bluuebunny/crossref_metadata_2025 huggingface dataset:
#290 : Does Extending the Time Interval Between hCG Trigger and Oocyte Retrieval from 36 to 37 Hours Affect the Rate of Euploid Blastocysts?
Authors: Barber Elad , Lantsberg Daniel , Mizrachi Yossi , Kelley Rebecca , Gurner Kathryn , Stock-Myer Sharyn , Gardner David
Published: January 2024

Background and Aims: Data are lacking regarding the optimal time interval between human chorionic gonadotropin (hCG) administration and ovum pick-up (hCG-OPU interval), and its impact on blastocyst euploidy. Our aim was to compare the blastocyst euploidy rate between IVF cycles with hCG-OPU interval of 36 and 37 h.

Method: In this historic cohort study, we reviewed all hCG-triggered, PGT-A, IVF cycles performed in a single clinic, between 2018 and 2022. Commencing in September 2021, clinicians gradually changed the hCG-OPU interval from 37 to 36 h. We compared the outcomes of cycles with hCG-OPU interval of 36 h (35.5-36.5) to 37 h (36.6-37.5). The primary outcome was the number of euploid embryos. Cycles with oocyte donation, and cycles utilized GnRH-agonist triggers or dual-triggers were excluded.

Results: The euploidy rates were similar between the 36-h group (n=2,584) and 37 h group (n=5,575; 39.7% vs. 38.8%, respectively, p=0.42).

Compared to the 36-h group, patients in the 37-h group were characterized by higher numbers of total oocytes collected (15.9±8.9 vs. 17.3±9.8, respectively, p<0.001), mature (MII) oocytes (8.3±8.2 vs. 9.6±9.6, respectively, p<0.001) and 2PN embryos (9.8±5.5 vs. 10.3±6.4, respectively, p<0.001). On multivariate logistic regression analysis, the hCG-OPU interval was not associated with euploidy (aOR 0.91, 95% CI 0.82-1.01), after controlling for female and male ages, female BMI, and number of oocytes collected.

Conclusion: hCG-OPU intervals of 36 and 37 h resulted in similar blastocyst euploidy rates in IVF cycles. This finding has the potential to aid the decision-making processes when managing IVF procedures.

The 37-h group was characterized by a lower female age and higher doses of gonadotropins and consequentially more eggs collected, mature eggs and 2PN embryos compared to the patients of the 36 h group. Nonetheless, the two groups had comparable rates of euploid embryos reinforcing our primary finding.

Data are presented as mean ± standard deviation or n (%); hCG- Human chorionic gonadotropin; OPU- ovum pickup; BMI- BMI kg/m2, Gonadotropins- in IU; ICSI- Intra cytoplasmic sperm injection.

Data are presented as mean ± standard deviation or n (%); hCG- Human chorionic gonadotropin; OPU- ovum pickup; 2PN- 2 Pronuclei.
#311 : Intrauterine Administration of Human Chorionic Gonadotropin in Women Undergoing IVF– An Individual Participant Data Meta-Analysis
Authors: Zou Haowen , Abdallah Karim , Wirleitner Barbara , Hong Kathleen , Thanaboonyawat Isarin , Laokirkkiat Pitak , Arabipoor Arezoo , Badehnoosh Bita , Kokeguchi Shojo , Makhlouf Ahmed , Gadalla Moustafa , Showell Marian , Li Wentao , Mol Ben , Wang Rui
Published: January 2024

Background and Aims: Human chorionic gonadotropin (hCG) has been proposed as an intrauterine intervention around embryo transfer period due to its potential to enhance endometrium receptivity and implantation. Existing randomised controlled trials (RCTs) showed inconsistent findings and multiple meta-analyses on this topic showed high unexplained heterogeneity. Individual participant data meta-analysis (IPDMA) is considered the “gold standard” synthesis method due to its ability to standardise and harmonise the data reporting and analysis. In this IPDMA, we aimed to investigate the effectiveness and safety of intrauterine hCG before embryo transfer.

Method: We searched Cochrane Gynaecology and Fertility Group Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase and PsycINFO without language restrictions up to November 2022. We included RCTs comparing intrauterine administration of hCG before embryo transfer versus placebo or no intervention in women undergoing IVF. The outcomes were live birth, clinical pregnancy and other fertility outcomes. We invited trial authors to share the de-identified IPD and established the IHABT collaboration. We performed a one-stage IPDMA as the main analysis.

Results: Eight RCTs including IPD of 2338 participants were included. These RCTs were conducted in 6 different countries, with a dosage of intrauterine hCG between 500 IU and 1000 IU. In women undergoing IVF, compared to the control group, intrauterine administration of hCG before embryo transfer does not improve live birth rates (7 RCTs, 2245 participants, odds ratio [OR] 0.98, 95% confidence interval [CI] 0.82–1.17) or clinical pregnancy rates (8 RCTs, 2338 participants, OR 1.13, 95%CI 0.89–1.43). There was insufficient evidence of a difference between the two groups on any of the other fertility outcomes.

Conclusion: Intrauterine administration of hCG does not improve live birth or clinical pregnancy rates in women undergoing IVF. Therefore, it should not be offered as an IVF add-on in clinical practice.
#384 : Effectiveness of Progesterone Monitoring and Rescue Protocol in Frozen Embryo Transfer Cycle
Authors: Nguyen Chien , Nguyen Ly , Nguyen Xuyen
Published: January 2024

Background and aim: Hormonal monitoring impact on overall pregnancy rate in frozen embryo transfer (FET) cycles and hence progesterone supplement adjustments remain debatable in current literature. This study aims to investigate the effect of monitoring and follow-up of serum progesterone level on the day of FET, and progesterone supplement adjustments effects on pregnancy outcomes for FET in programmed hormonal replacement therapy cycles.

