1.Association between homocysteine and recurrent pregnancy loss (RPL) and its effects on IVF/ICSI-ET outcomes in RPL patients
Manman LIU ; Rui ZHANG ; Hebo ZHANG ; Mengfan YUAN ; Bingnan REN ; Junwei ZHANG ; Feng LI ; Wenjuan ZHANG ; Chaozhao LIU ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2025;45(8):779-786
Objective:To investigate the association between homocysteine (Hcy) and recurrent pregnancy loss (RPL), as well as its impact on clinical pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:This retrospective cohort study collected clinical data from patients undergoing IVF/ICSI-ET at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between December 2020 and March 2024. Patients were divided into no history of pregnancy loss group (named control group, n=1 027) and RPL group ( n=743) based on history of pregnancy loss. Peripheral blood Hcy levels were compared between the two groups. Multivariate logistic regression was performed to adjust for confounding factors and determine whether Hcy is an independent risk factor for RPL. RPL patients were divided into four subgroups based on Hcy quartiles, named Q1 subgroup (Hcy<7.03 μmol/L), Q2 subgroup (7.03 μmol/L≤Hcy<8.63 μmol/L), Q3 subgroup (8.63 μmol/L≤Hcy<10.44 μmol/L), and Q4 subgroup (Hcy≥10.44 μmol/L), to further analyze the impact of Hcy level on pregnancy outcomes after IVF/ICSI-ET in these patients. Results:1) Baseline characteristics between control and RPL groups: statistically significant differences were observed in female age, male age, female body mass index (BMI), duration of infertility, cause of infertility, and peripheral blood Hcy levels (all P<0.05). 2) After adjusting for female age, male age, female BMI, duration of infertility, and cause of infertility via multivariate logistic regression, elevated Hcy levels was identified as an independent risk factor for RPL (a OR=1.366, 95% CI: 1.298-1.438, P<0.001). 3) Baseline characteristics of the four RPL subgroups: antral follicle count (AFC) differed significantly among Q1, Q2, Q3 and Q4 subgroups [17.00 (11.00, 24.00), 15.00 (10.00, 24.00), 14.00 (7.00, 22.25), 15.50 (8.00, 22.00), P=0.043]. No statistically significant differences were observed in other baseline characteristics (all P>0.05). 4) Pregnancy outcomes across the four RPL subgroups: miscarriage rates in the Q1, Q2, Q3 and Q4 subgroups were 18.18% (18/99), 30.61% (30/98), 33.70% (31/92), and 35.96% (32/89), respectively, live birth rates were 44.26% (81/183), 36.17% (68/188), 32.80% (61/186), and 30.65% (57/186), respectively. Intergroup differences in miscarriage rate and live birth rate were statistically significant ( P=0.033, P=0.036). Specifically, miscarriage rate in the Q3 and Q4 subgroups, and live birth rate in the Q4 subgroup were significantly higher than those in the Q1 subgroup (all q<0.05). However, no significant differences were observed in clinical pregnancy rate or early miscarriage rate among the four groups (all P>0.05). After adjusting for confounding factors using multivariate logistic regression, taking the Q1 subgroup as the control, there were no statistically significant differences in the clinical pregnancy rate between the remaining groups and the Q1 subgroup (all P>0.05). The early miscarriage rate in the Q3 subgroup (a OR=2.184, 95% CI: 1.077-4.426, P=0.030) and the early miscarriage rate in the Q4 subgroup (a OR=2.290, 95% CI: 1.116-4.697, P=0.024) were significantly higher than those in the Q1 subgroup; the miscarriage rate in the Q3 subgroup (a OR=2.207, 95% CI: 1.125-4.330, P=0.021) and the miscarriage rate in the Q4 subgroup (a OR=2.377, 95% CI: 1.209-4.674, P=0.012) were significantly higher than those in the Q1 subgroup; the live birth rate in the Q3 subgroup (a OR=0.615, 95% CI: 0.401-0.944, P=0.026) and the live birth rate in the Q4 subgroup (a OR=0.560, 95% CI: 0.364-0.863, P=0.009) were significantly lower than those in the Q1 subgroup. Conclusion:Elevated Hcy is a high-risk factor for RPL in IVF/ICSI-ET patients and may adversely affect pregnancy outcomes.
