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Zhao S, Lyu C, Liu Y, Wang X, Zhang Z, Lv H, Ni T, Yan J. Preimplantation genetic testing for aneuploidy could not improve cumulative live birth rate among 1003 couples with recurrent pregnancy loss. Chin Med J (Engl) 2024:00029330-990000000-01043. [PMID: 38630915 DOI: 10.1097/cm9.0000000000003041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Indexed: 04/19/2024] Open
Affiliation(s)
- Shaotong Zhao
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Chunzi Lyu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Yingbo Liu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Xiyao Wang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Zhaowen Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Hong Lv
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong 250012, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong 250012, China
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Ni T, Zhou W, Liu Y, Cui W, Liu Y, Lu J, Zhang Q, Chen ZJ, Li Y, Yan J. Excessive Exogenous Gonadotropins and Genetic and Pregnancy Outcomes After Euploidy Embryo Transfer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2024; 7:e244438. [PMID: 38564220 PMCID: PMC10988349 DOI: 10.1001/jamanetworkopen.2024.4438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/25/2024] [Indexed: 04/04/2024] Open
Abstract
Importance The safety of exogenous gonadotropin treatment, based on its effect on embryos and pregnancy outcomes, remains inconclusive. Objective To evaluate the associations of different doses and durations of gonadotropins with embryonic genetic status and pregnancy outcomes after euploid embryo transfer in couples with infertility. Design, Setting, and Participants This study was a post hoc analysis of a multicenter randomized clinical trial (RCT) conducted at 14 reproductive centers throughout China from July 2017 to June 2018 that evaluated the cumulative live birth rate with or without preimplantation genetic testing for aneuploidy (PGT-A) among couples with infertility and good prognosis. The PGT-A group from the original RCT was selected for secondary analysis. Patients were divided into 4 groups according to the total dosage of exogenous gonadotropins and treatment duration: group 1 (≤1500 IU and <10 days), group 2 (≤1500 IU and ≥10 days), group 3 (>1500 IU and <10 days), and group 4 (>1 500 IU and ≥10 days). Group 1 served as the control group. Data were analyzed from June through August 2023. Interventions Blastocyst biopsy and PGT-A. Main outcomes and measures The primary outcomes were embryonic aneuploidy, embryonic mosaicism, and cumulative live birth rates after euploid embryo transfer. Results A total of 603 couples (mean [SD] age of prospective mothers, 29.13 [3.61] years) who underwent PGT-A were included, and 1809 embryos were screened using next-generation sequencing. The embryo mosaicism rate was significantly higher in groups 2 (44 of 339 embryos [13.0%]; adjusted odds ratio [aOR], 1.69 [95% CI, 1.09-2.64]), 3 (27 of 186 embryos [14.5%]; aOR, 1.98 [95% CI, 1.15-3.40]), and 4 (82 of 651 embryos [12.6%]; aOR, 1.60 [95% CI, 1.07-2.38]) than in group 1 (56 of 633 embryos [8.8%]). There were no associations between gonadotropin dosage or duration and the embryo aneuploidy rate. The cumulative live birth rate was significantly lower in groups 2 (83 of 113 couples [73.5%]; aOR, 0.49 [95% CI, 0.27-0.88]), 3 (42 of 62 couples [67.7%]; aOR, 0.41 [95% CI, 0.21-0.82]), and 4 (161 of 217 couples [74.2%]; aOR, 0.53 [95% CI, 0.31-0.89]) than in group 1 (180 of 211 couples [85.3%]). Conclusions and relevance In this study, excessive exogenous gonadotropin administration was associated with increased embryonic mosaicism and decreased cumulative live birth rate after euploid embryo transfer in couples with a good prognosis. These findings suggest that consideration should be given to minimizing exogenous gonadotropin dosage and limiting treatment duration to improve embryo outcomes and increase the live birth rate. Trial Registration ClinicalTrials.gov Identifier: NCT03118141.
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Affiliation(s)
- Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Wei Zhou
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Yingbo Liu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Weiran Cui
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Yang Liu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Juanjuan Lu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Li
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, China
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Wang W, Zhao Q, Liu Y, Guo L, Zhou W, Zhang Q, Yan J, Ni T. The impact of first-trimester subchorionic hematomas on pregnancy outcomes after euploid embryo transfer: a retrospective cohort study. BMC Pregnancy Childbirth 2024; 24:180. [PMID: 38454339 PMCID: PMC10918983 DOI: 10.1186/s12884-024-06359-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/20/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The aim of the retrospective cohort study was to investigate the prognostic effect of subchorionic hematomas (SCH) in the first trimester on pregnancy outcomes after euploid embryo transfer. METHODS We retrospectively analyzed women achieving singleton pregnancy by PGT-A or PGT-SR from January 2017 to January 2022. Patients were enrolled in the study if they had a viable intrauterine pregnancy at ultrasound between 6 0/7 and 8 0/7 weeks of gestation. Pregnancy outcomes as well as the incidence of maternal complications were compared between patients with and without SCH. Logistic regression was used for adjusting for potential confounding factors. RESULTS A total of 1539 women were included, of which 298 with SCH and 1241 with non-SCH. The early miscarriage rate in SCH group was significantly higher than that in the non-SCH group (10.1% vs. 5.6%, adjusted odds ratio [aOR] 1.99, 95% confidence interval [CI] 1.25-3.16, P = 0.003). The live birth rate in SCH group was significantly lower than that in the non-SCH group. (85.6% vs. 91.2%, aOR 0.57, 95% CI 0.39-0.84, P = 0.005). In addition, SCH group had an increased risk of hypertensive disorder of pregnancy (HDP) (8.9% vs. 5.2%, P = 0.022), especially in hematoma with bleeding (19.3% vs. 6.0%, P = 0.002). The incidence of gestational diabetes mellitus (GDM), major congenital abnormalities rate, normal birth weight rate and low birth weight rate were similar between the two groups. CONCLUSIONS The presence of SCH in the first trimester was associated with worse pregnancy outcomes after euploid embryo transfer, including an increased risk of early miscarriage and hypertensive disorder of pregnancy, along with a reduced live birth rate.
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Affiliation(s)
- Weilin Wang
- Center for Reproductive 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
| | - Qing Zhao
- Center for Reproductive 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
| | - Yingbo Liu
- Center for Reproductive 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
| | - Ling Guo
- Center for Reproductive 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
| | - Wei Zhou
- Center for Reproductive 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
| | - Qian Zhang
- Center for Reproductive 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
| | - Junhao Yan
- Center for Reproductive 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
| | - Tianxiang Ni
- Center for Reproductive 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.
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Liu Y, Lan X, Lu J, Zhang Q, Zhou T, Ni T, Yan J. Preimplantation Genetic Testing for Aneuploidy Could Not Improve Cumulative Live Birth Rate Among 705 Couples with Unexplained Recurrent Implantation Failure. Appl Clin Genet 2024; 17:1-13. [PMID: 38322806 PMCID: PMC10840415 DOI: 10.2147/tacg.s441784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024] Open
Abstract
Objective We evaluate whether next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A) improves the cumulative pregnancy outcomes of patients with unexplained recurrent implantation failure (uRIF) as compared to conventional in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). Patients and Methods This was a retrospective cohort study (2015-2022). A total of 705 couples diagnosed with uRIF were included in the study. 229 women transferred blastocysts based on morphological grading (IVF/ICSI) and 476 couples opted for PGT-A to screen blastocysts by NGS. Women were further stratified according to age at retrieval (<38 years and ≥38 years). The primary outcome was the cumulative live-birth rate after all the embryos were transferred in a single oocyte retrieval or until achieving a live birth. Confounders were adjusted using binary logistic regression models. Results Cumulative live-birth rate was similar between the IVF/ICSI group and the PGT-A group after stratified by age: IVF/ICSI vs PGT-A in the <38 years subgroup (49.7% vs 57.7%, adjusted OR (95% CI) = 1.25 (0.84-1.84), P = 0.270) and in the ≥38 years subgroup (14.0% vs 19.5%, adjusted OR (95% CI) = 1.09 (0.41-2.92), P = 0.866), respectively. Nonetheless, the PGT group had a lower first-time biochemical pregnancy loss rate (17.0% vs 8.7%, P = 0.034) and a higher cumulative good birth outcome rate (35.2% vs 46.4%, P = 0.014) than the IVF/ICSI group in the <38 years subgroup. Other pregnancy outcomes after the initial embryo transfer and multiple transfers following a single oocyte retrieval were all similar between groups. Conclusion Our results showed no evidence of favorable effects of PGT-A treatment on improving the cumulative live birth rate in uRIF couples regardless of maternal age. Use of PGT-A in the <38 years uRIF patients would help to decrease the first-time biochemical pregnancy loss and increase the cumulative good birth outcome.
