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Objective: To investigate the status quo and analyze the influencing factors of the knowledge, attitude, and practice of pre-hospital emergency among caregivers for older adults. Methods: In this cross-sectional study, 133 caregivers for older adults in Guangdong province, China, nursing homes were selected as survey participants from December 2021 to June 2022 via convenience sampling. All participants were administered a general information questionnaire and a Pre-Hospital Emergency Knowledge, Attitude, and Practice Questionnaire. For data analysis, we used descriptive and inferential statistics. Results: The scores on the knowledge, attitude, and practice dimensions were 24.65 ± 4.49, 24.52 ± 4.34, and 24.05 ± 4.67, respectively. Regression analysis showed that the age, professional skill level, and healthcare education experience of the caregivers were the main influencing factors of their pre-hospital emergency knowledge. Additionally, the presence/absence of direct participation in the pre-hospital emergency of the caregivers was the primary influencing factor of attitude, while education level and employment status were the factors mainly influencing pre-hospital emergency practice. Conclusion: Caregivers for older adults currently have a low-to-medium level of knowledge, attitude, and practice of pre-hospital emergency. The main factors affecting the implementation of pre-hospital emergency for caregivers in China are their older age, low education levels, temporary employment and imperfect occupational security system. [ABSTRACT FROM AUTHOR]

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Objectives: To compare the prevalence of chronic periodontitis between men who had semen abnormalities and those who had normozoospermia through a case–control study. Materials and Methods: Male patients who visited the assisted reproduction clinic of a large general hospital and were diagnosed with semen abnormalities were included in the case group. The control group was composed of patients of the same clinic with normozoospermia. The semen analysis included sperm concentration, count and progressive and total motility, which were measured in the laboratory. A questionnaire and clinical periodontal examination were conducted for all participants. Logistic regression was performed to explore the relationship between chronic periodontitis and male infertility. Results: A total of 192 participants were included: 63 participants (32.8%) had some type of semen abnormality (case group), while 129 participants (67.2%) had normozoospermia (control group). The case group had a significantly higher prevalence of moderate/severe periodontitis than the control group (33.3% vs. 17.8%, p =.012). The logistic regression showed that participants who had moderate/severe periodontitis had a greater chance of having semen abnormalities after adjusting for other confounding factors (OR = 3.377, p =.005). Conclusions: Periodontitis is associated with semen abnormalities and sperm motility in men. [ABSTRACT FROM AUTHOR]

