Objective:To explore the effect of previous different spontaneous abortion times on pregnancy outcomes of patients with the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was performed on the clinical data of patients with the first IVF/ICSI-ET in the Reproductive Center of Henan Provincial People's Hospital from January 1, 2010 to December 31, 2018. A total of 12 912 patients were included. According to the number of previous spontaneous abortions, the patients were divided into four groups: zero time group ( n=10 948), 1 time group ( n=1 506), 2 times group ( n=345) and ≥3 times group ( n=113). The basic data of patients and pregnancy outcomes after assisted pregnancy were compared among the four groups, and the influence of the number of previous spontaneous abortions on pregnancy outcomes of IVF/ICSI-ET patients was investigated by univariate and categorical multivariate logistic regression analysis. Results:Univariate logistic regression analysis showed that age, infertility duration, previous spontaneous abortion times, endometrial thickness, the numbers of embryos transferred and high-quality embryos transferred were all influencing factors of implantation rate, pregnancy rate, early spontaneous abortion rate and live birth rate (all P<0.001, except for the influence of endometrial thickness on early spontaneous abortion rate P=0.002). The types of embryo transferred, follicle-stimulating hormone (FSH) level, luteinizing hormone (LH) level, LH/FSH, and anti-Müllerian hormone (AMH) level all had effects on the implantation rate, the pregnancy rate, and the live birth rate (all P<0.001, except for the effect of AMH on the live birth rate P=0.002). Body mass index (BMI) was the influencing factor of early spontaneous abortion rate and live birth rate ( P=0.006, P=0.002). After adjusting for confounding factors, multiple regression analysis showed that with zero time group as the reference group, the implantation rate of ≥3 times group ( OR=0.63, 95% CI: 0.42-0.94, P=0.025) was significantly decreased; the early spontaneous abortion rate was significantly increased in 1 time group ( OR=1.56, 95% CI: 1.27-1.93, P<0.001), 2 times group ( OR=2.28, 95% CI: 1.61-3.23, P<0.001), and ≥3 times group ( OR=3.32, 95% CI: 1.89-5.82, P<0.001); the live birth rate was significantly reduced in 1 time group ( OR=0.80, 95% CI: 0.71-0.91, P<0.001), 2 times group ( OR=0.66, 95% CI: 0.52-0.84, P<0.001) and ≥3 times group ( OR=0.45, 95% CI: 0.29-0.67, P<0.001). Conclusion:The number of previous early spontaneous abortions is an independent factor affecting the implantation rate, the early spontaneous abortion rate and the live birth rate for patients undergoing IVF/ICSI-ET. With the increase of the number of previous early spontaneous abortions, the implantation rate and the live birth rate after IVF/ICSI were gradually decreased, and the risk of early spontaneous abortion gradually increased.

