Growing evidence suggests that metabolic disturbances underlie pregnancy losses, imposing a substantial public health burden among young women of reproductive age. Glycolipid metabolism 7 factors (GLM7) is a composite glycolipid metabolism index derived from routinely measured metabolic indicators; however, its relevance to pregnancy loss in young women remains unexamined. The present study analyzed publicly available data from the 2009–2018 National Health and Nutrition Examination Survey (NHANES) cycles. Participants were categorized as having no pregnancy loss, single pregnancy loss, or recurrent pregnancy loss (≥ 2 losses). GLM7 was calculated as the logarithm of the product of age, body mass index, fasting blood glucose, fasting insulin, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels. The association between GLM7 and pregnancy loss categories was evaluated, potential dose–response patterns were explored, and effect modification by selected sociodemographic and behavioral factors was assessed. Of the 736 women included in the analysis, 300 (37

Prolonged menstrual cycles may indicate potential cardiometabolic conditions; however, there are limited data on how these associations vary among women without polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF). In this study, we aimed to investigate the association between menstrual cycle length, pregnancy complications, and adverse birth outcomes among women without PCOS undergoing frozen embryo transfer (FET). Women who delivered singleton live births and had complete pre-pregnancy menstrual cycle data were eligible for inclusion in this study, and were grouped according to the menstrual cycle length (≤ 27, 28–31, 32–35, and ≥ 36 days). Multivariable logistic regression models adjusted for age, body mass index, parity, infertility factors, IVF-FET parameters, and embryo characteristics were used to estimate the adjusted odds ratios (aORs) for gestational diabetes mellitus (GDM) and gestational hypertension. Women with prolonged cycles (≥ 36 days) had a higher risk of GDM (aOR 1.54; 95

ABSTRACT Hyperandrogenism has been linked to increased preeclampsia risk, but its independent role remains unclear due to confounding by polycystic ovary syndrome (PCOS). This retrospective cohort study investigated whether non‐PCOS hyperandrogenism is associated with hypertensive disorders of pregnancy (HDP) and adverse pregnancy outcomes in women undergoing frozen embryo transfer (FET), and whether hyperandrogenism synergizes with overweight/obesity to further increase these risks. We analyzed data from 1556 infertile women who underwent FET at Ruijin Hospital and delivered between January 2015 and December 2022. Participants were classified into four groups based on the presence of hyperandrogenism and overweight/obesity: controls ( n = 1201), hyperandrogenism only ( n = 116), overweight/obesity only ( n = 209), and both hyperandrogenism and overweight/obesity ( n = 30). Multivariable logistic regression models were used to evaluate associations with HDP and related adverse outcomes. In multivariable analyses, overweight/obesity was independently associated with an increased risk of gestational diabetes mellitus (GDM) (adjusted odds ratio [aOR] 1.62) and gestational hypertension (aOR 3.45), whereas the coexistence of overweight/obesity and hyperandrogenism was strongly associated with higher risks of preeclampsia (13.3%, aOR 7.53), preterm birth (23.3%, aOR 3.67), and cervical length shortening (CLS) (6.7%) compared to the controls. These results suggest that in women without PCOS undergoing FET, the coexistence of hyperandrogenism and overweight/obesity identifies a high‐risk hypertensive phenotype characterized by a substantially elevated risk of preeclampsia. Moreover, our findings may indicate synergistic effects of endocrine and metabolic disturbances on pregnancy‐related blood pressure dysregulation and could facilitate early risk stratification for HDP.

Increased expression of tribbles pseudokinase 3 (TRIB3), which is attributed to increased levels of free fatty acids in the follicular fluid of women with obesity, is correlated with reduced oocyte developmental competence. Connexin 43 (Cx43) is a crucial element of gap junctions in human ovarian granulosa cells (GCs) and facilitates oocyte development. This study aimed to investigate whether high TRIB3 expression and decreased oocyte development potential is regulated by aberrant Cx43 expression in human GCs under high fatty acid culture conditions. GCs from women undergoing in vitro fertilization were grouped by body mass index (BMI). The human granulosa-like tumor cell line (KGN) was exposed to palmitic acid (PA), and its effect on cell apoptosis, viability and proliferation was assessed. The effects of TRIB3 overexpression and knockdown on KGN cells were analyzed. Gene and protein expression, along with the activity of the Wnt/β-catenin signaling pathway, were analyzed using quantitative reverse transcription-PCR, western blotting, immunofluorescence staining, and co-immunoprecipitation. Gap junction function was assessed using a scrape loading/dye transfer assay. Fertilization rates declined in women with overweight or obesity. In the GCs of these women, TRIB3 and Cx43 were upregulated. The protein expression of TRIB3 and Cx43 increased in KGN cells exposed to PA. TRIB3 overexpression led to increased Cx43 expression, whereas TRIB3 knockdown resulted in reduced Cx43 expression. Further mechanistic investigations revealed that TRIB3 upregulated Cx43 by reducing the degradation of β-catenin in the Wnt signaling pathway. TRIB3 overexpression can enhance Cx43 expression in human GCs by inhibiting the Wnt/β-catenin pathway, thereby reducing oocyte maturation rate. These findings could be used to improve the quality of female oocytes and enhance infertility therapy in the clinic.

