OBJECTIVETo investigate whether intracytoplasmic sperm injection (ICSI) can improve the clinical outcomes of the male patients with 100% teratozoospermia.

METHODSWe retrospectively analyzed the clinical data of 152 couples undergoing in vitro fertilization-embryo transfer (IVF-ET), including 75 cycles of IVF and 77 cycles of ICSI. We compared the rates of normal fertilization, high-quality embryos, transferrable embryos, implantation, clinical pregnancy, and abortion between the two groups.

RESULTSIn the 100% teratozoospermia patients the number of transferrable embryos was significantly lower in the IVF than in the ICSI group (78.91% vs 84.92%, P < 0.05), while the rates of normal fertilization and implantation were higher in the former than in the latter (60.26% vs 57.87% and 48.00% vs 39.55%, both P > 0.05). There were no statistically significant differences between the two groups in the female age, Gn days, Gn dose, BMI, infertility duration, endometrial thickness, and basal serum FSH and E2.

CONCLUSIONICSI cannot improve the clinical outcomes of the male patients with 100% teratozoospermia.

Abortion, Spontaneous ; Azoospermia ; Embryo Implantation ; Embryo Transfer ; Female ; Fertilization ; Fertilization in Vitro ; statistics & numerical data ; Humans ; Male ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; statistics & numerical data

OBJECTIVETo investigate the influence of seasons, blood types and semen parameters on the cryosurvival rate of frozen-thawed spermatozoa from sperm donors.

METHODSWe retrospectively analyzed the influence of seasons, blood types, abstinence period, semen volume, sperm morphology, and pre-freeze sperm motility and concentration on the cryosurvival rate of frozen-thawed sperm in 4 088 semen samples from Shaanxi Human Sperm Bank.

RESULTSThe cryosurvival rate of the post-thaw sperm was correlated negatively with the progressive motility of the pre-freeze sperm (r = -0.262, P < 0.01), but positively with pre-freeze sperm concentration (r = 0.247, P < 0.01), and it was significantly higher in the 6-day abstinence group ([70.2 +/- 5.4]%) than in the other abstinence groups (P < 0.01), so was it in the normal sperm morphology rate > 20% group ([71.4 +/- 5.1]%) than in the others (P < 0.01). The survival rate of the post-thaw sperm was not correlated with seasons, blood types, and semen volume (P > 0.05).

CONCLUSIONSperm motility, concentration and morphology and the abstinence period of sperm donors may be valuable predictors of the cryosurvival rate of post-thaw sperm, but no correlation was found between the survival rate and seasons, blood types and semen volume.

Adult ; Cryopreservation ; Humans ; Male ; Retrospective Studies ; Semen Preservation ; Sperm Motility ; Spermatozoa ; Young Adult

OBJECTIVETo investigate the correlation of the fertilization strategy and embryo transfer (ET) time with the incidence of ectopic pregnancy.

METHODSWe selected 3,331 fresh and 2,706 frozen-thawed ET cycles for the patients undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The fresh transfers included 2 546 IVF-ET and 785 ICSI-ET cycles and 2,220 day-3 embryo and 1,111 day-5 blastocyst transfers, while the frozen-thawed transfers included 2,080 IVF-ET and 626 ICSI-ET cycles and 741 day-3 embryo and 1 965 day-5 or -6 blastocyst transfers. We compared the incidence rate of ectopic pregnancy associated with different fertilization strategies and ET time.

RESULTSThe incidence rate of ectopic pregnancy was 1. 41% (36/2 546) in the IVF-ET cycles and 3.44% (27/785) in the ICSI-ET cycles of the fresh transfers, significantly lower in the IVF-ET than in the ICSI-ET cycles (P < 0.01), and it was 1.01% (21/2,080) in the IVF-ET cycles and 0.80% (5/626) in the ICSI-ET cycles of the frozen-thawed transfers, with no remarkable difference between the two groups (P > 0.05). The IVF-ET and ICSI-ET cycles included 2,220 fresh day-3 (F-D3) embryos, 1,111 F-D5 blastocysts, 741 frozen-thawed day-3 (T-D3) embryos, and 1,965 T-D5/6 blastocysts. The incidence rate of ectopic pregnancy was 1.71% (n = 38) in the F-D3, 2.25% (n = 25) in the F-D5, 1.35% (n = 10) in the T-D3, and 0.81% (n = 16) in the T-D5/6 group, respectively, significantly lower in the T-D5/6 than in the other three groups (P < 0.05).