Objective:To study the relationship between endometrial thickness (EMT) at the time of human chorionic gonadotropin (hCG) trigger day or endometrial transformation day and spontaneous abortion in in vitro fertilization (IVF) cycle and analyze the threshold effect. Methods:A retrospective cohort study was performed to analyze the clinical data of infertile patients who underwent the first IVF cycle in the Reproductive Center of Henan Provincial People's Hospital from January 2010 to December 2018. The patients were divided into four groups according to EMT, group A: EMT<8 mm, group B: 8 mm≤EMT<10 mm, group C: 10 mm≤EMT<12 mm, and group D: EMT≥12 mm. The effect of EMT on spontaneous abortion rate during IVF cycle was investigated by univariate analysis, multivariate logistic regression analysis, smooth curve fitting and the threshold effect analysis.Results:In all 12 912 IVF cycles, 8 674 cycles got clinical pregnancy, 1 102 cycles resulted in early spontaneous miscarriage and the spontaneous abortion rate was 12.70%. Univariate regression analysis showed that age, body mass index, duration of infertility, type of infertility, male factors in infertility factors, No. of spontaneous abortions, EMT and No. of embryos transferred had influences on the spontaneous abortion rate (all P<0.05). Multivariate logistic regression analysis adjusted for confounding factors and group A was used as control group. The results showed that the spontaneous abortion rate of groups B, C and D was significantly lower than that of group A during embryo transfer at cleavage stage ( P=0.008 , P<0.001, P<0.001); there was no significant difference in spontaneous abortion rate with the increase of EMT during blastocyst stage ( P>0.05). The threshold effect analysis showed that when the EMT was <10.3 mm, the spontaneous abortion rate decreased significantly with the increasing of EMT for cleavage embryo, and the spontaneous abortion rate decreased 14.7% with each 1 mm increment in EMT ( OR=0.853, 95% CI: 0.792-0.918, P<0.001); there was no significant difference in spontaneous abortion rate when EMT was ≥10.3 mm ( OR=1.006, 95% CI: 0.959-1.056, P=0.798). The spontaneous abortion rate changed steadily with the increase of EMT, and the difference was not statistically significant for blastocyst embryo ( P>0.05). Conclusion:In IVF cycle, the relationship between EMT and spontaneous abortion was curvilinear for cleavage embryo. Before the EMT reached the threshold of 10.3 mm, the spontaneous abortion rate decreased significantly with the increase of EMT.

Objective:To explore the effect of previous different spontaneous abortion times on pregnancy outcomes of patients with the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was performed on the clinical data of patients with the first IVF/ICSI-ET in the Reproductive Center of Henan Provincial People's Hospital from January 1, 2010 to December 31, 2018. A total of 12 912 patients were included. According to the number of previous spontaneous abortions, the patients were divided into four groups: zero time group ( n=10 948), 1 time group ( n=1 506), 2 times group ( n=345) and ≥3 times group ( n=113). The basic data of patients and pregnancy outcomes after assisted pregnancy were compared among the four groups, and the influence of the number of previous spontaneous abortions on pregnancy outcomes of IVF/ICSI-ET patients was investigated by univariate and categorical multivariate logistic regression analysis. Results:Univariate logistic regression analysis showed that age, infertility duration, previous spontaneous abortion times, endometrial thickness, the numbers of embryos transferred and high-quality embryos transferred were all influencing factors of implantation rate, pregnancy rate, early spontaneous abortion rate and live birth rate (all P<0.001, except for the influence of endometrial thickness on early spontaneous abortion rate P=0.002). The types of embryo transferred, follicle-stimulating hormone (FSH) level, luteinizing hormone (LH) level, LH/FSH, and anti-Müllerian hormone (AMH) level all had effects on the implantation rate, the pregnancy rate, and the live birth rate (all P<0.001, except for the effect of AMH on the live birth rate P=0.002). Body mass index (BMI) was the influencing factor of early spontaneous abortion rate and live birth rate ( P=0.006, P=0.002). After adjusting for confounding factors, multiple regression analysis showed that with zero time group as the reference group, the implantation rate of ≥3 times group ( OR=0.63, 95% CI: 0.42-0.94, P=0.025) was significantly decreased; the early spontaneous abortion rate was significantly increased in 1 time group ( OR=1.56, 95% CI: 1.27-1.93, P<0.001), 2 times group ( OR=2.28, 95% CI: 1.61-3.23, P<0.001), and ≥3 times group ( OR=3.32, 95% CI: 1.89-5.82, P<0.001); the live birth rate was significantly reduced in 1 time group ( OR=0.80, 95% CI: 0.71-0.91, P<0.001), 2 times group ( OR=0.66, 95% CI: 0.52-0.84, P<0.001) and ≥3 times group ( OR=0.45, 95% CI: 0.29-0.67, P<0.001). Conclusion:The number of previous early spontaneous abortions is an independent factor affecting the implantation rate, the early spontaneous abortion rate and the live birth rate for patients undergoing IVF/ICSI-ET. With the increase of the number of previous early spontaneous abortions, the implantation rate and the live birth rate after IVF/ICSI were gradually decreased, and the risk of early spontaneous abortion gradually increased.