Background: Among the POSEIDON criteria, group 3 and group 4 have an expected low prognosis. For those patients with inadequate ovary reserve, embryo accumulated from consecutive oocyte retrieval cycles for multiple frozen-thawed embryo transfers (FET) has become more common. It is necessary to inform them of the pregnancy outcomes after single or multiple FET cycles before the treatment. However few studies about cumulative live birth rate (CLBR) for those with low prognosis have been reported. Methods: This retrospective study included 4712 patients undergoing frozen embryo transfer cycles from July 2015 to August 2020. Patients were stratified as POSEIDON group 3, group 4, control 1 group (< 35 years) and control 2 group (≥35 years). The primary outcome is CLBRs up to six FET cycles and the secondary outcomes were LBRs per transfer cycle. Optimistic approach was used for the analysis of CLBRs and the depiction of cumulative incidence curves. Results: Under optimistic model analyses, control 1 group exhibited the highest CLBR (93.98%, 95%CI 91.63%-95.67%) within 6 FET cycles, followed by the CLBR from women in POSEIDON group 3（92.51%，95%CI 77.1-97.55）was slightly lower than that in control 1 group. The CLBR of POSEIDON group 4（55% ,95%CI 39.34%-70.66%）was the lowest and significantly lower than that of control 2 group（88.7%, 95%CI 80.68%-96.72%）. Further, patients in POSEIDON group 4 reached a CLBR plateau after 5 FET cycles. Conclusions: The patients of POSEIDON group 3 may not be considered as traditional “low prognosis” in clinical practice as extending the number of FET cycles up to 6 can archive considerably CLBR as control women. While for the POSEIDON group 4, a simple repeat of the FET cycle is not recommended after four failed FET cycles, some strategies such as PGT-A may be beneficial.

Objective To determine whether polycystic ovary syndrome (PCOS) increases adverse pregnancy and birth outcomes in women undergoing frozen embryo transfer (FET). Design Retrospective cohort study. The PCOS group was matched 1:2 with the control group population using propensity score matching (PSM). Patients During an 8-year period, 2,955 patients aged 20 to 40 years who underwent FET and delivered between January 2015 and December 2022 at the Reproductive Medical Center of Ruijin Hospital were evaluated for adverse pregnancy outcomes. Intervention(s) None. Main Outcome Measures All patients were assessed for specific pregnancy complications and birth outcomes, with a sub-group analysis conducted to compare PCOS patients with and without hyperandrogenism. Results Women with PCOS demonstrated higher rates of gestational diabetes mellitus (24.9% vs. 16.4%; relative risk (RR) 1.51 [95% confidence interval (CI): 1.26-1.82]; P <0.001), gestational hypertension (12.2% vs. 8.9%; RR 1.37 [95% CI: 1.05-1.80]; P = 0.022), preterm prelabour rupture of membranes (7.0% vs. 3.6%; RR 1.92 [95% CI: 1.29-2.86]; P = 0.001), cervical length shortening (1.8% vs. 0.4%; RR 8.39 [95% CI: 1.56-12.49]; P = 0.002), large-for-gestational age (17.4% vs. 13.7%; RR 1.27 [95% CI: 1.02-1.57]; P = 0.032), and low birth weight (19.9% vs. 16.0%; RR 1.25 [95% CI: 1.02-1.52]; P = 0.030) in overall PSM analysis. Newborns of patients with PCOS had a higher risk of preterm birth < 37 weeks (10.5% vs. 6.6%; RR 1.59 [95% CI: 1.12-2.26]; P = 0.009) in singleton pregnancies. PCOS patients with hyperandrogenism showed a higher incidence of cervical length shortening (5.5% vs. 0.5%; adjusted odds ratio (AOR) 15.62 [95% CI: 2.25-108.48]; P = 0.005) compared to those without, after adjusting for relevant confounders. Conclusion PCOS increases the incidence of adverse pregnancy outcomes after FET cycles. Our study suggests women with PCOS may warrant further monitoring and additional counseling before and during pregnancy.

