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1.
Zhongguo Zhen Jiu ; 40(2): 211-4, 2020 Feb 12.
Artigo em Chinês | MEDLINE | ID: mdl-32100511

RESUMO

The characteristics of syndrome differentiation and the experience of professor YI Wei were briefly introduced for the treatment of infertility of ovulation disturbance, including three aspects, named the thought of diagnosis and treatment, the therapeutic method and the acupoint prescription, as well as the clinical case report. Academically, professor YI Wei is deeply influenced by professor JIN Rui, the acupuncture master of Xin'an school and Lingnan school. Regarding the treatment of gynecological diseases, the academic thought of professor LUO Song-ping and ZHANG Yu-zhen is contributed. Professor YI attaches the importance to the syndrome differentiation based on meridian and collateral, supplemented by the syndrome differentiation of zangfu, yinyang, qi and blood, cold and heat, as well as the deficiency and excess. In clinical treatment, the acupoints are selected specially from the conception vessel, the governor vessel, the thoroughfare vessel and the belt vessel. The extra meridians are equally important as the regular ones in the treatment, especially the belt vessel. Additionally, the treatment focuses on communicating the congenital qi with the acquired one, regulating the liver and benefiting the kidney, as well as adjusting the heart, the spleen and the stomach to ease the uterus. Simultaneously, the great consideration is paid to the menstruation regulation so as to promote pregnancy.


Assuntos
Terapia por Acupuntura , Infertilidade Feminina/terapia , Meridianos , Moxibustão , Ovulação , Pontos de Acupuntura , Feminino , Humanos , Medicina Tradicional Chinesa , Gravidez
2.
Medicine (Baltimore) ; 99(3): e18848, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011503

RESUMO

BACKGROUND: Endometrial thickness has been identified as a prognostic factor for pregnancy rate for patients with female infertility. Thin endometrium is defined as <7 mm on the day of ovulation, or on the day of human chorionic gonadotrophin (HCG) injection in fresh in vitro fertilization (IVF) cycles, or the day to start progesterone in frozen-thaw embryo transfer cycles, as stated in the guideline of thin endometrium from the Canadin Fertility and Andrology Society and Chinese expert consensus from the Society of Reproductive Medicine, Chinese Medical Association. Many medicines are used for improving the endometrial thickness and embryo implantation rate of the patients with thin endometirum, but thin endometrium remains a major troublesome clinical problem with limited efficacy.Platelet-rich plasma (PRP), as a growing and robust therapeutic option in musculoskeletal medicine, is a preparation of autologous plasma with a high concentration of platelets, and the therapeutic mechanism is based on the capacity to supply supra physiologic amounts of essential growth factors to provide a regenerative stimulus for promoting repair in tissues with low healing potential. Some randomized controlled trials have reported the application of PRP for patients with thin endometrium with satisfactory effect. However, there is no systematic review on efficacy and safety of PRP as a treatment of thin endometrium. METHODS: The data and information will be retrieved from the databases of MEDLINE, Embase, Web of Science, Clinicaltrials.org., Cochrane Library, China Biology Medicine Database, Wan Fang Database, China National Knowledge Infrastructure Database, VIP Science Technology Periodical Database, and OpenGrey for gray literature. The randomized controlled clinical trials are going to be selected before December 20, 2019, in English or Chinese language, with the search terms including "thin endometrium,""platelet-rich plasma," "endometrial thickness," "hemorheology of endometrium," "pregnancy rate," and "adverse reactions." RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement. RESULTS AND CONCLUSION: The efficacy and safety of PRP for the treatment of thin endometrium will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with thin endometirum.


Assuntos
Endométrio/patologia , Infertilidade Feminina/terapia , Plasma Rico em Plaquetas , Feminino , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto
3.
Zhonghua Fu Chan Ke Za Zhi ; 55(1): 9-14, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32074767

