BMJ : British Medical Journal最新文献

{"title":"IVF in women with low ovarian reserve or response.","authors":"Simone Cornelisse, Sebastiaan Mastenbroek","doi":"10.1136/bmj.r49","DOIUrl":"https://doi.org/10.1136/bmj.r49","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r49"},"PeriodicalIF":105.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frozen versus fresh embryo transfer in women with low prognosis for in vitro fertilisation treatment: pragmatic, multicentre, randomised controlled trial.","authors":"Daimin Wei, Yun Sun, Han Zhao, Junhao Yan, Hong Zhou, Fei Gong, Aijun Zhang, Ze Wang, Lei Jin, Hongchu Bao, Shuyun Zhao, Zhuoni Xiao, Yingying Qin, Ling Geng, Linlin Cui, Yan Sheng, Mei Sun, Peihao Liu, Lingling Ding, Hong Liu, Keliang Wu, Yan Li, Yao Lu, Bufang Xu, Bei Xu, Luqing Zhang, Heping Zhang, Richard S Legro, Zi-Jiang Chen","doi":"10.1136/bmj-2024-081474","DOIUrl":"10.1136/bmj-2024-081474","url":null,"abstract":"<p><strong>Objective: </strong>To test the hypothesis that a freeze-all strategy would increase the chance of live birth compared with fresh embryo transfer in women with low prognosis for in vitro fertilisation (IVF) treatment.</p><p><strong>Design: </strong>Pragmatic, multicentre, randomised controlled trial.</p><p><strong>Setting: </strong>Nine academic fertility centres in China.</p><p><strong>Participants: </strong>838 women with a low prognosis for IVF treatment defined by ≤9 oocytes retrieved or poor ovarian reserve (antral follicle count <5 or serum anti-Müllerian hormone level <8.6 pmol/L).</p><p><strong>Interventions: </strong>Eligible participants were randomised (1:1) to undergo either frozen embryo transfer or fresh embryo transfer on the day of oocyte retrieval. Participants in the frozen embryo transfer group had all of their embryos cryopreserved and underwent frozen embryo transfer later. Participants in the fresh embryo transfer group underwent fresh embryo transfer after oocyte retrieval.</p><p><strong>Main outcome measures: </strong>The primary outcome was live birth, defined as the delivery of neonates with a heartbeat and respiration at ≥28 weeks' gestation. Secondary outcomes were clinical pregnancy, singleton or twin pregnancy, pregnancy loss, ectopic pregnancy, birth weight, maternal and neonatal complications, and cumulative live birth after embryo transfers within one year after randomisation.</p><p><strong>Results: </strong>In an intention-to-treat analysis, the rate of live birth was lower in the frozen embryo transfer group than in the fresh embryo transfer group (32% (132 of 419) <i>v</i> 40% (168 of 419); relative ratio 0.79 (95% confidence interval 0.65 to 0.94); P=0.009). The frozen embryo group had a lower rate of clinical pregnancy than the fresh embryo group (39% (164 of 419) <i>v</i> 47% (197 of 419); 0.83 (0.71 to 0.97)). The cumulative live birth rate was lower in the frozen embryo transfer group compared with the fresh embryo transfer group (44% (185 of 419) <i>v</i> 51% (215 of 419), 0.86 (0.75 to 0.99)). No difference was observed in birth weight, incidence of obstetric complications, or risk of neonatal morbidities.</p><p><strong>Conclusions: </strong>Fresh embryo transfer may be a better choice for women with low prognosis in terms of live birth rate compared with a freeze-all strategy. The treatment strategies that prevent fresh embryo transfers, such as accumulating embryos with back-to-back cycles or performing routine preimplantation genetic testing for aneuploidy, warrant further studies in women with a low prognosis.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry ChiCTR2100050168.</p>","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"e081474"},"PeriodicalIF":105.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic fatigue syndrome: Outcry over Cochrane decision to abandon review of exercise therapy.","authors":"Jacqui Wise","doi":"10.1136/bmj.r169","DOIUrl":"https://doi.org/10.1136/bmj.r169","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r169"},"PeriodicalIF":105.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canada reopens investigation into mystery neurological illnesses.","authors":"Owen Dyer","doi":"10.1136/bmj.r168","DOIUrl":"https://doi.org/10.1136/bmj.r168","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r168"},"PeriodicalIF":105.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biden pardons Anthony Fauci and others to protect them from Trump retribution.","authors":"Janice Hopkins Tanne","doi":"10.1136/bmj.r170","DOIUrl":"https://doi.org/10.1136/bmj.r170","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r170"},"PeriodicalIF":105.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four US states consider new laws for people who have abortions to be punished as murderers.","authors":"Janice Hopkins Tanne","doi":"10.1136/bmj.r174","DOIUrl":"https://doi.org/10.1136/bmj.r174","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r174"},"PeriodicalIF":105.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human case of avian flu detected in England.","authors":"Zosia Kmietowicz","doi":"10.1136/bmj.r177","DOIUrl":"https://doi.org/10.1136/bmj.r177","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r177"},"PeriodicalIF":105.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covid inquiry: Chief medical officer's scepticism about mandatory vaccination of healthcare staff.","authors":"Gareth Iacobucci","doi":"10.1136/bmj.r161","DOIUrl":"https://doi.org/10.1136/bmj.r161","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r161"},"PeriodicalIF":105.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BMA apologises for \"upset and distress\" caused by call for UK graduates to have preferential access to specialty training.","authors":"Ella Hubbard","doi":"10.1136/bmj.r157","DOIUrl":"https://doi.org/10.1136/bmj.r157","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r157"},"PeriodicalIF":105.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian government says primary care by non-physicians must be publicly funded.","authors":"Carolyn Brown","doi":"10.1136/bmj.r156","DOIUrl":"https://doi.org/10.1136/bmj.r156","url":null,"abstract":"","PeriodicalId":9201,"journal":{"name":"BMJ : British Medical Journal","volume":"388 ","pages":"r156"},"PeriodicalIF":105.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}