bluuebunny/crossref_metadata_2025 huggingface dataset:
O-052 Male fertility testing - new horizons, ideas and research
Authors: Salas-Huetos A
Published: June 2022

The diagnosis of male infertility is primarily based on the macroscopic analysis of semen and microscopic analysis of sperm (mainly concentration and count, motility, and morphology) through the seminogram. Although six different editions of the “WHO Manual for the Laboratory Examination and Processing of Human Semen” have been published to date, the diagnostic potential of this approach has been called into question. Additionally, recent studies report a significant decline in sperm counts and fecundability in general. Therefore, the need for alternative diagnostic approaches that effectively predict fertility in men is urgently needed.

In this talk we will cover what the limitations of the current semen analysis are, what novel tests are available and more important the new horizons, ideas and research in male fertility testing. We will focus in: 1) the usefulness of sperm functionality analyses (e.g., vitality, plasma membrane and acrosome integrity, plasma membrane lipid disorder, mitochondrial membrane potential, mitochondrial peroxide and superoxide levels, intracellular levels of ROS and Ca2+, and sperm chromatin condensation, among others), 2) the clinical implications of sperm DNA fragmentation and the newest recommendations for assisted reproduction clinics, 3) the newly described monogenic causes of human male infertility, and 4) how comorbidities are related with infertility.
O-112 Fertility awareness: Educating the teenagers in europe
Authors: Özdemir E
Published: June 2022

The term fertility awareness has been long associated with specific methods of family planning. Within the context of reproductive health and fertility issues, fertility awareness is a level of knowledge of the society on the topics of human reproduction system, fertility life cycle, possible threats to reproductive health and the ways of its protection. Moreover, as the birth rates have been continuously falling throughout Europe and the number of European citizens with fertility issues has increased during the last 50 years, fertility and infertility have been put into the spotlight for scientists, policy-makers, non-government organizations and other stakeholders. Therefore, the level of fertility awareness should be increased among all society groups. The main objective of the Fertility Awareness Project is to digitally reach teenagers aged 15-18 in various European countries in order to check their knowledge of fertility and to raise their awareness level. Fertility Awareness Project will follow a knowledge-based, holistic, systemic approach built on two pillars: collecting information and providing information. For this purpose, a digital tool will be developed to measure/increase fertility awareness and this tool will be disseminated in 4 selected European countries among teenagers aged 15-18, aiming to reach as many respondents as possible. After the data collection, a large effort will be devoted to evaluate the results based on the application usage by the target group. Thus, the Fertility Awareness Project will provide reliable information on the levels of fertility awareness among young people in Europe and the outcome of the project will help us to advocate for actions to promote fertility education on EU and national levels.
O-114 Preimplantation genetic testing for monogenic diseases without necessary familial members
Authors: Li R
Published: June 2022

Preimplantation genetic testing for monogenic diseases (PGT-M) is available for any single gene defects theoretically, as long as the disease-causing locus has been unequivocally identified. However, PGT-M has faced great challenges for couples with more than one genetic mutation, de novo mutations or without essential family members for linkage analysis. In order to overcome these challenges, we developed a comprehensive strategy which includes preimplantation genetic testing for aneuploidies (PGT-A) and chromosomal structural rearrangements (PGT-SR) study, as well as monogenic diagnosis study for couples bearing de novo mutations or without necessary familial members. The innovation of our strategy is to use the gamete (polar body or single sperm) or embryo as proband for linkage analyses (GEPLA) to detect an embryo’s carrier status. GEPLA strategy uses affected embryo as proband or gametes carrying mutant alleles as proband for SNP linkage analyses, that were suitable for all types of patients mentioned above. Using this novel developed method, nine autosomal dominant polycystic kidney disease (ADPKD) couples with either de novo mutation or without a positive family history were recruited. Moreover, other two couples with single gene disorders (SMA and NF2) which lack of essential family members for linkage analysis including de novo mutation, and also combined with reciprocal translocation were recruited too. For nine ADPKD couples, a total of 34 embryos from 13 PGT-M cycles were examined and two couples were successfully delivered healthy babies. For the other two couples, 15 embryos were screened, and two embryos were determined as free of the monogenic disease and specific chromosomal abnormalities created by reciprocal translocations. This study provides a creative approach for embryo diagnosis of patients with de novo mutations or patients lacking of essential family members for linkage analysis, and even for reciprocal chromosome translocation concurrently.
O-152 The role of South-South and Triangular Cooperation in the establishment of national and regional registries
Authors: Zegers F , Dyer S , De Mouzon J , Kupka M , Banker M , Ishihara O , Chambers G.M , Adamson G.D
Published: June 2022

The United Nations refers to South-South cooperation as a broad framework of collaboration between developing countries in the Global South. It can take place on a bilateral, regional, or interregional basis. Its main purpose is to share knowledge, skills, resources and successful initiatives to meet development goals through concerted partnerships. Triangular cooperation implies the presence of traditional donor countries and organizations which facilitate South-South initiatives. Both forms of cooperation carry distinct benefits and differ from the more traditional North-South partnerships.

