bluuebunny/crossref_metadata_2025 huggingface dataset:
#18 : Risk Factors for Placenta Accreta Spectrum in Pregnancies Conceived after Frozen-Thawed Embryo Transfer in a Hormone Replacement Cycle
Authors: Fujita Tomoyuki , Yoshizato Toshiyuki , Mitao Hiroshi , Shimomura Takuya , Fukagawa Mayumi , Ushijima Kimio
Published: January 2024

Background and Aims: Assisted reproductive technology (ART), especially frozen–thawed embryo transfer (FET) in a hormone replacement cycle (HRC) is a risk factor for placenta accreta spectrum (PAS). This study aimed to clarify the risk factors for PAS related to the maternal background and ART techniques in pregnancies conceived after FET in an HRC.

Method: We performed a case–control study in two tertiary perinatal centers in Japan. Among 14,028 patients who delivered at ≥24 weeks of gestation or were transferred after delivery to two tertiary perinatal centers between 2010 and 2021, 972 conceived with ART and 13,056 conceived without ART. PAS was diagnosed in patients 1) with histopathological findings of placenta increta/percreta, 2) those requiring manual evacuation of the placenta after delivery, or 3) those with retained placental tissue. Among women who conceived after FET in an HRC, 62 with PAS and 340 without PAS were included in this study. Multivariate logistic regression models were used for case–control comparisons, with adjustment for maternal age at delivery, parity, endometriosis or adenomyosis, the number of previous uterine surgeries of cesarean section, myomectomy, endometrial polypectomy or endometrial curettage, placenta previa, the stage of transferred embryos and endometrial thickness at the initiation of progestin administration.

Results: PAS was associated with [Formula: see text]2 previous uterine surgeries (adjusted odds ratio [OR], 3.57; 95% confidence interval [CI], 1.60–7.97) and the number of blastocysts transferred (adjusted OR, 2.89; 95% CI, 1.15–7.26). In patients with <2 previous uterine surgeries, PAS was associated with an endometrial thickness of <7.0 mm (adjusted OR, 5.18; 95% CI, 1.10–24.44).

Conclusion: A history of multiple previous uterine surgeries, the number of blastocysts transferred and a thin endometrium before ET are risk factors for PAS in pregnancies conceived after FET in an HRC.
#267 : The Spindle Localization ICSI (SL-ICSI) Improves the Fertilization Rate Decreased by Aging
Authors: Kawano Hiroomi , Takai Aya , Abe Mutsumi , Iimura Yuki , Nakajima Naotsuna , Chen Mo , Ochi Azusa , Yamauchi Akihiro , Shinoda Mari , Yoshida Masato , Yamashita Naoki
Published: January 2024

Background and Aims: The position of meiotic spindle in metaphase II oocyte can be different from the underneath of the first polar body. In order to prevent the meiotic spindle damage during ICSI, confirming the position of the spindle is effective. In this study, we analyzed the meiotic spindle deviation and outcomes of ICSI with the patient age.

Method: From 2017 to 2022, 5620 oocytes with the first polar body underwent SL-ICSI were analyzed. SL-ICSI was performed 4-5 hours after oocyte retrieval. Furthermore, the meiotic spindle deviation from the polar body was classified according to the angle; Group A: 0-5∘, Group B: 6-45∘, Group C: 46-90∘, Group D: 90∘<. The spindle invisible oocytes were regarded as group E. The average age, the fertilization rate and good blastocyst rate in each group were analyzed. Statistical analysis was performed by one-way ANOVA and Tukey’s post-hoc test.

Results: The proportions of spindle-visible oocyteswere 98.7%; 41.2%, 36.1%, 14.6%, 6.8%, and 1.3% respectively, in group A to E. The mean agesin each group were 39.0, 39.6, 40.1, 40.6, and 40.7, respectively. In addition, the correlation between the age and the location of spindle was revealed (A-BCDE: [Formula: see text] < 0.001). The fertilization rates were 84.8%, 84.9%, 84.7%, 83.5%, 50.7%, respectively, and significantly decreased in group E ([Formula: see text] < 0.001). Abnormal fertilization rates were 4.3%, 5.1%, 6.4%, 7.3%, 20.5%, respectively, and significantly increased in group E ([Formula: see text] < 0.001). Good blastocyst rates were 49.8%, 52.4%, 47.6%, 50.5%, 3.3%, respectively, and significantly decreased in group E ([Formula: see text] < 0.001).

