1.
Autologous peripheral blood mononuclear cells intrauterine instillation to improve pregnancy outcomes after recurrent implantation failure: a systematic review and meta-analysis
Wu Y, Li L, Liu L, Yang X, Yan P, Yang K, Zhang X
Archives of gynecology and obstetrics. 2019
Abstract
PURPOSE Recurrent implantation failure (RIF) is a common cause of disappointment and a big challenge after assisted reproduction technology treatments. The objective of this study was to evaluate the existing literature to explore whether peripheral blood mononuclear cells' (PBMCs) instillation could improve pregnancy outcomes among patients with RIF. METHODS We conducted a comprehensive search including PubMed, EMBASE, Cochrane library and various databases in China. Three randomized controlled trials (RCTs) and three non-randomized controlled trials (non-RCTs) were included. We included subgroup and sensitivity analyses using Stata 12.0. RESULTS The results of the three RCTs showed that PBMC improved outcomes in all patients compared with placebo or no-treatment [clinical pregnancy rate (CPR): odds ratio (OR) 2.45, 95% confidence interval (CI) 1.53-3.91; implantation rate (IR): OR 2.46, 95% CI 1.48-4.09; live birth rate (LBR): OR 2.43, 95% CI 1.32-4.49]. However, the results of the three non-RCTs indicated that there were no statistically significant differences in the outcomes and that the heterogeneity was higher (I(2) > 0%). Subgroup analysis further suggested that PBMCs treatment significantly increased the CPR, IR and LBR in the three or more implantation failure subgroups (CPR: OR 2.83, 95% CI 1.29-6.22; IR: OR 3.74, 95% CI 1.71-8.19; LBR: OR 3.03, 95% CI 1.15-7.98). CONCLUSIONS Among patients with three or more implantation failures, this treatment improved IR, LBR, and CPR compared to that in controls, due to the limited data available, PBMCs' intrauterine instillation should only be used in the context of clinical trials.
2.
Clinical experience with iron supplementation in pregnancy Chinese
Wu Y, Weng L, Wu L
Chung-Hua Fu Chan Ko Tsa Chih [Chinese Journal of Obstetrics & Gynecology]. 1998;33((4):):206-8.
Abstract
OBJECTIVE To study the efficacy of iron supplementation during pregnancy and its influences on the outcome of pregnancy. METHODS A total of 369 pregnant women were enrolled in this study. According to the hemoglbin levels at recruitment, there were 2 groups: preventive (Hb > or = 110 g/L) and treatment (Hb < 110 g/L) groups. In the preventive group, women entered the study from 20-24 gestational weeks and were randomly assigned to materna treatment (n = 96) who took materna 1 tablet daily or control group (n = 95) who took no other supplementation. In the treatment groups, women less than 36 gestational weeks were accepted. They were randomly divided as materna (n = 93) 1 tablet/d, ferrous sulfate 0.3 g tid/d (n = 50) or Ferroids 1 tablet/d (n = 35) groups. Both Hb and serum ferritin concentrations were determined at admission and immediately after delivery. In some cases serum ferritin in the umbilical vein were measured as well. Hemoglobin levels were examined every 4 weeks during the observational period. RESULTS In the preventive groups, maternal serum ferritin levels after materna treatment were significantly higher than that before treatment and the control group (P < 0.05). As for the anemia women, compared the serum ferritin concentration, materna treatment had significantly higher levels than that at admission (P < 0.05), and also higher than that in the ferrous sulfate or ferroids tratment groups (P < 0.05). The s-ferritin in the umbilical vein had no correlation with the paired maternal levels. There were no significant differences in the pregnancy outcomes among all the groups. CONCLUSION Materna can increase the iron storage and effectively improve the iron deficiency during pregnancy, and has no impact on the prgnancy outcomes.