bluuebunny/crossref_metadata_2025 huggingface dataset:
P-414 Ultrastructural and functional defects in cilia of endometrial glands from women with reproductive failure
Authors: Pearson-Farr J , Doherty R , Chatelet D , Goggin P , Ng B , Lucas J , Cleal J , Lewis R , Cheong Y
Published: June 2022

Study question

Do endometrial gland factors influence pregnancy success?

Summary answer

Increased proportion of cilia defects during the window of implantation in endometrial glands from women with reproductive failure compared to controls

What is known already

Endometrial glands are important for embryo implantation and successful pregnancy. There is an unmet clinical need to relate endometrial gland structure to function, identify markers for reproductive failure and targets for therapeutic interventions. Ciliated epithelial cells in the endometrium are a distinct cell type with a particular cell transcriptomic signature. Cilia defects have been reported in endometrial glands from women with reproductive failure however, a quantitative study of cilia defects in endometrial glands is yet to be established.

Study design, size, duration

An observational study comparing women with subfertility, recurrent pregnancy loss and controls

Participants/materials, setting, methods

Endometrial samples were collected during the implantation period from fertile controls (n = 10), women with subfertility (n = 11) and women with recurrent pregnancy loss (n = 15). Ciliated cells in endometrial glands were imaged by transmission electron microscopy and the proportion of cilia defects were quantified and compared between study groups. Endometrial glands were isolated from endometrial biopsies and the cilia beat frequency of ciliated cells was quantified by high-speed video analysis.

Main results and the role of chance

Our study reports a significant increase in the proportion of cilia ultrastructural defects in endometrial glands from women with subfertility versus fertile controls (P < 0.05). Cilia defects included microtubule disarrangement, transposition and loss of cilia inner dynein arm motor proteins. Ciliated cells in endometrial glands from women with recurrent pregnancy loss demonstrated a higher proportion of defects compared to fertile controls but this did not reach statistical significance (P = 0.07). A significant decrease in cilia beat frequency was reported in ciliated cells of endometrial glands from women with subfertility compared to fertile controls (P < 0.05).

Limitations, reasons for caution

This is an observational study with a relatively small sample size however, the participants in the study and control groups were matched for age, BMI and menstrual cycle characteristics.

Wider implications of the findings

This study quantified ultrastructural and functional differences of ciliated cells in endometrial glands from women with reproductive failure. Endometrial glands with perturbed cilia structure and function may be non-conductive to successful pregnancy. Differences in endometrial gland cilia could be used to identify a perturbed endometrium and develop targeted therapies.

Trial registration number

not applicable
P-473 Low radiation affects follicle count in sheep ovaries
Authors: Saueressig R , Reiser E , Frank M , Tollinger S , Haybäck J , Ganswindt U , Toth B
Published: June 2022

Study question

What is the effect of low dose radiation on follicle count in sheep ovaries?

Summary answer

Even low dose radiation has a negative impact on the follicle count in sheep ovaries.

What is known already

Radiotherapy is a corner stone of state-of-the-art cancer treatment, especially in young cancer patients. Survival rates are constantly rising, resulting in long-term survivors with potential child wish. High doses of radiation lead to a permanent damage to the ovaries. Little is known about the damage after low dose radiation to the ovaries including both follicles and stroma.

Study design, size, duration

Prospective ongoing study, including n = 41 sheeps and 942 ovarian punches (Ø 3mm). So far, n = 12 sheep and n = 120 punches were analysed between April 2020 and January 2022. After finishing the experiments with sheep ovarian tissue, we will continue with a mouse model and human ovarian tissue.

Participants/materials, setting, methods

942 cortex punches out of a total of n = 41 sheep were obtained and cryopreserved. After thawing the punches were radiated with a dose of 0.0, 0.5, or 9.0 Gy using a cesium 137 radionuklide source (GSR C1, GammaService Medical GmbH). The punches were fixed in formalin, embedded in paraffin, cut into serial sections of 3-5 µm and stained with Hematoxylin and Eosin for follicle counting as well as Caspase 3 and Ki67.

Main results and the role of chance

Follicle loss was already observed after low dose radiation (0.5 Gy). Mean follicle count after 0 Gy, 0.5 Gy, and 9 Gy were 7.5, 2.3 and 1.8, respectively. While after 0 Gy, no signs of degeneration were visible, after radiation with 9 Gy follicles showed strong signs of degeneration including disorganization of granulosa cells, pyknosis and stromal irregularities.

Limitations, reasons for caution

Limitations of our study include the pilot character and therefore small sample size. The presented data only display part of the overall project including also an in-vivo mouse model.

Wider implications of the findings

As even low dose radiation seems to damage ovarian follicles, further in-vivo studies are needed to confirm these results. Moreover, fertility preservation methods need to be offered consequently to young cancer patients receiving radiotherapy.

Trial registration number

25
P-480 Oocyte survival and embryo viability rates are not affected by the transportation of vitrified donor oocytes: a sibling study with oocytes from the same cohort
Authors: Basile N , Pascual M , Cardoso M.C , Guilherme P , Neuspiller F
Published: June 2022

Study question

Are oocyte survival and embryo viability rates impaired by the shipment of vitrified donor oocytes in nitrogen vapors from one country to another

Summary answer

Oocyte survival and embryo viability rates are not affected by their transportation in nitrogen vapors showing similar parameters in the clinics of origin and abroad.