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Affiliation(s)
- Yang Liu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Xiangxin Lan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Juanjuan Lu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Tingting Zhou
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, People’s Republic of China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, People’s Republic of China
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Hu C, Deng J, Liu M, Ni T, Chen ZJ, Yan J, Li Y. Endometrial BMP2 Deficiency Impairs ITGB3-Mediated Trophoblast Invasion in Women With Repeated Implantation Failure. Endocrinology 2024; 165:bqae002. [PMID: 38195194 DOI: 10.1210/endocr/bqae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Repeated implantation failure (RIF) leads to a waste of high-quality embryos and remains a challenge in assisted reproductive technology. During early human placentation, the invasion of trophoblast cells into the decidua is an essential step for the establishment of maternal-fetal interactions and subsequent successful pregnancy. Bone morphogenetic protein 2 (BMP2) has been reported to regulate endometrial receptivity and promote trophoblast invasion. However, whether there is dysregulation of endometrial BMP2 expression in patients with RIF remains unknown. Additionally, the molecular mechanisms underlying the effects of BMP2 on human trophoblast invasion and early placentation remain to be further elucidated. METHODS Midluteal phase endometrial samples were biopsied from patients with RIF and from routine control in vitro fertilization followed by quantitative polymerase chain reaction and immunoblotting analyses. Human trophoblast organoids, primary human trophoblast cells, and an immortalized trophoblast cell line (HTR8/SVneo) were used as study models. RESULTS We found that BMP2 was aberrantly low in midluteal phase endometrial tissues from patients with RIF. Recombinant human BMP2 treatment upregulated integrin β3 (ITGB3) in a SMAD2/3-SMAD4 signaling-dependent manner in both HTR8/SVneo cells and primary trophoblast cells. siRNA-mediated integrin β3 downregulation reduced both basal and BMP2-upregulated trophoblast invasion and vascular mimicry in HTR8/SVneo cells. Importantly, shRNA-mediated ITGB3 knockdown significantly decreased the formation ability of human trophoblast organoids. CONCLUSION Our results demonstrate endometrial BMP2 deficiency in patients with RIF. ITGB3 mediates both basal and BMP2-promoted human trophoblast invasion and is essential for early placentation. These findings broaden our knowledge regarding the regulation of early placentation and provide candidate diagnostic and therapeutic targets for RIF clinical management.
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Affiliation(s)
- Cuiping Hu
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
| | - Jianye Deng
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
| | - Mingxi Liu
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
| | - Tianxiang Ni
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
| | - Zi-Jiang Chen
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
- Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences (No. 2021RU001), Jinan, Shandong, 250012, China
| | - Junhao Yan
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
| | - Yan Li
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan, Shandong, 250012, China
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan, Shandong, 250012, China
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Lyu C, Ni T, Guo Y, Zhou T, Chen Z, Yan J, Li Y. Insufficient GDF15 expression predisposes women to unexplained recurrent pregnancy loss by impairing extravillous trophoblast invasion. Cell Prolif 2023; 56:e13514. [PMID: 37272232 PMCID: PMC10693185 DOI: 10.1111/cpr.13514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
Insufficient extravillous trophoblast (EVT) invasion during early placentation has been shown to contribute to recurrent pregnancy loss (RPL). However, the regulatory factors involved and their involvement in RPL pathogenesis remain unknown. Here, we found aberrantly decreased growth differentiation factor 15 (GDF15) levels in both first-trimester villous and serum samples of unexplained recurrent pregnancy loss (URPL) patients as compared with normal pregnancies. Moreover, GDF15 knockdown significantly reduced the invasiveness of both HTR-8/SVneo cells and primary human EVT cells and suppressed the Jagged-1 (JAG1)/NOTCH3/HES1 pathway activity, and JAG1 overexpression rescued the invasion phenotype of the GDF15 knockdown cells. Induction of a lipopolysaccharide-induced abortion model in mice resulted in significantly reduced GDF15 level in the placenta and serum, as well as increased rates of embryonic resorption, and these effects were reversed by administration of recombinant GDF15. Our study thus demonstrates that insufficient GDF15 level at the first-trimester maternal-foetal interface contribute to the pathogenesis of URPL by impairing EVT invasion and suppressing JAG1/NOTCH3/HES1 pathway activity, and suggests that supplementation with GDF15 could benefit early pregnancy maintenance and reduce the risk of early pregnancy.
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Affiliation(s)
- Chunzi Lyu
- Center for Reproductive MedicineShandong UniversityJinanShandongChina
- Key Laboratory of Reproductive Endocrinology of Ministry of EducationShandong UniversityJinanShandongChina
| | - Tianxiang Ni
- Center for Reproductive MedicineShandong UniversityJinanShandongChina
- Key Laboratory of Reproductive Endocrinology of Ministry of EducationShandong UniversityJinanShandongChina
| | - Yaqiu Guo
- Department of AnesthesiologyJinan Maternal and Child Health HospitalJinanShandongChina
| | - Tingting Zhou
- Center for Reproductive MedicineShandong UniversityJinanShandongChina
- Key Laboratory of Reproductive Endocrinology of Ministry of EducationShandong UniversityJinanShandongChina
| | - Zi‐Jiang Chen
- Center for Reproductive MedicineShandong UniversityJinanShandongChina
- Key Laboratory of Reproductive Endocrinology of Ministry of EducationShandong UniversityJinanShandongChina
| | - Junhao Yan
- Center for Reproductive MedicineShandong UniversityJinanShandongChina
- Key Laboratory of Reproductive Endocrinology of Ministry of EducationShandong UniversityJinanShandongChina
| | - Yan Li
- Center for Reproductive MedicineShandong UniversityJinanShandongChina
- Key Laboratory of Reproductive Endocrinology of Ministry of EducationShandong UniversityJinanShandongChina
- Medical Integration and Practice CenterShandong UniversityJinanShandongChina
- Lead Contact
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Liu Y, Ni T, Zhao Q, Cui W, Lan X, Zhou T, Zhang Q, Yan J. Maternal hypercholesterolemia would increase the incidence of embryo aneuploidy in couples with recurrent implantation failure. Eur J Med Res 2023; 28:534. [PMID: 37990245 PMCID: PMC10662148 DOI: 10.1186/s40001-023-01492-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The association of dyslipidemia with embryo development and pregnancy outcomes is largely unknown, especially in unexplained recurrent implantation failure (uRIF) patients. Here, this study aimed to explore the impact of abnormal blood lipid levels on embryo genetic status and pregnancy outcomes after preimplantation genetic testing for aneuploidy (PGT-A) from a clinical perspective. METHODS This study retrospectively analyzed 502 patients diagnosed as uRIF. They were divided into four groups according to the levels of cholesterol and triglyceride: nonhyperlipidemia group (NonH group), simple hypercholesterolemia group (SHC group), simple hypertriglyceridemia group (SHC group) and mixed hyperlipidemia group (MixH group). At the same time, patients were divided into non-low HDL-C group and low HDL-C group according to their HDL-C level. The outcomes of embryos genetic testing and pregnancy outcomes after PGT-A was analyzed between groups. Binary logistic regression and/or generalized estimating equation (GEE) model were conducted to investigate the association of different types of dyslipidemia with embryonic aneuploidy rate and cumulative live-birth rate. RESULTS 474 women who met the inclusion criteria were divided into four groups: NonH group (N = 349), SHC group (N = 55), SHT group (N = 52) and MixH group (N = 18). Compared with the NonH group, SHC group had a significantly increased rate of embryo aneuploidy [48.3% vs. 36.7%, P = 0.006; adjusted OR (95% confidence interval) = 1.52(1.04-2.22), P = 0.029], as well as a reduced number of good-quality embryos on day 5 or 6 [3.00 ± 2.29 vs. 3.74 ± 2.77, P = 0.033]. The SHC group showed a tendency of a lower cumulative live birth rate (47.0% vs. 40.0%), a lower incidence of good birth outcome (37.2% vs. 34.5%) and a higher risk of clinical pregnancy loss (11.1% vs. 17.9%), but did not reach statistical significance (P > 0.05). The incidences of obstetric or neonatal complications and other adverse events were similar in the four groups. Whether patients have low HDL-C did not differ in pregnancy outcomes. CONCLUSIONS We found that uRIF women with hypercholesterolemia had an increased proportion of aneuploid embryos and a reduced proportion of high-quality embryos, while different types of hyperlipidemia had no correlation with cumulative live birth rate as well as pregnancy and neonatal outcomes.
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Affiliation(s)
- Yang Liu
- Center for Reproductive 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
| | - Tianxiang Ni
- Center for Reproductive 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
| | - Qing Zhao
- Center for Reproductive 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
| | - Weiran Cui
- Center for Reproductive 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
| | - Xiangxin Lan
- Center for Reproductive 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
| | - Tingting Zhou
- Center for Reproductive 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
| | - Qian Zhang
- Center for Reproductive 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
| | - Junhao Yan
- Center for Reproductive 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.
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Yang L, Ni T, Huang Y, Yan Y, Xia M, Zhou W, Zhang Q, Yan J. Impact of a previous late miscarriage on subsequent pregnancy outcomes: A retrospective cohort study over 10 years. Int J Gynaecol Obstet 2023; 163:610-617. [PMID: 37208989 DOI: 10.1002/ijgo.14862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 04/05/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE To explore the prognostic impact of a previous late miscarriage (LM) on the subsequent pregnancy outcomes of women with infertility. METHOD This retrospective cohort study included couples who had experienced LM following their first embryo transfer during an in vitro fertilization (IVF) cycle from January 2008 to December 2020. Subgroup analysis and binary logistic regression were performed to evaluate the associations between LM due to different causes and subsequent pregnancy outcomes. RESULTS A total of 1072 women who had experienced LM were included in this study, comprising 458, 146, 412, and 56 women with LM due to unexplained factors (unLM), fetal factors (feLM), cervical factors (ceLM; i.e. cervical incompetence), and trauma factors (trLM), respectively. Compared with the general IVF (gIVF) population, the early miscarriage rate was significantly higher in the unLM group (8.28% vs. 13.47%, adjusted odds ratio [OR] 1.60, 95% confidence interval [95% CI] 1.12-2.28; P = 0.01). Furthermore, women in the unLM and ceLM groups had a dramatically increased risk of recurrent LM (unLM: 4.24% vs. 9.43%, aOR 1.91, 95% CI 1.24-2.94; P = 0.003; ceLM: 4.24% vs.15.53%, aOR 2.68, 95% CI 1.82-3.95; P < 0.001) and consequently a reduced frequency of live birth (unLM: 49.96% vs. 43.01%, aOR 0.75, 95% CI 0.61-0.91; P = 0.004; ceLM: 49.96% vs. 38.59%, aOR 0.61, 95% CI 0.49-0.77; P < 0.001) compared with the gIVF population. CONCLUSION A previous LM due to an unexplained factor or cervical incompetence was significantly associated with a higher risk of miscarriage and a lower live birth rate after subsequent embryo transfer.
