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Endometrial receptivity is key to clinical pregnancy by in vitro fertilization-embryo transfer （IVF-ET） technique. Endometrial thickness （EMT） is a major index for pregnancy monitoring, but the optimal time indicating endometrial receptivity is controversially uncertain. Multiple studies have demonstrated the correlation between EMT and IVF pregnancy outcomes and EMT of a moderate range is essential for good pregnancy outcomes and a thin endometrium produces negative pregnancy outcomes. In this paper, we reviewed the research on the impact of EMT on IVF-ET pregnancy outcomes in terms of timing of EMT measurement, clinical pregnancy rate, live birth rate, ectopic pregnancy rate, placenta praevia, and low birth weight, investigating the mechanism of occurrence and treatment of thin endometrium so as to provide clinical references for improving IVF pregnancy outcomes. [ABSTRACT FROM AUTHOR]

目的比较常规体外受精（IVF）和卵胞质内单精子注射（ICSI）两种不同授精方式对解冻移植第六天（D6）囊胚患者妊娠结局的影响。方法回顾性队列研究分析中山大学附属第三医院生殖中心2018年1月至2020年4月期间解冻移植第六天囊胚移植患者的临床资料，按受精方式分为常规IVF组（446例）和ICSI受精组（200例）。按是否有第五天（D5）囊胚移植史，分为仅有D6囊胚冷冻及移植的患者，以及有D5囊胚移植史的患者。比较两组患者基本资料、囊胚质量及妊娠结局。结果IVF组和ICSI组患者BMI，不孕年限，基础FSH差异均无统计学意义（P > 0.05）。ICSI组患者年龄小于IVF组患者，原发性不孕的比例高于常规IVF组，获卵数和正常受精卵子数高于常规IVF受精组（P < 0.001）。常规IVF组五期和六期囊胚比例高于ICSI组（21.6 % vs. 3.14 %， P < 0.001）。ICSI组ICM评分为A级的囊胚高于IVF组（23.8 % vs. 14.3 %， P = 0.01）。ICSI组HCG阳性率和临床妊娠率均高于IVF组（65.5 % vs. 48.4 %， P < 0.001； 56 % vs. 41.3 %， P = 0.001），ICSI组胚胎种植率和活产率也高于常规IVF组（43.8 % vs. 30.9 %， P < 0.001； 43.0 % vs. 31.8 %， P = 0.006）。校正两组间年龄、获卵数等影响因素后，ICSI组临床妊娠率仍高于常规IVF组（OR：1.590， 95 % CI： 1.030， 2.455， P = 0.036）。ICSI组出生婴儿体质量低于IVF组（P = 0.016），早产率、性别比与分娩方式在两组间差异无统计学意义。结论ICSI受精的D6囊胚解冻移植后的临床妊娠率高于常规IVF受精的D6囊胚，活产率有升高的趋势，可能与IVF与ICSI病人导致囊胚发育慢的因素不同有关。ICSI受精的D6囊胚解冻移植后相对好的妊娠结局，可在一定程度上弥补ICSI周期囊胚发育相对较慢导致的妊娠结局的差异。

目的在解冻单囊胚移植后HCG阳性患者中，评估囊胚形态评分对第 12 天血清β-人绒毛膜促性腺激素（β-hCG）水平和活产结局的影响；分析血清β-hCG 水平对活产的预测价值。方法回顾本院2016年1月至2020年5月的519个单囊胚激素替代治疗-冻融胚胎移植（HRT-FET） 周期HCG阳性患者的数据。先根据Gardner 囊胚分级分为4组（AA、AB、BA和BB）；再根据囊腔扩张程度分期分为4组（3期、4期、5期、6期，Gardner 评分）。比较不同分级和分期的囊胚移植后第 12 天的血清β-hCG浓度和活产率；通过相关性检验确定囊胚Gardner 分级或分期与血清β-hCG水平之间的关系，绘制ROC 曲线确定预测活产的血清β-hCG临界值。结果① 移植后第 12 天血清β-hCG浓度AA组和AB组均显著高于BB组（P P P = 0.120）。移植不同分期的囊胚后第 12 天血清β-hCG浓度和活产率差异均无统计学意义 （P = 0.091，P = 0.557）。② 囊胚分级与第 12 天血清β-hCG浓度之间存在显著的弱相关性（rs = -0.221，P rs = -0.228，P rs = -0.052，P = 0.240），在控制了混杂因素后相关性仍然不显著（rs = -0.029，P = 0.508）。③ ROC 曲线分析得出，第 12 天血清β-hCG 预测活产的临界值为657.5 mU/mL （P < 0.001）。结论囊胚的分级和分期不影响活产率，不同分级的囊胚产生的血清β-hCG 差异有统计学意义；可通过早期血清β-hCG 值预测活产。

