bluuebunny/crossref_metadata_2025 huggingface dataset:
O-162 Emerging mechanisms of oocyte genome integrity
Authors: Dunkley S , Mogessie B
Published: June 2022

Ageing is accompanied by aneuploidy in mammalian eggs, which underlies common pregnancy failures in reproductively older females. This is consistent with gradual, ageing-related depletion of centromeric cohesion proteins leading to premature separation of sister chromatids. However, such progressive cohesion loss does not satisfactorily explain the sharp rise in egg aneuploidy near the end of female reproductive life. Here we show that F-actin helps to keep most sister chromatids together after centromeric cohesion has deteriorated in ageing mammalian eggs. By combining targeted protein degradation with advanced microscopy of chromosomal dynamics in eggs of young and aged females, we demonstrate that actin mitigates premature sister chromatid separation arising from centromeric cohesion loss by limiting microtubule-dependent chromatid disengagement. We propose that impairment of this function underlies ageing-related exponential rise in egg aneuploidy.
O-280 Cycle programming prior to IVF
Authors: Blockeel C
Published: June 2022

The GnRH antagonist protocol has become increasingly popular for ovarian stimulation (OS), thanks to a number of advantages over the long GnRH agonist protocol: a reduced duration of stimulation with lower consumption of gonadotrophins and a lower rate of the ovarian hyperstimulation syndrome (OHSS), without any compromise in delivery rates.

Despite the clear benefits associated with the GnRH antagonist protocol, the long GnRH agonist protocol allows a more flexible and controlled schedule of oocyte retrievals: this is important both for the patient, who wants to undergo reproductive treatment at her own convenience, and for the IVF clinic. Cycle scheduling allows not only a more equal distribution of the work load, but can also avoid the vast majority of oocyte retrievals during weekend days.

To circumvent this shortcoming, the use of oral contraceptive pills (OCP) has been advocated as a programming method for IVF cycles using the GnRH antagonist protocol. Although the published evidence is clear about the negative impact of this method of programming, it is still widely used over the globe. Nevertheless, there are other possibilities of scheduling the oocyte retrievals, such as the use of estradiol, a pretreatment of GnRH antagonists, and other approaches. These options will be highlighted in the lecture.
P-047 The effects of dietary branched-chain amino acids on mice semen parameters and plasma amino acids profile
Authors: Sefidabi R , Kamali R , Shahverdi A , Pezeshki A , Ghasemi Z , Rashki Ghaleno L , Alizadeh A
Published: June 2022

Study question

Are there any differences between the effect of each member of the branched-chain amino acids (BCAAs) on sperm parameters and plasma amino acids profile?

Summary answer

Valine supplementation had destructive effects on sperm parameters and viability. However, blood amino acids profile were similar among treatments.

What is known already

BCAAs, a group of three essential amino acids, have a crucial role on protein synthesis, besides being strongly associated with impaired glucose and fat metabolism. Although BCAAs supplements are one of the most demanding products for the fitness industry to increase the lean body mass and boost exercise performance, little information exists on the advantages and disadvantages of dietary BCAAs on male fertility.

Study design, size, duration

Fifty NMRI mature male mice were divided into five groups and were fed diets as follow: Control (CTR): 2.4% Beta-alanine, Leucine (Leu): 1.18% Leu + 1.2% Beta-alanine, Isoleucine (Ile): 0.58% Ile + 1.8% Beta-alanine, Valine (Val): 0.65% + 1.7% Beta-alanine, and BCAAs (Leu:Ile:Val ratio of 2:1:1): 2.4% BCAA: 1.18% Leu + 0.58% Ile + 0.65% Val. After 5 weeks, testes and epididymides were dissected, and sperm parameters and plasma amino acids profile were assessed.

Participants/materials, setting, methods

Semen parameters were evaluated by a Computer-Aided Semen Analysis (CASA) system. Plasma amino acids concentrations were determined by HPLC. Data were analyzed using SPSS and statistical differences among various groups were determined by ANOVA and Tukey’s post-hoc test.

Main results and the role of chance

Higher BCAAs intake, particularly Val, increased the destructive mechanisms on sperm viability. The results showed no significant difference on body weight after 40 days. Sperm concentration (8.4 vs. 4.5 ×106), progressive motility (51.5 vs. 27.2 %), and viability (67 vs. 56 % for CTR and Val group, respectively) decreased dominantly in the Val group compared to CTR (p≤0.05). The immotile parameter was significantly higher in the Val group compared to the CTR (p≤0.05). In addition, there were no significant differences on plasma amino acids profile.

Limitations, reasons for caution

The current study's limitation is that only one level of BCAAs was used. Given the potential role of Val on sperm cell death, further data on different levels of all BCAAs, especially Val administration and evaluation of the related mechanisms are needed.

Wider implications of the findings

The findings of our study show, for the first time, that individual levels of Ile and Leu have different effects on sperm parameters compared with all BCAAs or Val. More attention should be given to BCAAs supplementation and semen quality that was previously ignored.

Trial registration number

not applicable
P-053 Sperm chromatin integrity in men from infertile couples with teratozoospermia and normozoospermia
Authors: Bozhedomov V , Lipatova N , Bozhedomova G , Kamarina R , Shomarufov A , Kamalov A
Published: June 2022

Study question

What is the relationship between sperm morphology and sperm chromatin integrity (SCI) in patients with normal sperm concentration (SC) and motility (SM)?