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Affiliation(s)
- Linlin Yang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Yumei Huang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Yueyue Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Mingdi Xia
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Wei Zhou
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
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Yu W, Jin C, Zhang Q, Ni T, Yan J. Does reciprocal translocation affect the meiotic segregation products of non-translocation chromosomes? HUM FERTIL 2023; 26:702-711. [PMID: 37961879 DOI: 10.1080/14647273.2023.2262810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/25/2023] [Indexed: 11/15/2023]
Abstract
This retrospective cohort study aimed to assess the effect of chromosomal reciprocal translocation on meiotic segregation products of non-translocation chromosomes. A total of 744 reciprocal translocation carriers and 875 non-carriers were included in this study. A total of 6,832 blastocysts were biopsied and tested by next-generation sequencing. Blastocysts from the carrier group were classified into five subgroups according to the theoretical segregation pattern of quadrivalent structure. For carrier patients, normal meiotic segregation products of the non-translocation chromosome were classified after excluding the segregation modes of the quadrivalent structure. The proportion of normal non-translocation chromosome meiotic segregation products was similar between the carrier and noncarrier groups (p = 0.69). The generalized Estimation Equation revealed that there was no correlation between reciprocal translocation and meiotic segregation products of non-translocation chromosomes. Moreover, subgroup analyses showed that the segregation modes of quadrivalent structure (p = 0.00) and carrier's gender (p = 0.00) may affect the meiotic segregation products of non-translocation chromosomes. In conclusion, reciprocal translocation does not directly reduce the proportion of normal segregation products of non-translocation chromosomes. The difference among subgroups of different quadrivalent segregation patterns implied that interchromosomal effect may exist but the high incidence of chromosomal abnormalities for reciprocal translocation carriers should not be attributed to interchromosomal effect.
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Affiliation(s)
- Wenhao Yu
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Chenxi Jin
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, China
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Zou J, Ni T, Yang M, Li H, Gao M, Zhu Y, Jiang W, Zhang Q, Yan J, Wei D, Chen ZJ. The effect of parental carrier of de novo mutated vs. inherited balanced reciprocal translocation on the chance of euploid embryos. F S Sci 2023; 4:193-199. [PMID: 37182600 DOI: 10.1016/j.xfss.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To evaluate whether the effect of de novo mutated balanced reciprocal translocation on the rate of euploid embryos varied from inherited balanced reciprocal translocation. DESIGN A retrospective cohort study compared the percentage of euploid embryo and proportion of patients with at least 1 euploid embryo between de novo mutated balanced reciprocal translocation (i.e., the group of de novo mutated carriers) and inherited balanced reciprocal translocation (i.e., the group of inherited carriers). SETTING An academic fertility center. PATIENT(S) A total of 413 couples with balanced reciprocal translocation (219 female carriers and 194 male carriers) who underwent their first cycle of preimplantation genetic testing for structural rearrangements were included. INTERVENTION(S) Carriers of balanced reciprocal translocation either de novo mutated or inherited. MAIN OUTCOME MEASURE(S) The percentage of euploid embryo and proportion of patients with at least 1 euploid embryo. RESULT(S) The carriers of the de novo mutated balanced reciprocal translocation had a lower percentage of euploid embryos (19.5% vs. 25.5%), and were less likely to have at least 1 euploid embryo (47.1% vs. 60.1%) compared with the carriers of the inherited balanced reciprocal translocation. In the male-carrier subgroup, the percentage of euploid embryos (16.7% vs. 26.7%) and proportion of patients with at least 1 euploid embryo (41.9% vs. 67.5%) were lower among the de novo mutated carriers than those among the inherited carriers. However, in the female-carrier subgroup, there was no statistically significant difference in the percentage of euploid embryos (22.4% vs. 24.4%) or the proportion of patients with at least 1 euploid embryo (52.3% vs. 53.7%) between the de novo mutated carriers and inherited carriers. CONCLUSION(S) The de novo mutated balanced reciprocal translocation was associated with a lower percentage of euploid embryos and lower chance of obtaining at least 1 euploid embryo than the inherited balanced reciprocal translocation.
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Affiliation(s)
- Jialin Zou
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Medical Integration and Practice Center, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Medical Integration and Practice Center, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Min Yang
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Medical Integration and Practice Center, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Hongchang Li
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Ming Gao
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Yueting Zhu
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Wenjie Jiang
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Medical Integration and Practice Center, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China
| | - Daimin Wei
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Medical Integration and Practice Center, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, Jinan, People's Republic of China; Medical Integration and Practice Center, Shandong University, Jinan, People's Republic of China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, People's Republic of China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, People's Republic of China; Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People's Republic of China
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11
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Zhang Q, Yu W, Jin C, Ni T, Zhou T, Zhao Q, Wang W, Li Y, Yan J. Impact of Multiple Vitrification-Warming Procedures and Insemination Methods on Pregnancy and Neonatal Outcomes in Preimplantation Genetic Testing for Aneuploidy. Reprod Sci 2023; 30:2302-2312. [PMID: 36735146 DOI: 10.1007/s43032-023-01177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 01/22/2023] [Indexed: 02/04/2023]
Abstract
This study was to determine whether multiple vitrification-warming procedures and insemination method are associated with pregnancy and neonatal outcomes in preimplantation genetic testing for aneuploidy (PGT-A). This was a retrospective, single-center, observational study of 112 patients who underwent standard PGT-A practice and 154 patients who desired PGT-A for their vitrified unbiopsied blastocysts. A total of 97 euploid blastocysts biopsied and vitrified-warmed once and 117 euploid blastocysts biopsied once but vitrified-warmed twice (83 in vitro fertilization [IVF]-derived and 34 intracytoplasmic sperm injection [ICSI]-derived euploid blastocysts) were transferred. The primary outcome was the blastocyst survival rate for transfer, live birth rate, and neonatal outcomes. The results showed that an additional vitrification-warming procedure on blastocysts resulted in a lower but not statistically different survival rate for transfer. Compared with euploid blastocysts vitrified-warmed once, those vitrified-warmed twice provided statistically similar live birth rate. Neonatal outcomes, including the sex ratio, gestational age, birthweight, preterm birth rate, and low birthweight rate, did not differ between single and double vitrification. No significant differences were observed in rates of blastocyst survival, blastocyst euploid and live birth, and neonatal outcomes resulting from either conventional IVF or ICSI. The neonatal follow-up of babies live-born so far did not report any congenital malformations. In conclusion, an additional vitrification-warming on blastocysts had no detectable adverse impact on clinical outcomes after frozen-thawed single euploid blastocyst transfer in PGT-A cases; and ICSI did not confer any benefit in improving clinical outcomes compared with conventional IVF in cases requiring PGT-A on already vitrified nonbiopsied blastocysts.
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Affiliation(s)
- Qian Zhang
- Center for Reproductive 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
| | - Wenhao Yu
- Center for Reproductive 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
| | - Chenxi Jin
- Center for Reproductive 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
| | - Tianxiang Ni
- Center for Reproductive 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
| | - Tingting Zhou
- Center for Reproductive 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
| | - Qing Zhao
- Center for Reproductive 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
| | - Weilin Wang
- Center for Reproductive 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
| | - Yunjia Li
- Linyi People's Hospital, Linyi, 276000, Shandong, China
| | - Junhao Yan
- Center for Reproductive 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.
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12
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Sun Y, Cui L, Lu Y, Tan J, Dong X, Ni T, Yan J, Guan Y, Hao G, Liu JY, Zhang B, Wei D, Hong Y, He Y, Qi J, Xu B, Lu J, Zhang Q, Zhao S, Ji X, Du X, Zhang J, Liu J, Wang J, Huang Y, Huang D, Du Y, Vankelecom H, Zhang H, Chen ZJ. Prednisone vs Placebo and Live Birth in Patients With Recurrent Implantation Failure Undergoing In Vitro Fertilization: A Randomized Clinical Trial. JAMA 2023; 329:1460-1468. [PMID: 37129654 PMCID: PMC10155063 DOI: 10.1001/jama.2023.5302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/18/2023] [Indexed: 05/03/2023]
Abstract
Importance Implantation failure remains a critical barrier to in vitro fertilization. Prednisone, as an immune-regulatory agent, is widely used to improve the probability of implantation and pregnancy, although the evidence for efficacy is inadequate. Objective To determine the efficacy of 10 mg of prednisone compared with placebo on live birth among women with recurrent implantation failure. Design, Setting, and Participants A double-blind, placebo-controlled, randomized clinical trial conducted at 8 fertility centers in China. Eligible women who had a history of 2 or more unsuccessful embryo transfer cycles, were younger than 38 years when oocytes were retrieved, and were planning to undergo frozen-thawed embryo transfer with the availability of good-quality embryos were enrolled from November 2018 to August 2020 (final follow-up August 2021). Interventions Participants were randomized (1:1) to receive oral pills containing either 10 mg of prednisone (n = 357) or matching placebo (n = 358) once daily, from the day at which they started endometrial preparation for frozen-thawed embryo transfer through early pregnancy. Main Outcomes and Measures The primary outcome was live birth, defined as the delivery of any number of neonates born at 28 or more weeks' gestation with signs of life. Results Among 715 women randomized (mean age, 32 years), 714 (99.9%) had data available on live birth outcomes and were included in the primary analysis. Live birth occurred among 37.8% of women (135 of 357) in the prednisone group vs 38.8% of women (139 of 358) in the placebo group (absolute difference, -1.0% [95% CI, -8.1% to 6.1%]; relative ratio [RR], 0.97 [95% CI, 0.81 to 1.17]; P = .78). The rates of biochemical pregnancy loss were 17.3% in the prednisone group and 9.9% in the placebo group (absolute difference, 7.5% [95% CI, 0.6% to 14.3%]; RR, 1.75 [95% CI, 1.03 to 2.99]; P = .04). Of those in the prednisone group, preterm delivery occurred among 11.8% and of those in the placebo group, 5.5% of pregnancies (absolute difference, 6.3% [95% CI, 0.2% to 12.4%]; RR, 2.14 [95% CI, 1.00 to 4.58]; P = .04). There were no statistically significant between-group differences in the rates of biochemical pregnancy, clinical pregnancy, implantation, neonatal complications, congenital anomalies, other adverse events, or mean birthweights. Conclusions and Relevance Among patients with recurrent implantation failure, treatment with prednisone did not improve live birth rate compared with placebo. Data suggested that the use of prednisone may increase the risk of preterm delivery and biochemical pregnancy loss. Our results challenge the value of prednisone use in clinical practice for the treatment of recurrent implantation failure. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR1800018783.
