Objective To explore the influencing factors of readmission within 90 days in frail patients with chronic obstructive pulmonary disease(COPD),construct an early warning model and evaluate its discrimination and effectiveness.Methods A total of 831 COPD patients with frailty were included and divided into the readmission group(290 cases)and the control group(541 cases)based on whether they were readmitted within 90 days after discharge.The electronic medical record data were collected and compared between the two groups of patients.Multivariate Logistic regression analysis was used to screen independent influencing factors for readmission within 90 days in COPD weak patients.A predictive model was established.The column chart was drawn.The discriminability of the predictive model was evaluated through receiver operating characteristic(ROC)curves.The clinical practicality and the predictive model calibration were evaluated through decision curves and calibration curves.Results The body mass index(BMI)of the readmission group was lower than that of the non readmission group,and the proportion of acute exacerbation of COPD hospitalizations≥2 times in the past year,the Edmonton frailty scale(REFS)score and the Chalson comorbidity index(CCI)were higher in the readmission group than those of the non readmission group(P＜0.05).Multivariate Logistic regression analysis showed that BMI(OR=0.721,95%CI:0.636-0.818),the number of acute exacerbations of COPD hospitalizations in the past year(OR=3.040,95%CI:1.944-4.753),REFS score(OR=1.726,95%CI:1.486-2.005)and CCI score(OR=3.917,95%CI:3.079-4.983)were all independent influencing factors for readmission within 90 days in COPD frail patients(P＜0.05).Based on the results of multiple factor Logistic regression analysis,the column chart warning model was constructed.The AUC value of the ROC curve was 0.847(95%CI:0.820-0.874),the specificity was 87.20%and the sensitivity was 64.50%.The calibration curve of the predictive model was close to the diagonal,and the calibrationa degree was good.The decision curve suggested that the prediction model had clinical practicality.Conclusion The early warning model constructed based on the influencing factors of readmission hospitalization within 90 days in weak patients with COPD has good predictive effect and clinical practicability.

Objective Compare the clinicopathological factors of microsatellite unstable(dMMR)and microsatellite stable(pMMR)in right colon cancer and analyze the factors affecting overall survival(OS)and disease-free survival(DFS)between the two groups.Methods Clinical data with right colon cancer of patients who underwent radical resection from January 1,2016 to December 31,2023 were retrospectively analyzed(a total of 247 patients were included,including 43 dMMR and 204 pMMR).Through propensity score matching,the baseline difference between the two groups was matched 1∶1,and a total of 86 cases were obtained,43 cases in dMMR and 43 cases in pMMR.The difference of relevant indicators between the two groups was analyzed,and univariate and multivariate Cox analysis was performed for OS and DFS.The survival curve was plotted,and the comparison of survival rates was conducted using the Log rank test.Results According to age,location,tumor length,shape,histological type,T,N,TNM stage,nerve invasion,and differentiation degree with 1∶1 matching(P＜0.05),there was no statistical difference in baseline data between dMMR and pMMR patients with right colon cancer(P＞0.05).It was found that 5-year OS of dMMR patients with right colon cancer was significantly better than pMMR(P＜0.05),and 5-year DFS dMMR was better than pMMR(P＜0.05).Protective factors affecting OS of dMMR right colon cancer included tumor length＜5 cm,T1-3,M0,Stage Ⅰ-Ⅲ,absence of intravascular cancer thrombi and absence of nerve invasion(P＜0.05).In survival analysis,M0 was compared with M,(95％vs.60％,P＜0.05).Stage Ⅰ-Ⅲ compared with stage Ⅳ(95％vs.54％,P＜0.05);No vascular cancer thrombus vs.cancer thrombus(94％vs.88％,P＜0.05).Protective factors affecting DFS of dMMR right colon cancer included age＜50 years,no mucous or sig-ring cells,M0,StageⅠ-Ⅲ,and no intravascular cancer thrombus(P＜0.05).In survival analysis,M0 was compared with M,(90％vs.63％,P＜0.05).Stage Ⅰ-Ⅲ compared with stage Ⅳ(92％vs.57％,P＜0.05);There was a significant difference between non-vascular cancer thrombus and vascular cancer thrombus(91％vs.77％,P＜0.05).Conclusion The patients with dMMR had higher OS and DFS than pMMR,which were not affected by clinical factors.

