[Influence of basic thyroid-stimulating hormone levels on outcomes of IVF/ICSI in Qinghai].
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Abstract:
To study basic thyroid stimulating hormone (bTSH) levels impact on outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in Qinghai.Totally 282 cases with IVF cycles and 93 cases with ICSI cycles were studied prospectively, according to bTSH level, patients were divided into four groups. Reproduction rate, clinical pregnancy rate, miscarriage rate and live birth rate were studied among four groups.(1) In 375 cases with IVF/ICSI cycles, bTSH was positively correlated with abortion rate (r = 0.42, P = 0.04), but live birth rate and growing rate showed negative correlations with bTSH (r = -0.42, -0.28; P = 0.04, 0.03). bTSH and the number of eggs, the number of fertilized eggs, the number of embryos, biochemical pregnancy rate, and clinical pregnancy rate were no significant correlation (all P > 0.05). (2) Among women at group of ≤ 1.7, >1.7 and ≤ 2.5, >2.5 and ≤ 3.5, >3.5 mU/L, the implantation rates were 28.7%, 27.3%, 37.7% and 19.2%, live birth rates were 80.9%, 75.0%, 82.7%, and 59.8%, abortion rates were 19.0%, 15.0%, 16.7%, 40.1%; they all showed significant difference (all P < 0.05). Abortion rate in women with high bTSH level was higher than that of women with lower bTSH level, however implantation rate, live birth rate in women with high bTSH level were lower.When bTSH level is >3.5 mU/L, the abortion rate were increased, but live birth rate, rate of implantation were decreased.Keywords:
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The aim of our study was to evaluate the effect of low-molecular-weight heparin on pregnancy outcomes in women without thrombophilia during in vitro fertilization/intracytoplasmic sperm injection treatment.We searched Pubmed, Web of Science, Embase, Cochrane and CNKI (from inception to 2 February 2018). Our study identified randomized controlled trials or quasi-randomized controlled trials comparing low-molecular-weight heparin subcutaneous treatment with no treatment or only luteal support control. The outcomes included live birth rate, clinical pregnancy rate and miscarriage rate.Five trials, including 935 women receiving in vitro fertilization/intracytoplasmic sperm injection treatment, were included in meta-analyses. There were 458 women receiving low-molecular-weight heparin and 477 in the control group. No significant differences for live birth rate, clinical pregnancy rate and miscarriage rate were found between the low-molecular-weight heparin and control groups. Of them, four trials reported live birth rate as an outcome and the risk ratio was 1.13 (95% confidence interval 0.88-1.43, p = 0.34). All five trials reported clinical pregnancy rate as an outcome, the risk ratio was 1.08 (95% confidence interval 0.87-1.32, p = 0.47). Three trials reported miscarriage rate and the risk ratio was 0.58 (95% confidence interval 0.30-1.10, p = 0.09). In women with two or more failed in vitro fertilization/intracytoplasmic sperm injection cycles, the risk ratio of live birth rate was 1.15 and the risk ratio of clinical pregnancy rate was 1.17. In women with three or more failed in vitro fertilization/intracytoplasmic sperm injection cycles, the risk ratios of live birth rate and clinical pregnancy rate were 1.36 and 1.35, respectively.Our results suggested that low-molecular-weight heparin had no effect on pregnancy success rate in non-thrombophilic women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment. However, to justify the use of low-molecular-weight heparin in clinical practice, multicenter trials are still necessary.
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Background Metformin is widely used for treating women with polycystic ovary syndrome ( PCOS ), and many patients with PCOS who are infertile receive gonadotrophins while being treated with metformin. Objectives To assess the effects of metformin administration in infertile patients with PCOS who receive gonadotrophins for in vitro fertilisation ( IVF ) and intracytoplasmic sperm injection ( ICSI ) cycles. Search strategy We searched international scientific databases, websites for the registration of trials, and bibliographies of retrieved articles, books, and review articles up to August 2012. Selection criteria Randomised controlled trials ( RCT s). Data collection and analysis Authors independently reviewed and extracted the data. Main results Ten RCT s (with a total of 845 women with PCOS ) were included in the final analysis. Metformin administration in IVF / ICSI cycles had no effect on the rates of pregnancy ( OR 1.20, 95% CI 0.90–1.61) and live birth ( OR 1.69, 95% CI 0.85–3.34). No effect of metformin dose, metformin pretreatment duration, and stopping time of metformin administration was observed on these reproductive end points. Metformin administration reduced the risk of ovarian hyperstimulation syndrome ( OHSS ; OR 0.27, 95% CI 0.16–0.46) and of miscarriage ( OR 0.50, 95% CI 0.30–0.83), while increased that of implantation ( OR 1.42, 95% CI 1.24–2.75). Author's conclusions In infertile patients with PCOS treated with gonadotrophins for IVF / ICSI cycles, metformin exerts no clinical effect on rates of pregnancy or live birth, but it reduces the risk of OHSS , and improves the rates of miscarriage and implantation. Further RCT s are needed to assess the reproductive effect of metformin in young well‐selected patients with PCOS and specific phenotypes and features.