2.Association between homocysteine and recurrent pregnancy loss (RPL) and its effects on IVF/ICSI-ET outcomes in RPL patients
Manman LIU ; Rui ZHANG ; Hebo ZHANG ; Mengfan YUAN ; Bingnan REN ; Junwei ZHANG ; Feng LI ; Wenjuan ZHANG ; Chaozhao LIU ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2025;45(8):779-786
Objective:To investigate the association between homocysteine (Hcy) and recurrent pregnancy loss (RPL), as well as its impact on clinical pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:This retrospective cohort study collected clinical data from patients undergoing IVF/ICSI-ET at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University between December 2020 and March 2024. Patients were divided into no history of pregnancy loss group (named control group, n=1 027) and RPL group ( n=743) based on history of pregnancy loss. Peripheral blood Hcy levels were compared between the two groups. Multivariate logistic regression was performed to adjust for confounding factors and determine whether Hcy is an independent risk factor for RPL. RPL patients were divided into four subgroups based on Hcy quartiles, named Q1 subgroup (Hcy<7.03 μmol/L), Q2 subgroup (7.03 μmol/L≤Hcy<8.63 μmol/L), Q3 subgroup (8.63 μmol/L≤Hcy<10.44 μmol/L), and Q4 subgroup (Hcy≥10.44 μmol/L), to further analyze the impact of Hcy level on pregnancy outcomes after IVF/ICSI-ET in these patients. Results:1) Baseline characteristics between control and RPL groups: statistically significant differences were observed in female age, male age, female body mass index (BMI), duration of infertility, cause of infertility, and peripheral blood Hcy levels (all P<0.05). 2) After adjusting for female age, male age, female BMI, duration of infertility, and cause of infertility via multivariate logistic regression, elevated Hcy levels was identified as an independent risk factor for RPL (a OR=1.366, 95% CI: 1.298-1.438, P<0.001). 3) Baseline characteristics of the four RPL subgroups: antral follicle count (AFC) differed significantly among Q1, Q2, Q3 and Q4 subgroups [17.00 (11.00, 24.00), 15.00 (10.00, 24.00), 14.00 (7.00, 22.25), 15.50 (8.00, 22.00), P=0.043]. No statistically significant differences were observed in other baseline characteristics (all P>0.05). 4) Pregnancy outcomes across the four RPL subgroups: miscarriage rates in the Q1, Q2, Q3 and Q4 subgroups were 18.18% (18/99), 30.61% (30/98), 33.70% (31/92), and 35.96% (32/89), respectively, live birth rates were 44.26% (81/183), 36.17% (68/188), 32.80% (61/186), and 30.65% (57/186), respectively. Intergroup differences in miscarriage rate and live birth rate were statistically significant ( P=0.033, P=0.036). Specifically, miscarriage rate in the Q3 and Q4 subgroups, and live birth rate in the Q4 subgroup were significantly higher than those in the Q1 subgroup (all q<0.05). However, no significant differences were observed in clinical pregnancy rate or early miscarriage rate among the four groups (all P>0.05). After adjusting for confounding factors using multivariate logistic regression, taking the Q1 subgroup as the control, there were no statistically significant differences in the clinical pregnancy rate between the remaining groups and the Q1 subgroup (all P>0.05). The early miscarriage rate in the Q3 subgroup (a OR=2.184, 95% CI: 1.077-4.426, P=0.030) and the early miscarriage rate in the Q4 subgroup (a OR=2.290, 95% CI: 1.116-4.697, P=0.024) were significantly higher than those in the Q1 subgroup; the miscarriage rate in the Q3 subgroup (a OR=2.207, 95% CI: 1.125-4.330, P=0.021) and the miscarriage rate in the Q4 subgroup (a OR=2.377, 95% CI: 1.209-4.674, P=0.012) were significantly higher than those in the Q1 subgroup; the live birth rate in the Q3 subgroup (a OR=0.615, 95% CI: 0.401-0.944, P=0.026) and the live birth rate in the Q4 subgroup (a OR=0.560, 95% CI: 0.364-0.863, P=0.009) were significantly lower than those in the Q1 subgroup. Conclusion:Elevated Hcy is a high-risk factor for RPL in IVF/ICSI-ET patients and may adversely affect pregnancy outcomes.
