bluuebunny/crossref_metadata_2025 huggingface dataset:
#197 : The Associations Between Modifiable Risk Factors and Spontaneous Abortion: A Two-Sample Mendelian Randomization Study
Authors: Feng Bo , Yang Hao
Published: January 2024

Back and Aims: Early identification of modifiable risk factors is essentialfor the prevention of spontaneous abortion (SA). We aimed to systematically explore the relationships between genetically predicted modifiable risk factors and SA.

Method: We obtained genetic variants associated with the modifiable risk factors at the genome-wide significance (p< 5× [Formula: see text]) level from genome-wide association studies (GWAS). Two-sample Mendelian Randomization (MR) analysis was used to investigate the relationship between 42 modifiable risk factors and SA.

Results: The studyfound that genetically predicted HLA DR++ monocyte %leukocyte, HLA DR on CD14+ monocyte, HLA DR on monocyte, and type of transport used were associated with an increased risk of SA (all with [OR]>1 and p< 0.05). Conversely, CD14+ CD16- monocyte absolute count, age first had sexual intercourse, never smoked, and education status were found to be negatively associated with SA (all with [OR]<1 and p< 0.05). Additionally, the study observed potential associations between genetically predicted CD25 on switched memory B cell, lymphocyte count, monocyte absolute count, CD8+ natural killer T %T cell, asthma, appendicular lean mass, rheumatoid arthritis, complement C1q tumor necrosis factor-related protein 1 (CTRP1), hand grip strength, waist-to-hip ratio, and usual walking pace with an increased risk of SA. Conversely, lymphocyte count was associated with a suggestive lower risk of SA in the results.

Conclusion: Our analysis revealed that several modifiable risk factors were associated with SA. Specifically, genetically predicted a higher proportion of HLA DR++ monocytes in leukocytes, HLA DR on CD14+ monocyte, HLA DR on monocyte and often using cycle as transportation were associated an increased risk of SA, while evaluated CD14+ CD16- monocyte absolute count, first sexual intercourse at an older age, never smoked, and higher education were with a decreased risk of SA.
#211 : The Causal Effects of Circulating Biomarkers of Immunity and Inflammation on Endometriosis: A Bidirectional Mendelian Randomization Analysis
Authors: Zhang Yaoyao
Published: January 2024

Background and Aims: Endometriosis is a chronic gynecological disease with a high prevalence among reproductive-aged women. Several studies have investigated the causal effect of different serum biomarkers of immunity and inflammation on the occurrence and progression of endometriosis. However, the results of these studies remained inconclusive and even controversial. Herein, this study aims to analyze the causal associations of genetically predicted levels of different circulating biomarkers of immunity and inflammation with the risk of endometriosis using a bidirectional two-sample Mendelian randomization (MR) approach.

Methods: The single-nucleotide polymorphisms (SNPs) of exposures which indicate the genetic variants were used as instrumental variables (IVs) and were all obtained from the genome-wide association study (GWAS) of European ancestry from the IEU GWAS database. Besides, we performed bidirectional MR analysis to test the associations. The causal effects were estimated through the inverse-variance weighted method (IVW). The sensitivity examinations of each result after the MR analysis were performed to detect if any heterogeneity and pleiotropy existed.

Results: Our results demonstrated that higher interleukin-9 (IL-9) level was associated with the occurrence of endometriosis, while macrophage colony stimulating factor (MCSF) level, TNF-related apoptosis inducing ligand (TRAIL), sE-Selectin and basophil count showed the opposite. Genetically predicted endometriosis was related to higher immunoglobulin E (IgE) level and platelet count. No evidence of bidirectional association was detected on the other serum inflammatory biomarkers with endometriosis. Neither pleiotropy nor heterogeneity was found in our study.

Conclusion: Our results suggested that some dysregulated circulating biomarkers of immunity and inflammation is causally associated with the occurrence of endometriosis, and at the same time endometriosis may lead to the abnormality of some of these factors. Our findings provided genetic insights on potential novel strategies in the primary prevention, diagnosis and treatment of endometriosis.
#240 : Diagnostic Accuracy of Hysterosalpingo-Foam Sonography (HyFoSy) for Fallopian Tube Patency Assessment in Infertile Women
Authors: Le Tieu My , Vo Binh , Pham Anh , Vu Anh , Pham Toan , Truong Tham , Ho Tuong , Dang Vinh
Published: January 2024

Background and Aims: Tubal patency assessment is an important part of routine infertility work-up. It has been suggested that hysterosalpingography should no longer be considered as a ‘first line’ diagnostic procedure. We aimto determine the accuracy of an alternative technique, hysterosalpingo-foam sonography (HyFoSy), in tubal patency assessment in infertile women.

Methods: This prospective study was conducted at My Duc Hospital and was approved by the institutional ethics committee (25/2019/MD). Infertile women who were scheduled for undegoing laparoscopy during infertility investigation. A visual analogue scale (VAS) score for perception of pain during HyFoSy was used. Laparoscopywith dye chromotubation, was performed on the same day and used as a gold standard. Clinicians performing laparoscopy were blinded to HyFoSy results. Sensitivity, specificity, negative and positive predictive value (NPV, PPV)and 95% confidence interval (CI) were calculated. A sample size of 455 women was needed to demonstrate a non-exceeding 8% of fluctuation hypothesis of the two sensitivity and specificity (power 0.80, two-sided alpha 5%, loss to follow-up 5%).

