BACKGROUNDEndometriosis affects natural fertility through various approaches, and in vitro fertilization (IVF) is a good treatment. But the IVF result of endometriosis patients is still under debate. We investigated the effect of endometriosis on IVF by analyzing the data from a single reproductive center.

METHODSA retrospective, database-searched cohort study was performed. Relevant information was collected from the electronic records of women who underwent IVF/intracytoplasmic sperm injection between January 2006 and December 2010 in the Assisted Reproductive Unit of Sir Run Run Shaw Hospital. Patients with endometriosis were enrolled the study group. The rest of the women formed the control group. The main outcome was the clinical pregnancy rate. Secondary outcomes were oocytes retrieved number, fertilization rate, high-quality embryo rate, number of high-quality embryo for embryo transplantation, and implantation embryo/high-quality embryo ratio (IE/HQE ratio). Comparisons were performed by the c(2)-test and independent t-test.

RESULTSThe endometriosis group (n = 177) had a markedly lower oocytes retrieved number, fertilization rate, implantation rate, and clinical pregnancy rate (7.6 ± 5.1, 63.6%, 27.7%, and 45.2%, respectively) compared with the non-endometriosis group (n = 4267; 11.8 ± 7.3, 68.4%, 36.2%, and 55.2%, respectively). Stratified analysis showed that this difference was found in the subgroup younger than 35-years old, while only fertilization rate and implantation rate were different in the elder subgroup. The ratio of high-quality embryos transferred is lower in endometriosis group (53.7% vs. 71.8%, P < 0.05), but there is no difference in IE/HQE ratio between two groups. There is no significant difference in fertilization rate, implantation rate, and clinical pregnancy rate between mild and severe endometriosis patients.

CONCLUSIONSEndometriosis patients suffer a decreasing IVF pregnancy rates mainly caused by reducing oocytes number and fertilization rate, regardless of the severity of the disease. Appropriate intracytoplasmic sperm injection manipulation might improve the outcomes of IVF.

Endometriosis ; physiopathology ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; etiology ; therapy ; Pregnancy ; Pregnancy Rate ; Retrospective Studies

With the ascending attack rate of anovulatory infertility year by year, people also began to pay attention to its treat methods. According to Doctor Ma Kun,who are engaged in clinical work about the treatment for anovulatory infertility, kidney deficiency is the basic pathogenesis and blood stasis is an important factor that has been through. Flexible use of tonifying the kidney and promoting blood circulation treatment of anovulatory infertility in clinic, has achieved remarkable curative effect. Director Ma adjusts menstruation by the different periods, and regulates both patients' negative emotions and sleep quality. Through years of clinical experience accumulation, Director Ma gradually formes special treatment of anovulatory infertility by flexibly using of tonifying the kidney and promoting blood circulation individually.
Adult ; Anovulation ; drug therapy ; physiopathology ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Kidney ; drug effects ; physiopathology

OBJECTIVETo observe the impacts on endometrial and pregnancy outcomes treated with acupuncture and moxibustion in the patients of in vitro fertilization-embryo transfer (IVF-ET) and explore the application value, of acupuncture and moxibustion in IVF-ET treatment.

METHODSOne hundred and fourteen patients of IVF-ET treated with standard long-term program at luteal phase were randomized into an observation group and a control group, 57 cases in each one. In the observation group, at the beginning of ovulatory induction, moxibustion was applied to Shenque (CV 8) and acupuncture was to Zhongji (CV 3), Guanyuan (CV 4), Qihai (CV 6), Zigong (EX-CA 1), Xuebai (SP 10), etc. till the transfer time for one session of treatment. Totally, 3 sessions were required. In the control group, no intervention of acupuncture and moxibustion was applied. The endometrial morphology, subendometrial blood flow index, the levels of serum estradiol (E2), progesterone (P) and luteinizing hormone (LH) on the day of injection of human chorionic gonadotropin (hCG), the dosage and time of gonadotropin (Gn), oocyte count, high-quality embryo number, embryo cultivation rate and clinical pregnant rate were observed in the two groups.

RESULTSThe A type endometrial proportion on hCG day and high-quality embryo rate in the observation group were higher than those in the control group, indicating the significant differences (both P< 0.05). The difference in endometrial thickness on hCG day was not significant between the two groups (P> 0.05). In the observation group, endometrial hemodynamic index (peak systolic blood velocity/end-diastolic blood velocity, S/D), resistive index (RI) and pulse index (PI) were lower than those in the control group (P<0. 01, P<0. 05). The levels of serum E2 and P on hCG day in the observation group were higher than those in the control group (both P<0. 05). The differences were not significant in Gn dose, Gn medication time, numbers of follicles >1. 6 cm on hCG day, oocyte count, embryo cultivation rate and clinical pregnancy rate and LH level on hCG day between the two groups (all P>0. 05).

