Pub Date : 2021-09-01DOI: 10.1142/s2661318221500122
J. K. Ko, K. Lam, H. H. Cheng, M. Lui, S. S. Yung, R. Li, E. Lau, P. C. Ho, W. Yeung, E. H. Ng
Background: Fertility preservation is increasingly important with improving cancer survival rates and the delay in childbearing in modern societies. The objective of our study was to review the experience of the fertility preservation programme in a tertiary-assisted reproduction unit in Hong Kong. Methods: This is a retrospective study involving men and women who were seen at a tertiary-assisted reproduction unit for fertility preservation counselling before gonadotoxic treatment from January 2005 to December 2020. Their medical records in paper and electronic forms were reviewed. Results: There were 75 consultations for female fertility preservation from 2010 to 2020 involving 72 women. Twenty women underwent 22 cycles of ovarian stimulation for oocyte or embryo cryopreservation, two of whom subsequently transported their oocytes abroad for further management and another two achieved natural conception. Additional four women who did not have oocyte or embryo cryopreservation achieved natural conception after cancer treatment. Eleven (15.2%) women were followed up at a reproductive endocrinology clinic after their cancer treatment. From 2005 to 2020, 265 men had sperm cryopreserved. Twenty-six (9.8%) came back to use the cryopreserved sperms, the wives of 13 (50.0%) of whom achieved an on-going pregnancy. Six of them transferred out and 40 discarded the cryopreserved sperms. Conclusions: There was generally an increasing number of patient consultations for fertility preservation in our Centre over the past decade but a consistently low rate of utilisation of cryopreserved gametes for both women and men. Post-cancer treatment fertility evaluation and monitoring was a major area of deficiency in Hong Kong. More structured post-cancer treatment fertility follow-up is needed.
{"title":"Fertility Preservation Programme in a Tertiary-Assisted Reproduction Unit in Hong Kong","authors":"J. K. Ko, K. Lam, H. H. Cheng, M. Lui, S. S. Yung, R. Li, E. Lau, P. C. Ho, W. Yeung, E. H. Ng","doi":"10.1142/s2661318221500122","DOIUrl":"https://doi.org/10.1142/s2661318221500122","url":null,"abstract":"Background: Fertility preservation is increasingly important with improving cancer survival rates and the delay in childbearing in modern societies. The objective of our study was to review the experience of the fertility preservation programme in a tertiary-assisted reproduction unit in Hong Kong. Methods: This is a retrospective study involving men and women who were seen at a tertiary-assisted reproduction unit for fertility preservation counselling before gonadotoxic treatment from January 2005 to December 2020. Their medical records in paper and electronic forms were reviewed. Results: There were 75 consultations for female fertility preservation from 2010 to 2020 involving 72 women. Twenty women underwent 22 cycles of ovarian stimulation for oocyte or embryo cryopreservation, two of whom subsequently transported their oocytes abroad for further management and another two achieved natural conception. Additional four women who did not have oocyte or embryo cryopreservation achieved natural conception after cancer treatment. Eleven (15.2%) women were followed up at a reproductive endocrinology clinic after their cancer treatment. From 2005 to 2020, 265 men had sperm cryopreserved. Twenty-six (9.8%) came back to use the cryopreserved sperms, the wives of 13 (50.0%) of whom achieved an on-going pregnancy. Six of them transferred out and 40 discarded the cryopreserved sperms. Conclusions: There was generally an increasing number of patient consultations for fertility preservation in our Centre over the past decade but a consistently low rate of utilisation of cryopreserved gametes for both women and men. Post-cancer treatment fertility evaluation and monitoring was a major area of deficiency in Hong Kong. More structured post-cancer treatment fertility follow-up is needed.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74323202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-30DOI: 10.1142/s2661318221500092
V. Ho, T. Pham, Hieu L. T. Hoang, L. Vuong