Objective To investigate the effect of intrauterine pretreatment with hysteroscopy before operation on the pregnancy outcome of intrauterine insemination（IUI）. Methods The clinical data of 1 062 treatment cycles of IUI assisted pregnancy for the first time in the Department of Reproductive Medicine of the Affiliated Hospital of Binzhou Medical University from January 2017 to October 2021 were retrospectively analyzed. A total of 964 cycles in which the female′s bilateral fallopian tubes were unobstructed were included in the study. The patients were divided into the observation group and the control group according to whether hysteroscopy was performed before operation. The observation group included 616 cycles of uterine cavity pretreatment by hysteroscopy before IUI, and the control group included 348 cycles without hysteroscopy before IUI operation. The clinical characteristics and pregnancy outcomes of the two groups were analyzed. Results There were no significant differences between the two groups in age, duration of infertility, basal follicle stimulating hormone（bFSH）, basal luteinizing hormone（bLH）, anti-mullerian hormone（AMH）, body mass index（BMI）, total number of forward motile sperm after treatment, endometrial thickness on the day of operation, proportion of infertility type and proportion of ovulation induction cycle（P＞0. 05）. The clinical pregnancy rate, ectopic pregnancy rate and live birth rate in the observation group were higher than those in the control group, with no statistically significant differences（P＞0. 05）. The abortion rate in the observation group was significantly lower than that in the control group, with statistically significant differences（P＜0. 05）. Conclusion For infertility patients with unobstructed bilateral fallopian tubes, pretreatment of uterine cavity by hysteroscopy before IUI can significantly reduce the abortion rate and have a positive effect on improving the live birth rate. [ABSTRACT FROM AUTHOR]

BACKGROUND: Controlled ovarian hyperstimulation has gradually become a routine method to increase the number of oocytes retrieved, but there has been controversy over whether the more oocytes retrieved the better. There is still no unified conclusion about the ideal range of egg retrieval number. OBJECTIVE: To explore the effect of number of oocytes retrieved on embryo fertilization outcome and clinical pregnancy outcome in fertilization in vitro treatment cycle. METHODS: 489 patients undergoing in vitro fertilization treatment (including conventional in vitro fertilization and intracytoplasmic sperm injection) were divided into the following five groups according to the number of oocytes retrieved: 1-4 group, 5-8 group, 9-12 group, 13-16 group, and ≥17 group. The fertilization rate, cleavage rate, transferable embryo rate, high-quality embryo rate, and clinical pregnancy outcome were compared in each group, and the effect of the number of oocytes retrieved on the outcome of in vitro fertilization was analyzed. RESULTS AND CONCLUSION: The number of oocytes retrieved was significantly correlated with the normal fertilization rate, transferable embryo rate, and high-quality embryo rate. Too many or too few retrieved oocytes could lead to a decrease in the normal fertilization rate and an increase in the abnormal fertilization rate, a decrease in the rates of transferable embryos and high-quality embryos, a decrease in the clinical pregnancy rates, embryo implantation rates, and live birth rates. In conclusion, too many or too few oocytes retrieved can lead to the decline of embryo quality and affect the clinical outcome of in vitro fertilization. The number between 5 and 16 oocytes may be appropriate, while the number between 9 and 12 oocytes may be optimal. During ovulation induction, clinicians should not only aim to increase the number of oocytes retrieved, but should pursue enough high-quality oocytes to reasonably formulate personalized ovulation induction programs for different patients. [ABSTRACT FROM AUTHOR]