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Affiliation(s)
- Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Linlin Cui
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Yao Lu
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jichun Tan
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, China
| | - Xi Dong
- Reproductive Medicine Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Yichun Guan
- Reproductive Medicine Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guimin Hao
- Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia-Yin Liu
- Department of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, China
| | - Bo Zhang
- Center for Reproductive Medicine, Maternal and Child Health Hospital/Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Daimin Wei
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Yan Hong
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yaqiong He
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jia Qi
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Bing Xu
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Juanjuan Lu
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Shanshan Zhao
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, China
| | - Xiaowei Ji
- Reproductive Medicine Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaofang Du
- Reproductive Medicine Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Zhang
- Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jinyong Liu
- Department of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, China
| | - Jing Wang
- Department of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, China
| | - Yingqin Huang
- Center for Reproductive Medicine, Maternal and Child Health Hospital/Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Dongmei Huang
- Center for Reproductive Medicine, Maternal and Child Health Hospital/Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Yanzhi Du
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Hugo Vankelecom
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Zi-jiang Chen
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- Shandong Technology Innovation Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
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Wang J, Zhou W, Song Z, Ni T, Zhang Q, Chen ZJ, Yan J. Does the risk of embryo abnormality increase in PCOS women? A secondary analysis of a multi-center randomized controlled trial. J Clin Endocrinol Metab 2022; 108:e249-e257. [PMID: 36546342 DOI: 10.1210/clinem/dgac726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT Some studies reported the early miscarriage rate was higher in PCOS women. However, whether the risk of embryo abnormalities increases in PCOS women is lack of evidence. OBJECTIVE To evaluate the association between polycystic ovarian syndrome (PCOS) and embryo ploidy. DESIGN A secondary analysis of multi-center randomized controlled trial which was conducted from July 2017 to June 2018. The original intent was to identify whether preimplantation genetic test for aneuploidy (PGT-A) improves the live birth rate as compared with in-vitro fertilization (IVF). SETTING 14 reproductive centers. PATIENTS 190 patients diagnosed with PCOS and 1:1 age-matched non-PCOS patients were chosen from PGT-A group. A total of 380 patients with 1118 embryos were included in our study. INTERVENTIONS Women diagnosed with PCOS. MAIN OUTCOME MEASURES Embryonic aneuploidy and embryonic mosaic. RESULTS After adjusted for potential confounders, the rate of embryonic aneuploidy and embryonic mosaic in PCOS group were comparable with control group [embryonic aneuploid rate PCOS group: 14.0% vs control group: 18.3%, adjusted OR (95%CI): 0.78(0.54,1.12), P = 0.19; embryonic mosaic rate 10.9% vs 10.1%, adjusted OR (95%CI): 0.91(0.59,1.40), P = 0.66]. We further stratified PCOS women into four groups according to phenotype. The rate of aneuploid and mosaic embryos was comparable between each of PCOS phenotype and control group. There was still no significant difference of embryonic aneuploid and embryo mosaic rates within four phenotypes. CONCLUSIONS The risk of aneuploid and mosaic embryos was not increased in PCOS women. Thus, we suggests that the miscarriage rate arising from abnormal embryonic chromosomes could be similar between PCOS and non-PCOS women.
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Affiliation(s)
- Jiahui Wang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
| | - Wei Zhou
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
| | - Zhiyi Song
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, 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
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- Shandong Technology Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China
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Huang C, Zhang Q, Ni T, Zhou T, Lv C, Li Y, Yan J, Chen ZJ. Deficiency of RARα Suppresses Decidualization via Downregulating CEBPB Transcription in Women With Recurrent Implantation Failure. Front Endocrinol (Lausanne) 2022; 13:753416. [PMID: 35663305 PMCID: PMC9161677 DOI: 10.3389/fendo.2022.753416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Recurrent implantation failure (RIF) is a disease associated with endometrial receptivity dysfunction. Retinoic acid receptor alpha (RARα) is an important protein in many biological processes, such as differentiation and development. However, the exact underlying mechanism whereby RARα affects RIF remains unknown. This study investigated RARα expression and its contribution in the mid-luteal phase endometria of patients with RIF. Methods The expression levels of RARα and CCAAT/enhancer-binding protein (C/EBP) β in the endometria of the RIF and normal group were investigated using western blotting and immunohistochemistry. In in vitro experiments, immortal telomerase-transformed human endometrial stromal cells (T-HESCs) were incubated with medroxyprogesterone-17-acetate (MPA) and cyclic adenosine monophosphate (cAMP) for 4 days to induce decidualization. The expression levels of the decidualization markers prolactin (PRL) and insulin-like growth factor-binding protein-1 (IGFBP-1) were determined using quantitative polymerase chain reaction. RARα was knocked down using a small interfering RNA, and C/EBPβ was overexpressed from an adenoviral vector. The transcriptional regulation of CEBPB by RARα was determined by chromatin immunoprecipitation (ChIP) assay and luciferase assays. Results We found that the expression levels of RARα decreased in the mid-luteal endometria of RIF patients. After 4 days of decidualization induction in vitro, RARα knockdown impaired the decidualization of T-HESCs and downregulated the expression of C/EBPβ. The restoration of C/EBPβ expression rescued the RARα knockdown-induced suppression of T-HESC decidualization. In ChIP analysis of lysates from decidualized T-HESCs, the CEBPB promoter region was enriched in chromatin fragments pulled down using an anti-RARα antibody. However, the relationship between CEBPB transcription and RARα expression levels was only observed when the decidualization of T-HESCs was induced by the addition of cAMP and MPA. To identify the binding site of RARα/retinoid X receptor α, we performed luciferase assays. Mutation of the predicted binding site in CEBPB (-2,009/-1,781) decreased the transcriptional activity of the reporter. To confirm this mechanism, the expression levels of C/EBPβ in the mid-luteal endometria of RIF patients were determined and found to decrease with decreased RARα expression levels. Conclusion A deficiency of RARα expression in the mid-luteal endometrium inhibits decidualization due to the downregulation of CEBPB transcription. This is a potential mechanism contributing to RIF.
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Affiliation(s)
- Caiyi Huang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai Jiao Tong University, Shanghai, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Qian Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Tingting Zhou
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Chunzi Lv
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Yan Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Junhao Yan
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai Jiao Tong University, Shanghai, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
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15
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Yan J, Qin Y, Zhao H, Sun Y, Gong F, Li R, Sun X, Ling X, Li H, Hao C, Tan J, Yang J, Zhu Y, Liu F, Chen D, Wei D, Lu J, Ni T, Zhou W, Wu K, Gao Y, Shi Y, Lu Y, Zhang T, Wu W, Ma X, Ma H, Fu J, Zhang J, Meng Q, Zhang H, Legro RS, Chen ZJ. Live Birth with or without Preimplantation Genetic Testing for Aneuploidy. N Engl J Med 2021; 385:2047-2058. [PMID: 34818479 DOI: 10.1056/nejmoa2103613] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Embryo selection with preimplantation genetic testing for aneuploidy (PGT-A) may improve pregnancy outcomes after initial embryo transfer. However, it remains uncertain whether PGT-A improves the cumulative live-birth rate as compared with conventional in vitro fertilization (IVF). METHODS In this multicenter, randomized, controlled trial, we randomly assigned subfertile women with three or more good-quality blastocysts to undergo either PGT-A or conventional IVF; all the women were between 20 and 37 years of age. Three blastocysts were screened by next-generation sequencing in the PGT-A group or were chosen by morphologic criteria in the conventional-IVF group and then were successively transferred one by one. The primary outcome was the cumulative live-birth rate after up to three embryo-transfer procedures within 1 year after randomization. We hypothesized that the use of PGT-A would result in a cumulative live-birth rate that was no more than 7 percentage points higher than the rate after conventional IVF, which would constitute the noninferiority margin for conventional IVF as compared with PGT-A. RESULTS A total of 1212 patients underwent randomization, and 606 were assigned to each trial group. Live births occurred in 468 women (77.2%) in the PGT-A group and in 496 (81.8%) in the conventional-IVF group (absolute difference, -4.6 percentage points; 95% confidence interval [CI], -9.2 to -0.0; P<0.001). The cumulative frequency of clinical pregnancy loss was 8.7% and 12.6%, respectively (absolute difference, -3.9 percentage points; 95% CI, -7.5 to -0.2). The incidences of obstetrical or neonatal complications and other adverse events were similar in the two groups. CONCLUSIONS Among women with three or more good-quality blastocysts, conventional IVF resulted in a cumulative live-birth rate that was noninferior to the rate with PGT-A. (Funded by the National Natural Science Foundation of China and others; ClinicalTrials.gov number, NCT03118141.).