1Department of Gynecology and Obstetrics, Reproductive Medical Center, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China, 2Institute of Reproductive Medicine, School of Medicine, Nantong University, Nantong 226019, China, and 3Department of Andrology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen 361005, China †These authors contributed equally to this work. *Correspondence address. Tel: +86-18351326136; E-mail: zhangxn@ntu.edu.cn (X.Z.) / Tel: +86-13860456076; E-mail: shayanwei928@126.com (Y.S.) / Tel: +86-15221427862; E-mail: kangniu@sina.com (Z.N.)

ObjectiveTo assess the causal effect of type 2 diabetes mellitus (T2DM) on male infertility (MI) and erectile dysfunction (ED) by Mendelian randomization (MR) analysis.MethodsData for T2DM, MI, and ED were obtained from genome-wide association studies (GWAS) involving 298, 957, 73, 479, and 223, 805 Europeans, respectively. We performed univariate MR analysis using MR Egger, Weighted median (WM) and Inverse variance weighted (IVW) methods to assess causal effects among the three. Through the Genotype Tissue Expression (GTEx) database, single-nucleotide polymorphisms (SNPs) that affect the expression levels of T2DM-related genes were located using expression quantitative trait loci (eQTL).ResultsMR analysis showed a significant causal relationship between T2DM and ED (WM, OR: 1.180, 95%CI: 1.010-1.378, P = 0.037; IVW, OR: 1.190, 95%CI: 1.084-1.300, P < 0.001). There is also a significant causal relationship between T2DM and MI (MR Egger, OR: 0.549, 95%CI: 0.317-0.952, P = 0.037; WM, OR: 0.593, 95%CI: 0.400, P = 0.010; IVW, OR: 0.767, 95%CI: 0.600-0.980, P = 0.034). ED may not cause MI (P > 0.05). We also found that rs6585827 corresponding to the PLEKHA1 gene associated with T2DM is an eQTL variant affecting the expression of this gene.ConclusionT2DM has a direct causal effect on ED and MI. The level of PLEKHA1 expression suppressed by rs6585827 is potentially associated with a lower risk of T2DM.

Background Physicians need an appropriate embryo transfer strategy to address the challenge of reducing multiple birth rates, while maintaining the couples’ live birth rate during assisted reproductive technology. Methods We included 10,060 frozen embryo transfer cycles from January 2015 to March 2020 in reproductive medical center of Ruijin hospital, Shanghai, China. Patients were grouped according to the number and grade of cleavage-stage embryo or blastocysts transferred. Live birth rate and multiple live birth rate were compared among groups of women of different ages. Multivariable logistic regression models were used to estimate the risk of multiple live birth using different combinations of transferred embryos. Results The transfer of double good-quality embryos was an independent predictor for multiple birth in women aged <30 years and those aged 36−39 years [<30 years: aOR =1.54 (95% CI: 1.14−2.06, P < 0.01); 36−39 years: aOR =1.84 (95% CI: 1.0−3.4, P < 0.01)]. Further, for women aged <36 years, the transfer of good-quality + poor-quality blastocysts was an independent predictor for multiple birth rate [<30 years: aOR=2.46 (95% CI: 1.45−4.18, P < 0.01); 31−35 years: aOR =4.45 (95% CI: 1.97−10.06, P < 0.01)]. Conclusions Single-good-quality blastocyst transfer is recommended for women of all ages. When good-quality cleavage embryos are available, the choice of single or double embryo transfer with good- or average-quality embryo should depend on the age of women. Double embryo transfer with the highest possible grade of embryos is recommended for women aged ≥40 years.

Recent studies have demonstrated that hyperglycemia induces inflammation in male reproductive system to cause sperm damages and infertility, which may be associated with re-polarization of tissue macrophages from an anti-inflammation M2-like subtype to a pro-inflammation M1-like subtype. However, the underlying mechanisms are not fully determined and a practical approach to interfere with the progression of infertility is lacking. Here, we transduced the testicular macrophages back to the M2-like phenotype with adeno-associated viruses carrying an M2-trigger, Jumonji domain-containing protein D3 (JMJD3), under a macrophage-specific CD68 promoter (CD68p-JMJD3), in streptozotocin-induced diabetic mice. We found that JMJD3-induced M2-polarization of testicular macrophages significantly improved the mating capability of diabetic male mice. The diabetes-induced impairment of the motility of spermatozoa and the decreases in the serum and testicular testosterone levels were both significantly alleviated in CD68p-JMJD3-treated diabetic mice. Thus, our study proposes a practical strategy to treat hyperglycemia-associated infertility.