Background:Polycystic ovary syndrome (PCOS) is diagnosed when [Formula: see text]2 of the following symptoms are present: ovulation disorder (OD), hyperandrogenism (HA), and polycystic ovary morphology (PCO). Clinical features of PCOS are heterogeneous and there are four clinical phenotypes: A (OD + HA + PCO); B (HA + OD); C (HA + PCO); and D (OD + PCO). Women with a PCOS phenotype that includes severe HA are at increased risk for pregnancy complications. There are currently no data on impact of PCOS phenotypes on in vitro fertilization (IVF) outcomes in Vietnamese women. This study investigated the association between PCOS phenotypes and IVF outcomes. Methods:This is a secondary analysis of a randomized controlled trial conducted in patients with PCOS undergoing IVF at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam between January 2018 and April 2019. The primary outcome was live birth rate. Results:A total of 192 patients were included, of whom 33 patients had phenotype A (17.2%) and 159 had phenotype D (82.8%); no patients had phenotype B or C. Body mass index was significantly higher in patients with phenotype A than D (25.36 ± 4.78 versus 22.08 ± 3.21, [Formula: see text] = 0.001). There were no differences in laboratory and pregnancy outcomes between patients with phenotypes A and D. The live birth rate was lower in patients with phenotype A versus D, but the between-group difference did not reach statistical significance (33.3% vs. 42.8%, [Formula: see text] = 0.419). Conclusions:The common PCOS phenotypes in Vietnamese women with infertility were A and D. No impact of PCOS phenotypes on IVF treatment outcomes was detected in this secondary analysis; larger studies are needed
背景:多囊卵巢综合征(PCOS)被诊断为以下症状2:排卵障碍(OD)，高雄激素(HA)，多囊卵巢形态(PCO)。多囊卵巢综合征的临床特征具有异质性，临床表型有四种:A型(OD + HA + PCO);B (ha + od);C (ha + pco);D (OD + PCO)。患有多囊卵巢综合征(PCOS)表型的女性，包括严重的HA，妊娠并发症的风险增加。目前尚无关于多囊卵巢综合征表型对越南妇女体外受精(IVF)结果影响的数据。本研究探讨了PCOS表型与IVF结果之间的关系。方法:这是对2018年1月至2019年4月期间在越南胡志明市美德医院IVFMD接受体外受精的PCOS患者进行的一项随机对照试验的二次分析。主要观察指标为活产率。结果:共纳入192例患者，其中A型33例(占17.2%)，D型159例(占82.8%);A型患者的体重指数明显高于D型患者(25.36±4.78 vs 22.08±3.21，[公式:见文]= 0.001)。A型和D型患者的实验室和妊娠结局无差异。A型患者的活产率低于D型患者，但组间差异无统计学意义(33.3%比42.8%，[公式:见文]= 0.419)。结论:越南不孕妇女常见的PCOS表型为A型和d型，本二次分析未发现PCOS表型对IVF治疗结果的影响;需要更大规模的研究
{"title":"Impact of Polycystic Ovary Syndrome Phenotypes on in Vitro Fertilization Outcomes in Vietnamese Women: A Secondary Analysis of a Randomized Controlled Trial","authors":"V. Ho, T. Pham, Hieu L. T. Hoang, L. Vuong","doi":"10.1142/s2661318221500092","DOIUrl":"https://doi.org/10.1142/s2661318221500092","url":null,"abstract":"Background:Polycystic ovary syndrome (PCOS) is diagnosed when [Formula: see text]2 of the following symptoms are present: ovulation disorder (OD), hyperandrogenism (HA), and polycystic ovary morphology (PCO). Clinical features of PCOS are heterogeneous and there are four clinical phenotypes: A (OD + HA + PCO); B (HA + OD); C (HA + PCO); and D (OD + PCO). Women with a PCOS phenotype that includes severe HA are at increased risk for pregnancy complications. There are currently no data on impact of PCOS phenotypes on in vitro fertilization (IVF) outcomes in Vietnamese women. This study investigated the association between PCOS phenotypes and IVF outcomes. Methods:This is a secondary analysis of a randomized controlled trial conducted in patients with PCOS undergoing IVF at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam between January 2018 and April 2019. The primary outcome was live birth rate. Results:A total of 192 patients were included, of whom 33 patients had phenotype A (17.2%) and 159 had phenotype D (82.8%); no patients had phenotype B or C. Body mass index was significantly higher in patients with phenotype A than D (25.36 ± 4.78 versus 22.08 ± 3.21, [Formula: see text] = 0.001). There were no differences in laboratory and pregnancy outcomes between patients with phenotypes A and D. The live birth rate was lower in patients with phenotype A versus D, but the between-group difference did not reach statistical significance (33.3% vs. 42.8%, [Formula: see text] = 0.419). Conclusions:The common PCOS phenotypes in Vietnamese women with infertility were A and D. No impact of PCOS phenotypes on IVF treatment outcomes was detected in this secondary analysis; larger studies are needed","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76647501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-28DOI: 10.1142/s2661318221500079
J. Varghese, Monica Peter, M. Kamath
Oogenesis in mammalian females, including humans, is arrested prior to birth. Females, therefore, are born with a limited number of primary oocytes. This is in direct contrast to males in whom spermatogenesis continues during the entire lifespan following puberty. Here, we discuss possible evolutionary advantages that this confers and contrast this with age-related decline in oocyte quality that results in diminished fertility with advancing maternal age. We believe that a better understanding of these processes would be helpful in developing strategies to preserve fertility as maternal age increases, especially in the context of the current demographic shift with more and more women seeking fertility treatment at advanced age.