3.Effect of EECP on vascular endothelial growth factor and cardiopulmonary function in patients with SAP
Wanji GUO ; Manman LI ; Caiping ZHENG ; Xinxin REN ; Kang CHEN ; Xiaoyan PENG ; Qingdan YUAN ; Zixuan LI
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(12):1428-1432
Objective To explore the effect of enhanced external counterpulsation(EECP)on ser-um vascular endothelial growth factor(VEGF)level and cardiopulmonary function in patients with stable angina pectoris(SAP).Methods A prospective double-blind controlled trial was con-ducted on 300 SAP patients admitted to Departments of Cardiovascular Medicine and Geriatrics of Jincheng People's Hospital from January 2021 to December 2023.They were randomly divided in-to study group(150 cases)and control group(150 cases).Coronary angiography or coronary CT angiography indicated that there were 101,101 and 98 cases,respectively,of one-,two-and three-vessel diseases.The patients of both groups were given conventional drug therapy(secondary pre-ventive drug for coronary heart disease),and those of the study group received EECP therapy ad-ditionally.The changes in serum VEGF level and related indicators of cardiopulmonary exercise test before and after one course of standardized treatment(36 h)were observed and compared be-tween the two groups.Results The VEGF level was significantly higher in the patients with three-vessel disease than those with two-and one-vessel diseases(P<0.05).The level was obvi-ously increased in the study group and control group after intervention than before(238.41±82.57 ng/L vs 218.75±82.58 ng/L,224.47±85.08 ng/L vs 218.96±83.04 ng/L,P<0.01),and the former group obtained better improvement of VEGF than the latter group(P<0.01).The level in the study group and the control group with one-,two-and three-vessel lesions was notably higher than those before intervention(P<0.05,P<0.01).The study group with one-,two-and three-vessel lesions had statistical differences in the VEGF level after intervention when compared with that in the control group(P<0.01).The levels of Peak VO2/kg and VO2/kg@AT were sig-nificantly increased in both groups after intervention than before(P<0.01),with those of the study group notably higher than those of the control group[19.87±5.18 ml/(kg·min)vs 17.15±5.18 ml/(kg·min),P<0.01;14.33±2.24 ml/(kg·min)vs 12.81±1.57 ml/(kg·min),P<0.01].Conclusion EECP treatment is helpful to increase VEGF level and improve cardiopul-monary function in SAP patients.
4.The effect of phased goal oriented liquid therapy on tissue perfusion and cognitive function in lung cancer patients undergoing radical surgery
Xianghui WANG ; Yongxue CHEN ; Xinbo WANG ; Xiaona WEI ; Manman MA ; Yan SUN ; Danqi REN ; Yanan LIU ; Yaning GUO ; Rui WANG
Journal of Chinese Physician 2024;26(1):43-47
Objective:To explore the effects of phased goal directed fluid therapy (GDFT) during anesthesia surgery on tissue perfusion and cognitive function in patients undergoing radical lung cancer surgery.Methods:A total of 108 lung cancer patients were prospectively selected and randomly divided into a control group and a study group using a random number table method. The control group received classical restrictive liquid therapy, while the study group received staged GDFT. We compared the surgical time, intraoperative blood loss, colloid fluid dosage, crystalloid fluid dosage, total output, and urine volume between two groups of patients; Two groups of patients were compared in terms of oxygenation index (OI), respiratory index (RI), central venous oxygen saturation (ScvO 2), lactate (Lac), central venous arterial carbon dioxide partial pressure difference (Pcv-aCO 2), oxygen supply index (DO 2I), and oxygen uptake rate (O 2ERe) before anesthesia induction (T 0), before single lung ventilation (T 1), 1 hour of single lung ventilation (T 2), immediate resumption of dual lung ventilation (T 3), 30 minutes of dual lung ventilation (T 4), and after surgery (T 5); The Mini Mental State Examination (MMSE) was used to evaluate the cognitive function scores of two groups of patients 1 day before surgery and 1 and 3 days after surgery, while recording the incidence of cognitive dysfunction (POCD) and pulmonary complications (including pulmonary infection, acute lung injury, pulmonary embolism, pulmonary edema, atelectasis, etc.) within 3 days after surgery. Results:The amount of crystal fluid and urine output in the research group was significantly lower than that in the control group, while the amount of colloidal fluid was significantly higher than that in the control group (all P<0.05). The OI of the study group T 1-T 5 was significantly higher than that of the control group, while the RI