BACKGROUND:Due to a slight rise in beta-human chorionic (β-hCG) levels that are undetectable, and vaginal bleeding that is similar to regular menstruation, ectopic pregnancy (EP) that occurs during the expected menstrual cycle prior to ovulation induction as part of in vitro fertilization (IVF) is likely to be undiagnosed. We present two cases of unexpected EP and emphasize the importance of the β-hCG assay when an unexplained increase in progesterone is present prior to the triggering of ovulation during controlled ovarian stimulation (COS).CASE SUMMARY:A 26-year-old woman with primary infertility and a 31-year-old woman with secondary infertility. Both patients sought IVF treatment due to fallopian tube obstruction and underwent COS using the gonadotropin-releasing-hormone (GnRH)-antagonist protocol. In the late stage of COS, progesterone levels in both patients significantly increased, and luteinizing hormone levels decreased, followed by oocyte retrieval failure. A right salpingectomy was performed and tubal ectopic pregnancy was diagnosed by pathology in the first patient, and the second patients was diagnosed with a suspected EP abortion because her β-hCG levels declined to 12.5 mIU/mL. After full recovery for 2 mo, the first patient entered a new IVF treatment cycle with a GnRH-antagonist regimen and successfully achieved eight oocytes and three viable embryos. After 6 mo, the second patient received another COS treatment with a progestin-primed ovarian stimulation protocol and successfully achieved nine oocytes and five viable embryos.CONCLUSION:β-hCG levels in the initial and midterm phases of COS must be considered in patients with unusual hormone dynamics.

IntroductionLow molecular-weight heparin (LMWH) plays a role in repeated implantation failure (RIF), but outcomes are controversial. LMWH can potentially modulate local immune responses associated with the establishment and maintenance of pregnancy. The study aimed to explore the effects of LWMH in uterine inflammatory cytokine profiles and pregnancy outcomes of patients with repeated implantation failure (RIF) but without thrombophilia. MethodsWe compared clinical characteristics and reproductive outcomes among 326 patients with RIF, but not thrombophilia, undergoing frozen embryo transfer (FET) cycle with or without LMWH treatment. Endometrium secretions were aspirated from both groups after 3 days of progesterone administration before and after LMWH treatment. Cytokine mRNA expression was analyzed in primary endometrial cells in vitro. ResultsThe clinical and ongoing pregnancy rates did not significantly differ between the groups (31.5% vs. 24.4%, p = 0.15; 29.6% vs. 20.7%, p = 0.06). Concentrations of IL-6 and granulocyte-colony stimulating factor (G-CSF) in uterine secretions were significantly increased in the LWMH group, regardless of pregnancy outcomes (P < 0.05). And, in all patients treated with LWMH, those of secreted IL-6, IL-15 and G-CSF were significantly increased in pregnant group (P < 0.05). The expression of mRNA for G-CSF and IL-6 was significantly increased in human endometrial stromal cells in vitro (P < 0.05) after stimulation with LWMH (10 IU/mL). ConclusionsUterine cytokine profiles after LMWH administration are associated with pregnancy outcomes and LMWH may be beneficial for patients with three implantation failures who do not have coagulation disorders.

Numerous air pollutants have been reported to influence the outcomes of in vitro fertilization (IVF). However, whether air pollution affects implantation in frozen embryo transfer (FET) process is under debate. We aimed to find the association between ambient air pollution and implantation potential of FET and test the value of adding air pollution data to a random forest model (RFM) predicting intrauterine pregnancy. Using a retrospective study of a 4-year single-center design，we analyzed 3698 cycles of women living in Shanghai who underwent FET between 2015 and 2018. To estimate patients' individual exposure to air pollution, we computed averages of daily concentrations of six air pollutants including PM2.5, PM10, SO2, CO, NO2, and O3 measured at 9 monitoring stations in Shanghai for the exposure period (one month before FET). Moreover, A predictive model of 15 variables was established using RFM. Air pollutants levels of patients with or without intrauterine pregnancy were compared. Our results indicated that for exposure periods before FET, NO2 were negatively associated with intrauterine pregnancy (OR: 0.906, CI: 0.816-0.989). AUROC increased from 0.712 to 0.771 as air pollutants features were added. Overall, our findings demonstrate that exposure to NO2 before transfer has an adverse effect on clinical pregnancy. The performance to predict intrauterine pregnancy will improve with the use of air pollution data in RFM.