What is known already

The demand for donor eggs increases as egg donation cycles rise in ART clinics. Due to the legislation in some countries and the lack of donors, clinics choose to import vitrified oocytes from egg banks. Vitrification is a well established technique and the effectiveness of egg banks with vitrified oocytes has been proven. However, the comparison of sibling oocytes from the same donor's cohort in origin and after transportation remains to be study

Study design, size, duration

This is a retrospective, multicentric, observational study

Participants/materials, setting, methods

A total of 1030 vitrified oocytes from 55 donors were split between recipients in two different countries. Three clinics, one in Argentina (clinic of origin) and two in Brasil (clinics of destination) participated in this study. A total of 717 oocytes remained in the clinic of origin and were used to perform IVF cycles, while 313 oocytes were shipped abroad to the clinics of destination. Oocytes were transported at -196ºC in tanks with nitrogen vapors.

Main results and the role of chance

No significant differences were observed for any of the parameters analyzed except for the blastocyst rate. The lower blastocyst rate observed for the clinics of destination could be explained by the fact that one of the clinics performed embryo transfers and cryopreservations on day 3 leaving only surplus embryos (with lower potential) to blastocyst culture. When analyzing the embryo utilization rate, defined as the total of embryos on day 3 or day 5 destined to transfer or cryopreservation, results were not statistically different between the clinic of origin and both clinics of destination.

Limitations, reasons for caution

This study only evaluated the performance of sibling oocytes between the clinic of origin and two clinics of destination. It may be necessary to expand the number of clinics to generalize that sibling oocytes have the same potential regardless if they are shipped or not.

Wider implications of the findings

This study supports the establishment of international donor egg banks to attend the demands of IVF centers around the world. The transportation of vitrified oocytes from one country to another is a safe procedure as demonstrated by similar embryo viability parameters derived from sibling vitrified donor oocytes.

Trial registration number

Not applicable
P-513 Quality of life assessment of women undergoing in vitro fertilization treatment in Kazakhstan
Authors: Suleimenova M , Lokshin V , Karibayeva S , Glushkova N , Terzic M
Published: June 2022

Study question

What is the quality of life of Kazakhstani women with infertility and what additional factors can affect it?

Summary answer

The FertiQoL questionnaire showed the low quality of life of Kazakhstani women and a significant affect some factors.

What is known already

Studies showed that infertility problems are among the saddest events in people's lives. It is reported that women undergoing IVF procedures are experiencing various types of psychological burdens like stress, anxiety and depression.

Study design, size, duration

This cross-sectional study involved women of reproductive age undergoing an IVF cycle at a large IVF center in Kazakhstan in the period from September 1, 2020 to September 31, 2021.

Participants/materials, setting, methods

The survey was carried out using the Google Form program and was sent to patients of large IVF clinic of Kazakhstan by the attending physician for an online survey. Out of 500 women who were given questionnaires, 453 women completely filled out. Questionnaire results data were entered into SPSS version 26.0 for aggregation and statistical analysis. Two-sample Student's t-test or one-way analysis of variance (ANOVA) was used to test for differences between groups.

Main results and the role of chance

Total FertiQoL was 59.6±11.3. 292 women with primary infertility and 161 with secondary infertility. According to the main indicators as Total FertiQoL and Core FertiQoL, the results of the scales were significantly higher (p < 0.001). The source of income for infertility treatment affects the level of Treatment FertiQoL. Cronbach's α coefficients of the FertiQoL subscale averaged 0.8. Cronbach's α coefficients of the FertiQoL subscale averaged 0.8.

We examined the satisfaction scores by FertiQoL, dividing them into two groups according to the presence of children (Table 3). FertiQoL scores were statistically significantly higher in the group with children than in the group with primary infertility in all areas (p < 0.05), except for Relation, Tolerability (p = 0.65, p = 0.59).

Limitations, reasons for caution

This study cross-sectional and was conducted in the countries of the Commonwealth of Independent States (CIS) for the first time. We want to continue research in cooperation with other CIS countries.

Wider implications of the findings

The duration of infertility, age and low economic status negatively affect the quality of life of women. The availability of subsidies from the state for infertility treatment improves the quality of life. The health expenditure percentage of GDP may affect the overall level of satisfaction of women.

Trial registration number

IRB-A108
P-530 tRNA fragments in follicle fluid can be explored in Diminished Ovarian Reserve patients as a marker of IVF outcomes
Authors: Dawkins J , Donelson F , Bossa D , Zhang C , Sathe A , Owen D , Nam Y
Published: June 2022

Study question

Can tRNA fragments in follicle fluid be explored for markers that predict blastocyst formation in patients with diminished ovarian reserve?

Summary answer

tRNA-Ser-CGA-4 is up-regulated in the follicle fluid of patients with diminished ovarian reserve (DOR)

What is known already

tRNA fragments are a novel class of small non-coding RNAs that have been shown to play regulatory roles in reproductive biology.

Study design, size, duration

Non-Randomized case control study in patients presenting for IVF treatment at a University affiliated fertility clinic from September 2020- January 2021. Thirty three patients were included: 15 patients with DOR and 18 controls.

