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15 September 2017, Volume 36 Issue 5
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Prediction of PGD Outcome Based on the Follicular Output Rate ZHANG Yuan, SHU Li, WU Wei, MA Xiang, MAO Yun-dong, WANG Wei, LIU Jia-yin 2017, 36 (5):  357-360.  Abstract ( 1440 )   PDF (877KB) ( 8529 )   Objective：To evaluate the follicular output rate (FORT) as a prognostic indicator of response to ovarian and the reproductive competence after PGD. Methods: A total of 158 PGD patients who underwent controlled ovarian stimulation using a long protocol were retrospectively studied. FORT was calculated as the ratio of preovulatory follicle count on the day of stimulation×100/small antral follicle count (3-10 mm in diameter) at baseline. Patients were divided into 2 groups：the low FORT group（79 women） and the high FORT group (79 women）. The response of ovarian and IVF-ET pregnancy outcome were analyzed. Results: Among 158 PGD cycles, the numbers of retrieved oocytes and embryos available for transfer in the high FORT group were significantly higher than those in the low FORT group (P＜0.05). However, there were no significant differences in the 2PN fertility rate, good-quality embryos rate and blastocyst formation rate between two groups (P＞0.05). Conclusions: FORT can be used as a index to predict effectively the number of oocytes retrieved and the number of embryos for transfer in the PGD cycle, but it cannot predict the developmental potential of the embryo. Related Articles | Metrics

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Trial of Recombinant Human Growth Hormone in Women with Normal Ovarian Response Undergoing In Vitro Fertilization and Embryo Transfer OUYANG Xiao-e, HU Rong 2017, 36 (5):  361-363.  Abstract ( 1524 )   PDF (848KB) ( 8472 )   Objective：To investigate the effect of recombinant human growth hormone (rhGH) on the clinical outcomes of those patients with normal ovarian response undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods: A total of 180 patients with normal ovarian response undergoing IVF-ET in our hospital, from January 2014 to December 2016, were divided into two groups． The study group (n=91) received the routine long-term protocol of controlled ovarian hyperstimulation (COH) and rhGH treatment. The control group (n=89) only received the routine long-term protocol of COH. The basic characteristics and pregnancy outcomes of two groups were compared. Results：There were no significant differences in the duration of infertility, gonadotropin dosage, the ratio of type A endometrium and the number of transplanted embryos between the two groups (all P＞0.05). The age, BMI, endometrial thickness and the level of estrogen on hCG day and the number of embryo with high quality in the study group were significantly higher than those in the control group (P＜0.05). Compared with the control group, the study group had a limited increase in the implanting rate and clinical pregnancy rate（but P＞0.05）. Conclusions: In those patients with normal ovarian response undergoing IVF-ET, rhGH can promote the egg maturation, embryo and endometrial development, and improve the endometrial tolerance. However, rhGH can not improve the clinical pregnancy outcome of the patients with normal ovarian response. Related Articles | Metrics

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Analysis of Ovarian Stimulation with HMG Combined with Low-dose hCG and Successful Pregnancy in 4 Patients with Hypogonadotropic Amenorrhea, and A Brief Review WANG Hai-yan, LI Bei-qing, GU Zhu-jun 2017, 36 (5):  364-367.  Abstract ( 1653 )   PDF (844KB) ( 8606 )   Objective：To investigate the effect of ovarian stimulation with HMG combined with low-dose of hCG on those inferlity patients with hypogonatropic hypogonadism and amenorrhea. Methods:  Four infertility patients with hypogonatropic hypogonadism and amenorrhea were treated with HMG and low-dose of hCG for two cycles after one treatment with only HMG for four cycle, as for their ovarian stimulation. Follicular development was monitored by vaginal ultrasound-B and serum sexual hormone. Results: Totally, there were 4 cycles of only HMG treatment, and 8 cycles of HMG+hCG treatment. Compared with the only HMG cycles, the HMG+hCG cycles had the number of dominant follicles between 1 and 4, the cumulating pregnancy rate 50%, no moderate and severe OHSS, and a term birth for every patient.  Conclusions: The protocol of HMG combined with low-dose of hCG can be tried in those infertility patients with hypogonatropic hypogonadism for ovarian stimulation. However, the safety and efficiency of this combined protocol should be tested by other clinical trials and large samples. Related Articles | Metrics