Objective:To investigate the pregnancy outcomes and cumulative live birth rate (CLBR) after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) in patients with high basal follicle-stimulating hormone (bFSH) levels. Methods:This retrospective cohort study included clinical data from patients who underwent IVF/ICSI-ET treatment at the Reproductive Medical Center of Peking University Third Hospital from January 2018 to December 2022. Patients were divided into three groups based on the highest bFSH level during all cycles of treatment: group A (15 U/L≤bFSH<25 U/L), group B (25 U/L≤bFSH<40 U/L), and group C (bFSH≥40 U/L). After propensity score matching (PSM) based on the female body mass index, the baseline data, embryology laboratory outcomes, and assisted reproductive outcomes such as clinical pregnancy rate among the three groups of patients were compared. Binary logistic regression analysis was used to explore the impact of various factors on live birth, and the trend of CLBR across multiple cycles was also studied.Results:After PSM, 340 cycles were included in group A, 340 cycles were included in group B, 127 cycles were included in group C. There were statistically significant differences among the three groups in antral follicle count, bFSH, basal progesterone, basal luteinizing hormone, and anti-Müllerian hormone levels ( P=0.004, P<0.001, P<0.001, P<0.001, P<0.001). In the analysis of controlled ovarian stimulation (COS) protocols, groups A and B mainly used conventional COS protocol, while group C primarily used mild stimulation protocol. The duration and dosage of gonadotropin used were the highest in group A [10 (7, 12) d, 2 728 (1 650, 3 725) U], with statistically significant differences among the three groups (all P<0.001). On the day of human chorionic gonadotropin injection, there were statistically significant differences in estradiol and progesterone levels among the three groups ( P=0.022 and P=0.048, respectively). The cancellation rate of cycles did not differ significantly among the three groups ( P>0.05), while the number of oocytes retrieved ( P<0.001) and the rate of cycles with no transferable embryos ( P=0.034) showed statistically significant differences. The type of embryos transferred in all three groups was mainly cleavage-stage embryos, and there were statistically significant differences in the rate of two pronuclei and high-quality embryos among the groups ( P=0.003 and P=0.006, respectively). The rate of high-quality embryos decreased with increasing bFSH levels, and comparisons between group A and group B, as well as group A and group C, showed statistically significant differences (all P<0.016 7). The biochemical pregnancy rate and the clinical pregnancy rate in fresh cycles differed significantly among the three groups ( P=0.025 and P=0.010, respectively), while the live birth rate per initiated cycle showed marginal significance ( P=0.058). However, the miscarriage rate and the live birth rate per transfer cycle did not differ significantly among the groups (all P>0.05). Binary logistic regression analysis revealed that bFSH ( OR=0.955, 95% CI: 0.912-1.000, P=0.050) and the number of oocytes retrieved ( OR=1.104, 95% CI: 1.009-1.207, P=0.031) were independent predictors of live birth. Analysis of CLBR curves across multiple oocyte retrieval cycles showed that CLBR gradually increased with the number of oocyte retrievals and stabilized at 14.32% after the fifth retrieval. Conclusion:High bFSH levels reduce the live birth rate per initiated cycle but do not affect the live birth rate per transfer cycle. Increasing age and a low number of oocytes retrieved can both decrease the live birth rate. Multiple oocyte retrieval and transfer cycles can improve CLBR in patients with high bFSH level to some extent, but it tends to stabilize after the fifth cycle.