{"title":"Oogenesis Arrest Prior to Birth: A Trade-off between Possible Evolutionary Advantages and Age-Related Oocyte Dysfunction?","authors":"J. Varghese, Monica Peter, M. Kamath","doi":"10.1142/s2661318221500079","DOIUrl":"https://doi.org/10.1142/s2661318221500079","url":null,"abstract":"Oogenesis in mammalian females, including humans, is arrested prior to birth. Females, therefore, are born with a limited number of primary oocytes. This is in direct contrast to males in whom spermatogenesis continues during the entire lifespan following puberty. Here, we discuss possible evolutionary advantages that this confers and contrast this with age-related decline in oocyte quality that results in diminished fertility with advancing maternal age. We believe that a better understanding of these processes would be helpful in developing strategies to preserve fertility as maternal age increases, especially in the context of the current demographic shift with more and more women seeking fertility treatment at advanced age.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89308406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1142/s2661318221500031
H. Hattori, Yuko Atsumi, Y. Nakajo, N. Aono, M. Koizumi, M. Toya, H. Igarashi, K. Kyono
Background: To evaluate obstetrical and neonatal outcomes of singletons conceived after advanced assisted reproductive technology (ART) techniques: conventional IVF pregnancies (C-IVF), ejaculated sperm intracytoplasmic sperm injection (ICSI), assisted oocyte activation (AOA), in vitro maturation (IVM), and testicular sperm extraction (TESE). Methods: The subjects were 3,028 singletons who were born after fresh or frozen embryo transfer. The subjects were separated into five groups: C-IVF (n = 855), ICSI (n = 1,869), AOA (n = 42), IVM (n = 32), and TESE (n = 230). We evaluated obstetrical and neonatal outcomes calculating the adjusted odds ratio (AOR) using multivariable logistic regression analyses for fresh and frozen embryos and for cleavage and blastocyst transfer. The C-IVF group was used as a background control for the ICSI group. Moreover, the TESE, AOA, and IVM groups were compared to the ICSI group to evaluate the effects of the ICSI procedure itself. Results: The incidence of perinatal complications was significantly lower in the ICSI-fresh group (AOR = 0.29, 95% CI: 0.10–0.83, p ¡ 0.05). Regarding sex ratio, the IVM was significantly associated with sex ratio imbalance toward female in both fresh and frozen groups (AOR = 0.30, 95% CI: 0.10–0.96, AOR = 0.27, 95% CI: 0.07–0.98, p ¡ 0.05). On the other hand, there were no significant differences in preterm birth rate, low birth weight rate and congenital abnormalities rate between conventional IVF, ICSI, and the other groups. Conclusions: There were no negative effects on obstetrical and neonatal outcomes between conventional IVF and ICSI. Although this was a limited sample size study, advanced ART technologies such as AOA, IVM, and TESE also seem to have a low risk of adverse impact on obstetrical and neonatal outcomes but may have a slight impact on sex ratio.
{"title":"Obstetrical and Neonatal Outcomes of 3,028 Singletons Born After Advanced ART Techniques: Ejaculated Sperm Intracytoplasmic Sperm Injection, Artificial Oocyte Activation, in Vitro Maturation and Testicular Sperm Extraction","authors":"H. Hattori, Yuko Atsumi, Y. Nakajo, N. Aono, M. Koizumi, M. Toya, H. Igarashi, K. Kyono","doi":"10.1142/s2661318221500031","DOIUrl":"https://doi.org/10.1142/s2661318221500031","url":null,"abstract":"Background: To evaluate obstetrical and neonatal outcomes of singletons conceived after advanced assisted reproductive technology (ART) techniques: conventional IVF pregnancies (C-IVF), ejaculated sperm intracytoplasmic sperm injection (ICSI), assisted oocyte activation (AOA), in vitro maturation (IVM), and testicular sperm extraction (TESE). Methods: The subjects were 3,028 singletons who were born after fresh or frozen embryo transfer. The subjects were separated into five groups: C-IVF (n = 855), ICSI (n = 1,869), AOA (n = 42), IVM (n = 32), and TESE (n = 230). We evaluated obstetrical and neonatal outcomes calculating the adjusted odds ratio (AOR) using multivariable logistic regression analyses for fresh and frozen embryos and for cleavage and blastocyst transfer. The C-IVF group was used as a background control for the ICSI group. Moreover, the TESE, AOA, and IVM groups were compared to the ICSI group to evaluate the effects of the ICSI procedure itself. Results: The incidence of perinatal complications was significantly lower in the ICSI-fresh group (AOR = 0.29, 95% CI: 0.10–0.83, p ¡ 0.05). Regarding sex ratio, the IVM was significantly associated with sex ratio imbalance toward female in both fresh and frozen groups (AOR = 0.30, 95% CI: 0.10–0.96, AOR = 0.27, 95% CI: 0.07–0.98, p ¡ 0.05). On the other hand, there were no significant differences in preterm birth rate, low birth weight rate and congenital abnormalities rate between conventional IVF, ICSI, and the other groups. Conclusions: There were no negative effects on obstetrical and neonatal outcomes between conventional IVF and ICSI. Although this was a limited sample size study, advanced ART technologies such as AOA, IVM, and TESE also seem to have a low risk of adverse impact on obstetrical and neonatal outcomes but may have a slight impact on sex ratio.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74120585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1142/s2661318221500055