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Effect of Ulipristal Acetate on Human Sperm Parameters: An In Vitro Trial WANG Lu, DUAN Biao, SHI Zhen 2017, 36 (5):  368-372.  Abstract ( 1311 )   PDF (1716KB) ( 8408 )   Objective：Ulipristal acetate (UPA), a progesterone receptor modulator, has been used as an emergency contraceptive. In this study, we investigated the effect of UPA on human sperm parametersby in vitro experiments. Methods: Fifteen semen samples with normal parameters were used. After liquidation and resuspend with G-IVF, each sample was sub-divided into 6 groups, 0.5 mL each sample. Spermatozoa were incubated in the culture medium containing 0.04, 0.4, 4 and 40 μmol/L of UPA. Two controls were the blank control and the DMSO control. The sperm viability, motility, DNA integrity, acrosome reaction, sperm hyperactivation, and intracellular free calcium concentration were measured. Results: There were no significant differences in the viability, motility and morphology among two controls and four treatment groups (P＞0.05). In those groups treated with UPA at greater concentration than 0.4 μmol/L, the ratio of DNA damage and tail moment were significantly increase, the ratio of sperm hyperactivation was reduced, and the acrosome reaction and the calcium ion concentration in spermatozoa were significantly reduced (P＜0.01). Conclusions: In the in vitro experiments, we found that UPA inhibited the acrosome reaction and hyperactivation of human sperm, and decreased the concentration of intracellular calcium. These actions could be related to the sperm damage induced by UPA. Related Articles | Metrics

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Cardiovascular Protection of 17β-estradiol by Down-regulating the Expression of MCP-1 and RhoA LIU Wen-hua, ZHANG Zhi-fen, TANG Shan-shan, CHEN Lin-jie，HUANG Zhe-ren, WEI Shuang-shuang 2017, 36 (5):  373-377.  Abstract ( 1272 )   PDF (13440KB) ( 8214 )   Objective：To observe the regulation of estrogen on the expressions of Monocyte chemotactic factor 1 (MCP-1) and Ras homolog gene family member A (RhoA) in female ovariectomized Sprague-Dawley rats, so as to study the protective effect of estrogen on cardiovascular system. Methods: Forty five female rats aged 12 weeks were randomly divided into five groups: the blank control group (CON, n=10), the ovariectomized group (OVX, n=12), the estrogen-treated group with 17β-estradiol (OVX+E2, n=13) and the sham-operated group (SHAM, n=10). 200 μg/(kg·d) 17β-estradiol was administered in the OVX+ E2 group for 16 weeks, the other three groups were given equal normal saline. After 16 weeks, the levels of serum estradiol (E2), follicle-stimulating hormone (FSH), monocyte chemotactic factor 1 (MCP-1) and RhoA were measured by ELISA; the heart tissue was harvested and weighted, the morphological change was observed by HE staining. The levels of tissue silence regulating protein 1 (SIRT1), activated protein kinase (AMPK) were measured by ELISA. The expressions of MCP-1 and RhoA were detected by immunofluorescence histochemistry. Results: The levels of serum and heart tissue RhoA and MCP-1 in the OVX+E2 group were significantly lower than those in the OVX group (P＜0.05). The levels of heart tissue SIRT1 and AMPK in the OVX+E2 group were significantly higher than those in the OVX group (P＜0.05). Conclusions: The estrogen replacement plays a protective effect in those female ovariectomized rats by down-regulating the expressions of serum and heart tissue MCP-1 and RhoA. The potential mechanism is that the AMPK/SIRT1 pathway may be up-regulated by 17β-estradiol. Related Articles | Metrics

