腹部超声引导下胚胎移植术的临床观察

目的为了提高体外受精-胚胎移植术后临床妊娠率,降低胚胎残留率和异位妊娠率,探讨在腹部超声引导下胚胎移植对妊娠结局的影响。方法回顾性分析2007年4月至2008年12月,在本中心体外受精-胚胎移植(包括卵母细胞内单精子显微注射)268个周期,其中移植周期260(未移植8个周期),将无B超引导下移植组为A组84个周期,将在B超引导下移植组为B组176个周期,比较两组的临床妊娠率,胚胎残留率和异位妊娠率。结果A组临床妊娠率25%(21/84),胚胎残留率4.76%(4/84),异位妊娠率14.29%(3/21),种植率16.56%(27/163)。B组临床妊娠率30.68%(54/176),胚胎残留率1.13%(2/176)、异位妊娠率1.85%(1/54)、种植率23.06%(86/373)。结论腹部超声引导下胚胎移植能提高体外受精-胚胎移植的临床妊娠率,降低胚胎残留率和异位妊娠率。是一种安全可靠的胚胎移植方法。     

年龄对玻璃化冻融胚胎移植结局的影响

目的探讨年龄对玻璃化冻融胚胎移植结局的影响。方法对于2008年1月1日至2009年12月31日在湖北十堰市人民医院生殖医学中心接受冻融胚胎移植的342个周期的相关资料进行回顾性统计学分析,根据患者年龄、移植Ⅰ级胚胎数,比较不同年龄组之间的临床妊娠率。结果 A组（21岁～35岁）有297个周期,妊娠率50.51%;B组（36岁～45岁）45个周期,妊娠率33.33%。两组之间的临床妊娠率有显著性差异。在A组,移植2个Ⅰ级胚胎的临床妊娠率为58.28%;在B组,移植2个Ⅰ级胚胎的临床妊娠率为50%,均高于同组其它数目和胚胎级别移植的临床妊娠率。结论在玻璃化冻融胚胎移植周期中,年龄和胚胎质量对妊娠的成功起主要作用。     

冷冻胚胎复苏移植中子宫内膜最佳容受时间的研究

目的 分析在冷冻胚胎复苏移植过程中，各种内膜准备的方案中的内膜转化后不同转化时间移植对妊娠率的影响。方法 回顾性分析2020年2至12月在广西壮族自治区生殖医院行冷冻囊胚复苏移植的1147周期，分析不同的内膜准备方案中不同的转化时间移植胚胎的妊娠率。结果 在激素替代周期中，内膜转化第5天移植的临床妊娠率为57.75%，内膜转化第6天移植的临床妊娠率为51.22%，两者妊娠率差异无统计学意义（P=0.413）。在自然周期自然排卵中，卵泡排卵第4天移植的临床妊娠率为42.86%，胚胎种植率为28.57%，排卵第5天移植临床妊娠率为62.04%，胚胎种植率为46.99%，排卵第6天移植临床妊娠率为64.71%，胚胎种植率为45.16%，排卵第7天移植无1例妊娠，四组的临床妊娠率总体差异无统计学意义（P=0.065），排卵第7天移植的胚胎种植率分别与排卵第5天移植和排卵第6天移植的胚胎种植率比较，差异均有统计学意义（P=0.038,P=0.033）。在自然周期注射HCG第5天移植的临床妊娠率为62.16%，注射HCG第6天移植的临床妊娠率为57.29%，注射HCG第7天移植临床妊娠率为54.5...     

提前复苏分裂速率较慢胚胎对妊娠率的影响

目的探讨冻融胚胎移植(FET)周期中,提前一日复苏冷冻前分裂速率较慢的胚胎对妊娠结局的影响。方法回顾性分析哈尔滨医科大学附属第一医院生殖中心2006年3月至2009年9月561例FET周期中,移植冷冻前分裂速率较慢胚胎的周期共88个。其中,33个周期为移植当日复苏胚胎,培养1-4h后移植。55个周期为移植前一日复苏胚胎,培养18-24h移植。比较两组胚胎移植后的妊娠率和种植率。结果移植当日复苏组与移植前一日复苏组妊娠率(9.1%,32.7%)与种植率(4.2%,15.5%)均有显著性差异(P﹤0.05);而患者平均年龄、移植前平均内膜厚度、胚胎复苏存活率及100%卵裂球存活率均无显著性差异(P﹥0.05)。结论对冷冻前分裂速率较慢胚胎提前一日复苏,可提高临床妊娠率和种植率。     

