Reproductive biomedicine online最新文献_第10页

Oestrogen promotes the progression of adenomyosis by inhibiting CITED2 through miR-145 雌激素通过 miR-145 抑制 CITED2 促进子宫腺肌病的进展

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-12 DOI: 10.1016/j.rbmo.2024.104108

Research question

Is the microRNA miR-145 involved in adenomyosis, and by what mechanisms does it affect disease development and is itself regulated?

Design

Fluorescence in-situ hybridization was used to observe the expression pattern of miR-145 in adenomyosis ectopic endometrium (n = 13), adenomyosis eutopic endometrium (n = 15) and non-adenomyosis eutopic endometrium (n = 14). RNA sequencing was used to screen target genes as well as downstream pathways of miR-145, which were validated by reporter gene assay, quantitative polymerase chain reaction and western blot, and further analysed using cell migration assay and chromatin immunoprecipitation assay.

Results

The fluorescence in-situ hybridization assay revealed a noteworthy elevation in miR-145 expression in adenomyosis tissue compared with non-adenomyosis tissue. Furthermore, RNA sequencing analysis revealed that overexpression of miR-145 resulted in heightened expression of genes associated with the cytokine signalling pathway, nucleotide-binding and oligomerization domain-like pathway and adhesion pathway, including IL-1β and IL-6. Our study has identified CITED2 as a downstream direct target gene of miR-145, which is implicated in the inhibition of stromal cell migration induced by miR-145. Moreover, chromatin immunoprecipitation was used to validate the direct effect of oestradiol on the promoter region of miR-145, mediated by oestrogen receptor α, which facilitates the upregulation of miR-145 expression.

Conclusion

Our findings provide evidence supporting the role of oestradiol, acting through its receptor α, in modulating the discovered miR-145-CITED2 signalling axis, thereby promoting the progression of adenomyosis.

设计采用荧光原位杂交技术观察miR-145在子宫腺肌病异位内膜（13例）、子宫腺肌病异位内膜（15例）和非子宫腺肌病异位内膜（14例）中的表达模式。利用 RNA 测序筛选 miR-145 的靶基因及下游通路，并通过报告基因检测、定量聚合酶链反应和 Western 印迹进行验证，还利用细胞迁移检测和染色质免疫共沉淀检测进行了进一步分析。此外，RNA 测序分析表明，miR-145 的过表达导致细胞因子信号通路、核苷酸结合和寡聚化结构域样通路以及粘附通路相关基因（包括 IL-1β 和 IL-6）的表达增加。我们的研究发现，CITED2 是 miR-145 的下游直接靶基因，与 miR-145 诱导的基质细胞迁移抑制作用有关。此外，染色质免疫沉淀技术还验证了雌二醇对 miR-145 启动子区域的直接影响，这种影响是由雌激素受体 α 介导的，它促进了 miR-145 表达的上调。

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引用次数: 0

Effect of a novel copper chloride gel on endometrial growth and function in healthy volunteers 研究新型氯化铜凝胶对健康志愿者子宫内膜生长和功能的影响

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-09 DOI: 10.1016/j.rbmo.2024.104107

Research question

Does the application of a micro-dose of copper chloride gel increase endometrial production of vascular endothelial growth factor (VEGF) without compromising endometrial function or producing embryo toxicity?

Design

An estimate of optimal dose was made based on cell culture studies. Ten healthy participants received an initial uterine application of placebo gel, followed by copper chloride gel (37.5 μM, 75 μM, or 150 μM dose) in a later hormone replacement cycle. Endometrial biopsies (day 5.5 luteal) and pelvic ultrasound were carried out during each cycle to evaluate endometrial function and growth. Uterine fluid was assessed for residual copper levels on the day of biopsy, and copper chloride gel underwent mouse embryos assay assessment for potential embryo toxicity.