D. Rao, K. Mantravadi, V. Sharanappa
Background and objective: Day-5 blastocyst embryos are usually chosen for assisted reproductive therapy. We compared the reproductive outcomes of the euploid blastocysts developed on Day 5 versus Day 6. Methods: This single-center, retrospective observational study analyzed patients aged 25–45 years, who underwent intracytoplasmic sperm injection from December 2014 to November 2018. Depending on the day of trophectoderm biopsy, patients were categorized into Day-5 and Day-6 groups. Percentages of euploid embryos were calculated for both groups, and elective single euploid blastocysts were transferred in a frozen embryo transfer (FET) cycles. The study endpoints were the comparisons of the reproductive outcomes including clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR) between Day-5 and Day-6 euploid FET groups. Results: A total of 801 embryos from 184 patients were evaluated [Day 5 ([Formula: see text]=769); Day 6 ([Formula: see text]=32); 42.45% were euploid] with the rate of euploidy in Day-5 and Day-6 groups at 42.52% and 40.62%, respectively. A total of 126 patients underwent FET with 126 elective single euploid embryos (Day 5: 117; Day 6: 9). For Day-5 versus Day-6 groups, a significantly higher IR (61.54% vs. 44.44%; [Formula: see text] = 0.0531), CPR (61.54% vs. 44.44%; [Formula: see text] = 0.0531), and LBR (61.54% vs. 33.33%; [Formula: see text] = 0.0014) were reported. Multivariate analysis on ANOVA suggested, comparable pregnancy rates at Day 5 and Day 6 ([Formula: see text] = 0.728). Conclusions: Day-5 euploid blastocysts seem to offer better reproductive outcomes than Day-6 euploid blastocysts. Further research is recommended to evaluate the reproductive outcomes of Day-6 blastocysts.
背景与目的:辅助生殖治疗通常选择第5天的囊胚。我们比较了第5天和第6天发育的整倍体囊胚的生殖结果。方法:本研究为单中心、回顾性观察性研究，分析了2014年12月至2018年11月25-45岁接受卵胞浆内单精子注射的患者。根据滋养外胚层活检的日期，将患者分为第5天和第6天组。计算两组整倍体胚胎的百分比，并在冷冻胚胎移植(FET)周期中移植选择性的单个整倍体囊胚。研究终点是比较第5天和第6天整倍体FET组的生殖结局，包括临床妊娠率(CPR)、着床率(IR)、流产率(MR)和活产率(LBR)。结果:184例患者共801个胚胎被评估[第5天]([公式:见文]=769);第6天([公式:见正文]=32);42.45%为整倍体，第5天和第6天整倍体率分别为42.52%和40.62%。126例患者接受了FET, 126个选择性的单整倍体胚胎(第5天:117;第5天组与第6天组相比，IR显著更高(61.54% vs. 44.44%;[公式:见正文]= 0.0531)，CPR (61.54% vs. 44.44%;[公式:见文]= 0.0531)，LBR (61.54% vs. 33.33%;[公式:见文]= 0.0014)。多因素方差分析显示，第5天和第6天的妊娠率可比([公式:见文]= 0.728)。结论:第5天的整倍体囊胚似乎比第6天的整倍体囊胚提供更好的生殖结果。建议进一步研究以评估第6天囊胚的生殖结果。
{"title":"Euploid Day-5 Blastocysts Versus Euploid Day-6 Blastocysts — Will the Reproductive Outcomes Differ? An Observational Study","authors":"D. Rao, K. Mantravadi, V. Sharanappa","doi":"10.1142/s2661318221500055","DOIUrl":"https://doi.org/10.1142/s2661318221500055","url":null,"abstract":"Background and objective: Day-5 blastocyst embryos are usually chosen for assisted reproductive therapy. We compared the reproductive outcomes of the euploid blastocysts developed on Day 5 versus Day 6. Methods: This single-center, retrospective observational study analyzed patients aged 25–45 years, who underwent intracytoplasmic sperm injection from December 2014 to November 2018. Depending on the day of trophectoderm biopsy, patients were categorized into Day-5 and Day-6 groups. Percentages of euploid embryos were calculated for both groups, and elective single euploid blastocysts were transferred in a frozen embryo transfer (FET) cycles. The study endpoints were the comparisons of the reproductive outcomes including clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR) between Day-5 and Day-6 euploid FET groups. Results: A total of 801 embryos from 184 patients were evaluated [Day 5 ([Formula: see text]=769); Day 6 ([Formula: see text]=32); 42.45% were euploid] with the rate of euploidy in Day-5 and Day-6 groups at 42.52% and 40.62%, respectively. A total of 126 patients underwent FET with 126 elective single euploid embryos (Day 5: 117; Day 6: 9). For Day-5 versus Day-6 groups, a significantly higher IR (61.54% vs. 44.44%; [Formula: see text] = 0.0531), CPR (61.54% vs. 44.44%; [Formula: see text] = 0.0531), and LBR (61.54% vs. 33.33%; [Formula: see text] = 0.0014) were reported. Multivariate analysis on ANOVA suggested, comparable pregnancy rates at Day 5 and Day 6 ([Formula: see text] = 0.728). Conclusions: Day-5 euploid blastocysts seem to offer better reproductive outcomes than Day-6 euploid blastocysts. Further research is recommended to evaluate the reproductive outcomes of Day-6 blastocysts.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78269074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1142/s2661318221500043
Yuta Kasahara, T. Hashimoto, Ryo Yokomizo, Yuya Takeshige, K. Yoshinaga, M. Toya, H. Igarashi, H. Kishi, K. Kyono