Background Granulosa cells (GCs) in cumulus oophorus highly express follicle stimulating hormone receptor (FSHR), which is the most important mediator of both estradiol synthesis and oocyte maturation. Obese women have elevated free fatty acids (FFAs) levels in their follicular fluids and decreased FSHR expression in GCs, which is related to an altered protein kinase B/glycogen synthase kinase 3β (Akt/GSK3β) signaling pathway . Such FFA increases accompany 3-fold rises in pseudokinase 3 (TRIB3) expression and reduce the Akt phosphorylation status in both the human liver and in insulinoma cell lines. Therefore, in a high FFA environment, we determined if TRIB3 mediates regulation of FSHR via the Akt/GSK3β signaling pathway in human GCs. Methods GCs from women undergoing in vitro fertilization were collected and designated as high and low FFAs cohorts based on their follicular fluid FFA content. GCs with low FFA levels and a human granulosa-like tumor (KGN) cell line were exposed to palmitic acid (PA), which is a dominate FFA follicular fluid constituent. The effects were assessed of this substitution on the Akt/GSK3β signaling pathway activity as well as the expressions of TRIB3 and FSHR at both the gene and protein levels by qPCR, Western blot and immunofluorescence staining analyses. Meanwhile, the individual effects of TRIB3 knockdown in KGN cells and p-AKT inhibitors were compared to determine the mechanisms of FFA-induced FSHR downregulation. Results The average FSH dose consuming per oocyte (FSH dose/oocyte) was elevated and Top embryo quality ratio was decreased in women with high levels of FFAs in their follicular fluid. In these women, the GC TRIB3 and ATF4 protein expression levels were upregulated which was accompanied by FSHR downregulation. Such upregulation was confirmed based on corresponding increases in their gene expression levels. On the other hand, the levels of p-Akt decreased while p-GSK3β increased in the GCs. Moreover, TRIB3 knockdown reversed declines in FSHR expression and estradiol (E2) production in KGN cells treated with PA, which also resulted in increased p-Akt levels and declines in the p-GSK3β level. In contrast, treatment of TRIB3 -knockdown cells with an inhibitor of p-Akt (Ser473) resulted in rises in the levels of both p-GSK3β as well as FSHR expression whereas E2 synthesis fell. Conclusions During exposure to a high FFA content, TRIB3 can reduce FSHR expression through stimulation of the Akt/GSK3β pathway in human GCs. This response may contribute to inducing oocyte maturation.

Background Increasing evidence supports a relationship between obesity and either infertility or subfertility in women. Most previous omics studies were focused on determining if the serum and follicular fluid expression profiles of subjects afflicted with both obesity-related infertility and polycystic ovary syndrome (PCOS) are different than those in normal healthy controls. As granulosa cells (GCs) are essential for oocyte development and fertility, we determined here if the protein expression profiles in the GCs from obese subjects are different than those in their normal-weight counterpart. Methods GC samples were collected from obese female subjects ( n = 14) and normal-weight female subjects ( n = 12) who were infertile and underwent in vitro fertilization (IVF) treatment due to tubal pathology. A quantitative approach including tandem mass tag labeling and liquid chromatography tandem mass spectrometry (TMT) was employed to identify differentially expressed proteins. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were then conducted to interrogate the functions and pathways of identified proteins. Clinical, hormonal, and biochemical parameters were also analyzed in both groups. Results A total of 228 differentially expressed proteins were noted, including 138 that were upregulated whereas 90 others were downregulated. Significant pathways and GO terms associated with protein expression changes were also identified, especially within the mitochondrial electron transport chain. The levels of free fatty acids in both the serum and follicular fluid of obese subjects were significantly higher than those in matched normal-weight subjects. Conclusions In GCs obtained from obese subjects, their mitochondria were damaged and the endoplasmic reticulum stress response was accompanied by dysregulated hormonal synthesis whereas none of these changes occurred in normal-weight subjects. These alterations may be related to the high FFA and TG levels detected in human follicular fluid.