Results

The copper gel significantly increased endometrial VEGF expression (quantitative polymerase chain reaction), and also increasing endometrial thickness by an average of 2.2 mm compared with matched control cycles. The copper gel did not adversely affect endometrial morphology or maturation (histological dating and molecular receptivity testing), and mouse embryos assay studies showed no evidence of embryo toxicity. Furthermore, uterine cavity flush samples mostly lacked copper, with only negligible amounts present in one sample.

Conclusion

Applying copper chloride gel to the uterine cavity upregulated endometrial VEGF and significantly increased endometrial thickness and volume. No adverse effects on the endometrium or embryos were observed. Copper chloride gels show promise for treating suboptimal endometrial thickness if the results of this study are confirmed by larger randomized controlled trials.

研究问题施用微剂量氯化铜凝胶是否会增加子宫内膜血管内皮生长因子（VEGF）的生成，同时不损害子宫内膜功能或产生胚胎毒性？设计根据细胞培养研究估算出最佳剂量。十名健康参与者先在子宫内涂抹安慰剂凝胶，然后在以后的激素替代周期中涂抹氯化铜凝胶（37.5 μM、75 μM或150 μM剂量）。在每个周期内进行子宫内膜活检（黄体期第 5.5 天）和盆腔超声检查，以评估子宫内膜的功能和生长情况。结果铜凝胶显著增加了子宫内膜血管内皮生长因子的表达（定量聚合酶链反应），与匹配的对照周期相比，子宫内膜厚度平均增加了 2.2 毫米。铜凝胶不会对子宫内膜的形态或成熟度产生不利影响（组织学测定和分子接受性测试），小鼠胚胎实验研究也没有显示出胚胎毒性。此外，宫腔冲洗样本大多不含铜，只有一个样本中的铜含量可忽略不计。未观察到对子宫内膜或胚胎的不良影响。如果这项研究的结果能通过更大规模的随机对照试验得到证实，那么氯化铜凝胶有望用于治疗子宫内膜厚度不理想的情况。

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引用次数: 0

Luteal phase support with oral progesterone improves live birth rate in intrauterine insemination cycles using letrozole 口服黄体酮的黄体期支持可提高使用来曲唑联合或不联合 HMG 的人工授精周期患者的活产率

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-09 DOI: 10.1016/j.rbmo.2024.104077

Research question

Does luteal phase support (LPS) with oral progesterone improve the live birth rate (LBR) in patients undergoing intrauterine insemination (IUI) cycles with letrozole?

Design

This retrospective cohort study included 1199 IUI cycles with letrozole between January 2017 and December 2021. A nearest neighbour random matching approach was employed to pair the LPS group and the control group in a 1:2 ratio. Eight variables were chosen for matching in the propensity score matching (PSM) model: age; body mass index; duration of infertility; cause(s) of infertility; antral follicle count; basal concentration of FSH; rank of IUI attempts; and leading follicle size. LBR was selected as the primary outcome.

Results

In total, 427 LPS cycles were matched with 772 non-LPS (control) cycles after PSM. The LBR was significantly higher in the LPS group compared with the control group (19.7% versus 14.5%; P = 0.0255). The clinical pregnancy rate (23.2% versus 17.6%; P = 0.0245) and ongoing pregnancy rate (20.6% versus 15.8%; P = 0.0437) were also significantly higher in the LPS group. The biochemical pregnancy rate, ectopic pregnancy rate and miscarriage rate were similar in the two groups (P > 0.05). The intergroup comparison revealed no significant variances in terms of gestational age, mode of delivery, ectopic pregnancy rate or abortion rate. Furthermore, there were no significant differences in birth weight or birth length between the two groups.

Conclusions

Luteal support with oral progesterone significantly improved the LBR in IUI cycles with letrozole, but did not affect neonatal outcomes.