Summary answer

SCI violations in form of sperm DNA fragmentation (SDF) and incomplete protamination (IP) are more common in teratozoospermia, even when SC and SM are normal

What is known already

Deterioration of sperm chromatin integrity in the form of SDF and IP are the significant factors affecting male reproductive potential (WHO, 2021).

Study design, size, duration

This multicenter retrospective cross-sectional study included 479 men aged 18-45 years who were observed for infertility for more than 1 year.

Participants/materials, setting, methods

Only men: 1) with sperm concentration and motility that were not lower than the 5% centile according to WHO-2021 (16 million/ml and 30%, respectively), 2) without any inflammatory processes in genitourinary organs, 3) with obtained tests for SCI were included in the study. The men were divided into 3 groups (gr.) depending on the percentage of morphologically abnormal forms: I - 86-95% (n = 229), II - 96-99% (n = 228), III - 100% (n = 22).

Main results and the role of chance

The mean SDF in groups I, II, III were 9.0% (6-15), 12.0% (8-16) and 16.5% (13-20) (pI-II = 0.009; pII-III = 0.002; pI-III = 0.001), respectively. SDF index (Halosperm® Assay) in groups I, II, and III were 1.3 (1.2-1.5), 1.4 (1.3-1.5), and 1.5 (1.4-1.7), respectively (pI-II = 0.004; pII-III = 0.001; pI-III = 0.009). In 23% (I), 27% (II), and 55% of cases (III) the SDF value exceeded the threshold value (>15%) (pI-II > 0.05; pII-III <0.02; pI-III <0.005). Histone-positive sperm were revealed in 17% (12-23), 19.5% (13-27), and 31% (19-42) of cases in groups I, II, and III, respectively (pI-II > 0.05; pII-III = 0.014; pI-III = 0.02); The 30% of SDF threshold value was exceeded in groups I, II, and III, in 12%, 20%, and 52% of cases (pI-II < 0.05; pII-III < 0.005; pI-III < 0.001).

Limitations, reasons for caution

The reference values of SDF and the proportion of histone-positive sperm have not yet been determined properly, even in WHO 2021, therefore, the prevalence of SCI abnormalities in various spermiological diseases needs to be clarified in the future.

Wider implications of the findings

SCI and IP can be applied more widely in the investigation of men from infertile couples, especially, men with teratozoospermia. It should also be considered in men from infertile couples with normal semen parameters.

Trial registration number

Not applicable
P-058 Risk factors associated with sperm DNA fragmentation in Tunisian subfertile men
Authors: Boussabbeh M , Ben Jmaa M , Sallem A , Belghaieb I , Ammar O , Mehdi M
Published: June 2022

Study question

The aim of the study was to investigate risk factors for sperm DNA fragmentation to determine which factors influence significantly the sperm DNA fragmentation.

Summary answer

Obesity seems to lead to higher risk of sperm DNA damage in Tunisian subfertile men.

What is known already

A positive association between lifestyle conditions, varicocele, advanced age and exposure to toxicants and DNA fragmentation has been documented.

Study design, size, duration

It’s a retrospective case control study. 61 Patients registered from October 2018 to December 2021 were divided into two groups: group “C” with good quality sperm DNA (n = 20) and group “F” with fragmented sperm DNA (n = 41).

Participants/materials, setting, methods

DNA fragmentation was measured using terminal deoxynucleotidyltransferase dUTP nick and labeling assay. The Odds Ratio (OR) and their 95% CI were calculated using univariate logistic regression in order to quantify the association between the variable of interest “Sperm DNA fragmentation” and the various risk factors: lifestyle conditions (e.g. tobacco smoking, alcohol consumption, and obesity), age, professional exposure to high temperature and toxic products and urological history (e.g. varicocele, testicular hypotrophy or hypertrophy).

Main results and the role of chance

Our results showed that tobacco, professional exposure to high temperature and toxic products and urological history are risk factors that may alter sperm DNA with an odds ratio (OR) of 2.1, 1.9 and 1.5, respectively. Interestingly, we demonstrated that obesity seems to be the most significant risk factor of DNA fragmentation with an OR of 4.2 (p = 0.002).

Limitations, reasons for caution

Further studies are needed to investigate the mechanism by which obesity occur sperm DNA damage.

Wider implications of the findings

Our finding are in accordance with several retrospective studies demonstrating that obesity is liable to sperm DNA damage

Trial registration number

not applicable
P-146 Blastocyst morphometry and morphology predict ploidy
Authors: Shapiro B , Garner F , Kaye L , Rasouli M , Verma K , Bedient C
Published: June 2022

Study question

Are objective measurements and subjective assessments of blastocysts predictive of aneuploidy?

Summary answer

Aneuploidy was predicted equally well by lower trophectoderm cell count (objectively measured morphometry) or by a lower subjective trophectoderm grade.

What is known already

Blastocyst morphological grade has been reported to be moderately predictive of embryo ploidy. However, due to its subjective nature, morphological grade may be significantly more difficult to code into artificial intelligence algorithms when compared to objective measurements.

Study design, size, duration

This retrospective cohort study included all 1409 blastocysts that were subject to pre-implantation genetic testing (PGT) in a 30-month study period.

