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Yao Y, Liu W, Zhang X, Su N, Huang L, Nong Y, Xiao X, Liu F. Normal weight obesity is associated with lower AFC and adverse IVF outcomes. Front Endocrinol (Lausanne) 2024; 15:1332995. [PMID: 38455649 PMCID: PMC10917978 DOI: 10.3389/fendo.2024.1332995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/08/2024] [Indexed: 03/09/2024] Open
Abstract
Background Body weight could be classified into underweight, normal weight and overweight according to percentage of body fat (%BF), and normal weight obesity (NWO) is defined as a normal BMI but a high %BF. While the impact of NWO in women fecundity remain unknow. Therefore, this study aimed to investigate the associations between %BF and reproductive outcomes among in vitro fertilization (IVF) women with normal BMI. Methods A total of 469 women were included in this study and were classified into low %BF, normal %BF and high %BF according to previous study. Multivariate generalized regression models were employed to evaluate the associations of %BF with ovarian reserve parameters, IVF outcomes and early pregnancy outcomes. We further run sensitivity analyses by restricted the analysis to young women and those only with tubal factor, respectively. Results About 32.2% of normal BMI women were misclassified according %BF, with 16.4% of them were low %BF and 15.8% were high %BF. The high %BF group had significantly lower antral follicle count (AFC) than normal %BF groups, and the AFC showed a tendency of decrease as %BF increased. In sensitivity analysis in young women, high %BF group also had significantly lower number of good-quality embryos when compared to normal %BF groups. The results expanded to all IVF outcomes when analysis restricted to tubal factor women. Conclusion In summary, misclassifications of body weight status based on BMI are common according to %BF, and NWO is associated with adverse reproductive outcomes.
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Affiliation(s)
- Yangcheng Yao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wenjuan Liu
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiqian Zhang
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Nianjun Su
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Li Huang
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yingqi Nong
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiaomin Xiao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Fenghua Liu
- Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
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Guler I, Demirdag E, Akdulum MFC, Polat M, Erdem A, Erdem M. Serum LH level prior to progestin administration is significant on pregnancy and live birth in programmed frozen-thawed embryo transfer cycles. Front Endocrinol (Lausanne) 2023; 14:1293576. [PMID: 37929039 PMCID: PMC10621734 DOI: 10.3389/fendo.2023.1293576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose To evaluate the impact of serum LH levels prior to progestin administration on the outcomes of programmed frozen-thawed embryo transfer (FET) cycles. Methods Retrospective cohort study was conducted to compare the treatment outcomes between four groups based on the 25 percentiles of serum LH levels before progestin administration in 596 cycles of 518 patients undergoing artificial endometrial preparation protocols for FET. Primary outcome measures were ongoing and live birth rates. Secondary outcome measures were the pregnancy rates, clinical pregnancy rates, and pregnancy loss rates. Results The trends in clinical pregnancy (CPR) and live birth rates (LBR) increased from the first to the fourth quartile (Q1 to Q4) of serum LH levels prior to progestin administration (37,0% to 48,3%, p = 0.042, and 22.6% to 39.5%, respectively, p = 0.003). Pregnancy loss rates (PLR) were higher in group Q1, although the difference was not statistically significant. Based on a multivariate logistic regression analysis, a low serum LH level before progestin initiation was found to be the most significant predictor associated with a negative effect on live birth (OR: 0,421, 95% CI 0,178 - 0,994, p=0,048). The day of estrogen initiation was significantly correlated with serum LH levels and quartiles of serum LH levels before progestin administration (r=0,200, p=0,015 and r=0,215, p=0,009, respectively). Conclusion The serum LH level prior to progestin administration significantly affects pregnancy and live birth rates in patients undergoing an artificial endometrial preparation protocol for FET. LH monitoring should be incorporated into the follow-up, in addition to assessing endometrial thickness and morphology in artificial FET cycles.