研究问题口服黄体酮的黄体期支持（LPS）是否能提高来曲唑宫腔内人工授精（IUI）周期患者的活产率（LBR）？采用近邻随机匹配法，将来曲唑组与对照组按 1:2 的比例配对。在倾向得分匹配（PSM）模型中选择了八个变量进行匹配：年龄；体重指数；不孕持续时间；不孕原因；前卵泡计数；FSH基础浓度；人工授精尝试次数；前卵泡大小。结果在 PSM 后，共有 427 个 LPS 周期与 772 个非 LPS（对照）周期进行了配对。LPS 组的 LBR 明显高于对照组（19.7% 对 14.5%；P = 0.0255）。LPS 组的临床妊娠率（23.2% 对 17.6%；P = 0.0245）和持续妊娠率（20.6% 对 15.8%；P = 0.0437）也明显高于对照组。两组的生化妊娠率、异位妊娠率和流产率相似（P > 0.05）。组间比较显示，孕龄、分娩方式、宫外孕率和流产率均无明显差异。结论口服黄体酮黄体支持可显著改善来曲唑人工授精周期的 LBR，但不会影响新生儿结局。

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引用次数: 0

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation 各种避孕药对计划进行卵母细胞冷冻保存的患者的卵母细胞产量和成熟度的影响：一项回顾性队列研究

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-07 DOI: 10.1016/j.rbmo.2024.104105

Carlos Hernandez-Nieto , Saher Siddiqui , Loreli Mejia-Fernandez , Tamar Alkon-Meadows , Joseph Lee , Richard Slifkin , Tanmoy Mukherjee , Alan B. Copperman

Research question

Do the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)?

Design

This retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus–oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts.

Results

A total of 4059 oocyte freezing cycles were included in the analysis. Eight types of contraceptive method were recognized in patients undergoing ovarian stimulation: intrauterine device (IUD), copper (n = 84); IUD, levonorgestrel low dose (<52 mg) (n = 37); IUD, levonorgestrel (n = 192); subdermal etonogestrel implant (n = 14); injectable medroxyprogesterone acetate (n = 11); etonogestrel vaginal ring (n = 142); combined oral contraceptive pills (n = 2349); and norelgestromin transdermal patch (n = 10). The control group included patients not using contraceptives or using barrier or calendar methods (n = 1220). Among all the cohorts the median number of cumulus–oocyte complexes retrieved during oocyte retrieval was comparable (P = 0.054), and a significant difference in oocyte maturity rate with median number of vitrified oocytes was found (P = 0.03, P < 0.001, respectively). After adjusting for confounders a multivariate analysis found no association between the type of contraceptive and proportion of metaphase II oocytes available for cryopreservation.

Conclusions

Among the various forms of contraception, none was shown to have an adverse association with oocyte yield or maturation rate in patients undergoing POC.

研究问题在接受计划性卵母细胞冷冻保存（POC）的患者中，各种形式的激素和非激素类避孕药与卵巢刺激结果（如卵母细胞产量和成熟度）是否有关联？设计这项回顾性队列研究纳入了 2011 年至 2023 年期间接受 POC 周期的所有患者。研究记录了 POC 周期前使用的避孕药具类型。研究评估了阴道取卵后获得的卵母细胞-卵母细胞复合体的中位数，以及所有队列中进行玻璃化处理的分裂期 II 卵母细胞的比例。结果共有 4059 个卵母细胞冷冻周期纳入分析。在接受卵巢刺激的患者中，有八种避孕方法得到认可：铜宫内节育器（84 例）；左炔诺孕酮低剂量宫内节育器（52 毫克）（37 例）；左炔诺孕酮宫内节育器（192 例）；皮下伊托诺孕酮植入（14 例）；注射用醋酸甲羟孕酮（n = 11）；依托孕烯阴道环（n = 142）；复方口服避孕药（n = 2349）；炔诺酮透皮贴片（n = 10）。对照组包括未使用避孕药具或使用屏障法或日历法的患者（n = 1220）。在所有组别中，取卵过程中取回的积液-卵母细胞复合体的中位数相当（P = 0.054），而卵母细胞成熟率与玻璃化卵母细胞中位数存在显著差异（分别为 P = 0.03、P < 0.001）。在对混杂因素进行调整后，一项多变量分析发现，避孕药具类型与可用于冷冻保存的分裂期 II 卵母细胞比例之间没有关联。

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引用次数: 0

Double vitrification and warming of blastocysts does not affect pregnancy, miscarriage or live birth rates 囊胚的双重玻璃化和加温不会影响试管婴儿的植入率或出生结果

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-06 DOI: 10.1016/j.rbmo.2024.104103

Research question

Does double blastocyst vitrification and warming affect pregnancy, miscarriage or live birth rates, or birth outcomes, from embryos that have undergone preimplantation genetic testing for aneuploidies (PGT-A) testing?

