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Effect of Acupuncture on Outcomes of in vitro Fertilisation:A Scoping Review

Chinese Journal of Integrative Medicine 2022年第5期28卷 472-480页

作者： XIU Wen-cui GANG Wei-juan JIAO Rui-min SHI Lan-jun YANG Ji-wei JING Xiang-hong SHI Xiao-shuang Institute of Acupuncture and Moxibustion China Academy of Chinese Medical SciencesBeijing(100700)China

Objectives:To identify,examine and summarize the available evidence on the effectiveness and safety of acupuncture for in vitro fertilisation(IVF)outcomes.Methods:Eight electronic databases,including Pub Med,EMBASE,Cochrane Database of Systematic Review,Cochrane Central Register of Controlled Trials,China National Knowledge Infrastructure,Wanfang Database,Chinese Biomedical Database and VIP Database,were searched,supplemented by manual searches.Two researchers independently conducted the literature screening,data extraction,and methodological quality assessments.A narrative description was provided to show the general information and specific characteristics of the included studies.A bubble plot was used to visually display the overall effects of acupuncture on IVF outcomes.Results:Eighty-two studies were identified,including 64 primary studies and 18 systematic reviews.Transcutaneous electrical acupoint stimulation,electric acupuncture and manual acupuncture were applied in most studies and compared with no acupuncture,sham acupuncture and placebo acupuncture control groups.Sixty-three(98.4%)primary studies reported clinical pregnancy rate,and positive effects of acupuncture were found in 34 studies(54.0%).Live birth rate was reported in only 18(28.1%)primary studies,of which 10(55.6%)showed positive results.In addition,only 8 and 2 systematic reviews showed that acupuncture could increase clinical pregnancy events and live birth events,respectively.However,none of these reviews was of high methodological quality.Conclusions:Available evidence suggests that acupuncture therapy could improve clinical pregnancy rates.However,whether acupuncture could increase live birth events was difficult to determine based on the few studies that have reported this outcome indicator.Furthermore,the methodological quality of most systematic reviews was assessed as critically low or low.Studies with a rigorous design and standardized implementation should be performed to refine the available evidence.

关键词： acupuncture in vitro fertilisation clinical pregnancy rate Live birth rate scoping review

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Pregnancy Outcomes for Day 5 Versus Day 6 Single Frozen-thawed Blastocyst Transfer with Different Qualities of Embryos: A Large Matched-cohort Study

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Current Medical Science 2023年第2期43卷 297-303页

作者： Qiong YU Hui HE Xin-ling REN Shi-fu HU Lei JIN Reproductive Medicine Center Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of Obstetrics and Gynecology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patients who underwent blastocyst transfer in frozen-thawed cycles at day 5 or 6 were matched for potential confounding factors.A total of 2207 matched pairs of FBT cycles were included from January 2016 to December 2019 in our Reproductive Medicine Center.Results The clinical pregnancy rate(CPR)and Live birth rate(LBR)were significantly increased in day 5 blastocyst transfers when compared to day 6 blastocyst transfers,in terms of the same embryo quality.For FBT cycles with good-quality embryo,the CPR at day 5 and 6 was 61.30%and 57.56%,respectively(P=0.045),and the LBR was 44.79%and 36.16%,respectively(P<0.001).For FBT cycles with poor-quality embryo,the CPR at day 5 and 6 was 48.61%and 40.89%,respectively(P=0.006),and the LBR was 31.71%and 25.74%,respectively(P=0.019).The CPR for FBT cycles with good-quality embryo was statistically higher at day 6 than that at day 5 with poor-quality embryo transferred(57.56%vs.48.61%,P=0.001).Maternal age,anti-Müllerian hormone(AMH),endometrial thickness,embryo quality,and the day of blastocyst expansion were independently correlated with the CPR and LBR.The FBT cycles at day 5 had significantly higher CPR(adjusted odds ratio[OR]=1.246,95%confidence intervals[CI]:1.097–1.415,P=0.001)and LBR(adjusted OR=1.435,95%CI:1.258–1.637,P<0.001)than those at day 6.Conclusion The embryo quality is the primary indicator for FBT cycles.Day 5 blastocysts should be preferred when the quality of embryo at day 5 is the same as that at day 6.