Conclusion: The introduction of SL-ICSI can be effective for elderly patients. The meiotic spindle of oocytes is highly likely to deviate from the first polar body by aging. Furthermore, if the spindle-invisible oocyte is observed, ICSI should be carefully carried out.
#270 : Single-Center Retrospective Cohort Analysis: Preimplantation Genetic Testing for Monogenic Disorders (PGT-M) for Monogenic Nephropathy
Authors: Liu Xinyu , Zhang Qian , Zhao Qing , Cao Kexin , Zhou Wei , Ni Tianxiang , Sun Shuzhen , Yan Junhao
Published: January 2024

Background and Aims: Hereditary nephropathy, including monogenic nephropathy, is an important cause of renal insufficiency and end-stage renal disease. Therefore, genetic blockade is necessary for couples with monogenic nephropathy. Following routine application of prenatal diagnosis, preimplantation genetic testing for monogenic disorders (PGT-M) has been applied to the genetic blockade of monogenic disease patients. The purpose of this study is to retrospectively analyze genetic counseling process for patients with nephropathy-related disease and provide clinical overviews of patients with monogenic nephropathy who underwent PGT-M.

Method: A single-center retrospective cohort study was conducted at Center for Reproductive Medicine, Shandong University from January 2014 to December 2022. 352 couples with nephropathy-related disease were included in the cohort totally. Statistical analysis was performed using Statistical Package for Social Science software 26.0.

Results: Of the 352 couples with nephropathy-related disease, 291 underwent genetic counseling, followed by 180 accepting genetic screening. 104 couples with monogenic nephropathy indications proceeded with PGT-M, including 91 of autosomal dominant inheritance, 9 of autosomal recessive inheritance, 3 of X-linked dominant inheritance, and one of X-linked recessive inheritance. 498 blastocysts were tested by PGT-M combined with preimplantation genetic testing for aneuploidy (PGT-A), making 72 transferable embryos, 249 non-transferable embryos, 72 genetic counseling embryos and 7 amplification failedembryos. Finally, 80 vitrified-thawed single blastocyst transfer cycles were performed. Live births occurred in 38 women, of which 37 transferred embryos with non-pathogenic genotypes. The results of prenatal diagnosis of all newborns were consistent with the testing results for embryos transferred. The cumulative live birth, biochemical pregnancy, clinical pregnancy, ongoing pregnancy and pregnancy loss rates were 36.54%, 56.73%, 49.04%, 7.69%, and 22.03% respectively.

Conclusion: PGT-M is an effective means of genetic blockade for couples with monogenic nephropathy. The absence of genetic abnormalities detected by prenatal diagnosis in healthy newborns without monogenic nephropathy also underscore its validity.
#284 : Impact of Dosage and Duration of Exogenous Gonadotropins on Embryonic Genetic Status and Cumulative Live Birth Rate: A Secondary Analysis of a Multicenter, Randomized Controlled Trial
Authors: Liu Yingbo , Zhou Wei , Zhang Qian , Ni Tianxiang , Yan Junhao , Chen Zijiang
Published: January 2024

Background and Aims: The safety of exogenous gonadotropins regarding its impact on embryos as well as pregnancy outcomes is still inconclusive. This study aimed to evaluate the effects of different doses and duration of gonadotropins on embryonic genetic status, pregnancy outcomes in infertile women with a good prognosis.

Method: This is a secondary analysis of a multi-center, randomized controlled trial conducted from July 2017 through June 2018, which investigated the efficacy of preimplantation genetic testing for aneuploidy (PGT-A) in good-prognosis infertile population. Couples with PGT-A treatment were included in this study, and were divided into four groups according to the total dosage of exogenous gonadotropins and the duration of stimulation: Group1,2,3,4 with gonadotropins doses and stimulation duration [Formula: see text]1500 IU, <10 days; [Formula: see text]1500 IU, [Formula: see text]10 days; >1500 IU, <10 days; >1500 IU, [Formula: see text]10 days, respectively. Group 1 served as the control group. The main outcome measures were the rates of embryonic aneuploidy, mosaicism and cumulative live birth after transfers of euploid embryos.