Design

This retrospective observational analysis of embryo transfers was performed at a single centre between January 2017 and August 2022. The double-vitrification group included frozen blastocysts that were vitrified after 5–7 days of culture, warmed, biopsied (either once or twice) and re-vitrified. The single vitrification (SV) group included fresh blastocysts that were biopsied at 5–7 days and then vitrified.

Results

A comparison of the 84 double-vitrification blastocysts and 729 control single-vitrification blastocysts indicated that the double-vitrification embryos were frozen later in development and had expanded more than the single-vitrification embryos. Of the 813 embryo transfer procedures reported, 452 resulted in the successful delivery of healthy infants (56%). There were no significant differences between double-vitrification and single-vitrification embryos in the pregnancy, miscarriage or live birth rates achieved after single-embryo transfer (55% versus 56%). Logistic regression indicated that while reduced live birth rates were associated with increasing maternal age at oocyte collection, longer culture prior to freezing and lower embryo quality, double vitrification was not a significant predictor of live birth rate.

Conclusions

Blastocyst double vitrification was not shown to impact pregnancy, miscarriage or live birth rates. Although caution is necessary due to the study size, no effects of double vitrification on miscarriage rates, birthweight or gestation period were noted. These data offer reassurance given the absence of the influence of double vitrification on all outcomes after PGT-A.

研究问题双囊胚玻璃化和升温是否会影响经过植入前非整倍体基因检测（PGT-A）的胚胎的妊娠率、流产率、活产率或出生结局？双玻璃化组包括经过5-7天培养、升温、活检（一次或两次）和再玻璃化的冷冻囊胚。对 84 个双玻璃化囊胚和 729 个对照单玻璃化囊胚进行比较后发现，双玻璃化胚胎比单玻璃化胚胎冷冻时间更晚，胚胎体积也更大。在报告的 813 例胚胎移植手术中，452 例成功娩出健康婴儿（56%）。在单胚胎移植后的怀孕率、流产率或活产率方面，双冷冻胚胎和单冷冻胚胎没有明显差异（55% 对 56%）。逻辑回归表明，虽然活产率的降低与产妇采集卵母细胞时年龄的增加、冷冻前培养时间的延长和胚胎质量的降低有关，但双玻璃化并不是预测活产率的重要因素。尽管由于研究规模有限，有必要谨慎行事，但双重玻璃化对流产率、出生体重或妊娠期均无影响。鉴于双重玻璃化技术对PGT-A后的所有结果都没有影响，这些数据让人放心。