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Affiliation(s)
- Ismail Guler
- Gazi University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Türkiye
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Zhang Y, Fu X, Gao S, Gao S, Gao S, Ma J, Chen ZJ. Preparation of the endometrium for frozen embryo transfer: an update on clinical practices. Reprod Biol Endocrinol 2023; 21:52. [PMID: 37291605 DOI: 10.1186/s12958-023-01106-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023] Open
Abstract
Over the past decade, the application of frozen-thawed embryo transfer treatment cycles has increased substantially. Hormone replacement therapy and the natural cycle are two popular methods for preparing the endometrium. Hormone replacement therapy is now used at the discretion of the doctors because it is easy to coordinate the timing of embryo thawing and transfer with the schedules of the in-vitro fertilization lab, the treating doctors, and the patient. However, current results suggest that establishing a pregnancy in the absence of a corpus luteum as a result of anovulation may pose significant maternal and fetal risks. Therefore, a 'back to nature' approach that advocates an expanded use of natural cycle FET in ovulatory women has been suggested. Currently, there is increasing interest in how the method of endometrial preparation may influence frozen embryo transfer outcomes specifically, especially when it comes to details such as different types of ovulation monitoring and different luteal support in natural cycles, and the ideal exogenous hormone administration route as well as the endocrine monitoring in hormone replacement cycles. In addition to improving implantation rates and ensuring the safety of the fetus, addressing these points will allow for individualized endometrial preparation, also as few cycles as possible would be canceled.
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Affiliation(s)
- Yiting Zhang
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Xiao Fu
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Shuli Gao
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Shuzhe Gao
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Shanshan Gao
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China.
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China.
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China.
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.
| | - Jinlong Ma
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China
- Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, 250012, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200135, China
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200135, China
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Zhang X, Wang X, Wang M, Gu J, Guo H, Yang Y, Liu J, Li Q. Effect of comorbidity assessed by the Charlson Comorbidity Index on the length of stay, costs, and mortality among colorectal cancer patients undergoing colorectal surgery. Curr Med Res Opin 2023; 39:187-195. [PMID: 36269069 DOI: 10.1080/03007995.2022.2139053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Charlson Comorbidity Index (CCI) is a good predictor for hospitalization cost and mortality among patients with chronic disease. However, the impact of CCI on patients after colorectal cancer surgery is unclear. This study aims to investigate the influence of comorbidity assessed by CCI on length of stay, hospitalization costs, and in-hospital mortality in patients with colorectal cancer (CRC) who underwent surgical resection. METHODS This historical cohort study collected 10,271 adult inpatients for CRC undergoing resection surgery in 33 tertiary hospitals between January 2018 and December 2019. All patients were categorized by the CCI score into four classes: 0, 1,2, and ≥3. Linear regression was used for outcome indicators as continuous variables and logical regression for categorical variables. EmpowerStats software and R were used for data analysis. RESULTS Of all 10,271 CRC patients, 51.72% had at least one comorbidity. Prevalence of metastatic solid tumor (19.68%, except colorectal cancer) and diabetes without complication (15.01%) were the major comorbidities. The highest average cost of hospitalization (86,761.88 CNY), length of stay (18.13 days), and in-hospital mortality (0.89%) were observed in patients with CCI score ≥3 compared to lower CCI scores (p < .001). Multivariate regression analysis showed that the CCI score was associated with hospitalization costs (β, 7340.46 [95% confidence interval (CI) (5710.06-8970.86)], p < .001), length of stay (β, 1.91[95%CI (1.52-2.30)], p < .001), and in-hospital mortality(odds ratio (OR),16.83[95%CI (2.23-126.88)], p = .0062) after adjusted basic clinical characteristics, especially when CCI score ≥3. Notably, the most specific complication associated with hospitalization costs and length of stay was metastatic solid tumor, while the most notable mortality-specific comorbidity was moderate or severe renal disease. CONCLUSION The research work has discovered a strong link between CCI and clinical plus economic outcomes in patients with CRC who underwent surgical resection.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Miaoran Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiyu Gu
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Huijun Guo