Objective:To investigate the outcomes of natural cycle (NC) and modified natural cycle (MNC) assisted reproductive technology (ART) in patients with diminished ovarian reserve (DOR), and to provide a scientific basis for individualized treatment strategies for DOR patients.Methods:A retrospective cohort analysis was performed on the clinical data of DOR patients who underwent ART at the Center for Reproductive Medicine of the Department of Obstetrics and Gynecology, Peking University Third Hospital from January 1, 2015 to December 31, 2023. Patients were divided into the NC group ( n=801) and the MNC group ( n=385) based on their treatment protocol. The primary outcomes were cycle cancellation rate and oocyte retrieval rate. Secondary outcomes included clinical pregnancy rate and live birth rate per fresh embryo transfer cycle and frozen-thawed embryo transfer cycle, cumulative pregnancy rate and cumulative live birth rate per started cycle and per transfer cycle, as well as laboratory parameters such as the number of retrieved oocytes, the number of two pronuclei (2PN) fertilized oocytes, the number of transferable embryos, and transferable embryo formation rate. Further, multivariate logistic regression was used to analyze the impact of the treatment protocol on pregnancy and live birth outcomes. Results:There were no statistically significant differences between the NC and MNC groups in terms of general characteristics such as age, body mass index, and baseline hormone levels (all P>0.05). The cycle cancellation rate was significantly higher in the NC group [19.10% (153/801)] than in the MNC group [10.65% (41/385), P<0.001], and the oocyte retrieval rate was significantly lower in the NC group [66.31% (431/650)] than in the MNC group [74.86% (259/346), P=0.005]. The number of retrieved oocytes [1 (0,1)], the number of 2PN fertilized oocytes [1 (0,1)], and the number of transferable embryos [0 (0, 1)] were also significantly lower in the NC group than in the MNC group [1 (1, 2), P<0.001; 1 (1, 1), P<0.001; 0 (0, 1), P<0.001]. However, there were no statistically significant differences in 2PN fertilization rate and transferable embryo formation rate between the NC and MNC groups (all P>0.05). In both fresh embryo transfer cycles and frozen-thawed embryo transfer cycles, there were no statistically significant differences in clinical pregnancy rate and live birth rate between the NC and MNC groups (all P>0.05). The cumulative pregnancy rate per started cycle and transfer cycle, the cumulative live birth rate per started cycle and per transfer cycle were also not significantly different between the NC and MNC groups (all P>0.05). Multivariate logistic analysis showed no significant association between NC and clinical pregnancy or live birth compared with MNC. Conclusion:While MNC to some extent reduced the cycle cancellation rate and improved oocyte retrieval rates compared with NC, it did not ultimately improve pregnancy outcomes in DOR patients.

[Purpose]To analyze the incidence and mortality of liver cancer in Fusui County of Guangxi Zhuang Autonomous Region in 2019 and the trend of change from 201 1 to 2019.[Meth-ods]Based on the incidence and mortality data of liver cancer in Fusui County from 2011 to 2019,the crude incidence rate,crude mortality rate,age-standardized rate by Chinese standard population(ASIRC/ASMRC),age-standardized rate by world standard population(ASMRW/ASM-RW),disability-adjusted life years(DALY),years of life lost(YLL),years of lived with disability(YLD)were calculated.The Joinpoint linear regression model was used to calculate the average annual percentage change(AAPC)of the ASIRC/ASMRC and DALY rate of liver cancer in Fusui County from 2011 to 2019.[Results]In 2019,there were 345 new cases and 298 deaths of liver cancer in Fusui County,accounting for 28.49％and 35.86％of all new cases and death cases of malignant tumors in Fusui County,respectively.The crude incidence rate,ASIRC and ASIRW were 74.71/105,67.55/105 and 65.63/105,respectively;the crude mortality rate,ASMRC and ASMRW were 64.53/105,58.78/105 and 56.88/105,respectively.In 2019,ASIRC/ASMRC of men were higher than those of women(105.32/105 and 95.67/105 for men;27.26/105 and 19.11/105 for women).The peak incidence and mortality rates were in the 65～69 and 80～84 age groups,re-spectively.The incidence rate of liver cancer in Fusui County declined from 82.50/105 in 2011 to 67.55/105 in 2019,with an AAPC of-3.01％(P=0.024),but the mortality rate did not have sig-nificant changes(AAPC=-1.44％,P=0.224).The rate of DALY decreased from 14.51/105 to 10.36/105,with an AAPC of-2.82％(P=0.050).[Conclusion]The incidence rate and DALY rate of liv-er cancer in Fusui County showed an overall decreasing trend from 2011 to 2019,but still re-mained at a high level.It is necessary to further strengthen the prevention,screening and early treatment of liver cancer in this region,especially for men and the elderly.

