Objective:To explore the effect of preimplantation genetic testing (PGT) on perinatal outcome and offspring health.Methods:Retrospective case-control analysis was made on the data of patients undergoing PGT and intracytoplasmic sperm injection (ICSI) assisted pregnancy and single blastocyst transplantation in Reproductive Medicine Center of the Second Affiliated Hospital of Naval Medical University from January 2015 to August 2021. A total of 882 patients were included and 1 081 cycles of frozen-thawed embryo transfer (FET) were performed. Among them, 399 patients in the PGT group underwent 527 cycles, and 483 patients in the ICSI group underwent 554 cycles. According to the different indications of PGT technology, they were divided into PGT for structural rearrangements/monogenic defects/single gene defects monogenic (PGT-SR/M) subgroup and PGT for aneuploidies (PGT-A) subgroup. The clinical pregnancy rate, the abortion rate and the live birth rate were compared with those in the ICSI group. The clinical pregnancy after transplantation was analyzed, and the live birth was taken as the observation end point. There were 102 cases in the PGT-SR/M subgroup, 184 cases in the PGT-A subgroup, and 268 cases in the ICSI group. The perinatal outcome and the safety of offspring were compared respectively.Results:The clinical pregnancy rate in the PGT-SR/M subgroup [71.96% (136/189)] was higher than that in the ICSI group [61.73% (342/554), P=0.011], while there was no statistically significant difference between the PGT-A subgroup [64.50% (218/338)] and the ICSI group ( P>0.05). The live birth rate of both PGT-SR/M subgroup and PGT-A subgroup was higher than that of the ICSI group, but the differences were not statistically significant (all P>0.05). There were no statistically significant differences in the rates of miscarriage, premature birth, and pregnancy complications among the groups (all P>0.05). In addition, there were no statistically significant differences between the PGT-SR/M subgroup and the PGT-A subgroup in terms of low birth weight rate, macrosomia birth rate, and the incidence of birth defect (all P>0.05). The growth and development curve of children in the PGT group was normal within 2 years of age, and there were no statistically significant differences in height and weight between the PGT group and the ICSI group (all P>0.05). Conclusion:Under the same fertilization method, invasive embryo biopsy procedures did not increase the incidence of perinatal complications during pregnancy, and no adverse effects of PGT on the growth and development of offspring have been found.

Objective:To explore the effect of preimplantation genetic testing (PGT) on perinatal outcome and offspring health.Methods:Retrospective case-control analysis was made on the data of patients undergoing PGT and intracytoplasmic sperm injection (ICSI) assisted pregnancy and single blastocyst transplantation in Reproductive Medicine Center of the Second Affiliated Hospital of Naval Medical University from January 2015 to August 2021. A total of 882 patients were included and 1 081 cycles of frozen-thawed embryo transfer (FET) were performed. Among them, 399 patients in the PGT group underwent 527 cycles, and 483 patients in the ICSI group underwent 554 cycles. According to the different indications of PGT technology, they were divided into PGT for structural rearrangements/monogenic defects/single gene defects monogenic (PGT-SR/M) subgroup and PGT for aneuploidies (PGT-A) subgroup. The clinical pregnancy rate, the abortion rate and the live birth rate were compared with those in the ICSI group. The clinical pregnancy after transplantation was analyzed, and the live birth was taken as the observation end point. There were 102 cases in the PGT-SR/M subgroup, 184 cases in the PGT-A subgroup, and 268 cases in the ICSI group. The perinatal outcome and the safety of offspring were compared respectively.Results:The clinical pregnancy rate in the PGT-SR/M subgroup [71.96% (136/189)] was higher than that in the ICSI group [61.73% (342/554), P=0.011], while there was no statistically significant difference between the PGT-A subgroup [64.50% (218/338)] and the ICSI group ( P>0.05). The live birth rate of both PGT-SR/M subgroup and PGT-A subgroup was higher than that of the ICSI group, but the differences were not statistically significant (all P>0.05). There were no statistically significant differences in the rates of miscarriage, premature birth, and pregnancy complications among the groups (all P>0.05). In addition, there were no statistically significant differences between the PGT-SR/M subgroup and the PGT-A subgroup in terms of low birth weight rate, macrosomia birth rate, and the incidence of birth defect (all P>0.05). The growth and development curve of children in the PGT group was normal within 2 years of age, and there were no statistically significant differences in height and weight between the PGT group and the ICSI group (all P>0.05). Conclusion:Under the same fertilization method, invasive embryo biopsy procedures did not increase the incidence of perinatal complications during pregnancy, and no adverse effects of PGT on the growth and development of offspring have been found.