This presentation will describe how, under the umbrella and support of ICMART, regional and interregional ART registries in the developing South, specifically the Latin American registry (REDLARA) and the African registry (ANARA), are contributing to the development, sustainability and cohesion in ART monitoring among the many countries they represent. With an innovative and standardized ART registry as a backbone, 35 countries in these two continents are now organized in regional reproductive networks increasing their recognition, visibility and impact,

We shall demonstrate that this south-south and triangular cooperation, built upon a spirit of community and regional belonging is a strong facilitator of ART monitoring and transfer of technology to the developing South, and its ongoing expansion and reach. In Latin America, where REDLARA was established 30 years ago, local and expedited channels of communication have furthermore underpinned the training of embryologists, clinicians and other health care professionals through regional networks of professionals and certified training centers. This has resulted in enhanced ART self-reliance including the capability to implement new ART technologies and also monitor their availability, utilization, effectiveness and safety. Similar initiatives, strongly supported by REDLARA and ICMART, are starting to be implemented among African institutions via ANARA.

Lastly, we shall demonstrate that our regional as well as global ART registries, together with other international organizations, have contributed to the dissemination of knowledge and serve as monitors and external quality controls now for 35 countries and almost 300 institutions in Latin America and Africa. Furthermore, given that both continents are progressively implementing the same cycle-based reporting system, new knowledge will be gained by examining regional and country similarities and differences.
O-154 Genetic screening in male infertility: time for new guidelines?
Authors: Oud M
Published: June 2022

Approximately 1 in 7 couples wishing to conceive fail to do so after one year of trying. About half of the cases can be assigned to male factors. Currently, genetic causes explain approximately 4-9% of all cases of male infertility, with strong variation among the different subtypes of infertility. Presently a majority of all infertile males (60-70%) remain without a clear diagnosis, despite the expectation that genetic causes explain a substantial fraction of these patients. Without a genetic diagnosis, it is impossible for a clinician to accurately provide counseling to couples with questions about the causes of their infertility, possible co-morbidities, the potential success of ART treatment and the reproductive health of their offspring. Hence, knowing and understanding the genetic causes of infertility is of enormous value to patients and clinicians.

Already for more than 25 years, genetic testing is recommended for patients with severe oligozoospermia or azoospermia. These tests typically include karyotyping, azoospermia factor (AZF) deletion screening and/or CFTR mutation testing (in case of CBAVD). For a long time, further genetic testing was time-consuming and expensive, resulting in slow progress to unveil novel causes of male infertility in both research and clinic. The uptake of next-generation sequencing (NGS) methods has revolutionized genetic testing for a plethora of disorders, allowing for cost-effective screening of variants in limited gene panels, all coding parts of genes (exome), or the entire genome. NGS is now routinely used by many laboratories for genetic testing in diagnostics and research. Using these new technologies, we and others have identified numerous novel causal variants in genes indispensable for human fertility.

Although the use of NGS in male infertility research is skyrocketing in recent years, it has not yet broadly found its way into diagnostics. This means that 1) numerous patients with over a hundred newly discovered monogenic causes of male infertility are presently left undiagnosed and 2) large groups of patients with phenotypes such as globozoospermia or multiple morphological abnormalities of the sperm flagellum do not routinely receive genetic testing, even though diagnostic yields of up to 60% can be expected.

The field of genetics of male infertility is rapidly evolving and it is time for patients to benefit from these advances. This talk will cover the steps we and others are taking towards bringing NGS methods such as whole exome sequencing to the clinic for male infertility and will show the first results on the validation of our whole exome sequencing-based test for male infertility.
O-166 Alterations of stimulation in the face of endometriosis
Authors: Cedars M
Published: June 2022

Endometriosis is a common diagnosis in women with infertility.  As IVF is increasingly being utilized as the most effective treatment for infertility, the implication of a prior endometriosis diagnosis on the ovarian stimulation portion of the process becomes of paramount importance.  Early studies suggested pre-treatment with GnRH agonist improved pregnancy outcome.  These studies were in a time when stimulation, retrieval, fertilization and culture, and transfer occurred in a single cycle. This was considered to improve “oocyte health” decreasing the inflammatory environment in which the follicle develops.  However, increasingly, information has evolved about the impact of endometriosis on eutopic endometrium.  So, the relevance of this treatment in the current model, whereby stimulation and transfer are frequently separated, has not be considered in detail. Other common dogma regarding the role of endometriosis in fertility, IVF and pregnancy are beginning to be questioned. In this presentation, we discuss the implication of endometriosis on all aspects of ovarian stimulation including pre-cycle evaluation and management and how these treatments may impact ovarian reserve and ovarian reserve assessment.  We then discuss current data regarding benefits and potential risks of pre-treatment suppression. We will consider stimulation specifics and adjuvants and whether stimulation itself may have an impact on the progression of endometriosis.  In a time when surgery, the prior mainstay of diagnosis and management for endometriosis, is performed less commonly, will non-invasive markers of endometriosis increase identification and treatment indications?  Are there data that these treatments actually improve outcome of ovarian stimulation?  How does endometriosis impact oocyte and embryo “quality”?  Our goal is to harmonize data, as applied in modern fertility care, regarding endometriosis evaluation, treatment and impact on IVF outcome.
O-167 Microfluidics to mimic female reproductive tract
Authors: Xiao S
Published: June 2022