{"title":"Double vitrification and warming of blastocysts does not affect pregnancy, miscarriage or live birth rates","authors":"","doi":"10.1016/j.rbmo.2024.104103","DOIUrl":"10.1016/j.rbmo.2024.104103","url":null,"abstract":"<div><h3>Research question</h3><p>Does double blastocyst vitrification and warming affect pregnancy, miscarriage or live birth rates, or birth outcomes, from embryos that have undergone preimplantation genetic testing for aneuploidies (PGT-A) testing?</p></div><div><h3>Design</h3><p>This retrospective observational analysis of embryo transfers was performed at a single centre between January 2017 and August 2022. The double-vitrification group included frozen blastocysts that were vitrified after 5–7 days of culture, warmed, biopsied (either once or twice) and re-vitrified. The single vitrification (SV) group included fresh blastocysts that were biopsied at 5–7 days and then vitrified.</p></div><div><h3>Results</h3><p>A comparison of the 84 double-vitrification blastocysts and 729 control single-vitrification blastocysts indicated that the double-vitrification embryos were frozen later in development and had expanded more than the single-vitrification embryos. Of the 813 embryo transfer procedures reported, 452 resulted in the successful delivery of healthy infants (56%). There were no significant differences between double-vitrification and single-vitrification embryos in the pregnancy, miscarriage or live birth rates achieved after single-embryo transfer (55% versus 56%). Logistic regression indicated that while reduced live birth rates were associated with increasing maternal age at oocyte collection, longer culture prior to freezing and lower embryo quality, double vitrification was not a significant predictor of live birth rate.</p></div><div><h3>Conclusions</h3><p>Blastocyst double vitrification was not shown to impact pregnancy, miscarriage or live birth rates. Although caution is necessary due to the study size, no effects of double vitrification on miscarriage rates, birthweight or gestation period were noted. These data offer reassurance given the absence of the influence of double vitrification on all outcomes after PGT-A.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 3","pages":"Article 104103"},"PeriodicalIF":3.7,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141036570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoplasmic reticulum stress-mediated ferroptosis in granulosa cells contributes to follicular dysfunction of polycystic ovary syndrome driven by hyperandrogenism 颗粒细胞中ER应激介导的铁蛋白沉积是高雄激素导致多囊卵巢综合征卵泡功能障碍的原因之一

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-06 DOI: 10.1016/j.rbmo.2024.104078

Research question

Does hyperandrogenaemia affect the function of ovarian granulosa cells by activating ferroptosis, and could this process be regulated by endoplasmic reticulum stress?

Design

Levels of ferroptosis and endoplasmic reticulum stress in granulosa cells were detected in women with and without polycystic ovary syndrome (PCOS) undergoing IVF. Ferroptosis and endoplasmic reticulum stress levels of ovarian tissue and follicle development were detected in control mice and PCOS-like mice models, induced by dehydroepiandrosterone. An in-vitro PCOS model of KGN cells was constructed with testosterone and ferroptosis inhibitor Fer-1. Endoplasmic reticulum stress inhibitor, tauroursodeoxycholate (TUDCA), determined the potential mechanism associated with excessive induction of ferroptosis in granulosa cells related to PCOS, and levels of ferroptosis and endoplasmic reticulum stress were detected.

Results

Activation of ferroptosis and endoplasmic reticulum stress occurred in granulosa cells of women with PCOS and the varies of PCOS-like mice. The findings in KGN cells demonstrated that testosterone treatment results in elevation of oxidative stress levels, particularly lipid peroxidation, and intracellular iron accumulation in granulosa cells. The expression of genes and proteins associated with factors related to ferroptosis, mitochondrial membrane potential and ultrastructure showed that testosterone activated ferroptosis, whereas Fer-1 reversed these alterations. During in-vitro experiments, activation of endoplasmic reticulum stress induced by testosterone treatment was detected in granulosa cells. In granulosa cells, TUDCA, an inhibitor of endoplasmic reticulum stress, significantly mitigated testosterone-induced ferroptosis.

Conclusions

Ferroptosis plays a part in reproductive injury mediated by hyperandrogens associated with PCOS, and may be regulated by endoplasmic reticulum stress.

研究问题高雄激素血症是否会通过激活高铁血症而影响卵巢颗粒细胞的功能，这一过程是否会受到内质网应激的调节？在脱氢表雄酮诱导的对照组小鼠和多囊卵巢综合症样小鼠模型中，检测了卵巢组织和卵泡发育中的铁蛋白沉积和内质网应激水平。用睾酮和铁蛋白沉积抑制剂Fer-1构建了KGN细胞的体外多囊卵巢综合征模型。内质网应激抑制剂牛磺脱氧胆酸盐（TUDCA）确定了与多囊卵巢综合征相关的颗粒细胞过度诱导铁蛋白沉积的潜在机制，并检测了铁蛋白沉积和内质网应激的水平。在 KGN 细胞中的研究结果表明，睾酮处理会导致颗粒细胞氧化应激水平升高，尤其是脂质过氧化和细胞内铁积累。与铁变态反应、线粒体膜电位和超微结构相关的基因和蛋白质的表达表明，睾酮激活了铁变态反应，而 Fer-1 则逆转了这些变化。在体外实验中，在颗粒细胞中检测到了由睾酮处理诱导的内质网应激激活。在颗粒细胞中，内质网应激抑制剂 TUDCA 能显著减轻睾酮诱导的铁蛋白沉积。