体外受精中移植胚胎数目与临床妊娠结局的关系

目的探讨移植胚胎数目对临床妊娠结局的影响。方法根据移植胚胎数目的不同分为三组：1组为单胚胎移植组,2组为移植2个胚胎组,3组为移植3个胚胎组。分析三组患者移植的胚胎情况及移植后的临床妊娠结局。结果移植1个胚胎的妊娠率（20.7%）明显低于其它组（P〈0.05）,且流产率高（29.4%）,移植2个胚胎的妊娠率及种植率与移植3个胚胎的相似,但移植2个胚胎的流产率和多胎率明显低于移植3个组（P〈0.05）。结论单胚胎移植可以降低多胎率,但妊娠率偏低,移植2个胚胎可以获得较高的妊娠率并且可以降低多胎率的发生。     

女性乙肝病毒携带者体外受精-胚胎移植妊娠结局分析

目的探讨女性乙肝病毒（HBV）携带者行体外受精-胚胎移植（IVF-ET）助孕治疗后的妊娠结局。方法回顾性总结分析2010年3月至2012年12月在我中心因女性不孕进行IVF-ET助孕治疗的患者病历资料共422周期,以女方HBsAg阳性而男方HBsAg阴性为A组：HBV携带组共81个周期;双方均HBsAg阴性为B组：正常对照组共341个周期。比较两组的IVFET治疗结局。结果两组患者在年龄、不孕年限、Gn使用天数及总使用量、获卵数、移植胚胎数无差异的情况下,其受精率、卵裂率、D3优质胚胎率、胚胎种植率、临床妊娠率、早期流产率及总流产率亦无显著性差异（P〉0.05）。结论女性HBV携带者行IVF-ET助孕治疗对妊娠结局没有影响。     

超快速玻璃化冷冻人早期胚胎的临床应用价值初探

目的观察cryotop超快速玻璃化冷冻人早期胚胎的临床效果并探讨其应用价值。方法玻璃化冷冻试剂盒购自日本KITAZATO Biopharma公司,对新鲜周期胚胎移植后未妊娠患者的胚胎施行胚胎复苏,观察胚胎复苏后的存活率,胚胎分级和临床妊娠情况。结果共行胚胎复苏63个周期,201个胚胎,胚胎复苏后存活189个,胚胎复苏存活率为94.03%（189/201）;移植胚胎63个周期,移植胚胎总数187个,平均每周期移植胚胎2.97个（187/63）;临床妊娠30个周期,临床妊娠率为47.62%（30/63）,种植率为20.32%（38/187）,多胎率为23.33%（7/30）,流产率为6.67%（2/30）。结论 cryotop超快速玻璃化冷冻法简便且胚胎存活率高,是一种较好的冷冻人早期胚胎的方法。     

激素替代治疗周期402例冻融胚胎移植的回顾性分析

目的回顾性分析激素替代治疗（hormone replacement therapy, HRT）周期冻融胚胎移植（frozen - thawed embryo transfer, FET）的妊娠结局并探讨其影响因素。方法回顾性分析2011年1月～2012年1月中山大学附属第一医院生殖中心接受激素替代治疗周期冻融胚胎移植的不孕患者的妊娠结局和其相关因素。结果研究期间366个患者行402个HRT周期冻融胚胎移植,临床妊娠率为41．5％,年龄≤35岁患者妊娠率为43．4％;〉35岁患者妊娠率为27．7％。多胎率为29．9％,种植率为22．4％,其中D3天胚胎种植率为19．7％,囊胚种植率为37．7％。接受单个胚胎移植的患者,D3天胚胎种植率为9．1％,囊胚种植率为53．3％。结论激素替代周期冻融胚胎移植能获得满意种植率,影响其临床妊娠率因素包括女方年龄、ET日雌激素水平,以及ET胚胎数目、类型和质量。     

不同发育时期的冻融胚胎移植的成功率分析

目的探讨辅助生殖技术中,胚胎冷冻时的发育阶段对冻融胚胎移植的成功率的影响.方法回顾性分析107个冻融胚胎移植周期.结果胚胎复苏率为57.2%(271/474),临床妊娠率为27.1% (29/107),种植率为15.1% (39/259).按胚胎冷冻时期不同分为受精后第二天组(2～6细胞)和第三天组(4～10细胞),Day 3组的胚胎存活率显著高于Day 2组,但完整胚胎存活率、妊娠率、种植率均无显著性差异(P＞0.05).妊娠组的完整胚胎存活率及移植胚胎数目明显高于未妊娠组(P＜0.05).两组的子宫内膜的厚度和分型差异无显著性.结论在受精后第二天或第三天冷冻的胚胎,复苏后胚胎移植的妊娠率、种植率均无显著性差异.冻融胚胎形态良好,有足够的移植胚胎数目是保证冻融胚胎移植成功的重要因素.     

