ABSTRACT
Premature ovarian insufficiency (POI) is a common gynecological endocrine disease, which seriously affects women's physical and mental health and fertility, and its incidence is increasing year by year. With the development of social economy and technology, psychological stressors such as anxiety and depression caused by social, life and environmental factors may be one of the risk factors for POI. We used PubMed to search peer-reviewed original English manuscripts published over the last 10 years to identify established and experimental studies on the relationship between various types of stress and decreased ovarian function. Oxidative stress, follicular atresia, and excessive activation of oocytes, caused by Stress-associated factors may be the main causes of ovarian function damage. This article reviews the relationship between psychological stressors and hypoovarian function and the possible early intervention measures in order to provide new ideas for future clinical treatment and intervention.
Subject(s)
Primary Ovarian Insufficiency , Stress, Psychological , Humans , Primary Ovarian Insufficiency/psychology , Primary Ovarian Insufficiency/etiology , Primary Ovarian Insufficiency/therapy , Female , Stress, Psychological/complications , Oxidative Stress/physiology , Risk Factors , Depression/etiologyABSTRACT
BACKGROUND: While single embryo transfer (SET) is widely advocated, double embryo transfer (DET) remains preferable in clinical practice to improve IVF success rate, especially in poor prognosis patients with only poor quality embryos (PQEs) available in addition to one or no good quality embryos (GQEs). Furthermore, previous studies suggest PQE might adversely affect the implantation of a GQE when transferred together. This study aims to evaluate the effect of transferring an additional PQE with a GQE on the outcomes in poor prognosis patients. METHODS: A total of 5037 frozen-thawed blastocyst transfer (FBT) cycles between January 2012 and May 2019 were included. Propensity score matching was applied to control for potential confounders, and we used generalized estimating equations (GEE) models to identify the association between the effect of an additional PQE and the outcomes. RESULTS: Overall, transferring a PQE with GQE (Group GP) achieved significantly higher pregnancy rate (PR), live birth rate (LBR) and multiple pregnancy rate (MPR) than GQE only (group G). The addition of a PQE increased LBR in patients aged 35 and over and in patients who received over 3 cycles of embryo transfer (ET) (48.1% vs 27.2%, OR:2.56, 95% CI: 1.3-5.03 and 46.6% vs 35.4%, OR:1.6, 95% CI: 1.09-2.35), but not in women under 35 and in women who received less than 3 cycles of ET (48.7% vs 43.9%, OR:1.22, 95% CI: 0.93-1.59 and 48.3% vs 41.4%, OR:1.33, 95% CI: 0.96-1.85). Group GP resulted in significantly higher MPR than group G irrespective of age and the number of previous IVF cycles. CONCLUSIONS: An additional PQE does not negatively affect the implantation potential of the co-transferred GQE. Nevertheless, the addition of a PQE contributes to both live birth and multiple birth in poor prognosis patients. Physicians should still balance the benefits and risks of DET.
Subject(s)
Embryo Transfer , Embryo, Mammalian/cytology , Infertility , Pregnancy, Multiple , Adult , Embryo Transfer/methods , Embryo Transfer/standards , Embryo Transfer/statistics & numerical data , Female , Fertilization in Vitro , Humans , Infant, Newborn , Infertility/diagnosis , Infertility/epidemiology , Infertility/therapy , Male , Pregnancy , Pregnancy Outcome/epidemiology , Pregnancy Rate , Pregnancy, Multiple/physiology , Pregnancy, Multiple/statistics & numerical data , Prognosis , Quality Control , Retrospective Studies , Single Embryo Transfer/standards , Single Embryo Transfer/statistics & numerical dataABSTRACT
PURPOSE: The purpose of the study is to compare the newborns weight in singleton term birth following transfer of thawed blastocysts-frozen on either day 5 or day 6 after in vitro fertilization. METHOD: The retrospective study included 1444 frozen-thawed blastocyst transfer (FBT) cycles resulting in live singleton births between Jan 2013 and Dec 2016. The main outcomes measured were absolute birth weight, z-score adjusted for gestational age and gender, and incidence of large-for-gestational-age (LGA) newborns. Generalized linear model (GLM) and logistic regression were used in multivariate analyses. RESULT(S): Both the absolute birth weight (3416.49 ± 404.74 vs 3349.22 ± 416.17) and the z-score (0.6 ± 0.93 vs 0.41 ± 0.93) were significantly higher on day 6 FBT in comparison with day 5 FBT. The incidence of LGA newborns was also increased on day 6 FBT (22.8 vs 14.7%, P = 0.006). Adjusted for maternal age, BMI, PCOS diagnosis, present of vanishing twin, and embryo quality, the odds ratio (95% confidence interval) for LGA on day 6 FBT comparing with day 5 FBT was 1.76 (1.18-2.64). CONCLUSION(S): Day 6 FBT is associated with increased birth weight and contributes to the incidence of LGA newborns in FBT.