The female reproductive tract (FRT) consists of major organs of the ovary, the female gonad, and downstream fallopian tube, uterus, and cervix. There are intimate relationships between cells in each reproductive organ as well as between each organ to sustain women’s menstrual cycle and fertility. So far, there are few effective in vitro or ex vivo models that both faithfully recapitulate the hallmarks of female reproduction and possess scalability. In this presentation, I will first introduce how we used an alginate hydrogel-based 3D encapsulated in vitro follicle growth (eIVFG) system to engineer a mini-ovary, which can recapitulate key ovarian functions as occurring in vivo, including gonadotropin-dependent folliculogenesis, oocyte maturation, ovarian steroidogenesis, ovulation, and luteinization. Next, I will introduce how we used the emerging microfluidic technology to engineer an FRT-on-a-chip. The FRT-on-a-chip allows organ-organ integration of hormonal signaling, which simulates women’s 28-day menstrual cycle and also the pregnancy-like endocrine loops. In summary, the engineered mini-ovary and FRT-on-a-chip are new powerful tools for studying female reproductive biology, disease, contraception, drug development, and toxicology.
O-169 A CV of trying
Authors: Lukkarinen A
Published: June 2022

Anna Lukkarinen shares real patient experiences from treatments along the infertility path. Focusing on the key points learned from these experiences, she highlights the important role that professionals have as contributors to patients’ emotional and physical well-being. In particular, she addresses the following themes:

• Public side vs. private side treatments

• Patient-professional power structures

• Patient-patient encounters

• Dealing with fear, sorrow, and longing

• The encounters’ long-term effects

It is important to remain aware that most patients enter the infertility path non-knowledgeable and inexperienced. For these outcomes of experiential learning to become accessible to all patients, old and new, they need to be internalized by patient-serving professionals.
O-195 Disease-free survival is not impacted by fertility preservation techniques for breast cancer women
Authors: Grynberg M , Amsellem N , Mayeur A , Laup L , Pistilli B , Delaloge S , Sifer C , Sonigo C
Published: June 2022

Study question

Do fertility preservation (FP) strategies using ovarian stimulation or not, impact long-term disease-free survival of breast cancer (BC) patients?

Summary answer

The disease-free survival of BC patients is not impacted by FP techniques whatever the timing of chemotherapy (neoadjuvant /adjuvant) and the use of ovarian stimulation.  

What is known already

Fertility is often impaired in young women treated for BC. Therefore, FP has become a major issue in this population. Cryopreservation of oocytes or embryos after controlled ovarian hyperstimulation (COH) represents the most established method in this clinical situation. However, the hormonal consequences of COH protocols still raise safety concerns, often leading oncologists to contraindicate the use of this FP technique. Although alternative FP options without exogenous hormone administration may be considered, they remain suboptimal for treating the putative future infertility.

Study design, size, duration

Retrospective bicentric cohort study including including 740 BC women, 18-43 years of age, referred for FP between 2013 and 2019.

Participants/materials, setting, methods

Overall, 328 underwent at least one ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (No STIM group). Log Rank test was used to compare both groups and Cox proportional-hazard model was applied for multivariable analyses.

Main results and the role of chance

Women of the No STIM group were significantly younger and present with more severe disease. Follow-up data for recurrences were available for 80.9% of the cohort and the median time to follow-up was 4.2 [2.9-5.8] vs. 5.6 [4.1-6.7] years between STIM and No STIM group (p < 0.0001). According to log-rank test, the risk of recurrence did not differ between the two groups (p = 0.09) even after adjustment on age, SBR grade, triple negative status or type of planned chemotherapy.

Limitations, reasons for caution

The retrospective nature of the study represents the main limitation. The median follow-up of 4.2 to 5.6 years, might be considered short to assess the long-term safety of FP techniques. The heterogeneity between oncological centers regarding the use of COH and specific protocols may lalso be a reason for caution.

Wider implications of the findings

Our findings provide reassuring safety data on the use COH for FP in BC patients, whatever the timing of chemotherapy. However, further investigations with a longer follow-up are needed to definitely consider COH safe in particular in neoadjuvant situations. In addition, the benefit of letrozole supplementation during COH requires confirmation.