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引用次数: 0

Good practice in clinical embryology laboratories: Association of Reproductive and Clinical Scientists Guidelines 2024 生殖与临床科学家协会（ARCS）--临床胚胎学实验室良好操作指南 2024 年

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-05 DOI: 10.1016/j.rbmo.2024.104102

Clinical embryology is a dynamic and ever-evolving field, and as such clinical practice guidelines must be regularly reviewed and updated. Accordingly, this document supersedes previous good clinical practice in clinical embryology guidance, developing, and updating where necessary, existing good practice guidelines. The Association of Reproductive and Clinical Scientists (ARCS) suggests this Good Laboratory Practice framework as appropriate and effective to ensure the best possible care for all individuals undertaking fertility treatment. Efforts have been made to ensure that the language used is inclusive and reflective of the wide range of patients who seek treatment. The guidance provided within this document aims to be relevant within an international context and to consider the range of regulatory considerations affecting clinical embryology laboratories. This guideline was written to guide best practice but is not intended as a tool to judge the practice of centres within the UK or beyond.

临床胚胎学是一个不断发展的动态领域，因此临床实践指南必须定期审查和更新。因此，本文件取代了之前的临床胚胎学良好临床实践指南，发展并在必要时更新了现有的良好实践指南。生殖与临床科学家协会 (Association of Reproductive and Clinical Scientists, ARCS) 建议，本良好实验室实践框架是适当而有效的，可确保为所有接受生育治疗的人提供最佳护理。我们努力确保所使用的语言具有包容性，并能反映出寻求治疗的患者的广泛性。本文件中提供的指导旨在与国际背景相关，并考虑到影响临床胚胎学实验室的一系列监管因素。编写本指南的目的是为了指导最佳实践，但并不打算将其作为评判英国境内外各中心实践的工具。

引用次数: 0

Attitude of Belgian women towards enucleated egg donation for treatment of mitochondrial diseases and infertility 比利时妇女对捐献无核卵子治疗线粒体疾病和不孕症的态度

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-04 DOI: 10.1016/j.rbmo.2024.104101

Guido Pennings , Björn Heindryckx , Dominic Stoop , Heidi Mertes

Research question

What is the attitude of Belgian women of reproductive age towards enucleated egg donation? Does the willingness of women to donate differ when they would donate enucleated or whole eggs?

Design

In 2022, an online survey was conducted among a representative sample of 1000 women in Belgium aged 18–50 years. The item on willingness to anonymously donate enucleated eggs was dichotomized into those willing to donate and those not willing to donate or uncertain.

Results

No statistically significant difference was found between the willingness to donate enucleated eggs and whole eggs (whether anonymously or identifiably). Anonymity, however, affected the willingness to donate, with considerably fewer women willing to donate identifiably. The respondents were divided about their parental status if they were to donate enucleated eggs, with less than one-half (44%) not considering themselves to be a genetic mother. Women willing to donate enucleated eggs anonymously were less likely to view themselves as a genetic mother of the child compared with others. Fewer than one in five considered the technique unacceptable because the resulting child would carry genetic material of three persons.

Conclusions

Women in the general population did not show a greater willingness to donate enucleated eggs than whole eggs. The fact that the respondents were strongly divided on whether or not they would consider themselves to be a genetic mother of the resulting child may explain this result. Other factors, such as the potential high risk for the child, may also have contributed to less willingness.