Methods: In this study, all patients who were scheduled for FET had their progesterone (P4) and estradiol (E2) level assessed in the morning of FEM and if their P4 level was less than 10 ng/ml, intramuscular progesterone was given for 7-10 days since the day of FET to rescue the cycle.

Results: In 2022, in Vinmec IVF center, there were in total 659 FET cycles, all was single blastocyst transfer and applied the mention protocol to rescue the cycle in case P4 level was less than 10 ng/ml. The chemical (62,87% vs 59.94%), clinical (56,68% vs 54,83%) and ongoing pregnancy rate (46,25% vs 45,17%) were comparable between the two group (with and without parenteral progesterone), P<0,05.

Conclusions: Monitor P4 level on the day of FET and use parenteral progesterone in case P4 level is less than 10 ng/ml could be an effective method to rescue the cycle and improve the outcome. Further studies are needed to draw a better conclusion and recommendation in this aspect.
#388 : Clinical Outcomes of Modified Natural Cycle Versus Hormone Replacement Therapy for Endometrial Preparation for Frozen Embryo Transfer
Authors: Pham My Thi , My Hanh Pham Thi , Thi My Pham , Sy Hung Ho , Thu Hien Le Thi
Published: January 2024

Background and Aims: Frozen embryo transfer is a current trend in practice worldwide. Modified Natural Cycle, Hormone Replacement Therapy are common endometrial preparation protocols in Vietnam. The aim of this study was to compare the outcomes of a Modified Natural Cycle vs Hormone Replacement Therapy for Endometrial Preparation for Frozen Embryo Transfer.

Method: This was a single center randomized clinical trial. It was conducted in the period between August 2022 and March 2023 in Andrology and Fertility Hospital of Hanoi. A total of 166 patients were randomly allocated to two groups, either the hormone replacement cycle (83 patients) (HRT group) or the modified natural cycle (83 patients) (mNC group).

Results: The mean age was 31 vs 30 years in mNC and HRT. The endometrial thickness on the day of Progesterone administration in mNC was higher than HRT (10.99±1.46 và 10.70±1.06 mm), p>0.05. There was no significant difference between mNC group and HRT group regarding implantation rate, clinical pregnancy rate, on-going rate. After adjusting for age, BMI, duration of infertility, type of infertility, history of miscarriage, number of failed embryo transfers, endometrial thickness on the day of Progesterone administration, number of good-quality embryos transferred showed that the clinical pregnancy rate in the HRT was higher than that mNC, but the relationship was not statistically significant with p>0.05.

Conclusion: The selection of regimen to use for endometrial preparation for frozen embryo transfer depends on individualized patient treatment, particularly with respect to the selection of the endometrial preparation method particularly with respect to the selection of the endometrial preparation method.
#155 : Embryo Thaw and Biopsy - A Clinical Guide for Patients
Authors: Leung Vivian , Zhang Shelley , Johnson Kerri , Sorby Kelli
Published: January 2024

Background and Aims: Preimplantation genetic testing allows the selection of chromosomally normal embryos for transfer, and therefore may reduce the time required to live birth.

Some patients request to perform biopsy on previously cryopreserved embryos. This includes situations where the embryos were frozen untested, or no result was obtained from the initial trophectoderm biopsy.

Method: We analysed the outcomes of 108 embryos over 3 years in the effort to provide guidance to patients in terms of the expectations when considering performing thaw and biopsy on cryopreserved embryos. This includes 32 untested embryos (planned for PGT) (Group A), 45 embryos frozen without the intention of testing (Group B) and 34 embryos that had no results obtained in the first biopsy (Group C).

The developmental timing of the embryos in the initial culture and the extended culture timing following thawing, was examined using timelapse footage.

Results: Among the 108 embryos that were thawed and subsequently cultured, 78.7% embryos were suitable for biopsy with an average of 8.5 h in extended culture.

Group A had the lowest proportion of embryos suitable to biopsy after extended culture (56.3%), which is significantly lower than Group B (83.3%, P=0.0181) and Group C (94.1%, P=0.0004).

Interestingly, Group A had the lowest proportion of euploid embryos (16.7%), followed by Group B (40.0%) and Group C (46.9%). Interestingly, of the Group C embryos that previously failed to amplify only 26.7% were euploid, compared to 64.7% for those that previously amplified but failed to pass quality control.

There was no correlation between time to blastulate, time to form full blastocyst or culture time and euploidy rate.

At the time of our study, 18 of the 32 euploid embryos were thawed and transferred, resulting in 44.4% clinical pregnancy rate.

Conclusion: This analysis provides important information to guide patients’ expectations at a clinical level.
#118 : The “HERAQoL-P”: Development of a Meaningful, International Quality of Life Tool for PCOS
Authors: Avery Jodie , Pirotta Stephanie , Jiskoot Geranne , Helm Melanie Gibson
Published: January 2024

Background and Aims: Women with Polycystic Ovary Syndrome (PCOS) have diverse experiences of Quality of Life (QoL) depending on their age, ethnicity, socio economic status, severity and phenotype. PCOS, a common endocrine condition in women, exhibits problematic symptoms related to fertility, weight gain, mental health and sleep. QoL is an important health outcome, yet standard measures include predefined items, that may be unimportant to individuals.

