Xihong Li

Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center.

The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART).

Pregnancy outcomes of women with a congenital unicornuate uterus after IVF–embryo transfer

Unicornuate uteri are caused by non-development of one Müllerian duct. The objective of this study was to investigate pregnancy outcomes of singleton and/or twin pregnancies in women with unicornuate uterus after IVF-embryo transfer (IVF-ET). The study group comprised 238 patients with a unicornuate uterus and the control group 818 patients with normal uterus. Compared with pregnancies with normal uterine morphology, a unicornuate uterus was associated with an increased risk of early pregnancy loss [adjusted odds ratio (aOR) 1.88, 95% confidence interval (CI) 1.25-2.83; P = 0.002], premature delivery (aOR 2.11, 95% CI 1.45-3.07; P < 0.001), perinatal mortality (aOR 3.35, 95% CI 1.89-5.94; P < 0.001), low birthweight (LBW, aOR 1.43, 95% CI 1.04-1.79; P = 0.005) and very low birthweight (VLBW, aOR 2.58, 95% CI 1.53-4.34; P < 0.001). Additionally, significantly lower rates of term delivery (aOR 0.43, 95% CI 0.31-0.58; P < 0.001) and live birth (aOR 0.53, 95% CI 0.37-0.76; P < 0.001) were observed. These findings indicate that the presence of unicornuate uterus is associated with significantly increased risk of some adverse pregnancy outcomes compared with pregnancies with a normal uterus in women who undergo IVF-ET.

ESHRE–ESGE versus ASRM classification in the diagnosis of septate uterus: a retrospective study

AbstractBackground The European Society of Human Reproduction and Embryology–European Society for Gynaecological Endoscopy (ESHRE–ESGE) system is designed mainly for clinical orientation; its overdiagnosis of septate uteri was confirmed in a general population in comparison to the American Society of Reproductive Medicine (ASRM) supplemental classification proposed by Ludwin. However, the agreement among septate uterus recognition using the ESHRE–ESGE and the supplemental ASRM classifications and the rate of overdiagnosis of septate uterus by ESHRE-ESGE in infertile women remain unclear.MethodsWe conducted a retrospective study of 53,540 infertile patients in our reproductive centre from June 2013 to December 2016, to compare septate uterus recognition using three systems. The data were analysed by the ESHRE–ESGE system, the ASRM by Salim and the ASRM by Ludwin separately. The concordance of diagnoses of septate uteri using these three systems was compared.ResultsESHRE–ESGE classification significantly increased the frequency of septate uteri (11.31%, 6056 vs. 7.20%, 3854 vs. 3.80%, 2034). Good agreement was observed between the ESHRE-ESGE and the ASRM by Salim (k = 0.686, p < 0.001) and between the ASRM by Salim and that by Ludwin (k = 0.671, p < 0.001), while moderate agreement was found between the ESHRE–ESGE and ASRM by Ludwin systems (k = 0.444, p < 0.001). These results suggest that Ludwin’s criteria are the strictest, while the ESHRE–ESGE system is much more relaxed for septate uterus diagnosis.ConclusionA risk of overtreatment may also exist in infertile patients when using the ESHRE–ESGE system. Therefore, the ESHRE–ESGE system should be used with caution when guiding hysteroscopic metroplasty in infertile patients.