Results: A total of 579 couples were included, with 1737 embryos being genetically screened using NGS. After adjusting for confounding factors, embryo mosaicism rate was significantly increased in Group 2, 3, 4 in comparison with Group 1 (Group 2,3,4: 13.4%, 14.8%, 12.4%, respectively, vs. Group1: 8.9%; adjusted OR [95% CI]: 1.65[1.07, 2.54], [Formula: see text]=0.024; 1.76[1.02, 3.30], [Formula: see text]=0.041; 1.50[1.01, 2.22], [Formula: see text]=0.043; respectively). There was no association between gonadotropins dose or duration and embryo aneuploidy rate. The cumulative live-birth rate was significantly lower in Group 2, 3 and 4 than that in Group 1 (Group 2,3,4: 73.2%, 64.8%, 75.2%, respectively, vs. Group 1: 85.0%; adjusted OR [95% CI]: 0.50 0.28, 0.89], [Formula: see text]=0.019; 0.34[0.17, 0.68], [Formula: see text]=0.002; 0.59[0.35, 0.98], [Formula: see text]=0.043; respectively).

Conclusions: High dose, prolonged ovarian stimulation may increase mosaic embryo rate and decrease cumulative live-birth rate after transfers of euploid embryos.in infertile women with a good prognosis.
#345 : Progestin-Primed Ovarian Stimulation Protocol Slightly Improves the IVF Funnel in Patients with Poor Ovarian Response
Authors: Thach Than Trong
Published: January 2024

Background and Aims: Controlled Ovarian Stimulation (COS) is a crucial first step in the In Vitro Fertilization (IVF) or Intra-Cytoplasmic Sperm Injection (ICSI) process. Progestin-primed ovarian stimulation (PPOS) has been recently introduced as an alternative to traditional COS regimens. However, the efficacy of PPOS regimen among infertile women with poor ovarian response (POR) remains unclear. This study aims to evaluate the effect of PPOS regimen on the chance of success throughout the IVF process in Vietnamese infertile women with POR.

Method: This randomized controlled trial included 120 infertile women with POR (according to POSEIDON criteria) who received IVF at Tam Anh Fertility Center (Hanoi, Vietnam). PPOS and GnRH_ant regimens were randomly applied to the participants (n=60 for each group). A chain of 4 successive Binomial regression models has been applied to estimate the chance of success for 4 steps: oocyte maturation, fertilization and achieving good quality day-3 and day-5 embryos. The effect of PPOS in comparison with GnRH_ant protocol was evaluated by marginal risk-ratio (RR) from each model.

Results: Chances of successfully achieving the MII oocytes, fertilization, high-quality D3 and D5 embryos were all moderately higher when using the PPOS regimen, compared with those of GnRH_ant protocol (95% confidence intervals of RR were respectively 0.88–1.07, 0.89–1.14, 0.96–1.14 and 0.74–1.73).

Conclusion: Although not yet reached a statistical significance, those results indicated that using PPOS protocol may slightly improve the chance of success in 4 first critical steps of the IVF process for infertile women with POR.
#27 : A Sibling Study: How Individual Culture Strategy Affects Embryo Ploidy Status in IVF/PGT-A Cycles?
Authors: Vu Anh , Nguyen Huong
Published: January 2024

Background and Aims: The result of individual and group culture embryo studies remained conflicting. Several studies assumed that the blastulation rate was lower when culturing embryos separately. Meanwhile, there has been little information on whether individual culture can affect embryo ploidy status. This study was designed to find a relationship between culture strategies and the embryo’s ploidy status in IVF/PGT-A cycles.

Method: 91 IVF/PGT-A cycles with at least four zygotes enrolled in a randomized control trial from September 2021 to June 2022 in Tam Anh general hospital. Zygotes from each cycle were randomly assigned to individual culture(10 ul/drop) or group cultured of 3-5 zygotes (50 ul/drop). Among those, 280 blastocysts derived from biopsy-all cycles (137 from individual culture and 143 from group culture) and already determined for ploidy status were to be analyzed. Information of the embryo, including maternal age, paternal age, day of the biopsy, embryo quality (excellent, good, fair, poor), blastocoele expansion (2-6), ICM score (A, B, C), TE score (A, B, C), and PGT-A result (euploid, aneuploidy or else) was collected and analyzed along with the type of culture. Simple and multiple regression analyses using generalized linear mixed model were applied to evaluate the relation between embryo ploidy status as the dependent variable and independent factors.