Participants/materials, setting, methods

Patients were stimulated by appropriate protocols according to their age, diagnosis and AMH.

At retrieval, non-bloody follicle fluid (FF) was retrieved for after removing the cumulus-oophorus complex. FF was centrifuged at 1600 g x 10 mins and filtered with 80 nm filter for analysis.

Main results and the role of chance

There were no differences between the two groups with respect to age, BMI and duration of infertility. The mean age was 35.1 years

As anticipated, the mean AMH, antral follicle count and number of eggs retrieved were statistically lower in the DOR groups compared with controls (<0.05)

The fertilization rate was 61.2% in DOR vs 79.5% in controls

The blastocyst rate was 39.5% in DOR patients and 50.6% in controls

Total RNA yield was lower in DOR patients, as 50% of the DOR samples had undetectable levels (p < 0.001).

Samples were predominantly processed in duplicate. Input into the pipeline was paired end data which showed an overall tRNA fragment count that was higher in the DOR population. Log2FC showed an up-regulation of the tRNA fragments tRNA-Ser-CGA-4, tRNA-Cys-GCA-15, tRNA-Cys-GCA-10 and tRNA-Cys-GCA-19 in the DOR population.

Limitations, reasons for caution

Undetectable levels in follicle fluid of some of the DOR patients introduced selection bias

Larger sample size and broader applicability across various ethnic groups.

Wider implications of the findings

Follicle fluid can be explored to give insight into the signaling pathways of ovarian biology

Non-invasive method of assessing oocyte competence

Useful in explaining the pathophysiology of DOR

Can these findings assist is in the identification of therapeutic targets to delay the progression of age related/non-age related DOR?

Trial registration number

not applicable
P-539 Effects of gender of chromosomal translocation's carrier on pre-implantation genetic testing for structural rearrangement (PGT-SR) outcomes
Authors: Houissa Ediss H , Reignier A , Lammers J , Moradkhani K , Freour T , Loubersac S
Published: June 2022

Study question

Do the outcomes of PGT-SR cycles vary according to the gender of chromosomal translocation’s carrier?

Summary answer

The rate of balanced embryos was significantly higher when translocation carrier was a male as compared to female, but clinical outcomes were not significantly different.

What is known already

It has been well described that chromosomal translocations lead to very high rate of unbalanced embryos, and have a subsequent negative impact on blastulation, implantation, miscarriage and live birth rates.PGT-SR allows selecting balanced embryos and increases the chances of pregnancy, while decreasing the risk of micarriage in couples with chromosomal translocations. However, whether the gender of translocation carrier is associated with significantly different impact on PGT-SR outcomes is not known.

Study design, size, duration

This is a monocentric retrospective cross-sectional study conducted in all PGT-SR cycles performed between 2015 and 2020.

A total of 603 cycles, carried out in 283 couples, were included in the analysis.

Participants/materials, setting, methods

Two groups have been formed according to the gender of translocation carrier, Group 1 for female carriers (107 couples, 229 cycles), and group 2 for male (175 couples, 373 cycles).

The rate of balanced embryos, ovarian stimulation parameters, number of oocytes, biopsy rate, clinical pregnancy rate and live birth rate were compared between both groups.

Main results and the role of chance

Female age and infertility etiologies were comparable between both groups.

Mean total dose of gonadotrophin and peak E2 levels were not significantly different in both groups (2422± 895 units vs 2290 ± 858 respectively, p > 0.05) (2460± 1346 pg/ml vs 2497 ± 1397, p > 0.05). There was no significant difference in the number of oocytes and biopsied embryos rate between Group 1 and Group 2.

The rate of balanced embryo after PGT-SR was significantly lower in group 1 (female carriers) than in group 2 (21.1% vs 24.8% respectively, p = 0.036). Finally, biochemical pregnancy rate and live birth rate per transfer were not statistically different between both groups (46.2% vs 43.2% and 20.3% vs 18.5% respectively, p > 0.05).

Limitations, reasons for caution

The retrospective nature of the study was its main limitation. PGT-A was not used, preventing from concluding on embryo euploidy rate.

Wider implications of the findings

Further fundamental studies should be performed to explore the respective mechanisms involved in chromosomal rearrangements according to gender. Our study suggests that a higher number of oocytes could be targeted in female translocation carriers in order to increase the probability of obtaining at least one balanced embryo.

Trial registration number

2
P-562 Extended carrier screening using the qCarrier Plus® test in the field of reproductive medicine: retrospective results after five years of experience
Authors: Forne's Garcia N , Garcia Cruz R , Carreño Gago L , Borgia A , Segura Puimedon M , Armengol Dulcet L
Published: June 2022

Study question

To determine the reproductive risk of women and couples for the tested recessive and X-linked diseases.

Summary answer

An increased reproductive risk has been identified in 6% of women and in 6% of couples due to the presence or coincidence of pathogenic variants.

What is known already

Carrier testing is an established method to determine the reproductive risk of couples undergoing reproduction techniques. This risk assessment may differ depending on the analyzed diseases and the studied population.

Study design, size, duration

Observational retrospective study in more than 10,000 samples from gamete donors and patients undergoing assisted reproduction treatment, referred to our laboratory during 5 years for carrier screening using the qCarrier Plus® test.