The full physical, emotional, and social impact of PCOS is not captured with existing PCOS QoL measures. These factors need to be addressed within person-centred care in order to achieve the best possible health outcomes in both the short and long term. We aim to scope and understand priorities for quality of life (QoL) dimensions from women with PCOS throughout life, to provide a conceptual framework for the creation of a meaningful, scientifically validated quality of life tool.

Method: Based on the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) questionnaire, we surveyed 80 women and interviewed 17 women diagnosed with PCOS in Australia, with another 93 completing the survey in the Netherlands, about aspects of life important for their quality of life.

Interview questions include the impact of this condition on physical, mental and emotional health, and understand whether PCOS affects women differently according to their symptoms and background profile.

Results: This work informs the development of a new QoL tool which will be internationally validated, reflecting the diverse PCOS features with the greatest impact, enabling better evaluation of Patient Reported Outcomes.

Conclusion: A high-quality QoL questionnaire could highlight women’s specific priorities, and then measure whether their healthcare addresses such priorities. We will then create the HERAQoL-P, with extensive potential to have impact, in both research and clinical care, adding to the evidence base for PCOS.
#147 : Artificial Intelligence is Equally Capable of Predicting Viability of Embryos Created from Vitrified Oocytes, Despite Observed Differences in Morphokinetic Behaviour
Authors: Pereira Gabriella , Sorby Kelli
Published: January 2024

Background and Aims: With oocyte vitrification increasingly employed and the ever-expanding presence of artificial intelligence (AI) in the laboratory, it is essential to understand whether the same weight can be given to AI models’ predictions when vitrified oocytes are utilized.

Method: Embryos were cultured in Embryoscope+ and assigned an iDA score, generated after 112 hours in culture.

Data was collected from 186 vitrified oocyte (VO) cycles using a total of 1577 vitrified oocytes, along with control data from 43,957 fresh oocytes.

Data analysed included all standard morphokinetic parameters, iDA scores, embryo utilisation and clinical pregnancy.

Statistical analyses were performed using Logistic Regression, Fisher’s exact test and unpaired t-tests.

Results: The majority of cycles utilised clinic-recruited donor oocytes (70.7%), followed by autologous (25.9%) and known-donor oocytes (3.4%). No difference was observed in blastocyst utilisation between the three groups (48.0%, 48.1% and 52.9% respectively). In patients undertaking a single cycle utilising both fresh and vitrified oocytes, blastocyst utilisation was significantly higher in fresh oocytes (58.98% vs. 41.12%, p<0.0001), however, no difference in clinical pregnancy rate was observed (40.0% vs. 40.5%).

Fresh and vitrified oocytes displayed significantly different morphokinetic behaviour across all time points assessed. The magnitude of difference was greatest during compaction and blastulation, with VO embryos compacting on average 6.53 hours later than control embryos (p<0.0001) and commencing blastulation 4.58 hours later (p<0.0001).

When analysing iDA scores against the clinical pregnancy rate of fresh vs. vitrified oocytes, logistic regression showed no difference in areas under the curve (AUC) between the two groups (0.6431 vs. 0.6390, 95% Confidence Intervals 0.6111–0.6751 and 0.5474-0.7300 respectively), demonstrating no reduction in the AI’s ability to predict embryo viability despite their morphokinetic differences.

Conclusion: AI technology predicted clinical pregnancy equally well whether embryos originated from fresh or vitrified oocytes, despite confirmation of significantly delayed morphokinetic parameters in embryos formed from vitrified oocytes.
#228 : Variability of Symptom Profiles in Individuals with Mate Kirikoopu/Endometriosis and/or Huahua Hua Kuao/Polycystic Ovary Syndrome in Aotearoa New Zealand
Authors: Salemink-Waldren Jamie , Adamson Zachary , Bush Deborah , Campbell Rebecca , Hohmann-Marriott Bryndl , Johnson Neil , Nisa-Waller Arianna , Pankhurst Michael , Girling Jane
Published: January 2024

Background and Aims: Although opposing risk factors have been proposed for mate kirikōpū/endometriosis (oestrogen-dependence) and huahua hua kūao/polycystic ovary syndrome (PCOS; androgen dependence), there is a cohort of individuals with both endometriosis and PCOS. We propose that disease comorbidity will alter symptom profiles in comparison to those with only one disease, and that analysis of these differential profiles may hint at underlying mechanisms of disease pathology.

Methods: An anonymous online survey was distributed via social media (NZ residents, >18 years) and included questions related to diagnosis, symptoms, treatment and management of endometriosis and/or PCOS.

Results: In total, 1323 responses (median [range] = 31 years [18–72]) were received within a two-week period (endometriosis only: n=615, 48%; PCOS only: n=459, 35%; both diseases: n=247, 19%). When asked about symptoms ‘ever experienced’, comorbid individuals report both symptoms commonly ascribed to endometriosis (e.g, dysmenorrhea) as well as those ascribed to PCOS (e.g., irregular periods) thereby exacerbating impacts on quality of life. An exception, the proportion of individuals reporting absent menstrual periods was increased in cormobid individuals (45%) relative to those with endometriosis only (21%), but decreased relative to those with PCOS only (67%), suggesting a more complex interaction between the two diseases.