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Affiliation(s)
- Junhao Yan
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Yingying Qin
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Han Zhao
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Yun Sun
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Fei Gong
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Rong Li
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Xiaoxi Sun
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Xiufeng Ling
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Hong Li
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Cuifang Hao
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Jichun Tan
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Jing Yang
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Yimin Zhu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Fenghua Liu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Dawei Chen
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Daimin Wei
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Juanjuan Lu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Tianxiang Ni
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Wei Zhou
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Keliang Wu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Yuan Gao
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Yuhua Shi
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Yao Lu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Ting Zhang
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Wei Wu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Xiang Ma
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Hailan Ma
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Jing Fu
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Junqiang Zhang
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Qingxia Meng
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Heping Zhang
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Richard S Legro
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
| | - Zi-Jiang Chen
- From the Center for Reproductive Medicine, Cheeloo College of Medicine, Key Laboratory of Reproductive Endocrinology of the Ministry of Education, and the National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Shandong Key Laboratory of Reproductive Medicine, and Shandong Provincial Clinical Research Center for Reproductive Health, Jinan (J.Y., Y.Q., H.Z., D.W., J.L., T.N., W.Z., K.W., Y.G., Y.S., Z.-J.C.), the Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics (Y.S., Z.-J.C., Y.L., T.Z.), and the Obstetrics and Gynecology Hospital of Fudan University, Shanghai JIAI Genetics and IVF Institute, Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University (X.S., J.F.), Shanghai, the Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, and Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha (F.G., H.M.), the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetrics and Gynecology, Key Laboratory of Assisted Reproduction, Ministry of Education, and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing (R.L.), the Department of Reproductive Medicine, the Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital (X.L., J.Z.), and the Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University-Jiangsu Province Hospital (X.M., W.W.), Nanjing, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou (H.L., Q.M.), the Center for Reproductive Medicine of Yantai Yuhuangding Hospital, Yantai (C.H.), the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang (J.T.), the Center for Reproductive Medicine, Wuhan University, Wuhan (J.Y.), the Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou (Y.Z.), the Department of Reproductive Health and Infertility, Guangdong Women and Children Hospital, Guangzhou (F.L.), and the Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei (D.C.) - all in China; the Department of Biostatistics, Yale University School of Public Health, New Haven, CT (H.Z.); and the Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA (R.S.L.)
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Zhou T, Ni T, Li Y, Zhang Q, Yan J, Chen ZJ. circFAM120A participates in repeated implantation failure by regulating decidualization via the miR-29/ABHD5 axis. FASEB J 2021; 35:e21872. [PMID: 34449947 DOI: 10.1096/fj.202002298rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 11/11/2022]
Abstract
Repeated implantation failure (RIF) is a major problem that limits the pregnancy rate associated with assisted reproductive technology. However, the pathogenesis of RIF is still unknown. Recently, the expression levels of circular RNAs (circRNAs) were profiled in the endometrial tissues of patients with RIF. However, the exact role of circRNAs in RIF remains unclear. In our study, we found that circFAM120A levels were significantly down-regulated in the endometrium at the window of implantation in RIF patients compared with non-RIF controls. The suppression of circFAM120A expression inhibited decidualization in human endometrial stromal cells (hESCs). Furthermore, RNA-seq analysis after circFAM120A knockdown revealed ABHD5 as a potential downstream target gene of circFAM120A. As expected, down-regulating ABHD5 in hESCs also inhibited decidualization. Using the starBase and TargetScan databases, we predicted that miR-29 may interact with ABHD5, based on nucleotide sequence matching. Luciferase reporter assay showed that miR-29 bound to the 3' UTR of ABHD5 at the predicted complementary sites. Moreover, miR-29 mimics efficiently reduced ABHD5 expression levels and suppressed the decidualization process, whereas a miR-29 inhibitor partly rescued ABHD5 mRNA expression level and decidualization reduced by the knockdown of circFAM120A. Therefore, circFAM120A modulated decidualization in RIF through the miR-29/ABHD5 axis.
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Affiliation(s)
- Tingting Zhou
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Yan Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Qian Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Junhao Yan
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
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Zhou J, Wu JS, Yan Y, Li J, Ni T, Shao W, Mei JH, Xiong WZ, Wu H. MiR-199a modulates autophagy and inflammation in rats with cerebral infarction via regulating mTOR expression. Eur Rev Med Pharmacol Sci 2021; 24:6338-6345. [PMID: 32572931 DOI: 10.26355/eurrev_202006_21532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the roles of micro ribonucleic acid (miR)-199a in rats with cerebral infarction by regulating mammalian target of rapamycin (mTOR). MATERIALS AND METHODS A total of 36 Sprague-Dawley rats were randomly assigned into three groups, including: sham group (n=12), model group (n=12) and miR-199a mimics group (n=12). In sham group internal and external carotid arteries were exposed. The ischemia-reperfusion model was successfully established using suture embolization in the other two groups. After modeling, rats in sham group and model group were intraperitoneally injected with normal saline. However, rats in miR-199a mimics group were injected with miR-199a mimics. Following intervention for 3 d, sampling was conducted. Neurological deficit was evaluated in rats based on the Zea-Longa scoring system. Hematoxylin-eosin (HE) staining was performed to observe neuronal morphology. The expression of mTOR was detected using immunohistochemistry, and the relative expression level of tau protein was determined via Western blotting (WB). Besides, the messenger RNA (mRNA) expressions of mTOR and tau were detected by quantitative Polymerase Chain Reaction (qPCR). Finally, inflammatory factor content was measured through enzyme-linked immunosorbent assay (ELISA). RESULTS Model group and miR-199a mimics group exhibited a substantially higher Zea-Longa score than sham group (p<0.05). Compared with model group, the Zea-Longa score rose prominently in miR-199a mimics group (p<0.05). According to the results of HE staining, the structure of neurons in sham group was clear and intact, while the structure of neurons in model group was disordered. Meanwhile, neuronal morphology in miR-199a mimics group was significantly worse than that in model group (p<0.05). Immunohistochemistry results demonstrated that the positive expression level of mTOR was considerably upregulated in both model group and miR-199a mimics group in comparison with sham group (p<0.05). Moreover, its positive expression level in miR-199a mimics group was markedly higher that in model group (p<0.05). Based on the results of WB, model and miR-199a mimics groups exhibited a remarkably higher relative expression level of tau protein than sham group (p<0.05). However, the relative expression level of tau protein in miR-199a mimics group was prominently higher than that in model group (p<0.05). QPCR results manifested that the relative mRNA expression levels of mTOR and tau in model group and miR-199a mimics group were dramatically higher than those in sham group (p<0.05). Compared with those in model group, the relative mRNA expression levels of mTOR and tau increased significantly in miR-199a mimics group (p<0.05). ELISA results revealed that model group and miR-199a mimics group had prominently higher content of inflammatory factors than sham group (p<0.05). In addition, content of inflammatory factors in miR-199a mimics group was considerably higher than that in model group (p<0.05). CONCLUSIONS MiR-199a modulates mTOR expression to exert important regulatory effects on the autophagy and inflammation in rats with cerebral infarction.
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Affiliation(s)
- J Zhou
- Department of Internal Medicine, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China.
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18
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Yao H, Lu W, Niu G, Zhang Q, Jiang Q, Liu H, Ni T. Characterizing the air pollution of the cities in the closure of corona virus disease 2019 in China. Int J Environ Sci Technol (Tehran) 2021; 18:2053-2062. [PMID: 33868434 PMCID: PMC8042843 DOI: 10.1007/s13762-021-03311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/08/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
With the rapid development of industrialization and urbanization in China, energy and vehicle consumption have continued to increase in recent years and air pollution has become serious. In early 2020, Corona Virus Disease 2019 broke out in Wuhan, China. From January 29, 2020, several sources of the air pollution almost all stopped working, including gasoline burning vehicles, dust producing building sites, coal-fired factories, etc. Five indicators of the atmospheric environmental quality were observed from December 19, 2019 to April 30, 2020 in nine cities and 1-h average concentrations, 24-h average concentrations and Air Quality Index were assessed. The 1-h average concentrations of the nitrogen dioxide, the ozone and the sulfur dioxide showed obvious difference though the closure did not change the sequence of the five pollutants' concentrations in the air at diverse sampling moments. The changing of the 24-h average concentrations of the five pollutants indicated the amount of pollutants in the air were greatly affected by human activities. The nitrogen dioxide, the sulfur dioxide and the particulate matters decreased obviously in the closure. The air in the metropolis and the south-east cities were relatively clean and the pollutants' concentrations decreased slightly during the closure period. The northern and the heavy industrial cities showed significant drop on air pollution indicators and the air quality of the two city groups could be greatly improved if some effective measures could be taken of environmental management and regional development.