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Relationship between Gene Polymorphism of C9orf3 and Genetic Susceptibility of Polycystic Ovary Syndrome LI Juan, PAN Wen-feng, ZHANG Chun-ren, LIU Li-dong, MA Hong-xia, SONG Jin-long 2017, 36 (5):  378-381.  Abstract ( 1324 )   PDF (1248KB) ( 8417 )   Objective：To explore the association of the single nucleotide polymorphism (SNP) rs3802457 of C9orf3 gene with polycystic ovarian syndrome (PCOS). Methods: 106 women with PCOS (the PCOS group) and 41 healthy females(as the control) were recruited in the first affiliated hospital of Guangzhou Medical University. Genomic DNA was extracted from the EDTA anticoagulants whole blood, and the target C9orf3 gene was amplified by PCR and sequenced by Sanger reactions. The biochemical data of the blood fat and clinical variables were compared between the PCOS group and the control group. Results: There were three kinds of genotypes, including CC, CT and TT in the rs3802457 of the C9orf3 gene. The genotype frequencies of rs3802457 were 87.7%, 12.3% and 0% in the group of PCOS. Comparably, they were 68.3%, 29.3% and 2.4% in the control group. The allele frequencies of C and T were 93.9% and 6.1% in the PCOS group, and 82.9% and 17.1% in the control group, respectively. There were significant differences in the genotype frequencies (P＜0.05) and the allele frequencies (P＜0.05) in the rs3802457 of the C9orf3 gene between the two groups. Body mass index and waist-to-hip in the PCOS group were significantly higher than those in the control group (P＜0.05). No significant differences in the data of biochemistry (total cholesterol /high density lipoprotein /low density lipoprotein) were observed between the two groups (P＞0.05) except for triglyceride (P＜0.05). The HDL level in those PCOS patients with CC genotype was significantly lower than that in PCOS patients with CT genotype (P＜0.05). Conclusions: SNP variant of rs3802457 of C9orf3 gene may be involved in the pathogenesis of the PCOS. Related Articles | Metrics

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The Relationship between MTHFR Gene Polymorphism and Unexplained Recurrent Spontaneous Abortion HUANG Shan-ying，TANG Guo-ling，LIU Qing-zhi，YAO Ji-long，YAO Xiu-hua 2017, 36 (5):  382-384.  Abstract ( 1425 )   PDF (796KB) ( 8503 )   Objective：To study the relationship between the gene polymorphism of methylene tetrahydrofolate reductase (MTHFR) and the unexplained recurrent spontaneous abortion (URSA). Methods：83 patients with unexplained recurrent spontaneous abortion (the URSA group) and 90 normal women of reproductive age (the control group) were recruited. Fluorescence quantitative PCR was used to detect the MTHFR gene C677T, A1298C single nucleotide polymorphisms (SNP). The frequency distribution of genotype and allele was compared, and  the risk of different genotypes to URSA was evaluated. Results：The distribution of MTHFR genotypes in both groups was consistent with the Hardy-Weinberg balance. There were significant differences in the frequencies of C677T genotype and alleles between the URSA group and the control group (P＜0.05). There were no significant differences in the frequencies of A1298C genotype and alleles between the two groups (P＞0.05). The frequency of homozygous genotype in the URSA group was higher than that in the control group (30.1% vs. 13.3%,  χ2=7.237,  P=0.007). The risk of URSA in those patients with TT homozygous genotype was 3.289 times higher than that in the patients with CC homozygous genotype (OR=3.289, 95%CI: 1.342-8.063). Conclusions：The gene polymorphism of MTHFR C677T site is a risk factor of URSA, and the TT homozygoous genotype increases the risk of URSA. Related Articles | Metrics

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Screening of Mutations of Deafness-related Genes in 201 Preconception Women LIANG Yue-hong，REN Chen-chun，WANG Wen-jing，ZHANG Hai-xia，YANG Wei-wei，LI De-ming，ZHANG Yue-xiang 2017, 36 (5):  385-387.  Abstract ( 1365 )   PDF (5339KB) ( 8475 )   Objective：To screen the mutations of four major deafness-related genes in preconception women, and to evaluate the frequency and type of common mutations of child-bearing aged women in Tianjin area. Methods：Nine mutations in four genes including GJB2, SLC26A4, GJB3 and mtDNA 12S rRNA were analyzed in 201 preconception women using a designed genechip. The partner of the mutation carrier was detected by Sanger sequencing of GJB2 or SLC26A4 gene. Results：Ten women (4.98%) carried one mutation. Among them, six carried a mutation of GJB2 gene, three carried a mutation of SLC26A4 gene, and one carried a mutation of mtDNA 12S rRNA. The partner of one carrier with the 235delC heterozygosis mutation of GJB2 gene carried the mutation 109G＞A heterozygosis mutation. Conclusions：Screening of the mutations of deafness-related genes is an effective method to find those carriers and to reduce the birth rate of deaf children. Related Articles | Metrics