Trial registration number

Not applicable
O-222 Surveillance of scientific research integrity in medically assisted reproduction: a systematic review of the retracted literature
Authors: Minetto S , Zanirato M , Pisaturo V , Makieva S , Esposito S , Cermisoni G.C , Rabellotti E , Viganò P , Candiani M , Papaleo E , Alteri A
Published: June 2022

Study question

How many retracted papers are there in the medically assisted reproduction (MAR) literature and, more importantly, what are their particulars?

Summary answer

Article retraction within MAR literature is increasing and the most common reasons for retraction are errors in data and duplicate publications.

What is known already

Article retraction accounts for one of the most serious consequences of research misconduct. Articles may be subject to retraction whenever the findings are found to be unreliable, redundant, plagiarised or the authors are found to have performed unethical research or hidden

Trial registration number

N/A
O-224 Novel bio-markers of Immunological response to the implanting embryo
Authors: Li T.C
Published: June 2022

Embryos, as allograft, will fail to implant unless they can escape rejection by maternal immune response. It is postulated that embryos escape Immune surveillance using a mechanism similar to that of cancer cells via Immune check point pathways: (a) via producing a surface protein called PD-L1, which binds to PD-1 receptor in T-cells; and (b) via producing a surface protein called Galectin-9 which binds to T-cell immunoglobulin and mucin domain 3 (TIM-3). The binding of these ligands to the corresponding receptors in the T-cells would prevent the latter from recognizing them as foreign, hence escape destruction. In a prospective, longitudinal, observational cohort study involving subjects undergoing blastocyst transfer, it was found that among women who conceived, there was an instant, transient and significant reduction of Tim-3 expression on the surface of peripheral NK cells, T cells and NK-like T cells on days 3 and 6 after ET, which returned to baseline level by day 9 after ET. The change in women who did not conceive appeared in an opposite direction. Furthermore, reduction in Tim-3 expression in pNK cells predates the occurrence of miscarriage by 3 weeks in women with miscarriage when compared with those with live birth. These observations are accompanied by significant changes in peripheral blood cytokine profiles which may be used as clinically useful biomarkers to monitor the maternal immunological response to successful implantation.
O-282 Is the poly parenthood the new type of parenthood?
Authors: Herbrand C
Published: June 2022

Is multi-parenthood the new type of parenthood?

Conceiving and raising a child with someone who is not a committed conjugal partner has long been disapproved of and is still regarded by some with concern or disdain. However, this way of having children, also referred to as ‘co-parenting’, has increasingly become a family-building option in itself. Originally describing the cooperation of parents in raising their children after divorce, this term now also designates people who deliberately pursue this type of family arrangement and commit to raising a child together, possibly with their respective partners. This parental path is usually chosen to provide a child with a mother and a father with whom they can develop long-lasting relationships.

This paper explores some of the opportunities and challenges presented by co-parenting involving more than two parental figures, by focussing on the experiences and accounts of lesbian women and gay men engaged in such family arrangements in Belgium. Drawing on work by social theorists of the family, the main features and advantages of these arrangements are examined to show that while co-parenting might at first seem marginal and complicated, it appears particularly well adapted to contemporary social constraints and parenting expectations. It can facilitate the achievement of a number of ideals and expectations valued in contemporary society, including: the biological heteronormativefamily model; the possibility to negotiate and implement reflexive parentalpractices; the need for a committed but personalised parenthood; and the desire for a betterand more flexible life-balance. Despite these advantages for those involved, multi-parental arrangements raise a set of social, ethical and legal questions that challenge broader legal and ideological family norms.
O-316 From insult to injury: war and cross border reproductive care (CBRC). Difficulties for patients and collaborators
Authors: Shenfield F
Published: June 2022

From Insult to Injury: War and Cross Border Reproductive Care (CBRC) after Covid

Ukraine has had a thriving fertility sector for many years, both for its citizens and foreigners, for whom it has been a very popular destination for cross-border commercial surrogacy, with an estimate of between 2000 and 2500 babies born each year. Such cross border reproductive activities had already been complicated by the Covid pandemics of the last 2 years, but when Russia invaded the country in February 2022, intended parents, surrogates, egg donors, agencies and local clinics faced an emergency which led to acute distress in addition to that already felt by all with a sudden war in Europe.

We discuss the available facts with regards to the disruption to fertility services for all concerned, as well as the complex legal and ethical issues surrounding this emergency. Neighboring countries have been accepting (mostly women) refugees, who may need health care in a system stressed by extra numbers of patients. Intended parents have been trying to ensure their plans are confirmed whilst their surrogate has probably moved to a different jurisdiction. Above all, the voice of collaborators may have been overwhelmed by that of the (future) families they are contracted to help. All this, will leave its mark on CBRC in an area which has been a traditional European and recently Chinese hub for years to come.
P-083 The incidence of sperm DNA damage in men with chronic reproductive health issues
Authors: Nyantakyi A , Al-Hussini M , Ramsay J , Minhas S , Lewis S , Haddock L , Yap T
Published: June 2022

Study question

What is the incidence of sperm DNA damage in men attending tertiary (urological) healthcare with long histories of infertility?