Results: Between 2019 and 2022, we recruited 455 women. Five women had inconclusive HyFoSy results, three women withdrew consents. Data analysis was performed on 447 women (868 tubes). The sensitivity and specificity of HyFoSy, as compared to laparoscopy, were 0.76 (95% CI 0.72–0.80) and 0.71 (95% CI 0.67–0.75), respectively. HyFoSy gave a PPV of 0.72 (95% CI 0.69–0.76) and a NPV of 0.75 (95% CI 0.72–0.78). 50% of women reported no pain. No adverse events were reported.

Conclusion: HyFoSy is a well-tolerated, safe, and reliable technique compared to laparoscopy for tubal patency assessment.
#293 : Trends of Statistical Significance Reporting in Abstracts of Reproductive Medicine Studies from 1990 to 2022
Authors: Feng Qian , Li Wentao , Mol Ben
Published: January 2024

Background and Aims: Despite efforts to minimize publication reporting bias in medical research, it remains unclear whether the magnitude and patterns of the bias have changed over time. We aim to assess the frequency in which the statistical information is presented in forms other than P-values and evaluate how statistical significance was reported in the abstracts of reproductive medicine studies.

Method: We studied reproductive medicine studies published in 23 Q1 journals in reproductive medicine, and five top medical journals, including JAMA, Lancet, BMJ, NEJM, and PLOS Medicine. We text-mined abstracts from 1990 to 2022 to extract P-value, confidence interval (CI), and text description in statistical significance; the presence of effect size metrics and Bayes factors were searched. One thousand abstracts were randomly selected and manually checked. The extracted statistical significance information was then analysed for temporal trends and distribution.

Results: We identified 24,550 reproductive medicine abstracts. The proportion of abstracts reporting isolated P-values was 13.9% in 1990 and 18.8% in 2021 (Figure 1); reporting isolated P-values was 3.0% (95% CI, 0.5%-11.3%) in meta-analyses, 20.8% (95% CI, 11.3%-34.5%) in randomized controlled trials, and 33.3% (95% CI, 23.8%-44.3%) in basic research in 2021. By contrast, the proportion of abstracts in reporting effect measures without P-value surged from 4.1% to 23.3% from 1990 to 2021. The reported P-values (n = 18,132) mainly clustered at 0.001 (20.0%) and 0.05 (16.2%). Of the 14,689 abstracts containing at least one statement describing statistical significance, 74.9% of abstracts made at least one statistically significant statement; this proportion had merely changed over time (Figure 2).

Conclusion: Despite the increasing adoption of effect measures to convey statistical significance, reporting isolated P-values remains common. Publication reporting bias is pervasive and persisting in reproductive medicine abstracts; the inflated treatment could mislead all types of patient care and policy decisions.
#31 : Outcome of Diagnostic and Therapeutic Laparoscopic Procedures in Sub Fertility in Farooq Hospital, Lahore, Pakistan
Authors: Farooq Fariha
Published: January 2024

Background and Aims: Sub-fertility is a global issue, and its prevalence worldwide is around 10% to 15%. The aim of this study was to find out the cause of subfertility and outcome in terms of positive pregnancy followingdiagnostic and therapeutic laparoscopy.

Methods: A Non-randomized control trial was carried out in 110 patients presenting with subfertility in a tertiary care hospital of Lahore, from January 2022 to Dec 2022. A sample of 110 patients was collected through Non-Probability, Consecutive sampling technique. Data was collected by using a structured questionnaire. Those patients whose husbands had abnormal semen analysis were excluded from the study. Data were analyzed using SPSS version 23. Chi square test was applied used to find out associations between laparoscopic procedures and age, type of infertility, marital years and outcome in terms of becoming pregnant. P value was fixed as [Formula: see text]0.05 as significant.

Results: Out of 110 females with subfertility, 54 (49.1%) were in the age group 26-30 years. Most common presentation was subfertility in 76 (69.1%). Ultrasound findings were normal in (n=73, 66.4%) patients whereas intra-operatively (n=46, 41.8%) had normal findings. Main Causes identified were blocked tubes (n=12, 11%), Polycystic ovary (n=10, 9.1%) and Pelvic tuberculosis (n=4, 3.6%). Bi variate analysis of laparoscopic procedures with Sociodemographic profile showed significant results such as Age (p=0.002), marital years (p=0.000) and conception after laparoscopic procedures (p=0.022. Binary logistic regression showed significant results with positive pregnancy outcome with p value of 0.024 with (95% CI of 1.139-6.241).

Conclusion: In Pakistan TB is a neglected cause of subfertility diagnosed through laparoscopic procedures only. Strong association was observed with positive pregnancy outcome and therapeutic laparoscopy in 16(47.1%) of the patients.
#49 : Does Percutaneous Epididymal Sperm Aspiration (PESA)-Sperm Attribute as the Game Changer in High-Risk Male Factor Fertility for Intracytoplasmic Sperm Injection (ICSI)?
Authors: Gupta Shyam Nandan , Srinivas B V , Pandey Deepak
Published: January 2024

Background and Aims: The surgically retrieved sperms either from PESA, TESA and microTESA are considered to contribute satisfactory outcome in ICSI cycles in male factor infertility especially in Azospermia. Although the different sources of sperm for ICSI don’t affect the fertilisation rates in ICSI cycles, but the sperm obtained from fresh PESA may become game changer with higher implantation rates, resulting in better clinical pregnancy and live birth outcomes.

Method: This comparative study was based at single reproductive center and evaluated 344 PESA-ICSI patients with high-risk male factors from July 2021 to Dec 2022 henceforth were compared with ejaculated-ICSI.

