Objective:To compare the clinical outcomes of platelet-rich plasma(PRP)and Granulocyte colony-stimulating factor(G-CSF))in patients with thin endometrium undergoing frozen-thawed embryo transfer(FET). Methods:A retrospective analysis of 186 patients with thin endometrium undergoing IVF-FET in Reproductive Center of Beijing Amcare Beisanhuan Women & children's Hospital from January 1,2020 to June 30,2023 was conducted.Patients were divided into PRP group(105 cases)and G-CSF(81 cases)group according to different clinical intervention with intrauterine infusion.Comparisons were conducted on the changes of endometrial thickness before and after infusion,and pregnancy outcomes including clinical pregnancy rate,biochemical pregnancy rate,ongoing pregnancy rate,early miscarriage rate.Then the patients in each group were divided into two subgroups as severe thin endometrium group and mild thin endometrium group with endometrial thickness of 6.5 mm as the boundary.The changes of endometrial thickness before and after infusion as well as pregnancy outcomes were compared. Results:The average increase of endometrial thickness before and after infusion was 25.04％in PRP group and 18.32％in G-CSF group respectively with significant differences(P=0.003).No significant differences were found in pregnancy outcomes between the two groups(P＞0.05).In severe thin endometrium group,the increase of endometrial thickness in PRP group was significantly higher than that in G-CSF group(31.23％vs.22.34％,P=0.009)while there were no significant differences in pregnancy outcomes between the two groups(P＞0.05).In mild thin endometrium group,the increase of endometrial thickness in PRP group was still significantly higher than that in G-CSF group(19.52％vs.13.11％,P=0.033)and no significant differences were found in pregnancy outcomes(P＞0.05). Conclusions:Both PRP and G-CSF intrauterine infusion can effectively improve the pregnancy outcomes of FET cycles in patients with thin endometrium,with PRP showing better performance in increasing endometrial thickness,indicating that PRP intrauterine infusion is an effective treatment.
Objective:To investigate the risk of anxiety and depression in patients before induced abortion by using the hospital anxiety and depression scale(HADS). Methods:The convenience sampling method was used to select 871 patients before artificial abortion in Peking University First Hospital,and the HADS scale was used to screen the occurrence of anxiety and depression.Among them,866 patients completed the HADS scale.Chi-square test and binary logistic regression were used to analyze the influencing factors of anxiety and depression. Results:Among 866 patients who completed the HADS scale measurement before induced abortion,the incidence rate of anxiety and depression before abortion was 18.59％(161/866).With the increase of weekly exercise frequency,monthly income personal and partner education level,life happiness level,sexual activity,the proportion of anxiety and depression gradually decreases.The proportion of anxiety and depression was highest among individuals who primarily engage in physical labor among different professions,and the proportion of anxiety and depression in married individuals was significantly lower than that in unmarried and divorced individuals(P＜0.05).The proportion of anxiety and depression among individuals living alone was the highest among different living conditions.Patients with more than 3 induced abortions had the highest proportion of anxiety and depression.The patients with 4 pregnancies had the highest proportion of anxiety and depression,while those with 2 pregnancies had the lowest proportion of anxiety and depression.Binary logistic regression analysis showed that weekly exercise frequency,residential status,personal education level,life happiness level,and pregnancy frequency were influencing factors for the occurrence of anxiety and depression. Conclusions:The proportion of patients undergoing artificial abortion who experience negative emotions such as depression and anxiety is relatively high.There are significant differences in the occurrence of anxiety and depression among artificial abortion patients with different characteristics.In the nursing work of obstetrics and gynecology,special attention should be paid to the groups who are more prone to anxiety and depression,targeted psychological nursing interventions should be taken,and personalized health education and psychological counseling should be done before surgery.
子宫破裂是一种严重的、危及孕产妇及新生儿生命的不良产科事件,具有极高的大出血率和死亡率.子宫破裂主要的危险因素是瘢痕子宫,既往无子宫手术史的孕妇发生子宫破裂极其罕见.本文报道1例罕见的非瘢痕子宫妊娠子宫不完全性破裂的病例,对其病情发展及诊治经过进行整理,并对相关文献进行复习,分析该类孕妇的临床特征,以期提高临床医生对此类疾病的警惕性,做到及早发现和及早干预,避免不良围产结局的发生.
