Combined Therapies of Traditional Chinese Medicine Treat Low-prognosis Patients Undergoing IVF-ET Again / 中国实验方剂学杂志

ObjectiveTo objectively evaluate the clinical efficacy of multiple therapies of traditional Chinese medicine （TCM） in low-prognosis patients who received antagonist protocol for in vitro fertilization and embryo transfer （IVF-ET） again. MethodA total of 128 patients with kidney Yin deficiency， liver depression， and blood stasis who planned to receive antagonist protocol for IVF-ET in the West China Second Hospital of Sichuan University were enrolled and assigned into two groups by random number table method. The observation group （64 casces） was treated by oral administration of Chinese medicine decoction + enema of kidney-tonifying and blood-activating method + auricular point sticking + oral administration of dehydroepiandrosterone （DHEA）， while the control group （64 casces） was treated by only oral administration of DHEA. After treatment for three menstrual cycles， both groups received the antagonist protocol for IVF-ET. The TCM syndrome scores， basic sex hormone levels， antral follicle count （AFC）， the usage of gonadotropin （Gn）， endometrial receptivity indicators， embryo quality indicators， and pregnancy outcomes were compared between the two groups. ResultAfter treatment， the observation group showed decreased follicle-stimulating hormone （FSH）/luteinizing hormone （LH） ratio， lowered level of estradiol （E2）， increased AFC， decreased amount and days of Gn usage， improved endometrial receptivity indicators （endometrial thickness on trigger and ET days， proportion of endometrial type A in endometrial types and the level of E2 on trigger day） and embryo quality indicators （the rates of mature follicles， fertilization， normal fertilization， and premium embryos）， and decreased TCM syndrome scores （P<0.05， P<0.01）. Moreover， the observation group had lower FSH/LH ratio， E2 level， and amount of Gn usage， higher AFC， poorer endometrial receptivity and embryo quality indicators， and lower TCM syndrome scores than the control group after treatment （P<0.05， P<0.01）. In addition， except for 3 cases of natural pregnancy， the observation group outperformed the control group in terms of improving the clinical pregnancy rates during initiation cycle and transplantation cycle and clinical pregnancy rate and decreasing biochemical pregnancy rate and early abortion rate （P<0.05）. ConclusionCombined therapies of TCM can alleviate the clinical symptoms， reduce TCM syndrome scores， reduce the Gn usage amount， improve the number and quality of embryos and endometrial receptivity， and coordinate the synchronous development of endometrium and embryo. In this way， they can increase the clinical pregnancy rate and reduce biochemical pregnancy rate and early abortion rate in the low prognosis patients with kidney yin deficiency， liver depression， and blood stasis who are undergoing IVF-ET again.

Infertility Treatments Resulting in Twin Pregnancy: Does It Increase the Risk for Future Childhood Malignancy.

Background: Controversy exists in the literature regarding the possible association between infertility treatments in singleton pregnancies and long-term risk for childhood malignancy. Data regarding infertility treatments in twins and long-term childhood malignancies are scarce. Objective: We sought to investigate whether twins conceived following infertility treatments are at an increased risk for childhood malignancy. Study design: A population-based retrospective cohort study, comparing the risk for future childhood malignancy in twins conceived by infertility treatments (in vitro fertilization and ovulation induction) and those who were conceived spontaneously. Deliveries occurred between the years 1991 and 2021 in a tertiary medical center. A Kaplan-Meier survival curve was used to compare the cumulative incidence of childhood malignancies, and a Cox proportional hazards model was constructed to control for confounders. Results: During the study period, 11,986 twins met the inclusion criteria; 2910 (24.3%) were born following infertility treatments. No statistically significant differences were noted between the groups comparing the rate (per 1000) of childhood malignancies (2.0 in the infertility treatments group vs. 2.2 in the comparison group, OR 1.04, 95% CI 0.41-2.62; p = 0.93). Likewise, the cumulative incidence over time was comparable between the groups (log-rank test, p = 0.87). In a Cox regression model, controlling for maternal and gestational age, no significant differences in childhood malignancies were noted between the groups (adjusted HR = 0.82, 95% CI 0.49-1.39, p = 0.47). Conclusions: In our population, twins conceived following infertility treatments are not at an increased risk for childhood malignancies.