Objective. To assess the effect of embryonic age on the pregnancy outcomes of blastocyst graded as CC in single frozen-thawed blastocyst transfer cycles. Methods. A total of 565 patients undergoing single frozen-thawed blastocyst transfer at Shanghai TOWAKO Hospital from April 2017 to December 2019 were included in this study, and they were divided into high-quality blastocyst group (grade AA, AB, and BA; n=189), medium-quality blastocyst group (grade BB, AC, and CA; n=114), low-quality blastocyst group (grade CB and BC; n=140) and CC grade blastocyst group (n=122). And the CC grade blastocysts were further divided into CC grade blastocysts of Day 5 (D5 subgroup, n=26), Day 6 (D6 subgroup, n=81) and Day 7 (D7 subgroup, n=15) according to the embryonic age. Thereafter, the cycle characteristics and pregnancy outcomes of the four groups and the three embryonic age subgroups of CC grade blastocysts were compared. Results. The clinical pregnancy rate (58.7% vs 54.4% vs 47.1% vs 25.4%, P=0.000) and live birth rate (46.2% vs 43.2% vs 36.2% vs 17.6%, P=0.000) of the high-quality, medium-quality, low-quality, and CC grade blastocyst groups decreased sequentially. Multivariate analysis showed that embryo quality was significantly correlated with clinical pregnancy rate. Compared with high-quality blastocyst group, CC grade blastocyst group had a lower clinical pregnancy rate (aOR=0.81, 95%CI 0.71 - 0.93, P=0.003). The analysis of CC grade blastocyst embryonic age subgroups showed that the clinical pregnancy rate (42.3% vs 23.5% vs 6.7%, P=0.040) and live birth rate (31.6% vs 15.6% vs 0, P=0.133) of the D5, D6 and D7 subgroups also decreased sequentially. Multivariate analysis showed that the embryonic age had a significant impact on the clinical pregnancy rate of CC grade blastocyst transfer. Compared with the D5 subgroup, the D7 subgroup had a lower clinical pregnancy rate (aOR= 0.69, 95%CI 0.49-0.96, P=0.032). Conclusion. D5 CC grade blastocysts predict good pregnancy outcome. Although the clinical pregnancy rate of D6 CC grade blastocysts is low, they are still useable. However, D7 CC grade blastocysts are of little clinical value. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of human chorionic gonadotrophin (hCG) at reduced doses of 2 000 IU and 3 000 IU for moderate or high responders with the dose of 5 000 IU in term of inducing final oocyte maturation for IVF/ICSI and the subsequent pregnancy outcome in frozen-thawed embryo transfer (FET). Methods: In the retrospective cohort study, 2 166 patients undergoing IVF/ICSI with moderate or high response were recruited and classified into three groups according to the trigger dose of hCG: 2 000 IU (group A, n=722), 3 000 IU (group B, n=722) and 5 000 IU (group C, n=722). The main outcome was the proportion of mature oocytes retrieved, fertilization rates, clinical pregnancy rates, cumulative pregnancy rates and incidence of ovarian hyperstimulation syndrome (OHSS). Results: No evidence of statistically difference was found in the proportion of mature oocytes retrieved (89.92%, 91.40%, 90.20%, respectively) and fertilization rate (79.8%, 80.07%, 80.51%, respectively) among groups A, B and C. Serum E2 level on the day of hCG injection, the number of mature oocytes retrieved and good-quality embryos in group A were significantly higher than those in group B and group C. Clinical pregnancy rates per transfer cycle (45.95%, 43.97% and 44.25%), ongoing pregnancy rates (43.17%, 40.91% and 42.53%), implantation rates (30.74%, 27.78% and 29.86%) and cumulative pregnancy rates per patient (58.31%, 53.6% and 54.85%) were comparable among groups A, B and C. The incidence of OHSS in groups A, B and C (0%, 0.14% and 0.28%) was low, with no significant difference. Conclusion: A reduced hCG dose of 2 000 IU for moderate or high responders leads to similar efficacy compared with a dose of 5 000 IU in inducing oocyte maturation without adversely affecting the pregnancy outcome meanwhile eliminating the risk of OHSS. [Copyright &y& Elsevier]

Objective: To study the clinical effects of Yupei Qisun Sequential Method (YQSM, by Shen supplementing and Pi invigorating) of Chinese medicine on correlated indices of repeated implantation failure patients in the fresh cycle., Methods: Sixty patients with more than three failure cycles of in virto fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) were recruited. They were assigned to the treatment group (treated by IVF/ICSI and Chinese medicine) and the control group (treated by IVF/ICSI alone), 30 in each group. The total dose of gonadotropin (Gn), the days of controlled ovary hyperstimulation (COH), the thickness of endometrium on the day of embryo transplantation, the number of retrieved oocytes, the fertilization number, the embryo number, the high quality embryo number, the pregnancy rate, and the implantation rate were compared., Results: In the treatment group the numbers of embryo and high quality embryo were 7.5 +/- 4.9 and 5.1 +/- 3.2 respectively, which were both higher than those of the control group with significant difference (5.1 +/- 3.2, 3.2 +/- 1.8; P < 0.05). No significant difference existed in aspects of the total numbers of Gn, the days of COH, the thickness of endometrium on the day of embryo transplantation, the numbers of retrieved oocytes, the fertilization number, the pregnancy rate, and the implantation rate between the two groups (P > 0.05)., Conclusion: YQSM combined with COH could improve the quantity and the quality of embryos, which was promising to increase the accumulative pregnancy rate of RIF patients.