CONCLUSIONIn IVF-ET treatment, acupuncture and moxibustion affect estrogen level on hCG day, improve high-quality embryo rate, endometrial blood flow state and morphology so that the endometrial receptivity is increased and the method is expected to be the assistant therapeutic approach for the improvement of IVF-ET outcome.

Acupuncture Therapy ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Moxibustion ; Pregnancy ; Pregnancy Outcome ; Young Adult

Dingkun Dan is a representative of the classic gynecological medicine. With Tonifying the liver and kidney, supplementing Qi and nourishing blood, regulating menstruation Shuyu, promoting the role of pain. Used in treatment of liver and kidney deficiency, deficiency of both qi and blood, Qi stagnation and blood stasis caused by irregular menstruation, menstrual pain, uterine bleeding, leukorrhea with reddish discharge, bruise blood removal, infertility, and various postpartum deficiency and bone steaming hot flashes of gynecological common disease. In recent years, Dingkun Dan's new uses have been reported, the clinical application value is worth further digging. In this paper, clinical application and research progress of Dingkun Dan since the founding of new China were briefly discussed, and summarize for the randomized controlled trials.
China ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; Kidney ; drug effects ; physiopathology ; Liver ; drug effects ; physiopathology ; Menstruation ; drug effects ; Randomized Controlled Trials as Topic

OBJECTIVETo observe the effects of "menstrual cycle-based acupuncture therapy" on ovarian function and pregnancy results of in vitro fertilization-embryo transfer (IVF-ET) in patients with decline in ovarian reserve (DOR).

METHODSA total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups.

RESULTSCompared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P< 0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P < 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P < 0.01) and cycle cancellation rate was reduced (P< 0.01).

CONCLUSIONThe "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET.

Acupuncture Therapy ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Menstrual Cycle ; Middle Aged ; Ovarian Reserve ; Ovary ; physiopathology ; Pregnancy ; Young Adult

OBJECTIVETo assess the relationships among human follicular fluid-induced acrosome reaction, sperm morphology and in vitro fertilization rates.

METHODSThe relationships among human follicular fluid-induced acrosome reaction, sperm morphology and in vitro fertilization rates were investigated by Spearman rank correlation in 79 infertile couples. And the sperm morphology analysis was performed by crystal violet staining and based on strict criteria.

RESULTSA significant positive correlation was found between the percentage of human follicular fluid-induced acrosome reaction and that of normal sperm morphology (n = 49, r = 0.3763, P < 0.01), but no significant correlation was observed either between the percentage of human follicular fluid-induced acrosome reaction and in vitro fertilization rates or between that of normal sperm morphology and in vitro fertilization rates (n = 21, r = 0.2666, P > 0.05 and n = 50, r = 0.0018, P > 0.05, respectively).

CONCLUSIONThere is a significant positive correlation between the percentage of human follicular fluid-induced acrosome reaction and that of normal sperm morphology, but no such correlation either between the percentage of human follicular fluid-induced acrosome reaction and in vitro fertilization rates or between that of normal sperm morphology and in vitro fertilization rates.

Acrosome Reaction ; physiology ; Adult ; Female ; Fertilization in Vitro ; Follicular Fluid ; Humans ; Infertility, Male ; physiopathology ; therapy ; Male ; Retrospective Studies ; Spermatozoa ; physiology

OBJECTIVETo investigate the effect of allogeneic leukocyte immunization combined with in vitro fertilization-embryo transfer (IVF-ET) for treatment of infertility induced by habitual abortion.

METHODSAllogeneic leukocyte immunization was performed in 9 patients with infertility induced by habitual abortion, with another 9 patients undergoing IVF-ET without habitual abortion as the control group. All the patients were treated with long GnRH-a protocols. The infertility patients with recurrent spontaneous abortion history were immunized with lymphocytes from the husband for before IVF-ET and after clinical pregnancy.

RESULTSThe fertilization rates of the immunotherapy group and control group were 81.3% and 82.2%, respectively, showing no significant difference (P>0.05). Five patients in each group had clinical pregnancy, and a twin pregnancy occurred in the control group. The embryo implantation rates were also comparable between the two groups (22.7% vs 28.6%, P>0.05). All the fetuses resulted from IVF-ET developed normally and were healthily delivered.

CONCLUSIONAllogeneic leukocyte immunotherapy along with IVF-ET is effective for treatment of infertility resulting from recurrent spontaneous abortion.