研究问题比利时育龄妇女对无核卵子捐赠的态度如何？在捐献无核卵子或完整卵子时，女性的捐献意愿是否有所不同？设计2022年，对比利时1000名18-50岁的女性进行了在线调查。结果在匿名捐献无核卵子和捐献全卵（无论是匿名捐献还是可识别捐献）的意愿方面，没有发现明显的统计学差异。但是，匿名捐献会影响捐献意愿，愿意匿名捐献的妇女人数要少得多。受访者对其捐献无核卵子后的父母身份存在分歧，不到二分之一（44%）的受访者不认为自己是遗传母亲。与其他人相比，愿意匿名捐献去核卵子的妇女不太可能认为自己是孩子的遗传母亲。只有不到五分之一的人认为这种技术是不可接受的，因为由此产生的孩子将携带三个人的遗传物质。受访者在是否认为自己是所生孩子的遗传母亲这一问题上存在很大分歧，这可能是造成这一结果的原因。其他因素，如孩子可能面临的高风险，也可能是导致意愿降低的原因。

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引用次数: 0

Impact of inclusion of a poor-quality embryo with a good-quality embryo on pregnancy outcomes in vitrified-warmed blastocyst transfers 在试管婴儿/卵胞浆内单精子显微注射周期中，同时移植劣质胚胎和优质胚胎对妊娠结果的影响

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-04 DOI: 10.1016/j.rbmo.2024.104104

Research question

Does the co-transfer of a good-quality embryo and a poor-quality embryo influence pregnancy outcomes in comparison to the transfer of a single good-quality embryo in vitrified-warmed blastocyst transfer cycles?

Design

This retrospective cohort study involved a total of 11,738 women who underwent IVF/intracytoplasmic sperm injection cycles and vitrified-warmed blastocyst transfer at a tertiary-care academic medical from January 2015 to June 2022. The study population was categorized into two groups: single-blastocyst transfer (SBT; participants who underwent single good-quality embryo transfer, n = 9338) versus double-blastocyst transfer (DBT; participants who underwent transfers with a poor and a good-quality embryo, n = 2400).

Results

The live birth rate (LBR) was significantly higher in the DBT group in comparison with the SBT group (65.6% versus 56.3%, P < 0.001). Multivariable logistic regression analysis showed that DBT was an independent predictor for LBR with a strong potential impact (adjusted odds ratio 1.55, 95% confidence interval 1.41–1.71; P < 0.001). However, the multiple birth rate was significantly higher in the good-quality embryo and poor-quality embryo group compared with patients undergoing a single good-quality embryo transfer (41.4% versus 1.8%; P < 0.001).

Conclusions

In vitrified-warmed blastocyst transfer cycles, LBR was higher following DBT with one good-quality and one poor-quality embryo compared with SBT. However, this was at the expense of a marked increase in the likelihood of multiple gestations. Physicians should still balance the benefits and risks of double-embryo transfer.

研究问题与玻璃化温育囊胚移植周期中移植单一优质胚胎相比，优质胚胎和劣质胚胎共同移植是否会影响妊娠结局？设计这项回顾性队列研究涉及 2015 年 1 月至 2022 年 6 月期间在一家三级学术医疗机构接受试管婴儿/卵胞浆内单精子注射周期和玻璃化温育囊胚移植的 11738 名女性。研究人群分为两组：单囊胚移植（SBT；接受单个优质胚胎移植的参与者，n = 9338）与双囊胚移植（DBT；接受劣质和优质胚胎移植的参与者，n = 2400）。结果DBT组的活产率（LBR）明显高于SBT组（65.6%对56.3%，P <0.001）。多变量逻辑回归分析表明，DBT 是 LBR 的独立预测因素，具有很强的潜在影响（调整后的几率比 1.55，95% 置信区间 1.41-1.71；P <0.001）。结论在玻璃化温育囊胚移植周期中，与 SBT 相比，使用一个优质胚胎和一个劣质胚胎进行 DBT 后，LBR 更高。然而，这是以多胎妊娠可能性的显著增加为代价的。医生仍应权衡双胚胎移植的益处和风险。

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引用次数: 0

Pain after oocyte retrieval in women with endometriosis undergoing fertility preservation or IVF 患有子宫内膜异位症、接受生育力保存或体外受精的妇女取卵后的疼痛

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online

Pub Date : 2024-05-03 DOI: 10.1016/j.rbmo.2024.104100

Maha Eid , Adrien Lemoine , Lena Bardet , Lise Selleret , Sophie Stout , Emmanuelle Mathieu d'Argent , Anna Ly , Nathalie Sermondade , Cyril Touboul , Charlotte Dupont , Nathalie Chabbert-Buffet , Kamila Kolanska

Research question

Do women with endometriosis undergoing oocyte retrieval for fertility preservation experience the same level of pain as women undergoing oocyte retrieval for IVF?