Results: The rates of euploid, aneuploidy and other results of embryos cultured individually were 39.4%, 37.2%, and 23.4%, respectively. These results did not yield a significant difference compared with the cultured group. There was no relationship between culture strategies and the aneuploidy rate of the embryos (OR = 1.16, CI 0.64-2.13). However, biopsy days 6-7 and decreasing grade of TE might be related factors for a higher rate of aneuploidy.

Conclusion: Culture embryos individually or in groups hadnot yet shown any effect on embryo’s ploidy status.
#48 : Blastocyst Versus Day-3 Embryo Transfers After In Vitro Maturation with Pre-Maturation Step (CAPA-IVM) in PCOS Patients
Authors: Pham Hoang Huy , Le Anh , Nguyen Tri , Pham Toan , Ho Tuong , Vuong Lan
Published: January 2024

Background and Aims: IVM combined with a pre-maturation step known as capacitation IVM (CAPA-IVM) improves the competence of in-vitro matured oocytes. According to our previous study, the current clinical practice of transferring day-3 embryos resulted in a live birth rate of 35.2% after the first frozen embryo transfer (FET) following CAPA-IVM. Advances in embryo culture systems have allowed us to extend the duration of embryo culture to blastocyst. There is a lack of data on blastocyst transfer following CAPA-IVM. The aim of this study is to compare the effectiveness of blastocyst versus day-3 embryo transfer after CAPA-IVM in PCOS patients.

Methods: A retrospective cohort study was conducted at two infertility centers in Vietnam from 1 January 2018 to 28 February 2022. The study compared two groups of PCOSwomen who had frozen embryo transferred (FET) with CAPA-IVM. Group 1 had blastocyst transfer and Group 2 had day-3 embryo transfer. The couples made the final decision on the stage of embryos transferred. The inclusion criteria were women aged between 18-40 years and had freeze-all their embryos. The primary outcome was the live birth rate after the first FET.

Results: Out of 275 eligible women for the study, 87 of themhad blastocyst transfer, and 188 had day-3 embryo transfer. The mean number of embryos transferred for blastocyst transfer and day-3 embryo transfer were 1.27 and 1.93, p < 0.001, respectively. Live birth rate after the first transfer was comparable between blastocyst and day-3 embryo transfers (34.5% vs. 37.8%, p=0.696, respectively). The blastocyst transfer group had a significantly lower multiple pregnancy rate as compared to day-3 embryo transfer group (4.6% vs. 18.0%; p=0.005, respectively).

Conclusions: Blastocyst transfer had comparable live birth rate but lower multiple pregnancy rate to day-3 embryo transfer after the first FET following CAPA-IVM in PCOS women.
#56 : Pregnancy and Live Birth Rates in Minimal Stimulation IVF Cycles from Rescue In-Vitro Maturation of Oocytes
Authors: Mendiola Rudie Frederick , Ong-Jao Ednalyn , Perillo Gayla , Francisco Fides Marie
Published: January 2024

Background and Aims: Rescue in-vitro maturation (IVM) of immature oocytes retrieved during oocyte pick up has been shown to be a promising treatment method for infertility.

The objectives of this retrospective study were 1) to determine the rescue IVM rate of immature oocytes and 2) to determine pregnancy and live birth rates.

Method: Immature oocytes were classified as germinal vesicle (GV) or meiosis I (MI) oocytes. They were matured to metaphase II (MII) in-vitro and were fertilized through intracytoplasmic sperm injection. Embryos were cultured to cleavage embryos or blastocyst.

Results: A total of 6,060 immature oocytes in 3,030 cycles of patients undergoing minimal stimulation IVF treatment at a private fertility clinic in the Philippines were included. Average age of the women was 36.78 ± 4.383 S.D. (min. 21, max. 50).

The maturation rates to MII were 39.08% from GV and 68.05% from MI. Cleavage formation rates were 15.03% from GV and 40.35% from MI. Blastocyst utilization rates were 3.79% from GV and 16.70% from MI.

Pregnancy rates (PR) were as follows: Overall - 11.3%; GV - 5.6%, and MI - 15.5%.

Live birth rates (LBR) were as follows: Overall - 9.3%, GV - 4.3%, and MI - 13.3%.

Age was significantly negatively correlated with PR and LBR (P<0.001).

Using logistic binary regression, the predicted numbers of GV needed to achieve pregnancy and live birth were 16 and 18 oocytes, respectively; for MI these were 8.8 and 10 oocytes, respectively. These numbers are comparable to those reported in literature regarding the number of mature oocytes needed for IVF success.