Participants/materials, setting, methods

This test uses massive sequencing technology to screen for mutations causing 328 autosomal recessive and X-linked diseases. For the present study, only pathogenic or probably pathogenic variants were considered and variants of uncertain significance (VUS) were excluded.

Main results and the role of chance

Our data indicate that around 80% of the individuals in our cohort are carriers of at least one pathogenic variant, while 50% are carriers for multiple diseases. An increased reproductive risk has been identified in approximately 6% of women tested for being carriers of pathogenic variants in the X chromosome genes, and in 6% of couples due to coincidence of pathogenic variants causing the same disease. Furthemore, 40 of the genes included in our panel have a carrier frequency greater than 1%.

Limitations, reasons for caution

There are both technical and human limitations that might interfere in the analytical process, and that might hamper the identification of some genetic variants.

Wider implications of the findings

Not applicable.

Trial registration number

Not applicable
P-573 Women's age is the best success predictor in a cohort of poor responders: A retrospective analysis according to POSEIDON criteria
Authors: Amaral M.E , Monteleone P.A.A , Ejzenberg D , Baracat E.C
Published: June 2022

Study question

Are there differences between patients classified according to the Poseidon criteria regarding IVF sucess rates?

Summary answer

POSEIDON groups differ from each other. Woman's age, more than the ovarian reserve, is the main factor of poor prognosis in IVF cycles.

What is known already

Poor ovarian response to stimulation in an IVF cycle has an estimated incidence of 9-24%. The criteria used to characterize this group of patients are heterogeneous, making it difficult to address risk factors, to determine prognosis and to propose novel treatment options. The most used diagnostic criteria are the Bologna criteria and more recently the Poseidon classification.

Study design, size, duration

An observational, retrospective cohort study, based on 558 ART cycles performed between 2015 and 2018 at a single center in Brazil.

Participants/materials, setting, methods

Group division was acording to POSEIDON criteria: groups 1A (n = 15), 1B (n = 19), 2A(n = 48), 2B (n = 59), 3 (n = 17) and 4 (n = 50). Two control groups were stablished for comparison purposes: C1 with no previous poor response, normal ovarian reserve and women's age < 35 years (n = 157) and C2 with women's age ≥ 35 years (n = 193). Data was obteined from clinical records and analyzed with SPSS program.

Main results and the role of chance

Groups 3, 4 and 2A of Poseidon had less oocytes recovered (p < 0,001). Group 4 formed fewer embryos (p = 0,001). A previous history of poor response in younger patients wasnt't found to translate in a poor response in a second cycle, since there was no difference between groups 1A and 1B compared to group C1 regarding number of oocytes retrieved. Groups 1B and C1 had a higher clinical pregnancy rate (p = 0,028) and groups 2 and 4 had lower pregnancy rates per started cycle (p < 0,001).

Limitations, reasons for caution

Retrospective and observational study.

Wider implications of the findings

The findings of this study play a role in improving patients counselling. The results are encouraging for young women with normal reserve and a previous bad response, since they weren't found to have poor outcomes in a new cycle. Woman's age should be the main criteria to determine patient prognosis.

Trial registration number

not applicable
P-574 Ovarian Revitalisation using Platelet Rich Plasma
Authors: Singh P , Rastogi R
Published: June 2022

Study question

Can we rejuvinate ovaries (with low ovarian reserve) by injecting fresh platelet rich plasma ?

Summary answer

With ovarian PRP injections, Ovarian reserve will increase and number of follicles increases in treated ovaries .

What is known already

Till date no definitive treatment is available to restore function of ovaries. Few drugs e.g. granulocyte colony stimulating factor etc tried for the same but no satisfactory result was achieved. Oral ovulogens and gonadotropins cannot produce satisfactory number of ova in these patients. So they were forced to go for donar ova. By using ovarian PRP injections couple can have a chance of their own biological child.

Study design, size, duration

we conducted the pilot study involving injection of autologous fresh platelet rich plasma injection into the ovaries of subfertile females by comparison of their fertility parameters viz. hormonal profile involving measurements of blood levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH), prostaglandin E2 levels (PGE2); antral follicular count (AFC); number of mature follicles (NMF) and number of retrieved oocytes (NRO) in both pre-PRP and post-PRP states.

Participants/materials, setting, methods

Forty-five subfertile females of more than 20 years were included in our study . All the patients underwent fresh autologous PRP injection under transvaginal ultrasonographic guidance. Besides the demographic data, each patient’s hormonal profile (including blood levels of AMH, FSH, LH, PGE2), AFC, NMF and NRO in both pre-PRP and post-PRP state were recorded in a predesigned proforma. Statistical evaluation of the recorded data was done using appropriate methods and tools.

Main results and the role of chance

Mean age, weight, height, body mass index and years of subfertility of the patients in our study was 31.27yrs, 58.38kg, 154.84cm, 24.37kg/m2 and 8.44years respectively. The mean blood levels of AMH increased significantly in post-PRP state (1.6 vs 2.4pg/ml) in contrast to significant decrease in blood level of FSH (21.4 vs 12.5mIU/ml), LH (15.1 vs 5.9mIU/ml) & PGE2 (162.7 vs 66pg/ml). The AFC, NMF & NRO also increased in post-PRP state relative to pre-PRP state. The differences in above levels and numbers were statistically significant.