Conclusions: These data highlight the heterogenity of disease phenotype in individuals with endometriosis and/or PCOS. We suggest that an understanding of the intersection of these two common diseases, and a recognition of the associated phenotypic diversity, will provide avenues of research to better understand the pathophysiology of both endometriosis and PCOS.
#312 : Outcomes for Women Who Utilise Electively Frozen Oocytes
Authors: Dalton Anna , Pacela-Ince Leanne , Koch Juliette
Published: January 2024

Background and Aims: Frozen oocyte thaw (FOT) cycles are becoming increasingly common within IVF clinics in Australia, as women choose to freeze eggs and delay using those eggs until a more suitable time. Typically, Australian women freezing eggs are older than those women who have been studied in overseas FOT cycles. The aim of this study was to report outcomes of FOT cycles.

Method: We performed a retrospective cohort study of 141 FOT cycles (from 129 patients) over a 10-year period from January 2010 to December 2020, at a single IVF clinic in Adelaide, Australia. We assessed the outcomes of those cycles in terms of oocyte warm survival, ICSI fertilisation rates, utilisation rates, pregnancy rates and live birth rates.

Results: The average age of women undergoing FOT cycles was 36.5 ± 4.9 years. The reasons for egg freezing cycles included male factor (45.5%), elective (44.1%), religious (6.3%), fertility preservation (2.8%) and anonymous oocyte donation (1.4%). From the 143 FOT cycles, 1094 oocytes were collected; 82% of oocytes survived the warm process and 62% fertilized normally. There were 59 fresh embryo transfers (5.1% cleavage and 94.9% blastocyst, 22.0% DET and 78% SET) and 32 frozen blastocyst embryo transfers (12.5% DET and 87.5% SET). The pregnancy rate per fresh transfer was 30.0% (18/59) and per frozen transfer was 37.5% (12/32). The live birth rate per fresh transfer was 27% (16/59) and per frozen transfer was 37.5% (12/32). The live birth rate per initiated FOT cycle was 11% (16/143).

Conclusion: Rates of live birth per initiated FOT cycle at our clinic was 11%, similar to the ANZARD live birth rate for all fresh cycles initiated in 2020 (10.9%). We therefore conclude that results for frozen oocytes are equivalent to fresh oocytes and can use this information when counselling patients on the outcomes of FOT cycles.
#87 : Intrauterine Adhesion in Ultrasound-Guided Manual Vacuum Aspiration (USG-MVA) Versus Electric Vaccum Aspiration (EVA): A Randomized Controlled Trial
Authors: Ng Karen , Chung Pui Wah Jacqueline , Law Sze Man , Ip Patricia Nga Ping , Li Tin Chiu
Published: January 2024

Background and Aims: Intrauterine adhesion (IUA) is a possible complication after uterine surgery, especially after sharp curettage for miscarriages as it destroys the endometrial stratum basalis. This study aimed to determine and compare the IUA in women who underwent ultrasound-guided manual vacuum aspiration (USG-MVA) as opposed to traditional surgical evacuation (EVA) for the management of their first-trimester miscarriage.

Methods: This was a prospective single-centre, randomised controlled trial conducted in a university-affiliated tertiary hospital. Chinese women aged [Formula: see text]18 years with a delayed miscarriage [Formula: see text]12 weeks of gestation or incomplete miscarriage attending the hospital were randomized to either USG-MVA or EVA for the management of their miscarriage. They were invited to come back for a hysteroscopic assessment for IUA at 6-20 weeks post-surgery to assess the incidence of IUA. Patients were contacted by phone at 6 months to assess their menstrual and reproductive outcomes.

Results: 303 patients underwent surgical evacuation, of whom 152 were randomized to the ‘USG-MVA’ and 151 patients to the ‘EVA’. 126 from the USG-MVA group and 125 from the EVA group returned and completed the hysteroscopic assessment. The incidence of the IUA from USG-MVA was 19.0% (n=24/126) and was significantly lower compared to EVA, which was at 32.0% (n=40/125). There was no significant difference in menstrual outcomes at 6 months postoperatively between the two groups, but more patients had miscarriages in the EVA group with IUA.

Conclusions: IUAs are a possible complication of USG-MVA. However, USG-MVA is associated with a lower incidence of IUA postoperatively at 6-20 weeks. USG-MVA is a feasible, effective, and safe alternative surgical treatment with less IUA for the management of first-trimester miscarriage.
#357 : Uterine Fibroids Treatment Using Radio Frequency Ablation at Hanoi Obstetrics and Gynecology Hospital, Vietnam: A Preliminary Assessment
Authors: Ahn Dao Le Thi , Van Vu Duong , Toan Thang Vuong , Duy Anh Nguyen
Published: January 2024

Complicated uterine fibroids in young women, who wish to preserve fertility, and/ or unwilling to undergo surgery, or those having uterine fibroids deemed difficult for surgical intervention, need a less invasive and effective treatment method.

Objectives: To evaluate the results of treatment of uterine fibroids by Radio Frequency Ablation (RFA) at Hanoi Obstetrics and Gynecology Hospital, Vietnam (HOGH) for 8 months.

Materials and Methods: A cross-sectional study with longitudinal follow-up. Patients with symptomatic uterine fibroids including abnormal uterine bleeding, pelvic pain, anemia; in need of preserving fertility; without any RFA contra-indications.

Results: 18 patients with 20 fibroids were met with the study’s inclusion criteria. The average fibroid size was 4.6±1.3 cm. 77,8% of patients having anemia. Average thermal ablation time was 12.2±4.1 minutes. Fibroids’ size decreased 43.6% after 1 month, 69.6% after 3 months and 83.6% after 6 months. Menstrual disorders and pelvic pain were considerably improved after 1 month and 3 months.