Objective:To investigate the safety and efficacy of in vitro activation (IVA) following cryopreserved ovarian tissue autotransplantation in the treatment of patients with premature ovarian insufficiency (POI). Methods:We reported and reviewed the treatment and follow-up of a patient with POI, who underwent IVA combined with cryopreserved ovarian tissue transplantation.Results:The patient naturally concepted and delivered a healthy baby boy, who became the first live birth after cryopreserved ovarian tissue transplantation in China. The baby showed normal physical, motor and mental development during two-year follow-up.Conclusion:IVA combined with cryopreserved ovarian tissue transplantation can effectively activate residual follicles in some POI patients and allow them to conceive their own genetic offspring. IVA technology may become a new choice for fertility treatment of POI patients.

Objective:To study the effect of embryo transfer medium EmbryoGlue on the clinical outcomes of frozen-thawed embryo transfer.Methods:A retrospective cohort study was performed in 2848 cycles from patients undergoing frozen-thawed embryo transfer from January 1, 2016 to December 31, 2020 in the Reproductive Medicine Center, the Second Affiliated Hospital of Naval Medical University. According to the embryo transfer medium, those cycles were divided into two groups, the G-2 group including 1605 cycles and the EmbryoGlue group including 1243 cycles. Baseline characteristics and clinical outcomes were compared between the two groups. Propensity score matching (PSM) was performed on age, infertility factor, duration of infertility, endometrial preparation protocol, endometrial thickness, number of embryos transferred, number of good-quality embryos transferred and stage of embryo, then clinical outcomes were compared between the two groups again.Results:There were significant differences of the age [(33.46±4.66) years vs. (31.92±4.62) years, P<0.001], duration of infertility [(4.11±2.98) years vs. (3.36±2.60) years, P<0.001], endometrial thickness [(9.51±1.77) mm vs. (10.01±1.77) mm, P<0.001], number of embryos transferred (1.52±0.50 vs. 1.59±0.49, P=0.001), number of good-quality embryos transferred (1.28±0.64 vs. 1.47±0.57, P<0.001) between EmbryoGlue group and G-2 group before PSM. There was no statistically significant difference in the baseline characteristics between the two groups after PSM (all P>0.05). There were no statistically significant differences in biochemical pregnancy rate [61.1% (609/996) vs. 61.9% (617/996), P=0.713], clinical pregnancy rate [56.5% (563/996) vs. 57.0% (568/996), P=0.821], implantation rate [44.3% (674/1523) vs. 44.4% (691/1555), P=0.919], ectopic pregnancy rate [1.8% (10/563) vs. 1.8% (10/568), P=0.984] and abortion rate [16.9% (95/563) vs. 17.3% (98/568), P=0.865] between the two groups. Conclusion:Using EmbryoGlue as embryo transfer medium can obtain the same clinical outcomes as G-2, and EmbryoGlue cannot yet be considered to improve the clinical outcomes of frozen-thawed embryo transfer.

Objective:To investigate the safety and efficacy of in vitro activation (IVA) following cryopreserved ovarian tissue autotransplantation in the treatment of patients with premature ovarian insufficiency (POI). Methods:We reported and reviewed the treatment and follow-up of a patient with POI, who underwent IVA combined with cryopreserved ovarian tissue transplantation.Results:The patient naturally concepted and delivered a healthy baby boy, who became the first live birth after cryopreserved ovarian tissue transplantation in China. The baby showed normal physical, motor and mental development during two-year follow-up.Conclusion:IVA combined with cryopreserved ovarian tissue transplantation can effectively activate residual follicles in some POI patients and allow them to conceive their own genetic offspring. IVA technology may become a new choice for fertility treatment of POI patients.