Background: The clinical value of personalized embryo transfer (pET) guided by the endometrial receptivity analysis (ERA) tests for recurrent implantation failure (RIF) cases is still unclear. The aim of this study is to clarify the efficacy of ERA leading to personalization of the day of embryo transfer (ET) in RIF patients. Methods: A retrospective study was performed for 94 patients with RIF who underwent ERA between July 2015 and December 2019. Pregnancy outcomes in a previous vitrified-warmed blastocyst transfer (previous VBT) and a personalized vitrified-warmed blastocyst transfer (pVBT) in identical patients were compared. The details of each pVBT were further analyzed between patients in a non-displaced group, which indicated “receptive” cases in ERA results and those who were in the displaced group, which indicated “non-receptive” cases. Results: When the pregnancy rate, both per patient and per transfer cycle, of previous VBT and pVBT were compared, a significant increase in pVBT was observed between the two methods (5.3% vs. 62.8%, 4.4% vs. 47.9%, respectively). The pregnancy rates, implantation rates, and clinical pregnancy rates of the first pVBT were significantly higher in the displaced group than the non-displaced group. The cumulative ongoing pregnancy rate of the displaced group tended to be higher compared to that of the non-displaced group in the first pVBT, although the difference was not statistically significant (51.0% vs. 31.1%, [Formula: see text] = 0.06). Conclusions: Our study demonstrates that pVBT guided by ERA tests may improve pregnancy outcomes in RIF patients whose window of implantation (WOI) is displaced, and its effect may be more pronounced at the first pVBT. The displacement of WOI may be considered to be one of the causes of RIF, and its adjustment may contribute to the improvement of pregnancy outcomes in RIF patients.
背景:子宫内膜容受性分析(ERA)试验指导下的个体化胚胎移植(pET)治疗复发性着床失败(RIF)的临床价值尚不明确。本研究的目的是阐明ERA对RIF患者胚胎移植(ET)日期个性化的功效。方法:对2015年7月至2019年12月期间接受ERA治疗的94例RIF患者进行回顾性研究。比较了相同患者以前玻璃化加热囊胚移植(以前的VBT)和个性化玻璃化加热囊胚移植(pVBT)的妊娠结局。进一步分析非移位组患者(ERA结果为“可接受”病例)和移位组患者(ERA结果为“不可接受”病例)之间每个pVBT的细节。结果:比较既往VBT和pVBT的每名患者和每个转移周期的妊娠率，两种方法的pVBT显著增加(分别为5.3%比62.8%，4.4%比47.9%)。移位组第一pVBT的妊娠率、着床率、临床妊娠率均显著高于未移位组。在第一次pVBT中，移位组的累积持续妊娠率有高于非移位组的趋势，但差异无统计学意义(51.0% vs. 31.1%，[公式:见文]= 0.06)。结论:我们的研究表明，ERA试验指导下的pVBT可以改善着床窗(WOI)移位的RIF患者的妊娠结局，并且在第一次pVBT时效果更明显。WOI的移位可能是RIF发生的原因之一，其调整可能有助于改善RIF患者的妊娠结局。
{"title":"Evaluation of Pregnancy Outcomes of Vitrified-Warmed Blastocyst Transfer before and after Endometrial Receptivity Analysis in Identical Patients with Recurrent Implantation Failure","authors":"Yuta Kasahara, T. Hashimoto, Ryo Yokomizo, Yuya Takeshige, K. Yoshinaga, M. Toya, H. Igarashi, H. Kishi, K. Kyono","doi":"10.1142/s2661318221500043","DOIUrl":"https://doi.org/10.1142/s2661318221500043","url":null,"abstract":"Background: The clinical value of personalized embryo transfer (pET) guided by the endometrial receptivity analysis (ERA) tests for recurrent implantation failure (RIF) cases is still unclear. The aim of this study is to clarify the efficacy of ERA leading to personalization of the day of embryo transfer (ET) in RIF patients. Methods: A retrospective study was performed for 94 patients with RIF who underwent ERA between July 2015 and December 2019. Pregnancy outcomes in a previous vitrified-warmed blastocyst transfer (previous VBT) and a personalized vitrified-warmed blastocyst transfer (pVBT) in identical patients were compared. The details of each pVBT were further analyzed between patients in a non-displaced group, which indicated “receptive” cases in ERA results and those who were in the displaced group, which indicated “non-receptive” cases. Results: When the pregnancy rate, both per patient and per transfer cycle, of previous VBT and pVBT were compared, a significant increase in pVBT was observed between the two methods (5.3% vs. 62.8%, 4.4% vs. 47.9%, respectively). The pregnancy rates, implantation rates, and clinical pregnancy rates of the first pVBT were significantly higher in the displaced group than the non-displaced group. The cumulative ongoing pregnancy rate of the displaced group tended to be higher compared to that of the non-displaced group in the first pVBT, although the difference was not statistically significant (51.0% vs. 31.1%, [Formula: see text] = 0.06). Conclusions: Our study demonstrates that pVBT guided by ERA tests may improve pregnancy outcomes in RIF patients whose window of implantation (WOI) is displaced, and its effect may be more pronounced at the first pVBT. The displacement of WOI may be considered to be one of the causes of RIF, and its adjustment may contribute to the improvement of pregnancy outcomes in RIF patients.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91136742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1142/s2661318221500067
M. M. Shume, J. Banu, Shakeela Ishrat, Serajoom Munira, M. J. Uddin, S. Sultana