Objective:To explore the mechanism by which moxibustion improves cold-induced blood stasis pattern(CIBSP)and to uncover the biological basis underlying the correlation between the Conception Vessel(CV),Governor Vessel(GV),Thoroughfare Vessel(TV),and the uterus by investigating the effects of mild moxibustion on the hypothalamic-pituitary-ovary axis(HPOA)in CIBSP model rats.Methods:Forty-eight female Sprague-Dawley rats were divided into a blank group,a model group,a CV group,a GV group,a TV group,and a non-meridian non-point(NMNP)group according to the random number table method,with 8 rats in each group.Except for rats in the blank group,the other rats were subjected to an ice water bath plus epinephrine to prepare CIBSP models.Each intervention group was given mild moxibustion on the first day of modeling.Qihai(CV6),Guanyuan(CV4),and Zhongji(CV3)were selected in the CV group;Huangshu(KI16),Dahe(KI12),and Henggu(KI11)were selected in the TV group;Xuanshu(GV5),Mingmen(GV4),and Yaoyangguan(GV3)were selected in the GV group;three NMNP spots were selected in the NMNP group.Mild moxibustion was administered for 20 min each time,once a day,for 14 consecutive days.The symptom scores of CIBSP and uterine electromyogram were compared among groups;morphological changes in reproductive organs were observed by hematoxylin-eosin staining;enzyme-linked immunosorbent assay was used to detect serum reproductive hormones and neurotransmitters.The mRNA and protein expression levels of estrogen receptor(ER),follicle-stimulating hormone receptor(FSHR),and luteinizing hormone receptor(LHR)were detected by real-time quantitative polymerase chain reaction,immunohistochemistry,or Western blotting assays.Results:Compared to the blank group,the model group showed a significantly increased CIBSP symptom score,an amplified in vivo uterine myoelectric value;decreased ovarian follicles,thinner endometrial epithelium,and disordered structure with the pathological examination,decreased serum levels of reproductive hormones,6-keto-prostaglandin F1α(6-keto-PGF1α),and β-endorphin(β-EP),increased thromboxane B2(TXB2),5-hydroxytryptamine(5-HT),and substance P(SP),and decreased mRNA and protein expression of ovarian ER,FSHR,and LHR(P<0.05 or P<0.01).Compared to the model and NMNP groups,each point-intervention group showed a decreased CIBSP symptom score and uterine myoelectric value;increased ovarian follicles,thickened endometrium,increased glands,up-regulated serum reproductive hormones,6-keto-PGF1α,and β-EP,down-regulated serum TXB2,5-HT,and SP and increased mRNA and protein expression of ovarian ER,FSHR,and LHR(P<0.05 or P<0.01).Conclusion:Moxibustion at points from the CV,GV,and TV("three branches from one source")can improve the reproductive neuroendocrine function of CIBSP rats,and this effect may be mediated through the regulation of the HPOA.These detections suggest that the biological basis of point-uterus correlation may be based on HPOA regulation.

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose(FDG)PET/CT in primary pulmonary enteric adenocarcinoma.Methods The clinical and imaging data of 9 patients with primary pulmonary enteric adenocarcinoma who under-went 18F-FDG PET/CT examination were retrospectively analyzed,including lesion distribution,morphology,maximum standardized uptake value(SUVmax),clinical symptoms and signs,gastroscopy finding,puncture pathological results,and serum tumor markers[carbohydrate antigen 72-4(CA72-4),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbo-hydrate antigen 199(CA199)].Results Pathological examination confirmed a diagnosis of primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors through clinical evaluation.In all nine patients,18F-FDG PET/CT examination did not reveal any evidence of digestive system malignancies,and gastrointestinal microscopy was negative.Primary lesions were observed as masses or nodular types in 6 cases(5 in the left lung and 1 in the right lung),while 3 cases exhibited diffuse bilateral pulmonary involvement(manifested as multiple patchy opacities,nodules,ground-glass opacities,and consolidations).All pulmonary primary lesions showed increased 18F-FDG uptake,with SUVmax ranging from 2.7 to 12.8,mean 8.6±3.7.The six masses-or nodular-type primary lesions showed maximum diameters ranging from 2.1 to 10.5 cm,mean(5.23±3.06)cm.Four cases demonstrated hilar and mediastinal lymph node metastases,intrapulmonary metastases,and distant metastases,while 1 case showed only distant metastasis.Elevated levels of serum tumor markers were observed as follows:CA72-4 in 7 cases(10-273.3 U/mL),CEA in 7 cases(5-147.4 ng/mL),CA199 in 6 cases(31.22-4 364 U/mL),and CYFRA21-1 in 5 cases(8.31-99.7 ng/mL).Conclusion When pathological biopsy of a pulmonary lesion suggests primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors,and 18F-FDG PET/CT shows no gastrointestinal masses,this may support the diagnosis of primary pulmonary enteric adenocarcinoma.