Participants/materials, setting, methods

Per clinic routine, embryos from oocyte were cultured to the blastocyst stage following conventional ovarian stimulation, oocyte retrieval, and intracytoplasmic sperm injection. If the patients opted for PGT, a laser was used to open the zona at the cleavage stage, trophectoderm biopsies were collected at the blastocyst stage, and biopsies were analyzed by next-generation sequencing. Inner cell mass sizes were measured by ocular micrometer and trophectoderm cells were counted in one plane of focus.

Main results and the role of chance

The mean patient age (including oocyte donors) was 31.9±6.4 years and the mean number of collected oocytes was 23.0±12.9. In multivariable logistic regression, greater patient age was the best available predictor of blastocyst aneuploidy (P < 0.0001). Along with age in the model, the observation of fewer trophectoderm cells (P = 0.0019) was also predictive of aneuploidy. Alternatively, the failure to have an A-grade trophectoderm (P = 0.0007) was also predictive of aneuploidy, also with age in the model. Neither the objectively measured inner cell mass size nor subjective inner cell mass grade were significant predictors of ploidy. Overall, objectively measured blastocyst morphometry was about equally predictive of ploidy as was subjective blastocyst grading, and area under the receiver operating characteristic curve was 0.62 for each model.

Limitations, reasons for caution

This study was retrospective, allowing the possibility of selection bias among patients and among embryos chosen for biopsy.

Wider implications of the findings

Artificial intelligence algorithms assessing embryos might benefit from the similar performance of subjective grading and objective measurements, because it is much easier to code objective measurements into the algorithms.

Trial registration number

None.
P-157 Embryo culture under high humidity conditions in time lapse system does not improve ongoing pregnancy rates: a retrospective propensity score model study 299 ICSI cycles
Authors: Lagalla C , Bartolacci A , Coticchio G , Intra G , Dell'Aquila M , Parodi F , Patria G , Zacà C , Borini A
Published: June 2022

Study question

Does culture in high relative humidity conditions (HC) improve ongoing pregnancy rates when using a time-lapse system (TLS) for embryo culture?

Summary answer

Using The use of a TLS under HC does not increase the likelihood a pregnancy in comparison with cultured in dry condition (DC).

What is known already

Factors potentially affecting embryo development demand precise control in the IVF laboratory environment, especially for correct incubator usage. TLS provide stability during embryo culture, which is a well-known key factor for undisturbed embryo development. The humidity content of embryo culture atmosphere is especially relevant to prevention of oscillations in culture media osmolality. Previous data suggest that culture under HC has a significant effect on embryo quality and morphokinetics. However, studies assessing the effect of HC on clinical outcome are rare and inconclusive.

Study design, size, duration

A retrospective study of 299 women undergoing their first ICSI cycle from April 2021 to December 2021, of whom patients assigned to dry or humid conditions were 184 and 115, respectively.

Participants/materials, setting, methods

We used a GERI incubator, with 6 separated chambers for individual patients (3 HC, 3 DC). The effect of HC on ongoing pregnancy rate was assessed by the propensity matched sample, to reduce potential differences between women undergoing either HC or DC and to obtain unbiased estimation of treatment effect. Variables included in the propensity score model were female age, AMH, FSH, BMI, partner’s age, sperm quality and number of embryos transferred.

Main results and the role of chance

Patient demographics were homogeneously distributed in the two study groups. After adjusting for several confounding variables and applying the Propensity Score, no statistically differences were observed for embryo quality on day 3 [51,64 ± 34,33 (DC) Vs 53,83 ± 30,71 (HC)], blastulation rate [45,5% ± 22,60 (DC) Vs 45,9 ± 22,80 (HC)] and ongoing pregnancy rate. A trend was observed of increased ORs for ongoing pregnancy in HC conditions [OR = 1.56, 95% CI (0,77-3,15), p=0.21].

Limitations, reasons for caution

The study is limited by its retrospective design, although a propensity score model may mitigate such a limitation. The lack of data on live birth rate is an additional limitation.

Wider implications of the findings

These results suggest that HC conditions does not increases the likelihood of embryos to achieve an ongoing pregnancy with respect to those cultured in dry conditions. Further data collection and analysis are ongoing to investigate more thoroughly and extended clinical outcome results.

Trial registration number

N.A.
P-217 Laboratory and clinical outcomes for fresh and vitrified-warmed oocytes after Piezo-intracytoplasmic sperm injection (Piezo-ICSI)
Authors: Low S.Y , Lim A.Y.X , Lee C.S.S
Published: June 2022

Study question

How is the performance of Piezo-ICSI on vitrified-warmed oocytes compared to fresh oocytes in human IVF?

Summary answer

Laboratory outcomes for fresh and vitrified-warmed oocytes after Piezo-ICSI were comparable.

What is known already

ICSI is utilized as the fertilization method for 60-80% IVF patients undergoing assisted reproductive technology (ART) worldwide. In the past 3 decades, Piezo-ICSI (Prime Tech Ltd, Japan), a refined ICSI methodology had shown increased fertilization and survival rates. The fertilization rate (2PN, 1PN, and >2PN) achieved via Piezo-ICSI was reported as high as 84-91% in previous publications.