We aimed to study the association between sperm DNA fragmentation and recurrent pregnancy loss (RPL) in the Chinese population via a retrospective observational study of Chinese couples who had experienced RPL between May 2013 and August 2018. The study population included 461 men from couples with RPL and 411 men from a control group (couples with clinical pregnancy via in vitro fertilization owing to female causes). Routine semen analysis, sperm chromatin analysis, and microscopic (high-power) morphological analysis were performed using semen samples. Semen samples were assessed for volume, sperm count, and motility. The sperm DNA fragmentation index (DFI) was calculated, and the median DFI was obtained. Men were categorized as having normal (37.8%; DFI ≤ 15.0%), moderate (33.6%; 15.0% < DFI < 30.0%), or severe (28.6%; DFI ≥ 30.0%) DNA fragmentation levels. The percentage of men with severe DNA fragmentation was significantly higher in the RPL (42.3%) group than that in the control group (13.1%), whereas the percentage of men with normal levels of DNA fragmentation was significantly lower in the RPL group (22.8%) than that in the control group (54.7%). Subsequent analysis also demonstrated that the sperm DNA fragmentation rate had a moderate reverse correlation with the sperm progressive motility rate (r = -0.47, P < 0.001) and the total motile sperm count (r = -0.31, P < 0.001). We found a positive correlation between RPL and sperm DNA fragmentation. The results suggest that increased sperm DNA damage is associated with RPL.

Embryos with low morphological scores can still develop to the blastocyst stage and result in good clinical outcomes. However, no studies have reported the possible effects of transferring cryopreserved blastocysts developed from poor-quality cleavage stage embryos on pregnancy and perinatal outcomes. In this retrospective study, the clinical value of transferring blastocysts derived from day 3 poor-quality cleavage stage embryos during in vitro fertilization and embryo transfer procedures was evaluated. According to the quality of embryos on day 3 from which the transferred blastocyst originated, patients were divided into three groups: poor-quality (111 cycles, group A), good-quality (235 cycles, group B), and top-quality (119 cycles, group C). Group A experienced the highest miscarriage rate (30.2%) which was increased when compared to group C (12.5%) (P = 0.03). The clinical pregnancy rates and live birth rates were not significantly different among the three groups. However, good blastocyst originating from top day 3 embryos resulted in higher live birth rate. Of the 218 live births, no differences in obstetric and perinatal outcomes were noted among the three groups. The results showed that extended culture of poor-quality cleavage stage embryos could resulted in favorable clinical pregnancy rates but at a higher incidence of miscarriages. Meanwhile, the risk of adverse perinatal outcomes was not increased.

Objective To evaluate the location of transferred embryos under various parameters during embryo transfer in in vitro fertilization (IVF) by applying an in vitro experimental model for embryo transfer (ET). Methods Mock ET simulations were conducted with a laboratory model of the uterine cavity. The transfer catheter was loaded with a sequence of air and liquid volumes, including development-arrested embryos donated by patients. The transfer procedure was recorded using a digital video camera. An orthogonal design, including three independent variables (uterine orientation, distance of the catheter tip to the fundus, and injection speed) and one dependent variable (final embryo position), was applied. Results The uterine cavity was divided into six regions. The distribution of the transferred matter within the uterine cavity varied according to the uterine orientation. Medium speed-injected embryos were mostly found in the static region while fast- and slow-speed injected embryos were mostly found in the fundal region and the cervical-left region, respectively. The possibility of embryo separation from the air bubble increased from 11.1% in slow injection cases to 29.6% and 48.1% in medium and fast injection cases, respectively. Conclusion The experimental model provides a new method for investigating ET procedures. Fast injection of embryos into a retroverted uterus may be more likely to result in embryo separation from the air bubble.

目的 通过调查上海交通大学医学院附属瑞金医院生殖医学中心的女性不孕患者,探索医务社会工作介入的时机和方法,旨在为患者提供全方位的医疗服务和人性化关怀.方法 采用随机抽样的方法,应用《医院焦虑抑郁量表》(HADS)和《社会支持量表》(SSRS)对225名患者进行问卷调查.结果 治疗阶段、不孕原因、工作情况和经济压力等因素对不孕女性的情绪影响或社会支持使用具有显著性差异.结论 医院要以建立基金、社会呼吁的形式帮助患者减轻经济压力,支持和鼓励医务社工与医护合作把握不同治疗时期的特点,及时进行社会关系重建等衍生服务,帮助患者实现生理、心理和社会的全面康复.