Summary answer

The majority of these men (95%), all with normal semen analyses had high levels of sperm DNA damage.

What is known already

Conventional semen analysis assesses sperm concentration, motility, and morphology but with a high degree of biological variability. Around 25% of men are given a diagnosis of unexplained infertility by normal semen analysis. The World Health Organisation (WHO) stated in 2021 that ‘clinically there is a growing awareness that chromosomal anomalies and gene mutations underlie a diverse spectrum of male infertility,’ so now recommends that sperm DNA is determined as an extended analysis. Sperm DNA damage occurs more often in infertile men and DNA damage is associated with recurrent pregnancy loss and decreased live birth rates following fertility treatment.

Study design, size, duration

A retrospective study of men attending a tertiary centre with productive failure had been offered a standard semen analysis and sperm DNA fragmentation using SpermComet technology.

Participants/materials, setting, methods

Results from 148 men tested between April 2017 and September 2021 were recruited from a tertiary urological database in the UK. Alongside a semen analysis, they also had a sperm DNA fragmentation test.

Sperm DNA quality for the participants was assessed and reported as average, low and high DNA damage as a percentage compared with clinical thresholds used by Examen from their sperm data bank of 74 fertile sperm donors with recently achieved clinical pregnancies.

Main results and the role of chance

The average comet score was 37.8% +/-0.5, low comet score was 35.3% +/- 1.5 and high comet score was 20.2% +/-1.2. These values were all significantly outside ( p < 0.001, Mann Whitney test)) fertile parameters.

95% of these men presenting for infertility investigations had a significantly raised DNA damage across their semen sample with low proportions of healthy sperm and high levels of sperm with genomic damage.

Limitations, reasons for caution

Retrospective design, small sample size, lack of randomisation and low power analysis.

Wider implications of the findings

Sperm DNA damage was found in most of these men who, over years of investigation hadn't been offered tests other than semen analysis or therapy to improve their sperm quality. Thus, this tool could be a useful adjunct to semen analysis to guide the men to reproductive health.

Trial registration number

not applicable
P-124 The impact of Fragile x premutation carrier state on embryo morphokinetic development, A comparison between genetically normal and abnormal embryos
Authors: Shulman Y , Kalma Y , Malcov M , Kopel R , Azem F , Almog B , Cohen Y
Published: June 2022

Study question

Does inheritance of FMR1 pre mutant allele affect embryos morphokinetic development?

Summary answer

Embryos that inherit the FMR1 pre-mutant allele are of a lower morphokinetic quality at the blastocyte stage compared to those with the normal allele.

What is known already

Previous studies suggest lower oocyte yield and blastulation rate in FMR1 premutation carriers undergoing preimplantation genetic testing for monogenic diseases (PGT-M). Yet, data is lacking concerning embryo morphokinetic development in this group.

Study design, size, duration

Retrospective analysis, on 529 embryos from 126 in vitro fertilization (IVF)- PGT-M cycles of 39 FMR-1 premutation women carriers.

Participants/materials, setting, methods

Morphological and morphokinetic parameters acquired by the time-lapse monitoring system were compared between embryos carrying the FMR-1 permutated allele (FMR1 group n = 271) to those who inherited the normal allele (Normal group n = 258). Outcomes measures were embryos morphokinetic parameters up to day 3, the start of blasulation time (tSB) for day 5 embryos, and the rate of top-quality embryos at days 3 and 5.

Main results and the role of chance

No differences were found between the groups in all morphokinetic parameters from the time of ICSI until biopsy on day 3. Blastulation rate was comparable between the groups. However, FMR1 embryos exhibited delayed start of blastulation compared to the genetically normal embryos (median tSB 104.2 hrs (99.3-110.3) vs 101.6 hrs (94.5-106.7), P = 0.01) and had lower top quality embryo rate (25.6% vs 38.8%, P = 0.04).

Limitations, reasons for caution

This study is limited by its retrospective design and inability to assess CGG expansion in the embryo.

Wider implications of the findings

This study offers new insight into the impact of permutated FMR1 gene in the early stages of embryo development. Further studies are needed in order to apply these results in clinical decision-making.

Trial registration number

not applicable
P-128 Role of PGT-A and ERA to optimise reproductive outcomes of couples with recurrent implantation failure
Authors: Mathew S.T , Chaitanya K , Rao D
Published: June 2022

Study question

In couples with Recurrent Implantation Failure (RIF), can Pre-implantation Genetic Testing for Aneuploidy (PGT-A) or Endometrial Receptive Array (ERA) help to optimise the reproductive outcomes?

Summary answer

In RIF patients PGT-A or ERA individually do not seem to optimize outcomes. PGT-A in-combination with ERA seems to be a beneficial intervention.

What is known already

Role of PGT-A and ERA to optimize reproductive outcomes has been ambigious. In this current study we wanted to evaluate their efficacy in RIF patients.