Objective: To survey birth defects of neonates conceived by using various types of in vitro fertilization and embryo transfer (IVF-ET) between 1998 and 2007 in Shanghai., Methods: From 1998 to 2007, 8507 neonates from 6551 pregnancies conceived through assistant reproductive technology (ART) from 7 reproductive medicine center in Shanghai were enrolled in this retrospective study, including Shanghai Ji-Ai Genetics and IVF Institute, Shanghai Jiaotong University School of Medicine affiliated Renji Hospital, Ruijin Hospital, China Welfare Institute International Maternal and Infant Health Hospital, Shanghai First Maternity and Infant Health Hospital, Shanghai the Ninth People's Hospital and the Second Military Medical University affiliated Changhai Hospital. The clinical data about the type and incidence of birth defect were analyzed. Meanwhile, the factors associated with birth defect were investigated, such as various ART, gender, mother age, numbers of gestational sac, the source and quality of sperm., Results: The birth defect rate was 1.08% (92/8507) and the most remarkable malformation occurred in circulation system [34% (31/92)]. The rates of major congenital malformations were 1.21% (34/2799) in fresh conventional IVF-ET, 1.07% (20/1871) in IVF-frozen-thawed embryo transfer (IVF-FET), 1.04% (23/2212) in fresh intracyto plasmic sperm injection (ICSI)-ET and 0.92% (15/1625) in ICSI-FET, which did not show statistical difference (P > 0.05). There was also no significantly different incidence of malformations between 1.12% (49/4371) in male neonates and 1.02% (42/4136) in female neonates (P > 0.05). However, the occurrence of congenital malformation is positively related with maternal age, the rates were 0.84%(41/4884) in mother's age less than 30 years and 1.77% (16/902) in mother' age more than 35 years, which reached statistical difference (P < 0.05). It also showed remarkable different incidence among 0.53% (25/4679) in singletons, 1.59% (57/3576) in twins and 3.97% (10/252) in triplets (P < 0.05). No remarkable difference of malformation rate among sperm sources used in fertilization were observed, including 1.09% (81/7419) in ejaculated sperm, 1.21% (7/579) in percutaneous epididymal aspiration (PESA) and 0.79% (4/509) in donor sperm (P > 0.05)., Conclusions: The overall incidence of birth defect in neonates from ART is similar to those conceived naturally and is not associated with different types of IVF-ET, embryo cryopreservation, sperm sources. However, maternal age and multiple pregnancies confer the higher possibility of birth defect.

Objective: To explore the effectiveness of the fallopian tubes embolization for the hydrosalpinx before in vitro fertilization and embryo transfer (IVF-ET)., Methods: The fallopian tubes embolization was performed on 46 hydrosalpinx patients. First, the hysterosalpingography was performed to show the positions and shape of the hydrosalpinx. Then the hydrops was drawn into the celiac cavity in order to be absorbed after performing fallopian tube recanalization. Finally, transvaginal therapy was performed, putting the embolization microcoils into the fallopian tube through a micro-catheter One month after the fallopian tubes embolization, hysterosalpingography was conducted to check for the effectiveness of the embolization. After 3 months, all the 46 patients received the treatment of IVF-ET., Results: The interventional treatment of 82 fallopian tubes obtained one time success among 46 cases of fallopian tubes embolization. Among them, obvious results were achieved in 72 fallopian tubes, taking up 88% of the total; effective results were seen in 10 fallopian tubes, accounting for 12% of the total. No one was invalid. In the same period, compared with the 91 cases of non-hydrosalpinx as the control group, the embolization group of patients achieved a higher fertilization rate (69%), and clinical pregnancy rate (41%), compared with the control group (63% and 39% respectively), but without a significant difference ( P>0.05). However, the ectopic pregnancy rate (0) and the abortion rate (8%) were significantly lower than the control group (8%, 16% respectively; P<0.05)., Conclusions: Fallopian tubes embolization used in hydrosalpinx treatment before IVF-ET is an innovative approach, simple, safe, economical, with no negative impact on ovarian function. It can significantly increase the clinical pregnancy rate and prevent the occurrence of tubal pregnancy. It is a feasible and effective method.