RESUMO

Objective: To explore and compare the preventive effect of using letrozole and gonadotropin-releasing hormone (GnRH) antagonist during luteal phase of patients at high risk for ovarian hyperstimulation syndrome (OHSS). Methods: A total of 99 infertile women undergoing in vitro fertilization and embryo transfer or intracytoplasmic sperm injection with high risk for OHSS were enrolled in this randomized controlled trial.The letrozole group (n=51) received letrozole of 7.5 mg daily for 3 days;the GnRH antagonist group (n=48) were given cetrorelix of 0.25 mg subcutaneously daily for 3 days. Both groups received support therapy combined with embryo cryopreservation. The incidence of OHSS was surveyed. And the serum concentration of estradiol, LH and progesterone on days 3, 5 and 8 after oocytes retrieval were measured. Results: There were no statistical differences in terms of baseline characteristics of patients and outcomes of controlled ovarian hyperstimulation between the two groups.The incidence of moderate and severe OHSS was found no significantly difference between letrozole group [11.8%(6/51)] and GnRH antagonist group [10.4%(5/48);P>0.05]. The estradiol concentration of the indicated days on days 3,5 and 8 after oocytes retrieval in letrozole group and GnRH antagonist group were (1 417±3 543) versus (15 210±9 921) pmol/L, (1 692±4 330) versus (18 680±11 567) pmol/L, (239±336) versus (3 582±5 427) pmol/L, respectively;compared with GnRH antagonist group, the estradiol level was significantly lower in the letrozole group (all P<0.01). The luteinizing hormone level in the letrozole group were (0.46±0.40), (0.56±0.55)and (0.67±0.58) U/L on days 3,5 and 8 after oocytes retrieval, which were significantly higher than those of GnRH antagonist group [(0.28±0.28), (0.30±0.19) and (0.45±0.37) U/L, respectively; all P<0.05]. There was no obvious differences on progesterone levels between letrozole group and GnRH antagonist group (all P>0.05),and on days 8 after oocytes retrieval,the level of progesterone in each group were significantly lower than those on day 3 and 5 after oocytes retrieval (P<0.05). Conclusion: Letrozole has the same efficiency as GnRH antagonist for the prevention of OHSS, faster and cheaper to use, but its efficacy seems not to be related to the suppression of steroidogenic during the luteal phase.


Assuntos
Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Infertilidade Feminina/terapia , Letrozol/uso terapêutico , Síndrome de Hiperestimulação Ovariana/prevenção & controle , Indução da Ovulação , Estradiol/sangue , Feminino , Fertilização In Vitro , Humanos , Fase Luteal , Hormônio Luteinizante/sangue , Progesterona/sangue
4.
Zhonghua Fu Chan Ke Za Zhi ; 55(1): 15-20, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32074768

RESUMO

Objective: To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility. Methods: A total of 519 cases diagnosed as unexplained infertility, received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015. The causes of infertility were evaluated, and the subjects were followed up to observe the nature pregnancy rate. Results: Among 519 unexplained infertility patients, pelvic abnormalities had been explored in 466 (89.8%, 466/519) cases. Pelvic endometriosis combined with adhesions, pelvic adhesion alone, uterine leiomyoma and uterine cavity polyp were 72.4% (376/519), 12.3% (64/519), 3.7% (19/519) and 1.3% (7/519) respectively. The total natural pregnancy rate within the 3 years of follow up was 53.9% (208/386), and the natural pregnancy rate was 29.8% (31/104) in patients aged 35 years and over. Conclusions: The patients with clinical diagnosis of unexplained infertility should be examined by hysteroscopy and laparoscopy. Under the examination, the causes of infertility could be found more intuitively, and targeted treatment could be carried out to improve the pregnancy rate. The natural pregnancy rate of the elderly patients decrease obviously after operation, and the time of natural trying pregnancy should not be too long.


Assuntos
Histeroscopia , Infertilidade Feminina/diagnóstico por imagem , Infertilidade Feminina/terapia , Laparoscopia , Adulto , Endometriose/complicações , Endometriose/diagnóstico por imagem , Feminino , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico por imagem , Gravidez , Aderências Teciduais/complicações , Aderências Teciduais/diagnóstico por imagem
5.
Life Sci ; 240: 117066, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31738881

RESUMO

Tissue engineering and the use of scaffolds have shown high therapeutic potentialities about male and female infertility. Nowadays, many couples are suffering from infertility problems. There are different causes for infertility including chemotherapy (for male and female), uterine injuries, and intrauterine adhesions. Extra-cellular matrix in tissue engineering provides a supportive medium for blood or lymphatic vessels making it a suitable substrate for cell implantation and growth. Dominant successes in this branch have been in use of patient-derived primary cells, these cells loaded in scaffolds and used to generate tissue for re-implantation. However, this method has limitations, because of the invasive nature of cell collection, also the cells patient-derived may be not healthy and become the source of disease. Therefore, use of stem cells, including embryonic stem (ES) cells, bone marrow mesenchymal stem cells (BM-MSCs) and umbilical cord-derived mesenchymal stem cells (UC-MSCs) have been considered. Cell/scaffold systems have a substantial role in fertility organs or agents repair or regeneration. This review summarizes the novel scaffold-based tissue engineering approaches to treat infertility.


