Pregnancy outcomes in patients with polycystic ovary syndrome who conceived after single thawed blastocyst transfer: a propensity score-matched study.

BACKGROUND: It remains unclear whether polycystic ovary syndrome (PCOS) is an independent risk factor for pregnancy complications in women undergoing assisted reproductive technology (ART) treatment. For the integrative treatment of PCOS patients, it is still important to investigate the pregnancy outcomes of PCOS patients after adjusting for potential biases, such as body mass index, embryo quality and endometrial preparation method. METHODS: This retrospective cohort study ultimately included a total of 336 PCOS patients who conceived after single thawed blastocyst transfer in the PCOS group and 2,325 patients in the control group from January 2018 to December 2020. A propensity score matching (PSM) model was used, and 336 PCOS patients were matched with 336 patients in the control group. RESULTS: Before PSM, no differences in the miscarriage rate, pregnancy complication rate, preterm birth rate, or live birth rate were found between the PCOS group and the control group. After PSM, the late miscarriage rate of the PCOS group was significantly higher than that of the control group (3.3% vs. 0.6%, P = 0.040), although the early miscarriage rates were similar (14.0% vs. 13.7%). The rates of pregnancy complications, preterm birth and live birth in the PCOS group were comparable to those in the matched control group (P = 0.080, P = 0.105, P = 0.109, respectively). The neonatal weights of male infants and female infants were similar between the two groups (P = 0.219, P = 0.169). Subgroup analysis showed that PCOS patients with homeostasis model assessment of insulin resistance (HOMA-IR) levels ≥ 2.49 had a significantly increased risk of preterm birth compared with those with HOMA-IR levels < 1.26 and 1.26 ≤ HOMA-IR levels < 2.49 (26.0% vs. 6.0% vs. 9.8%, P = 0.005). PCOS patients with total testosterone levels ≥ 0.7 ng/ml had a higher early miscarriage rate but a lower late miscarriage rate than those with total testosterone levels < 0.7 ng/ml (29.4% vs. 12.3%, 0% vs. 3.6%, respectively, P = 0.032). CONCLUSIONS: PCOS is an independent risk factor for late miscarriage in patients conceived after a single thawed blastocyst transfer, even after adjusting for biases. Among PCOS patients, insulin resistance and hyperandrogenism are associated with a higher risk of preterm birth and early miscarriage, respectively.

Comparison of DNA fragmentation levels in spermatozoa with different sex chromosome complements.

RESEARCH QUESTION: Do spermatozoa with different sex chromosome complements (X and Y; aneuploidy and monosomy) exhibit different degrees of DNA damage? DESIGN: A prospective, observational study to measure the DNA fragmentation level and sex chromosome complement simultaneously using combined sperm chromosome dispersion (SCD) and fluorescence in-situ hybridization tests. Two methods were used to evaluate SCD images: a traditional semi-quantitative method to categorize halo size and a newly developed quantitative method based on the Matlab image analysis programme to more precisely measure the halo area and calculate the halo size index (HSI). RESULTS: The HSI (which was inversely proportional to DNA fragmentation level) of Y chromosome-bearing spermatozoa was significantly (P < 0.05) lower than that of X chromosome-bearing spermatozoa in both normozoospermic and pathozoospermic groups. The HSI of sex chromosome-aneuploid spermatozoa was also significantly (P < 0.05) lower than that of monosomic spermatozoa. CONCLUSIONS: Our results indicated that Y chromosome-bearing spermatozoa are more susceptible to DNA damage than X chromosome-bearing spermatozoa, and the segregation errors during the meiotic division of spermatogenesis (resulting in aneuploidy) constitute an important contributory cause of DNA damage.

The Therapeutic Effects of a Traditional Chinese Medicine Formula Wuzi Yanzong Pill for the Treatment of Oligoasthenozoospermia: A Meta-Analysis of Randomized Controlled Trials.

Oligoasthenozoospermia is a crucial factor in male infertility. Wuzi Yanzong (WZYZ) pill is a popular traditional Chinese medicine (TCM) formula which has been used for male infertility treatment for years. However, its effects on semen quality remain controversial. We conducted a preregistered meta-analysis to assess the effect of WZYZ pill for the therapeutic effects on oligoasthenozoospermia. Five randomized controlled trials including 960 participants were selected from databases of domains in North-East Asian regions, PubMed, Embase, and Cochrane Library. WZYZ pill group yielded a greater mean increment on sperm concentration (5 trials: MD 5.99, 95% CI 2.12-9.85, P = 0.002), sperm motility (5 trials: MD 4.57, 95% CI 0.47-8.68, P = 0.03), sperm morphology (2 trials: MD -1.93, 95% CI -4.87-1.01, P = 0.20), activity of acrosomal enzyme (2 trials: MD 28.27, 95% CI 12.41-44.14, P < 0.01), volume of semen (2 trials: MD 0.56, 95% CI 0.21-0.91, P = 0.002), and a decrement of sperm DNA fragmentation index (2 trials: MD -3.82, 95% CI -6.45--1.19, P = 0.004). However, qualities of selected studies were generally unsatisfactory, and there was inherent heterogeneity among some of the outcomes. Despite these limitations, the WZYZ pill improved sperm quality by improving several semen parameters and decreasing DNA damage in oligoasthenozoospermia patients.

Corrigendum to "The Therapeutic Effects of a Traditional Chinese Medicine Formula Wuzi Yanzong Pill for the Treatment of Oligoasthenozoospermia: A Meta-Analysis of Randomized Controlled Trials".

[This corrects the article DOI: 10.1155/2018/2968025.].