CONCLUSIONThe incidence rate of ectopic pregnancy is associated with fertilization strategies, which is significantly lower in frozen-thawed than in fresh embryo transfers.

Blastocyst ; Embryo Transfer ; adverse effects ; methods ; statistics & numerical data ; Female ; Fertilization in Vitro ; adverse effects ; methods ; statistics & numerical data ; Humans ; Incidence ; Pregnancy ; Pregnancy Rate ; Pregnancy, Ectopic ; epidemiology ; etiology ; Sperm Injections, Intracytoplasmic ; adverse effects ; methods ; statistics & numerical data

OBJECTIVETo investigate the influence of the rate of morphologically normal sperm (MNS) on the clinical outcomes of conventional in vitro fertilization (IVF) in patients with one retrieved oocyte.

METHODSFrom January 2013 to January 2015, a total of 256 couples with one retrieved oocyte underwent conventional IVF in our center. According to the rate of MNS, the patients were divided into two groups: MNS < 4% (134 cycles) and MNS ≥ 4% (122 cycles). We compared the rates of no transferrable embryo cycles, fertilization, cleavage, normal fertilization, abnormal fertilization, high-quality embryo and transferrable embryo between the two groups. A total of 75 fresh embryo transfer cycles were performed, 43 in the MNS < 4% group and the other 32 in the MNS ≥ 4% group. We also compared the rates of implantation, clinical pregnancy and abortion between the two groups.

RESULTSThere were no statistically significant differences between the two groups in the rates of no transferrable embryo cycles, fertilization, cleavage, normal fertilization, abnormal fertilization, high-quality embryo and transferrable embryo (P > 0.05). The rates of implantation, clinical pregnancy and abortion exhibited no remarkable differences either in the fresh embryo transfer cycles between the two groups (P > 0.05).

CONCLUSIONThe rate of MNS does not affect the clinical outcomes of conventional IVF in patients with one retrieved oocyte.

Abortion, Spontaneous ; Cleavage Stage, Ovum ; Embryo Implantation ; Female ; Fertilization ; Fertilization in Vitro ; methods ; statistics & numerical data ; Humans ; Male ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate ; Single Embryo Transfer ; statistics & numerical data ; Sperm Count ; Spermatozoa ; physiology

Radiotherapy is an important treatment of cervical cancer,the treatment of locally advanced cervical cancer mainly depends on external beam radiotherapy and brachytherapy.However,in the process of the cervical cancer radiotherapy,the vagina has an ambivalent role in the treatment of cervical cancer,being as well a target organ (upper vagina) as an organ at risk.Vaginal radiation-induced injury will appear when it received high doses of radiation.And sexual dysfunction caused by radiation-induced injury has become an important problem cervical cancer survivor.In this article,recent vaginal dose and vaginal radiation injury-related studies have been summarized to unravel the pathophysiological changes,clinical symptoms,clinical diagnosis and treatment of vaginal radiation-induced injury.

Objective To investigate the effect of laser artificial shrinkage(LAS)on pregnancy outcome in vitrification of human expanded blastocysts.Methods We selected 3859 frozen-thawed blastocyst-stage embryo transfers from January 2014 to December 2015.The transfers were divided into LAS group(n=3 176)and non-LAS group(n=683),which were then subdivided into ＜36 y subgroup and ≥36 y subgroup according to their age.Main outcomes measures were thawing rate,implantation rate and clinical pregnancy rate.Results Thawing rate, clinical pregnancy rate and implantation rate were 97.32%(5 453/5 603),66.81%(2 118/3 170),and 53.55%(2 912/5 438)in LAS group.In non-shrink group,they were 95.13%(1 173/1 233),62.70%(427/681),and 49.74%(582/1 170),which did not significantly differ from those in the former group(P＜0.05).Further analysis of the subgroups showed that thawing rate was significantly higher in LAS group than in non-shrink group of patients＜36 y(97.27% vs.95.33%;P＜0.05).Thawing rate and biochemical pregnancy rate were significantly higher in LAS group than in non-shrink group in patients ≥36 y(97.75% vs.93.66%;65.45% vs.50.65%,P＜0.05). Cancellation rate was not significantly different between the two groups(0.19% vs.0.29%, P ＞ 0.05). Conclusion LAS technique can increase thawing rate,clinical pregnancy rate and implantation rate before cryopreservation of blastocysts.

