[Effect of Tiaojing Cuyun acupuncture therapy on pregnancy outcomes in women with diminished ovarian reserve undergoing IVF-ET: a cohort study].

OBJECTIVE: To assess the effect of Tiaojing Cuyun acupuncture therapy (acupuncture for regulating menstruation and promoting pregnancy) on pregnancy outcomes in patients with diminished ovarian reserve (DOR) undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS: Eighty women with DOR were divided into an observation group (40 cases, 1 case dropped out) and a control group (40 cases, 1 case dropped out) according to whether Tiaojing Cuyun acupuncture therapy was given or not. In the control group, IVF-ET was delivered. In the observation group, before IVF-ET, Tiaojing Cuyun acupuncture therapy was given. Two groups of acupoints were used alternatively, including Baihui (GV 20), Shenting (GV 24), Benshen (GB 13), Zhongwan (CV 12), Guanyuan (CV 4), and bilateral Tianshu (ST 25), Shenshu (BL 23), Ciliao (BL 32), etc. Acupuncture was operated once every other day, three interventions a week, for 12 weeks. The primary outcome was clinical pregnancy rate (CPR). Secondary outcomes included the total days and amount of gonadotropin (Gn) used, the number of oocytes retrieved, the number of oocytes in metaphase of second meiosis (MⅡ), the number of transferable embryos, the number of high-quality embryos, the cycle cancellation rate, the positive rate of human choriogonadotropin (HCG), the embryo implantation rate, live birth rate (LBR), the basal serum levels of sex hormones (follicular stimulating hormone [FSH], estradiol (E2), FSH/luteinizing hormone [LH]) and antral follicle count (AFC). RESULTS: CPR in the observation group was higher than that in the control group (53.8% [21/39] vs. 17.9% [7/39], P<0.05). The results of the number of oocytes retrieved, the number of oocytes in MⅡ, the number of transferable embryos, the number of high-quality embryos, the positive rate of HCG, the embryo implantation rate, and LBR in the observation group were higher than those in the control group (P<0.05). The serum level of FSH and FSH/LH in the observation group were lower thau those in the control group (P<0.05). The differences were not significant statistically in the total days and amount of Gn used, the cycle cancellation rate, serum level of E2 and AFC between the two groups (P>0.05). Logic regression analysis showed that CPR increased in the observation group when compared with that of the control group (OR = 5.33, 95%CI: 1.90-14.97, P = 0.001). CONCLUSION: Acupuncture can improve the pregnancy outcomes of DOR women undergoing IVF-ET.

Evaluative effectiveness of follicular output rate, ovarian sensitivity index, and ovarian response prediction index for the ovarian reserve and response of low-prognosis patients according to the POSEIDON criteria: a retrospective study.

The aim was to explore the implications of follicular output rate (FORT), ovarian sensitivity index (OSI), ovarian response prediction index (ORPI), and follicle-to-oocyte index (FOI) in low-prognosis patients defined by POSEIDON criteria. In total, 4030 fresh in vitro fertilization (IVF) cycles from January 2013 to October 2021 were included in this retrospective cohort analysis and were categorized into four groups based on the POSEIDON criteria. The FORT between Groups 1 and 2 (0.61 ± 0.34 vs. 0.65 ± 0.35, P = 0.081) and Groups 3 and 4 (1.08 ± 0.82 vs. 1.09 ± 0.94, P = 0.899) were similar. The OSI in the order from the highest to the lowest were 3.01 ± 1.46 in Group 1, 2.28 ± 1.09 in Group 2, 1.54 ± 1.04 in Group 3, and 1.34 ± 0.96 in Group 4 (P < 0.001). The trend in the ORPI values was consistent with that in the OSI. FORT, OSI, ORPI, and FOI complemented each other and offered excellent effectiveness in reflecting ovarian reserve and response, but they were not good predictors of clinical pregnancy rate (CPR) from IVF.

The expression of microRNA-197-3p regulates the proliferation of ovarian granulosa cells through CUL3 in polycystic ovarian syndrome.

MicroRNAs (miR) have been shown to exhibit marked dysregulation in polycystic ovarian syndrome (PCOS). Additionally, granulosa cell proliferation and apoptosis are important in PCOS pathogenesis. Considering this, the current study aimed at characterization of the regulatory function of miR-197-3p on the growth and proliferation of ovarian granulosa cells at the molecular level. The results showed that miR-197-3p is significantly repressed (P<0.05) in PCOS tissues and granulosa cells. Granulosa cell proliferation was significantly (P<0.05) inhibited by miR-197-3p overexpression via induction of apoptosis. In silico analysis predicted cullin 3 (CUL3) as the regulatory target of miR-197-3p, which was also confirmed by the dual luciferase reporter assay. CUL3 was overexpressed in KGN ovarian granulosa cells, and its silencing mimicked the tumor suppressive effects of miR-197-3p. Taken together, miR-197-3p exhibits a negative regulatory role in regulating granulosa ovarian cell proliferation via posttranscriptional repression of CUL3 in PCOS.

The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience.

INTRODUCTION: The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer. METHODS: The clinical data of 612 patients who received single fresh blastocyst transfer for first cycle, as well as the data of 253 patients who had already delivered were analyzed retrospectively. The patients were divided into two groups according to blastocyst formation time (D5 or D6). The following subgroup analyses were performed: (i) the morphologic grading of blastocyst and (ii) the protocol of COS. RESULTS: We observed that D5 single embryo transfer (SET) were associated with higher clinical pregnancy rate (CPR, 59.04% vs. 31.73%, P < 0.001) and live birth rate (LBR, 43.90% vs. 24.04%, P < 0.001) than D6 SET following fresh cycle. Patients in D5 group experienced more good blastocysts transfer (45.47%vs. 13.46%, P < 0.001) and less poor blastocysts transfer (9.64%vs. 45.19%, P < 0.001) than patients in D6 group. As to early stage and good quality blastocysts, the CPR and LBR were similar between D5 and D6 group. GnRH antagonist protocol had a demonstrable inferiority comparing with the early-follicular-phase long-acting GnRH-agonist long protocol (EFLL) or the mid-luteal-phase long-acting GnRH-agonist long protocol (MLLL) with regard to the CPR and LBR in D6-SET group. CONCLUSIONS: The analysis found that ovarian reserve of patients in D6-SET group was comparatively worse than that of patients in D5-SET group and D6-SET patients represented a subgroup of infertility patients usually having relatively poor embryo quality. The results should be interpreted with caution as the very low numbers in the respective group limited the use of statistical tests and the real significance values.