Assuntos
Infertilidade Feminina/terapia , Infertilidade Masculina/terapia , Engenharia Tecidual/métodos , Tecidos Suporte , Animais , Feminino , Humanos , Masculino , Transplante de Células-Tronco Mesenquimais , Gravidez , Transplante de Células-Tronco
6.
Int J Cancer ; 146(3): 829-838, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30989639

RESUMO

Advances in multimodality cancer treatments have increased the risk of long-term complications in early-onset cancer survivors. For female cancer survivors, these include diminished reproductive function, often resulting in a narrowed fertile window. The aim of our study was to evaluate the use of fertility treatments in cancer survivors (aged 0-39 years at diagnosis) compared to siblings. Data from Finnish registers on cancer, birth and prescribed medications were merged to identify 8,929 survivors and 9,495 siblings without previous deliveries. Fertility drug purchases from 1993 to 2012 at the age of 16-41 years were included. A Poisson regression model was used to estimate incidence rate ratios (IRRs) for the use of fertility drugs, adjusting for age and calendar time at fertility drug purchase. Fertility treatments were more common in survivors compared to siblings, as 6.1% of survivors compared to 3.8% of siblings had bought fertility drugs (IRR 1.43, 95% confidence interval [CI] 1.25-1.65). A subclassification of fertility treatments into ovulation inductions and assisted reproductive technology (ART), showed increased use of ART (IRR 2.41, 95% CI 1.97-2.96), whereas the use of ovulation induction was similar in survivors and siblings. Analyses by calendar time periods showed the use of ART to be significantly higher in the most recent decade, from 2003 onwards. We conclude that cancer survivors have an increased risk for subfertility, which is why fertility counseling is important. However, our results mirror a more active approach among clinicians towards fertility treatments in cancer survivors during the most recent years.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Fármacos para a Fertilidade/uso terapêutico , Infertilidade Feminina/terapia , Neoplasias/complicações , Adolescente , Adulto , Antineoplásicos/efeitos adversos , Estudos de Casos e Controles , Criança , Pré-Escolar , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Fertilidade/efeitos dos fármacos , Fertilidade/efeitos da radiação , Finlândia , Humanos , Lactente , Recém-Nascido , Infertilidade Feminina/etiologia , Masculino , Neoplasias/mortalidade , Neoplasias/terapia , Gravidez , Radioterapia/efeitos adversos , Sistema de Registros/estatística & dados numéricos , Técnicas de Reprodução Assistida/estatística & dados numéricos , Irmãos , Adulto Jovem
7.
BMC Complement Altern Med ; 19(1): 301, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694617

RESUMO

BACKGROUND: Complementary and alternative medicine (CAM) use among infertile women is popular in many countries, including Korea. Previous research has repeatedly found more than half of infertile women surveyed use CAM therapies for fertility enhancement and overall well-being. However, there is currently little evidence to support this practice, and this raises the question of infertile women's experiences in the uptake of those modalities and sociodemographic and psychological factors associated with CAM use. Thus, this study aims to explore the perceptions and experiences of infertile women with regard to their use of CAM in Korea. METHODS: A cross-sectional study was conducted using data from 263 infertile women attending infertility specialty clinics in Seoul, Korea, in June 2012. The survey instrument included 47 questions on the use of CAM, demographic characteristics, health status, and infertility related factors such as duration and type of infertility, experience and satisfaction of conventional treatment, and self-perceived severity of infertility condition. Chi-square test and logistic regression were used for data analysis. RESULTS: Among 286 respondents (response rate, 95.3%), a total of 263 women were included in the final analysis. 63.5% of respondents used one or more types of CAM modalities during infertility treatment. The utilization of CAM was associated with employment status, duration of infertility treatment, and self-perceived severity of the disease. The most commonly used CAM modalities were multivitamin and herbal medicine, and differences in types of CAM modalities used were found between the group with a higher rating of self-perceived disease severity and the lower perceived severity group. CONCLUSIONS: High prevalence of CAM use among infertile women was observed in Korea. Our findings support that infertile women's own understanding of their illness and physical condition influences self-care behavior such as CAM use. This calls for an urgent need for further in-depth study of the clinical effects of popular CAM modalities among infertile women when used in conjunction with conventional treatment.


Assuntos
Terapias Complementares/psicologia , Infertilidade Feminina/terapia , Adulto , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/psicologia , Pacientes/psicologia , Percepção , República da Coreia , Índice de Gravidade de Doença
8.
Medicine (Baltimore) ; 98(44): e17560, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689760

RESUMO

INTRODUCTION: The purpose of this paper is to evaluate the efficacy and safety of moxibustion in infertility females/women undergoing in vitro fertilization and embryo transfer (IVF-ET). METHODS AND ANALYSIS: We will electronically search PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trial, China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wan-fang Database from their inception. Also, we will manually retrieve other resources, including reference lists of identified publications, conference articles, and grey literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to moxibustion in female infertility patients undergoing IVF-ET will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed effect model or random effect model depend on the heterogeneity test. The clinical total effective rate and the clinical pregnancy rate will be the primary outcomes. Ovulation rate, endometrial thickness, hormone level, traditional Chinese medicine (TCM) Syndrome Integral Scale and the adverse event will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis, and the level of evidence will be assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Continuous data will be expressed in the form of weighted mean difference or standardized mean difference with 95% confidence intervals (CIs), while dichotomous data will be expressed in the form of relative risk with 95% CIs. RESULTS: This study will provide a high-quality comprehensive evaluation of the efficacy and safety of moxibustion in the treatment of female infertility patients undergoing IVF-ET. CONCLUSION: This review will provide evidence to judge for judging whether moxibustion is effective in treating female infertility patients undergoing IVF-ET. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42019135593.