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yufei Yang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jian Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Du H, Yang B, Wang H, Zeng Y, Xin J, Li X. The non-linear correlation between the volume of cerebral white matter lesions and incidence of bipolar disorder: A secondary analysis of data from a cross-sectional study. Front Psychiatry 2023; 14:1149663. [PMID: 37009125 PMCID: PMC10061585 DOI: 10.3389/fpsyt.2023.1149663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
Cerebral white matter lesions (WML) are major risk factors for bipolar disorder (BD). However, studies on the association between cerebral WML volume and BD risk are limited. This study aimed to investigate the relationship between cerebral WML volume and BD incidence. This is a secondary retrospective analysis of patients (N = 146, 72 males, 74 females, mean age = 41.77 years) who have previously undergone magnetic resonance imaging examinations. Information was obtained from the Dryad database. Univariate analysis, piecewise linear regression model, and multivariable logistic regression model were used for statistical analysis. A non-linear relationship was recognized between the cerebral WML volume and BD incidence, in which the inflection point of the WML volume was 6,200 mm3. The effect sizes and confidence intervals on the left and right sides of the emphasis point were 1.0009 (1.0003, 1.0015) and 0.9988 (0.9974, 1.0003), respectively. Subgroup analysis (WML volume < 6,200 mm3) showed that the cerebral WML volume (for 0.1 mm3 increase) was positively related to the BD incidence (OR = 1.11, 95% confidence interval [CI] (1.03, 1.21)). Here we show that the cerebral WML volume is positively and non-linearly correlated to the BD risk. Volumetric analysis of WML provide a better understanding of the association between WML and the BD risk, and thereby the pathophysiological mechanisms of BD. Graphical abstract A non-linear relationship between the volume of cerebral white matter lesions (WML) and bipolar disorder (BD) incidence is shown. The cerebral WML volume is positively and non-linearly correlated to the BD risk. The correlation is stronger when the cerebral WML volume was <6,200 mm3.Graphical AbstractA non-linear relationship between the volume of cerebral white matter lesions and bipolar disorder incidence is shown after adjusting for age; sex; lithium, atypical antipsychotic, antiepileptic, and antidepressant drug use; BMI; migraine; smoking; hypertension; diabetes mellitus; substance and alcohol dependency; and anxiety disorder.
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Affiliation(s)
- Hui Du
- Department of Blood Transfusion, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China
| | - Bing Yang
- Neurological Department and Stroke Center, the First Affiliated Hospital of Jinan University and Clinical Neuroscience Institute, Jinan University, Guangzhou, Guangdong, China
| | - Hui Wang
- Department of Neurology, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China
| | - Yaqing Zeng
- Department of Neurology, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China
| | - Jianpin Xin
- Department of Radiology, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China
| | - Xiaoqiang Li
- Department of Neurology, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China
- *Correspondence: Xiaoqiang Li,
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Shi Q, Jiang Y, Kong N, Huang C, Liu J, Shen X, Sun Y, Lu F, Mei J, Zhou J. Serum LH Level on the Day of hCG Administration as a Predictor of the Reproductive Outcomes in Ovulation Induction Cycle Frozen-Thawed Embryo Transfer. J Pers Med 2022; 13:jpm13010052. [PMID: 36675713 PMCID: PMC9862278 DOI: 10.3390/jpm13010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Purpose: To evaluate the clinical utility of serum luteinizing hormone (LH) level in predicting frozen embryo transfer (FET) outcomes among the patients with an ovulation induction (OI) cycle. Methods: A total of 250 patients who underwent OI cycle frozen-thawed embryo transfer from January 2018 to June 2020 in Drum Tower Hospital affiliated with Nanjing University Medical School were retrospectively analyzed. The primary outcomes were clinical pregnancy rate and the live birth rate. Results: The results showed that a significant difference in Serum LH level on the day of human chorionic gonadotropin (hCG) administration was observed between the clinical pregnancy group and no clinical pregnancy group (p = 0.002), while there was no significant difference between the live birth group and no live birth group (p = 0.06). Multiple logistic regression analysis of factors related to clinical pregnancy showed serum LH level on the day of hCG administration was related to improved clinical pregnancy rate (OR was 1.02, 95% CI: 1.0-1.03, p = 0.02), while serum LH level had no significant effect on live birth rate. The ROC curves revealed the serum LH level was significantly correlated with clinical pregnancy rate and live birth rate; the cut-off point of serum LH level on the day of hCG administration was 8.46 miu/mL for clinical pregnancy rate (AUC 0.609, p = 0.003). Conclusion: In patients with OI FET, serum LH level on the day of hCG administration might be a biomarker for the prediction of clinical pregnancy. The prediction that patients who underwent OI cycle frozen-thawed embryo transfer with serum LH levels below 8.46 mIU /mL might be pregnant appeared to be meaningful.