Objective Observing and analyzing the delivery behaviour of cynomolgus macaques, to establish the criteria for determining the occurrence of delivery in cynomolgus macaques, and then combining with veterinary assistance in order to improve the live birth rate of cynomolgus macaques. Methods By backtracking and analyzing the surveillance videos of 112 perinatal cynomolgus macaques with a gestation period of 140 d or more from 2017 to 2021, we observed and recorded the main behavioural manifestations of the cynomolgus macaques during labour, including Valsalva's maneuver, touching and licking the birth canal, lying on their backs or stomachs, and rolling and tumbling of the body. On this basis, we established the weights of delivery-related behavioural indicators and exhaustively analysed the perinatal behavioural performances of 30 cynomolgus macaques for delivery determination. Results The perinatal behavioural validation results of the 30 cynomolgus macaques showed that the behavioural indicators of Valsalva's maneuver, touching and licking the birth canal, lying on the stomach or on the floor, body rolling and tumbling occurred with different frequencies, among which Valsalva's maneuver and lying on the stomach or on the back were the most important, with weight values of 35.5% and 27.2%, respectively. These two behaviours can be used to accurately determine the onset of parturition in cynomolgus macaques. The average live birth rate of the monkeys that were accurately determined to have given birth and were assisted by veterinarians reached 87.1%, which was significantly higher than that of the monkeys that had unassisted spontaneous deliveries, which was 63.5%, and there was a significant difference between these two rates (P<0.05). Conclusion The combination of accurate birth determination and veterinary assisted delivery can significantly increase the live birth rate of experimental cynomolgus macaques. [ABSTRACT FROM AUTHOR]

Objective ·To compare the pregnancy outcomes of infertile women with bilateral severe hydrosalpinx receiving neosalpingostomy or salpingectomy. Methods ·The single-center prospective cohort study from 2005 to 2012 focused on pregnancy outcomes of infertile women aged 20-40 years, with bilateral severe hydrosalpinx, undergoing bilateral neosalpingostomy or salpingectomy in International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine. The choice for treatment was based on a shared decision approach, and the participants were divided into the neosalpingostomy group and salpingectomy group. After registration of baseline characteristics, including age, birth place, reproductive history, preoperative hysterosalpingography results, surgical findings, and pregnancy outcomes, women were followed up on an annual basis until July 2020 for the occurrence of live birth by outpatient follow-up or telephone questionnaire. Intention-to-treat analysis and per-protocol analysis were applied to compare the pregnancy outcomes. Kaplan-Meier analysis and COX proportional hazard model were used to analyze the reproductive outcomes. In addition, subgroup analysis was performed based on age stratification. The main outcome measures were live birth rate, cumulative live birth rate, and factors affecting live birth. Secondary outcome measures included the mode of conception, time to live birth, biochemical pregnancy rate, clinical miscarriage rate, and ectopic pregnancy rate. Results ·A total of 113 women were included in the analysis, 58 women underwent bilateral neosalpingostomy, and 55 women underwent bilateral salpingectomy. The study demonstrated that in infertile women with bilateral severe hydrosalpinx, bilateral salpingectomy achieved higher cumulative live birth rate than bilateral neosalpingostomy (76.36% vs 62.07, HR=2.18,95%CI 1.37-3.45). In the neosalpingostomy group, 34.48% (20/58) live births were obtained after in vitro fertilization treatment, and 27.59% (16/58) live births were obtained through spontaneous conception which mainly occurred within 3 years after initial neosalpingostomy, while all live births in the salpingectomy group were obtained after assisted reproductive therapy. However, the risk of ectopic pregnancy was higher in the neosalpingostomy group than that in the salpingectomy group (20.69% vs 1.82%, P<0.001). No statistically significant differences regarding biochemical pregnancy and clinical miscarriage between the two groups were found. During the subgroup analysis, the cumulative live birth rate of the salpingectomy group (n=51) was significantly higher than that of the neosalpingostomy group (n=48) in women younger than 35 years old (HR=2.25, 95%CI 1.39-3.66), while between two groups of women aged 35 years old or older, there was no statistically significant difference in the cumulative live birth rate (HR=1.60, 95%CI 0.36-7.19). In addition, after adjustment for confounding factors including age, previous abortion history, fibroid, benign ovarian cyst, and endometriosis, COX proportional hazard analysis revealed that salpingectomy was positively correlated to live birth compared with neosalpingostomy (aHR=1.94, 95%CI 1.18-3.18). Conclusion ·For infertile women with bilateral severe hydrosalpinx, neosalpingostomy provides the possibility for spontaneous conception but also brings about certain risk of ectopic pregnancy. Bilateral salpingectomy can achieve higher cumulative live birth rate while receiving postoperative in vitro fertilization treatment. [ABSTRACT FROM AUTHOR]