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Affiliation(s)
- H. Yao
- School of Geography, Nantong University, Nantong, 226019 China
- Jiangsu Yangtze River Economic Belt Research Institute, Nantong, 226019 China
| | - W. Lu
- School of Geography, Nantong University, Nantong, 226019 China
- Jiangsu Yangtze River Economic Belt Research Institute, Nantong, 226019 China
| | - G. Niu
- School of Geography, Nantong University, Nantong, 226019 China
- Jiangsu Yangtze River Economic Belt Research Institute, Nantong, 226019 China
| | - Q. Zhang
- School of Geography, Nantong University, Nantong, 226019 China
- Jiangsu Yangtze River Economic Belt Research Institute, Nantong, 226019 China
| | - Q. Jiang
- School of Geography, Nantong University, Nantong, 226019 China
- Jiangsu Yangtze River Economic Belt Research Institute, Nantong, 226019 China
| | - H. Liu
- School of Geography, Nantong University, Nantong, 226019 China
- Jiangsu Yangtze River Economic Belt Research Institute, Nantong, 226019 China
| | - T. Ni
- School of Geographic and Oceanographic Science, Nanjing University, Nanjing, 210023 China
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19
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Zhang Q, Ni T, Dang Y, Ding L, Jiang J, Li J, Xia M, Yu N, Ma J, Yan J, Chen ZJ. MiR-148a-3p may contribute to flawed decidualization in recurrent implantation failure by modulating HOXC8. J Assist Reprod Genet 2020; 37:2535-2544. [PMID: 32772270 DOI: 10.1007/s10815-020-01900-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate whether miR-148a-3p overexpression is associated with disrupted decidualization of recurrent implantation failure (RIF). METHODS Endometrial miRNA and mRNA expression profiles during the implantation window derived from women with and without RIF were identified using microarray and RT-qPCR. Immortalized human endometrial stromal cells (HESCs) were cultured for proliferation and in vitro decidualization assays after enhancing miR-148a-3p expression or inhibiting putative target gene homeobox C8 (HOXC8) expression. RT-qPCR, western blot, and luciferase reporter assays were used to confirm the relationship between miR-148a-3p and HOXC8 gene. RESULTS MiR-148a-3p was significantly upregulated in RIF endometrial tissues. Forced expression of miR-148a-3p notably attenuated HESC in vitro decidualization. Mechanistic studies revealed that miR-148a-3p directly bounds to the HOXC8 3' untranslated region (3'UTR) and suppressed HOXC8 expressions in both mRNA and protein levels. Further investigations demonstrated that inhibition of HOXC8 in HESCs induced similar effects on decidual process as those induced by miR-148a-3p overexpression. CONCLUSION Taken together, our findings suggested that elevated miR-148a-3p might account for flawed decidualization in RIF by negatively regulating HOXC8, raising the possibility that miR-148a-3p might be a novel therapeutic target in RIF.
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Affiliation(s)
- Qian Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Tianxiang Ni
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Yujie Dang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Lingling Ding
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Jingjing Jiang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Jing Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Mingdi Xia
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Na Yu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Jinlong Ma
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China
| | - Junhao Yan
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China. .,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China. .,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, No. 157 Jingliu Road, Jinan, 250012, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.,Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, 250012, Shandong, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetic, Shanghai, 200127, China.,Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
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20
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Ni T, Wu Q, Zhu Y, Jiang W, Zhang Q, Li Y, Yan J, Chen ZJ. Comprehensive analysis of the associations between previous pregnancy failures and blastocyst aneuploidy as well as pregnancy outcomes after PGT-A. J Assist Reprod Genet 2020; 37:579-588. [PMID: 32103397 PMCID: PMC7125264 DOI: 10.1007/s10815-020-01722-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/13/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate the associations of previous pregnancy failures, including implantation failures (IFs), biochemical pregnancy losses (BPLs), and early (EMs) and late miscarriages (LMs), with blastocyst aneuploidy and pregnancy outcomes after PGT-A. METHODS This study included 792 couples who underwent PGT-A after multiple pregnancy failures. Subgroup analyses were used to compare the blastocyst aneuploidy rate (BAR), implantation rate (IR), early miscarriage rate (EMR), and live birth rate (LBR). Multiple linear and logistic regression models were used to evaluate the associations. The control group comprised couples with ≤ 2 IFs, ≤ 1 BPL, ≤ 1 EM, and no LM. RESULTS Notably, a history of ≥ 4 IFs was significantly associated with an increase in aneuploid blastocysts (42.86% vs. 33.05%, P = 0.044, B = 10.23 for 4 IFs; 48.80% vs. 33.05%, P = 0.002, B = 14.43 for ≥ 5 IFs). Women with ≥ 4 prior EMs also harbored more aneuploid blastocysts (41.00% vs. 33.05%, P = 0.048; B = 9.23). Compared with the control group, women with ≥ 4 prior EMs had a significantly higher EMR (6.58% vs. 31.11%, P < 0.001, OR = 6.49) and a lower LBR (53.49% vs. 34.18%, P = 0.007, OR = 0.56) after euploid transfer. Moreover, a history of LM(s) was associated with adverse pregnancy outcomes after PGT-A (OR for EM = 3.16; OR for live birth = 0.48). However, previous BPLs and 2 EMs were not associated significantly with blastocyst aneuploidy and pregnancy outcomes after PGT-A. CONCLUSION A history of high-order IFs or EMs and existence of LM(s) were significantly associated with blastocyst aneuploidy and adverse pregnancy outcomes after PGT-A, whereas no such associations were observed with BPLs or 2 EMs.
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Affiliation(s)
- Tianxiang Ni
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
| | - Qianqian Wu
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
| | - Yueting Zhu
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
| | - Wenjie Jiang
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
| | - Qian Zhang
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
| | - Yan Li
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China.
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China.
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China.
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, 157 Jingliu Road, Jinan, 250001, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Key Laboratory of Reproductive Medicine, 157 Jingliu Road, Jinan, 250001, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, 157 Jingliu Road, Jinan, 250001, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, 845 Lingshan Road, Shanghai, 200000, China
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Lu W, Wang Y, Zhang Q, Owen S, Green M, Ni T, Edwards M, Li Y, Zhang L, Harris A, Li JL, Jackson DG, Jiang S. TNF-derived peptides inhibit tumour growth and metastasis through cytolytic effects on tumour lymphatics. Clin Exp Immunol 2019; 198:198-211. [PMID: 31206614 DOI: 10.1111/cei.13340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2019] [Indexed: 01/08/2023] Open
Abstract
Tumour necrosis factor (TNF) is a multi-functional cytokine with profound and diverse effects on physiology and pathology. Identifying the molecular determinants underlying the functions and pathogenic effects of TNF is key to understanding its mechanisms of action and identifying new therapeutic opportunities based on this important molecule. Previously, we showed that some evolutionarily conserved peptides derived from TNF could induce cell death (e.g. apoptosis and/or necrosis), a feature of immune defence mechanisms shared by many vertebrates. In this study, we demonstrated that necrosis-inducing peptide P16 kills human glioblastoma cancer cells and primary human hepatoma or renal cancer cells isolated from patients who had not responded to standard treatments. Importantly, we show that the necrosis-inducing peptide P1516 significantly improves survival by inhibiting tumour metastasis in a 4T1 breast cancer syngeneic graft mouse model. Because the lymphatic system is an important metastatic route in many cancers, we also tested the effect of TNF-derived peptides on monolayers of primary human lymphatic endothelial cells (hDLEC) and found that they increased junctional permeability by inducing cytoskeletal reorganization, gap junction formation and cell death. Transmission electron microscopy imaging evidence, structural analysis and in-vitro liposome leakage experiments strongly suggest that this killing is due to the cytolytic nature of these peptides. P1516 provides another example of a pro-cytotoxic TNF peptide that probably functions as a cryptic necrotic factor released by TNF degradation. Its ability to inhibit tumour metastasis and improve survival may form the basis of a novel approach to cancer therapy.