The following high-risk male infertility patients were included - 1. No blastocyst formation in two stimulation cycles with ejaculated sperm, 2. If >2 IVF failure (with/o > 4 blastocyst transfer), 3. Severe OAT/azoospermia, 4. Sperm morphology <2% (and/or DFI >25%) even after 6 week of lifestyle n antioxidant therapy and 5. Miscellaneous factor like morbid obesity BMI>40, age >45 with/o history of chronic smoking and alcoholic.

The embryo quality was assessed from good blastocyst rate and pregnancy outcome was recorded as implantation and clinical pregnancy rate.

Results: As per the inclusion criteria 344 high-risk infertile male (21%) underwent PESA-ICSI and compared with 1346 ejaculated-ICSI patients. The average no of M2 oocytes were takes for ICSI purpose is similar in both group (9.2 and 9.4 per oocyte retrieval). The blastocyst rate in PESA-ICSI group was 51% as compare 48% in ejaculated-ICSI but there was outstanding good-blastocyst rate (34% compared to 24%, P<0.01). Both the group showed nearly equal implantation rate (83% compare to 80.4%) but ongoing pregnancy up to 12 weeks was significantly high as compare to ejaculated-ICSI group (77% vs 62% P <0.01)

Conclusion: The high-risk male infertility must be addressed with timely evaluation and decision. PESA offers safe, simple, daycare and promising results in terms of sperm yield and pregnancy outcome, must be offered as first line approach.
#164 : In-Vitro Vitamin D Treatment on Human Sperm Improves Capacitation, Acrosome Reaction, and Protein Expression of Sperm-Oocyte Activation Factors (SOAF)
Authors: Ang Wan Yi , Hamdan Mukhri , Nelli Giribabu
Published: January 2024

Background and Aims: Although many studies have been done to investigate the relationship between serum vitamin D and male infertility, the effect of in-vitro vitamin D treatment on sperm remains unclear, particularly the effect on sperm capacitation, hyperpolarisation, sperm-oocyte fusion and oocyte activation. This study aims to examine whether in-vitro vitamin D treatment on sperm can improve the condition of sperm parameters and further increase fertilisation and pregnancy rate.

Method: Fifty men (N=50, fertile n=26; infertile men n=24, were recruited during their visit to fertility clinics for semen analysis. Each washed semen sample was aliquoted and divided into control and in-vitro vitamin D treatment groups.

For in-vitro vitamin D treatment, semen samples were treated with 1nM in-vitro for 1 hour at 37°C. Intracellular calcium released, capacitation status and mitochondria membrane potential were measured after incubation in both the control and in-vitro vitamin D treatment groups. Furthermore, immunofluorescence of sperm-origin SOAF, Phospholipase C Zeta (PLC[Formula: see text]), was done to investigate fluorescence intensity.

Results: Compared to the control, higher intracellular calcium release was noted following in-vitro vitamin D treatment, represented by higher Fluo-4AM staining (MD=25043, P=0.02). In the treatment group, sperm capacitation rate and CTCF were higher when Chlortetracyclin (CTC) (MD=4.7%, P=0.01) and immunofluorescence of phosphotyrosine (MD=0.03, P=0.01) were examined. More hyperpolarised mitochondria membranes in the treatment group showed by JC-1 staining (P=0.01) compared to the control group. The red-to-green, fluorescent ratio is 1.62 in the control group and 2.24 in the treatment group. Moreover, immunofluorescence of PLC[Formula: see text] shows that the treatment improves this protein’s expression (MD=8.013×10[Formula: see text], P=0.02). Thus, in-vitro vitamin D enhances the functionality of sperm by increasing intracellular calcium ions, sperm capacitation, hyperpolarisation and protein expression.

Conclusion: Adding vitamin D in in-vitro fertilisation (IVF) in media culture is beneficial as capacitation, sperm membrane polarisation and SOAF protein expression were increased and therefore contributed to successful IVF.
#204 : First Recorded Normal Live Birth After ICSI with Electrophoretically Isolated Spermatozoa Using the Felix™ System
Authors: Jayaram Ramya , Govindarajan Mirudhubashini
Published: January 2024

Background and Aims: This report describes the first live birth with sperm isolated using the Felix™ system.

Methods: Thirty-three couples undergoing ovarian stimulation were recruited based on high raw semen DNA Fragmentation Index (DFI) of >20%, as assessed by the sperm chromatin structure assay. The Felix™ system, which isolates sperm based on charge and size was used as the sperm preparation method, over a six-minute interval. Mature oocytes were injected using Intracytoplasmic Sperm Injection (ICSI). Normally fertilised zygotes were cultured until day three or five. Suitable embryos were vitrified and subsequently transferred in a frozen embryo cycle. Biochemical pregnancy was determined by plasma human chorionic gonadotrophin level of >20 IU and clinical pregnancy was determined by the presence of fetal heat and/or sac on ultrasound. Miscarriage and live births rates were also recorded.

Results: Raw semen concentration, progressive motility and total motility levels were in the normal range according to 6[Formula: see text] World Health Organisation criteria. However, sperm DFI was relatively high (range 20% to 80%). The average age of females was 30 years (range 21 to 44). A total of 374 oocytes were collected from the 33 females, with 266 mature oocytes then injected by ICSI. This resulted in 83% fertilisation rate and embryo utilisation of 65%. Four females underwent single embryo transfer, and 29 females underwent double embryo transfer. Of those, 19 (58%) biochemical pregnancies were achieved resulting in 14 (42%) ongoing clinical pregnancies. Three miscarriages and two normal live births have been reported to date. Interestingly, the two live births resulted from men of DFI of 80% and 33%.