OBJECTIVETo evaluate the effect of alprazolam use on psychological status and hospitalization cost in patient with paroxysmal supraventricular tachycardia underwent electrophysiology studies or radiofrequency catheter ablation.

METHODSIn this prospective, randomized, double-blind, placebo-controlled study, 142 inpatients [77 males, mean age (43.1 +/- 14.5) years] were randomly assigned to receive alprazolam (0.4 mg qd at 10PM for 3 days, n = 72) or placebo (n = 70) 3 days before scheduled electrophysiology studies or radiofrequency catheter ablation. All patients were examined by the Chinese version of Symptom Checklist-90 (SCL-90) at 24 hours before the procedure.

RESULTSCompared with the placebo group, the scores of somatization (1.38 +/- 0.40 vs. 1.65 +/- 0.56, P < 0.01), anxiety (1.50 +/- 0.39 vs. 1.69 +/- 0.50, P < 0.05), phobic anxiety (1.24 +/- 0.36 vs. 1.47 +/- 0.57, P < 0.01), psychotism constructs (1.24 +/- 0.34 vs. 1.35 +/- 0.30, P < 0.05) and global severity index (1.36 +/- 0.35 vs. 1.49 +/- 0.37, P < 0.05) were significantly decreased in alprazolam group. The hospitalization costs were also significantly lower in alprazolam group (32 498 +/- 1170) yuan compared to placebo group (32 947 +/- 1096) yuan, P < 0.05.

CONCLUSIONThe alprazolam use before electrophysiology studies and radiofrequency catheter ablation can improve the patients' psychological status and reduce the hospitalization costs.

Adolescent ; Adult ; Aged ; Alprazolam ; therapeutic use ; Anti-Anxiety Agents ; therapeutic use ; Catheter Ablation ; economics ; psychology ; Double-Blind Method ; Female ; Hospitalization ; economics ; Humans ; Male ; Middle Aged ; Prospective Studies ; Tachycardia, Paroxysmal ; psychology ; therapy ; Tachycardia, Supraventricular ; psychology ; therapy ; Young Adult

OBJECTIVETo investigate the effects of carnitine on human sperm motility and its potential role in the treatment of male infertility diseases.

METHODSWe obtained sperm by testis puncture from obstructive azoospermia patients and cultured them in vitro with normal culture solution (the control group) and the solution with L-carnitine at the concentration of 100 and 250 mmol/L, respectively. We observed the changes in sperm motility and morphology before and after the treatment, detected the expressions of the germ-specific genes, Vasa, Dazl, Acr, Prm1 and ATPase 6.0 by RT-PCR, and investigated the relationship between L-carnitine and the genes associated with sperm development and maturation.

RESULTSAfter 24 -72 hours of treatment, the percentage of motile sperm was significantly higher in the 100 mmol/L L-carnitine group than in the control and 250 mmol/L L-carnitine groups (P < 0.01); the number of forward moving sperm was obviously increased and sperm morphology remained normal in the 100 mmol/L L-carnitine group. RT-PCR showed that L-carnitine increased the expressions of Acr, Prm1, Dazl and ATPase 6. 0 at the concentration of 100 mmol/L, and decreased the expressions of Dazl, Acr and Prm1 at 250 mmol/L.

CONCLUSIONL-carnitine at a proper concentration may improve the motility of incubated testicular sperm by upregulating the expressions of some sperm-specific genes, which helps sperm selection for intracytoplasmic sperm injection. However, a higher concentration of L-carnitine may reduce the expressions of these genes, probably due to its increased toxicity.

Azoospermia ; etiology ; genetics ; metabolism ; Carnitine ; pharmacology ; Cells, Cultured ; Gene Expression ; Humans ; Infertility, Male ; Male ; Reverse Transcriptase Polymerase Chain Reaction ; Sperm Count ; Spermatozoa ; drug effects ; metabolism ; Testis ; drug effects ; metabolism

OBJECTIVELong term glucocorticoid (prednisolone) treatment on human growth hormone (hGH) secretion in children and adolescents and to investigate the effectiveness and safety of the recombinant human growth hormone (rhGH) treatment.