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The Outcomes of Vaginal Birth after Prior Cesarean and Related Factors PENG Lan, CHEN Da-li, WU Xiao, CHAI Li-qiang 2017, 36 (5):  388-391.  Abstract ( 1337 )   PDF (921KB) ( 8522 )   Objective: To assess the maternal and infant outcomes of vaginal birth after cesarean(VBAC), and to identify those influencing factors. Methods: A total of 210 pregnant women who underwent VBAC in our hospital from January 2015 to December 2016 were retrospectively analyzed.  All of them had a singleton pregnancy with cephalic presentation, term birth and trial of labor after casarean (TOLAC), without any pregnancy complication. Those cases were divided into two groups according to the mode of delivery: the successful TOLAC group (VBAC group) and the failed TOLAC group. The maternal-infant outcomes and other clinical data were compared. Results: The total success rate of TOLAC was 80.5% (169/210). Forty one women underwent the failed TOLAC, due to fetal distress or a non-progress of labor. The independent influencing factors of VBAC were as follows:  a prior vaginal birth (OR=9.61，95%CI：1.20-76.96), spontaneous labor(OR=5.88，95%CI：2.36-14.64) and body mass index (BMI, OR=0.86，95%CI：0.76-0.97), in which a prior vaginal birth and spontaneous labor were the protective factors and high BMI was the risk factors of VBAC. The area under curve(AUC) of  the graphic receive operator characteristic (ROC) curve was 0.76. The intrapartum blood loss and the proportion  who required of blood transfusion in the VBAC group were significantly lower than those in the failed TOLAC group (P＜0.05).  There were no significant differences in the incidence of neonates asphyxia and proportion of neonates who had to be admitted to intensive care unit between the two groups(P＞0.05). Conclusions: The independent influencing factors of VBAC were the prior vaginal birth, spontaneous labor and BMI. The individualized assessment of VBAC, and the prediction model based on the influencing factors in future, may be helpful to improve the success rate of TOLAC. Related Articles | Metrics

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Clinical Effect of Emergency Cervical Cerclage Combined with Atosiban in the Treatment of Cervical Incompetence WANG Qiu-ming，WU Hai-ying，DANG Qun 2017, 36 (5):  392-395.  Abstract ( 1525 )   PDF (812KB) ( 8604 )   Objective：To investigate the clinical effect of the emergency cervical cerclage combined with atosiban in the treatment of cervical incompetence. Methods：A total of 27 patients with cervical incompetence, who were treated with emergency cervical cerclage and atosiban between January 2013 to December 2015, were analyzed retrospectively. Clinical effect, pregnancy outcome and maternal adverse events were assessed. Results：The combining treatment can effectively extend the gestational age for (8.6±5.4) weeks, with the delivery age (31.8±4.7) weeks and the total live birth rate 74.1% (20/27). The efficacy of atosiban on uterine contraction was 62.9% (17/27). Only four patients presented atosiban-related side effects, three of them presented with mild nausea and vomiting and one patient mild headache. No case discontinued atosiban because of drug-related side effects. Conclusions：The combination of atosiban with emergency cervical cerclage for the treatment of cervical incompetence can effectively extend the gestational age at delivery, and improve the pregnancy outcome. Related Articles | Metrics

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Expression of HOXA11 in Endometrial Tissues of Patients after Radical Trachelectomy ZHANG Dan-dan, SONG Zi-xuan, LIU Dan, PANG Li 2017, 36 (5):  396-399.  Abstract ( 1236 )   PDF (1089KB) ( 8471 )   Objective：To measure the expression levels of HOXA11 mRNA and protein in endometrial tissues of patients after radical trachelectomy (RT), and to investigate the effect of HOXA11 on endometrial receptivity. Methods: There were two groups in this study. The RT group included 16 infertile patients after RT treatment. Another group included 16 fertile patients after RT as control. The endometrial tissue was biopsied with the informed consent. The expression of HOXA11 mRNA in endometrial tissue was detected by real-time RT-PCR. The expression levels of HOXA11, Integrin-β3, β-catenin and DKK1 proteins were measured by Western blots. Results: The expression of HOXA11 mRNA in the RT infertile group was significantly lower than that in the control group (P＜0.05). The expression levels of HOXA11, Integrin-β3, β-catenin and DKK1 proteins in the RT infertile group were significantly lower than those in the control group (all P＜0.05). Interestingly, the expression level of HOXA11 was positively correlated with the expression level of Intergin-β3, β-catenin or DKK1, respectively (P values were 0.006, 0.004 and 0.007). Conclusions: The expression of HOXA11 in endometrial tissue was significantly decreased in those infertile patients after RT, which down regulated the expression of integrin-β3 and the Wnt/β-catenin pathway related with endometrial receptivity. This is one of the possible mechanisms of the failed embryo implantation and infertile outcome. Related Articles | Metrics