of T 2-T 5 was significantly lower than that of the control group (all P<0.05). The ScvO 2 of the study group T 1 to T 5 was significantly higher than that of the control group, and the Lac was significantly lower than that of the control group (all P<0.05); The MMSE scores of both groups of patients were significantly lower than those before surgery on day 1 and 3 after surgery, and the MMSE scores of the study group were significantly higher than those of the control group on day 1 and 3 after surgery (all P<0.05). The incidence of POCD within 3 days after surgery in the study group was 16.67%(9/54), lower than 37.04%(20/54) in the control group (χ 2=5.704, P=0.017); The incidence of pulmonary complications in the study group was lower than that in the control group (5.56% vs 22.22%, χ 2=4.955, P=0.026). Conclusions:The application of staged GDFT during anesthesia in patients undergoing radical lung cancer surgery can further improve tissue perfusion, improve microcirculation and oxygen supply-demand balance of systemic organs and tissues, including the brain, alleviate perioperative brain function damage, and reduce the occurrence of postoperative POCD compared to conventional liquid therapy.
5.Effect of vaginal microbiota disorder on pregnancy outcomes in frozen-thawed embryo transfer patients: a retrospective cohort study
Manman LIU ; Hebo ZHANG ; Shilian XU ; Rui ZHANG ; Jiangdi HUANG ; Ruxue YANG ; Liang ZHOU ; Bingnan REN ; Junwei ZHANG ; Zhaozhao LIU ; Wenjuan ZHANG ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2024;44(5):456-462
Objective:To explore the effect of vaginal microbiota disorder on pregnancy outcomes in the first-time frozen-thawed embryo transfer (FET) patients and perinatal outcomes in single pregnancy live delivery patients.Methods:The clinical data of 2 299 cycles of FET patients in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2021 to December 2022 were collected in a retrospective cohort study. According to the types of dominant bacteria in the vaginal microbiota before transplantation, they were divided into three groups: control group (dominant bacteria were Lactobacillus, which was Gram positive bacteria, 1 849 cycles), the Gram negative bacilli group (191 cycles), and the Gram positive cocci group (259 cycles). Baseline data and pregnancy outcomes were compared among the three groups. The perinatal outcomes of select single pregnancy live birth FET patients who met the inclusion criteria were further analyzed among the three groups. The main observation indicators were live birth rate, miscarriage rate, and preterm birth rate. A multivariate logistic regression model was used to control confounding factors in the main observation indicators, and to analyze the relationship between dominant bacterial types in the vaginal microbiota and live birth rate, miscarriage rate, and preterm birth rate.Results:The difference in endometrial thickness on the day of transplantation among control group, Gram negative bacilli group, and Gram positive cocci group was statistically significant [(9.38±1.58) mm, (9.56±1.70) mm, and (9.84±1.74) mm, respectively, P<0.001]. In the endometrium preparation methods, the proportion of down-regulation+artificial cycle patients in the Gram positive cocci group was higher than that in control group, and the difference was statistically significant [13.13% (34/259) and 7.46% (138/1 849), respectively, P<0.016 7]. In the pregnancy outcomes, there was a statistically significant difference in live birth rate among control group, Gram negative bacilli group, and Gram positive cocci group [49.86% (922/1 849), 49.21% (94/191) and 41.70% (108/259), respectively, P=0.048]. The live birth rate of the Gram positive cocci group was lower than that of control group, and the difference between the two groups was statistically significant ( P<0.016 7). There were no statistically significant differences in other pregnancy outcomes and perinatal outcomes of single pregnancy live birth FET patients (all P>0.05). The multivariate logistic regression model corrected for female age, infertility years, basal follicle stimulating hormone, anti-Müllerian hormone, proportion of single embryo transfer, proportion of single blastocyst transfer, endometrial thickness on transfer day, and endometrial preparation methods, Gram positive cocci were independent risk factors for live brith after FET transplantation (a OR=0.73, 95% CI: 0.55-0.95, P=0.021). Conclusion:The dominant bacteria in the vaginal microbiota before embryo transfer are Gram positive cocci, which may be related to a decrease in live birth rate in first-time FET patients, but not significantly related to the perinatal outcomes.