Objective:To investigated the effect of different sperm morphological percentages on clinical pregnancy rate in intrauterine insemination(IUI). Methods:The clinical data of 2 637 IUI treatment cycles[controlling for female age＜40 years old and total progressive motile sperm count(TPMSC)≥5 million]performed at our reproduction center from December 2019 to December 2022 were retrospectively analyzed.The patients were divided into 3 groups according to the percentage of normal sperm morphology(＜1.0％,≥1.0％to＜4.0％,and ≥4.0％,respectively).The clinical characteristics and clinical pregnancy rate of patients were compared between the groups,and logistic regression models were used to analyze the relationship between sperm morphology and clinical pregnancy rate in IUI. Results:Of the 2,637 IUI treatment cycles included,clinical pregnancy was achieved in 321 cycles(12.17％).In the analysis strictly classified according to sperm morphology,the clinical pregnancy rates in the normal sperm morphology percentage＜1.0％,≥1.0％to＜4.0％,and ≥4.0％groups were 12.87％,11.63％,and 12.62％,respectively,and there was no significant difference in the comparison of the groups(P＞0.05).The multivariate logistic analysis showed that different levels of sperm morphology could not independently predict clinical pregnancy outcome in IUI[OR(95％CI)=1.016(0.973,1.061),P=0.470],whereas sexual dysfunction[OR(95％CI)=2.809(1.415,5.578),P=0.003]and ovulation induction protocol[OR(95％CI)=1.480(1.058,2.072),P=0.022]could independently predict clinical pregnancy outcome in IUI. Conclusions:Under the premise of controlling the age of the female partner and TPMSC,there was no significant difference in the clinical pregnancy rate among patients with different percentages of normal sperm morphology,including those with severe teratozoospermia.
Objective:To investigate the effects of endometrial preparation schemes on pregnancy outcome of frozen embryo transfer. Methods:The clinical data of the infertile patients(3 556 cycles)who underwent frozen embryo transfer(FET)assisted pregnancy in Reproductive Hospital of the Second Affiliated Hospital of Zhengzhou University from December 2014 to December 2022 were retrospective analyzed.The patients were divided into four groups according to the endometrial preparation scheme:the natural cycle group(Group A,n=467),the ovulation induction group(Group B,n=230),the hormone replacement group(Group C,n=2 112),and the pituitary down-regulation combined with hormone replacement group(Group D,n=747).The basic characteristics and the pregnancy outcomes were compared among the groups. Results:There was no significant difference in basic characteristics including age,infertile years,body mass index(BMI),the number of embryos transferred,the endometrial thickness on the transferred day,the number of embryos thawed,the embryo survival rate after thawed,and the high-quality embryos rate as well as the proportion of transferred embryos types among the four groups(P＞0.05).As for the pregnancy outcomes of four groups,the embryo implantation rate in Group D was significantly higher than those of the other three groups,and those of Group C and Group A were significantly higher than that of Group B(P＜0.05).The full-term labor rate in Group C was significantly higher than those of the other three groups,and that of Group D and Group A were significantly higher than that of Group B(P＜0.05).There were no significant differences in the clinical pregnancy rate,the ectopic pregnancy rate,the early abortion rate,the persistent pregnancy rate,the late abortion rate and the live birth rate among the four groups(P＞0.05). Conclusions:The pituitary down-regulation combined with hormone replacement can effectively increase the embryo implantation rate.The hormone replacement can effectively increase the full-term labor rate.Compared to these two endometrial preparation schemes,the pregnancy outcome of the natural cycle is acceptable,and the pregnancy outcome of the ovulation induction group is poor.Therefore,as for patients undergoing FET assisted pregnancy,an appropriate endometrial preparation scheme need to be developed based on their own characteristics.