目的探索激素替代疗法（HRT-FET）周期中，单独使用阴道微粒化黄体酮（MVP）作为黄体支持时，血清低孕酮（P4）水平对活产、胎龄和新生儿出生体质量的不良影响是否可通过联合口服地屈孕酮（DYG）得到改善。方法本研究分析了单独使用MVP的549个HRT-FET周期，并匹配年龄、血清P4水平的同期联合使用MVP和DYG的495个周期。主要结果指标为活产率（LBR），次要结果为临床妊娠率（CPR）、孕周（GW）和新生儿出生体质量（BW）。结果验孕日孕酮P4上升是获得活产的保护因素，单独使用MVP情况下，P4水平vs. 40.7%，P＜0.001），CPR （34.6% vs. 50.1%，P＜0.001）、足月分娩率 （18.6% vs. 32.6%，P=0.003） 和新生儿正常出生体质量（normal birth weight， NBW）发生率（17.9% vs. 34.4%，Pvs. 40.6%，P=0.366），但显著延长新生儿分娩平均孕周［（37.28±3.01）周 vs.（38.36±1.48）周；P=0.043］，并提高新生儿NBW率（18.2% vs. 27.6%；P=0.039），降极低出生体质量和低出生体质量儿（LBW+VLBW）的比例（7.7% vs. 2.2%；P=0.037）。结论在单独使用MVP的HRT-FET周期中，低血清P4水平（

Objective: The aim of the present study is to compare the effects of Natural Cycle and modified Natural Cycle protocols for frozen-thawed embryo transfer on clinical pregnancy rate and live birth rate. Methods: This prospective randomized controlled trial comprised 145 patients scheduled for frozen-thawed embryo transfer and was conducted at a university hospital between 2019 and 2021. The Natural Cycle protocol was administered to 73 patients and the modified Natural Cycle protocol to 72 patients and the clinical outcome was compared between the groups. The main outcome measure was live birth rate. Results: Baseline characteristics and cycle parameters were similar in both groups. There was no difference in clinical pregnancy rate (58.9% and 54.2%, respectively; p =.565) and live birth rate between the Natural Cycle and modified Natural Cycle groups (49.3% and 48.6% respectively; p =.932). Conclusion: This study established that clinical pregnancy and live birth rates were not affected by natural cycle ovulation being spontaneous or hCG-triggered among patients undergoing frozen-thawed embryo transfer. Thus, the protocol for natural cycle frozen-thawed embryo transfers should be chosen according to the priorities of the patient and the physician. [ABSTRACT FROM AUTHOR]