Assuntos
Fertilização In Vitro/métodos , Infertilidade Feminina/terapia , Moxibustão/efeitos adversos , Moxibustão/métodos , Adolescente , Adulto , Endométrio/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Ovulação/fisiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Adulto Jovem
9.
Medicine (Baltimore) ; 98(44): e17731, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689817

RESUMO

INTRODUCTION: Many infertile patients have used Korean medicines (KMs) as a primary or adjuvant therapeutic method to improve in vitro fertilization success rates. The aim of this multicenter observational study is to investigate the effects of KMs on poor ovarian reserve (POR) in infertile patients. METHODS AND ANALYSIS: We will perform a prospective multicenter observational study. This study will recruit 50 women between 25 and 44 years of age with infertility caused by POR from among patients who visit the KM clinic. All participants will visit the KM clinic on the 2nd or 3rd day of menstruation to receive the KMs. KM treatment will be delivered for 3 menstrual cycles (3 months) and will include herbal decoction, acupuncture, or moxibustion on demand. Every participant will be assessed based on KM clinical symptoms, a quality of life questionnaire, and ovarian reserve test results. ETHICS AND DISSEMINATION: The study was approved by Institutional Review Board of Semyung University (SMU-IM-190501). The results will be published in a peer-reviewed journal and will be disseminated electronically and in print. TRIAL REGISTRATION NUMBER: Clinical Research Information Service: KCT0004209.


Assuntos
Terapia por Acupuntura/métodos , Fertilização In Vitro/métodos , Infertilidade Feminina/terapia , Medicina Tradicional Coreana/métodos , Moxibustão/métodos , Fitoterapia/métodos , Insuficiência Ovariana Primária/terapia , Adulto , Feminino , Humanos , Infertilidade Feminina/etiologia , Estudos Observacionais como Assunto , Reserva Ovariana , Estudos Prospectivos , Qualidade de Vida , República da Coreia , Resultado do Tratamento
10.
Presse Med ; 48(11 Pt 1): e307-e315, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31727487

RESUMO

INTRODUCTION: Fertility disorders in autoimmune diseases are well described. However, little is known about the presence of a humoral serum autoimmunity in case of infertility (antinuclear antibodies, ACAN or antiphospholipid, APL) without criteria of autoimmune disease. METHODS: We studied the prevalence, associated factors, and efficacy of immunomodulatory therapy in patients with unexplained infertility. Two groups were created retrospectively among patients followed in medically assisted procreation (PMA) for infertility: a group with serum autoimmunity (AI+) (ACAN, APL or anti-thyroperoxidase antibodies) and a group without serum autoimmunity (HAVE-). Clinical, biological, and therapeutic data were collected. RESULTS: The prevalence of autoimmunity was 33% among consultant patients. One hundred patients were seen in internal medicine consultation, 70 were included in the AI+ group and 30 in the AI- group. In the AI+ group, 76% had ACANs, 29% had anti-TPOs and 23% had APLs. There was a significant correlation between ACAN level and the presence of endometriosis (P=0.048). Immunomodulatory therapy was introduced for 68 of the 70 women in the AI+ group; pregnancy occurred in 28 patients (40%) during the treatment period, compared with 7 in the "AI-" group (23%), with a tendency to significance (P=0.09). In conclusion, there is an increased prevalence of serum autoimmunity in patients with fertility disorders, possibly with the efficacy of an immunomodulatory treatment to confront prospective therapeutic studies.


