Objective:To investigate whether there are differences in clinical pregnancy and perinatal outcomes among different protocols for artificial insemination by donor (AID) in female patients aged ≤35 years.Methods:This retrospective cohort study analyzed clinical data of patients who underwent AID at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2016 to January 31, 2021. Based on ovulation induction therapy, patients were divided into 4 groups: natural cycle (NC) group, letrozole (LE)/clomiphene (CC) group, gonadotropin (Gn) group and LE/CC combined with Gn (LE/CC+Gn) group. The clinical outcomes, incidence of complications, and offspring health were compared among these groups, and logistic regression analysis was employed to investigate the effects of different protocols on the clinical and perinatal outcomes of AID cycles.Results:In NC group, LE/CC group, Gn group and LE/CC+Gn group, the cycle cancellation rate [0.5% (11/2 147), 1.1% (12/1 045), 1.6% (9/549), 3.2% (9/315), P<0.001], the clinical pregnancy rate [31.5% (673/2 136), 35.8% (370/1 033), 42.8% (231/540), 38.2% (117/306), P<0.001], the multiple pregnancy rate [0.7% (5/673), 3.2% (12/370), 3.5% (8/231), 6.8% (8/117), P<0.001], the abortion rate [12.8% (86/673), 9.2% (34/370), 5.2% (12/231), 8.5% (10/117), P=0.008] and the live birth rate [27.2% (581/2 136), 31.4% (324/1 033), 40.0% (216/540), 34.3% (105/306), P<0.001] were statistically significant, while the differences among the four groups in the ectopic pregnancy rate, the preterm birth rate, and the overdue birth rate were not statistically significant (all P>0.05). After adjusting for confounding factors, the differences were not statistically significant in all indicators compared with the NC group (all P>0.05), except for the miscarriage rate in the LE/CC+Gn group, which was significantly higher than that in the NC group (a OR=2.141, 95% CI: 1.12-4.09; P=0.021). For patients who have been using the same treatment protocol, the cumulative pregnancy rate and the cumulative live birth rate in the NC group and the LE/CC group increased with the increase of assisted reproductive cycles, and the difference was statistically significant (all P<0.001). Regardless of whether confounding factors were adjusted, there were no statistically significant differences in neonatal mortality rate, low birth weight rate, normal birth weight rate, macrosomia rate, and male-to-female ratio among the groups (all P>0.05). Conclusion:In AID cycles with female patients aged ≤35 years, stimulated cycles had similar pregnancy outcomes to natural cycles and did not increase the risk of adverse neonatal outcomes or multiple pregnancies. Choosing the LE/CC stimulation protocol can improve the cumulative pregnancy rate of patients with abnormal ovarian follicle development or ovulation function.

Objective:To investigate whether there are differences in clinical pregnancy and perinatal outcomes among different protocols for artificial insemination by donor (AID) in female patients aged ≤35 years.Methods:This retrospective cohort study analyzed clinical data of patients who underwent AID at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2016 to January 31, 2021. Based on ovulation induction therapy, patients were divided into 4 groups: natural cycle (NC) group, letrozole (LE)/clomiphene (CC) group, gonadotropin (Gn) group and LE/CC combined with Gn (LE/CC+Gn) group. The clinical outcomes, incidence of complications, and offspring health were compared among these groups, and logistic regression analysis was employed to investigate the effects of different protocols on the clinical and perinatal outcomes of AID cycles.Results:In NC group, LE/CC group, Gn group and LE/CC+Gn group, the cycle cancellation rate [0.5% (11/2 147), 1.1% (12/1 045), 1.6% (9/549), 3.2% (9/315), P<0.001], the clinical pregnancy rate [31.5% (673/2 136), 35.8% (370/1 033), 42.8% (231/540), 38.2% (117/306), P<0.001], the multiple pregnancy rate [0.7% (5/673), 3.2% (12/370), 3.5% (8/231), 6.8% (8/117), P<0.001], the abortion rate [12.8% (86/673), 9.2% (34/370), 5.2% (12/231), 8.5% (10/117), P=0.008] and the live birth rate [27.2% (581/2 136), 31.4% (324/1 033), 40.0% (216/540), 34.3% (105/306), P<0.001] were statistically significant, while the differences among the four groups in the ectopic pregnancy rate, the preterm birth rate, and the overdue birth rate were not statistically significant (all P>0.05). After adjusting for confounding factors, the differences were not statistically significant in all indicators compared with the NC group (all P>0.05), except for the miscarriage rate in the LE/CC+Gn group, which was significantly higher than that in the NC group (a OR=2.141, 95% CI: 1.12-4.09; P=0.021). For patients who have been using the same treatment protocol, the cumulative pregnancy rate and the cumulative live birth rate in the NC group and the LE/CC group increased with the increase of assisted reproductive cycles, and the difference was statistically significant (all P<0.001). Regardless of whether confounding factors were adjusted, there were no statistically significant differences in neonatal mortality rate, low birth weight rate, normal birth weight rate, macrosomia rate, and male-to-female ratio among the groups (all P>0.05). Conclusion:In AID cycles with female patients aged ≤35 years, stimulated cycles had similar pregnancy outcomes to natural cycles and did not increase the risk of adverse neonatal outcomes or multiple pregnancies. Choosing the LE/CC stimulation protocol can improve the cumulative pregnancy rate of patients with abnormal ovarian follicle development or ovulation function.

OBJECTIVETo compare the clinical therapeutic effects and safety on menopausal symptoms between manual acupuncture (MA) and electroacupuncture (EA).

METHODSFifty patients were randomized into an MA group (25 cases) and an EA group (25 cases). In the MA group, the regular needling technique and pseudo-EA were used at Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25) and Sanyinjiao (SP 6). In the EA group, the acupoints were the same as the MA group and stimulated with EA and pseudo-MA (no manipulation applied in treatment), with disperse-dense wave, 10 Hz/50 Hz, 0.5 to 1.0 mA. In the two groups, the needles were retained for 30 min. The treatment was given once every two days, three times a week, totally for 8 consecutive weeks. The results of the menopause rating scale (MRS), the menopause-specific quality of life (MENQOL), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) as well as adverse reactions were evaluated before treatment, in 4 and 8 weeks of treatment separately.

RESULTSCompared with those before treatment, the scores of MRS, MENQOL, SAS and SDS were all reduced in the 4 and 8 weeks of treatment in the two groups (all<0.05). The results in 8 weeks of treatment were lower than those in 4 weeks of treatment in the two groups (all<0.05). The differen-ces were not significant statistically between the two groups (all>0.05). Compared with those before treatment, the levels of FSH and LH reduced and Eincreased after treatment in the two groups, without significant differences (all>0.05). The differences were not significant statistically between the two groups (all>0.05). The severe adverse reactions were not found in the treatment of the two groups.

CONCLUSIONSBoth manual acupuncture and electroacupuncture relieve the symptoms of depression and anxiety in menopausal syndrome,improve the living quality and do not induce apparent changes in serological sex hormones in the patients.