Reproductive outcomes of dual trigger with combination GnRH agonist and hCG versus trigger with hCG alone in women undergoing IVF/ICSI cycles: a retrospective cohort study with propensity score matching.

BACKGROUND: Despite a large number of studies on the selection of trigger drugs, it remains unclear whether the dual trigger with human chorionic gonadotropin (hCG) and gonadotropin-releasing hormone (GnRH) agonist, compared to the trigger with hCG alone, can improve the reproductive outcome of patients undergoing assisted reproductive technology. Therefore, this study aimed to compare the laboratory and clinical outcomes of dual trigger versus single trigger. METHODS: In this retrospective cohort study, we evaluated 520 in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles between July 2014 and September 2020 at the Reproductive and Genetic Center of Integrative Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine. All patients underwent IVF/ICSI treatment with fresh embryo transfer using the GnRH antagonist protocol. We used propensity score matching to control for confounding variables and binary logistic regression analysis to determine the correlations between trigger methods and pregnancy outcomes. After propensity score matching, 57 cycles from each group were evaluated and compared for laboratory or clinical outcomes in this retrospective cohort study. RESULTS: There was no significant difference in the number of oocytes retrieved, embryos available, top-quality embryos, or the rate of normal fertilization between the dual-trigger and single-trigger protocols, respectively. The incidence of ovarian hyperstimulation syndrome, implantation rate, biochemical pregnancy rate, clinical pregnancy rate, ectopic pregnancy rate, early miscarriage rate, and live birth rate were also similar between the two groups, while the miscarriage rate (37.0% vs. 12.5%, p = 0.045) was higher in the dual-trigger than the single-trigger group. Subsequent binary logistic regression analysis showed that age was a remarkably significant independent predictor of both clinical pregnancy rate (odds ratio = 0.90, 95% confidence interval: 0.84-0.97, p = 0.006) and live birth rate (odds ratio = 0.89, 95% confidence interval: 0.82-0.97, p = 0.005). CONCLUSIONS: Therefore, dual-trigger for final oocyte maturation might increase miscarriage rate, but in terms of the laboratory and other pregnancy outcomes such as clinical pregnancy rate, early miscarriage rate or live birth rate, there was no evidence to show that dual trigger was superior to an hCG-trigger alone for patients undergoing GnRH-antagonist cycles with fresh embryo transfer. TRIAL REGISTRATION: Retrospectively registered.

Structural and anti-inflammatory characterization of a novel neutral polysaccharide from North American ginseng (Panax quinquefolius).

Neutral polysaccharides are one of the active components in the American ginseng roots. Recently, the studies about American ginseng polysaccharides are mainly centered on acidic polysaccharides, while there is relatively limited research that explores neutral polysaccharides. In this study a novel neutral polysaccharide (PPQN) was isolated from American ginseng roots and its structure and anti-inflammatory activity were investigated. The average molecular weight (Mw) of PPQN was 3.1 kDa. Monosaccharide components' analysis indicated that PPQN was composed of glucose (Glc) and galactose (Gal) in a molar ratio of 1:1.15. Secretions of nitric oxide (NO), TNF-α, IL-6, and IL-1ß after lipopolysaccharide (LPS) stimulation were detected in PPQN pre-treatment RAW264.7 macrophages. PPQN (150 µg/mL) exhibited more effective inhibition of TNF-α, IL-1ß, and IL-6 secretions, followed by NO production with respective values of 40.5%, 41.1%, 34.4%, and 11.1% suppression. These results indicated that PPQN may have therapeutic implications in treatment of inflammation and inflammatory-related diseases.

Gene cloning, sequence analysis, and expression profiles of a novel ß-ring carotenoid hydroxylase gene from the photoheterotrophic green alga Chlorella kessleri.

In this study, a full-length complementary DNA (cDNA) sequence of ß-ring carotenoid hydroxylase (CHY), designated Ckecyp97a1, was isolated via reverse transcription-polymerase chain reaction and rapid amplification of cDNA ends (RACE) methods. The cloned Ckecyp97a1 cDNA was 2,264-bp in length, and contained an open reading frame (ORF) of 1,944-bp with 5'-terminal untranslated region (UTR) of 66-bp and 3'-terminal UTR of 254-bp and encoded a ß-ring CHY protein of 647 amino acids. The deduced protein had a calculated molecular mass of 71.43 kDa with an estimated isoelectric point (pI) of 6.72. Multiple sequence alignment and phylogenetic analysis revealed that Ckecyp97a1 was homologs to known chloroplastic cytochrome P450 (P450) CHY. The typical catalytic motifs of the P450 were highly conserved in the protein sequences of CkeCYP97A1. The Ckecyp97a1 transcriptional expression and carotenoids accumulation were observed under high light (HL) of different wavelengths (white: 390-770 nm and blue: 420-500 nm). The results revealed that Ckecyp97a1 transcript increased strongly throughout the course of the HL illumination treatment (22-70 h) under white HL treatment, while decreased during 10-58 h under blue HL treatment. The concentrations of lutein, α-carotene, and ß-carotene were relatively steady and below the control level under both treatments. The zeaxanthin concentration was higher under white HL treatment than those under control and blue HL treatments. Ckecyp97a1 gene showed different expression patterns under different light wavelengths treatments. The data obtained in this study demonstrates that CkeCYP97A1 is the enzyme responsible for carotenoid hydroxylation involved in HL acclimation for photoheterotrophic green alga Chlorella kessleri CGMCC 4917.

Antioxidant and immunoregulatory activity of alkali-extractable polysaccharides from North American ginseng.

The alkali-extractable polysaccharide (AEP) was isolated from the root of North American ginseng. Two fractions, AEP-1 and AEP-2, were further purified by gel filtration column chromatography. Gas chromatography analysis identified that AEP-1 was composed of Glc, Gal and GalA. And AEP-2 mainly contained Ara, Man, Gal, Glc and GalA. Antioxidant assays indicated that AEP and AEP-2 exhibited significant antioxidant activities in a dose-dependent manner. AEP-2 also exhibited macrophage-activating activity by increasing NO, TNF-α and IL-6 production. The results suggest that AEP-2 could be used as potential antioxidants and immunomodulators.