Study design, size, duration

This retrospective cohort study included 12,195 fresh and 1,065 vitrified-warmed oocytes retrieved or warmed from 1334 and 93 patients respectively between January 2020 and November 2021. Mean age was 35.9 (ranged 19-49) for fresh oocytes and 27.3 (ranged 18-49) for vitrified-warmed oocytes. The vitrified-warmed oocytes were mainly originated from young donors and thus reflected in lower maternal age in this cohort

Participants/materials, setting, methods

All oocytes fertilized using Piezo-ICSI technology during the study period were included. Piezo-ICSI is performed using a piezo impact drive unit (MB-S; Prime Tech Ltd, Japan) driven by a controller (PMM4G; Prime Tech Ltd, Japan). The ultrathin walled micropipette (PINU06-25FT; Prime Tech Ltd, Japan) filled with 1-1.5cm operation liquid (Flourinert FC-770; Sigma, Belgium) was used for microinjection. For vitrified-warmed oocytes, Cryotec Method (Reprolife, Japan) was used for both vitrification and warming of oocytes.

Main results and the role of chance

The two groups (fresh and vitrified-warmed oocytes) were comparable (p > 0.05) in terms of fertilization (2PN and >2PN) rate (81.5% vs 80.0%), post-ICSI oocytes survival rate (93.3% vs 92.8), blastocyst-formation rate from 2PN oocytes (74.6% vs 71.0%) and blastocyst-utilization rate from 2PN oocytes (53.2% vs 49.3%).

This study demonstrated that fresh and vitrified-warmed oocytes achieved comparable laboratory outcome following the use of Piezo-ICSI technique and ultrathin walled injection pipette.

Limitations, reasons for caution

The methodology in performing Piezo-ICSI differs compared to conventional ICSI, hence training is required to achieve optimal results.

Wider implications of the findings

Our data resonates with previously published data using the same Piezo-ICSI platform.

Trial registration number

Not applicable
P-309 Endometriosis does not compromise early embryonic development as well as live birth: a retrospective analysis of 716 standard in vitro fertilization cycles
Authors: Borini A , Dell' Aquila M , Bartolacci A , Intra G , Parodi F , Patria G , Zacà C , Borini E , Coticchio G
Published: June 2022

Study question

Does endometriosis compromise early embryonic development and/or clinical outcome in standard in vitro fertilization (sIVF) cycles?

Summary answer

Endometriosis does not compromise embryo development or clinical outcome in sIVF cycles characterised by normal semen parameters.

What is known already

IVF is an elective approach to overcome endometriosis-related infertility. The notion that IVF outcomes are altered in women with endometriosis the is scarce and conflicting. Different meta-analyses reached diverging conclusions concerning a possible impact of endometriosis on clinical outcome. With reference to laboratory outcomes, a reduced fertilization rate with sIVF was observed in several but not all studies.

Study design, size, duration

A retrospective analysis of 716 women undergoing their first sIVF cycles from 2015 to February 2021, 205 with in situ endometrioma (class IV) and 511 with tubal factor infertility.

Participants/materials, setting, methods

Diagnosis of endometriosis was based on ultrasound observation of cysts on at least two occasions at least two menstrual cycles apart. Women carrying atypical lesions, i.e., cysts with sonographic appearance compatible but not distinctive for endometriosis, were excluded. Multivariate analysis was conducted using the generalized estimating equation (GEE) approach, thus making it possible the analysis of variables with non-normal distribution. The primary study outcome was live birth rate.

Main results and the role of chance

After adjustment for maternal, paternal age, maternal body mass index (BMI), anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH) we found no significant difference in fertilization rate [78,69 ± 26,16 (Endo) Vs 79,5 ± 24,01 (Tubal)], embryo quality [33,33 (0 – 57,86) endometriosis vs. 33,40 (0 – 67,70) tubal factor], blastulation rate [52,00 ± 15,01 (endometriosis) vs. 55,49 ± 14,98 (tubal factor)], top quality blastocyst [38,15 ± 18,67 (endometriosis) vs. 34,62 ± 14,77 (tubal factor)], ongoing pregnancy [OR = 0,84, 95% CI (0,54 – 1,32)], live birth [OR = 0,89, 95% CI (0,53 – 1,48)], and miscarriage rate [OR = 0,68, 95% CI (0,27 – 1,74)]. The only significantly different outcome was the percentage of embryos with ≥ 8 blastomeres on day 3 [25,00 (0 - 60,00) endometriosis Vs 40,00 (0 - 67,00) tubal factor].

Limitations, reasons for caution

The retrospective design of the study and lack of data on cumulative live birth rates are additional limitations.

Wider implications of the findings

The results of our study suggest that in women with endometriosis fertilization rate, embryo quality, blastulation rate and live birth rate are not affected in sIVF cycles.

Trial registration number

N.A.
P-407 Pregnancy outcomes of different endometrial preparation in patients with a history of cesarean section
Authors: Gan R , Gong F
Published: June 2022

Study question

To investigate the efficacies of three cycle regimens in women receiving frozen embryo transfer with a history of cesarean section(CS).

Summary answer

In women undergoing frozen embryo transfer with a history of CS, hormone replacement therapy for endometrial preparation was associated with a higher early miscarriage rate.

What is known already

Rates of CS are rising worldwide. Many women with a history of a CS delivery conceived through assisted reproductive technology (ART) are in need of frozen embryo transfer (FET) for their second progeny. Various protocols for endometrium preparation have been used to provide an optimal uterine environment for the transfer of thawed embryos, but the evidence supporting the superiority of one protocol over another is insufficient.