Conclusions: RFA had good initial results in reducing fibroids size and improving relating symptoms during the study period.
#378 : Intrauterine Suture of Levonorgestrel Intrauterine Device Under Hysteroscopy
Authors: Shi Xiaoyu , Zhang Shengpeng , Feng Limin
Published: January 2024

Background and Aims: Levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective and long-term treatment for adenomyosis, especially for patients who have severe dysmenorrhea symptoms but a strong desire to preserve their uterus. However, expulsion of the device for patients with an enlarged uterus remains a problem. In this study, an LNG-IUS was stitched on the posterior wall of the uterus under hysteroscopy, which can be an alternative method to this problem.

Methods: 21 patients with adenomyosis who had previously been treated with the LNG-IUS and experienced expulsion for at least one time were enrolled. The fixation of the LNG-IUD on the posterior wall of the uterus was performed with a 4-0 Ethicon polypropylene non-absorbable suture through an endoscopic needle driver and a knot-pushing device.

Results: During the postoperative follow-up, all patients experienced complete remission of their symptoms: a significant decrease in menstrual flow, relief of dysmenorrhea, and improvement in quality of life. No expulsion of device and other compilations were found.

Conclusions: In patients with adenomyosis suffering from dysmenorrhea or heavy menstrual blood loss, suture fixation of an LNG-IUS using the hysteroscopic cold knife surgery system is a minimally invasive and effective alternative treatment for patients with an enlarged uterus and decreases the risk of LNG-IUS expulsion.
#120 : Effect of Aromatase Inhibitor, Letrozole on Semen Parameters in Eugonadotropic Hypoandrogenic Men with Oligozoospermia
Authors: Jahan Israt
Published: January 2024

Background and Aims: Some men with severely defective sperm production commonly have excess aromatase activity, reflected by low serum testosterone and relatively elevated estradiol level. Elevated levels of estrogen lead to feedback inhibition of the hypothalamic-pituitary-gonadal axis, and the end result is a decrease in LH necessary for the production of testosterone and FSH to optimize sperm production.

The aim of the study was to evaluate the effect of aromatase inhibitor, letrozole on the semen parameters of infertile male having oligozoospermia, low serum testosterone level and testosterone to estradiol ratio < 10.

Method: This prospective study was conducted in the Department of Reproductive Endocrinology and Infertility at Bangabandhu Sheikh Mujib medical University, Dhaka, Bangladesh during the period from May 2019 to April 2020. The sample size was 30 sub fertile men with oligozoospermia (<-10 million/ml), low serum testosterone level (<300 ng/dl), and low testosterone to estradiol ratio (<10). All patients were treated with letrozole 2.5 mg daily for 4 months. At the end of the 4 months semen analysis was performed. Statistical analysis was carried out by using IBM Statistical Package for Social Sciences version 25 for windows.

Results: The sperm concentration, sperm motility and total motile sperm count significantly increased after letrozole treatment. The side effects were mild and well tolerated.

Conclusion: This study suggests that some men with oligozoospermia low serum testosterone levels and normal gonadotropin concentration may have a treatable endocrinopathy. Letrozole may be used to improve sperm parameters in infertile men with low serum testosterone to estradiol ratio.
#268 : Assessment of Seminal Micro-Biota and Its Impact on Semen Parameters Using Next-Generation Sequencing
Authors: Vajpeyee Manisha , Tiwari Shivam , Yadav Lokendra , Chimote Nishad
Published: January 2024

Background and Aims: To assess seminal microbiome and its impact on semen parameters, Male genitourinary tract infections are believed to affect reproductive health and affect semen quality. Despite a possible link between bacteria and infertility, few studies have attempted to characterize the seminal microbiota in healthy and diseased subjects.

Methods: The microbial composition was analysed by 16S ribosomal RNA (rRNA) gene amplification with (MinION) oxford Nanopore Ltd. In a cohort of infertility-related cases (N = 166) and controls (N = 69).

Results: Diverse kinds of bacteria were present in most of the samples from infertile patients with normal and abnormal semen parameters, the bacterial communities varied widely between subjects, however, statistical tests showed a significant negative association between sperm quality and the presence of certain pathogenic bacteria. In seminal hyper-viscosity group had a lower abundance of the probiotic’s lactobacillus and a higher abundance of infections Proteobacteria.

In addition, the principal component analysis (PCA) revealed a difference in microbial composition between the normal and abnormal groups, as well as a larger microbial abundance in hyper-viscosity and oligoasthenospermia; samples compared to control groups.

Conclusions: We intend to describe seminal microbe’s role in reproduction as well as association with male infertility. Our results suggested that microbes play an important role in our life as they can have negative as well as positive impact of semen associated with male factor fertility.
#327 : The Characteristics of Menopausal Women in Moewardi Hospital: What Factors Could Lead to the Depression?
Authors: Jatiningtyas Abida Zuhra , Nugroho Christa Edo , Wijayanti Agung Sari , Budihastuti Uki Retno , Melinawati Eriana
Published: January 2024

Background and Aims: A Woman may begin to experience several symptoms during the premenopausal and menopausal stages, including depression. Some studies have linked the emergence of various symptoms, including emotional changes, to hormonal changes. Several factors could lead to depression, such as the knowledge and the behaviour of premenopausal and menopausal women, nutritional status, duration of menopause, access to health care, and many more. The primary goal of this study was to determine the relationship between menopause and depression by examining the subjects’ Hamilton Depression Rating Scale (HAM-D) results and some potentially related characteristics.