Objective The objective of this study was to investigate the effects of maytansine on proliferation,migration,in-vasion,apoptosis and autophagy of human thyroid cancer C643 cells.Methods C643 cells were treated with different concentrations(0.049,0.195,0.781,3.125,12.5,50 and 200 μmol/L)of maytansine,the effect of maytansine on the proliferation of C643 cells was detected by the sulforhodamine B(SRB)method,and the concentration of subsequent experiments was determined.C643 cells in the logarithmic growth stage period were divided into the control group,low-dose group,mid-dose group and high-dose group.The effects of maytansine on migration and invasion abilities of C643 cells were detected by cell scratch and Transwell chamber assay;The levels of reactive oxygen species(ROS)were detected by 2′,7′-dichlorofluorescein diacetate(DCFH-DA)fluorescent probe experi-ment;The apoptosis rate of C643 cells was detected by flow cytometry;The expression of proteins related to apoptosis or autophagy was detected by Western blot.Results Maytansine at concentrations of 0.049,0.195,0.781,3.125,12.5,50 and 200 μmol/L could in-hibit the proliferation of C643 cells(P<0.05),and exhibited a significant concentration time dependence.The half maximal inhibitory concentrations(IC50)at 24,48 and 72 h were 54.255,5.193 and 0.647 μmol/L,respectively;The cell scratch and Transwell chamber results showed that maytansine at concentrations of 0.1,1 and 10 μmol/L could reduce the migration and invasion abilities of C643 cells(P<0.05 and P<0.01).The fluorescence probe results showed that maytansine at concentrations of 0.1,1 and 10μmol/L could increase the intracellular ROS levels of C643 cells(P<0.01).The flow cytometry results showed that maytansine at concentrations of 0.1,1 and 10 μmol/L could concentration dependently increase the apoptosis rate of C643 cells(P<0.01).The Western blot results showed that with the increase of maytansine concentrations,the expression of Bax protein related to apoptosis in C643 cells increased(P<0.05),the expression of Bcl-2 decreased(P<0.05),the expression of LC3Ⅱ/Ⅰ(P<0.05)and Beclin-1(P<0.01)increased,while the expression of p62 decreased(P<0.001).Conclusion Maytansine can inhibit the proliferation,migration and invasion of human thyroid cancer C643 cells,and induce the synergistic effect on apoptosis and autophagy by increasing intracellular ROS levels.

Objective Compare the clinicopathological factors of microsatellite unstable(dMMR)and microsatellite stable(pMMR)in right colon cancer and analyze the factors affecting overall survival(OS)and disease-free survival(DFS)between the two groups.Methods Clinical data with right colon cancer of patients who underwent radical resection from January 1,2016 to December 31,2023 were retrospectively analyzed(a total of 247 patients were included,including 43 dMMR and 204 pMMR).Through propensity score matching,the baseline difference between the two groups was matched 1∶1,and a total of 86 cases were obtained,43 cases in dMMR and 43 cases in pMMR.The difference of relevant indicators between the two groups was analyzed,and univariate and multivariate Cox analysis was performed for OS and DFS.The survival curve was plotted,and the comparison of survival rates was conducted using the Log rank test.Results According to age,location,tumor length,shape,histological type,T,N,TNM stage,nerve invasion,and differentiation degree with 1∶1 matching(P＜0.05),there was no statistical difference in baseline data between dMMR and pMMR patients with right colon cancer(P＞0.05).It was found that 5-year OS of dMMR patients with right colon cancer was significantly better than pMMR(P＜0.05),and 5-year DFS dMMR was better than pMMR(P＜0.05).Protective factors affecting OS of dMMR right colon cancer included tumor length＜5 cm,T1-3,M0,Stage Ⅰ-Ⅲ,absence of intravascular cancer thrombi and absence of nerve invasion(P＜0.05).In survival analysis,M0 was compared with M,(95％vs.60％,P＜0.05).Stage Ⅰ-Ⅲ compared with stage Ⅳ(95％vs.54％,P＜0.05);No vascular cancer thrombus vs.cancer thrombus(94％vs.88％,P＜0.05).Protective factors affecting DFS of dMMR right colon cancer included age＜50 years,no mucous or sig-ring cells,M0,StageⅠ-Ⅲ,and no intravascular cancer thrombus(P＜0.05).In survival analysis,M0 was compared with M,(90％vs.63％,P＜0.05).Stage Ⅰ-Ⅲ compared with stage Ⅳ(92％vs.57％,P＜0.05);There was a significant difference between non-vascular cancer thrombus and vascular cancer thrombus(91％vs.77％,P＜0.05).Conclusion The patients with dMMR had higher OS and DFS than pMMR,which were not affected by clinical factors.