Study design, size, duration

A retrospective cohort study of patients (N = 6,159) with a history of CS who fulfilled the inclusion criteria were enrolled in the study from January 2014 to December 2019 at the CITIC-Xiangya Hospital of Reproduction and Genetics.

Participants/materials, setting, methods

Reproductive outcomes of patients in the natural cycle （NC） (n = 4,306) versus hormone replacement therapy（HRT） (n = 1,007) versus gonadotropin-releasing hormone agonist （GnRH-a） + HRT groups (n = 846) were compared. Multiple logistic regression analyses were performed to investigate the potential confounding factors.

Main results and the role of chance

The unadjusted odds of the miscarriage rate of singleton pregnancies were also significantly higher in the hormone replacement therapy compared with the natural cycle (25.5% versus 20.4%, respectively). After adjusting for possible confounding factors, the early miscarriage rate and the miscarriage rate of singleton pregnancies remained significantly higher in the hormone replacement therapy than the natural cycle. The clinical pregnancy rates in the hormone replacement therapy, hormone replacement therapy and treatment with gonadotropin-releasing hormone agonist of women with a history of cesarean section was 48.8%, 48% and 47.1%, respectively, and the live birth rates were 37%, 34.1% and 35.7%, respectively.

Limitations, reasons for caution

This study is limited by its retrospective design. Furthermore, the detailed ultrasound information on uterine myometrial defects, complications related to CS and the number of previous CSs were unavailable in our study. Another limitation is that pregnancy-related complications and neonatal outcomes were not analyzed.

Wider implications of the findings

Our study could help physicians improve their understanding of the impact of different protocols on pregnancy outcomes in patients with a history of CS. Prospective randomized trials should be conducted to assess the efficacy of endometrial preparation protocols for FET in women with a history of CS.

Trial registration number

not applicable
P-511 Measuring patient-centredness in publicly funded fertility care and private funded fertility care in China
Authors: Liang J , Ma Y , Li Q , Xu W , Jie Q
Published: June 2022

Study question

Does the Patient-Centred Questionnaire-Infertility (PCQ-Infertility) validate in China? Do patients experience different on patient-centredness in public fertility care compared to that in private fertility care?

Summary answer

PCQ-Infertility is valid in China. The patients in private fertility care have better experiences on patient-centredness than that in publicly fertility from results of PCQ-Infertility.

What is known already

Patient-centredness is one of the most important elements of quality of care. The PCQ-Infertility has validated to be a reliable tool to assess the extent of patient-centredness of fertility care in many countries, cross European counties to New Zealand. In China, physicians in many hospitals have recognized the importance of patient-centred infertility care, but lack of using instrument to measure it and then to improve it.

Study design, size, duration

This is a cross-sectional study. A survey with written questionnaire was performed among patients who diagnosed with infertility in Reproductive Medical Center of the First Affiliated Hospital of Hainan Medical University (publicly funded fertility care and Reproductive Medical Center of Hainan Modern Women and Children’s Hospital (private funded fertility care) between July and December 2021.

Participants/materials, setting, methods

In this study, 315 patients and 189 patients completed the survey at two reproductive medical centers. We used patient’s questionnaires to collect data on the patients’ experience with the quality of care. The PCQ-Infertility content, besides background questions, the questionnaire included 46 care aspects. Psychometric tests included inter-item and reliability analyses. An elaborate multivariate multilevel regression analysis was performed to assess the PCQs ability to measure differences in patient-centredness between reproductive medical centers.

Main results and the role of chance

The questionnaire was completed by 315 and 189 patients from the two hospitals. Patients’ mean scores on overall patient-centredness and the eight subscales (possible range 0–3) were calculated. High scores represent positive experiences with care. Both private and public hospitals scored high on care organization and communication. The lowest scores for both hospitals were the subscale, namely,‘information’. The significant differences between two hospitals were in “accessibility, respect for patient’s values, continuity and transition”.

Limitations, reasons for caution

This study is cross-sectional, the sample size is small, and enrolled fertility care centers are only two.

Wider implications of the findings

The PCQ-infertility is encouraged to be used in China to measure the patient-centredness, and can be adopted for quality improvement especially for publicly funded fertility care.

Trial registration number

ChiCTR2100053616
P-577 A Therapeutic Protocol in Previous Failed ART Patients With High Total NK Cells: An RCT
Authors: Saad A.S , Abdelaziz K
Published: June 2022

Study question

To evaluate a combined therapeutic protocol of lipid emulsion, prednisolone & LMWH in cases of failed ART cycles with high NK cells

Summary answer

The combined therapy of lipid emulsion, prednisolone & LMWH had a higher pregnancy rate but not significant than the standard therapy alone.

What is known already

Many researchers have proved that a high numbers and/or cytotoxicity of peripheral blood NK cells is associated with infertility, recurrent spontaneous miscarriage (RSM) and failed ART cycles.

Many investigations have shown that intralipid has the ability to suppress NK cell activity. It is well known that parenteral fat emulsions accumulate in macrophages modifying many immune responses. So, modifying the T helper1/ T helper 2 balance in favor of T helper 2 with implantation chances increase.

Prednisolone has an immunosuppressive and anti-inflammatory actions and has widely used in autoimmune diseases. Prednisolone also reduces the high numbers of uNK in RSM.

