1.Effects of controlled ovarian stimulation regimens on top-quality blastocyst development and perinatal outcomes with the freeze-all strategy: A retrospective comparative study
Sachin Ashok BHOR ; Kaname NAKAYAMA ; Hirofumi ONO ; Toshiko IWASHITA ; Koichi KINOSHITA
Clinical and Experimental Reproductive Medicine 2023;50(2):132-140
Objective:
This study aimed to determine the effect of ovarian stimulation regimens on the top-quality blastocyst development rate and perinatal outcomes with the freeze-all strategy.
Methods:
A retrospective comparative cohort analysis of 149 in vitro fertilization (IVF) cycles using the freeze-all strategy was conducted. The IVF cycles were stimulated with either a gonadotropin-releasing hormone antagonist or clomiphene citrate along with gonadotropin based on the patient’s serum anti-Müllerian hormone level. Oocyte retrieval, fertilization, and embryo culture were performed following standard procedures. All good-quality blastocysts were cryopreserved and used for frozen-thawed embryo transfer (FET) in subsequent cycles. The fertilization, blastulation, and top-quality blastocyst development rates were calculated. The perinatal outcomes of FET cycles, gestational period, and birth weight were assessed.
Results:
The main outcome of this study was the top-quality blastocyst development rate, and the secondary outcomes were perinatal parameters (e.g., gestational period and birth weight) between the stimulation regimens. Despite the higher number of usable-quality embryos in the antagonist group, the blastocyst development rate remained comparable (p=0.105). Similarly, perinatal outcomes were comparable in subsequent FET cycles (p=0.538).
Conclusion
These findings suggest that the choice between antagonist and clomiphene citrate with gonadotropin as stimulation in controlled ovarian stimulation regimens may not affect the top-quality blastocyst development rate. The IVF outcomes (e.g., clinical pregnancy, miscarriage, and live birth rates) remained unaffected in subsequent FET cycles. Unlike fresh embryo transfer, the birth weight and gestational length were not associated with prior controlled ovarian stimulation regimens when the freeze-all strategy was used.
2.Immunological effect of local ablationcombined with immunotherapy on solidmalignancies
Takahashi YUSUKE ; Matsutani NORIYUKI ; Nakayama TAKASHI ; Dejima HITOSHI ; Uehara HIROFUMI ; Kawamura MASAFUMI
Chinese Journal of Cancer 2017;36(6):252-257
Recent comprehensive investigations clarified that immune microenvironment surrounding tumor cells are deeplyinvolved in tumor progression, metastasis, and response to treatment. Furthermore, several immunotherapeutic trialshave achieved successful results, and the immunotherapeutic agents are available in clinical practice. To enhancetheir demonstrated efficacy, combination of immunotherapy and ablation has begun to emerge. Local ablationshave considerable advantages as an alternative therapeutic option, especially its minimal invasiveness. In addition,local ablations have shown immune-regulatory effect in preclinical and clinical studies. Although the correspondingmechanisms are still unclear, the local ablations combined with immunotherapy have been suggested in the treatmentof several solid malignancies. This article aims to review the published data on the immune-regulatory effectsof local ablations including stereotactic body radiotherapy, cryoablation, radiofrequency ablation, and high-intensityfocusedultrasound. We also discuss the value of local ablations combined with immunotherapy. Local ablations havethe potential to improve future patient outcomes; however, the effectiveness and safety of local ablations combinedwith immunotherapy should be further investigated.
3.Personality Traits Do Not Have Influence on Glycemic Control in Outpatients with Type 2 Diabetes Mellitus
Norio YASUI-FURUKORI ; Hiroshi MURAKAMI ; Hideyuki OTAKA ; Jutaro TANABE ; Miyuki YANAGIMACHI ; Masaya MURABAYASHI ; Koki MATSUMURA ; Yuki MATSUHASHI ; Hirofumi NAKAYAMA ; Satoru MIZUSHIRI ; Norio SUGAWARA ; Makoto DAIMON ; Kazutaka SHIMODA
Psychiatry Investigation 2020;17(1):78-84
Objective:
Glycemic control varies based on lifestyle factors and stress coping mechanisms, which are influenced by personality. The psychological factors associated with glycemic control have not yet been established in patients with type 2 diabetes mellitus (T2DM). The relationship between a 5-factor model of personality and glycemic control was evaluated in individuals with T2DM.
Methods:
The subjects were 503 Japanese outpatients with T2DM. Glycated hemoglobin A1c (HbA1c) levels, depressive status, insomnia and personality traits were assessed. Lifestyle factors of the patients, such as habitual alcohol consumption and smoking, were also included in the analyses.
Results:
Because the influence of insulin therapy on HbA1c is so strong, we stratified the patients according to insulin use. Simple regression analysis showed a significant correlation between HbA1c and neuroticism in patients who did not use insulin. After adjustment for confounders, multiple regression analyses revealed that none of the personality factors, including neuroticism, were found to be associated with HbA1c.
Conclusion
These findings suggest that personality traits do not have a large impact on glycemic control. Further studies are required to confirm the relationships between psychological factors and glycemic control using a longitudinal study design.