Objective:To investigate the pregnancy outcomes and cumulative live birth rate (CLBR) after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) in patients with high basal follicle-stimulating hormone (bFSH) levels. Methods:This retrospective cohort study included clinical data from patients who underwent IVF/ICSI-ET treatment at the Reproductive Medical Center of Peking University Third Hospital from January 2018 to December 2022. Patients were divided into three groups based on the highest bFSH level during all cycles of treatment: group A (15 U/L≤bFSH<25 U/L), group B (25 U/L≤bFSH<40 U/L), and group C (bFSH≥40 U/L). After propensity score matching (PSM) based on the female body mass index, the baseline data, embryology laboratory outcomes, and assisted reproductive outcomes such as clinical pregnancy rate among the three groups of patients were compared. Binary logistic regression analysis was used to explore the impact of various factors on live birth, and the trend of CLBR across multiple cycles was also studied.Results:After PSM, 340 cycles were included in group A, 340 cycles were included in group B, 127 cycles were included in group C. There were statistically significant differences among the three groups in antral follicle count, bFSH, basal progesterone, basal luteinizing hormone, and anti-Müllerian hormone levels ( P=0.004, P<0.001, P<0.001, P<0.001, P<0.001). In the analysis of controlled ovarian stimulation (COS) protocols, groups A and B mainly used conventional COS protocol, while group C primarily used mild stimulation protocol. The duration and dosage of gonadotropin used were the highest in group A [10 (7, 12) d, 2 728 (1 650, 3 725) U], with statistically significant differences among the three groups (all P<0.001). On the day of human chorionic gonadotropin injection, there were statistically significant differences in estradiol and progesterone levels among the three groups ( P=0.022 and P=0.048, respectively). The cancellation rate of cycles did not differ significantly among the three groups ( P>0.05), while the number of oocytes retrieved ( P<0.001) and the rate of cycles with no transferable embryos ( P=0.034) showed statistically significant differences. The type of embryos transferred in all three groups was mainly cleavage-stage embryos, and there were statistically significant differences in the rate of two pronuclei and high-quality embryos among the groups ( P=0.003 and P=0.006, respectively). The rate of high-quality embryos decreased with increasing bFSH levels, and comparisons between group A and group B, as well as group A and group C, showed statistically significant differences (all P<0.016 7). The biochemical pregnancy rate and the clinical pregnancy rate in fresh cycles differed significantly among the three groups ( P=0.025 and P=0.010, respectively), while the live birth rate per initiated cycle showed marginal significance ( P=0.058). However, the miscarriage rate and the live birth rate per transfer cycle did not differ significantly among the groups (all P>0.05). Binary logistic regression analysis revealed that bFSH ( OR=0.955, 95% CI: 0.912-1.000, P=0.050) and the number of oocytes retrieved ( OR=1.104, 95% CI: 1.009-1.207, P=0.031) were independent predictors of live birth. Analysis of CLBR curves across multiple oocyte retrieval cycles showed that CLBR gradually increased with the number of oocyte retrievals and stabilized at 14.32% after the fifth retrieval. Conclusion:High bFSH levels reduce the live birth rate per initiated cycle but do not affect the live birth rate per transfer cycle. Increasing age and a low number of oocytes retrieved can both decrease the live birth rate. Multiple oocyte retrieval and transfer cycles can improve CLBR in patients with high bFSH level to some extent, but it tends to stabilize after the fifth cycle.