Study design, size, duration

This was a prospective randomized controlled trial in 100 cases with failed ART cycles & high NK cells. From Jan 2019- Dec 2021

Participants/materials, setting, methods

One hundred failed ART cases with high NK cells were divided into 2 groups: (Control group)(50 cases) with previous failed ART cycles will undergo standard treatment (progesterone, low dose aspirin & folic a.). While the other (Interventional group)(50 cases) will have in addition to the previous protocol: lipid emulsion begin in the cycle before embryo transfer & prednisolone begin with the start of lipid emulsion & LMWH begin with the day of ET

Main results and the role of chance

Chemical pregnancy was higher in the interventional group (54.0%) than the control group (40.0%) but without statistical significance (P = 0.161). Also, ongoing pregnancy was higher in the interventional group (85.0%) than the control group (60.0%) but without statistical significance (P = 0.094). No significant difference was reported regarding clinical pregnancy (P = 0.943).

Limitations, reasons for caution

Wider implications of the findings

Our results suggest a hopeful therapeutic protocol that may be used in such failed ART cases especially when no other reason can be found. But selecting which cases will benefit the most will need much further investigations.

Trial registration number

NCT03792997
P-597 The effects of triple trigger on IVF outcomes and pregnancy rates in poor responder patients
Authors: Öner G , Yavuz A
Published: June 2022

Study question

Are there any positive effects of triple trigger on oocyte morphology, embryo quality and pregnancy rates in poor responder (POR) patients?

Summary answer

The trigger with human chorionic gonadotropin (hCG), gonadotropin-releasing hormone agonist (GnRHa) and human menopausal gonadotropin (hMG) may improve embryo quality and pregnancy rates in POR.

What is known already

The ESHRE consensus criteria define a poor ovarian response (POR) as less than four oocytes retrieved. Advanced female age and severe sperm disorder were associated fertilization failure after intracytoplasmic sperm injection (ICSI). Also, oocyte quality is pivotal to determine the fertilization of the oocyte. Hence there is no study to evaluate triple trigger on the embryo quality in POR and severe male infertility are excluded.

Study design, size, duration

In this prospective randomized study, we analyzed poor responder patients that have history of fertilization failure and cleavage arrest embryo, including 100 patients with only hCG trigger (group 1), 100 patients with dual trigger hCG + GnRHa (Group 2), and 100 patients with triple trigger hCG + GnRHa + hMG (Group 3). Patients who have the POR criteria according to MII oocytes lower than 4 were included in the analysis.

Participants/materials, setting, methods

Mean age, body mass index (BMI), AMH levels, day-2 FSH and E2, duration of infertility, LH and E2 levels on trigger day, duration of stimulation, total dose of gonadotropins used, number of previous trials, MII oocytes were examined and compared between the groups. Sperm concentration under 5 x 106 mL was not included to exclude severe male factor. Embryo quality, pregnancy rates evaluation was performed for each patient that has been performed GnRH antagonist protocols.

Main results and the role of chance

Age, Body Mass Index (BMI), AMH levels, day 2 FSH and E2, duration of infertility, duration of stimulation, E2 levels on trigger day, and total dose of gonadotropins usage between the three groups were similar. Number of MII oocytes, fertilization (2PN), and D5 (blastocyst) embryo transfer were significantly higher in Group 3 (Table 1). Pregnancy rates are higher in group 3 however significantly not significant.

Limitations, reasons for caution

The study is limited by its sample size and a higher sample size might be used in the future studies to corroborate the current findings. hMG trigger dosage may be arranged in another study.

Wider implications of the findings

Our results showed that the number of MII oocytes 2PN levels, D5 ET were higher in DOR patients triggered with hCG + GnRHa + hMG.

Trial registration number

28012022
P-676 Comparison of hCG triggering versus hCG in combination with a GnRH agonist: a prospective randomized controlled trial
Authors: Yang L , Luo K , Lu G , Lin G , Gong F
Published: June 2022

Study question

Does co-administration of GnRH agonist and Human chorionic gonadotropin(dual trigger) in PGT cycles improve the number of usable blastocysts per patient compared to hCG alone?

Summary answer

Using the dual trigger has no effect on the number of usable blastocysts undergoing the GnRH-ant protocol for PGT compared to triggering with hCG alone.

What is known already

HCG is used at the end of controlled ovarian hyperstimulation as a surrogate LH surge to induce final oocyte maturation. Recently, based on retrospective studies, the co-administration of GnRH agonist and hCG for final oocyte maturation (dual trigger) has been suggested to improve IVF outcome and pregnancy rates.

Study design, size, duration

A prospective, randomized, open-label controlled clinical trial (ChiCTR-ICR-2000031342), enrolled patients attending our university affiliated Infertility and IVF center (the Reproductive and Genetic Hospital of CITIC-Xiangya, China) between August 2020 and June 2021. This sample size achieves with a power of 80%, at a significance level(α) of 0.05. A sample size of 160 patients, 80 randomized to each group, was chosen to allow for those 10% dropped out.

Participants/materials, setting, methods

The inclusion criteria for participating were: women age 20–35years, AMH≥1.2ng/ml and /or AFC ≥5, Couples with PGT-SR preimplantation genetic testing for chromosomal structural rearrangements (patients with abnormal chromosomal structure only in male or female), undergoing one of their first PGT cycle attempts. Patients fulfilled the criteria on the trigger day were randomly assigned to receive hCG or the dual trigger for final oocyte maturation. The primary outcome was the number of usable blastocysts per patient.