Objective:To study the effect of embryo transfer medium EmbryoGlue on the clinical outcomes of frozen-thawed embryo transfer.Methods:A retrospective cohort study was performed in 2848 cycles from patients undergoing frozen-thawed embryo transfer from January 1, 2016 to December 31, 2020 in the Reproductive Medicine Center, the Second Affiliated Hospital of Naval Medical University. According to the embryo transfer medium, those cycles were divided into two groups, the G-2 group including 1605 cycles and the EmbryoGlue group including 1243 cycles. Baseline characteristics and clinical outcomes were compared between the two groups. Propensity score matching (PSM) was performed on age, infertility factor, duration of infertility, endometrial preparation protocol, endometrial thickness, number of embryos transferred, number of good-quality embryos transferred and stage of embryo, then clinical outcomes were compared between the two groups again.Results:There were significant differences of the age [(33.46±4.66) years vs. (31.92±4.62) years, P<0.001], duration of infertility [(4.11±2.98) years vs. (3.36±2.60) years, P<0.001], endometrial thickness [(9.51±1.77) mm vs. (10.01±1.77) mm, P<0.001], number of embryos transferred (1.52±0.50 vs. 1.59±0.49, P=0.001), number of good-quality embryos transferred (1.28±0.64 vs. 1.47±0.57, P<0.001) between EmbryoGlue group and G-2 group before PSM. There was no statistically significant difference in the baseline characteristics between the two groups after PSM (all P>0.05). There were no statistically significant differences in biochemical pregnancy rate [61.1% (609/996) vs. 61.9% (617/996), P=0.713], clinical pregnancy rate [56.5% (563/996) vs. 57.0% (568/996), P=0.821], implantation rate [44.3% (674/1523) vs. 44.4% (691/1555), P=0.919], ectopic pregnancy rate [1.8% (10/563) vs. 1.8% (10/568), P=0.984] and abortion rate [16.9% (95/563) vs. 17.3% (98/568), P=0.865] between the two groups. Conclusion:Using EmbryoGlue as embryo transfer medium can obtain the same clinical outcomes as G-2, and EmbryoGlue cannot yet be considered to improve the clinical outcomes of frozen-thawed embryo transfer.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis , classification and outcome of abnormal origin of pulmonary artery from ascending aorta ( AOPA) . Methods From January 2014 to June 2018 ,18 cases of AOPA diagnosed by echocardiography in 43966 fetuses from Shaanxi Fetal Congenital Heart Disease Diagnostic Center were retrospectively analyzed . The echocardiographic features ,pathological and anatomical classification ,genetic characteristics and outcome of postnatal echocardiography were summarized . Results Abnormal origin of pulmonary artery branches could be demonstrated by color Doppler imaging system in 18 cases . Ten cases ( 55 .6％ ) of right pulmonary artery abnormalities originated from ascending aorta ( AORPA ) ,in which 6 cases ( 60％ ) were distal pulmonary artery abnormalities ,4 cases ( 40％ ) were proximal pulmonary artery abnormalities . Eight cases( 44 .4％ ) of left pulmonary artery abnormalities originated from ascending aorta ( AOLPA ) ,including 7 cases ( 87 .5％ ) of distal pulmonary artery abnormalities and 1 case ( 12 .5％ ) of proximal pulmonary artery abnormalities . Twelve AOPAs were associated with other intracardiac malformations with 6 right ventricular double outlet (DORV) accompanying with pulmonary stenosis ,3 tetralogy of fallots( TOF) ,2 atrioventricular septal defects( AVSD) ,1 single ventricle with single atrium ,and 1 Berry syndrome ,and no casese were associated with extracardiac malformations .Amniocentesis karyotype analysis and gene chip detection in 5 cases showed normal results . Four of 18 cases were born ,in which 3 cases died and 1 case was progressively suffered with right pulmonary artery atresia ,10 cases were inducted of labor ( 4 autopsy) and following-up was lost in 4 cases . Conclusions Incidence of AOLPA and distal type in fetal AOPA is higher than that in child and adult from references ,DORV is abnormal type mostly associated with intracardiac malformation . AOPA has no obvious genetic result for less cases . The main risk after AOPA birth is pulmonary infection . Echocardiography is of great value for AOPA in prenatal diagnosis , outcome observation and surgical planning after birth .