Method: This research was held in Moewardi Hospital, Surakarta, Indonesia between July until December 2022, involving participants women aged 40-60 years old, totaling 60 people. Thematic analysis of semi-structured interviews based on the HAM-D was employed in this study. We examined the characteristics such as age, duration of menopause, body mass index, hypertension, anxiety, and activities. The data were collected from women aged 40 and over, in the premenopausal or menopausal phase, who agreed to be interviewed and gave informed consent and analysed with IBM SPSS Statistic 23.

Results: Statistical tests showed that there was no correlation between depression and a woman’s age (p=0.404), duration of menopause (p=0.846), body mass index (p=0.339), and hypertension (p=0.909). We found significant results of depression with anxiety (p<0.001) as well as patients’ activities (p<0.001). These two characteristics were included in the HAM-D and then grouped into five categories according to the HAM-D. This questionnaire gave results weak correlation between depression and the menopausal phase (p=0.176).

Conclusion: Several factors could lead to the incidence of depression in premenopausal and menopausal women. This study found that there was a correlation between depression and anxiety and patient’s activity.
#134 : Unraveling the mTORC1 Mediated Pathway for Reproductive Longevity Rejuvenation by Targetting RPS6
Authors: Tan Xue Ting , Teh Daniel BL , Lau Lang-Chu , Sim Weiling Eunice , Lee Jovin , Tang Richard , Lee Jonathan , Lee Jin-Young , Deng Shuo , Yap Celestial Theresa , Tan Tuan Zea , Ong Wei Yi , Pan Feng , Tan Xing Fei , Yip George W. , Huang Zhongwei
Published: January 2024

Background and Aims: The mTORC1 pathway is known to play a critical role in longevity and is a central regulator for various pathways including cellular, inflammation, and metabolic pathways. Age-related functional decline in tissue was associated with dysregulation of the mTORC1 pathway. mTORC1 suppression has been shown to improve ovarian function in mice, but the underlying cause remains elusive. We aim to investigate a common denominator of mTOR1, ribosomal protein S6 (rpS6), and its role in reproductive longevity through transient inhibition of the rps6 axis using murine models.

Method: Selective inhibition of the mTORC1 pathway and the rpS6 axis were achieved using rapamycin and LY2584702 Tosylate respectively. Subcutaneous injection of both drugs was administered to 48-week-old female virgin C57BL/6J mice for thrice weekly for 8 weeks. Reproductive outcomes such as mating frequencies, fecundity, and lifespan were recorded.

Results: Reproductive parameters measured revealed that these 48-week-old female virgin treated mice resulted in the increase in serum Anti-Mullerian hormone levels, total number of ovarian follicles, mating frequencies and probability of live births. Untreated control mice at 62 weeks old did not yield any live births. Comparison between the two treatment groups suggested that selective inhibition of rpS6 demonstrated higher probability of live births and higher average number of live offspring per litter.

Conclusion: This study provides novel insights into the roles of mTORC1 and rpS6 in both reproductive and healthy longevity. Our findings suggest temporary rpS6 inhibition successfully rejuvenated ageing ovaries, with the novel discovery in the improvement of fecundity of LY2584702 treated mice.
#320 : Metabolic Risks in Women with Polycystic Ovary Syndrome Diagnosed by the Rotterdam Criteria Versus the New International Criteria
Authors: Li Raymond Hang Wun , Ng Ernest Hung Yu
Published: January 2024

Background and Aims: In the Rotterdam criteria (2003), polycystic ovary morphology for diagnosing polycystic ovary syndrome (PCOS) was defined as an antral follicle count (AFC) of 12 or more (or ovarian volume of 10 cc or more) in either ovary. In the international guideline (2018), the AFC threshold was increased to 20. We compared the metabolic risks in women with PCOS diagnosed by these two ultrasound criteria.

Method: We prospectively recruited 467 women with PCOS diagnosed by the Rotterdam criteria, and 240 healthy ovulatory women as controls. Of those in the PCOS cohort, 142 had AFC of 12 to 19 (Rotterdam criteria group), while 325 had AFC of 20 or above in either ovary (international criteria group). The prevalence rates of dysglycaemia and metabolic syndrome (MetS) (and its constituent components) at baseline were compared by chi-squared test. The cumulative hazard of dysglycaemia and MetS were compared between the two groups by Kaplan-Meier survival analysis.

Results: Compared to controls, women in both groups had significantly higher (p<0.05) prevalence of dysglycaemia, MetS, elevated waist circumference, reduced HDL-cholesterol and elevated fasting glucose. In addition, those in the international criteria group had a significantly higher (p<0.05) prevalence of hypertriglyceridaemia and hypertension. Upon longitudinal follow-up censored at the sixth completed year, 23 (16.3%) women in the Rotterdam criteria group versus 80 (24.8%) women in the international criteria group had dysglycaemia (p=0.044), with a hazard ratio of 1.560 (95% CI 1.005-2.389) (p=0.048). Meanwhile, 33 (23.2%) and 96 (29.7%) women in the Rotterdam and international criteria groups respectively had MetS (p=0.151), with a hazard ratio of 1.343 (95% CI 0.910-1.984) (p=0.138).