Assuntos
Autoanticorpos/sangue , Autoimunidade , Infertilidade Feminina/imunologia , Anticorpos Antinucleares/sangue , Anticorpos Antifosfolipídeos/sangue , Autoantígenos/imunologia , Implantação do Embrião , Endometriose/imunologia , Feminino , França , Humanos , Imunomodulação , Infertilidade Feminina/sangue , Infertilidade Feminina/terapia , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Gravidez , Estudos Retrospectivos
11.
Curr Urol Rep ; 20(11): 77, 2019 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-31734736

RESUMO

PURPOSE OF REVIEW: This review highlights the role of imaging in the diagnosis and management of reproductive disorders. The additional information that imaging studies can contribute to reproductive medicine is emphasized, including the role of pelvic ultrasonography (US, including sonohysterography and contrast-enhanced hysterosalpingosonography), hysterosalpingography (HSG), and magnetic resonance imaging (MRI) of the female reproductive tract. In addition, the implications of congenital causes of infertility on the urinary tract in females are reviewed. While the evaluation of infertility in women is initially focused on the assessment of ovulation via serum hormone levels, imaging plays a role in evaluating other causes of infertility. Recent research in this field focuses on the establishment of a comprehensive single imaging study for the assessment of female reproductive disorders. Two proposed methods are MR hysterosalpingography and Fertiliscan, a combination of high-quality 3D ultrasound and assessment of tubal patency with hysterosalpingo-foam-sonography, though more research is needed to determine the risks and benefits of each method, as well as their reliability.


Assuntos
Histerossalpingografia , Infertilidade Feminina/diagnóstico por imagem , Imagem por Ressonância Magnética , Ultrassonografia/métodos , Anormalidades Congênitas/diagnóstico por imagem , Testes de Obstrução das Tubas Uterinas , Feminino , Genitália Feminina/anormalidades , Genitália Feminina/diagnóstico por imagem , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia
12.
J Med Case Rep ; 13(1): 321, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31665081

RESUMO

BACKGROUND: Infertility continues to be an enigmatic and emerging problem. Although in vitro fertilization has proved to be revolutionary and immensely beneficial to many people, it is far from perfect, and many women experience recurrent in vitro fertilization failures. There can be a multitude of factors involved in recurrent in vitro fertilization failures. The aim of this report was to explore the role of hysteroscopy in determining potential causes of in vitro fertilization failure and how the relevant hysteroscopic findings can address the issue of infertility in terms of a subsequent successful in vitro fertilization. CASE PRESENTATION: A 37-year-old white Arab woman with a history of eight in vitro fertilization failures and one curettage performed for a blighted ovum presented to our hospital because of inability to conceive. Her past medical history was significant for hypothyroidism and positive factor V Leiden. She underwent hystero contrast sonography, which revealed a normal uterine cavity with irregular fillings in the right corner. To explore this further, hysteroscopy was performed, which showed dense adhesions in the right upper corner and first-degree adhesions in the lower half of the uterus. After undergoing adhesiolysis and a cycle of estradiol valerate and progesterone, the patient successfully conceived twins. CONCLUSIONS: Hysteroscopy may play an important role before or in conjunction with assisted reproductive techniques to help infertile women and couples achieve their goals of pregnancy and live birth of a child.


Assuntos
Fertilização In Vitro/efeitos adversos , Histeroscopia , Gravidez de Gêmeos , Aderências Teciduais/cirurgia , Doenças Uterinas/cirurgia , Adulto , Amenorreia/complicações , Estradiol/uso terapêutico , Estrogênios/uso terapêutico , Feminino , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Gravidez , Progesterona/uso terapêutico , Progestinas/uso terapêutico , Aderências Teciduais/diagnóstico por imagem , Falha de Tratamento , Doenças Uterinas/diagnóstico por imagem
13.
Medicine (Baltimore) ; 98(38): e17160, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567955

RESUMO

RATIONALE: Fallopian tube obstruction and diminished ovarian reserve (DOR) are main factors including female infertility. Acupuncture might be effective in the treatment of the disease. PATIENT CONCERNS: A 39-year-old woman diagnosed with fallopian tube obstruction and DOR has been unable to conceive in the past 5 years, despite of receiving various treatments and 3-time in vitro fertilization (IVF) in different countries. DIAGNOSES: Under comprehensive consideration of clinical manifestations and hysterosalpingography examinations results, the patient was diagnosed as female infertility due to fallopian tube obstruction and DOR. INTERVENTION: Electroacupuncture treatment was performed 3 times per week for about 3 months. OUTCOMES: After 2-months of electroacupuncture treatment, the patient's menstrual cycle was back to normal, and she conceived after 3-month treatment and gave birth to a healthy baby boy finally. LESSONS: Electroacupuncture might be a complementary or alternative treatment for female infertility, particularly for women with fallopian tube obstruction and DOR.


