الملخص
As one of the earliest markers for predicting pregnancy outcomes,human chorionic gonadotropin (hCG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer (ET).In this retrospective study,patients with positive hCG (day 12 after transfer) were included to examine the hCG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles.For patients who got clinical pregnancy,the mean initial hCG value was significantly higher after frozen cycles than fresh cycles,and the similar result was demonstrated for patients with live births (LB).The difference in hCG value existed even after adjusting for the potential covariates.The area under curves (AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 mIU/mL for clinical pregnancy after fresh ET,0.894 and 399.50 mIU/mL for clinical pregnancy after frozen ET,0.812 and 222.86 mIU/mL for LB after fresh ET,and 0.808 and 410.80 mIU/mL for LB after frozen ET with acceptable sensitivity and specificity,respectively.In conclusion,single frozen blastocyst transfer leads to higher initial hCG values than single fresh blastocyst transfer,and the initial hCG level is a reliable predictive factor for predicting IVF outcomes.
الملخص
Soluble receptor for advanced glycation end products (sRAGE) can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular sRAGE levels and clinical outcomes in infertile women of young or advanced maternal age (AMA) undergoing in vitro fertilization (IVF).A total of 62 young women and 62 AMA women who would undergo IVF were included in this prospective study.The intrafollicular sRAGE concentration was measured to determine its association with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy in young and AMA women,respectively.Besides,correlations between sRAGE and age or follicle-stimulating hormone (FSH) were examined.We found that the intrafollicular sRAGE levels were higher in young patients than those in AMA patients,suggesting that the sRAGE levels were inversely correlated with age.In young patients,sRAGE showed no correlation with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy.But it was found that AMA patients with more retrieved oocytes,fertilized oocytes and high-quality embryos demonstrated higher sRAGE levels,which were a prognostic factor for getting clinical pregnancy independent of age or FSH level.In conclusion,the sRAGE levels decrease with age.Elevated intrafollicular sRAGE levels indicate good follicular growth,fertilization and embryonic development,and successful clinical pregnancy in AMA women,while in young women,the role of sRAGE may not be so predominant.