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Ethical Aspects of Socially-oriented Egg Freezing ZHANG Wei-wei，YANG Kun，ZHANG Yun-shan 2017, 36 (5):  400-403.  Abstract ( 1372 )   PDF (803KB) ( 8487 )   More and more healthy women ask for the egg preservation in recent years, in order to preserve their fertility for future demands for child(ren). This technique preserves fertility for women who do not want to be mothers just now, giving them the opportunity to have their own genetic babies when they are older. However, women tend to cryopreserve oocytes at the age over 35 years. In this age, their oocyte quantity and quality have been decreased, and the success rate of healthy live birth diminished, while pregnancy-related complications significantly increased. For the socially-oriented egg freezing, the professional field and the public have different opinions. Opponents consider that the social egg freezing is unjust, excessive health care and low cost-effective, and that it is against children′s will. Advocates believe that women have childbearing freedom, and that the social egg freezing can avoid the single mothers while save their fertility. They also believe that the benefit of oocyte freezing is better than oocyte donation. There are some ethical controversies of the social egg freezing in its social practice, including the role of qualified parents, the autonomous right of women, medical risk, cost-effectiveness and other issues. Related Articles | Metrics

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Association between Assisted Reproductive Technology and Disorders of Imprinted Genes JIA Qing-ge, WANG Xiao-hong 2017, 36 (5):  404-407.  Abstract ( 1409 )   PDF (826KB) ( 8627 )    Assisted reporductive technology (ART) is an effective treatment of  infertility. However, the safety of reproductive genetics of ART has being concerned. It was reported that the adverse pregnancy outcomes of ART such as low birth weight, spontaneous abortion, fetal malformation, premature delivery, perinatal death were increased. A large number of studies showed that some non-physical interventions on infertility patients, such as the controlling ovarian hyperstimulation, in vitro fertilization and embryo operation, could affect the epigenetics. The imprinting gene play a important role in fetal development during epigenetic modification. ART manipulation is just in the process of epigenetic reprogramming. Therefore, the disorders of imprinting gene will not only impact the fetal development, but also induce developmental abnormalities and many related diseases after birth. This review summarizes the relationship between ART and the disorders of imprinting genes such as Beckwith-Wiedemann syndrome, Prader-Willi syndrome, Angelman syndrome, Silver-Russell syndrome and so on. Related Articles | Metrics

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Progress in Uniparental Disomy-induced Chromosomal Abnormalities JIA Jing，HE Meng-zhou， ZHANG Jing-yi，CHEN Kai-yue，TANG Hong-ju，FENG Ling 2017, 36 (5):  408-411.  Abstract ( 2242 )   PDF (840KB) ( 8575 )   Uniparental disomy (UPD) is an uncommon chromosome condition, in which homologous chromosome or fragment are inherited from only one parent. UPD could lead to various clinical phenotypes due to either homozygosity of recessive mutations or aberrant patterns of imprinting. It cannot be effectively detected by conventional karyotyping, NIPT and CNV-sequence. In clinical work, the misdiagnosis could be usual because of the insufficient understanding of UPD or the limited detecting techniques. Here, we searched the UPD-related literatures and comprehensively summarized the pathophysiological mechanisms, clinical detecting techniques as well as the prevention and treatment of UPD. Related Articles | Metrics

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Clinical Application of In Vitro Oocyte Maturation LI Han, YANG Zhi-yong, CHIAN Ri-cheng 2017, 36 (5):  412-416.  Abstract ( 1556 )   PDF (847KB) ( 8631 )   In vitro maturation (IVM) refers to the maturation of immature oocytes at different stages. Immature oocytes obtained in different origins have different subsequent embryonic development capacity and pregnancy rates as well health live births rates. IVM as an efficient treatment has been used in those patients with polycystic ovary syndrome, ovary high response or low response, and fertility preservation. Several thousands of healthy IVM babies have been born in the world. The improvement of clinical IVM technology  focuses on IVM medium, the optimization of the culture environment and operation process. With the improvement of IVF efficiency and IVM culture system, the new treatment option was proposed that the combination of natural cycle/mild stimulation IVF treatment with immature oocyte retrieval and the followed IVM. This IVF combined with IVM may represent a viable alternative to the present standard treatment, or as a potential first-line treatment in future. Related Articles | Metrics