Conclusion: This report describes the first birth after sperm isolated using the Felix™ system followed by ICSI. The Felix™ system is an efficient procedure to prepare sperm and has the potential to be advantageous for patients with high DFI.
#116 : Prevalence of Aneuplodies in Chromosomes 13, 18, 21, X and Y in Embryos Generated by ICSI of Fertile Couples
Authors: Khan Shezae
Published: January 2024

Background and Aims: It has previously been reported that up to 70% of the embryos generated in an ART lab are chromosomally abnormal. Abnormalities in chromosomes 13, 18, 21, X and Y have been observed to be as common as 63% in embryos of sub-fertile couples. The aim of this study was to find if these abnormalities are just as common in embryos of fertile couples who have no history of an affected child.

Method: A retrospective cohort study was conducted on 409 embryos obtained from 113 couples undergoing preimplantation genetic testing at an ART center in Pakistan, between 1 January 2021 and 31 December 2022. The inclusion criteria was that fertile couples who had come for gender selection for family balancing. Age range of female partners was 28 years to 38 years. Male partners had normal semen parameters as per the World Health Organization (WHO) guidelines.

Results: A total of 70.7% (289/409) were unaffected by aneuploides in the five chromosomes.

There was a significant difference in the ratio of normal to abnormal embryos. Out of the normal embryos, there was no significant difference in the male (34.5%) and female (36.1%) embryos. There was no significant difference in the number of abnormal female and male embryos (p=0.127). Among the aneuploidies in the five chromosomes, trisomy 21 was the most common (n=27; 6.6%).

Conclusion: Approximately 20% of sub-fertile couples have an unknown etiology. Our results indicate that the five commonly known aneuploidies found in embryos of sub-fertile patients have a low prevalence in fertile patients. It is worth noting that this study is limited by the fact that abnormalities in sub-fertile couple were not analyzed and statistics from other already published studies was relied upon. Nonetheless, this data has provided perspectives for counselling couples of unexplained sub-fertility.
#121 : The Easier Blastocyst Biopsy, The More Trophectoderm Cells We Got
Authors: Li Chia-Jung , Lo Wei-Che , Sung Yen-Ju , Hsu Le-Tien , Chen Liang-Hsuan , Huang Shang-Yu , Chang Chia-Lin , Huang Hong-Yuan , Lee Chyi-Long , Sung Yung-Kuei , Wu Hsien-Ming
Published: January 2024

Background and Aims: Several studies showed various factors associated with pregnancy outcomes after the euploid embryo transfer, including parental, endometrial, and embryo biopsy. The consensus of the most suitable biopsied cell number is 5-10 cells among IVF labs. Therefore, for embryologists, how to have a steadily manipulated blastocyst to get an appropriate biopsied trophectoderm cell number is crucial. However, the factors related to biopsy manipulation are still being determined. Here, we retrospectively analyze the DNA concentrations from biopsied cells to test the hypothesis TE grading, hatching status, and biopsy day correlated with embryologists’ biopsy handling.

Method: A retrospective study enrolled 212 blastocysts from 49 PGT-A cycles (NGS platform) from September 2021 and March 2023 at the Fertility and Reproductive Genetic Center of Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. All the TE cells were removed by mechanical cutting by embryologists following the lab standard operating procedure. This study excluded five blastocysts (2.4%, 5/212) for the unsuccessful whole genome amplification (WGA), i.e., DNA concentration was less than 10 ng/[Formula: see text] l.

Results: No difference in average DNA concentration was found between embryo ploidy status (Fig. A, P=0.8), embryologist (Fig. A, P=0.65), and TE grading (Gardner TE grading B vs. C, P=0.8). However, combined hatching status and day of the biopsy revealed a significantly higher DNA concentration in the hatching Day 5 to Day 7 groups than in the hatched Day 5 to Day 7 group (Fig. B, P[Formula: see text]0.0001).

Conclusion: Our data suggest that the embryo ploidy status and Gardner grading of TE cells did not affect embryologists’ steadily performing biopsies. Interestingly, the easier biopsy, the more TE cells we got. This result implies that the hatching (Gardner expansion grade 5) embryo has a higher potential for damage after trophectoderm biopsy.
#152 : Exploring the Limitations of Linkage-Only PGT-M
Authors: Farrell Michael , Grkovic Steve , Traversa Maria , Jones Daniel , Livingstone Mark , McArthur Steven
Published: January 2024

Background and Aims: Although PGT-M cases can be conducted using linkage only, the inclusion of a direct test targeting the relevant genetic variants should be fundamental to best practise. We present four cases illustrating the limitations of linkage only PGT-M.

Methods: Three cases used STRs for linkage analysis and the fourth Illumina Infinium Karyomapping. Direct variant detection encompassed Sanger sequencing, STRs and/or fragment PCR.

Results:

Case 1 Osteoporosis-pseudoglioma syndrome

Sanger sequencing for LRP5c.3107G[Formula: see text]A and LRP5c.4487C[Formula: see text]A were critical for identifying a recombination in the familial control and subsequent correct assignment of STR phasing.

Case 2 Osteogenesis imperfecta type I

SNP-based linkage identified a recombinant embryo. Sanger sequencing for COL1A1c.2461G[Formula: see text]A resolved an unknown status to affected.

Case 3 Neurofibromatosis type II

Variant detection in this de novo mosaic case used two STRs within the NF2 exon2-11del to establish low- and high-risk linkage patterns. Two tumour samples with different second hit mutations exhibited reduced signal intensity for one allele. This was consistent with the presence of a weaker deleted allele due to sample contamination with non-tumour cells. Four of nine embryos contained two alleles within the minimum deletion and were first choice for transfer, resulting in an NAD prenatal confirmation and healthy liveborn.