Main results and the role of chance

160 patients were included in the study. The age (29.1 years versus 29.4 years), BMI (22.1 kg/m2 versus 21.9 kg/m2) and the AMH (5.3 ng/ml versus 5.3 ng/ml) were comparable between the two groups. Based on PP analysis, there were no statistical difference in the number of eggs retrieved (17.1 versus 15.9), the MII oocytes (13.3 versus 12.5), the number of usable blastocysts per patient (5.0 versus 4.6) and top-quality blastocysts per patient (3.4 versus 3.2) between the two groups.

Limitations, reasons for caution

None

Wider implications of the findings

The enhanced response observed with the dual trigger might lead to better IVF outcomes were it used more widely.

Trial registration number

ChiCTR-ICR-2000031342
P-730 Transparency and Trustworthiness in Randomised Controlled Trials in In Vitro Fertilisation: An Analysis of Published Literature
Authors: Bai Y
Published: June 2022

Study question

What is the transparency and trustworthiness of randomised controlled trials (RCTs) on in vitro fertilisation (IVF) in the past decade?

Summary answer

Quality of IVF-research has improved in the last decade. Further progress can be made by prospective RCT-registration, raw data accessibility and better outlined recruitment timelines.

What is known already

Transparency and trustworthiness are fundamental features in science, and especially in RCTs as these studies provide evidence that guides clinical practice. The number of published RCTs is increasing. The differing quality of the RCTs, however, remains a challenge. A recent study analysing the transparency and reproducibility of RCTs published in high impact journals from 2013 to 2018 has identified trial registration, protocol availability, data accessibility as avenues of improvement (Kemper, 2020). Ongoing optimisation of routine research practices will increase faith in the generated evidence and maximise its potential benefits to the community.

Study design, size, duration

We performed a meta-epidemiologic study with a two-author system. We searched for all RCTs evaluating IVF published from 01/01/2010 to 23/08/2021 inclusive. Included studies were scored on transparency and trustworthiness. The main parameters were trial registration, protocol publication, funding and

Trial registration number

Not applicable
A Guide for Successful Research Collaborations between Zoos and Universities
Authors: Schulz Andrew K , Shriver Cassie , Aubuchon Catie , Weigel Emily G , Kolar Michelle , Mendelson III Joseph R , Hu David L
Published: June 2022

Synopsis

Zoos offer university researchers unique opportunities to study animals that would be difficult or impractical to work with in the wild. However, the different cultures, goals, and priorities of zoos and universities can be a source of conflict. How can researchers build mutually beneficial collaborations with their local zoo? In this article, we present the results of a survey of 117 personnel from 59 zoos around the United States, where we highlight best practices spanning all phases of collaboration, from planning to working alongside the zoo and maintaining contact afterward. Collaborations were hindered if university personnel did not appreciate the zoo staff’s time constraints as well as the differences between zoo animals and laboratory animals. We include a vision for how to improve zoo collaborations, along with a history of our own decade-long collaborations with Zoo Atlanta. A central theme is the long-term establishment of trust between institutions.
Strategic 2-step surgery using thoracic endovascular aortic repair for an infected thoracic aortic aneurysm
Authors: Nakano Mitsunori , Miyagawa Atsushi , Shinoda Daigo , Yuri Koichi
Published: June 2022

An 81-year-old man with multiple comorbidities developed infected thoracic aortic aneurysm, and we employed a strategic 2-step surgical approach combining thoracic endovascular aortic repair and local debridement with an omental flap during the active phase of infection. No signs of reinfection were observed at the 1-year follow-up. This strategy can be a safe and less invasive alternative to conventional open surgery in patients with high surgical risk.
Interplay between demographic, clinical and polygenic risk factors for severe COVID-19
Authors: Crossfield Samantha S R , Chaddock Natalie J M , Iles Mark M , Pujades-Rodriguez Mar , Morgan Ann W
Published: June 2022

Background

We aimed to identify clinical, socio-demographic and genetic risk factors for severe COVID-19 (hospitalization, critical care admission or death) in the general population.

Methods

In this observational study, we identified 9560 UK Biobank participants diagnosed with COVID-19 during 2020. A polygenic risk score (PRS) for severe COVID-19 was derived and optimized using publicly available European and trans-ethnic COVID-19 genome-wide summary statistics. We estimated the risk of hospital or critical care admission within 28 days or death within 100 days following COVID-19 diagnosis, and assessed associations with socio-demographic factors, immunosuppressant use and morbidities reported at UK Biobank enrolment (2006–2010) and the PRS. To improve biological understanding, pathway analysis was performed using genetic variants comprising the PRS.

Results

We included 9560 patients followed for a median of 61 (interquartile range = 34–88) days since COVID-19 diagnosis. The risk of severe COVID-19 increased with age and obesity, and was higher in men, current smokers, those living in socio-economically deprived areas, those with historic immunosuppressant use and individuals with morbidities and higher co-morbidity count. An optimized PRS, enriched for single-nucleotide polymorphisms in multiple immune-related pathways, including the ‘oligoadenylate synthetase antiviral response’ and ‘interleukin-10 signalling’ pathways, was associated with severe COVID-19 (adjusted odds ratio 1.32, 95% CI 1.11–1.58 for the highest compared with the lowest PRS quintile).