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Affiliation(s)
- W Lu
- Department of Oncology, University of Oxford, Oxford, UK.,Shanghai JW Inflinhix Co. Ltd, Shanghai, P.R. China.,Oxford Vacmedix (Changzhou) Co. Ltd, Changzhou City, Jiangsu Province, P.R. China
| | - Y Wang
- Department of Cardiovascular Medicine, Wellcome Trust Centre for Human Genetics, University of Oxford, UK
| | - Q Zhang
- Oxford Vacmedix (Changzhou) Co. Ltd, Changzhou City, Jiangsu Province, P.R. China
| | - S Owen
- Department of Oncology, University of Oxford, Oxford, UK
| | - M Green
- Department of Oncology, University of Oxford, Oxford, UK
| | - T Ni
- Division of Structural Biology, Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Y Li
- Department of Oncology, University of Oxford, Oxford, UK
| | - L Zhang
- Department of Oncology, University of Oxford, Oxford, UK
| | - A Harris
- Department of Oncology, University of Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK
| | - J-L Li
- Department of Oncology, University of Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK.,Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth Science Park, Plymouth, PL6 8BU, UK
| | - D G Jackson
- MRC Human Immunology Unit, Radcliffe Department of Medicine, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, OX3 9DS, UK
| | - S Jiang
- Department of Oncology, University of Oxford, Oxford, UK.,Shanghai JW Inflinhix Co. Ltd, Shanghai, P.R. China.,Oxford Vacmedix (Changzhou) Co. Ltd, Changzhou City, Jiangsu Province, P.R. China.,Oxford Vacmedix UK Ltd, Oxford, UK
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22
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Li M, Fang Y, Yao M, Yu WR, Ni T, Gu C, Yang PG, Mao ZG. [Effects of transforming growth factor β1 receptor inhibitor SD-208 on human hypertrophic scar]. Zhonghua Shao Shang Za Zhi 2017; 32:389-95. [PMID: 27464628 DOI: 10.3760/cma.j.issn.1009-2587.2016.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the effects of transforming growth factor β1 (TGF-β1) receptor inhibitor SD-208 on human hypertrophic scar and its mechanisms. METHODS Scar fibroblasts were isolated from deprecated human hypertrophic scar tissue and then sub-cultured. Cells of the fifth passage were used in the following experiments. (1) Cells were divided into blank control group (BC) and 0.5, 1.0, 3.0, and 5.0 μmol/L SD-208 groups according to the random number table (the same grouping method below), with 6 wells in each group. Cells in group BC were added with 1 μL phosphate buffer solution, while cells in the latter four groups were added with 0.5, 1.0, 3.0, and 5.0 μmol/L SD-208, respectively. After being cultured for 12 hours, the proliferation activity of cells was detected by cell counting kit 8 and microplate reader (denoted as absorbance value). Suitable amount of substance concentration of SD-208 according to the results of proliferation activity of cells was chosen for the following experiments. (2) Another batch of cells were divided into group BC and 1, 3 μmol/L SD-208 groups and treated as in (1), with 8 wells in each group. The number of migration cells was detected by transwell method. (3) Another batch of cells were grouped and treated as in (2), and the microfilament morphology of cells was observed by rhodamine-phalloidin staining. (4) Another batch of cells were grouped and treated as in (2), and the protein expression of TGF-β1 was assessed with Western blotting. (5) Forty-eight BALB/c nude mice were divided into normal saline group (NS) and 1 μmol/L SD-208 group, and one longitudinal incision with length of 1 cm was made on their back. Then human hypertrophic scar tissue was embedded into the incision. On post injury day 7, multipoint injection of NS in a volume of 0.05 mL was performed in wounds of rats in group NS, while rats in 1 μmol/L SD-208 group were given 0.05 mL 1 μmol/L SD-208, once a day. On the day 0 (the same day), 2, 4, 6, 8, 10, 12, 14, 16, 18, and 20 post first time of injection, the weight of 8 nude mice was weighed by electronic scale, and scar area was measured by vernier caliper and the ratio of rest scar area was calculated. (6) In week 1, 2, and 3 post first time of injection, the protein expression of TGF-β1 of human hypertrophic scar tissue was assessed with Western blotting. Data were processed with one-way analysis of variance and two independent-sample t test. RESULTS (1) The proliferation activity of cells in group BC, 0.5, 1.0, 3.0, and 5.0 μmol/L SD-208 groups was respectively 1.00±0.03, 0.90±0.08, 0.68±0.11, 0.54±0.04, and 0.42±0.09, and the proliferation activity of cells in 0.5, 1.0, 3.0, and 5.0 μmol/L SD-208 groups was significantly lower than that in group BC (with t values from 2.9 to 22.1, P<0.05 or P<0.01). (2) The number of migration cells in 1, 3 μmol/L SD-208 groups was significantly less than that in group BC (with t values respectively 6.5 and 6.4, P values below 0.01). (3) Compared with that in group BC, fluorescence intensity of microfilaments of cells in 1, 3 μmol/L SD-208 groups was attenuated, and the pseudopod extended less. (4) The protein expressions of TGF-β1 of cells in group BC and 1, 3 μmol/L SD-208 groups were respectively 1.00±0.08, 0.80±0.08, and 0.61±0.05, and the protein expressions of TGF-β1 of cells in 1, 3 μmol/L SD-208 groups were significantly lower than those in group BC (with t values respectively 4.0 and 9.2, P values below 0.01). (5) The weights of nude mice in group NS and 1 μmol/L SD-208 group were similar on each time day (with t values from 0.2 to 1.1, P values above 0.05). The ratios of rest scar area of nude mice in two groups were decreased along with the injection time, and the ratios of rest scar area of nude mice in 1 μmol/L SD-208 group were significantly less than those in group NS from the day 6 to 20 post first time of injection (with t values from 1.8 to 15.9, P<0.05 or P<0.01). In week 1, 2, and 3 post first time of injection, the protein expressions of TGF-β1 of human hypertrophic scar tissue in nude mice in two groups showed a tendency of decrease, and the protein expressions of TGF-β1 of human hypertrophic scar tissue in nude mice in 1 μmol/L SD-208 group were significantly lower than those in group NS (with t values from 6.2 to 19.1, P values below 0.01). CONCLUSIONS SD-208 has significant inhibition effect on human hypertrophic scars, and the mechanism is correlated to the inhibition of protein expression of endogenous TGF-β1.
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Affiliation(s)
- M Li
- Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201999, China
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Ni T, Li J, Chen H, Gao Y, Gao X, Yan J, Chen ZJ. Male chromosomal polymorphisms reduce cumulative live birth rate for IVF couples. J Assist Reprod Genet 2017; 34:1017-1025. [PMID: 28573525 DOI: 10.1007/s10815-017-0951-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 05/12/2017] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Chromosomal polymorphisms are associated with infertility, but their effects on assisted reproductive outcomes are still quite conflicting, especially after IVF treatment. This study evaluated the role of chromosomal polymorphisms of different genders in IVF pregnancy outcomes. METHODS Four hundred and twenty-five infertile couples undergoing IVF treatment were divided into three groups: 214 couples with normal chromosomes (group A, control group), 86 couples with female polymorphisms (group B), and 125 couples with male polymorphisms (group C). The pregnancy outcomes after the first and cumulative transfer cycles were analyzed, and the main outcome measures were live birth rate (LBR) after the first transfer cycle and cumulative LBR after a complete IVF cycle. RESULTS Comparison of pregnancy outcomes after the first transfer cycle within group A, group B, and group C demonstrated a similar LBR as well as other rates of implantation, clinical pregnancy, early miscarriage, and ongoing pregnancy (P > 0.05). However, the analysis of cumulative pregnancy outcomes indicated that compared with group A, group C had a significantly lower LBR per cycle (80.4 vs 68.00%), for a rate ratio of 1.182 (95% CI 1.030 to 1.356, P = 0.01) and a significantly higher cumulative early miscarriage rate (EMR) among clinical pregnancies (7.2 vs 14.7%), for a rate ratio of 0.489 (95% CI 0.248 to 0.963, P = 0.035). CONCLUSION Couples with chromosomal polymorphisms in only male partners have poor pregnancy outcomes after IVF treatment manifesting as high cumulative EMR and low LBR after a complete cycle.
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Affiliation(s)
- Tianxiang Ni
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China
| | - Jing Li
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China
| | - Hong Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China
| | - Yuan Gao
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, 250021, China.,The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, 250021, China
| | - Xuan Gao
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, 250021, China.,The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, 250021, China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, 250021, China. .,The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, 250021, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong Provincial Key Laboratory of Reproductive Medicine, Jingliu Road 157, Jinan, 250021, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, 250021, China.,The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan, 250021, China.,Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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Ni T, Liu Y, Huang Y, Sun X, Wang J, Wang YD. Hysteroscopy combined dilatation and curettage, serum CA125 and CA19-9 play an important role in preserving fertility or endocrine function for early-stage endometrial cancer patients. EUR J GYNAECOL ONCOL 2017; 38:49-53. [PMID: 29767864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the role of hysteroscopy combined dilatation and curettage (D&C), serum CA125 and CA19-9 in endometrial cancer (EC) patients who desire to preserve fertility or endocrine function. MATERIALS AND METHODS This retrospective study included a total of 622 patients with EC between January 2006 and December 2014. The consistency of preoperative and postoperative histopathological findings were compared in patients who underwent D&C with or without hysteroscopy. The incidence of positive peritoneal cytology was also compared to assess the safety of hysteroscopy. Receiver operating characteristic (ROC) curve was used to evaluate the role of preoperative serum CA125 and CA19-9 in predicting extrauterine metastasis. RESULTS In 151 patients who underwent hysteroscopy combined D&C, the consistency of pre- and postoperative pathology was higher than the remaining 447 patients who underwent classical D&C alone (83.44% vs. 74.94%,p < 0.05) and there was no significant difference in the incidence of positive peritoneal cytology between the two groups (2.64% vs. 2.73%, p > 0.05). ROC curve analysis results showed the CA125 serum level of 31.75 U/ml and CA19-9 serum level of 35.40 U/ml were the best cutoff to predict extrauterine metastasis in endometrial cancer, with 66.7% sensitivity, 83% specificity, and 61.9% sensitivity and 84.9% of specificity, respectively. CONCLUSIONS Hysteroscopy combined D&C should be recommended for early-stage EC patients who desire to preserve fertility or endocrine function, and the preoperative serum levels of CA125 and CA19-9 were powerful in predicting tumor stage in these patients.