Study design, size, duration

This is a retrospective data of couples undergone treatment for RIF at our private fertility centre from January 2014 to July 2019. The study population was divided to four groups based on the treatments offered:

Group A: ERA (n = 47)

Group B: PGT-A (n = 54)

Group C: ERA+PGT-A (n = 49)

Group D: No PGT-A/ No ERA (n = 189)

Participants/materials, setting, methods

Couples with minimum two failed transfers were recruited. ICSI was the method of insemination. Blastocysts were subjected to genetic testing through Next-Generation Sequencing(NGS). All embryo transfers performed in a Frozen Embryo Replacement Cycle(FET). ERA was done as per our institutes Standard Operating Procedures(SOP) and for ERA patients ET was done as per the receptivity status.

Elective Single Euploid Blastocyst transfer (eSET) was done in grpB&C

un-screened double Blastocyst Transfer (DET) was done in grpA&D.

Main results and the role of chance

Clinical Pregnancy Rate (CPR), Miscarriage Rate (MR) Implantation Rate (IR), Multiple Pregnanacy rates (MPR) and Live Birth Rate (LBR) was evaluated in all groups.

Outcomes of groups A, B, C & D were as follows:

CPR – 68.09% Vs 62% Vs 68.42% Vs 70%

IR – 48.89% Vs 47.50% Vs 65.22% Vs 45%

MR – 12.77% Vs 9.25% Vs 5.26% Vs 17.89%

MPR – 16% Vs 0% Vs 0% Vs 17%

LBR – 51.06% Vs 46.8% Vs 63.16% Vs 45%

CPR was comaparble between all groups

ERA & PGT-A group seems to have the best IR, LBR with least miscarriage rates.

For RIF patients role of PGT or ERA when offered individually, doesn’t seem to optimize outcomes.

PGT-A in-combination with ERA seems to be beneficial to optimize outcomes.

Limitations, reasons for caution

This data is retrospective and there is a need for a well designed RCT to further validate the conclusion of this study. Caution needs to be exercised while offering PGT and ERA as they incurr additional financial burden to the patients.

Wider implications of the findings

Embryo Transfer cycles with a personalised window of implantation and transfer of a single Euploid embryo can help RIF patinets to have the best reproductive outcomes and can also help shorten the time to pregnancy.

Trial registration number

Not applicable
P-242 Oocyte morphology before vitrification is associated with the post-warming survival rate
Authors: Li C.J , Hsu L.T , Chen L.H , Chin T.H , Huang S.Y , Chang C.L , Huang H.Y , Soong Y.K , Wu H.M
Published: June 2022

Study question

Although oocyte vitrification is efficient for fertility preservation, the information about damage post-warming is limited. Could the oocyte morphology before vitrification predict the survival rate?

Summary answer

Precisely measuring the oolemma/whole oocyte surface area ratio may predict the post-warming survival rate before performing oocyte vitrification.

What is known already

Recent studies suggest that oocyte vitrification has higher post-warming survival and pregnancy rates. However, the oocyte post-warming survival rate depends on the oocyte quality but not maternal age. Furthermore, it has been well received that the cell surface/volume ratio is related to the efficiency of cryoprotective additives permeability. Moreover, the oocyte shows a large perivitelline space (PVS) that is negatively related to clinical outcomes. Nevertheless, no studies precisely defined large PVS by measuring the oolemma/whole oocyte surface area ratio. Therefore, we assessed the correlation between the oolemma/whole oocyte surface area ratio and the post-warming survival rate.

Study design, size, duration

A retrospective study enrolled 43 IVF cycles undergoing oocyte thawing from 2018 to 2020 at Linkou Chang Gung Memorial Hospital.

Participants/materials, setting, methods

A total of 161 oocytes were warmed. We excluded the oocyte were shipped to our center, MI stages, and without electric medical images. We retrospectively collected all the electric medical images of warmed oocytes that were measured the surface area of oolemma and whole oocyte using ImageJ. Linear regression and Receiver operating characteristic (ROC) curve analysis were performed for further analysis.

Main results and the role of chance

Our finding showed that the maternal age (38.1 ± 5.3) at oocyte vitrification was not correlated to survival rate (P = 0.26) and the oolemma/whole oocyte surface area ratio (P = 0.59). However, the ROC curve revealed that the oolemma/whole oocyte surface area ratio could predict the survival rate post-warm (AUC: 0.67, 95%CI: 0.56-0.78).

Limitations, reasons for caution

Small sample size limited the power of this study, and the higher advanced maternal age group involved in this study may not represent the younger group’s outcomes. Therefore, future studies need to enlarge the sample size to evaluate the prediction efficiency of the oolemma/whole oocyte surface area ratio.

Wider implications of the findings

Our study demonstrates the possible factor related to oocyte cryo-damage. The lower oolemma/whole oocyte surface area ratio represents the oocyte having a larger PVS that has a higher chance of damage after thawing, which shows that by precisely qualified the size of PVS could evaluate the oocyte quality before vitrification.