Conclusion

This study conducted in the pre-SARS-CoV-2-vaccination era, emphasizes the novel insights to be gained from using genetic data alongside commonly considered clinical and socio-demographic factors to develop greater biological understanding of severe COVID-19 outcomes.
Patient satisfaction with inpatient pharmacy services at tertiary care setting—a meta-analysis of recent literature
Authors: Azhar Anam , Wasif Gillani Syed , Jiaan Nada , Menon Vineetha , Abdi Semira , Rathore Hassaan A
Published: June 2022

Objectives

This study aimed to determine patient satisfaction with the following pharmacist-led services for inpatients in tertiary care hospitals.

Methods

Studies were identified from different databases from 2012 to 2020. A total of 1910 articles were identified using the search strategies out of which 1153 were rejected based on the review of titles and abstracts. The search criteria were the roles of inpatient pharmacists and patient satisfaction with inpatient pharmacy services. Multiple keywords were used such as ‘patient satisfaction’/‘inpatient pharmacist’/‘pharmacist hospital services’/‘clinical pharmacist roles’. The quality of each study was measured using the mixed methods appraisal tool, and the same was used to evaluate the risk of bias as well.

Key findings

A total of 11 cross-sectional studies were included in the evidence synthesis of this meta-analysis. Three studies tested the satisfaction of patients with inpatient counselling with a sample size of n = 742. The odd ratio (OR) was 215.33 (141.77 to 327.05) [95% confidence interval (CI)] showed a significant patient satisfaction (P = 0.00001) with the pharmacist’s inpatient counselling (I2 = 0%). Studies showed a statistically significant satisfaction of patients with discharge counselling P < 0.00001 and OR 55.74 (35.93 to 86.49) and heterogeneity I2 = 0%. In a total of five studies, the healthcare professional (HCP) satisfaction with pharmacist services was reported, and satisfied and unsatisfied HCPs were n = 801 and n = 362, respectively. Results showed high satisfaction (P < 0.00001) and OR 4.62 (95% CI, 3.89 to 5.48).

Conclusion

This meta-analysis concluded that clinical pharmacist services in an inpatient setting have a significant impact on increasing patient satisfaction with their treatment. The clinical pharmacist services are not very well implemented and are limited in some hospitals, but patients who have received these services were highly satisfied and expected to receive them more often.
Vienna—The Cradle of Sephardic Sephardism
Authors: Stechauner Martin
Published: June 2022

This article explores the rise and development of ‘Sephardism’ among Sephardic Jews in Vienna. Sephardism was originally a cultural phenomenon among the Ashkenazic Jews of Germany and Austria in the early nineteenth century. Based on the ‘Myth of Sephardic Supremacy’, they used it as a paradoxical emancipatory attempt to simultaneously stand out and integrate within the non-Jewish majority culture. Sephardic intellectuals in Vienna, living in a predominantly liberal Ashkenazic milieu, turned out to be highly receptive to some of the variants that German-Jewish Sephardism had to offer. Thus, during the second half of the nineteenth century, the Viennese Sephardim developed their own ‘Sephardic Sephardism’ with the aim of celebrating their own Sephardic (i.e. ‘Spanish’) heritage within a predominantly Ashkenazic environment. In the process, Sephardic Sephardism redefined the Viennese Sephardim’s self-image as Sephardic Jews, especially within the Eastern Sephardic Diaspora, where most Jews previously had little to no awareness of their Spanish origin.
Digital transit ports for the illicit trade in antiquities: the case of the ‘Afghan Genizah’
Authors: Palombo Cecilia , Yates Donna
Published: June 2022

In this article, we present the idea of a digital transit port, an online space that illicit cultural objects pass through in digital format while on a pathway to public legitimization. These virtual transit ports connect virtual illicit and illegally trafficked cultural objects with virtual consumers under the aegis of promoting access and preservation, while simultaneously normalizing the presence of these objects in market and academic spaces. Digital transit ports, then, make virtual versions of illicit cultural objects openly consumable, much like physical transit ports launder physical cultural objects. They may also legitimize use of the physical objects, infringing on legislative efforts at curbing the illicit trade. To explore the idea of the digital transit port, we will consider the case of the so-called ‘Afghan Genizah’ collection, a disarticulated group of historical documents from northern Afghanistan that have appeared on the international market most likely after being looted and trafficked illicitly outside their country of origin.
Quantum study of the bending relaxation of H2O by collision with H
Authors: Cabrera-González Lisán David , Denis-Alpizar Otoniel , Páez-Hernández Dayán , Stoecklin Thierry
Published: June 2022

Vibrationally excited levels of the H2O molecule are currently detected in various environments of the interstellar medium (ISM), and collisional data for H2O, including vibration with the main colliders of the ISM, are needed. The present study focuses on the bending relaxation of H2O by collision with H when taking bending–rotation coupling explicitly into account with the rigid-bender close-coupling (RB-CC) method. With this aim, a new four-dimensional potential energy surface including the H2O bending mode is developed from a large grid of ab initio energies computed using a high level of theory. For purely rotational transitions, our RB-CC rates show very good agreement with rigid-rotor calculations performed using our new potential energy surface (PES) and with those available in the literature. Calculations for pure rotational transitions inside the excited bending level ν2 = 1 of H2O are performed and compared with their equivalents inside ν2 = 0. Vibrational quenching of H2O is also calculated and found to be much more efficient through collision with H rather than with He.