Case 4 Neurofibromatosis type I

A de novo mosaic case required reverse linkage by means of a direct assay for the NF1c.1445_1446insCC variant. Affected embryos were subsequently used to phase flanking STRs and obtain linkage, resulting in one liveborn and one ongoing pregnancy.

Conclusions: When a direct test is not included in PGT-M, a family may not be able to be offered a test, or misdiagnosis risk may increase. For de novo, mosaic and cases with suspected recombination in a reference sample, analysis of multiple cycles and/or the inclusion of non-clinical embryos to increase sample numbers improves accuracy of testing.
#365 : Characteristics of Embryo Mosaicism Detected Using Next-Generation Sequencing PGT-A
Authors: Ikhsan Muhammad , Iffanolida Pritta Ameilia , Mutia Kresna , Muharam Raden , Wiweko Budi , Sumapraja Kanadi , Pratama Gita , Harzif Achmad Kemal , Maidarti Mila , Silvana Vita , Hestiantoro Andon
Published: January 2024

Background and Aims: Chromosomal mosaicism may occur in minority of embryos. Their commonality and uncertainty made the embryo mosaic rates vary from center to center. This study aims to evaluate the mosaicism rate and its characteristics during our Preimplantation Genetic Testing-A (PGT-A) service in Indonesia since 2020.

Method: We collected secondary data from our PGT-A results retrospectively since 2020. There were 196 embryos analyzed and descriptively shown for its characteristic including which chromosome is the most prevalent. We also carried out associative analysis to assess mosaicism and its clinical condition.

Results: From 196 embryos assessed, there were 106 (54.1%) embryos with chromosomal abnormality ranging from low mosaicism to whole chromosome aneuploidy. Low and high mosaicism rates were found in 25 (12.8%), 8 (4.1%) embryos, respectively. The most common chromosome affected by low mosaicism is chromosome 8 (9; 4.6%) and the most chromosome with abnormality found in chromosome 21 (20; 10.2%). There was no significant difference between mosaicism rate in the mean age (33.88 vs 33.26 years), but there was statistical significance difference in mean age (35.84 vs 33.26 years) for aneuploidy (monosomy or trisomy) compared to normal chromosome. For the clinical condition, we found only significant difference in high mosaicism rate for patient with indication for unknown etiology of infertility (p-value [Formula: see text]0.05%).

Conclusion: The mosaicism rate found in our center is relatively high compared to studies conducted elsewhere. The most common chromosome affected is chromosome 8. There was a significant difference in high mosaicism rate for unknown infertility indication of PGT-A.
#19 : Green Tea Extract Inhibits Endometriosis Progression by Increasing Superoxide Dismutase Serum Levels in the Rat Models
Authors: Trisetiyono Yuli , Artanto Yosef adi
Published: January 2024

Background and Aims: Endometriosis is a gynecological disorder defined as the presence of endometrial tissue outside the uterine cavity and affecting 10-15% of females of reproductive age. Oxidative stress has been reported as one of the main promoting factors of this disease. Green tea and its anti-angiogenic and antioxidant properties have promising potential to prevent the progression of endometriosis. This study aims to investigate the effect of green tea extract on endometriotic implant area and serum superoxide dismutase (SOD) levels in endometriosis rat models.

Method: Twenty-six Balb/c female rats were randomized into two groups of equal size: experimental group (EG) and control group (CG). All subjects in EG were given green tea extract 3 mg daily for 14 days. Endometriosis was induced on the fourteenth day in all subjects in both groups. The data of the endometriotic implant area and serum SOD were obtained and analyzed fourteen days after the induction of endometriosis.

Results: The endometriotic implant area of the group treated with green tea extract was significantly lower (p=0,022) RR=0,455, 95%CI=0.065-0,96) compared to the control group. The serum level of SOD in EG and CG were 5.33±0.52 ng/ml and 5.20±0.91 ng/ml, respectively (p=0.507).

Conclusion: Green tea extract inhibits endometriotic implant progression and increases the level of serum SOD in endometriosis-induced rat models.
#125 : The Role of BDNF Receptors in the Incidence of Endometrioma Tissue Invasion Onto the Chorioallantoic Membrane
Authors: Dewanto Agung , Rahmana Muhammad Dimas Reza , Arumsari Regina , Khasanah Nurida , Nugraha Wicesa , Trizia Vanessa , Anshori Khoiruddin
Published: January 2024

Background and Aims: Previous studies have explored the role of neurotrophins and their receptors, especially in forming deep endometriosis, endometriosis tissue invasion, and its effects on tissue proliferation. However, these studies do not include research on the pathogenesis of endometriomas. We tried to model the invasion of endometrioma tissue to find out more about its pathogenesis by using the chorioallantoic membrane (CAM) as the host. Immunohistochemistry (IHC) to detect neurotrophin BDNF and its receptors, namely TrkB and P75, are employed and linked between their expression and the process of invasion and proliferation.

Method: The endometriotic tissue samples were collected from women (n=27) who underwent hysteroscopy/laparoscopy at Dr. Sardjito Central Hospital. Peritoneal endometriosis (PE) lession, endometrioma (CC), and eutopic endometrium (EN) was analyzed with 15 tissue samples in each group. Samples were placed in a tube containing transport medium and transplanted into CAM of fertile chicken eggs for five days. Transplanted tissue was harvested, and histological preparations were made using the paraffin method. IHC staining was performed on p75, Ki67, TrkB, and BDNF staining. Invasion analysis and IHC evaluation were performed with a semi-quantitative method. Data were analyzed using IBMⓇ SPSS Statistics version 25.0. Statistical significance was accepted at P < 0.05.