Limitations, reasons for caution

Autologous PRP injection into ovaries improves hormonal profile, AFC and number of mature follicles as well as retrieved oocytes. Furthur followup is needed to know weather our patients concieve spontaneously or they will need some kind of assisted tecniques to concieve a pregnency.

Wider implications of the findings

Autologous PRP injection into ovaries improves hormonal profile, AFC and number of mature follicles as well as retrieved oocytes, it can be utilized as a revitalisation tool to boost fertility. Our study results reinforce the above concept. However, outcome-based studies are needed to further validate the results of our study.

Trial registration number

TMU/IEC/19-20/0113
P-605 Biomechanical characteristics of the ovarian cortex in POI patients and functional outcomes after drug-free IVA
Authors: Méndez M , Ferreri J , Calafell J.M , Otero J , Farré R , Manau D , Carmona F , Fàbregues F
Published: June 2022

Study question

Is there a relationship between the biomechanical characteristics of ovarian cortex of POI patients and the resumption ovarian function after Drug-Free IVA?

Summary answer

Physical properties of ovarian cortex in POI are different. A significant ovarian stiffness increase was observed when resumption of ovarian function occurred after Drug-Free IVA.

What is known already

There is increasing evidence that the ovarian extracellular matrix (ECM) plays a critical role in follicle development. Primordial follicles are localized at the collagen-rich ovarian cortex, which offers a rigid physical environment that supports follicular architecture and increases survival. Therefore, premature loss of ovarian function would be associated with a physically less rigid ovarian cortex.

Study design, size, duration

Prospective observational cohort study at a tertiary-care university hospital including POI patients according ESHRE criteria who underwent Drug-Free IVA by laparoscopy between January 2018 and December 2019 and were follow-up for a year after intervention.

Participants/materials, setting, methods

Nineteen patients were included. Resumption of ovarian function was defined as resumption of menstrual cycles (at least three consecutive episodes of menstrual bleeding) and/or the presence of follicles > 10 mm on ultrasound. A sample of ovarian cortex taken during the intervention was analyzed by atomic force microscopy (AFM) in order to quantitatively measure mechanical properties at the nanometer scale (Young’s elastic modulus, E).

Main results and the role of chance

Median data at intervention were: age = 35 years (28–39); length of amenorrhea = 2 years (1–10); FSH level = 104.4 mIU/ml (38.9–176); and AMH = 0.02 ng/ml (0.01–0.1). Resumption of ovarian function was observed in 10 patients (52.6 %), achieving 2 pregnancies (one spontaneous and one after an IVF cycle). Median stiffness (E) measured by AFM was 2583 Pa (999–11296). There were no differences in clinical and hormonal parameters as a function of resumption of ovarian activity. Remarkably, ovarian cortex stiffness was significantly increased in patients with ovarian activity after Dug-Free VIA: 5519 (2260–11296] vs 1501 [999–3474], p value <0.001.

Limitations, reasons for caution

The main limitations of the study are the unavailability of ovarian tissue samples from a control group of patients without POI and the inability to perform histological studies on the same samples in which the biomechanical study was carried out.

Wider implications of the findings

These findings show the high variability of ovarian cortex stiffness in POI and that the increase of this stiffness entails a more favorable status after Drug-Free IVA. This may be related to an ovary with more residual follicles, which would explain a greater chances of ovarian follicular reactivations after treatment.

Trial registration number

not applicable
P-630 Optimal route of progesterone administration for luteal phase support in frozen embryo transfer cycle : systematic review
Authors: Almohammadi A , Black M , Maheshwari A
Published: June 2022

Study question

The optimal route of progesterone administration for luteal phase support in a frozen embryo transfer: A systematic review

Summary answer

Due to the heterogeneity of the results, it was not possible to determine which route had the best outcome.

What is known already

Luteal phase support (LPS) with progesterone is used to optimize outcomes in frozen embryo transfer (FET) cycles, though there is uncertainty about optimal route of progesterone administration.

Study design, size, duration

Objective: To systematically review evidence from randomized controlled trials (RCTs) comparing the various routes (oral, vaginal, and intramuscular) of progesterone administration for LPS in women undergoing FETs.

Participants/materials, setting, methods

In a systematic review of RCTs Medline, Embase, Web of Science and Cochrane controlled trials register were searched without language restrictions from database inception to June 2021. Data were extracted and quality assessed for risk of bias. Individual results were computed as relative risks (RR) with 95% confidence intervals (CI). (Prospective registration, PROSPERO No. CRD4202251017)

Main results and the role of chance

There were 4 eligible trials including 2790 participants. Risk of bias was low concerning randomization process, but there were concerns with respect to intended interventions, missing data, outcome measurement and selective reporting. Interventions were heterogeneous with respect doses and types of progesterone. Only one study (at high risk of bias) showed a statistically significant result in favour of vaginal vs oral progesterone for clinical pregnancy rates (RR 0.45, 95% CI 0.22-0.92); for other route comparisons, individual results were not statistically significant.

Limitations, reasons for caution

The comparison of route of administration of progesterone for LPS needs robust multicentre trials, and advanced data syntheses including indirect comparisons and network meta-analyses in the future.