Design

This retrospective cohort study included 796 cycles in women with endometriosis undergoing oocyte retrieval for fertility preservation (n = 401) or IVF (n = 395) between January 2020 and October 2022. Post-operative pain assessments were compared between the two groups using a numeric rating scale (NRS).

Results

Women in the fertility preservation group were younger (32.1 ± 4.2 years versus 35.1 ± 4.1 years; P < 0.001), had a lower body mass index (22.8 ± 3.9 kg/m² versus 24.6 ± 4.4 kg/m²; P < 0.001) and had a lower concentration of anti-Müllerian hormone (1.8 ± 1.5 ng/ml versus 2.15 ± 2.11 ng/ml; P = 0.026) in comparison with women in the IVF group. The oestrogen concentration on the day of ovulation trigger was higher in women in the fertility preservation group (2188 ± 1152 pg/ml versus 2081 ± 995 pg/ml; P = 0.004), and the prevalence rates of adenomyosis and digestive endometrial lesions were lower in women in the fertility preservation group (14% versus 29%, P < 0.001; 16% versus 25%, P = 0.003, respectively) compared with women in the IVF group. After oocyte puncture, more women in the fertility preservation group had an NRS pain score >3 (moderate to severe pain) compared with women in the IVF group (20% versus 14%; P = 0.018). The progestin-primed ovarian stimulation (PPOS) protocol was identified as an independent predictive factor of greater post-operative pain (adjusted OR 2.30, 95% CI 1.06–5.15; P = 0.039).

Conclusion

Women with endometriosis undergoing fertility preservation reported more intense post-operative pain in the recovery room than women undergoing IVF. The PPOS protocol was an independent risk factor of intense pain (NRS pain score >3) in women with endometriosis, but further studies are needed to confirm this result.

研究问题为保留生育力而进行取卵术的子宫内膜异位症女性与为体外受精而进行取卵术的女性是否会经历相同程度的疼痛？设计这项回顾性队列研究纳入了2020年1月至2022年10月期间为保留生育力而进行取卵术（401人）或体外受精（395人）的796个周期的子宫内膜异位症女性。使用数字评分量表（NRS）对两组患者的术后疼痛评估进行比较。结果保留生育力组的女性更年轻（32.1 ± 4.2 岁对 35.1 ± 4.1 岁；P < 0.001），体重指数较低（22.8 ± 3.9 kg/m2 对 24.6 ± 4.4 kg/m2；P <；0.001），抗缪勒氏管激素浓度较低（1.8 ± 1.5 ng/ml 对 2.15 ± 2.11 ng/ml；P = 0.026）。与试管婴儿组相比，生育力保存组妇女在排卵触发日的雌激素浓度更高（2188 ± 1152 pg/ml 对 2081 ± 995 pg/ml；P = 0.004），腺肌症和消化道子宫内膜病变的发生率也更低（分别为 14% 对 29%，P < 0.001；16% 对 25%，P = 0.003）。卵母细胞穿刺后，NRS 疼痛评分为 3 分（中度至重度疼痛）的生育力保存组女性多于试管婴儿组女性（20% 对 14%；P = 0.018）。孕激素刺激卵巢（PPOS）方案是导致术后疼痛加剧的独立预测因素（调整后 OR 2.30，95% CI 1.06-5.15；P = 0.039）。PPOS方案是导致子宫内膜异位症妇女剧烈疼痛（NRS疼痛评分3分）的一个独立风险因素，但这一结果还需要进一步研究证实。

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