Background: The role of motile sperm count in intrauterine insemination (IUI) success rate is controversial. This retrospective cohort study performed among unselected infertile couples undergoing IUI was to explore the association between the total progressive motile sperm count (TPMSC) and the live birth rate (LBR) following IUI. Methods: The total cohort of 5363 cycles, 2666 infertile couples between January 2015 and December 2018 and finally 5171 cycles, 2647 couples were included for analysis in Sun Yat-sen memorial hospital of Sun Yat-sen University. The primary outcome was LBR per cycle. And the secondary outcome measure was clinical pregnancy rate (CPR) per cycle. Results: From the receiver operating characteristic (ROC) analysis of female age predicting live birth, female age cutoff was defined as 28 years. With a female age of ≤28 years, the CPRs were 11.5%, 14.9%, 16.1%, and 15.8% in quartile groups of pre-wash TPMSC, respectively. For the LBRs the values were 9.4%, 12.9%, 14.4%, and 11.3%, and there were also no significant differences in quartile groups of pre-wash TPMSC with ≤24 million (M), [24M–50M], [50M–97M], >97M. No statistically significant differences in the CPRs (p =.051) and LBRs (p =.088) were also observed in the quartiles groups of post-wash TPMSC. With a female age of >28 years, the CPR in couples with post-wash TPMSC ≤22.32 M was significantly lower than with post-wash TPMSC >81.0 M (p =.007). There was an obvious trend in which CPRs and LBRs increased with the post-wash TPMSC during the <81 M interval in women >28 years. Conclusions: The optimal female age cutoff for live birth was 28 years in IUI cycles. Pre-wash and post-wash TPMSC were not significantly associated with CPR and LBR per cycle. When female age >28 years, there was a better outcome with post-wash TPMSC >22.32 million. [ABSTRACT FROM AUTHOR]

The aim of this retrospective analysis was to explore whether an elevated ALT level before pregnancy is associated with a reduction in live birth rate after IVF-FET. Retrospective observational study. Shiyan People's Hospital, China between January 2019 and December 2019. Women aged ≤ 40 years. Freeze-thawed embryo transfer (FET) The live birth rate, which was defined as the delivery of a live baby after 24 weeks of gestation. The analysis included 365 FET cycles. There was a significant difference between groups in the live birth rate (p <.05), which was highest for the low ALT tertile and lowest for the high ALT tertile. Multiple regression analysis with adjustment for multiple potential confounders revealed that the odds of live birth were decreased for each one standard deviation increase in ALT (OR = 0.56, 95%CI = 0.42–0.75, p <.0001) and lower for the high ALT tertile than for the low ALT tertile (OR = 0.38, 95%CI = 0.19–0.75, p =.0055). Smooth curve fitting showed an inverse relationship between ALT and live birth rate. Our findings indicate that relatively small elevations in baseline serum ALT level can have a clinically relevant impact on the success of FET. [ABSTRACT FROM AUTHOR]

Aim of this study was to evaluate the effects of dual triggering with gonadotropin releasing hormone agonist and human chorionic gonadotropin (hCG) on outcomes of fresh embryo transfers following gonadotropin antagonist cycles in POSEIDON group 3 and group 4 low prognosis women and to compare the outcomes with hCG-only triggering. This study was conducted by retrospective analysis of patients with expected poor ovarian response (POSEIDON group 3 and 4) that underwent fresh embryo transfers following in-vitro fertilization/intracytoplasmic sperm injection cycles with either dual triggering or hCG-only triggering between January 2010 and April 2020. A total of 1068 women that underwent dual triggering and 1931 that underwent hCG-only triggering were included in the study. Number of retrieved oocytes, M2 oocytes, oocyte maturation rate, fertilization rate, obtained 2PN embryos, implantation rate, clinical pregnancy rate and live birth delivery rates were found significantly higher in dual-triggering group in comparison to hCG-only group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.02, p < 0.001 respectively). Dual trigger with concomitant injections of GnRH agonist and hCG in GnRH antagonist cycles appears to improve IVF outcomes, increase quality of embryos, reduce miscarriage rates and consequently increase live birth delivery rates in POSEIDON groups 3/4 poor responders. [ABSTRACT FROM AUTHOR]