Wider implications of the findings

The assessment of progesterone supplemention needs a universal agreed protocol to be implemented in guideline for clincian to follow

Trial registration number

Not applicable
P-633 Poor ovarian response: what are the implications for developmental and genetic health of embryos?
Authors: Bernarde F , Piccolomini M , Duarte O , Lo Turco E , Yamakami L , Faria A , Ferreira F.P
Published: June 2022

Study question

Are patients with a low ovarian response more likely to develop embryos with chromosomal alterations?

Summary answer

Low ovarian response has an impact on embryonic development and the genetic normality rate of embryos.

What is known already

Low ovarian response is characterized by a reduction in the follicular response resulting in a reduced number of eggs. This fact has an impact on the outcome of assisted reproduction treatments. Therefore, understanding the genetic behavior of the embryos of these patients is still a great challenge for both the clinic and the in vitro fertilization laboratory, because, with a better understanding of the embryo's genetic segregation process, it will be possible to apply more assertive behaviors in the human reproduction routine.

Study design, size, duration

This retrospective cross-sectional study included 73 patients up to 35 years old, splitted into two groups. The poor ovarian responder group (n = 32) and the controls (n = 41). The study group included patients with poor ovarian response, less than six MII oocytes after ovarian punction. The control group was selected according to the following inclusion criteria: the presence of tubal factor unexplained infertility, or adenomyosis. The data were collected between January 2019 and December 2021.

Participants/materials, setting, methods

All patients included in the study (n = 73) underwent the same assisted reproduction treatment with embryos transferred after biopsy and PGT-A. The T-Students test was applied to compare numerical variables and the q-square test for categorical variables. All the analysis was performed in SPSS software (V26). Patients who had other factors associated with poor ovarian response were excluded.

Main results and the role of chance

In the comparison between the groups, the differences in the levels of AMH, progesterone, and the number of oocytes in MII were observed, as expected for the two groups (p < 0.05). However, the control group had a higher rate of chromosomally normal embryos when compared to patients with a low ovarian response (60.9%± 30.1 vs 37.6%± 39.7, p = 0.0057) respectively. The other variables such as age, FSH, LH, BMI, estradiol, fertilization rate, rate of blastocyst formation, and quality of blastocysts did not show statistically significant differences.

Limitations, reasons for caution

Preliminary results with a low number of patients.

Wider implications of the findings

Patients with a low ovarian response may have lower rates of embryonic chromosomal normality, this fact is important for the indication of genetic testing for these couples. Future prospective studies should be carried out with a larger number of patients to understand the mechanisms that cause genetic alterations in embryos.

Trial registration number

non applicable
P-645 Intra-ovarian injection of autologous platelet-rich plasma (PRP) in poor prognosis IVF patients within 1 year of treatment: a cohort study
Authors: Barad D , Albertini D , Molinari E , Gleicher N
Published: June 2022

Study question

Does intraovarian injection of platelet-rich plasma (PRP) change parameters of ovarian function in patients with evidence of diminished ovarian reserve?

Summary answer

Over one year of follow-up there was no evidence of a positive effect of PRP treatment on ovarian function.

What is known already

Several authors have previously reported positive outcomes and improved response in ovarian function after treatment with PRP. However, thus far, no randomized controlled trials and few cohort studies have been published.

Study design, size, duration

This is a longitudinal cohort study following ovarian response among 80 patients with low functional ovarian reserve (LFOR) defined by AMH < 1.1 ng/mL, FSH > 12 mIU/mL or at least one prior IVF cycle with ≤ 3 oocytes for one year before and one year after intraovarian treatment with PRP.

Participants/materials, setting, methods

1.5 cc of PRP was injected into the cortex of ovaries in an average 12 injections per ovary. Beginning one month after their PRP treatment, patients underwent one or more cycles of ovulation induction for IVF. Outcome measures were endocrine response, and numbers of oocytes and embryos produced in by patients in response to a maximal gonadotropin stimulation before and after PRP treatment.

Main results and the role of chance

In this study women between ages 28 and 54 failed to demonstrate statistically significant outcome benefits from intra-ovarian PRP. Two very poor-prognosis 40-year-old patients with prior failed IVF cycles at other IVF centers that never reached embryo transfer, however, achieved pregnancy in an IVF cycle following PRP treatment for an ongoing pregnancy rate of 4.7% if a patient following PRP achieved retrieval of at least 1 oocyte with IVF.

Limitations, reasons for caution

This is an observational study of patients who performed poorly in past ovulation induction cycles, thus any improvement observed could have been accounted for by regression to the mean. The occurrence of two pregnancies in this group could be secondary to eventual success following a string of previous failures.

Wider implications of the findings

Even extremely poor prognosis will occasionally achieve a successful outcome from IVF. Uncontrolled case series cannot provide sufficient evidence to support routine use of an intervention like PRP. Future studies demand the use of well- controlled randomized trials.

Trial registration number

NCT04275700
P-646 IVF outcomes of embryos with abnormal PGT-A biopsy previously refused transfer – a prospective cohort study
Authors: Gleicher N , Albertini D , Molinari E , Barad D.H
Published: June 2022

Study question

Will patients who have embryos diagnosed as abnormal by preimplantation genetic testing for aneuploidy (PGT-A) choose to have those embryos transferred after those embryos were refused transfer at other institutions and what are the potential clinical outcomes of those transfers?