METHODSTwelve patients (age: 10.4∓1.2 years) who were treated in Peking Union Medical College Hospital from September 1999 to November 2009 were enrolled in this study. All of them had taken prednisolone with a dose of 0.5∓2.0 mg/(kg.d) for 6~18 months. Two different hGH stimulating tests was done and their growth and development was evaluated at regular intervals. Seven patients were given rhGH with a dose of 0.1 U/(kg.d) for 6~12 months to improve their growth and development after half a year of prednisolone withdrawal when their disease conditions were improved.

RESULTSThe growth speed of these 12 children decreased significantly during prednisolone treatment compared with before prednisolone treatment (1.2∓0.3cm/year vs.3.7∓1.2 cm/year,P12 months than those with a 6~12 months course (P0.05). The growth speed of seven children who received rhGH therapy for half a year were increased from 2.2∓0.1cm/year to 7.8∓0.5cm/year (P<0.05), and then to 6.9∓0.4cm/year one year later.

CONCLUSIONSThe long-term glucocorticoid treatment can decrease the hGH secretion, and thus leads to short stature and agenesis. However, the rhGH replacement can safely and effectively improve growth and development in these children after their primary diseases are improved and glucocorticoids are withdrawn.

Adolescent ; Child ; Female ; Follow-Up Studies ; Glucocorticoids ; adverse effects ; therapeutic use ; Human Growth Hormone ; secretion ; therapeutic use ; Humans ; Male ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

Objective To investigate the occurrence and degree of radiation-induced injury in vagina after radical radiotherapy of cervical cancer.Methods A total of 282 cases of patients with cervical cancer were collected from November 2016 to September 2017.All of the above patients underwent radical radiotherapy from 2008 to 2017 in the First Affiliated Hospital of Xi′an Jiaotong University.The patients′International Federation of Gynecology and Obstetrics(FIGO)staging(2009),brachytherapy dose,whether receive synchronous chemotherapy or not,age and body mass index(BMI)for the occurrence and severity of vaginal radiation injury at different time periods were analyzed by cross-sectional survey method.The single factor would be analyzed by the method of Chi-square test and the multiple factors would be analyzed by logistic regression method to checkout. Results Of the 282 patients, the incidence of radiation-injury in vaginal was 84.4%(238/282), with the incidence rate of degree Ⅰ,Ⅱ and Ⅲradiation injury were respectively 50.7%(143/282),29.8%(84/282)and 3.9%(11/282;χ2=153.375,P<0.05),and there was no degree Ⅳ. Until the end of the follow-up time, the incidence of radiation-induced injury in vaginal after completing the treatment within 1 year,1-2 years,>2-<5 years and≥5 years were respectively 80.0%(24/30), 87.2%(102/117), 88.2%(60/68)and 77.6%(52/67; χ2=4.231, P=0.238). There were 30 cases be followed within 1 year after treatment,the incidence rate of degreeⅠ,ⅡandⅢof radiation injury in vagina was 60.0%(18/30), 20.0%(6/30)and 0, respectively (χ2=28.636, P<0.05). There were 117 cases be followed between 1- 2 years after treatment, the incidence rate of degree Ⅰ, Ⅱ and Ⅲ vaginal radiation-induced injury were 54.7%(64/117),29.9%(35/117)and 2.6%(3/117),respectively(χ2=77.198, P<0.05).There were 68 cases be followed between>2-<5 years after treatment,the incidence rate of degreeⅠ,Ⅱ and Ⅲ vaginal radiation-induced injury were 51.5%(35/68),33.8%(23/68)and 2.9%(2/68), respectively(χ2=39.525,P<0.05).There were 67 cases be followed≥5 years after treatment,the incidence rate of degreeⅠ,ⅡandⅢvaginal radiation injury were 38.8%(26/67),29.9%(20/67)and 9.0%(6/67), respectively(χ2=16.395, P<0.05). The single-factor analysis result indicated that the brachytherapy dose had an obvious effect on vaginal radiation-induced injury(χ2=5.344,P=0.021);however,other factors,such as age, BMI, FIGO stages and synchronous chemotherapy, had no obvious effect on vaginal radiation-induced injury(all P>0.05). The multifactor analysis indicated that the brachytherapy dose was an independent factor affecting the occurrence of vaginal radiation-induced injury(P=0.043). Conclusion After the radical radiotherapy of cervical cancer, the vaginal radiation-induced injury is associated with the dose of brachytherapy.