目的探讨宫腔粘连（IUA）不同分类标准在预测其术后生殖结局方面的意义。方法搜集2017年1月至2018年2月在重庆市妇幼保健院诊断IUA并且进行宫腔镜手术的患者，最后纳入178名作为研究对象。所有入选患者均行宫腔粘连分离术，分别采用美国AFS评分、欧洲ESGE评级、Nasr评分以及国内评分系统进行完整评分，分析比较不同评分系统对IUA患者术后妊娠率和活产率的预测价值。结果① 术前不同月经类型、术后不同月经恢复情况及输卵管开口是否可见的妊娠率及活产率组间差异无统计学意义（P＞0.05）。不同粘连范围及粘连性质的妊娠率及活产率组间差异有统计学意义（P＜0.05）。② 在4种评分标准下，不同粘连程度间的妊娠率差异有统计学意义（P＜0.05）；AFS评分、ESEG评级、Nasr评分下不同粘连程度间的活产率差异有统计学意义（P＜0.05），而国内评分下不同粘连程度间的活产率异无统计学意义（P＞0.05）。③ 各评分系统对妊娠结局的预测效能：AFS评分、ESEG评级、Nasr评分内国内评分妊娠率曲线下面积（AUC）依次为0.609、0.602、0.645和0.588；活产率AUC依次为0.596、0.617、0.638和0.575。国内评分下妊娠率、活产率的AUC最小，Nasr评分下妊娠率、活产率的AUC最大，但均＜0.7。结论粘连范围越大、性质越偏肌性、程度越重，其生殖结局越差；AFS评分、ESGE评级、Nasr评分以及国内评分系统在预测生殖结局方面均存在一定缺陷。临床上需进一步探讨及制定更合理的评分标准来预测生殖结局。

目的分析卵裂期无可移植胚胎的患者，在第5天新鲜移植Gardner I期，Ⅱ期囊胚的临床结局，探讨最佳的移植策略。方法回顾性分析2014年1月至2019年12月本中心行IVF治疗，卵裂期无可移植胚胎行囊胚培养并且单囊胚移植的患者，其中 I期囊胚移植组97个周期，Ⅱ期囊胚移植组81个周期，对照组为第3天为2级胚胎的卵裂胚新鲜移植组754个周期（对照组 1），卵裂期无可移植胚胎的第6天冷冻囊胚FET周期144例（对照组 2）。研究组和对照组均为单囊胚/单胚胎移植周期。分析各组的临床结局及新生儿情况，包括活产率，临床妊娠率，早期流产率，继续妊娠率，新生儿出生孕周，体质量，身长。结果与对照组1相比，新鲜周期第5天的Ⅰ期囊胚移植组活产率（7.22% vs. 18.83%），临床妊娠率（11.34% vs. 25.33%）和继续妊娠率（7.22% vs. 19.89%）均显著下降（PP>0.05）。Ⅱ期囊胚移植组与对照组1相比，临床结局以及新生儿情况比较，差异均无统计学意义（P>0.05）。与对照组2相比，新鲜周期第5天的Ⅰ期囊胚移植组活产率（7.22% vs. 15.97%），临床妊娠率（11.34% vs. 24.31%）和继续妊娠率（7.22% vs. 15.97%）均显著下降（PP>0.05）。Ⅱ期囊胚移植组与对照组2相比，临床结局以及新生儿情况比较，差异均无统计学意义（P>0.05）。结论对于卵裂期不可移植胚胎行囊胚培养，第5天的I期囊胚继续延长培养后FET移植，Ⅱ期囊胚新鲜移植，可获得较高的临床妊娠率和活产率。

Objective To compare the efficacy and safety of domestic and imported recombinant human follicle stimulating hormone (rFSH) preparation for ovulation induction in non-low-response population with long-acting program in follicular phase. Methods Non-ovarian infertility patients with low response were retrospectively enrolled in our center for the first time to receive long-acting follicular phase IVF/ICSI assisted fertility treatment, all of whom received a COS long-acting follicular phase therapy, and were divided into the domestic rFSH group (n=267) and the imported rFSH group (n=240) according to different use of rFSH. Ovarian response, medication, egg fertilization and embryo, fresh embryo transfer and embryo thawing transfer were compared between the two groups. Results During the process of superovulation, the level of E2 on HCG day was lower in the domestic rFSH group than that in the imported rFSH group (P＜0.05). There were no significant differences in total Gn, days of Gn use, the number of MⅡ eggs, the number of D3 excellent embryos and number of high-quality blastocysts between the two groups (P＞0.05). In the primary efficacy indicators, there were no significant differences in the average number of egg retrieved, cumulative live birth rate of one COS number of fresh embryos, the clinical pregnancy rate in the transplantation cycle, and the clinical pregnancy rate in the freeze-thaw transplantation cycle between the two groups (P＞0.05). Conclusion Compared with imported rFSH in the follicular phase, domestic rFSH can achieve the same safe efficacy and clinical outcome in non-low response patients. [ABSTRACT FROM AUTHOR]