6.Effect of vaginal microbiota disorder on pregnancy outcomes in frozen-thawed embryo transfer patients: a retrospective cohort study
Manman LIU ; Hebo ZHANG ; Shilian XU ; Rui ZHANG ; Jiangdi HUANG ; Ruxue YANG ; Liang ZHOU ; Bingnan REN ; Junwei ZHANG ; Zhaozhao LIU ; Wenjuan ZHANG ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2024;44(5):456-462
Objective:To explore the effect of vaginal microbiota disorder on pregnancy outcomes in the first-time frozen-thawed embryo transfer (FET) patients and perinatal outcomes in single pregnancy live delivery patients.Methods:The clinical data of 2 299 cycles of FET patients in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2021 to December 2022 were collected in a retrospective cohort study. According to the types of dominant bacteria in the vaginal microbiota before transplantation, they were divided into three groups: control group (dominant bacteria were Lactobacillus, which was Gram positive bacteria, 1 849 cycles), the Gram negative bacilli group (191 cycles), and the Gram positive cocci group (259 cycles). Baseline data and pregnancy outcomes were compared among the three groups. The perinatal outcomes of select single pregnancy live birth FET patients who met the inclusion criteria were further analyzed among the three groups. The main observation indicators were live birth rate, miscarriage rate, and preterm birth rate. A multivariate logistic regression model was used to control confounding factors in the main observation indicators, and to analyze the relationship between dominant bacterial types in the vaginal microbiota and live birth rate, miscarriage rate, and preterm birth rate.Results:The difference in endometrial thickness on the day of transplantation among control group, Gram negative bacilli group, and Gram positive cocci group was statistically significant [(9.38±1.58) mm, (9.56±1.70) mm, and (9.84±1.74) mm, respectively, P<0.001]. In the endometrium preparation methods, the proportion of down-regulation+artificial cycle patients in the Gram positive cocci group was higher than that in control group, and the difference was statistically significant [13.13% (34/259) and 7.46% (138/1 849), respectively, P<0.016 7]. In the pregnancy outcomes, there was a statistically significant difference in live birth rate among control group, Gram negative bacilli group, and Gram positive cocci group [49.86% (922/1 849), 49.21% (94/191) and 41.70% (108/259), respectively, P=0.048]. The live birth rate of the Gram positive cocci group was lower than that of control group, and the difference between the two groups was statistically significant ( P<0.016 7). There were no statistically significant differences in other pregnancy outcomes and perinatal outcomes of single pregnancy live birth FET patients (all P>0.05). The multivariate logistic regression model corrected for female age, infertility years, basal follicle stimulating hormone, anti-Müllerian hormone, proportion of single embryo transfer, proportion of single blastocyst transfer, endometrial thickness on transfer day, and endometrial preparation methods, Gram positive cocci were independent risk factors for live brith after FET transplantation (a OR=0.73, 95% CI: 0.55-0.95, P=0.021). Conclusion:The dominant bacteria in the vaginal microbiota before embryo transfer are Gram positive cocci, which may be related to a decrease in live birth rate in first-time FET patients, but not significantly related to the perinatal outcomes.