抗生素治疗慢性子宫内膜炎对反复移植失败妊娠结局的影响

目的 探讨抗生素治疗对反复移植失败合并慢性子宫内膜炎患者妊娠结局的影响。方法 选取2020年8月至2022年3月于中国人民解放军总医院第七医学中心186例反复移植失败的慢性子宫内膜炎患者为研究对象,根据再次行冻融胚胎移植前是否行抗生素治疗及使用的抗生素种类,将其分为多西环素组（n=84）、联合用药（左氧氟沙星+甲硝唑）组（n=57）、未治疗组（n=45）。比较各组患者的临床基本资料和行冻融胚胎移植后的妊娠结局。结果 各组患者的年龄、BMI、不孕年限、基础窦卵泡数、基础卵泡生成素水平、既往移植周期数、既往移植优质胚胎数相比,差异无统计学意义（P>0.05）。各组患者子宫内膜准备方案、转化日的内膜厚度、移植胚胎数和类型比较差异均无统计学意义（P>0.05）。各组患者着床率、临床妊娠率、流产率比较,差异无统计学意义（P>0.05）。多西环素组和联合用药组患者活产率高于未治疗组,差异具有统计学意义（P<0.05）;多西环素组和联合用药组患者活产率比较,差异无统计学意义（P>0.05）。结论 应用抗生素治疗可以提高反复移植失败合并慢性子宫内膜炎患者的活产率。     

Ultrasound-guided embryo transfer and the accuracy of trial embryo transfer

BACKGROUND: Studies have suggested that ultrasound-guided embryo transfer (UG-ET) may improve the outcome in IVF; however, several factors may account for the improvement in pregnancy rate. This study examines the use of ultrasound to determine the accuracy of trial transfer (TT) in preparation for ET. METHODS: Sixty-seven consecutive patients prospectively underwent UG-ET over a 2 month period. Total cavity length by US was compared with the length noted by TT. A difference of > or = 1 cm was considered significant. All embryos were placed within 1-2 cm of the fundus by US. RESULTS: Twenty patients (29.9%) had a difference of > or = 1 cm and 13 patients (19.4%) had a difference of < or = 1.5 cm. Patients with a difference of > or = 1 or > or = 1.5 cm had a significantly greater depth at transfer (P < 0.001) and uterine cavity length (P < 0.001) when compared with patients without a difference. Clinical pregnancy, implantation, delivery and overall miscarriage rates did not differ between patients with a difference of > or = 1 or > or = 1.5 cm versus no difference. There were no ectopic pregnancies. CONCLUSIONS: Nineteen percent of patients had a discrepancy of > or = 1.5 cm and approximately 30% had a difference of > or = 1 cm from TT at UG-ET, suggesting a benefit to UG-ET. A large prospective randomized trial comparing UG-ET with blind transfer is required to assess further if UG-ET should be used in all cases of ET.     

Single embryo transfer is an option in frozen embryo transfer

BACKGROUND: A good strategy to decrease multiple pregnancy rate in assisted reproduction technology (ART) is the use of single embryo transfer (SET). METHODS: This retrospective study analysed 1647 frozen embryo transfers carried out during 1998-2003 in Helsinki University Central Hospital; of these, 872 were double embryo transfers (DETs) and 775 SETs. The SET group included 140 (18.1%) elective SETs (eSETs). RESULTS: The yearly rate of SETs in frozen cycles increased from 28 to 66%. Overall, the clinical pregnancy rate per frozen embryo transfer was 30.7% and the delivery rate 22.6%. The delivery rate was significantly higher in DET cryocycles than in SET cryocycles (25.7 versus 19.2%, respectively; P < 0.01). In DET cryocycles, the multiple delivery rate was 21.9%, 10 times higher than that observed in cryocycles with SET (2.0%) (P < 0.0001). When eSET was applied, no difference in delivery rate was observed when compared with cryocycles with DET (28.6 and 25.7%, respectively). CONCLUSIONS: SET can be used in frozen cycles to reduce multiple delivery rates.     