关键词： frozen-thawed blastocyst transfer day 5 versus day 6 embryo quality clinical pregnancy rate Live birth rate

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Pregnancy outcomes of four different cycle protocols for frozen embryo transfer: a large retrospective cohort study

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Reproductive and Developmental Medicine 2023年第3期7卷 135-141页

作者： Yue Qian Qi Wan Xiao-Qing Bu Tian Li Xiao-Jun Tang Yan Jia Qian Feng Xing-Yu Lv Xiang-Qian Meng Yin Yang Yu-Bin Ding Li-Hong Geng Min Xia Zhao-Hui Zhong Department of Epidemiology School of Public Health and ManagementResearch Center for Medicine and Social DevelopmentInnovation Center for Social Risk Governance in HealthChongqing Medical UniversityChongqing 400016China Chengdu Xi'nan Gynecological Hospital Chengdu 610011China Department of Gynecology and Obstetrics West China Second HospitalSichuan UniversityChengdu 610041China Key Laboratory of birth Defects and Related Diseases of Women and Children(Sichuan University) Ministry of EducationChengdu 610041China Department of Reproductive Medicine The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China School of Public Health and ManagementChongqing Medical UniversityChongqing 400016China Department of Gynecology Chongqing Hospital of Traditional Chinese MedicineChongqing 4uuuzlChina.

Objective:To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer(FET),including natural cycle(NC),hormone replacement therapy cycle(HRT),gonadotropin-releasing hormone agonist artificial cycle(GAC),and ovarian stimulation cycle(OC).Methods:This retrospective cohort study enrolled 10,333 cycles of frozen embryo transfer performed at Xinan Gynecological Hospital in Sichuan,China,from January 2018 to December 2018.The patient's baseline characteristics and pregnancy outcomes were extracted from the medical record system.Pregnancy outcomes were compared among the four groups and multiple logistic regression models were used to adjust for the confounding factors.Results:After adjusting for covariates,multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT group,GAC group,and OC group compared to the NC group in the entire population.The adjusted odds ratio of live birth was 0.976(95%)confidence interval[Cl](0.837-1.138)for the HRT group,0.959(95%confidence interval 0.797-1.152)for the GAC group,and 0.909(95%confidence interval 0.763-1.083)for the OC group.Conclusions:The natural protocol had comparable pregnancy outcomes compared to the other three endometrial preparation protocols in the overall FET population.More high-quality prospective randomized controlled trials are required to assess the efficacy of the four protocols and explore the optimal one.

关键词： Clinical pregnancy rate Endometrial preparation protocols Frozen-thawed embryo transfer Live birth rate Natural cycle

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Reproductive outcomes of intracytoplasmic sperm injection using testicular sperm and ejaculated sperm in patients with AZFc microdeletions:a systematic review and meta-analysis

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Asian Journal of Andrology 2021年第5期23卷 495-500页

作者： Yu Zhou Cun-Can Deng Wu-Jiang Liu Huang Liu Hou-Bin Zheng Yun-Ge Tang Xin-Zong Zhang Jun-Hong Deng Department of Urology The First Affiliated HospitalJinan UniversityGuangzhou 510630China NHC Key Laboratory of Male Reproduction and Genetics Family Planning Research Institute of Guangdong ProvinceGuangzhou 510600China Digestive Diseases Center The Seventh Affiliated Hospital of Sun Yat-sen UniversityShenzhen 518107China Department of Andrology Guangzhou First People's HospitalSchool of MedicineSouth China University of TechnologyGuangzhou 510180China