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The aim of this meta-analysis was to evaluate the effect of growth hormone (GH) supplementation in poor responders undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).PubMed, MEDLINE and Cochrane Library databases were searched for the identification of relevant randomized controlled trials. Outcome measures were live birth rate, clinical pregnancy rate, miscarriage rate, cycle cancelation rate, number of retrieved oocytes and total dose of gonadotropin.Fifteen randomized controlled trails (RCTs) involving 1448 patients were eligible for the analysis. GH supplementation improved live birth rate (RR, 1.74; 95% CI, 1.19-2.54), clinical pregnancy rate (RR, 1.65; 95% CI, 1.31-2.08) and retrieved oocytes number (SMD, 0.72; 95% CI, 0.28-1.16), while reducing cancelled cycles rate (RR, 0.62; 95% CI, 0.44-0.85) and dose of Gonadotropin (SMD,-1.05 95% CI, - 1.62 - -0.49) for poor ovarian response patients. Besides, there was no significant difference in the miscarriage rate between GH group and control group.Based on the limited available evidence, growth hormone supplementation seems to improve IVF/ICSI outcomes for poor ovarian responders. Further randomized controlled trials with large sample sizes are required to clarify the effect of GH adjuvant therapy in the treatment of women with poor ovarian response.
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The aim of this work was to evaluate the effects of extreme body mass index (BMI) on assisted reproductive treatment outcome and pregnancy outcome. This is a descriptive cohort study that evaluated 8,145 consecutive in-vitro fertilisation/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles in which BMI were known, from July 1997 to June 2005 in an inner London major fertility clinic. The data were collected prospectively and analysed retrospectively on women undergoing IVF/ICSI and ET. Patients' weight and height were established prior to treatment. IVF/ICSI treatment was then started using either a long or an antagonist protocol. Patients were divided into five groups: Group A (BMI < 19); Group B (BMI between 19 and 25.9); Group C (BMI between 26 and 30.9); Group D (BMI between 31 and 35.9); Group E (BMI > 36). The main outcomes measured were number of eggs collected, fertilisation rate, number of embryos available for transfer, pregnancy rate (PR), live-birth rate (LBR) and miscarriage rate (MR). The results showed no significant difference in the average number of days taking follicle stimulating hormone (FSH) for ovarian stimulation, the average amount of gonadotrophin used for stimulation, number of eggs collected and fertilisation rate. The pregnancy rate, miscarriage rate and the live-birth rate were not statistically different between all groups. However, in group E the miscarriage rate was significantly higher and the LBR was statistically lower compared with group B. We concluded that extreme BMI did not affect the super-ovulation outcome fertilisation rate and pregnancy rate. Women with a BMI > 35 had a higher miscarriage rate and hence a lower live-birth rate, but a reasonable pregnancy and live-birth rate can be achieved. For women with a BMI < 20 there was no difference in assisted reproduction treatment (ART) outcome and pregnancy outcome when compared with women with a normal BMI. This information should be used to advise patients who wish to embark on ART with extreme BMI.
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Objective
To evaluate the middle-late pregnancy outcomes of patients who were clinical pregnancy with cervical length no more than 3 cm before pregnancy in-vitro fertilization and embryo transfer (IVF-ET) treatment.
Methods
A retrospective analysis was performed on infertile women with embryo transfer from May 2009 to December 2014 in our center. There were 86 patients who were clinical pregnancy with cervical length no more than 3 cm on transfer day, among whom 8 cases were miscarriage, and the rest 78 patients with ongoing pregnancy as study groups. A total of 225 patients whose clinical pregnancy with cervical length more than 3 cm as control groups, among whom 32 cases were miscarriage and the rest 193 patients with ongoing pregnancy. By comparing different cervical length of single pregnancy group (single pregnancy group 1 and group 3) and the twin pregnancy group (twins pregnancy group 2 and group 4) late miscarriage rate, premature birth rate respectively, the risks of adverse middle-late pregnancy outcomes in patients with cervical length no more than 3 cm were analyzed.
Results
The proportion of patients with cervical length no more than 3 cm before pregnancy in single pregnancy group 1 was significantly higher than the cervical length more than 3 cm in single pregnancy group 3(18.7% vs. 7.3%)(P 0.05). Meanwhile, there was no significant difference in the proportion of late miscarriage between the patients with cervical length more than 3 cm before pregnancy in twins pregnancy group 4 and patients with cervical length no more than 3 cm before pregnancy in twins pregnancy group 2(33.3% vs. 19.5%), as well as the premature birth(20.0% vs. 19.6%)(P>0.05).
Conclusion
The adverse middle-late pregnancy outcome might be more likely happen in patients with cervical length no more than 3 cm before pregnancy.
Key words:
In-vitro fertilization and embryo transfer; Cervical length; Late miscarriage; Premature birth
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