Conclusion: We conclude that immature oocytes that undergo rescue IVM can be as effective as mature oocytes in producing desired results in minimal stimulation IVF.
#169 : The Use of PIEZO-ICSI Increases Fertilisation and Lowers Degeneration Rates when Compared to Conventional ICSI: In a Singapore Setting
Authors: Lim Wei Hou , Lim Wei Hou , Yap Pei Fang , Tan Heng Hao , Lee Colin Soon Soo
Published: January 2024

Background and Aims: PIEZO-ICSI was first introduced by Kimura & Yanagimachi in 1995 on mouse oocytes (1). It is a modified version of microinjection that uses piezoelectric pulses to enable fine movement of the needle. Further studies of PIEZO-ICSI on human oocytes showed improved outcomes in Japanese clinics (2-6) and similar findings were also reported by an Australian IVF group (7,8). In this study, we reflect on our experience using PIEZO-ICSI in a Singapore-based IVF clinic.

Method: A retrospective study of 535 ICSI cycles was performed from January 2020 to December 2022, comprising of 157 cycles using Conventional ICSI and 378 cycles using PIEZO-ICSI. Primary outcomes were fertilisation, degeneration, blastulation and blastocyst usable rates. Secondary outcomes include clinical pregnancy, implantation and miscarriage rates. Patients who used donor gametes, surgically retrieved sperm or utilised cleavage-staged embryos were excluded. Two senior embryologists were responsible for the microinjections and had no prior experience with PIEZO-ICSI. Statistical significance for laboratory and clinical outcomes were determined using Mann-Whitney U Test and chi-square contingency tables, respectively.

Results: The PIEZO-ICSI group showed significantly higher fertilisation (83.09% vs 69.62%, p<0.0001) and lower degeneration rates (3.17% vs 7.33%, p<0.0001) when compared to Conventional ICSI (Table 1). Blastulation (69.51% vs 64.86%, p=0.26) and blastocyst usable rates per 2PN (54.36% vs 51.26%, p=0.67) showed a higher trend in the PIEZO-ICSI group but did not meet statistical significance. The estimated time-to-competency for embryologists to achieve consistent outcomes with PIEZO-ICSI was three months (Figure 1). In terms of clinical outcomes, no significant differences were observed for clinical pregnancy (61.57% vs 56.97%, p=0.39), implantation (48.57% vs 43.59%, p=0.23) and miscarriage rates (23.70% vs 23.40%, p=0.96) between the PIEZO-ICSI and Conventional ICSI groups (Table 2).

Conclusion: The use of PIEZO-ICSI improves fertilisation and degeneration outcomes when compared to Conventional ICSI in a Singapore-based IVF clinic.
#190 : Impact of Fertilisation Techniques and Day of Biopsy on Pre-Implantation Genetic Testing Outcomes: A Retrospective Study
Authors: Braidwood Holly , Levin Kara , Filby Alicia , Fullston Tod , Pacella-Ince Leanne
Published: January 2024

Background and Aims: Pre-implantation genetic testing (PGT) is a technology utilised in assisted reproductive technologies (ART) to aid in embryo selection and reduce time to pregnancy. However, the impact on PGT outcomes of different fertilisation techniques, to date, has been the subject of a limited number of studies. Therefore, we investigated the effect of three different fertilisation methods - intracytoplasmic sperm injection (ICSI), PIEZO-ICSI, and standard in vitro fertilisation (IVF) - on PGT outcomes, with further analysis performed for day of biopsy.

Method: Retrospective analysis of 760 embryos biopsied for PGT from 290 patients undergoing IVF treatment in 2021. Fertilisation was achieved via ICSI, PIEZO-ICSI, or IVF, followed by embryo culture using a sequential media system. Trophectoderm biopsy samples were analysed using a Next Generation Sequencing based assay (Illumina VeriSeq PGS). Ploidy outcomes from PGT (euploid, aneuploid, mosaic, inconclusive and no result) were interrogated for differences between fertilisation method or day of biopsy (Day 5 or 6). For analyses, frequency data of ploidy outcomes were reported as percentages and divided into two maternal age groups: <38 and [Formula: see text]38 years. Statistical differences were determined using a chi-squared test.

