简介：AbstractThe International Society of Reproductive Genetics (ISRG) assembled a workgroup made up of clinicians, clinical laboratory directors, and scientists for the purpose of creating the guidelines for preimplantation genetic testing (PGT). The most up-to-date information and clinical insights for the optimal PGT practice were incorporated in these guidelines. Recommendations are provided for embryologists, medical geneticists, clinical laboratorians, and other healthcare providers to improve the wellbeing of patients seeking assisted reproductive treatment and their offspring.

简介：AbstractObjective:To evaluate the effect of morphologic factors on survival rate (SR), pregnancy rate (PR), and implantation rate (IR) of human embryo vitrification following frozen embryo transfer (FET) on day 3 post-ovulation.Methods:Women undergoing FET (n = 921) with embryos cryopreserved by vitrification between 2012 and 2013 were enrolled in this retrospective cohort study.Results:Embryos with >9 blastomeres yielded the highest SR of 100%. Lower SR was observed in embryos with 5 to 6 (57.5%) and 4 blastomeres (41.4%). In terms of blastomere symmetry, the SR of embryos with equally sized blastomeres was significantly higher than that of embryos with unequally sized cells (82.5% vs. 64.6%, P < 0.05). As fragmentation increased, SR decreased from 92.1% to 20.6% (P < 0.05). Significant differences were observed among groups when analyzing PR and IR according to the 3 embryonic parameters before vitrification. Embryos with 13 to 16 blastomeres yielded the highest PR (39.5%) and IR (24.1 %). The PR and IR of embryos with blastomeres of equal size were significantly higher than those with unequally sized blastomeres (36.5% vs. 21.7%, 23.7% vs. 12.4%, P < 0.05). After warming, embryos with 13 to 16 blastomeres yielded the highest PR and IR (40.9% and 24.2%, respectively). The PR and IR were observed to grow with an increase in the percentage of intact blastomeres (23.2%-38.2%, 14.2%-23.2%).Conclusions:These results show that vitrification methods do not effectively improve survival outcomes for embryos of poor quality and it is needed to develop a comprehensive vitrification protocol that considers all the practical aspects, including the current limitation regarding cleavage-stage embryos of poor quality.

简介：AbstractObjective:To investigate the efficacy of in-phase and quadrature (IQ) demodulation in electronic fetal heart rate monitoring (EFM) to reduce false reports of fetal heart rate (FHR) doubling or halving.Methods:This is a prospective cohort study. A total of 263 full-term pregnant women who delivered at Peking University Shenzhen Hospital between August 2019 and July 2020 were prospectively enrolled in the study. FHR monitoring began when the cervix was dilated to 2-3 cm and continued until delivery. Raw fetal Doppler audio signals and internal and external cardiotocography curves from internal electrode monitoring, EFM with conventional demodulation (external), and EFM with IQ demodulation (external) were acquired to compare FHR doubling and halving time. In cohort 1, FHR was compared between IQ demodulation and conventional demodulation. In cohort 2, FHR was compared between IQ demodulation, conventional demodulation, and internal FHR monitoring. Count data were statistically analyzed using the Chi-squared test, and measurement data were statistically analyzed using t-test for correlation coefficients, and Bland-Altman analysis for concordance ranges.Results:To compare IQ demodulation and conventional demodulation, 225 pregnant women were monitored for a total of 835,870 seconds. The beat-to-beat interval of FHRs in raw fetal Doppler audio signals was used as the reference. The results showed a doubling time of 3401 seconds (0.407%, 3401/835,870) and a halving time of 2918 seconds (0.349%, 2918/835,870) with conventional demodulation, compared to 241 seconds (0.029%, 241/835,870) and 589 seconds (0.070%, 589/835,870), respectively, with IQ demodulation. IQ demodulation reduced FHR doubling by approximately 93% (3160/3401) and FHR halving by approximately 80% (2329/2918) compared to conventional demodulation (P < 0.01).To compare IQ demodulation, conventional demodulation, and internal FHR monitoring, 38 pregnant women were monitored for a total of 98,561 seconds. FHR from internal electrode monitoring was used as the reference. The results showed a doubling time of 238 seconds (0.241%, 238/98,561) and a halving time of 235 seconds 0.238%, 235/98,561) with conventional demodulation, compared with 30 seconds (0.030%, 30/98,561) and 81 seconds (0.082%, 81/98,561), respectively, with IQ demodulation (P < 0.05). No significant difference was observed in doubling or halving time between IQ demodulation and internal FHR monitoring (P > 0.05). IQ demodulation was more closely correlated with internal FHR monitoring than conventional demodulation (0.986 vs. 0.947). The Bland-Altman analysis showed that the concordance range of IQ demodulation vs. internal FHR monitoring was significantly narrower than that of conventional demodulation vs. internal FHR monitoring ((-5.32,6.01) vs. (-10.87,11.46)).Conclusion:EFM with IQ demodulation significantly reduces false FHR doubling and halving, with an efficacy similar to that of internal FHR monitoring.