Studies have explored the assisted reproductive technology(ART)outcomes of Y-chromosome azoospermia factor c(AZFc)microdeletions,but the effect of sperm source on intracytoplasmic sperm injection(ICSI)remains unknown.To determine the ART results of ICSI using testicular sperm and ejaculated sperm from males with AZFc microdeletions,we searched Embase,Web of Science,and PubMed to conduct a systematic review and meta-analysis.The first meta-analysis results for 106 cycles in five studies showed no significant differences in the Live birth rate between the testicular sperm group and the ejaculated sperm group(risk ratio:0.97,95%confidence interval[CI]:0.73-1.28,P=0.82).The second meta-analysis of 106 cycles in five studies showed no difference in the abortion rate between the testicular sperm group and ejaculated sperm group(risk ratio:1.06,95%Cl:0.54-2.06,P=0.87).The third meta-analysis of 386 cycles in seven studies showed no significant difference in clinical pregnancy rates between the testicular sperm group and the ejaculated sperm group(risk ratio:1.24,95%Cl:0.66-2.34,P=0.50).Inevitable heterogeneity weakened our results.However,our results indicated that testicular sperm and ejaculated sperm yield similar ART outcomes,representing a meaningful result for clinical treatment.More properly designed studies are needed to further confirm our conclusions.

关键词： assisted reproductive technology azoospermia factor c microdeletions ejaculated sperm Live birth rate testicular sperm

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The effect of serum luteinizing hormone on trigger day with a GnRH antagonist protocol in IVF/ICSI treatment

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Gynecology and Obstetrics Clinical Medicine 2021年第4期1卷 205-210页

作者： Yanru Hou Li Tian Huixin Liu Jiajia Ai Yanbin Wang Huan Shen Department of Obstetrics and Gynecology Peking University People's HospitalChina Department of Clinical Epidemiology and Biostatistics Peking University People's HospitalChina

Objective:To investigate the effect of serum luteinizing hormone(LH)on trigger day with a Gonadotrophinreleasing hormone(GnRH)antagonist protocol in patients receiving in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)treatment for pregnancy outcomes.Methods:We retrospectively reviewed the medical documents of patients receiving IVF/ICSI with fresh embryo transfers from the Reproductive Medicine Center of Peking University People's Hospital between January 2016 and December 2018.730 patients were included and divided into three groups by their serum LH level determined on trigger day.All patients were categorized into Group A,Group B,and Group C based on LH concentrationsrates between Group A and Group C(24.8%versus 40.1%,respectively,Prates(39.3%versus 54.3%,respectively,P=0.078)and Live birth rate(LBR)(32.1%versus 46.5%,respectively,P=0.116),though the differences were not significant.Multivariate logistic regression analysis showed that the OR of Group C for clinical pregnancy(OR=1.849,P=0.040)and for LBR(OR=1.915,P=0.034)were significant using Group A as the base level.Conclusions:Our study has demonstrated that patients with higher serum LH levels(5.0–10.0 IU/L)on trigger day in the GnRH antagonist protocol may confer better clinical outcomes than those with lower LH levels(<1.0 IU/L).

关键词： Gonadotrophin-releasing hormone antagonist Controlled ovarian stimulation Luteinizing hormone Live birth rate

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Development and Validation of a Nomogram for Predicting the Probability of live birth in Infertile Women

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Reproductive and Developmental Medicine 2019年第2期3卷 77-83页

作者： Meng Zhang Hai-Qing Tian Tao Bu Xia Li Xiao-Hui Wan Duo-Lao Wang Hua Xu Xin-Min Mao Qing-Li Wang Xiao-Lin La Reproductive Medicine Center The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054XinjiangChina Center of Statistics and Information The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054XinjiangChina Department of Clinical Sciences and International Public Health Liverpool School of Tropical MedicineUniversity of LiverpoolLiverpool L693BXUnited Kingdom

Objective:To develop a nomogram to predict the probability of live birth on the basis of the association of patient characteristics in subfertile individuals or couples.Methods:A retrospective study was conducted from January 2014 to December 2015.A nomogram was built from a training cohort and tested on an independent validation cohort.A total of 2,257 patients who had undergone their first nondonor cycle of in vitro fertilization(IVF)(including intracytoplasmic sperm injection)were randomly split 2:1 into training(n=1,527)and validation(n=730)cohorts.Results:There were no statistically significant differences in the patients’baseline and cycle characteristics between the training and validation cohorts.On multiple logistic regression analysis,female age,antral follicle count,tubal factor,anovulation,ethnicity,unexplained fertility,and male factor were significantly associated with live birth.The nomogram had a C-index of 0.700(95%confidence interval[CI]:0.698-0.701)in the training cohort and 0.684(95%CI:0.681-0.687)in the validation cohort.Conclusions:Our nomogram can predict the probability of live birth for infertile women and can be used to guide clinicians and couples to decide on an IVF treatment option.