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Decreased Ovarian Reserve and Mitochondrial Genetic Abnormality ZHU Jing, ZHOU Yi-ran, CHEN Bei-li, CAO Yun-xia 2017, 36 (5):  417-420.  Abstract ( 1399 )   PDF (811KB) ( 8469 )   Decreased ovarian reserve (DOR), a premature low fertility, is associated with the low pregnancy rate, high miscarriage rate and high incidence of obstetric complications. Mitochondria are the energy supply center, which involved in a series of important physiological processes such as oocyte maturation and fertilization. Mitochondrial DNA (mtDNA) is a genetic material independent of the nuclear genome. Mitochondrial genetic abnormalities such as change in mitochondrial number, deletion of mtDNA fragments and mutation affect mitochondrial function result in the decreased energy production, thereby affecting oocyte development. In recent years, biologists have made some progress in using the mitochondrial transplantation to improve oocyte quality in patients with DOR. Therefore, we discuss the DOR etiology related to mitochondria, so as to provide a new idea for the future study of DOR mechanism. Related Articles | Metrics

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Effect of Wnt Signaling Pathway in Female Reproductive System LIU Ning, LIU Ying 2017, 36 (5):  421-425.  Abstract ( 1417 )   PDF (850KB) ( 8449 )   The Wnt pathway is an evolutionarily conserved signaling pathway. Meanwhile, it is a complexity network involving numerous ligands, receptors and various pathways that plays important roles in embryonic development, cell growth and multiplication of stem cell, tumor initiation. The Wnt signaling pathway as a key factor also plays  a role in regulating the development of female reproductive system. The abnormality of this pathway is associated with a variety of female reproductive system diseases and may even lead to tumors. Some experiments proved that the abnormality of the Wnt pathway is related to the epithelial-mesenchymal transition. The epithelial-mesenchymal transition actually plays an important role in the development and progression of tumor. This pathway is also involved in tumor metastasis, recurrence and resistance. This review is about the role of the Wnt signaling pathway in female reproductive system and its relationship with female reproductive system diseases. Related Articles | Metrics

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Folate and DNA Methylation Related with Neural Tube Defects CHANG Ge，NIU Bo 2017, 36 (5):  426-429.  Abstract ( 1428 )   PDF (796KB) ( 8532 )   Neural tube defects (NTDs) are severe congenital malformations caused by genetic and environmental factors, which brings heavy burden to our society and family. Folate, a necessary nutrient for the human body, participates in the carbon metabolism related with purine and pyrimidine synthesis, methylation and other important reactions. Folate also affects a variety of development-related genes and signaling pathways. Folate is a very important nutrient for the development of neural tube. A large number of epidemiological studies showed that the supplement of folate can effectively prevent NTDs. However, the mechanism is not entirely clear. DNA methylation is an epigenetic mechanism that was extensively studied. More and more studies showed that the abnormal DNA methylation was closely related to NTDs. In this review, we summarized the relationship between NTDs and folate metabolism, key enzymes and related genes of folate metabolism, and DNA methylation, so as to clavify the role of folate and DNA methylation in NTDs, then provide more references for us to understand the pathogenesis of NTDs and the effective prevention. Related Articles | Metrics

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Factors Affecting the Clinical Pregnancy and Live Birth Following Single Blastocyst Transfer SUN Qing, XIONG Feng, LI Guan-gui, WAN Cai-yun, CHEN Pei-lin, ZENG Yong 2017, 36 (5):  430-433.  Abstract ( 1376 )   PDF (809KB) ( 8424 )   European Society of Human Reproduction and Embryology (ESHRE) proposed the standard definition of the effective treatment with assisted reproductive technology (ART) in 2002: live birth and a single healthy baby. The best way to reduce multiple pregnancies, which is one of the serious complications of ART, is the strategy of single blastocyst transfer (SBT). Theoretically, SBT can avoid the possibility of dizygotic twins. However, the SBT without any selection in patient and embryo may result in the reduction of pregnancy rate and live birth rate, but also increase economic and time cost as well as mental pressure. Therefore, the selective single blastocyst transfer (eSBT) should be recommended in those suitable patients. The consultation with respect to the factors related with the clinical outcome and live birth of SBT may be helpful to evaluate effectively the patients′ status and the success rate of SBT, so as to accept SBT more easily, which eventually help them bring a healthy baby home as soon as possible. Related Articles | Metrics