Objective To explore the detection rate ,types ,accompanying abnormalities and prognosis of fetal congenital heart disease(CHD) in a single center in northwest China ,in order to set up a foundation for further studying the epidemiological characteristics of fetal CHD and integrated management of fetal CHD in the prenatal and postnatal . Methods A total of 2725 CHD in 45015 fetus diagnosed by fetal echocardiography were enrolled . The fetal CHD detection rate and the composition ratio were calculated . Follow-up results between the simple CHD and complex CHD were analyzed . Results The detection rate of fetal CHD in our center was up to 6 .1％ . There were 1589 cases of complex CHD ,accounting for 58 .3％ in all the fetal CHD ,of which the most common type was single ventricle ,followed by tetralogy of Fallot , atrioventricular septal defect and double outlet right ventricle ;Simple CHD 1136 cases ,accounting for 41 .7％ in all the fetal CHD ,the most common type was ventricular septal defect . The number of abortion cases ,intrauterine and postnatal natural deaths of fetal CHD accounted for 60 .3％ ( 1357/2251) of the total follow-up ,of which complex CHD and chromosomal abnormalities accounting for the majority . 68 cases of CHD underwent surgical treatment after birth ,of which complex CHD were predominant . 37 cases of simple CHD spontaneous closure and 27 cases of simple CHD genetic test results were abnormal . Conclusions The detection rate of CHD in this group is relatively high ,which is related to the prenatal diagnosis consultation center . Fetal complex CHD is more common while the prognosis is worse than simple CHD . Prenatal and postnatal integrated management of fetal CHD has important clinical value in early treatment of complex CHD .

Objective To evaluate the effect of emulsified isoflurane post-conditioning on the mitochondrial function during lung ischemia-reperfusion (I/R) in rats in an in vitro experiment.Methods Twenty-four SPF healthy male Sprague-Dawley rats,weighing 250-300 g,were used in the study.After the animals were anesthetized,the lungs were removed,connected to the perfusion system and then divided into 4 groups (n=6 each) using a random number table:control group (group C),group I/R,emulsified isoflurane post-conditioning group (group EI) and intralipid post-conditioning group (group IL).After 20 min of equilibration,the lungs were continuously perfused for 105 min in group C,and the lungs were subjected to 45 min ischemia followed by 60 min reperfusion to establish the model of lung I/R injury in the other three groups.During the reperfusion period,the common perfusate was used in group I/R,the perfusate containing 1.68 mmol/L emulsified isoflurane was used in group EI,and the equal volume of perfusate containing 30％ intralipid was used in group IL.At the end of the equilibration (T0),immediately after beginning of reperfusion (T1) and at 30 and 60 min of reperfusion (T2.3),the arterial oxygen partial pressure (PaO2),airway resistance,pulmonary compliance and tidal volume (VT) were recorded.The right upper lobe of the lung was removed at T3 for determination of wet to dry weight ratio (W/D ratio).The right middle lobe of the lung was removed at T3 for pathologic examination with light microscope.The contents of reactive oxygen species (ROS),NAD+ and ATP in lung tissues were detected.Results Compared with group C,the PaO2,pulmonary compliance and Vr were significantly decreased,and the airway resistance was increased at T1-3,and the W/D ratio and ROS content were increased,and NAD+ and ATP contents were decreased at T3 in I/R,EI and IL groups (P＜0.05).Compared with I/R and IL groups,the PaO2,pulmonary compliance and VT were significantly increased,and the airway resistance was decreased at T2.3,and the W/D ratio and ROS content were decreased,and NAD+ and ATP contents were increased at T3 in group EI (P＜0.05).The pathologic changes of lungs were significantly attenuated in group EI as compared with group I/R.Conclusion The mechanism by which emulsified isoflurane post-conditioning attenuates lung I/R injury is related to decrease in mitochondrial dysfunction in rats in an in vitro experiment.

Objective To explore the application value of fetal echocardiography for the diagnosis and prognosis assessment of anomalous pulmonary venous connection (APVC),by comparing the results of prenatal diagnosis of APVC by ultrasound and follow-up.Methods Eighty-one APVC fetuses diagnosed by fetal echocardiography were followed up regularly.These results were compared with postnatal ultrasound diagnosis,operation and anatomy.The main points of methodology and differential diagnosis were summarized.Results Eighty-one APVC fetuses included 68 cases of total APVC(31 cases of supracardiac type,15 cases of intracardiac type,22 cases of infracardiac type),13 cases of Partial APVC(2 cases of supracardiac type,10 cases of intracardiac type,1 case of infracardiac type);12 cases of isolated APVC,69 cases of complex APVC(combined with other cardiovascular abnormalities);6 cases were born(4 infants of isolated APVC survived after operation,2 infants of complex APVC died),2 cases were ongoing pregnancy,71 cases were aborted (30 cases were dissected),2 cases were lost to follow-up.Conclusions Fetal echocardiography has important application value in diagnosis and prognosis assessment of APVC and the ones with other cardiovascular abnormalities.