Results: Fertilisation technique did not have a significant effect on ploidy across both maternal age cohorts (% euploid embryos: >38 years old (n=431) PIEZO-ICSI 61% vs ICSI 58% vs IVF 51%; p>0.05, and [Formula: see text]38 years old (n=329) PIEZO-ICSI 37% vs ICSI 40% vs IVF 39%; p>0.05). For both age groups, no significant differences were observed in PGT outcomes for Day 5 biopsy compared to Day 6 (% euploid embryos: <38 years old (n=431) Day 5 62% vs Day 6 54%; p>0.05, and [Formula: see text]38 years old (n=329) Day 5 45% vs Day 6 37%; p>0.05).

Conclusion: The study suggests that different fertilisation techniques or the day of biopsy may not influence PGT outcomes.
#191 : Embryo Quality, But Not Direct Cleavage, Reverse Cleavage or Multinucleation is the Most Important Parameter Affecting the Live Birth Rate After Frozen Single Embryo Transfer
Authors: Cam Van Nguyen Thi
Published: January 2024

Background and aims: Is there any chance for an embryo having one of these types of abnormal cleavage including direct cleavage (DC), reverse cleavage (RC) or multinucleation can result in a healthy baby? The answer is still unclear and there are very few reports about this. In this study, we used a time-lapse (TL) monitoring system to identify whether there was a phenomenon of DC, RC or multinucleation in the developmental duration of blastocysts that were transferred in frozen cycles. And then we evaluated and compared the live birth rate in these cases.

Materials and Methods: This study retrospectively reviewed 192 cases of embryo culture in TL system and subsequently transferred for the first time in frozen single blastocyst transfer cycles from November 2019 to June 2022. There were 2 groups: group I (83 cases) included patients with euploid blastocyst transfer and group II (109 cases) included patients with non-PGTA blastocyst transfer. In this study, the live birth rate (LBR) after transferring embryos with or without DC, RC and multinucleation were investigated and compared in each group.

Results: In both of groups, there was no difference in the LBR of embryo transfers with DR, RC, multinucleation and embryo transfers without DC, RC, multinucleation (p>0.05, chi-square test). In group I, the LBR in cases of good blastocyst transfer (grade 1) was statistically higher than that in cases of grade 3 blastocyst transfer (64.8% (35/54) versus 11.1% (1/9), p<0.05, chi-square test. In group II, the LBR in cases of good blastocyst transfer (grade 1) was higher than that in cases of grade 3 blastocyst transfer but not significantly (53.1% (43/81) versus 40% (4/10), p>0.05, chi-square test).

Conclusion: In PGTA group and non-PGTA group, the live birth rates after frozen single blastocyst transfer were similar between the cases of blastocyst transfer with DC, RC, multinucleation and the cases of blastocyst transfer without DC, RC, multinucleation. A higher live birth rate following good quality blastocyst transfer than poor quality blastocyst transfer in both groups.
#278 : Relationship Between Level Expression of miRNA-191 and miRNA-548c-3p in Embryo Culture Medium and Embryo Chromosomal Status
Authors: Kurniawan Riyan Hari , Muharam Raden , Widyahening Indah Suci , Iffanolida Pritta Ameilia , Wiweko Budi
Published: January 2024

Background: microRNA (miRNA) is expressed by the human embryos and shows the difference between euploid and aneuploid embryos. miRNA which is secreted in culture media is expected to be a biomarker for embryo chromosomal status testing. This research aims to analyse the relationship between expression level of miRNA-191 and miRNA-548c-3p in embryo culture media and embryo chromosomal status.

Methods: This cross-sectional research was done on 30 embryos from 12 patients aged 28-40 years old who underwent an in vitro fertilization (IVF) program in three clinics. Embryos were cultured until blastocyst stage. PGT-A was done after blastocyst biopsy on day 5 or 6, and chromosomal analysis was done using the NGS method. The expression levels of miRNA-191 and miRNA-548c-3p were analysed from culture media sample of the embryo using qPCR method. Then the relationship between miRNA-191 and miRNA-548c-3p expression level with embryo chromosomal status was analysed.

Results: There is no significant difference in subjects’ characteristics between the euploid and aneuploid embryo groups (p>0.05) [Table 1]. There is no significant difference in the expression level of miRNA-191 of the euploid and aneuploid embryo groups. (Median quantification 8.69 vs 1.064 with p=0.351) [Table 2]. There is no significant difference in the expression level of miRNA-548c-3p of the euploid and aneuploid embryo groups. (Median quantification 9.06 vs 6.635 with p=0.709) [Table 3].