Assuntos
Eletroacupuntura , Doenças das Tubas Uterinas/complicações , Infertilidade Feminina/terapia , Reserva Ovariana , Adulto , Eletroacupuntura/métodos , Feminino , Humanos , Ciclo Menstrual , Gravidez , Complicações na Gravidez
14.
Medicine (Baltimore) ; 98(41): e17470, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593108

RESUMO

Antral follicle count (AFC) has been widely investigated for the prediction of clinical pregnancy or live birth. This study discussed the effects of AFC quartile levels on pregnancy outcomes combined with female age, female cause of infertility, and ovarian response undergoing in vitro fertilization (IVF) treatment. At present, many research about AFC mainly discuss its impact on clinical practice at different thresholds, or the analyses of AFC with respect to assisted reproductive technology outcomes under using different ovarian stimulation protocols. Factors that include ovarian sensitivity index, female age, and infertility cause are all independent predictors of live birth undergoing IVF/intracytoplasmic sperm injection, while few researchers discussed influence of female-related factors for clinical outcomes in different AFC fields.A total of 8269 infertile women who were stimulated with a long protocol with normal menstrual cycles were enrolled in the study, and patients were categorized into 4 groups based on AFC quartiles (1-8, 9-12, 13-17, and ≥18 antral follicles).The clinical pregnancy rates increased in the 4 AFC groups (28.25% vs 35.38% vs 37.38% vs 40.13%), and there was a negative association between age and the 4 AFC groups. In addition, female cause of infertility like polycystic ovary syndrome, Tubal factor, and other causes had great significance on clinical outcome, and ovarian response in medium (9-16 oocytes retrieved) had the highest clinical pregnancy rate at AFC quartiles of 1 to 8, 9 to 12, 13 to 17, and ≥18 antral follicles.This study concludes that the female-related parameters (female cause of infertility, female age, and ovarian response) combined with AFC can be useful to estimate the probability of clinical pregnancy.


Assuntos
Fatores Etários , Fertilização In Vitro/estatística & dados numéricos , Infertilidade Feminina/terapia , Indução da Ovulação/estatística & dados numéricos , Taxa de Gravidez , Adulto , Feminino , Fertilização In Vitro/métodos , Humanos , Infertilidade Feminina/etiologia , Nascimento Vivo , Modelos Logísticos , Análise Multivariada , Folículo Ovariano , Indução da Ovulação/métodos , Gravidez , Estudos Prospectivos , Curva ROC , Resultado do Tratamento
15.
Medicine (Baltimore) ; 98(42): e17294, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626086

RESUMO

BACKGROUND: As a fabulous part of Oriental Medcine, acupuncture and moxibustion possesses the advantage of high safety, convenience and less adverse effects. Unruptured follicular luteinization syndrome is a common cause of infertility in women of reproductive age, which seriously affects the physical and mental health of patients. Certain studies have reported that acupuncture can improve the rate of pregnancy in women with unruptured follicular luteinization syndrome. In this protocol, the effects of acupuncture on rates of ovulation and pregnancy among women with unruptured follicular luteinization syndrome will be further explored. METHODS: Electronic bibliographic databases such as: MEDLINE, EMBASE, PsycINFO, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), Health Technology Assessment Database, and Web of Science (Science and Social Science Citation Index), PubMed, Chinese Biomedical Databaseare, Chinese VIP Information, Chinese National Knowledge Infrastructure (CNKI), all helpful to identify relevant randomized controlled trials (RCTs) of effects of acupuncture on rates of ovulation and pregnancy among women with unruptured follicular luteinization syndrome. The pooled odds ratio of achieving a clinical pregnancy, ongoing pregnancy, or live birth were used as the main outcome and the secondary outcome includes the changes of ovarian artery dynamics before and after treatment, so as to the adverse reactions of treatment. We will use RevMan 5.3 software to help us to analyze all data and use the Cochrane evaluation manual 5.1.0 to help us to assess the methodological quality for incorporated RCTs. RESULT: This systematic review will provide evidence for assessing the effects of acupuncture on rates of ovulation and pregnancy in women with unruptured follicular luteinization syndrome. CONCLUSION: The results of this study will be a useful reference for clinical treatment with acupuncture to improve rates of ovulation and pregnancy among women with unruptured follicular luteinization syndrome.


Assuntos
Terapia por Acupuntura/métodos , Infertilidade Feminina/terapia , Ovulação , Feminino , Humanos , Infertilidade Feminina/etiologia , Luteinização , Metanálise como Assunto , Folículo Ovariano , Gravidez , Taxa de Gravidez , Síndrome , Revisão Sistemática como Assunto
16.
Pak J Pharm Sci ; 32(4): 1495-1499, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31608867

RESUMO

Infertility rate documented in Pakistan is 21.9% with only 25% success rate even after procedures like intracytoplasmic sperm injection (ICSI). This rate is further on the decline with enhancement of female age. We aimed to observe the effect of female age on oocyte parameters and reproductive outcome after ICSI. It was done by retrospective analysis of a quasi- experimental design carried out after approval from "Ethical review board of Islamabad clinic serving infertile couples" from July 2010 to August 2011. The response to ovarian stimulation in (282) females was assessed on the basis of groups, A, B, C and D with age ranges up to 25years; 25.1 to 30years; 30.1 to 35years and >35years, respectively. The outcome was assessed as non-pregnant, preclinical abortion and clinical pregnancy groups on the basis of beta hCG and cardiac activity by trans-vaginal scan. We observed that maximum number of pregnancies 32 (38%) occurred in C group, and least 10 (10%) in group A. There was a statistical reduction in the number of mature and fertilized oocytes as the age advanced from group C to D (p<0.05).This shows that reduction in maturity and fertilization of oocytes with advancement of age recommends early referral of couples to assisted reproductive clinics.