简介：AbstractBackground:Urticaria is a common skin disease characterized by episodes of wheals, and it has a negative effect on patients’ quality of life. Large-scale population-based epidemiological studies of urticaria are scarce in China. The aim of this survey was to determine the prevalence, clinical forms, and risk factors of urticaria in the Chinese population.Methods:This survey was conducted in 35 cities from 31 provinces, autonomous regions, and municipalities of China. Two to three communities in each city were selected in this investigation. Participants completed questionnaires and received dermatological examinations. We analyzed the prevalence, clinical forms, and risk factors of urticaria.Results:In total, 44,875 questionnaires were distributed and 41,041 valid questionnaires were collected (17,563 male and 23,478 female participants). The lifetime prevalence of urticaria was 7.30%, with 8.26% in female and 6.34% in male individuals (P < 0.05). The point prevalence of urticaria was 0.75%, with 0.79% in female and 0.71% in male individuals (P < 0.05). Concomitant angioedema was found in 6.16% of patients. Adults had a higher prevalence of urticaria than adolescents and children. Living in urban areas, exposure to pollutants, an anxious or depressed psychological status, a personal and family history of allergy, thyroid diseases, and Helicobacter pylori infection were associated with a higher prevalence of urticaria. Smoking was correlated with a reduced risk of urticaria.Conclusion:This study demonstrated that the lifetime prevalence of urticaria was 7.30% and the point prevalence was 0.75% in the Chinese population; women had a higher prevalence of urticaria than men. Various factors were correlated with urticaria.

简介：AbstractBackground:Empiric therapy for patients with unexplained recurrent pregnancy loss (URPL) is not precise. Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age. The clinical outcomes of URPL patients who have undergone in vitro fertilization-embryo transfer (IVF-ET) require elucidation. The IVF outcome and influencing factors of URPL patients need further study.Methods:A retrospective cohort study was designed, and 312 infertile patients with URPL who had been treated during January 2012 to December 2015 in the Reproduction Center of Peking University Third Hospital were included. By comparing clinical outcomes between these patients and those with tubal factor infertility (TFI), the factors affecting the clinical outcomes of URPL patients were analyzed.Results:The clinical pregnancy rate (35.18% vs. 34.52% in fresh ET cycles, P = 0.877; 34.48% vs. 40.27% in frozen-thawed ET cycles, P = 0.283) and live birth rate (LBR) in fresh ET cycles (27.67% vs. 26.59%, P = 0.785) were not significantly different between URPL group and TFI group. URPL group had lower LBR in frozen-thawed ET cycles than that of TFI group (23.56% vs. 33.56%, P = 0.047), but the cumulative LBRs (34.69% vs. 38.26%, P = 0.368) were not significantly different between the two groups. The increased endometrial thickness (EMT) on the human chorionic gonadotropin day (odds ratio [OR]: 0.848, 95% confidence interval [CI]: 0.748-0.962, P = 0.010) and the increased number of eggs retrieved (OR: 0.928, 95% CI: 0.887-0.970, P = 0.001) were protective factors for clinical pregnancy in stimulated cycles. The increased number of eggs retrieved (OR: 0.875, 95% CI: 0.846-0.906, P < 0.001), the increased two-pronucleus rate (OR: 0.151, 95% CI: 0.052-0.437, P < 0.001), and increased EMT (OR: 0.876, 95% CI: 0.770-0.997, P = 0.045) in ET day were protective factors for the cumulative live birth outcome.Conclusion:After matching ages, no significant differences in clinical outcomes were found between the patients with URPL and the patients with TFI. A thicker endometrium and more retrieved oocytes increase the probability of pregnancy in fresh transfer cycles, but a better normal fertilization potential will increase the possibility of a live birth.