Abortion, Habitual ; physiopathology ; Adoptive Transfer ; methods ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Humans ; Infertility, Female ; physiopathology ; therapy ; Pregnancy ; Pregnancy Outcome ; Treatment Outcome

OBJECTIVETo explore the impact and effect mechanism of electroacupuncture (EA) on oocyte quali ty in the patients with infertility of kidney deficiency pattern.

METHODSSixty-six cases differentiated as kidney de ficiency and with in vitro fertilization-embryo transplantation (IVF-ET), aged fromnt 35 to 42 years were rando- mized into an observation group and a control group, 33 cases in each one. The IVF-ET therapy of the long proto- col with gonadotrophin releasing hormone agonist was adopted in the two groups. In the observation group. on the 5th day of menstruation in IVF cycle, EA was applied to Sanyinjiao (SP 6). Zigong (EX CA 1), Zhongji (CV 3) and Guanyuan (CV 4). In the control group, the sham-acupuncture was applied to the same acupoints. The treatment was given once every two days till the date of egg collection and the needles were retained for 30 min each time. The change in the score of kidney deficiency syndrome, the high-quality oocyte rate, the high-quality embryo rate and clinical pregnant rate were observed in the two groups. The levels of insulin-like growth factor-i (IGF-1) and IGF-2 in follicular fluid and the serum β-endorphin β-EP) on the date of egg collection and the correlation with oocyte quality were compared bIetween the two groups.

RESULTS1) In the observation group, the kidney deficiency syndrome score after treatment was reduced apparently as compared with that before treatment (P<0. 05), the score after treatment in the observation group was reduced much more apparently as compared with the control group (P<0.05). 2) The high-quality egg rate and the high-quality embryo rate in the observation group were both higher than those in the control group [81.3% (161/198) vs 57.6% (98/170), 59.8% (58/97) vs 37.7% (26/69), both P<0.05]. 3) Compared with the control group. the levels of IGF-1 and IGF-2 in follicular fluid and serum β-EP on the day of egg collection were all increased obviously in the observation group (all P<0. 05). 4) The levels of IGF-1 and IGF-2 in follicular fluid and serum β-EP presented the linear positive correlation with the high-quality egg rate.

CONCLUSIONEA effectively improves the expressions of IGF in follicular fluid and serum β-EP, increases the high-quality egg rate and high-quality embryo rate and relieves the symptoms of kidney deficiency.

Acupuncture Points ; Adult ; Electroacupuncture ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; metabolism ; physiopathology ; therapy ; Insulin-Like Growth Factor I ; metabolism ; Kidney ; physiopathology ; Oocytes ; Pregnancy ; beta-Endorphin ; metabolism

OBJECTIVETo explore the therapeutic effect of acupuncture combined with medication on continuing unovulation infertility.

METHODSFifty cases of continuing unovulation infertility were randomly divided into an observation group and a control group, 25 cases in each group. The observation group was treated with Chinese herbal decoction plus acupuncture. Culuanpao decoction, Cupailuan decoction and Cuhuangti decoction were respectively given according to different menstrual cycles and acupuncture and moxibustion at Guanyuan (CV 4), Zhongji (CV 3), Luanchao (ovary), etc. The control group was treated with oral administration of Clomiphene and intramuscular injection of Chorionic Gonadotropin. They were treated for 6 cycles and the ovulation rate and the pregnancy rate were observed.

RESULTSThere was no significant difference in the ovulation rate between the two groups (P > 0.05). The pregnancy rate of 44.0% in the observation group was significantly higher than 16.0% in the control group (P < 0.05). The observation group was superior to the control group in the score of mucus and the endometrial thickness.

CONCLUSIONBoth acupuncture combined with medication and oral administration of clomiphene plus intramuscular injection of chorionic gonadotropin have higher ovulation rate, and the former was higher than the latter in the pregnancy rate.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Infertility, Female ; drug therapy ; physiopathology ; therapy ; Ovulation ; drug effects ; Pregnancy ; Pregnancy Rate

The impact of acupuncture for the pregnancy of in vitro fertilization-embryo transfer (IVF-ET) is discussed in the paper. Nowadays there are various conclusions about the impact of acupuncture for IVF-ET, and it may result from the differences in research designs. The effect is closely related to the demographic and clinical characteristics of subjects, such as age, the diagnosis of barrenness, blood flow index of uterine spiral arteries, the cycle of IVF, etc. Besides, the efficacy is influenced by treatment based on syndrome differentiation or not, the frequency and course of acupuncture in both the treating group and the control group, etc. If more reasonable design is achieved in the further study based on them, more reliable evidence will be provided for the effect and mechanism of the pregnancy of IVF-EF by acupuncture.
Acupuncture Therapy ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Male ; Pregnancy ; Pregnancy Rate ; Randomized Controlled Trials as Topic ; Treatment Outcome