Objective:To investigate the effect of atosiban on hemodynamic parameters of uterine arteries and clinical effect evaluation in patients with previous implantation failure undergoing frozen-thawed embryo transfer.Methods:A retrospective cohort study was conducted to analyze 298 cycles of FET in the Department of Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University from January 2021 to June 2023. Patients were categorized into atosiban group ( n=149) and control group ( n=149) according to whether administered atosiban or not. The related indicators and clinical outcomes were compared between the two groups. Hemodynamic parameters of the uterine arteries, including bilateral uterine artery peak systolic velocity/diastolic velocity (S/D), pulsatility index (PI), resistance index (RI), and serum levels of prostaglandin F2α (PGF2α) and oxytocin were compared before and after atosiban treatment. Univariate and multivariate logistic regression analysis were applied to assess the effect of atosiban on pregnancy outcomes. The effect of atosiban on live birth rate was analyzed by age stratification. Results:The implantation rate [51.92% (135/260)], the clinical pregnancy rate [67.11% (100/149)] and the live birth rate [59.06% (88/149)] in atosiban group were significantly higher than those in control group [41.13% (102/248), P=0.015; 51.01% (76/149), P=0.005; 40.27% (60/149), P=0.001]; and the early miscarriage rate [9.00% (9/100)] was lower than that of control group [19.74% (15/76), P=0.040]. Multivariate logistic regression analysis showed that atosiban was an independent influencing factor of live birth rate ( OR=2.236, 95% CI: 1.371-3.646, P=0.001). The post-treatment right uterine artery blood flow S/D [4.61 (4.00, 5.36)], PI [1.81 (1.58, 2.05)], RI [0.79 (0.75, 0.82)], and left uterine artery blood flow S/D [4.62 (3.83, 5.61)], PI (1.84±0.38), RI [0.79 (0.74, 0.82)] were all lower than those before treatment [right S/D 4.93 (4.06, 6.04), P<0.001; PI 1.93 (1.60, 2.17), P=0.001; RI 0.80 (0.76, 0.83), P<0.001; left S/D 5.05 (4.20, 6.32), P<0.001; PI 1.95±0.43, P<0.001; RI 0.81 (0.76, 0.84), P<0.001]. Besides, the levels of PGF2α [97.01 (85.15, 109.93) ng/L] and oxytocin [41.18 (37.16, 46.78) ng/L] after treatment in atosiban group were significantly lower than those before treatment [119.71 (108.85, 129.99) ng/L, P<0.001; 51.87 (46.44, 55.54) ng/L, P<0.001). Moreover, the endometrial peristalsis waves in atosiban group were significantly less after treatment [1.00 (0.00, 2.00) times/min] than before treatment [2.00 (1.00, 3.00) times/min], and the difference was statistically significant ( P<0.001). Conclusion:Atosiban can improve uterine artery blood flow and reduce endometrial peristalsis waves in women with previous implantation failure, which increases endometrial blood perfusion. Additionally, it can also reduce the levels of PGF2α and oxytocin, and optimize the pregnancy outcome of the frozen-thawed embryo transfer.