Assuntos
Infertilidade Feminina/terapia , Idade Materna , Injeções de Esperma Intracitoplásmicas , Falha de Tratamento , Adolescente , Adulto , Índice de Massa Corporal , Transferência Embrionária , Feminino , Humanos , Masculino , Recuperação de Oócitos , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Adulto Jovem
17.
Medicine (Baltimore) ; 98(39): e16965, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574795

RESUMO

This study presents the postoperative pregnancy rate of women with recurrent endometriosis and evaluates the predictive value of the endometriosis fertility index (EFI) for the pregnancy.A total of 107 women who wished to conceive after surgery for recurrent endometriosis from January 2007 to December 2016 were included. The EFI score was calculated postoperatively. The receiver operator characteristic (ROC) curve was plotted to determine the most promising contributor to predicting pregnancy, and Kaplan-Meier (K-M) analysis was used to estimate the cumulative pregnancy rate (CPR).A total of 61 pregnancies were registered in 58 women and the remaining 49 patients failed to become pregnant. The EFI score was strongly associated with the postoperative fertility prognosis. The CPRs during the first 2 and 3 years postoperatively were 51.86% and 66.38%, respectively, and increased to 71.98% within the first 5 years postoperatively in patients with EFI scores ≥5. However, the CPR was 26.00% during the first 2 years after surgery in individuals with EFI scores <5, and there was no increase in the CRP thereafter.Women suffering from recurrent endometriosis still experienced a probability of natural pregnancy, especially patients with EFI scores ≥5. The EFI score had good predictive power for postoperative pregnancy in these patients.


Assuntos
Endometriose/cirurgia , Fertilização , Índice de Massa Corporal , Endometriose/complicações , Feminino , Seguimentos , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Estimativa de Kaplan-Meier , Valor Preditivo dos Testes , Gravidez , Taxa de Gravidez , Curva ROC , Recidiva , Técnicas de Reprodução Assistida , Estudos Retrospectivos
18.
Int J Mol Sci ; 20(19)2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31548505

RESUMO

Ovarian follicle pool depletion, infertility, and premature menopause are all known sequelae of cancer treatment that negatively impact the quality of life of young cancer survivors. The mechanisms involved in this undesired iatrogenic ovarian damage have been intensively studied, but many of them remain unclear. Several chemotherapeutic drugs have been shown to induce direct and indirect DNA-damage and/or cellular stress, which are often followed by apoptosis and/or autophagy. Damage to the ovarian micro-vessel network induced by chemotherapeutic agents also seems to contribute to ovarian dysfunction. Another proposed mechanism behind ovarian follicle pool depletion is the overactivation of primordial follicles from the quiescent pool; however, current experimental data are inconsistent regarding these effects. There is great interest in characterizing the mechanisms involved in ovarian damage because this might lead to the identification of potentially protective substances as possible future therapeutics. Research in this field is still at an experimental stage, and further investigations are needed to develop effective and individualized treatments for clinical application. This review provides an overview of the current knowledge and the proposed hypothesis behind chemotherapy-induced ovarian damage, as well as current knowledge on possible co-treatments that might protect the ovary and the follicles from such damages.


Assuntos
Sobreviventes de Câncer , Fertilidade , Infertilidade Feminina , Doenças Ovarianas , Folículo Ovariano , Animais , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Feminino , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/metabolismo , Infertilidade Feminina/patologia , Infertilidade Feminina/terapia , Doenças Ovarianas/induzido quimicamente , Doenças Ovarianas/metabolismo , Doenças Ovarianas/patologia , Doenças Ovarianas/terapia , Folículo Ovariano/metabolismo , Folículo Ovariano/patologia , Qualidade de Vida
19.
Zhongguo Zhen Jiu ; 39(9): 927-31, 2019 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-31544378