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Affiliation(s)
- Qingqing Shi
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Yue Jiang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Na Kong
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Chenyang Huang
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Jingyu Liu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Xiaoyue Shen
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Yanxin Sun
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing 210008, China
| | - Feifei Lu
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Jie Mei
- Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
- Correspondence: (J.M.); (J.Z.)
| | - Jianjun Zhou
- Center for Molecular Reproductive Medicine, Nanjing University, Nanjing 210008, China
- Correspondence: (J.M.); (J.Z.)
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Liu WJ, Huang J, Sun L, Huang L, Zhang QY, Nong YQ, Wei JH, Wu KH, Liu FH. New biopsy after antibiotic treatment: effect on outcomes of assisted reproduction in patients with infertility and chronic endometritis. Reprod Biomed Online 2022; 45:1167-1175. [PMID: 36462787 DOI: 10.1016/j.rbmo.2022.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/17/2022] [Accepted: 07/30/2022] [Indexed: 12/25/2022]
Abstract
RESEARCH QUESTION What is the effect of chronic endometritis on patients with infertility, the necessity of endometrial re-examination and the effect of improving chronic endometritis after one cycle of antibiotic treatment on pregnancy outcomes? DESIGN Infertile patients (n = 4003) who underwent IVF and intracytoplasmic sperm injection treatment were included. Pregnancy outcomes of groups positive for chronic endometritis were compared with groups that were negative (group 1). Patients that were positive were divided into the chronic endometritis new biopsy group (group 2) and chronic endometritis non-re-examination group (group 3). After doxycycline treatment and re-examination, the chronic endometritis new biopsy group was divided into improved chronic endometritis group (ICE) and not-improved chronic endometritis group (NICE), and their general indicators and reproductive outcomes were compared. RESULTS No significant difference was observed in embryo implantation, early or late pregnancy loss, ectopic pregnancy, clinical pregnancy and live birth rates between groups 2 and 3. The clinical pregnancy and live birth rates in the NICE group were significantly lower than those in the ICE group (P = 0.008 and P = 0.001, respectively). After controlling for potential confounding factors, age, average number of high-quality embryos, endometrial thickness on the day of embryo transfer and number and type of embryo transfer were factors associated with live birth rates. CONCLUSIONS Endometrial re-examination of women with chronic endometritis treated with doxycycline had no effect on pregnancy outcomes. The first cycle of doxycycline treatment could effectively improve reproductive outcomes of women with five or more CD138+ cells/high-power field.
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Affiliation(s)
- Wen-Juan Liu
- The First Affiliated Hospital of Jinan University, 613 Huangpu Avenue West, Tianhe District, Guangzhou Guangdong Province 510630, China; Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Ju Huang
- The First Affiliated Hospital of Jinan University, 613 Huangpu Avenue West, Tianhe District, Guangzhou Guangdong Province 510630, China; Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Li Sun
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Li Huang
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Qian-Yu Zhang
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Ying-Qi Nong
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Jia-Hui Wei
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Kun-He Wu
- Department of Pathology, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China
| | - Feng-Hua Liu
- The First Affiliated Hospital of Jinan University, 613 Huangpu Avenue West, Tianhe District, Guangzhou Guangdong Province 510630, China; Department of Reproductive Medical Center, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou Guangdong Province 511400, China.