胚胎移植与囊胚移植的临床结局分析

背景：国内关于卵裂期胚胎移植与囊胚移植的临床比较与分析大样本报道较少见。 目的：比较第2,3天卵裂期胚胎移植与第5天囊胚移植的临床结局。 方法：选择2008-01/2009-12北京大学深圳医院生殖医学科行体外受精/卵胞浆内单精子显微注射共1612周期,比较第2,3天卵裂期胚胎移植与第5天囊胚移植的临床妊娠率、胚胎种植率、流产率、多胎率、出生婴儿性别比例等差异。 结果与结论：第2,3,5天移植组分别195,1 162,255周期,临床妊娠率分别为33.33%,38.04%,44.71%,种植率分别为21.37%,24.70%,31.96%;第5天移植组临床妊娠率和种植率均高于第2,3天移植组(P < 0.05);第2天移植组宫外孕发生率高于第3天移植组(P < 0.05)。3组流产、单卵双胎、多胎、早产及出生婴儿性别比例无差异。说明囊胚移植提高了临床妊娠率和种植率的同时,未增加流产、多胎、早产等风险,对男女性别比例的平衡无负面影响。     

Magnetization transfer MRS

This review deals with magnetization transfer (MT) effects observed in in vivo NMR spectroscopy. The basic experimental methods of MT experiments, the underlying kinetic mechanisms as well as the evaluation of measured data by fits to two- or three-pool models are described. Experimental results of both (31)P and (1)H in vivo MRS are reviewed showing the potential of MT experiments to characterize kinetic equilibrium reactions. This includes reactions where all involved components are MR visible, as well as situations where one indirectly measures pools of bound spins which cannot directly be observed in vivo. In particular, MT effects are described which have been observed in in vivo (1)H NMR spectra measured on the animal or human brain or on skeletal muscle. Possible mechanisms for the strong MT effects observed for the signals of creatine/phosphocreatine, lactate, alcohol and other metabolites are discussed. It is also emphasized that MT effects caused by water suppression techniques may lead to systematic errors in the quantification of in vivo (1)H NMR spectra.     

Agrobacterium-mediated DNA transfer

Summary Agrobacterium tumefaciens naturally transfers DNA into plant cells and is clearly one of the most effective methods of directed DNA transfer presently available. Two kinds of vectors are commonly used. Cointegrative vectors have the foreign genes incorporated directly into the Ti plasmid. Binary vectors carry two plasmids; the main Ti plasmid where most of the T-DNA has been removed, and a second plasmid containing the foreign genes between the usual border sequences. The vir genes on the main plasmid function to mobilize the foreign genes into a plant cell. Most plant transformation methods follow the procedure of cocultivating wounded tissue with vir-gene-induced bacteria. The cocultivation step is followed by transfer to a selective medium containing antibiotics to kill the bacterium and to allow only growth of transformed tissue. Several selectable markers are available that include resistance to antibiotics, herbicides, or drugs. In addition, several scorable markers such as the bacterial glucuronidase, chloramphenicol acetyl transferase, and the Agrobacterium opine genes are used to verify transformation. Southern blotting and inheritance of transferred genes are ultimately used to demonstrate stable transformation.     

Altered nuclear transfer

The present conflict over the moral status of the human embryo reflects deep differences in our basic convictions and is unlikely to be resolved through deliberation or debate. While there are currently no federally legislated constraints on the use of private funds for this research, there is a consensus opinion in the scientific community that without NIH support for newly created embryonic stem cell lines, progress in this important realm of research will be severely constrained. A May, 2005, report by the President’s Council on Bioethics, “Alternative Sources of Pluripotent Stem Cells,” outlines several proposals for obtaining pluripotent stem cells without the destruction of human embryos. One of these methods, Altered Nuclear Transfer, proposes to use the technology of somatic cell nuclear transfer (SCNT), but with a preemptive genetic or epigenetic alteration that precludes the integrated and coordinated organization essential for natural embryogenesis. Drawing on insights from systems biology, the distinction between totipotency (capacity to form a whole organism) and pluripotency (capacity to form all the cell types) is explored. The implications of this distinction are used to discuss the moral arguments for the inviolability of nascent human life and the moral standing of entities with only partial and unorganized developmental potential. A way forward is proposed that may open positive a venues of advance in both stem cell research and a broader arena of research in developmental biology.     

BioShuttle-mediated plasmid transfer

An efficient gene transfer into target tissues and cells is needed for safe and effective treatment of genetic diseases like cancer. In this paper, we describe the development of a transport system and show its ability for transporting plasmids. This non-viral peptide-based BioShuttle-mediated transfer system consists of a nuclear localization address sequence realizing the delivery of the plasmid phNIS-IRES-EGFP coding for two independent reporter genes into nuclei of HeLa cells. The quantification of the transfer efficiency was achieved by measurements of the sodium iodide symporter activity. EGFP gene expression was measured with Confocal Laser Scanning Microscopy and quantified with biostatistical methods by analysis of the frequency of the amplitude distribution in the CLSM images. The results demonstrate that the "BioShuttle"-Technology is an appropriate tool for an effective transfer of genetic material carried by a plasmid.