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Ni T, Sun X, Shan B, Wang J, Liu Y, Gu SL, Wang YD. Detection of circulating tumour cells may add value in endometrial cancer management. Eur J Obstet Gynecol Reprod Biol 2016; 207:1-4. [PMID: 27756035 DOI: 10.1016/j.ejogrb.2016.09.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/02/2016] [Accepted: 09/21/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the role of circulating tumour cells (CTCs) in patients with endometrial cancer (EC). STUDY DESIGN This study included 40 patients with a pre-operative diagnosis of high-risk EC between April 2015 and May 2016. Patients were further divided into high-risk (grade 3, non-endometrioid, myometrial invasion ≥1/2 and stage III-IV) and high-intermediate-risk (grade 2-3, endometrioid, myometrial invasion <1/2 and stage I-II) groups according to postoperative pathological results. CTCs were detected using the CellSearch system, and CTC results were correlated with standard clinicopathological characteristics and serum tumour marker CA125/HE4 status using Chi-squared test, continuity correction or Fisher's exact test. The pharmacodynamic effect was detected after the first cycle of adjuvant therapy. Patients were followed up for 13 months to assess outcomes. RESULTS Fifteen percent of patients had one or more CTCs. The presence of CTCs was found to be significantly associated with cervical involvement (83.33% vs 11.76%, p=0.00). No significant difference in CTC-positive rates was detected between the high-risk and high-intermediate-risk groups, and no significant correlation was found between CTCs and serum CA125/HE4, either by positive rates or exact serum levels of the conventional tumour markers. No more CTCs were detected after the first cycle of standard chemotherapy in this study, and no distant metastases or recurrence were found in the CTC-positive patients during the follow-up period. CONCLUSION The presence of CTCs was correlated with cervical involvement. Early-stage EC patients with CTCs may benefit from additional adjuvant therapies. Assessment of CTCs may be useful in the management of high-risk EC patients.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/blood
- CA-125 Antigen/blood
- Carcinoma, Endometrioid/blood
- Carcinoma, Endometrioid/pathology
- Carcinoma, Endometrioid/secondary
- Carcinoma, Endometrioid/therapy
- Cervix Uteri/drug effects
- Cervix Uteri/pathology
- Cervix Uteri/surgery
- Chemotherapy, Adjuvant
- Cystadenocarcinoma, Serous/blood
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/secondary
- Cystadenocarcinoma, Serous/therapy
- Endometrial Neoplasms/blood
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/prevention & control
- Endometrial Neoplasms/therapy
- Endometrium/drug effects
- Endometrium/pathology
- Endometrium/surgery
- Female
- Follow-Up Studies
- Humans
- Membrane Proteins/blood
- Middle Aged
- Myometrium/drug effects
- Myometrium/pathology
- Myometrium/surgery
- Neoplasm Grading
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/prevention & control
- Neoplasm Staging
- Neoplastic Cells, Circulating/drug effects
- Neoplastic Cells, Circulating/pathology
- Proteins/analysis
- Uterine Cervical Neoplasms/drug therapy
- Uterine Cervical Neoplasms/prevention & control
- Uterine Cervical Neoplasms/secondary
- Uterine Cervical Neoplasms/surgery
- Uterine Neoplasms/drug therapy
- Uterine Neoplasms/prevention & control
- Uterine Neoplasms/secondary
- Uterine Neoplasms/surgery
- WAP Four-Disulfide Core Domain Protein 2
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Affiliation(s)
- T Ni
- Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - X Sun
- Laboratory of Gynaecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - B Shan
- Fudan University Shanghai Cancer Centre, Shanghai, China
| | - J Wang
- Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Liu
- Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S-L Gu
- Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y-D Wang
- Department of Gynaecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Zajic S, Rossenu S, Hreniuk D, Kesisoglou F, McCrea J, Liu F, Sun L, Witter R, Gauthier D, Helmy R, Joss D, Ni T, Stoltz R, Stone J, Stoch SA. The Absolute Bioavailability and Effect of Food on the Pharmacokinetics of Odanacatib: A Stable-Label i.v./Oral Study in Healthy Postmenopausal Women. Drug Metab Dispos 2016; 44:1450-8. [DOI: 10.1124/dmd.116.069906] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/08/2016] [Indexed: 11/22/2022] Open
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Wu QY, Li WW, Li N, Li TF, Zhang C, Ni T, Cui YX, Li XJ, Xia XY. A novel nonsense mutation of ADAR1 gene in a Chinese patient with dyschromatosis symmetrica hereditaria. J Eur Acad Dermatol Venereol 2014; 28:1832-3. [PMID: 24673593 DOI: 10.1111/jdv.12381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Q-Y Wu
- Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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Abstract
This study aimed to identify marker genes in diabetic wounds using a dataset based on a DNA microarray of dermal lymphatic endothelial cells, and our results provide a basic understanding of diabetic wounds through further study of these differentially expressed genes (DEGs). From the Gene Expression Omnibus database, we downloaded a gene expression microarray (GSE38396) that includes 8 samples: 4 normal controls and 4 disease samples (type II diabetes). We then identified genes that were differentially expressed between normal and disease samples using packages in R language, constructed a protein-protein interaction (PPI) network and analyzed modules in the network. In addition, phylogenetic analysis was performed by MEGA to find the most conserved genes. Two hundred and thirteen genes were identified as being differentially expressed between normal and disease samples, and we constructed a PPI network that included 213 pairs of proteins. We then identified a module including 20 genes, the function of which was significantly enriched in wounding response. Lastly, the most conserved genes, CD44 and CCL5, were identified through phylogenetic analysis. In summary, we found differentially expressed marker genes, a wounding response-related module, and the most important genes CD44 and CCL5. Our findings suggest new approaches to therapies for diabetic wounds.
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Affiliation(s)
- T Ni
- Department of Burn and Plastic Surgery, No. 3 People's Hospital and Institute of Traumatic Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Ni T, Pinson JA, Gupta S, Santoro RJ. Two-dimensional imaging of soot volume fraction by the use of laser-induced incandescence. Appl Opt 1995; 34:7083-7091. [PMID: 21060570 DOI: 10.1364/ao.34.007083] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A recently developed laser-induced incandescence technique is used to make novel planar measurements of soot volume fraction within turbulent diffusion flames and droplet flames. The two-dimensional imaging technique is developed and assessed by systematic experiments in a coannular laminar diffusion flame, in which the soot characteristics have been well established. With a single point calibration procedure, agreement to within 10% was found between the values of soot volume fraction measured by this technique and those determined by conventional laser scattering-extinction methods in the flame. As a demonstration of the wide range of applicability of the technique, soot volume fraction images are also obtained from both turbulent ethene diffusion flames and from a freely falling droplet flame that burns the mixture of 75% benzene and 25% methanol. For the turbulent diffusion flames, approximately an 80% reduction in soot volume fraction was found when the Reynolds number of the fuel jet increased from 4000 to 8000. In the droplet flame case, the distribution of soot field was found to be similar to that observed in coannular laminar diffusion flames.
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Dai S, Qi S, Zhang L, Bai C, Ni T, Deng X. Laser Raman spectrometry study on experimental galactose-induced cataract. Yan Ke Xue Bao 1995; 11:143-6. [PMID: 8758842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To observe the dynamic changes of hydration in galactose induced cataract. METHODS Two groups of Wistar rats were used in the experiment. There were 12 rats in the experimental group, which were fed diet of 50% D-Galactose standard feed; while the control group had 8 rats fed standard feed. Their other living conditions were the same. At desired time periods, two Wistar rats fed galactose and one normal control were selected and killed 20 minutes before the instrument examination respectively, then, their lenses were removed from the orbs by a posterior approach. The cleaned fresh lens was placed in a quartz cuvette with Tris buffered balanced salt solution containing 5.5 mmol/L glucose. The quartz cuvette was placed on the stage of the Spectrometer. The laser beam was focused at the lens nuclear from the bottom of the cuvette and the scattered light was collected at 90 degrees to the incident beam. RESULTS Raman spectroscopy showed that (1) during the formation of galactose cataract, the water signal (at 3390cm-1) increased obviously, and the ratio of I3390/I2935 increased from 0.31 (3 days) to 2.26 (17 days), which is correlated with the imbibition of water in the lens nuclear; (2) the hydration of lens nuclear could be divided into two phases. The ratio I3390/I2935 was increased slowly and steadily by 11 days after galactose feeding. Then, the ratio turned to increase quite fast till 17 days. CONCLUSION The hydration of nuclear is changed simultaneously with the formation of cataract. The hydration of nuclear is mainly due to the imbalance of Na+/K+.
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Affiliation(s)
- S Dai
- Department of Ophthalmology, First Affiliated Hospital, Lan Zhou Medical College, China
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Snyder RO, Im DS, Ni T, Xiao X, Samulski RJ, Muzyczka N. Features of the adeno-associated virus origin involved in substrate recognition by the viral Rep protein. J Virol 1993; 67:6096-104. [PMID: 8396670 PMCID: PMC238031 DOI: 10.1128/jvi.67.10.6096-6104.1993] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
We previously demonstrated that the adeno-associated virus (AAV) Rep68 and Rep78 proteins are able to nick the AAV origin of DNA replication at the terminal resolution site (trs) in an ATP-dependent manner. Using four types of modified or mutant substrates, we now have investigated the substrate requirements of Rep68 in the trs endonuclease reaction. In the first kind of substrate, portions of the hairpinned AAV terminal repeat were deleted. Only deletions that retained virtually all of the small internal palindromes of the AAV terminal repeat were active in the endonuclease reaction. This result confirmed previous genetic and biochemical evidence that the secondary structure of the terminal repeat was an important feature for substrate recognition. In the second type of substrate, the trs was moved eight bases further away from the end of the genome. The mutant was nicked at a 50-fold-lower frequency relative to a wild-type origin, and the nick occurred at the correct trs sequence despite its new position. This finding indicated that the endonuclease reaction required a specific sequence at the trs in addition to the correct secondary structure. It also suggested that the minimum trs recognition sequence extended three bases from the cut site in the 3' direction. The third type of substrate harbored mismatched base pairs at the trs. The mismatch substrates contained a wild-type sequence on the strand normally cut but an incorrect sequence on the complementary strand. All of the mismatch mutants were capable of being nicked in the presence of ATP. However, there was substantial variation in the level of activity, suggesting that the sequence on the opposite strand may also be recognized during nicking. Analysis of the mismatch mutants also suggested that a single-stranded trs was a viable substrate for the enzyme. This interpretation was confirmed by analysis of the fourth type of substrate tested, which contained a single-stranded trs. This substrate was also cleaved efficiently by the enzyme provided that the correct strand was present in the substrate. In addition, the single-stranded substrate no longer required ATP as a cofactor for nicking. Finally, all of the substrates with mutant trss bound the Rep protein as efficiently as the wild-type did. This finding indicated that the sequence at the cut site was not involved in recognition of the terminal repeat for specific binding by the enzyme. We concluded that substrate recognition by the AAV Rep protein involves at least two and possibly as many as four features of the AAV terminal repeat.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- R O Snyder
- Department of Microbiology, State University of New York at Stony Brook Medical School 11794-8621
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Xu RM, Ni T, Xu XD. Two new species of Tabanus from Hubei, China (Diptera: Tabanidae). Acta Acad Med Wuhan 1984; 4:229-230. [PMID: 6527847 DOI: 10.1007/bf02857169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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