Objective: Individual dynamic weight management for overweight and obese patients undergoing in vitro fertilization embryo transfer (IVF-ET), to explore the effect of this intervention method on weight control and pregnancy outcome. Methods: From May 2017 to December 2018, a total of 99 overweight and obese patients who were hospitalized in our hospital for IVF-ET were randomly divided into experimental group (50 cases) and control group (49 cases). The methods of individual dynamic weight management and routine intervention were used to manage the weight of the two groups, and the differences of relevant indicators before and after the intervention were recorded and statistically analyzed. Results: The BMI D-value between the two groups before and after intervention was statistically significant (P<0.05), but no significant difference in intimal thickness, number of retrieved oocytes, available embryos and number of embryos transferred between the two groups (P>0.05). There was significant difference between the two groups in clinical pregnancy rate and live birth rate (P<0.05), but no significant difference in birth weight between the two groups (P>0.05), there was significant difference in intervention satisfaction score between the two groups (P<0.05). Conclusion: The intervention method of individual dynamic weight management can effectively reduce the weight of overweight and obese patients receiving IVF-ET, reduce body mass index, and improve the success rate and live rate of IVF-ET transplantation, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

【目的】探讨取消新鲜胚胎移植后冷冻胚胎移植时机是否对临床妊娠率及活产率有影响。【方法】 回顾性分析2014年1月至2015年12月期间本中心行体外受精-胚胎移植技术（IVF-ET）的患者资料，取消新鲜 胚胎移植后行冻胚移植共1 785周期，共355周期纳入本研究。以促排周期取卵日与第一次冷冻胚胎移植日的 间隔时间进行分组，小于等于45 d为邻近组（n = 79），大于45 d为非临近组（n = 276）。同时将两组按促排方案 各自再分为两个亚组，促性腺激素释放激素激动剂方案（简称激动剂方案）临近组（n = 44）、和非临近组（n = 191），促性腺激素释放激素拮抗剂方案（简称拮抗剂方案）临近组（n = 35）和非临近组（n = 85）。主要观察指标 为临床妊娠率（CPR）、活产率（LBR），分析各组及亚组间的差异。【结果】临近组与非临近组研究对象的年龄、 不孕年限、不孕因素、体质量指数（BMI）、基础卵泡刺激素（FSH）值、促性腺激素（Gn）总量、HCG日孕酮（P）水平 及获卵数等结果差异无统计学意义（P > 0.05）。而窦卵泡计数（AFC）、HCG日E2水平、Gn时间、促排卵方案、以 及FET内膜准备方案的差异有统计学意义（P < 0.05），其中临近组多囊卵巢综合征患者较非临近组多（50.6% vs. 30.8%，P = 0.001）。临近组与非临近组的临床妊娠率（51.9% vs. 48.2%，P = 0.561）、活产率（43.0% vs. 38.4%， P = 0.458）差异无统计学意义。比较不同促排卵方案亚组，激动剂方案：临近组与非临近组的临床妊娠率 （52.3% vs. 46.6%，P = 0.497）和活产率（45.5% vs. 36.6%，P = 0.279）；拮抗剂方案：临近组与非临近组的临床妊娠 率（51.4% vs. 51.8%，P = 0.973）和活产率（40.0% vs. 42.4%，P = 0.812），差异均无统计学意义。【结论】IVF周期 取消移植后立即行FET的CPR和LBR与至少经历一次月经后的FET无明显无差异。