Summary answer

Many patients have selected embryos with PGT-A abnormal trophectoderm biopsies transferred since these embryos can still offer a chance of live birth.

What is known already

PGT-A is a widely practiced method of selecting embryos for transfer based on biopsy of a few cells. Many clinical practices refuse to transfer PGT-A abnormal embryos even when there are no other “normal” embryos available.

Study design, size, duration

This is a prospective cohort of 69 couples who, since 2014, moved a total of 444 PGT-A abnormal embryos previously refused transfer at their parent institutions to our practice. Among these, 50 patients have, thus far, undergone 57 transfer cycles of 141 embryos.

Participants/materials, setting, methods

Embryos diagnosed at other institutions by PGT-A as abnormal (mostly using next generation sequencing) were moved to our academically affiliated private fertility and research center in New York City. Female age at retrieval was 41.35 ± 3.98 years, 74% were Caucasian, 12% Asian and 10% were of African descent. All embryos identified as PGT-A abnormal among prospectively identified couples were recorded in our center’s registry.

Main results and the role of chance

Among the 144 embryos transferred 102 (72.3%) had only 1 or 2 chromosomal abnormalities, 30 (21.3%) had 3 or more and 9 (6.4%) were “undiagnosed” because of degraded DNA, yet still had been refused transfer. Transfer of PGT-A abnormal embryos resulted in 8 live births, 11 miscarriages and no voluntary terminations. One child was born with a segmental duplication and required repair of coarctation of the aorta as a newborn. Many couples with only PGT-A abnormal embryos are willing to have their PGT-A abnormal embryos transferred and such transfers can result in establishment of ongoing euploid pregnancies and live births.

Limitations, reasons for caution

Findings in this case series may not be representative of the wider population of couples undergoing IVF with PGT-A in general. Not all abnormal phenotypes present in the immediate postnatal period so it will be important to continue to follow the development of these children.

Wider implications of the findings

PGT-A can result in a clinics refusal to transfer embryos with abnormal PGT-A biopsies, even those with mosaic findings, consequently large numbers of infertile women are prematurely advised that their only chance of motherhood is through third-party egg-donation.

Trial registration number

Not applicable
P-674 Optimal aspiration pressure level of suction pump for oocyte retrieval in IVF-ET
Authors: Kim T.Y , Kang M.J , Han S.J , Kim S , Kim H , Ku S.Y , Suh C.S
Published: June 2022

Study question

What is the appropriate suction pump pressure for oocyte retrieval in terms of oocytes and embryos quality?

Summary answer

The pressure of 150mmHg had a significantly higher number of oocytes retrieved compared with 120mmHg, but the oocyte quality and embryo quality were comparable.

What is known already

There is no conclusion on the optimal aspiration pressure level for oocyte retrieval in controlled ovarian stimulation (COS), and a variety of pressures between 100 and 200 mmHg are used, often based on manufacturer’s instructions.

Study design, size, duration

A retrospective analysis was performed on a total of 211 COS cycles of infertilie patients from September 2019 to December 2021 in a single tertiary center.

110 cycles were included in the 120 mmHg pressure group and 101 cycles were included in the 150 mmHg pressure group.

Participants/materials, setting, methods

Age, AMH, antral follicle count (AFC), the proportion of ICSI, the number of retrieved oocytes, the number of MII oocytes, MII rate, degeneration rate on day 1 of culture, and the number of embryos on day 3 of culture was compared and analyzed between the two groups. Variables such as Age, AMH, and AFC that may affect the results were corrected using analysis of covariance.

Main results and the role of chance

The number of retrieved oocytes was significantly higher in the 150 mmHg group compared to the 120 mmHg group (10.3 vs. 8.4, p = 0.016). Neither the number of MII oocytes nor the MII rate was significantly different between the two groups (6.1 vs. 5.5, p = 0.509 and 67.2% vs. 73.4%, p = 0.437 respectively). The degeneration rate on day 1 of culture and the number of embryos on day 3 of culture were also not significantly different between the two groups (6.2% vs. 4.4%, p = 0.282 and 5.7% vs. 4.7%, p = 0.109 respectively).

Limitations, reasons for caution

Since this study analyzed the appropriate pump pressure for oocyte retrieval in infertile patients, caution is needed in extending the study results to patients undergoing oocyte retrieval for the purpose of fertility preservation.

Wider implications of the findings

The results of this study revealed that oocyte collection could be efficiently performed without damaging the oocytes even with a higher aspiration pressure of 150 mmHg.

Trial registration number

not applicalbe
P-769 Endometrial thickness is not associated with birthweight as well as serum levels of pregnancy-associated plasma protein-A: a retrospective analysis of 560 newborns following frozen cycles
Authors: Asoglu M.R , Bahceci M
Published: June 2022

Study question

Does endometrial thickness (EMT) affect birthweight and maternal serum evels of pregnancy-associated plasma protein-A (PAPP-A) in singleton pregnancies following frozen-thawed blastocyst transfer (FET)?

Summary answer

EMT does not significantly affect birthweight and maternal serum evels of PAPP-A in singleton pregnancies following FET.