7.Effect of EECP on vascular endothelial growth factor and cardiopulmonary function in patients with SAP
Wanji GUO ; Manman LI ; Caiping ZHENG ; Xinxin REN ; Kang CHEN ; Xiaoyan PENG ; Qingdan YUAN ; Zixuan LI
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(12):1428-1432
Objective To explore the effect of enhanced external counterpulsation(EECP)on ser-um vascular endothelial growth factor(VEGF)level and cardiopulmonary function in patients with stable angina pectoris(SAP).Methods A prospective double-blind controlled trial was con-ducted on 300 SAP patients admitted to Departments of Cardiovascular Medicine and Geriatrics of Jincheng People's Hospital from January 2021 to December 2023.They were randomly divided in-to study group(150 cases)and control group(150 cases).Coronary angiography or coronary CT angiography indicated that there were 101,101 and 98 cases,respectively,of one-,two-and three-vessel diseases.The patients of both groups were given conventional drug therapy(secondary pre-ventive drug for coronary heart disease),and those of the study group received EECP therapy ad-ditionally.The changes in serum VEGF level and related indicators of cardiopulmonary exercise test before and after one course of standardized treatment(36 h)were observed and compared be-tween the two groups.Results The VEGF level was significantly higher in the patients with three-vessel disease than those with two-and one-vessel diseases(P<0.05).The level was obvi-ously increased in the study group and control group after intervention than before(238.41±82.57 ng/L vs 218.75±82.58 ng/L,224.47±85.08 ng/L vs 218.96±83.04 ng/L,P<0.01),and the former group obtained better improvement of VEGF than the latter group(P<0.01).The level in the study group and the control group with one-,two-and three-vessel lesions was notably higher than those before intervention(P<0.05,P<0.01).The study group with one-,two-and three-vessel lesions had statistical differences in the VEGF level after intervention when compared with that in the control group(P<0.01).The levels of Peak VO2/kg and VO2/kg@AT were sig-nificantly increased in both groups after intervention than before(P<0.01),with those of the study group notably higher than those of the control group[19.87±5.18 ml/(kg·min)vs 17.15±5.18 ml/(kg·min),P<0.01;14.33±2.24 ml/(kg·min)vs 12.81±1.57 ml/(kg·min),P<0.01].Conclusion EECP treatment is helpful to increase VEGF level and improve cardiopul-monary function in SAP patients.
8.Embryo transfer strategies of early follicular phase prolonged protocol
Junwei ZHANG ; Bingnan REN ; Sheling WU ; Yanli WU ; Jijun HU ; Manman LIU ; Lijun SUN ; Xingling WANG ; Yichun GUAN ; Mingze DU
Chinese Journal of Reproduction and Contraception 2021;41(7):618-623
Objective:To investigate the embryo transfer strategies of early follicular phase prolonged protocol, to reduce the risk of multiple birth rate while achieving a higher live birth rate.Methods:It was a retrospective cohort study. Patients who underwent gonadotropin-releasing hormone (GnRH) agonist protocols in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to February 2019 were included. According to the type of embryos transferred, we divided all cycles into four groups, fresh cycle cleavage stage embryo transfer group (group A), fresh cycle blastocyst transfer group (group B), freeze-thaw cleavage stage embryo transfer group (group C), freeze-thaw blastocyst transfer group (group D). The main outcome measures were live birth rate and multiple birth rate. Binary logistic regression was used to correct confounding factors.Results:The risk of moderate to severe ovarian hyperstimulation syndrome (OHSS) in group A [4.8% (110/2283)] was higher than that in group C [1.0% (6/614), P<0.001] and group D [2.1% (16/762), P<0.001]. The risk of moderate to severe OHSS in group B [3.8% (42/1116)] was higher than that in group C ( P<0.001). The multiple birth rate of the two embryos transfer group [group A 23.4% (535/2283), group C 20.8% (128/614) ] was significantly higher than that of the one blastocyst transfer group [group B 1.4% (16/1116), group D 0.9% (7/762)], and the difference was statistically significant ( P<0.001). The clinical pregnancy rate [68.7% (767/1116)] and the live birth rate [59.6% (665/1116)] of group B were higher than those of group A [63.5% (1449/2283), P=0.003; 54.8% (1250/2283), P=0.008], group C [60.1% (369/614), P<0.001; 51.6% (317/614), P=0.001] and group D [62.7% (478/762), P=0.007; 52.8% (402/762), P=0.003], but there was no statistical difference among group A, group C and group D. Taking group B as a reference, the live birth rate of group A (a OR=0.86, 95% CI=0.74-0.99, P=0.044), group C (a OR=76, 95% CI=0.62-0.93, P=0.008) and group D (a OR=0.79, 95% CI=0.65-0.95, P=0.013) was lower than that of group B. Conclusion:For the early follicular phase prolonged protocol, based on the control of OHSS, fresh cycle single blastocyst transplantation is preferred. While obtaining a higher live birth rate, the multiple birth rate is significantly reduced.