Results: Normal Endometrium expressed the highest expression of BDNF than peritoneal endometriosis and endometrioma (0.36± 0.38, 0.16± 0.13, 0.07± 0.07, P=0.007). The P75 expression correlated positively with Ki67 expression in PE and CC samples (P=0.012; P=0.008).

Conclusion: The p75 receptor may have a role in endometriosis tissue proliferation, but this receptor does not directly influence tissue invasion into CAM. While proliferation in endometriomas positively correlates with invasion into CAM, it is not correlated with peritoneal endometriosis.
#151 : Partial Urorectal Septum Malformation Sequence
Authors: Braña Jennifer Clarize , Alcantara-Boquiren Marie Janice , Pacioles - Flavier Carol Marjorie
Published: January 2024

Background and Aims: Cloacal malformations represent a wide range of defects and are considered one of the most challenging and interesting diseases. Occurrence is at 1 in 50,000 newborns and still with an unknown etiology. Partial urorectal septal malformation sequence (URSMS) is a rare and complex congenital anomaly that represents an embryonic event of urinary-rectal septal malformation resulting in the presence of a cloaca.

A 17-year-old nulligravid with imperforate anus at birth with primary amenorrhea was admitted for difficulty urinating. Genital examination noted fused labia with vaginal dimple and absent urethral opening.

Currently, there are no field studies of its incidence in the Philippines and no exact treatment has been described. This case aims to assist gynaecologists in diagnosing and treating patients with this malformation and to help future patients achieve a good quality of life and to be able to function sexually later in life despite these set of conditions.

Method: Abdominal CT scan, 3D ultrasound and MRI all showed uterine didelphys with vaginal duplication and bilateral hydrometrocolpos and vaginal aplasia. A diagnosis of partial URSMS was made using a complete medical history and the above diagnostic procedures correlating with PE. A multidisciplinary conference was held with the agreed plan of laparoscopy, hysterectomy, vaginal septum repair, cystoscopy, urethroplasty, and feminizing genitoplasty.

Results: The opening of the neovagina admitted two fingers and was 4 to 5 centimeters long. Three months after reconstruction, she reported having normal urination with amenorrhea and no recurrence of pelvic pain.

Conclusion: Early and accurate preoperative diagnosis and treatment planning, careful patient selection, and a holistic approach are cornerstones of management. Patient follow-up and long-term psychosocial support are important, as obstruction may recur in poorly compliant patients. If pregnancy does occur in these patients, a multidisciplinary approach to management is important, and the recommendation for delivery is usually cesarean delivery.
#393 : Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) — A Series of 6 Cases at a Tertiary Referral Centre
Authors: Lee Nikki , Ng Karen , Ip Patricia , Chan Symphorosa
Published: January 2024

Background and Aims: OHVIRA is a rare congenital urogenital anomaly. Diagnosis is often delayed because patients have normal onset of puberty and menstruation if there is partial obstruction with a communicating fenestration in the hemivagina. Symptoms can be non-specific such as abdominal pain and dysmenorrhoea, but urinary retention and a pelvic mass have been reported. Haematocolpos can cause anatomical distortion, making imaging difficult. Definitive management is by vaginoplasty but that can be complex, especially in an anatomically small child, or cases with chronic inflammation. Retrograde bleeding during obstruction is common, leading to endometriosis and ascending infection. This is associated with complex surgery, increased morbidity and subfertility, which is why early diagnosis and timely management are important.

Method: Medical records were retrieved from 6 patients with OHVIRA treated between 1 April 2021 and 31 March 2023 at a tertiary referral centre. For each patient, age of diagnosis, referral source, symptoms, diagnostic investigations, diagnostic challenges, anatomical findings, surgical managements, complications and outcomes were reviewed.

Results: Patient’s ages ranged from 10 to 33 years. Median age of diagnosis was 30. Cases were referred from paediatric surgery (n=1), gynaecology (n=2), general surgery (n=2) and urology (n=1). Symptoms included abdominal pain (n=4), pyrexia (n=2), intra-menstrual bleeding (n=2) and vaginal discharge (n=1). 3 patients had been misdiagnosed before referral. All had unilateral haematocolpos and underwent ultrasound (n=6) and either MRI (n=4) or CT (n=2), followed by vaginoplasty. 2 patients had emergency surgery for pelvic abscesses. There were no intra- or post-operative complications, or adverse outcomes.

Conclusion: Median age at diagnosis was advanced, and symptoms and referral source were variable. Misdiagnosis was frequent. Surgical management was successful with a single stage vaginoplasty. Ascending infection can be a consequence of delayed diagnosis and management. It is important to evaluate any female with dysplastic or absent kidneys for uterovaginal abnormalities.
#158 : Whole Transcriptome Analysis of In Vitro-Aged Mouse Oocytes: Effects of Antioxidant Mixture on Oocyte Quality
Authors: Qin Junwen , Takahashi Yuji , Kakuta A.P Shigeru , Kyuwa Shigeru
Published: January 2024

Background and Aims: Aging is known to have negative impacts on oocyte quality. We reported in the previous meeting that the quality of in vitro-aged oocytes was restored by application of a new antioxidant mixture (AOM). Aiming to understand how AOM influenced on oocyte quality, a whole transcriptome analysis was conducted in this study.

Method: Using an in vitro aging model, oocytes were collected from superovulated ICR mice, and part of them were cultured for 5h with (AOM group) or without (Aging group) AOM. Oocytes from fresh oocytes (Control group), Aging group and AOM group were subjected to RNA extraction, amplification, and a genechip microarray analysis. Genes expressed with absolute log2 fold change of [Formula: see text] 2 between two groups were designated as differentially expressed genes (DEGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was conducted for further analysis of DEGs.

