OBJECTIVE: To investigate the effect of Kidney-Tonifying and Phlegm-Resolving Method on the key molecules(AKT, p-AKT and GLUT4) of the AKT-GLUT4 insulin signal pathway in ovarian granular cells(OGC) and its effect on oocyte quality, embryo development and pregnancy outcomes of these infertile patients with polycystic ovary syndrome. DESIGN: Investigate the effect of Kidney-Tonifying and Phlegm-Resolving Method on the key moleculesof the AKT-GLUT4 insulin signal pathway in ovarian granular cells(OGC) by measurring HOMA-IR, highquality oocytes rate, high-quality embryos rate, clinical pregnancy rate, and the expression of AKT, p-AKT and GLUT4 in ovarian granulosa cells on the day of retrieval. MATERIALS AND METHODS: Sixty-six PCOS patients with Kidneydeficiency and phlegm-dampness treated by in vitro fertilization-embryo transfer (IVF-ET) were randomly and equally (33 patients per group)divided into two groups: the Erzhi Tiangui combined with Qi Gong Keli group (treatment group) and placebo (control group). Two groups of patients were treated with double-drop program(GnRH-a+Diane 35),the treatment group of patients taking the Diane 35 at the same time to giving the above traditional Chinese medicine, until HCG injection day.Patients in the placebo group were given placebo granules as described above. Score changes of Kidneydeficiency and phlegm-dampness symptom before and after treatment were measured, other outcomes including HOMA-IR, high-quality oocytes rate, high-quality embryos rate, clinical pregnancy rate, and the expression of AKT, p-AKT and GLUT4 in ovarian granulosa cells on the day of retrieval were measured. RESULTS: Compared to the placebo group, the Kidney-deficiency and phlegm-dampness symptoms significantly is improved in the chinese treatment group after treatment. In addition, the treatment group take a turn for the better in the HOMA-IR, high-quality oocytes ratio, high-quality embryos ratio, and clinical pregnancy rate (P<0.05 respectively). Compared with the other treatment gourp, the placebo group showed significantly high-regulated p-AKT levels and GLUT4 protein contents (P<0.05 respectively). CONCLUSIONS: The Erzhi Tiangui combined with Qi Gong Keli could significantly improve Kidney-deficiency and phlegm-dampness status in infertile patients, reduce HOMA-IR and increase their high-quality oocytes ratio, high-quality embryos ratio, and clinical pregnancy rate. Bushen Huatan Recipe might improve the insulin resistance status of ovary in PCOS patients through improving the expression of p-AKT and GLUT4 protein in ovarian granular cells, and then provide sufficient energy for oocyte biological function, so as to improve the IVF outcome in these infertile patients.
aneuploidy. Fertilisation was achieved by ICSI. Time-lapse monitoring started immediately after ICSI, with a 15 min interval between consecutive observations. Of 113 embryos analysed, 55 reached the blastocyst stage (BL-group) and 58 arrested sometime after the 2-cell stage (NoBL-group). ANN analysis was performed, at this stage, only during the first two cell divisions (175 frames; 2,625 min).RESULTS: We developed a classification platform consisting of three main steps: 1) collection of time-lapse images of preimplantation. embryos; 2) evaluation of time-lapse sequence images of each embryo by a particle image velocimetry software that detects cytoplasmic movements; 3) finally, analysis of cytoplasmic movement patterns through an ANN that predicts developmental competence. Specifically, cytoplasmic movements of single embryos development were measured as multivariate time series and used to train and test a Long-Short Term Memory (LSTM) neural network. LSTM displayed the capacity to learn ''long-term'' temporal dependences of both BL-and NoBL-group and provide a classification when challenged blind. Following a ten-fold cross validation of the training set, the specific LSTM selected was trained with 90% of data and tested on the remaining. Thus, based on the analysis of the cytoplasmic movement occurring during the first two cell divisions of single blind embryos (test set), the trained LSTM reached an 82% classification accuracy in the prediction of development to the blastocyst stage.CONCLUSIONS: This study represents an initial attempt to build up a robust system of classification of the quality of human preimplantation embryos totally automatised from input to output. A three-steps workflow, combining time-lapse imaging, particle image velocimetry and artificial neural network (ANN) classification, predicts with high accuracy embryo ability to develop to blastocyst stage. Further refinement of the approach is expected to impact embryo assessment ability and improve efficiency in assisted reproduction treatments.Reference: None. SUPPORT: None.
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