Trial registration number

Not applicable
P-244 Novel cleavage parameters to improve embryo selection
Authors: Serrano Novillo C , Uroz L , Marquez C
Published: June 2022

Study question

To study the impact of morphokinetic parameters during blastocyst development in the prediction of embryo ploidy.

Summary answer

Aneuploid embryos have aberrant kinetic behavior; the inclusion of the novel parameter st2 into embryo evaluation systems may improve blastocyst ploidy prediction,

What is known already

Selection of best embryo for transfer is key to success in in vitro fertilization (IVF) treatments and it is mainly based in morphokinetic criteria. Nevertheless, clinical pregnancy rates remain at ≈30%, a relatively low figure. Genetic screening of embryos may seem a great solution for this crossroad, as several studies demonstrate chromosomal alterations as one of the most common causes of abnormal embryos in IVF (and thus, poor clinical outcomes) but is an invasive technique and is not always recommended.

Study design, size, duration

Retrospective analysis of collected data.

Participants/materials, setting, methods

A total of 433 blastocysts from 96 treatments of patients for preimplantation genetic testing cycles were studied

Main results and the role of chance

The use of time-lapse culture systems allowed us to identify novel developmental features related to embryo ploidy. We present a new parameter, st2, detected at the beginning of the first cell cleavage as highly implicated in ploidy status (p < 0.001). Aneuploid embryos present slower developmental rates compared to euploid embryos for all of the key markers found in the study. Moreover, aneuploid embryos present aberrant behaviors and do not have a sequential development. Other previously studied parameters, including t3, t5, tSB, tB, cc2, cc3 and t5-t3 ,also present a strong associaiton with euploid chromosomal content if they take place in the optimal ranges stablished here.

Limitations, reasons for caution

This is a retrospective study that generates strong conclusions, but it could be interesting to test it in a prospective study.

Wider implications of the findings

Our results agree with previous studies showing slower and aberrant developmental rates for aneuploid embryos. In addition, we propose a novel parameter (st2) to include in the daily embryo evaluation for every clinician to avoid the bias described when using external algorithms or models.

Trial registration number

not applicable
P-268 Can AI be used as a tool in the evaluation of the risk of pregnancy loss after euploid single embryo transfer?
Authors: Yuksel B , Ozkara G , Yelke H , Okten B , Brualla Mora A , Derrick R , Erlich I , Ozer G , Kumtepe Y , Aygun M , Kahraman S
Published: June 2022

Study question

Can AI be used as a tool in the evaluation of the risk of pregnancy loss after euploid embryo transfer?

Summary answer

AI-annotated tSB (time to start blastulation) and tB (time to formation of full blastocyst) were predictive of miscarriage and live birth.

What is known already

Despite the advantage of PGT-A in preventing miscarriages, a pregnancy loss still can occur after the transfer of a chromosomally normal embryo. Unfortunately in the literature there are no clear criteria indicating which morphologically good euploid embryos may be at risk of resulting in pregnancy loss.

Study design, size, duration

Retrospective cohort analysis of 455 euploid embryos allowing for the analysis of a range of variables for prediction of live birth or miscarriage from ICSI cycles, that were cultured in the Embryoscope (Vitrolife) at a single clinic (Istanbul Memorial Hospital, ART and Reproductive Genetics Center), and transferred between 2017-2020. This is the largest reported AI study to date predicting outcome in euploid SETs.

Participants/materials, setting, methods

Patients were aged between 24-44 years. Each morphokinetic feature was annotated manually and by CHLOE-(Fairtility), and pregnancy outcomes were evaluated.

Main results and the role of chance

When annotated using AI, the average time (mean±standard deviation (SD)) for tSB (98±7 vs 97±7, p < 0.05) and tB (106±7 vs 105±, p = 0.02) were significantly longer in patients who miscarried compared to those that did not.

Implantation and blastulation scores were not significantly predictive of clinical miscarriage (0.77±0.22 vs 0.74±0.24, NS and 0.97±0.15 vs 0.97±0.16, NS for live birth and miscarriage, respectively).

Embryos that aborted and led to live birth had an equal proportion of direct unequal cleavage (DUC) (respectively, DUCs assessed by CHLOE was: 6.8% vs 6.8%, NS). There was no significant difference between the presence of DUC and the pregnancy outcome (miscarriage rate in the presence or absence of DUC was 16.1% vs 16.3%, NS).

Limitations, reasons for caution

Retrospective data using embryos selected for transfer

Wider implications of the findings

AI-annotated tSB and tB can be added to the already existing range of available evaluation methods for embryo viability and functions which can predict the risk of miscarriage after a euploid embryo transfer.

Trial registration number

NA
P-289 KIDscore and PGT-A: Is there a relationship between the findings?
Authors: Azambuja R , Wingert F , Proença L.A , Hentschke M.R , Badalotti-Teloken I , Dornelles V.C , Petracco Á , Badalotti M
Published: June 2022

Study question

Is there a correlation between Preimplantation Genetic Tests (PGT) results and Embryoscope’s KIDscore?