Results: In vitro aging triggered a total of 643 DEGs when compared with the control group. These DEGs were enriched in 19 biological processes, mostly associated with ribosomal synthesis, metabolic process, response to oxidative stress, apoptosis, signal transduction and mRNA processing. These changes are thought to be related to decreasing oocyte quality. AOM effectively prevented age-related change of those DEGs in a broad spectrum. The genes restored by AOM including Rpl7, Rpl35a, Rpl8, Mt1, Fabp2, Acadm, Hadhb, Gstm4, Ncf4, Ppp3ca, Fzd9, Phka2, Spp1 and Lsm6, are highly associated with cellular homeostatic events, suggesting that AOM not only induces changes of response to oxidative stress, but also normalizes gene expression related to cellular activities resulting in improving oocyte quality.

Conclusion: This study strongly suggests that AOM restores the gene expression involved in cellular homeostasis. Also, these findings provide new insights of oocyte quality.
#256 : Reproductive Outcomes and Satisfaction Among Patients Using Telemedicine During Assisted Reproduction: A Meta-Analysis
Authors: Tran Huy-Phuong , Nguyen Nam-Nhat , Ho Tuong-Nguyen , Tran Thuy-Thi-Thanh , Ly Loc-Thai , Hoang Tuyet-Thi-Diem , Le Dung-Thi-Phuong , Vo Toi-Van , Tran Giang-Le
Published: January 2024

Background and Aims: Telemedicine refers to the delivery of healthcare services through the use of information and communication technology, across distances. There has been a significant increase in the demand for infertility treatment and virtual consultations from home after the COVID-19 pandemic. Despite this, due to a lack of sufficient data, and concerns about patient compliance, telemedicine has struggled to gain widespread acceptance. Our aim was to compare the success of treatment between telemedicine and in-office care during assisted reproduction treatment. Additionally, we evaluated patient satisfaction with telemedicine.

Method: We conducted a literature search of published articles in the PubMed/MEDLINE, EMBASE, Scopus, and Web of Science databases up to November 30, 2022. We used the keywords “telemedicine” or “telehealth” and “in vitro fertilization” or “assisted reproduction”. Both randomized controlled trials and observational studies were included in the search. We registered our protocol on PROSPERO (Registration number: CRD42022379428).

Results: We identified 14 studies that reported data on 5182 patients. Quality assessment revealed an acceptable risk of bias for both randomized controlled trials and observational studies. The data showed that telemedicine was non-inferior to in-person care in terms of pregnancy rate achieved (OR 1.02, 95% CI: 0.83–1.25, p = 0.84). The Q test p-value of 0.99 and I2 statistic of 0% indicated that all the included studies were homogeneous. Patients who received telemedicine follow-ups during fertility treatment reported adequate satisfaction (88%, 95% CI: 77%-94%). Eggers’ test did not indicate the presence of Deek’s funnel plot asymmetry (p = 0.62), confirming that no publication bias was found.

Conclusion: Telemedicine use has resulted in a comparable treatment success rate in terms of pregnancy rate, when compared to face-to-face consultation. These emerging tools also yielded a high level of patient satisfaction.
#23 : Correlation of Multinucleated Embryo and Pregnancy Outcome
Authors: Razali Nuguelis , Tan Siew Yin , Ramly Ruhaima , Idris Siti Khadijah , Hamdan Mukhri
Published: January 2024

Background and Aims: Single embryo transfer is increasingly done in practice to avoid multiple pregnancy. Therefore, it is important to ensure the embryo with the best pregnancy outcome is selected. Although new criteria involving genomic, transcriptomic, and proteomic have been developed to predict embryo outcome, morphology of the embryo remains as the main indicator because it is easy to implement and less controversial.

To study the correlation of multinucleated embryos and pregnancy outcomes

Method: This is a retrospective review of a total of 411 embryos from 225 women undergoing their first IVF or ICSI cycle in University Malaya Medical Centre, Kuala Lumpur between January 2019 and October 2021.

Multinucleation was defined as the presence of more than one nucleus within at least one of the blastomeres of a 2-cell embryo and a time-lapse imaging system was used to observe embryo development (Embryoscope; Unisense Fertilitech). Group allocation was based on the presence or absence of multinucleation on day 2 after egg retrieval. Embryos with evidence of one or more blastomere having multinucleation were included in the studied group (n = 67 embryos). Embryos without any blastomere exhibiting multinucleation were included in the control group (n = 344 embryos).

Results: The data were based on 225 transfers of 411 embryos consisting of 16.3% (n = 67) from studied group and 83.7% (n = 344) from the control group. The biochemical pregnancy rate and implantation rate is lower in the studied group compared to the control group although not statistically significant (Table 1).

Conclusion: Multinucleated embryos reduce the implantation rate and clinical pregnancy rate although not statistically significant.
#50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART
Authors: Wijaya Liva , Shafira Nadia , Abidin Boy , Halim Ayang , Hasmoro Tri Bowo , Wiweko Budi
Published: January 2024

Background and Aims: Due to its similar molecular structures and biological activities, human chorionic gonadotropin (hCG) is used as a substitute for luteinizing hormone (LH) in ART. The weaknesses of using hCG as a trigger are the possibility of ovarian hyperstimulation syndrome in high responders and lacked FSH activity which promotes LH receptor formation in luteinizing granulosa cells, nuclear maturation, and cumulus expansion. GnRH agonist (GnRHa) reduces the development of OHSS and induces a physiological surge similar to the natural menstrual cycle. Because of shorter amplitude and duration of GnRHa-induced LH surge, GnRHa-alone trigger results in a higher early miscarriage rate. Combining these two agents; dual trigger increases oocyte maturation with reduced OHSS. Here we present reports in our clinic to differentiate the dual vs. hCG trigger results.