RESUMO

OBJECTIVE: To observe the effect of acupuncture and moxibustion therapy of Tiaochongren Gushenyuan on ovulation and embryo implantation in luteal phase defect patients with spleen-kidney yang deficiency. METHODS: A total of 80 patients were randomly divided into an observation group and a control group, 40 cases in each one.In the observation group,acupuncture was applied at Shenting (GV 24), Shenque (CV 8), Guanyuan (CV 4), Qixue (KI 13), Lieque (LU 7), Gongsun (SP 4), Taixi (KI 3), Zusanli (ST 36) and Taichong (LR 3). And moxibustion was given at Taixi (KI 3) using moxibustion box during follicular phase, the stimulation of Taichong (LR 3) was strengthened during ovulatory phase, moxibustion was adopted at Shenque (CV 8) to Guanyuan (CV 4), Zusanli (ST 36) and Taixi (KI 3) during luteal phase. In the control group, acupuncture was applied at Guanyuan (CV 4), Dahe (KI 12), Sanyinjiao (SP 6), Ciliao (BL 32), Zhibian (BL 54) and Shenque (CV 8). Moxibustion was given at Sanyinjiao (SP 6) using moxibustion box during follicular phase, and moxibustion was adopted at Shenque (CV 8) to Guanyuan (CV 4) during luteal phase. The treatment were given every Monday, Wednesday and Friday, and the treatment were stoped during menstrual period in the two groups. Totally 3 menstrual cycle treatment were required, and 3 menstrual cycles were followed up. The pregnancy rate was observed after treatment, the ovulation rate, maximum folliclular diameter and difference of maximum folliclular diameters in ovulatory phase, serum progesterone (P) and basal body temperature (BBT) were compared before and after treatment in the two groups. RESULTS: In the observation group, 6 cases of successful pregnancy during treatment,10 cases in follow-up, the clinical pregnancy rate was 40.0% (16/40). In the control group, 1 case of successful pregnancy during treatment, 5 cases in follow-up, the clinical pregnancy rate was 15.0% (6/40). The clinical pregnancy rate in the observation group was higher than the control group (P<0.05). The ovulation rate after treatment in the observation group was 90.0% (36/40), and the control group was 70.0% (28/40), compared before treatment, the ovulation rates were increased after treatment in the two groups (P<0.05). The observation group was higher than the control group, but there was no significant difference between the two groups (P>0.05). Compared before treatment, the maximum folliclular diameter and difference of maximum folliclular diameters in ovulatory phase, serum P after treatment were improved in the two groups (P<0.05), and the improvements of the observation group were significant compared with the control group (P<0.05). The BBT after treatment were superior to before treatment in the two groups (P<0.05). After treatment, the normal BBT in the observation group was 33 cases, while the control group was 22 cases (P<0.05). CONCLUSION: Acupuncture and moxibustion therapy of Tiaochongren Gushenyuan can promote folliclar development, improve dominant follicle morphology, increase the level of serum P. The therapeutic effect is superior to routine acupuncture in increasing ovulation rate and improving pregnancy outcome.


Assuntos
Terapia por Acupuntura , Infertilidade Feminina , Moxibustão , Pontos de Acupuntura , Feminino , Humanos , Infertilidade Feminina/terapia , Fase Luteal , Gravidez , Resultado da Gravidez
20.
Reprod Biol Endocrinol ; 17(1): 73, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477128

RESUMO

BACKGROUND: Mediterranean diet (MediDiet) had been reported to be beneficial to human health. However the relationship between diet pattern and outcomes of in vitro fertilization (IVF) treatment was scarcely researched. This study was aimed to explore the correlation between MediDiet pattern of infertile women and their clinical outcomes of IVF cycles. METHODS: An observational prospective cohort study was conducted in the reproductive center from September 2016 to December 2017. Seven hundred infertile women about to undergo IVF treatment were asked to conduct a questionnaire survey. Patients were assigned to higher MediDiet adherence group or lower MediDiet adherence group according to their Mediterranean diet scores. Laboratory parameters and clinical outcomes were compared and those were different between groups were further analyzed for their relationship with MediDiet adherence. RESULTS: A total of 590 women were finally included in the study. According to MediDiet scores, 228 participants were categorized as higher MediDiet adherence group and 362 others as lower MediDiet adherence group. No significant differences were found in baseline characteristics between groups. Higher MediDiet adherence group showed larger number of embryos available (8.40 ± 5.26 vs 7.40 ± 4.71, P = 0.028). Clinical pregnancy rate and implantation rate were similar between the two groups. In further correlation tests and multivariate linear regression analysis, number of fertilized oocytes and embryo yield were positively correlated to MediDiet adherence of participants. CONCLUSION: Infertile women with greater adherence to Mediterranean diet pattern were likely to obtain more embryos available in IVF cycle.


Assuntos
Dieta Mediterrânea , Embrião de Mamíferos/metabolismo , Fertilização In Vitro/métodos , Infertilidade Feminina/terapia , Adulto , Feminino , Humanos , Modelos Lineares , Masculino , Análise Multivariada , Gravidez , Taxa de Gravidez , Estudos Prospectivos , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento/estatística & dados numéricos
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