Summary answer

It seems that the higher the KIDscore, the higher the percentage of euploid embryos.

What is known already

Time lapse technology is bringing new perspectives in the relationship of embryos' morphokinetics and implantation rates after assisted reproduction techniques. However, it seems that only the embryo morphokinetics could be insufficient to predict euploidy. The KIDscoreTM D5 (KS5) algorithm, thus, is used for improving the implantation rates after a single euploid embryo transfer in its blastocyst stage and is related to higher rates of euploid embryos the higher the KS5, which could lead to higher implantation rates.

Study design, size, duration

Retrospective, observational study performed at a reproductive medicine center, using data collected between 2019 and 2021. A total of 802 embryos were included for analysis.

Participants/materials, setting, methods

All the embryos were biopsied for PGT (A, SR, and M), after being cultured for five or six days in an Embryoscope® time-lapse incubator (Vitrolife®, Canada). The embryos were then divided into three groups according to the KS5 evaluation: G1 (1-4), G2 (4.1-7), G3 (7.1-9.9) and the percentage of euploidy was evaluated in each group. For statistical analysis, Chi-square, and ANOVA tests, and Pearson correlation were used, considering p < 0.05.

Main results and the role of chance

The women’s mean age among groups G1 vs. G2 vs. G3 was, respectively: 39.1±3.5 vs. 38.7±3.3 vs. 37.6±3.8, p < 0.001; the mean KS5 of each group was: 2.9±0.7 vs. 5.4±0.8 vs. 8.0±0.7, p < 0.001 and finally, the euploidy rates comparing the G1 vs. G2 vs. G3 were, respectively: 98/341, 28.7% vs. 124/340, 36.5% vs. 63/121, 52.1%, p < 0.001. A weak correlation between women's age and KIDScore was also observed (-0.173, p < 0.001).

Limitations, reasons for caution

Although there is a positive correlation between embryomorphokinetics and euploidy, and the euploidy rate increases with higher KIDscore, only 50% of the high score embryos are euploids. Therefore, it is still important to perform embryo biopsy.

Wider implications of the findings

The findings suggest that better embryo morphokinetics provide greater chances of euploidy. Moreover, a weak negative correlation between women's age and KIDScore, possibly due to age-related aneuploidy, was observed. These results highlight time-lapse technology’s importance and the future perspective of morphokinetics evaluation improving implantation rates through euploidy identification.

Trial registration number

Not Applicable
P-373 T657C SYCP3 mutation increases the risk of recurrent miscarriage: a meta-analysis
Authors: Rybina A , Lokshin V , Karibayeva S , Abshekenova A , Askar E , Valiev R
Published: June 2022

Study question

Is the carrying the unfavorable SYCP3 mutation T657C polymorphism increase risk of recurrent miscarriage?

Summary answer

We showed that carrying the T657C polymorphism of the SYCP3 mutation of the synaptonemal complex contributes among the genetic causes of recurrent miscarriage.

What is known already

Recurrent pregnancy loss (RPL) is one of the most common reproductive problems. RPL occurs in 0.5-3% of married couples. The causes of RNP are varied. One of the reasons may be the carriage of an unfavorable polymorphism T657C mutation SYCP3. However, previous studies show conflicting results on mutation rates in women with RPL.

Study design, size, duration

Recurrent pregnancy loss (RPL) is one of the most common reproductive problems. RPL occurs in 0.5-3% of married couples. The causes of RNP are varied. One of the reasons may be the carriage of an unfavorable polymorphism T657C mutation SYCP3. However, previous studies show conflicting results on mutation rates in women with RPL.

Participants/materials, setting, methods

We performed a meta-analysis to determine the strength of the evidence supporting the contribution of carrying the unfavorable SYCP3 mutation T657C polymorphism to recurrent miscarriage. We searched 2 databases (PubMed, Google Scholar) for studies reporting the impact of T657C SYCP3 mutation on recurrent miscarriage up to 20 October 2021. We built a funnel plot to assess the presence of publication bias.The odd ratio (OR) and its 95% confidence interval (95% CI) served as pooled results.

Main results and the role of chance

The review included four studies with 1161 patients: 529 patients with RPL and 632 healthy women. Compared with the control group of healthy women, the risk of recurrent miscarriage increased by 2.37 times with the T657C SYCP3 mutation (RR 2.37, 95% CI 1.39, 4.01, P  <0.001).

Limitations, reasons for caution

The review included studies on different ethnic groups, patients were of different ages, which could affect the results of the studies.

Wider implications of the findings

Determining whether women with recurrent miscarriage belong to the carriers of the unfavorable polymorphism T657C of the SYCP3 mutation in the population will help in accumulating knowledge and understanding the processes of pregnancy loss.

Trial registration number

not avaliable