9.Embryo transfer strategies of early follicular phase prolonged protocol
Junwei ZHANG ; Bingnan REN ; Sheling WU ; Yanli WU ; Jijun HU ; Manman LIU ; Lijun SUN ; Xingling WANG ; Yichun GUAN ; Mingze DU
Chinese Journal of Reproduction and Contraception 2021;41(7):618-623
Objective:To investigate the embryo transfer strategies of early follicular phase prolonged protocol, to reduce the risk of multiple birth rate while achieving a higher live birth rate.Methods:It was a retrospective cohort study. Patients who underwent gonadotropin-releasing hormone (GnRH) agonist protocols in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to February 2019 were included. According to the type of embryos transferred, we divided all cycles into four groups, fresh cycle cleavage stage embryo transfer group (group A), fresh cycle blastocyst transfer group (group B), freeze-thaw cleavage stage embryo transfer group (group C), freeze-thaw blastocyst transfer group (group D). The main outcome measures were live birth rate and multiple birth rate. Binary logistic regression was used to correct confounding factors.Results:The risk of moderate to severe ovarian hyperstimulation syndrome (OHSS) in group A [4.8% (110/2283)] was higher than that in group C [1.0% (6/614), P<0.001] and group D [2.1% (16/762), P<0.001]. The risk of moderate to severe OHSS in group B [3.8% (42/1116)] was higher than that in group C ( P<0.001). The multiple birth rate of the two embryos transfer group [group A 23.4% (535/2283), group C 20.8% (128/614) ] was significantly higher than that of the one blastocyst transfer group [group B 1.4% (16/1116), group D 0.9% (7/762)], and the difference was statistically significant ( P<0.001). The clinical pregnancy rate [68.7% (767/1116)] and the live birth rate [59.6% (665/1116)] of group B were higher than those of group A [63.5% (1449/2283), P=0.003; 54.8% (1250/2283), P=0.008], group C [60.1% (369/614), P<0.001; 51.6% (317/614), P=0.001] and group D [62.7% (478/762), P=0.007; 52.8% (402/762), P=0.003], but there was no statistical difference among group A, group C and group D. Taking group B as a reference, the live birth rate of group A (a OR=0.86, 95% CI=0.74-0.99, P=0.044), group C (a OR=76, 95% CI=0.62-0.93, P=0.008) and group D (a OR=0.79, 95% CI=0.65-0.95, P=0.013) was lower than that of group B. Conclusion:For the early follicular phase prolonged protocol, based on the control of OHSS, fresh cycle single blastocyst transplantation is preferred. While obtaining a higher live birth rate, the multiple birth rate is significantly reduced.
10. Experimental studies on the repair and restitution of cartilage by cartilage acellular extracellular matrix and adipose tissue-derived stem cells
Lu WANG ; Manman REN ; Yuluo JIAN ; Baoxi MENG ; Fulian MA ; Wanjun WANG ; Shuying GUO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2019;54(2):133-138
Objective:
To investigate the effects of the repair and restitution of ear-shaped cartilage by adipose tissue-derived stem cells(ADSC) and cartilage acellular extracellular matrix.
Methods:
ADSC were extracted by digesting with collagenase type II from the adipose tissue from 32 patients with adiposity whose fats were drawn, and were cultured and subcultured in vitro. The natural biological scaffolds were prepared by acellular method using porcine ear cartilage, and then the second generation ADSC(5.0×107/ml) were inoculated on the preformed natural bio-scaffold scaffold by culturing

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