What is known already

Several studies have shown an association between EMT and low birth weight in pregnancies resulting from fresh embryo transfers. Supraphyiological levels of steroid hormone during ovarian stimulation may be responsible for poor fetal growth. Few studies have investigated the relationship between EMT and fetal growth potential in frozen-thawed embryo transfers.

Study design, size, duration

This retrospective study included women who underwent first-trimester combined screening for aneuploidy after frozen-thawed blastocyst transfer and subsequently delivered a singleton live birth after 24 weeks of gestations between January 2016 and July 2020 in a private IVF center.

Participants/materials, setting, methods

A total of 560 women met the inclusion criteria and were stratified into three groups based on the EMT percentiles: <7.7 mm (<10th percentile), 7.7–12 mm (10-90th percentile), and >12 mm (>90th percentile). The primary outcome measures were mean birth weight and mean PAPP-A level. A multivariable linear regression analysis was carried out to identify the association between birth weight and EMT after adjusting for variables found at < 0.1 level in the univariate analysis.

Main results and the role of chance

The mean birth weight was 3127 ± 783 g in those with EMT <7.7 mm 3225 ± 644 g in those with EMT 7.7-12 mm, and 3256 ± 599 g in those with EMT >12 mm (p = 0.577). The mean PAPP-A levels and PAPP-A<0.5 rates were similar in the groups, as well. In multivariate analysis, the number of previous ART attempts and maternal serum levvels of PAPP-A were found to be significant predictors of birth weight (p = 0.001 and p = 0.013, respectively). EMT was not a predictor of birth weight in both univariate and multivariate analyses. The multivariate logistic regression analysis indicated that the number of previous ART attempts was an independent factor for low birth weight (OR:1.39, 95%CI:1.09-1.76, p = 0.006).

Limitations, reasons for caution

The study has inheret limitations due to its retrospective nature. Further studies are needed to investigate the relationship between EMT and birth weight along with maternal serum levels of PAPP-A.

Wider implications of the findings

Our study provided a new angle of view for evaluating the association between EMT and neonatal birth weight by analyzing this association along with maternal serum levels of PAPP-A as a marker for placental function, suggesting that EMT is not an independent factor for neonatal birth weight.

Trial registration number

NA
Resentment, status dissatisfaction, and the emotional underpinnings of Japanese security policy
Authors: Ha Thao-Nguyen , Hagström Linus
Published: June 2022

What explains Japan’s security policy change in recent decades? Heeding the ‘emotional turn’ in International Relations, this article applies a resentment-based framework, which defines resentment as a long-lasting form of anger and the product of status dissatisfaction. Leveraging interviews with 18 conservative Japanese lawmakers and senior officials, the article discusses the role, function, and prevalence of resentment in the remaking of Japan’s security policy, premised on constitutional revision. The analysis reveals that conservative elites are acutely status-conscious; and that those who blame a perceived inferior status on Japan’s alleged pacifism are more likely to see revision of Article 9 as an end in itself. For a subset of conservatives, however, the goal is rather to stretch the Constitution to enhance Japan’s means of deterrence vis-à-vis objects of fear or in solidarity with allies. Overall, the article demonstrates that resentment provides a fruitful lens for analyzing status dissatisfaction in international politics.
Trusting on the shoulders of open giants? Open science increases trust in science for the public and academics
Authors: Song Hyunjin , Markowitz David M , Taylor Samuel Hardman
Published: June 2022

Researchers often focus on the benefits of adopting open science, yet questions remain whether the general public, as well as academics, value and trust studies consistent with open science compared to studies without open science. In three preregistered experiments (total N = 2,691), we find that the general public perceived open science research and researchers as more credible and trustworthy than non-open science counterparts (Studies 1 and 2). We also explored if open science practices compensated for negative perceptions of privately-funded research versus publicly-funded research (Study 2), although the evidence did not support this hypothesis. Finally, Study 3 examined how communication scholars perceive researchers and their work as a function of open science adoption, along with publication outlet (e.g., high-prestige vs. low-prestige journals). We observed open science research was perceived more favorably than non-open science research by academics. We discuss implications for the open science movement and public trust in science.
Zenker’s diverticulitis: a bitter pill to swallow
Authors: O’Neill R J , Cleere E F , Elsafty N , Gaffney R
Published: June 2022

Acute oesophageal obstruction from food bolus impaction is often triggered by underlying oesophageal pathology, both benign and malignant. These can be readily detected with standard investigations such as oesophagoscopy or computed tomography. Zenker’s diverticulum (ZD) is a benign condition frequently presenting with chronic dysphagia or may be asymptomatic. We report the case of an 81-year-old man with a previously undiagnosed 1-cm ZD causing complete oesophageal obstruction secondary to localized oedema from an impacted ibuprofen tablet. Although initial clinical, endoscopic and radiological findings were equivocal and suspicious for upper oesophageal malignancy, symptoms rapidly settled in response to systemic corticosteroids. The diagnosis was later confirmed on barium swallow with no other clinical, radiological or histopathological abnormalities identified. In conclusion, ZD is an uncommon cause of acute oesophageal obstruction which may occur in diverticula of all sizes. Surgery should be performed in patients with recurrent symptoms or large diverticula.