Background: New vessel formation or neovascularization has been recognized as a feature of endometriosis. Treatment with cabergoline suppresses cell proliferation and vascular-endothelial-growth-factor-mediated angiogenesis, thereby promoting regression of endometriotic lesions. Dienogest, a fourth-generation progestin currently in use for the treatment of endometriosis significantly decreases the volume of endometrial implants. Objective: The objective of the study was to see if cabergoline is as effective as dienogest in reducing the size of endometriomas and pelvic pain in women with endometriosis. Methods: The prospective comparative study was carried out on 56 women with endometrioma (diagnosed by ultrasound), divided by odd and even numbers into two groups. Cabergoline, 0.5 mg tablet twice weekly, was given to 28 women for 3 months. Dienogest, 2 mg tablet daily, was given to 28 women for the same duration. Pre- and post-treatment assessment of endometrioma size by transvaginal sonography and pelvic pain using the 10-cm visual analog scale (VAS) were recorded. Results: The percentage reduction in endometrioma size in women given dienogest was twice that compared to the women given cabergoline. Mean VAS score after 3 months was significantly lower in the cabergoline group compared to dienogest ([Formula: see text] ¡ 0.05). The incidence of nausea, vomiting, and headache were similar in cabergoline and dienogest group. There was polymenorrhea in the cabergoline group and irregular spotting in the dienogest group. Conclusions: Reduction of the size of endometrioma is less apparent with cabergoline than dienogest after 3 months of treatment. Cabergoline yields better results in decreasing pelvic pain compared to dienogest.
{"title":"The Effects of Cabergoline Compared to Dienogest in Women with Symptomatic Endometrioma","authors":"M. M. Shume, J. Banu, Shakeela Ishrat, Serajoom Munira, M. J. Uddin, S. Sultana","doi":"10.1142/s2661318221500067","DOIUrl":"https://doi.org/10.1142/s2661318221500067","url":null,"abstract":"Background: New vessel formation or neovascularization has been recognized as a feature of endometriosis. Treatment with cabergoline suppresses cell proliferation and vascular-endothelial-growth-factor-mediated angiogenesis, thereby promoting regression of endometriotic lesions. Dienogest, a fourth-generation progestin currently in use for the treatment of endometriosis significantly decreases the volume of endometrial implants. Objective: The objective of the study was to see if cabergoline is as effective as dienogest in reducing the size of endometriomas and pelvic pain in women with endometriosis. Methods: The prospective comparative study was carried out on 56 women with endometrioma (diagnosed by ultrasound), divided by odd and even numbers into two groups. Cabergoline, 0.5 mg tablet twice weekly, was given to 28 women for 3 months. Dienogest, 2 mg tablet daily, was given to 28 women for the same duration. Pre- and post-treatment assessment of endometrioma size by transvaginal sonography and pelvic pain using the 10-cm visual analog scale (VAS) were recorded. Results: The percentage reduction in endometrioma size in women given dienogest was twice that compared to the women given cabergoline. Mean VAS score after 3 months was significantly lower in the cabergoline group compared to dienogest ([Formula: see text] ¡ 0.05). The incidence of nausea, vomiting, and headache were similar in cabergoline and dienogest group. There was polymenorrhea in the cabergoline group and irregular spotting in the dienogest group. Conclusions: Reduction of the size of endometrioma is less apparent with cabergoline than dienogest after 3 months of treatment. Cabergoline yields better results in decreasing pelvic pain compared to dienogest.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"280 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75782237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1142/s2661318220500097
R. Pawa, L. Udomsrisumran, S. Kiatpongsan
Background: Fertility physicians are gatekeepers of assisted reproductive technology (ART) and have immediate control over access to fertility care. However, little is understood about their attitudes and willingness to provide and support different procedures. Therefore, we examined fertility physicians’ perspectives on support of public funding and willingness to provide care in various scenarios. Methods: We invited fertility physicians attending the 8th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2018) to participate in a 10-minute survey. Participants completed the survey anonymously and in private. Results: 78 out of 105 fertility physicians from 12 countries completed the survey (response rate = 74.3%). Mean age was 44.9 years (SD = 11.1). A majority of respondents supported public funding for ART: 76.3% for intrauterine insemination and 80.5% for in vitro fertilization. For controversial procedures, a majority agreed to provide social egg freezing (88.5%) compared to sex selection (25.6%) and gene editing for nonmedical reasons (19.2%), p < 0.001 for both comparisons. Support for public funding was also significantly higher for social egg freezing (51.3%) compared to sex selection (23.1%) and gene editing for nonmedical reasons (20.5%), p < 0.001 for both comparisons. For eligibility criteria, willingness to provide treatment to single women (50.0%) was significantly higher compared to other nontraditional family structures — single men (33.3%), p < 0.001, male homosexual couples (33.3%), p = 0.002, female homosexual couples (32.1%), p = 0.001 and unmarried heterosexual couples (32.1%), p = 0.004. Consistently, support for public finding was significantly higher for single women (32.1%) compared to single men (23.1%), p = 0.013, male homosexual couples (20.5%), p = 0.020, and unmarried heterosexual couples (20.5%), p = 0.006. Conclusions: These results show support for public funding and conservative opinions toward ART for nontraditional family structures among physicians in the Asia-Pacific region.