Method: We retrospectively analyzed the data from 68 patients who had undergone antagonist protocol from January 2021-January 2023. The final oocyte maturation was undertaken with a dual trigger with GnRHa (Buserelin 0.3 mg) combined with hCG (r-hCG 250 [Formula: see text]g) ([Formula: see text] = 33) or hCG alone ([Formula: see text] = 35).

Results: The mean age of both groups was 34 years old. The AMH level of the dual group ranged from 0.06 – 7.17 ng/mL, and in hCG alone group ranged from 0.16 – 12.3 ng/mL. Women in both groups got similar amounts of follicles and MII oocytes; dual group (14.8 and 12.72 vs. 14.9 and 13). The retrieval rate of oocytes was identical in both groups (86.6% vs. 89.9%). However, the maturation rate of dual group was slightly lower than the hCG group (77% vs. 82%), but it was statistically insignificant (independent t-test p 0.99).

Conclusion: We showed that dual trigger was not superior to hCG-alone trigger in terms of maturation rate of oocytes. Analysis of larger data is needed to show the real advantages.
#138 : Effect of Endometriosis on Human ICSI, and Endometriosis Follicle Fluid on Mouse Oocyte Maturation and Mitochondria
Authors: Adnyana Ida Bagus Praja Putra , Sudiman Jaqueline , Adnyana Ida Bagus Putra , Chandragiram Tjokorda , Dewi Ni Nyoman Ayu , Suardika Anom , Widianti I Gusti , Suwiyoga Ketut , Surya Udayana I Gusti Ngurah Bagus
Published: January 2024

Background and Aims: Endometriosis is the common cause of infertility. Assisted Reproductive Technology has become a promising choice for women with endometriosis, however, there is no consensus concerning the impact of endometriosis on the success rate. Our study was aimed to assess the impact of endometriosis on ICSI and to investigate the effect of endometriosis follicle fluid (FF) on mouse oocytes maturation and mitochondrial activity.

Methods: Hormonal stimulation, embryo quality and success rate from moderate-severe and minimal-mild endometriosis were compared with tubal infertility patients as controls. Then animal experiments were carried out involving the co-culturing of mouse oocytes with FF from moderate-severe endometriosis patients to assess mitochondrial dye, oocyte maturation, and protein levels of cytochrome C and cyclin B1 using ELISA.

Results: The number of follicles, mature oocytes, and fertilization rates were significantly lower in moderate-severe endometriosis group compared to control and minimal-mild endometriosis groups. This led to significantly decreased pregnancy rates in moderate-severe endometriosis group compared to minimal-mild endometriosis and control groups [26/72 (36.1%); 27/47 (57.4%); 85/152 (55.9%), p<0.05, respectively]. Implantation rates in moderate-severe endometriosis group decreased significantly compared to control group [31/166 (18.7%) vs 113/392 (28.8%), OR 1.76; 95% CI 1.14 to 2.79; p<0.05). Mitochondrial dye was significantly lower in mouse oocytes cultured with endometriosis FF compared to control and oocytes cultured with tubal factor FF. Cyclin B1 protein level was lower in oocytes cultured with endometriosis FF compared to control and oocytes cultured with tubal factor FF. There was no difference in cytochrome C protein level among groups.

Conclusions: Our results showed that moderate-severe endometriosis is associated with reduced quality of oocyte and embryo and leads to lower success rates of ICSI. This research also showed FF could impair mouse oocytes nuclear maturation which may be related to reduced cyclin B1 level and decrease activity of mitochondria.
#243 : Comparison of IVF Outcome Following Follitropin Alfa and Follitropin Delta Utilization at Melati Clinic, Harapan Kita Women and Children Hospital
Authors: Supriyadi Agus , Prasetiawati Novita , Sjarbaini Hadi , Tarigan Sudirmanto , Suardana Gde , Haekal Mohammad , Indah Deana Rosaria , Pariyanti Gangsar
Published: January 2024

Background and Aims: Follitropin delta is the third recombinant FSH (rFSH) preparation developed with an individualized dosing regimen based on patient’s body weight and AMH level. According to the existing report, a daily dose of follitropin delta provides an equivalent ovarian response to that of follitropin alfa. However, the effect of follitropin delta on the resulting embryo and biochemical pregnancy remains to be elucidated. Hence, the present study aims to evaluate the effect of follitropin delta on embryo quality and biochemical pregnancy rates compared with that of follitropin alfa in an in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle.

Methods: A retrospective cohort study was conducted between January and December 2022 at Melati Clinic, Harapan Kita Women and Children Hospital. A total of 59 IVF/ICSI cycles stimulated with follitropin alfa and 26 IVF/ICSI cycles treated with follitropin delta were subsequently analyzed.

Results: After analysis, no significant difference was observed regarding the embryo quality of both treatments (P>0.05). The median of the good, moderate, and poor embryos in the follitropin alfa and follitropin delta group was 2 vs. 3, 1 vs. 2, and 2 vs. 2, respectively. Similarly, the biochemical pregnancy rate between the follitropin alfa and follitropin delta group was comparable (25% vs. 15%, P>0.05).

Conclusions: In conclusion, our study suggests that stimulation with follitropin delta in IVF/ICSI cycles yields a similar embryo quality and biochemical pregnancy rates to those of follitropin alfa.