Objective:To investigate the effect of atosiban on hemodynamic parameters of uterine arteries and clinical effect evaluation in patients with previous implantation failure undergoing frozen-thawed embryo transfer.Methods:A retrospective cohort study was conducted to analyze 298 cycles of FET in the Department of Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University from January 2021 to June 2023. Patients were categorized into atosiban group ( n=149) and control group ( n=149) according to whether administered atosiban or not. The related indicators and clinical outcomes were compared between the two groups. Hemodynamic parameters of the uterine arteries, including bilateral uterine artery peak systolic velocity/diastolic velocity (S/D), pulsatility index (PI), resistance index (RI), and serum levels of prostaglandin F2α (PGF2α) and oxytocin were compared before and after atosiban treatment. Univariate and multivariate logistic regression analysis were applied to assess the effect of atosiban on pregnancy outcomes. The effect of atosiban on live birth rate was analyzed by age stratification. Results:The implantation rate [51.92% (135/260)], the clinical pregnancy rate [67.11% (100/149)] and the live birth rate [59.06% (88/149)] in atosiban group were significantly higher than those in control group [41.13% (102/248), P=0.015; 51.01% (76/149), P=0.005; 40.27% (60/149), P=0.001]; and the early miscarriage rate [9.00% (9/100)] was lower than that of control group [19.74% (15/76), P=0.040]. Multivariate logistic regression analysis showed that atosiban was an independent influencing factor of live birth rate ( OR=2.236, 95% CI: 1.371-3.646, P=0.001). The post-treatment right uterine artery blood flow S/D [4.61 (4.00, 5.36)], PI [1.81 (1.58, 2.05)], RI [0.79 (0.75, 0.82)], and left uterine artery blood flow S/D [4.62 (3.83, 5.61)], PI (1.84±0.38), RI [0.79 (0.74, 0.82)] were all lower than those before treatment [right S/D 4.93 (4.06, 6.04), P<0.001; PI 1.93 (1.60, 2.17), P=0.001; RI 0.80 (0.76, 0.83), P<0.001; left S/D 5.05 (4.20, 6.32), P<0.001; PI 1.95±0.43, P<0.001; RI 0.81 (0.76, 0.84), P<0.001]. Besides, the levels of PGF2α [97.01 (85.15, 109.93) ng/L] and oxytocin [41.18 (37.16, 46.78) ng/L] after treatment in atosiban group were significantly lower than those before treatment [119.71 (108.85, 129.99) ng/L, P<0.001; 51.87 (46.44, 55.54) ng/L, P<0.001). Moreover, the endometrial peristalsis waves in atosiban group were significantly less after treatment [1.00 (0.00, 2.00) times/min] than before treatment [2.00 (1.00, 3.00) times/min], and the difference was statistically significant ( P<0.001). Conclusion:Atosiban can improve uterine artery blood flow and reduce endometrial peristalsis waves in women with previous implantation failure, which increases endometrial blood perfusion. Additionally, it can also reduce the levels of PGF2α and oxytocin, and optimize the pregnancy outcome of the frozen-thawed embryo transfer.

Objective:To explore the application of oxytocin receptor antagonist atosiban in the fresh embryo transfer cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) program. Methods:We selected 2349 fresh embryo transfer cycles, ranging from January 2016 to December 2019 in Reproductive Medicine Center, the Second Affiliated Hospital of Zhengzhou University. Patients were randomly categorized into atosiban group (1176 cycles) and control group (1173 cycles). The related indicators and clinical outcomes were compared between the two groups.Results:The implantation rate [50.31% (1046/2079)], the clinical pregnancy rate [64.37% (757/1176)] and the live birth rate [53.17% (553/1040)] in atosiban group were remarkably higher than those of control group [39.09% (817/2090), 51.32% (602/1173), 41.01% (431/1051)], and the differences were significant statistically (all P<0.001). There were no differences in multiple pregnancy rate, multiple live birth rate, ectopic pregnancy rate and birth defect rate between the two groups (all P>0.05). Miscarriage rate of atosiban group [13.47% (102/757)] was lower than that of control group [16.44% (99/602)], but there was no significant difference ( P>0.05). Conclusion:Atosiban could inhibit uterus contraction and peristalticus to improve implantation rate, clinical pregnancy rate and live birth rate, and atosiban did not increase the risk of birth defect in offspring. Therefore, application of oxytocin receptor antagonist atosiban could improve the clinical outcome in the fresh embryo transfer cycle of IVF/ICSI.

Objective:To explore the application of oxytocin receptor antagonist atosiban in the fresh embryo transfer cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) program. Methods:We selected 2349 fresh embryo transfer cycles, ranging from January 2016 to December 2019 in Reproductive Medicine Center, the Second Affiliated Hospital of Zhengzhou University. Patients were randomly categorized into atosiban group (1176 cycles) and control group (1173 cycles). The related indicators and clinical outcomes were compared between the two groups.Results:The implantation rate [50.31% (1046/2079)], the clinical pregnancy rate [64.37% (757/1176)] and the live birth rate [53.17% (553/1040)] in atosiban group were remarkably higher than those of control group [39.09% (817/2090), 51.32% (602/1173), 41.01% (431/1051)], and the differences were significant statistically (all P<0.001). There were no differences in multiple pregnancy rate, multiple live birth rate, ectopic pregnancy rate and birth defect rate between the two groups (all P>0.05). Miscarriage rate of atosiban group [13.47% (102/757)] was lower than that of control group [16.44% (99/602)], but there was no significant difference ( P>0.05). Conclusion:Atosiban could inhibit uterus contraction and peristalticus to improve implantation rate, clinical pregnancy rate and live birth rate, and atosiban did not increase the risk of birth defect in offspring. Therefore, application of oxytocin receptor antagonist atosiban could improve the clinical outcome in the fresh embryo transfer cycle of IVF/ICSI.