{"title":"Fertility Physicians’ Opinions and Attitudes on Access to Assisted Reproductive Technology: An Asia-Pacific Perspective","authors":"R. Pawa, L. Udomsrisumran, S. Kiatpongsan","doi":"10.1142/s2661318220500097","DOIUrl":"https://doi.org/10.1142/s2661318220500097","url":null,"abstract":"Background: Fertility physicians are gatekeepers of assisted reproductive technology (ART) and have immediate control over access to fertility care. However, little is understood about their attitudes and willingness to provide and support different procedures. Therefore, we examined fertility physicians’ perspectives on support of public funding and willingness to provide care in various scenarios. Methods: We invited fertility physicians attending the 8th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2018) to participate in a 10-minute survey. Participants completed the survey anonymously and in private. Results: 78 out of 105 fertility physicians from 12 countries completed the survey (response rate = 74.3%). Mean age was 44.9 years (SD = 11.1). A majority of respondents supported public funding for ART: 76.3% for intrauterine insemination and 80.5% for in vitro fertilization. For controversial procedures, a majority agreed to provide social egg freezing (88.5%) compared to sex selection (25.6%) and gene editing for nonmedical reasons (19.2%), p < 0.001 for both comparisons. Support for public funding was also significantly higher for social egg freezing (51.3%) compared to sex selection (23.1%) and gene editing for nonmedical reasons (20.5%), p < 0.001 for both comparisons. For eligibility criteria, willingness to provide treatment to single women (50.0%) was significantly higher compared to other nontraditional family structures — single men (33.3%), p < 0.001, male homosexual couples (33.3%), p = 0.002, female homosexual couples (32.1%), p = 0.001 and unmarried heterosexual couples (32.1%), p = 0.004. Consistently, support for public finding was significantly higher for single women (32.1%) compared to single men (23.1%), p = 0.013, male homosexual couples (20.5%), p = 0.020, and unmarried heterosexual couples (20.5%), p = 0.006. Conclusions: These results show support for public funding and conservative opinions toward ART for nontraditional family structures among physicians in the Asia-Pacific region.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85542105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1142/s2661318220500115
T. Chowdhury, M. M. Shume, T. Chowdhury
Background: Tubal evaluation is an integral part of the evaluation of female infertility. Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes, which has been used as a first-line test for tubal assessment since 1920s. Laparoscopy is considered to be the gold standard for the diagnosis and management of tubo-peritoneal pathology. The objective of this study is to evaluate and compare the diagnostic value of both HSG and laparoscopy for assessment of tubal occlusion. Methods: This is a prospective cross-sectional study. Laparoscopic chromopertubation was conducted on 125 consecutive infertile women who attended the “Infertility Management Center” from October 2018 to September 2019. All patients had HSG performed in the radiology department of different hospitals. Laparoscopic findings were used as a reference standard to analyze the findings of HSG for tubal occlusion. Data were analyzed by SPSS software (version 16). Results: Normal HSG findings were seen in 53 patients (42.4%). Unilateral tubal occlusion was present in 38 (30.7%), and bilateral occlusion in 34 (27.2%) patients. Laparoscopy showed normal findings in 85 (68.0%) patients. Unilateral tubal occlusion was demonstrated in laparoscopy in 27 (21.6%) and bilateral tubal occlusion in 13 (10.4%) patients. HSG findings for diagnosis of tubal occlusion was true positive in 30 (24%) cases, false positive in 42 (33.6%) cases, false negative in 10 (8%) cases, and true negative in 43 (34.4%) cases in comparison to laparoscopy findings. Sensitivity of HSG was found to be 75.0%, specificity 50.6%, and accuracy 58.4%. Positive predictive value and negative predictive value were 41.7% and 81.1%, respectively. Conclusion: HSG is widely used for tubal assessment in Bangladesh as it is a relatively inexpensive, low-risk office procedure. But it has a low specificity and positive predictive value with a relatively high negative predictive value. Laparoscopy, on the other hand, is preferable when there is high suspicion of tubal pathology.
