NP-NF@NFF produced contains oxygen vacancies and heterojunctions. As a result, NP-NF@NFF electrode outperforms state-of-the-art noble metal catalysts with an extremely low overpotential of 210 and 285 mV at current densities of 10 and 100 mA cm-2, respectively. Additionally, the NP-NF@NFF electrode shows a 60-h stability period. Therefore, NP-NF@NFF provides new insights into the investigation of high-performance transition metal foam electrodes with effective active sites for efficient oxygen evolution at high current densities.

A high-pressure single-crystal-diffraction experimental system at 4W2 beamline of BSRF.

Information on the structural evolution of materials under high pressure is of great importance for understanding the properties of materials exhibited under high pressure. High-pressure powder diffraction is widely used to investigate the structure evolution of materials at such pressure. Unfortunately, powder diffraction data are usually insufficient for retrieving the atomic structures, with high-pressure single-crystal diffraction being more desirable for such a purpose. Here, a high-pressure single-crystal diffraction experimental system developed recently at beamline 4W2 of Beijing Synchrotron Radiation Facility (BSRF) is reported. The design and operation of this system are described with emphasis on special measures taken to allow for the special circumstance of high-pressure single-crystal diffraction. As an illustration, a series of diffraction datasets were collected on a single crystal of LaB6 using this system under various pressures (from ambient pressure to 39.1 GPa). The quality of the datasets was found to be sufficient for structure solution and subsequent refinement.