摘要：【目的】探讨基础血清抗苗勒管激素（AMH）水平与新鲜周期和冷冻周期活产率的关系及血清AMH水平对胚 胎移植的活产率的预测价值。【方法】选取2010年6月-2015年5月在我生殖中心进行第一次新鲜或冷冻胚胎移植周期的 不孕患者共2 942例进行回顾性分析。排除多囊卵巢综合征的患者。根据不孕患者的血清AMH水平分为低AMH水平组 （< 1.1 ng/mL，485例），中AMH水平组（1.1 ~ 7.0 ng/mL，1 989例）及高AMH水平组（> 7.0 ng/mL，468例）。再根据年龄将患者 分成不同的年龄亚组：A组：≤ 29岁，B组：30 ~ 34岁，C组：35 ~ 39岁及D组：40岁以上。比较同一年龄组内不同血清AMH 水平的种植率、临床妊娠率、流产率及活产率的差异。进一步采用多元回归分析方法分析基础血清AMH 对活产率的影 响。利用受试者工作特征曲线分析（ROC），评估血清AMH对活产率的预测价值。【结果】（1）在新鲜胚胎和冷冻胚胎移植周 期，基础血清AMH水平均与临床妊娠结局相关，血清AMH水平越低，种植率越低，同样临床妊娠率越低，活产率越低，而流 产率则越高，差异均有统计学意义。（2）年龄亚组分析显示，在新鲜及冷冻周期，A、B及C组的患者的基础血清AMH与活产 率相关，AMH越低，活产率越低，差异均有统计学意义。D组患者的基础血清AMH与冷冻周期的活产率相关（P < 0.05），与 新鲜周期的活产率无关（P = 0.092）。多元回归分析显示，在纳入了年龄、不孕年限、不孕原因、移植胚胎数、内膜准备方案 等影响结局的因素后，血清AMH对活产率的影响仍保持有统计学意义。（3）基础血清AMH预测新鲜周期及冷冻周期胚胎移 植活产率的受试者工作特征曲线（ROC）下面积分别为0.647、0.633。【结论】基础血清AMH是反映卵巢储备的良好指标之 一，与胚胎移植周期的妊娠结局有相关性，基础血清AMH水平越低，活产率越低。基础血清AMH是影响胚胎移植周期活产 率的独立影响因素，但对活产率的预测价值有限。

Objective: To evaluate the impact of ovarian stimulation on the outcome of intrauterine insemination (IUI).Design: Retrospective analysis.Setting: A single university-based centre.Population: A total of 5109 couples with 8893 cycles.Methods: The outcome of IUI with different protocols for ovarian stimulation was examined.Main Outcome Measures: The live birth rate (LBR), twin pregnancy rate and ovarian hyperstimulation syndrome (OHSS).Results: In ovulatory women without ovarian stimulation, the LBR was 7.6%. Stimulation with clomifene citrate (CC), letrozole (LE), human menopausal gonadotrophin (HMG), CC or LE combined with HMG achieved LBRs of 6.1, 5, 7.9, 8 and 12.2%, respectively. LE combined with HMG achieved a significantly improved LBR compared with no stimulation. HMG stimulation was associated with a higher rate of twins (7.4%) than no stimulation (0%, P < 0.01). In ovulatory women, the LBR appeared lower in CC and LE compared with no stimulation (P > 0.05). In anovulatory women, ovarian stimulation with CC, LE, HMG, CC or LE combined with HMG achieved LBRs of 11.3, 5.1, 11.8, 12.6 and 13.6%, respectively. No significant difference was observed. There were no triplet pregnancies or OHSS in stimulated cycles.Conclusions: In ovulatory women, ovarian stimulation with LE combined with HMG achieved a significantly improved live birth rate. HMG stimulation resulted in a high risk for twins.Tweetable Abstract: In ovulatory women, ovarian stimulation with letrozole and HMG resulted in a significantly improved LBR. [ABSTRACT FROM AUTHOR]