Conclusion: Women with PCOS, either diagnosed by the AFC threshold of the Rotterdam criteria or international criteria, are both at elevated risks of dysglycaemia and MetS, with the latter group demonstrating an exaggerated risk of dysglycaemia.
#81 : Result of Non-Invasive Preimplantation Genetic Testing for Aneuploidy in Different Culture Medium Condition
Authors: Iffanolida Pritta Ameilia , Harzif Achmad Kemal , Mutia Kresna , Febri Ririn Rahmala , Gunarwati Deka Putri , Maidarti Mila , Wiweko Budi , Hestiantoro Andon
Published: January 2024

Background and Aims: Non-invasive preimplantation genetic testing (niPGT-A) emerged from the discovery of embryonic DNA in spent embryo culture medium. Many studies have been developed in order to replace Preimplantation Genetic Testing (PGT) in assisted reproductive clinic, however the results between each study varies. We hypothesized that the condition of culture medium is one of the key factors that rely on. The aim of this study is to compare the niPGT-A result between single step culture medium (SCM) and two step culture medium (TCM).

Method: We conducted a cross-sectional study to compare the niPGT-A result between SCM and TCM with tropectoderm (TE) biopsy performed on day 5/6 as a gold standard for chromosomal analysis. The embryo was individually cultured in a 20 uL volume of cuture medium, for SCM group we used Sage one step culture medium from D1 to D5. For TCM group we used Cleav culture medium from D1 to D3 followed by Blast medium until D5. In day 5/6 we performed TE biopsy, and the embryo was freezing, then we took the spent blastocyst medium (SBM). A total 240 samples of SCM, TCM and TE were screened for chromosomal abnormality by Next Generation Sequencing (NGS) method.

Results: The amplification rate of SCM and TCM groups was both 100% with average DNA yield of 18.1 ng/uL and 25.2 ng/uL, respectively. We validated these results by comparing chromosome status of blastocyst stage embryos as the standard, SCM group have 98.4% sensitivity and 79.4% specificity meanwhile for TCM group chromosomal status assessment using SBM had sensitivity of 85% dan specificity of 70%.

Conclusion: The results found report successful amplification, high agreement rates and good sensitivity and specificity of the culture medium analysis. We can conclude that the time the embryo remains in contact with the culture medium favored the results.
#249 : Spotlight on the Artefacts in Next Generation Sequencing in PGT-A: Possible Reason for High Mosaicism Reporting
Authors: Singh Neeta , Gupta Ritu , Rani Lata , Sethi Ankita
Published: January 2024

Background and Aims: Advancement in Next Generation Sequencing (NGS) has led to the extensive utilization of Preimplantation Genetic testing for Aneuploidy. But one challenge, in reporting of aligned short read sequencing data, is the ability to discriminate between embryonic NGS profiles with genuine pathological copy number variations (CNVs) from artefacts arising from erroneous DNA amplification/library preparation. Do technical errors in VeriSeq-NGS lead to artefacts in CNV charts resulting in falsely increased reporting of chromosomal mosaicism?

Method: After ethical clearance and informed consent, patients [Formula: see text] 35 years, [Formula: see text]1 implantation failures and severe male factor infertility underwent PGT-A. Those with aneuploid embryos on TE biopsy, donated their embryos for research in year 2022. The DNA extraction and amplification was carried out using Sureplex-DNA amplification system. The libraries were prepared using VeriSeqTM-PGS Library Preparation kit. A total of 24 libraries were pooled, denatured and subjected to NGS using Illumina MiSeq system. CNV visualization and analysis for each sample was carried out using BlueFuse Multi Software (Illumina, USA). The aneuploid whole blastocyst were subjected to the same protocol.

Results: NGS profiles generated from the aneuploid whole blastocysts, were manually analyzed for CNVs and for any common genomic artifacts. The quality control was performed using Illumina-Quality Control requirements and only samples satisfying these requirements were used for analysis in the study. Common artifacts were identified affecting chromosome 7,11,16 and 19. Out of 22 blastocysts, NGS profiles of 21 blastocysts had artifact at chromosome 19, and 15 had artifacts at chromosome 7,11,16. These artifacts may be introduced during whole genome amplification and/or suboptimal NGS library preparation or is inherent weakness of the VeriSeq-NGS kit.

Conclusion: The four commonly occurring artefacts involved chromosome 7,11,16 and 19, which could be introduced during steps of whole genome amplification or library preparation. The awareness of these artefacts is important to reduce the false positive/inconclusive rate.
#371 : Immunological Analysis of Endometrial Receptivity: A New Hope for Patients with Recurrent Implantation Failures
Authors: Nguyen Chien , Nguyen Xuyen , Nguyen Ly
Published: January 2024

Background and Aim: Recurrent implantation failures (RIF) remain always a strong problem for all IVF teams. Our ART Center started in 2015 and quickly we wanted to focus on implantation failure. After 2 or 3 embryo transfers without pregnancy, guidelines provide to perform exams such as karyotypes, Anti phospholipid, thrombophilia, uterine Doppler, hysteroscopy, endometrial biopsy with CD 136, laparoscopy, sperm DNA Fragmentation. However, a large part of these failures remains unexplained. Following the studies performed in France by N. Lédée in 2013, this study evaluates the results of a new exploration based on immunological analysis of endometrial receptivity.

Methods: This study is proposed, after other explorations already done, for patients with 6 or more embryos D3 or 3 embryos D5 transferred without pregnancy. Such an analysis is achieved on endometrial biopsy performed in middle luteal phase and sent to MatriceLab (Paris)

Immunological exploration is based on uNK count (uterine Natural Killer cells) and cytokines expression. According to these parameters, “individualized” care is proposed to patient for next embryo transfers to correct the disorder identified by analysis.