Objective:To evaluate the relationship between sperm aneuploidy rate and clinical outcome of intracytoplasmic sperm injection (ICSI) in multiple morphological abnormalities of the sperm flagella (MMAF) patients.Methods:A total of 5 MMAF patients and 10 normal fertile individuals with normal parameters from Reproductive Center of the Second Affiliated Hospital of Zhengzhou University were collected from January 2017 to June 2018. Papanicolaou staining, scanning electron microscopy and transmission electron microscopy were performed to observe the morphological characteristics of sperm. Fluorescence in situ hybridization (FISH) was used to detect the patients’ sperm aneuploidy rate. Finally, ICSI was performed to observe the clinical outcome. Results:The results of the light microscope and scanning electron microscope showed morphologically abnormal spermatozoa in the ejaculated semen of patients, including absent, short, bent, coiled, and irregular flagella, and the central pair complex was absent in flagellum axoneme using transmission electron microscopy. There was no significant increase in patients’ sperm aneuploidy rate compared with normal control. Furthermore, in 7 ICSI cycles of 5 MMAF couples, all of them achieved clinical pregnancy, including 3 cases of live birth and 2 cases of spontaneous abortion.Conclusion:There are serious morphological and ultrastructural abnormalities in the sperm flagella of MMAF patients. The low aneuploidy rates suggest that ICSI of MMAF patients will likely be of good prognosis for future pregnancies.

Objective:To evaluate the relationship between sperm aneuploidy rate and clinical outcome of intracytoplasmic sperm injection (ICSI) in multiple morphological abnormalities of the sperm flagella (MMAF) patients.Methods:A total of 5 MMAF patients and 10 normal fertile individuals with normal parameters from Reproductive Center of the Second Affiliated Hospital of Zhengzhou University were collected from January 2017 to June 2018. Papanicolaou staining, scanning electron microscopy and transmission electron microscopy were performed to observe the morphological characteristics of sperm. Fluorescence in situ hybridization (FISH) was used to detect the patients’ sperm aneuploidy rate. Finally, ICSI was performed to observe the clinical outcome. Results:The results of the light microscope and scanning electron microscope showed morphologically abnormal spermatozoa in the ejaculated semen of patients, including absent, short, bent, coiled, and irregular flagella, and the central pair complex was absent in flagellum axoneme using transmission electron microscopy. There was no significant increase in patients’ sperm aneuploidy rate compared with normal control. Furthermore, in 7 ICSI cycles of 5 MMAF couples, all of them achieved clinical pregnancy, including 3 cases of live birth and 2 cases of spontaneous abortion.Conclusion:There are serious morphological and ultrastructural abnormalities in the sperm flagella of MMAF patients. The low aneuploidy rates suggest that ICSI of MMAF patients will likely be of good prognosis for future pregnancies.

OBJECTIVETo explore the genetic etiology of two Chinese pedigrees affected with autosomal dominant adult polycystic kidney disease and male infertility.

METHODSThe coding regions of the PKD1 and PKD2 genes were subjected to PCR and Sanger sequencing. Suspected pathogenic mutations were analyzed by pedigree analysis and bioinformatics analysis. Mutation screening was performed using Sanger sequencing of blood samples obtained from 50 healthy individuals.

RESULTSTwo novel heterozygous mutations, c.6953_6977 del(p.Arg2318Hisfs*15) and c.10937T>G (p.Val3646Gly) of the PKD1 gene were identified in the affected members of the two pedigrees, respectively, but not among to normal family members of the two pedigrees. Pedigree and bioinformatics analysis showed that both mutations were pathogenic. No pathological mutations were found in the cohort of 50 healthy individuals.

CONCLUSIONTwo novel mutations, c.6953_6977del(p.Arg2318Hisfs*15) and c.10937T>G (p.Val3646Gly) of the PKD1 gene may be responsible for the disease in the two pedigrees, which have enriched the spectrum of PKD1 gene mutations and provided a basis for genetic counseling and prenatal disgnosis.