关键词： In vitro Fertilization/Intracytoplasmic Sperm Injection Live birth rate Nomogram Predictive Model Treatment Outcome Prediction

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Intrauterine Insemination Treatment Strategy for Women over 35 Years Old： Based on a Large Sample Multi-center Retrospective Analysis

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Chinese Medical Journal 2016年第23期129卷 2873-2875页

作者： Shuo Yang Hong-Ying Peng Ying Li Li-Ying Zhou Li Yuan Yan-Min Ma Hui-Chun Wang Rong Li Ping Liu Jie Qiao Reproductive Medical Center Peking University Third Hospital Beijing 100191 China Reproductive Medical Center Haidian Maternal and Child Health Hospital Beijing 100080 China Reproductive Medical Center Beijing Obstetrics and Gynecology Hospital Beijing 100006 China Reproductive Medical Center Tianjin Fifth Central Hospital Tianjin 300450 China

As we all known, maternal age and ovarian reserve are two of the most important prognosis i-hctors for fertility, in 1980, the study of Menken et al. showed the female fertility declined after 32 years old, especially... 详细信息

关键词： Clinical Pregnancy rate Intrauterine Insemination Live birth rate Maternal Age

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The interaction effect between advanced paternal age and paternal obesity is associated with the low implantation rate in couples with unexplained recurrent pregnancy loss

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Gynecology and Obstetrics Clinical Medicine 2021年第4期1卷 197-204页

作者： Shuo Li Yaqian Shen Yueting Zhu Hongchang Li Wenjie Jiang Junhao Yan Zi-Jiang Chen Center for Reproductive Medicine Cheeloo College of MedicineShandong UniversityJinanShandong250012China Key Laboratory of Reproductive Endocrinology of Ministry of Education Shandong UniversityJinanShandong250012China Shandong Key Laboratory of Reproductive Medicine JinanShandong250012China Shandong Provincial Clinical Research Center for Reproductive Health JinanShandong250012China National Research Center for Assisted Reproductive Technology and Reproductive Genetics Shandong UniversityJinanShandong250012China Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics Shanghai200135China Center for Reproductive Medicine Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200135China

Objective:To explore the roles of advanced paternal age(APA)and abnormal paternal weight on embryo quality and pregnancy outcomes for unexplained recurrent pregnancy loss(uRPL)couples who underwent preimplantation genetic testing for aneuploidies(PGT-A).Methods:This study included 779 uRPL couples who underwent their first PGT-A cycles between 2014 and 2018.Male patients’aging and nutritional status were quantified by paternal age and body mass index(BMI).Routine semen parameters and sperm DNA fragmentation index(DFI)were used to reflect the seminal quality.Blastocyst formation rate and aneuploidy rate were used to reflect the embryo quality.Cycle cancellation rate,implantation rate,pregnancy loss rate,and Live birth rate were measured to evaluate the treatment efficiency from IVF.To remove the interference of maternal age,only the women younger than 38 years old were included.After univariate screening,interaction tests were performed in a generalized linear model(GLM)to further examine the effects of paternal age and BMI on each outcome indicator.Results:In the total population(779 cycles),there were no statistical differences in aneuploidy rate,cycle cancellation rate,implantation rate,pregnancy loss rate,and Live birth rate,whether stratified by paternal age or paternal BMI.Similar results occurred in the younger men(rate,and Live birth rate.After interaction testing,the results of GLM suggested that the interaction effect between APA and paternal obesity was associated with the low implantation rate of uRPL couples.Conclusions:For the uRPL couples seeking for PGT-A treatment,if the male patients have both advanced age and obesity,their spouses are at higher risks for embryo implantation failure.