Objective:To study the relationship between endometrial thickness (EMT) at the time of human chorionic gonadotropin (hCG) trigger day or endometrial transformation day and spontaneous abortion in in vitro fertilization (IVF) cycle and analyze the threshold effect. Methods:A retrospective cohort study was performed to analyze the clinical data of infertile patients who underwent the first IVF cycle in the Reproductive Center of Henan Provincial People's Hospital from January 2010 to December 2018. The patients were divided into four groups according to EMT, group A: EMT<8 mm, group B: 8 mm≤EMT<10 mm, group C: 10 mm≤EMT<12 mm, and group D: EMT≥12 mm. The effect of EMT on spontaneous abortion rate during IVF cycle was investigated by univariate analysis, multivariate logistic regression analysis, smooth curve fitting and the threshold effect analysis.Results:In all 12 912 IVF cycles, 8 674 cycles got clinical pregnancy, 1 102 cycles resulted in early spontaneous miscarriage and the spontaneous abortion rate was 12.70%. Univariate regression analysis showed that age, body mass index, duration of infertility, type of infertility, male factors in infertility factors, No. of spontaneous abortions, EMT and No. of embryos transferred had influences on the spontaneous abortion rate (all P<0.05). Multivariate logistic regression analysis adjusted for confounding factors and group A was used as control group. The results showed that the spontaneous abortion rate of groups B, C and D was significantly lower than that of group A during embryo transfer at cleavage stage ( P=0.008 , P<0.001, P<0.001); there was no significant difference in spontaneous abortion rate with the increase of EMT during blastocyst stage ( P>0.05). The threshold effect analysis showed that when the EMT was <10.3 mm, the spontaneous abortion rate decreased significantly with the increasing of EMT for cleavage embryo, and the spontaneous abortion rate decreased 14.7% with each 1 mm increment in EMT ( OR=0.853, 95% CI: 0.792-0.918, P<0.001); there was no significant difference in spontaneous abortion rate when EMT was ≥10.3 mm ( OR=1.006, 95% CI: 0.959-1.056, P=0.798). The spontaneous abortion rate changed steadily with the increase of EMT, and the difference was not statistically significant for blastocyst embryo ( P>0.05). Conclusion:In IVF cycle, the relationship between EMT and spontaneous abortion was curvilinear for cleavage embryo. Before the EMT reached the threshold of 10.3 mm, the spontaneous abortion rate decreased significantly with the increase of EMT.

Objective To evaluate the effect of the integrated strategy in prevention and control of intestinal nematodiasis in Hongze County,so as to provide the evidence for formulating the control strategies and measures in the future. Methods Since 1995,the integrated strategy has been carried out for intestinal nematodiasis,and the measures included deworming,health ed?ucation,safe water,sanitation and environmental remediation. The effects of the integrated strategy were evaluated by the inves?tigations of the prevalence of soil?transmitted nematodiasis,awareness of health knowledge and behaviors of residents. Results From 1995 to 2014,601 900 person?times were administrated with deworming medication and the coverage rate of villages and towns was 100%. The benefit rate of safe water was 100%. The popularity rate of harmless toilets was 92.77%. The prevalence of intestinal nematodiasis decreased from 26.04%in 1995 to 0.56%in 2014,and the difference had statistical significance(χ2=693.54,P < 0.01). The awareness rate of health knowledge and correct rate of health behaviors increased from 43.13% and 40.94%in 1995 to 98.00%and 96.80%in 2012,respectively(χ2=181.97 and 182.14 respectively,P<0.01). Conclusion The prevalence of intestinal nematodiasis has been controlled effectively through the integrated strategy in Hongze County ,Jiang?su Province.