Results: From 2016 to 2020, 114 biopsies have been performed and sent to MatriceLab. 112 were suitable for analysis. According with results, 4 main profiles have been isolated: Normal immunity (22,3%) Dysregulation immunity (77,7%). Low local immune activation (25%). Over local immune activation (40,2%). “Mix” profile (12,5%) 95 patients have been performing FET following the analysis. Mean age 32.6 ±3.6 years. Mean number of transfers before biopsy 3.9 ±1.6. Mean number of embryos previously transferred 9.6 ±4.4. Deliveries in normal immunity group: 33% (n=6). Deliveries in dysregulation group treated with adapted protocol: 53,2% (n=40)

Conclusions: This pregnancy rate is much better than usual pregnancy rate expected after six embryos D3 or three embryos D5 transferred without pregnancy.
#216 : High Live Birth Rates After Low Dose Lymphocyte Immunization Therapy (LD-LIT) with Partner Lymphocytes in Recurrent Miscarriage Patients
Authors: Gupta Shyam Nandan , Palanivel Vasanthi , Chari Srinivas , PS Jishnu
Published: January 2024

Background and Aims: Recurrent Miscarriage (RM) affects 1–2% of couples trying to conceive, with 50% remaining unexplained. Meta-analyses suggest LIT improves pregnancy outcomes for RM couples. However, results are conflicting due to differing criteria and protocols. This study evaluates low dose LIT effectiveness in patients with unexplained RM and Th1/Th2/Treg paradigm disorders.

Method: Self-controlled, prospective study of 23 RM patients receiving partner lymphocyte immunization from August 2021 to October 2022, with [Formula: see text]3 miscarriages less than 12 weeks when endometrium at ET was [Formula: see text]8mm and PGT embryos were used. Patients with abnormal Th1/Th2/Treg cell proportions and biomarkers were treated with paternal lymphocytes twice before embryo transfer (ET) and once post-pregnancy confirmation.

Results: Significant decrease in Th1 and increase in Th2 cytokines like TNF-a and IFN-g and significantly increase in Treg cells and TGF-b noted and blocking antibodies detected in all patients after LIT therapy. 20/23 (87%) post LIT conceived and 4 delivered healthy full-term babies (17%) and 3 patients have yet to undergo ET. 48% (11/23) uneventful ongoing pregnancies crossed [Formula: see text]14 weeks. 3 patients had miscarriages (13%). 1 patient (4%) did not conceive. 1(4%) conceived spontaneously ([Formula: see text]25 wks) and 1(4%) opted to try to conceive naturally. Cumulative uneventful pregnancy outcome 65%.

Conclusion: LIT was associated with high live birth rates, especially in women with RM. It not only ameliorates patient’s cellular immune function, but also further increases patient’s pregnancy success rate with high safety, which is worthy of clinical application and promotion. Being small size self-controlled study, this result needs to be validated with large we’ll planned RCTs. LIT may be considered a safe and effective treatment for RM/RIF in IVF patients in individual cases based on immunoprofiling (Th1/Th2/Treg paradigm disorders), after ruling out other potential causes of RM or RIF.
#220 : PDGFBB Improved the Biological Function of Menstrual Blood-Derived Stromal Cells and the Anti-Fibrotic Properties of Exosomes
Authors: Tan Jichun , Zhang Xudong , Zhang Siwen , Qi Jiarui
Published: January 2024

Background and Aims: Intrauterine adhesion (IUA) is a reproductive dysfunction disease characterized by endometrial fibrosis, with limited therapeutic options and poor prognosis. Our previous studies confirmed that menstrual blood-derived stromal cells (MenSCs) effectively attenuated endometrial fibrosis in IUA rats mainly through exosomes. This therapeutic effect can be enhanced by platelet-rich plasma (PRP), in which PDGFBB is an abundant growth factor. Therefore, we aimed to compare the effects of PRP and PDGFBB on the biological activities of MenSCs in vitro, and to further evaluate the molecular mechanism of MenSCs-derived exosomes (MenSCs-exos) in alleviating endometrial fibrosis.

Method: MenSCs were isolated for in vitro functional assays to examine the viability, migration, and stemness of MenSCs. Endometrial stromal cells (EndoSCs) were treated with 50 ug/ml of MenSCs-exos, obtained by differential ultracentrifugation extraction. The molecular mechanisms by which PDGFBB improves MenSCs and exosomes alleviate EndoSCs fibrosis were then explored using immunofluorescence, western blot, and co-immunoprecipitation.

Results: Both 100 ng/ml PDGFBB and 10% activated PRP promoted the proliferation and inhibit apoptosis of MenSCs in vitro. Compared with PRP, PDGFBB significantly promoted MenSCs migration. All of these effects were inhibited by the PDGFR-[Formula: see text] inhibitor sorafenib. PRP and PDGFBB activated AKT/NF-[Formula: see text]B signaling pathway in MenSCs and increased the expression of P65 and OCT4. Moreover, pretreatment of PDGFBB did not increase the secretion of MenSCs but significantly increased the anti-fibrosis effects of MenSCs-exos in IUA-EndoSCs. MenSCs-exos attenuated SMAD3 phosphorylation and increased YAP ubiquitination, which reduced the binding of YAP/SMAD3. Pretreatment with PDGFBB amplifies this effect.

Conclusion: In summary, PDGFBB could improve the biological functions of MenSCs via AKT/NF-[Formula: see text]B signaling pathway, including viability, migration, and stemness. PDGFBB amplified MenSCs-exos to attenuate endometrial fibrosis by inhibiting YAP activity, revealing a novel mechanism by which PRP enhanced MenSCs to repair tissue injury and providing a potential option for improving stem cell efficacy in IUA.