关键词： Advanced paternal age Implantation rate Live birth rate Obesity Preimplantation genetic test Unexplained recurrent pregnancy loss

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Effects of changing the control ovarian stimulation protocol in patients without a transplantable embryo in the previous in vitro fertilization/intracytoplasmic sperm injection cycle

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Reproductive and Developmental Medicine 2023年第4期7卷 218-223页

作者： Shan-Jia Yi Yi-Hua Yang Yin Bi Zhong-Hong Zeng Xi Wang Mu-Jun Li Wen-Hong Ma Guangxi Reproductive Medical Center The First Affiliated Hospital of Guangxi Medical UniversityNanning 530021China Reproductive Medicine Center Affiliated Hospital of Guilin Medical UniversityGuilin 541001China Reproductive Medicine Center Liuzhou Maternity and Child Healthcare Hospital Liuzhou 545001China

Objective:Some patients fail to obtain an embryo for transplantation during previousin vitro fertilization(IVF)or intracytoplasmic sperm injection(ICSI)cycles,and require multiple reproductive treatments.This study aimed to evaluate whether changing the control ovarian stimulation(COS)protocol during the subsequent stimulation cycle could improve laboratory and clinical outcomes in these patients.Methods:Patients without a transplantable embryo(TE)in the previous IVF/ICSI cycles were recruited during their second cycles.They were classified into two groups according to their first cycle protocol:Group A,patients treated with a gonadotropinreleasing hormone agonist(GnRH-a),and Group B,patients treated with a gonadotropin-releasing hormone antagonist(GnRH-ant).The study group included patients whose stimulation protocols were changed,whereas the control group consisted of patients who used the same stimulation protocol in the second cycle.We then compared the numbers of oocytes collected(OC)and TE,the incidence of non-TE,the pregnancy rate(PR),and the Live birth rate(LBR).Results:In Group A,the numbers of OC and TE were significantly lower(6.0±4.7vs.9.4±6.4,2.3±2.2vs.4.5±3.8,P<0.05)in the study group compared with those in the control group.In Group B,the numbers of OC and TE were higher(7.0±5.5vs.4.0±4.3,3.5±3.4vs.1.8±2.1,P<0.05)in the study group.There was a significant increase in the incidence of non-TE(adjusted odds ratio(AOR)=2.12,95%CI:1.04–4.69)of the study group in Group A but not in Group B.No significant differences in the PR or LBR were found between the study and control groups in either Group A or B.Conclusion:Changing the COS protocol from GnRH-ant to GnRH-a or continuing the GnRH-a protocol can improve laboratory outcomes in patients with no TE in the previous IVF/ICSI cycle.

关键词： GnRH agonist GnRH antagonist Transplantable embryo Pregnancy rate Live birth rate

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Clinical Results of In Vitro Fertilization or Intracytoplasmic Sperm Injection Treatments in Women Aged 40 Years and above

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Reproductive and Developmental Medicine 2018年第2期2卷 100-104页

作者： Ting-Yu Zhang Qin-Zhi Bu Chun-Ying Su Reproductive Medical Center First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

Objective:The study was designed to estimate the Live birth rate(LBR)and cumulative LBR(CLBR)in patients aged≥40 years undergoing in vitro fertilization or intracytoplasmic sperm injection treatments during their first and multiple ovarian stimulation cycle(s).Methods:A total of 697 advanced women underwent 1,293 treatment cycles,and 973 fresh embryo transfers were performed.The LBR and CLBR were analyzed with respect to an increase in the maternal age by every year.Results:A declining trend in LBR and CLBR of the first cycle was seen with an increase in maternal age.The LBR in women aged 40 years was significantly higher than that in women aged≥44 years(18.39%and 4.39%,respectively);the CLBR in women aged 40 years was also significantly higher than that in women aged 42,43,and≥44 years(22.40%,9.09%,9.09%,and 4.80%,respectively).However,there was no significant difference(P>0.05)in the rate of miscarriage among all groups.For those who underwent multiple cycles,the number of live-born babies decreased rapidly after three ovarian stimulation cycles;the LBR in patients aged 40 years was significantly higher than that in patients aged 42 years and≥44 years(15.24%,5.20%,and 4.49%,respectively),and the CLBR in patients aged 40-41 years was significantly higher than that in patients aged≥42 years.The CLBR in all groups gradually plateaued after three cycles;women aged 40-41 years achieved relatively reasonable CLBR,while the CLBR wasrate quickly decreased,and for women aged≥42 years,the decision to continue after three ovarian stimulation cycles should be made cautiously.

关键词： Advanced Age Clinical Results Cumulative Live birth rate Live birth rate

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