Progress of psychological status and targeted nursing intervention in assisted reproductive technology assisted pregnancy population in female athlete patients

Objective: To investigate the current psychological status and the impact of a focused nursing intervention in the population of women who have undergone an assisted reproductive technology pregnancy. Methods: As the targeted group, 100 infertile female athlete patients who underwent assisted reproductive technology (ART) in our hospital between March 2018 and June 2021 were chosen. Using a random number system, they were divided into two groups of 50 cases each: the routine group received routine nursing care, while the targeted group received targeted nursing care depending on the female athlete patients' psychological conditions; The conventional group was chosen from 50 additional cases of naturally conceived pregnant women who had standard prenatal testing at our institution during the same time frame. The results of the self-rating symptom scale (SCL-91) for the targeted group and the conventional group were compared; Pregnancy rate, SCL-90 ratings before and after the intervention, and satisfaction with the intervention were compared between the typical group and the targeted group. Results: Comparing the targeted group to the conventional group, the SCL-90 score of the targeted group significantly rose (P <0.05); Following the intervention, both the routine group's and the targeted group's SCL-90 scores were significantly lower than they had been (P<0.05), with the targeted group's scores being significantly lower than the routine group's; The pregnancy rate of the targeted group (50.00%) was substantially higher (P<0.05) compared to the conventional group (32.00%) ; The pregnancy rate in the targeted group (92.00%) was considerably higher (P<0.05) than in the conventional group (76.00%). (AU)

Analysis on correlation between semen parameters with spontaneous abortion in early pregnancy after in vitro fertilization assisted pregnancy operation / 国际检验医学杂志

Objective To investigate the correlation between semen parameters with spontaneous abortion in early pregnancy after in vitro fertilization (IVF) assisted pregnancy operation .Methods 220 patients with successful pregnancy after IVF assisted pregnancy operation in the reproductive center of this hospital were selected as the research subjects .Among them ,40 cases of early spontaneous abortion served as the observa-tion group and 180 cases without early spontaneous abortion occurrence as the control group .The related pa-rameters of sperm hyaluronic acid unbinding rate ,sperm nucleoprotein immaturity rate and sperm morphology normal rate were measured and analyzed by adopting the computer assisted sperm analysis (CASA) .Results The sperm hyaluronic acid unbinding rate and sperm nucleoprotein immaturity rate in the observation group were significantly higher than those in the control group ,the difference was statistically significant ( P<0 .05);the sperm morphology normal rate in the observation group was significantly lower than that in the control group ,the difference was statistically significant (P<0 .05);the other semen parameters had no statis-tical differences between the two groups (P>0 .05) .The statistical analysis result showed that the sperm hy-aluronic acid unbinding rate ,sperm DNA fragmentation rate and sperm nucleoprotein immaturity had the posi-tive correlation between each other ,which had the negative correlation with the other indicators .After the stepwise analysis by the binary Logistic regression model ,the results showed that the high risk factors affect-ing spontaneous abortion in early pregnancy after IVF included sperm nucleoprotein immaturity rate and sperm hyaluronic acid unbinding rate .Conclusion The sperm nucleoprotein immaturity rate and sperm hyalu-ronic acid unbinding rate are two high-risk factors inducing early spontaneous abortion after IVF .

Risk of hypertensive disorders in pregnancy following assisted reproductive technology: overview and meta-analysis.

The extent of the increased risk of pregnancy hypertensive disorders following assisted reproductive technology (ART) was investigated. PubMed and the Cochrane Collaboration Library were used as data sources to identify and select longitudinal cohorts comparing pregnancies following ART with spontaneously conceived pregnancies, between 1978 and June 2016. Risk ratios and 95% confidence intervals (CIs) of three outcomes, ie, gestational hypertension (GH), preeclampsia (PE), and their sum (PHD), were calculated. Stratification of results by gestation order (singletons and nonsingletons) was pursued, but a separate "all orders" mixed stratification was considered. Sixty-six longitudinal studies (7 038 029 pregnancies; 203 375 following any ART) were eligible. All outcomes independent of gestation order ("all orders") were increased following any invasive ART: GH (+79% [95% CI, 24%-157%]) and PE (+75% [95% CI, 50%-103%]) to a greater extent, with smaller increases in PHD (+54% [95% CI, 39%-70%]). The risk of PHD following ART steadily increased independent of gestation order.