{"title":"Comparison of Hysterosalpingography and Laparoscopy as Diagnostic Tool for Tubal Infertility in Bangladesh","authors":"T. Chowdhury, M. M. Shume, T. Chowdhury","doi":"10.1142/s2661318220500115","DOIUrl":"https://doi.org/10.1142/s2661318220500115","url":null,"abstract":"Background: Tubal evaluation is an integral part of the evaluation of female infertility. Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes, which has been used as a first-line test for tubal assessment since 1920s. Laparoscopy is considered to be the gold standard for the diagnosis and management of tubo-peritoneal pathology. The objective of this study is to evaluate and compare the diagnostic value of both HSG and laparoscopy for assessment of tubal occlusion. Methods: This is a prospective cross-sectional study. Laparoscopic chromopertubation was conducted on 125 consecutive infertile women who attended the “Infertility Management Center” from October 2018 to September 2019. All patients had HSG performed in the radiology department of different hospitals. Laparoscopic findings were used as a reference standard to analyze the findings of HSG for tubal occlusion. Data were analyzed by SPSS software (version 16). Results: Normal HSG findings were seen in 53 patients (42.4%). Unilateral tubal occlusion was present in 38 (30.7%), and bilateral occlusion in 34 (27.2%) patients. Laparoscopy showed normal findings in 85 (68.0%) patients. Unilateral tubal occlusion was demonstrated in laparoscopy in 27 (21.6%) and bilateral tubal occlusion in 13 (10.4%) patients. HSG findings for diagnosis of tubal occlusion was true positive in 30 (24%) cases, false positive in 42 (33.6%) cases, false negative in 10 (8%) cases, and true negative in 43 (34.4%) cases in comparison to laparoscopy findings. Sensitivity of HSG was found to be 75.0%, specificity 50.6%, and accuracy 58.4%. Positive predictive value and negative predictive value were 41.7% and 81.1%, respectively. Conclusion: HSG is widely used for tubal assessment in Bangladesh as it is a relatively inexpensive, low-risk office procedure. But it has a low specificity and positive predictive value with a relatively high negative predictive value. Laparoscopy, on the other hand, is preferable when there is high suspicion of tubal pathology.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83628626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1142/s2661318220500085
R. Warner, J. Avery, S. Neuhaus, M. Davies
Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes. Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26. Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females). Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.
背景:继上述相关文章的第1部分(描述了中东手术地区(MEAO)人口普查研究的母亲和父亲队列)之后，本文旨在描述胎儿和婴儿的特征和自报告数据的结果，包括活产、死产、所有其他妊娠损失和未知结果。方法:对报告数据的临床变量进行描述性分析。描述性统计(平均值、频率、百分位数)用于描述不良妊娠结局的发生。还计算了围产期结局的优势比。采用统计分析软件IBM SPSS v26对婴儿的特征和结局进行评价。结果:MEAO人口普查调查对象共报告15417例妊娠。其中，74%(11367例)为活产，0.75%为死产，20%为其他类型的妊娠丢失(异位妊娠、流产、终止妊娠)。MEAO普查人群中不良围产期结局的未调整几率高于澳大利亚一般人群，特别是死产(OR = 3.11, 95% CI 2.56-3.80)、围产期死亡(OR = 3.80, 95% CI 3.26-4.44)和新生儿死亡(OR = 5.43, 95% CI 4.27-6.91)。在MEAO人口中报告了499例出生缺陷和85例儿童癌症。在MEAO人群中，未调整的儿童癌症几率略高(OR = 1.7, 95% CI 0.09-3.28)，未调整的出生缺陷几率较低(OR = 0.52, 95% CI 0.40-0.68)。调查对象出生婴儿男女性别比为102(男5939:女5823)。结论:在澳大利亚国防军服役妇女的生殖健康方面，MEAO人口普查研究总体上令人放心，涉及流产风险和围产期结果。围产期和新生儿死亡和死产的几率增加值得进一步研究和评估，MEAO退伍军人后代患儿童癌症的可能性也值得进一步研究和评估。
{"title":"Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 2 — Prenatal, Fetal, and Neonatal Outcomes","authors":"R. Warner, J. Avery, S. Neuhaus, M. Davies","doi":"10.1142/s2661318220500085","DOIUrl":"https://doi.org/10.1142/s2661318220500085","url":null,"abstract":"Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes. Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26. Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females). Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.","PeriodicalId":34382,"journal":{"name":"Fertility Reproduction","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75391187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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