简介:AbstractObjective:To evaluate the effect of preimplantation genetic testing for aneuploidy (PGT-A) in infertile patients with recurrent pregnancy loss (RPL).Methods:A prospective randomized clinical trial was performed in a university-affiliated fertility center in Shanghai, China. Patients in the PGT-A group underwent blastocyst biopsy followed by single-nucleotide polymorphism microarray-based PGT-A and single euploid blastocyst transfer, whereas patients in the control group underwent routine in vitro fertilization/ICSI procedures and frozen embryo transfer of 1-2 embryos selected according to morphological standards.Results:Two hundred and seven infertile patients with RPL were included in this study and randomly assigned to either the control or the PGT-A group. Baseline variables and cycle characteristics were comparable between the two groups. The results showed that PGT-A significantly improved the ongoing pregnancy rate (55.34% vs. 29.81%) as well as the live birth rate (48.54% vs. 27.88%) and significantly reduced the miscarriage rate (0.00% vs. 14.42%) on a per-patient analysis. A significant increase in cumulative ongoing pregnancy rates over time was observed in the PGT-A group. Subgroup analysis showed that the significant benefit diminished for patients who attempted ≥2 PGT-A cycles.Conclusions:PGT-A significantly improved the ongoing pregnancy and live birth rate, while reduced miscarriage rate in infertile RPL patients. However, the significance diminished in patients attempting ≥2 cycles; thus, further studies are warranted to explore the most cost-effective number of attempts in these patients to avoid overuse.
简介:AbstractBackground:More and more scholars have called for the cumulative live birth rate (CLBR) of a complete ovarian stimulation cycle as a key indicator for assisted reproductive technology. This research aims to study the CLBR of the first ovarian hyperstimulation cycles and analyze the related prognosis factors that might affect the CLBR.Methods:Our retrospective study included first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles performed between January 2013 to December 2014. A total of 17,978 couples of first ovarian hyperstimulation IVF/ICSI cycles were included. The study was followed up for 4 years to observe the CLBR. The multivariable logistic regression model was used to analyze the prognosis factor, P value of <0.05 was considered statistically significant.Results:The cumulative pregnancy rate was 58.14% (10,452/17,978), and the CLBR was 49.66% (8928/17,978). The female age was younger in the live birth group when compared with the non-live birth group (30.81 ± 4.05 vs. 33.09 ± 5.13, P < 0.001). The average duration of infertility was shorter than the non-live birth cohort (4.22 ± 3.11 vs. 5.06 ± 4.08, P < 0.001). The preliminary gonadotropin used and the total number of gonadotropin used were lower in the live birth group when compared with the non-live birth group (both P < 0.001). Meanwhile, the number of oocytes retrieved and transferrable embryos were both significantly higher in the live birth group (15.35 ± 7.98 vs. 11.35 ± 7.60, P < 0.001; 6.66 ± 5.19 vs. 3.62 ± 3.51, P < 0.001, respectively).Conclusions:The women’s age, body mass index, duration of infertility years, infertility factors, controlled ovarian hyperstimulation protocol, the number of acquired oocytes, and number of transferrable embryos are the prognosis factors that significantly affected the CLBR.
简介:CD8+细胞毒素的T淋巴细胞(CTL)疲劳是为在长期的传染疾病的无效病毒消除的一个主要问题。我们产生了新奇ovalbumin(卵)特定的OVA-Texo和导致治疗学的免疫的HIV特定的Gag-Texo疫苗。在长期的感染估计他们的治疗学的效果,我们由与表示卵的侵入人体气管粘膜的病菌AdVova感染C57BL/6老鼠的i.v开发了一个新长期的感染模型。在长期的AdVova感染期间,老鼠CTL被发现房间死亡protein-1(PD-1)和淋巴细胞激活gene-3(LAG-3)到禁止的分子规划了的快车,证明在T房间增长,IFN-生产和cytolytic的重要缺乏完成机能上地精疲力尽并且。天真的CD8+T房间upregulated禁止的PD-ligand1(PD-L1),B淋巴细胞和T淋巴细胞衰减器和T房间联系变应力缺乏的分子(圣盘和痒)当时下面调整在在有长期的感染的老鼠的刺激之上的proliferative反应。显著地,OVA-Texo疫苗抵抗了T房间变应力缺乏并且变换了CTL疲劳。后者与(i)被联系为CTL功能的一个标记的upregulation,diacetylatedhistone-H3(diAcH3),(ii)CTL,宿主DC的发生独立人士或CD4+T细胞的四折的增加,并且(iii)CTLIFN-生产和cytotoxicity的恢复。在vivoOVA-Texo-stimulatedCTLupregulatedmTORC1的活动小径相关的分子Akt,S6,eIF4E和T赌注,和有一个mTORC1禁止者的CTL的处理,rapamycin,显著地在CTL减少了OVA-Texo-induced增加。有趣地,发信号的OVA-Texo-mediatedCD40L在观察免疫学的效果起了一个关键作用。重要地,Gag-Texo疫苗在长期的感染导致了作呕特定的治疗学的免疫。因此,这研究应该为人的免疫不全在新治疗学的疫苗的发展有严肃的影响病毒(HIV-1)感染。