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8
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Zhang X, Wang M, Zhu Z, Qu H, Gu J, Ni T, Wang Y, Wang X, Zhang R, Li Q. Serum potassium level, variability and in-hospital mortality in acute myocardial infarction. Eur J Clin Invest 2022; 52:e13772. [PMID: 35294777 DOI: 10.1111/eci.13772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/01/2022] [Accepted: 03/06/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Clinical guidelines recommend an optimal serum potassium concentration between 4.0 and 5.0 mmol/L in patients with acute myocardial infarction (AMI), which was based on lower-quality evidence from more than 20 years ago. Therefore, it is essential to re-evaluate the range of optimal potassium levels in patients with AMI in intensive care unit (ICU). METHODS This was a retrospective study based on Philips eICU Collaborative Research Database, which covered 9776 patients with AMI between 2014 and 2015. All patients had more than or equal to 2 serum potassium measurements and were categorized by the mean serum potassium level (<3.5, 3.5-4.5, 4.5-5.5, ≥5.5 mmol/L) and potassium variability (1st, 2nd, and ≥3rd standard deviation (SD)). Binary logistic regression was used to determine the association between mean potassium levels, variability and in-hospital mortality in AMI. RESULTS Of all 9776 AMI patients in ICU, 8731 (89.3%) patients were included. A total of 69847 potassium measurements were performed in these patients. There was a J-shaped relationship between mean serum potassium level and in-hospital mortality. The lowest mortality (mortality rate, 7.2%; 95% CI, 6.57%-7.76%) was observed in patients with mean potassium level between 3.5 and 4.5 mmol/L and a low potassium variability within the 1st SD. Logistic regression showed that the risk of in-hospital mortality is highest when the mean potassium level ≥5.5 mmol/L (57.6%; 95% Cl, 45.02%-70.24%; multivariable adjusted OR, 14.8; 95% CI, 8.4-26.2) compared to the reference group of 3.5-4.5 mmol/L and potassium variability within the 3rd SD (16.5%; 95% Cl, 15.19%-17.88%; multivariable adjusted OR, 3.3; 95% CI, 2.7-4.1) compared to 1st SD. Several sensitivity analyses confirmed these results. CONCLUSION Among AMI patients in ICU, the minimum risk of in-hospital mortality was observed in those with mean potassium levels between 3.5 and 4.5 mmol/L or a minimal potassium variability compared to those who had higher or lower values.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Miaoran Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhengchuan Zhu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiyu Gu
- Beijing University of Chinese Medicine, Beijing, China
| | - Tian Ni
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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9
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Alsbjerg B, Kesmodel US, Elbaek HO, Laursen R, Laursen SB, Andreasen D, Povlsen BB, Humaidan P. GnRH agonist supplementation in hormone replacement therapy-frozen embryo transfer cycles: a randomized controlled trial. Reprod Biomed Online 2021; 44:261-270. [PMID: 34924287 DOI: 10.1016/j.rbmo.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/14/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022]
Abstract
RESEARCH QUESTION Will two boluses of gonadotrophin-releasing hormone agonist (GnRHa) during hormone replacement therapy-frozen embryo transfer (HRT-FET) cycles reduce the total pregnancy loss rate? DESIGN Randomized controlled trial including a total of 287 HRT-FET cycles performed between 2013 and 2019. After randomization participants allocated to the GnRHa group (n = 144) underwent a standard HRT protocol, supplemented with a total of two boluses of triptorelin 0.1 mg; one bolus 2 days before starting vaginal progesterone and one bolus on the 7th day of progesterone. The control group (n = 143) underwent a standard HRT-FET protocol only. RESULTS The intention-to-treat analysis showed no significant difference in total pregnancy loss between the GnRHa group and the control group (21% versus 33%; relative risk [RR] 0.63, 95% confidence interval [CI] 0.35-1.11), nor was the biochemical pregnancy loss per positive human chorionic gonadotrophin (HCG) significantly lower in the GnRHa group (12%, 8/67) compared with the control group (25%, 18/72) (RR 0.48, 95% CI 0.22-1.02). Participants with a live birth had a significantly higher mean progesterone concentration compared with participants without a live birth (25.0 ± 12.2 versus 23.8 ± 8.9 nmol/l; P = 0.001). Furthermore, a trend for a higher live birth rate (LBR) correlated with the highest oestradiol quartile concentration (oestradiol >0.957 nmol/l). CONCLUSIONS Although a difference of 14% in biochemical loss and 12% in total pregnancy loss in favour of GnRHa supplementation was seen this did not reach statistical difference. Luteal progesterone and oestradiol concentrations correlate with LBR in the HRT-FET cycle, emphasizing the importance of luteal serum progesterone and oestradiol monitoring.
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Affiliation(s)
- Birgit Alsbjerg
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Ulrik S Kesmodel
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark
| | - Helle O Elbaek
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark
| | - Rita Laursen
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark
| | | | | | | | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital, Skive, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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