Conclusions: miRNA-191 expression level and miRNA-548c-3p expression level has no relationship with embryo chromosomal status. The level expression of miRNA-191 and miRNA-548c-3p in embryo culture has not been a good biomarker candidate for embryo chromosomal status.
#59 : Greater Hope Leads to More Babies? Examining the Relationship Between Perceived Social Hope, Fertility Intention and Reproductive Decision-Making Among Hong Kong Childless Adults
Authors: Kwan Tess Tung , Chan Celia Hoi Yan
Published: January 2024

Background and Aims: Hong Kong has one of the lowest fertility rates in the world at 1.1 children per woman. Prior studies focused on personal factors such as having a stable relationship and individual maturity as the most important conditions for parenthood. However, there is limited research about the relationship between individual perception of society and reproductive decision-making. Given that Hong Kong has experienced social turmoil such as the Umbrella Movement (2014), the Anti-Extradition Bill Movement (2019) and COVID-19 (2020) in this decade, this study explores whether the sense of social hope predicts fertility intention among Hong Kong childless adults.

Method: Five Hundred and Four childless Hong Kong Chinese (Mean age=31.48±5.96) were recruited through community networks and social media. Data was collected between May and June 2022. The modified and translated Social Hope Scale (5-item) specifying “Hong Kong” was adopted to assess the participants’ level of social hope, with a 5-point Likert-scale of 1 (Strongly disagree) to 5 (Strongly agree). The overall internal consistency of the translated version was excellent ([Formula: see text]=.92). Self-constructed items regarding fertility intention and family formation plan were included.

Results: 56.7% of the participants considered having children, yet only 28.8% of them had a concrete family formation plan. The average level of social hope was 2.24 out of 5. Regression analyses showed that social hope significantly predicted fertility intention ([Formula: see text]=.111, p<.05). As expected, there was no impact of the level of social hope on sexual desire. In a nutshell, the participants’ hopeful thinking for Hong Kong society predicts their fertility intention.

Conclusion: Given the social and political uncertainties are expected to continue in Hong Kong, these findings call for an increased psychosocial and fertility education for citizens to have long-term parenting planning and policies that increase their sense of social hope thus increasing their fertility intention.
#102 : The Impact of Guided Meditation [Mindfulness Based Intervention] on the Stress Levels in Patients Undergoing Infertility Treatment
Authors: Ganla Kedar
Published: January 2024

BACKGROUND: 1 in 8 couples have difficulty in conception. The majority of them are prone to psychological vunerability, ranging from anxiety to depression leading to shame, guilt, low self-esteem all of which lead to a poor quality of life. Mindfulness meditation improves parasympathetic functions and is a powerful modulator of the sympathetic nervous system.

AIMS & OBJECTIVES: To conduct a prospective, randomized, comparative trial at Private reproductive medicine clinic. To investigate the impact of ‘Guided Meditation’ on stress and anxiety level of infertile women during the infertility treatment. Via a questionnaires series and evaluation of autonomic function tests of patients before the intervention and after intervention

Patient(s): All enrolled women undergoing infertility (n=75), were asked to practice guided meditation daily for three months, post which they were reevaluated.

MATERIALS & METHODS: Inclusion Criteria

Women with Primary infertility Age - 21 to 50 years

Exclusion Criteria

Known case of any psychological/psychiatric illness Already taking antipsychotics, any medicine related to mood disorders, anxiety, depression, interfering with the serotonin pathway

Method/Design: Standardized scales of infertility-related coping strategies and fertility quality of life (FertiQoL), Becks Anxiety scale, Becks Depression scale, Patient Health Questionnaire (PHQ 10) were endorsed pre and post-MBI at the end of three months.

RESULT: The outcome measure is to evaluate if women post intervention revealed a significant increase in mindfulness, self-compassion, meaning-based coping strategies and changes in their FertiQoL, Beck’s anxiety scale and PHQ 10 domains. Inversely, if they presented a significant decrease in emotional regulation difficulties, active- and passive-avoidance coping strategies.

CONCLUSION: The impact of Guided Meditation or MBI by practice and its effective symptomatic reduction in their Anxiety & Depression scores [Stress levels]
#380 : Clickbait in Uterine Transplant Surgery
Authors: Morgan Tessa , Kiely Neill , Gerstl Brigitte , Arulpragasam Kaushalya , Pittman Jana , Deans Rebecca
Published: January 2024

Background and Aims: The proliferation of social media platforms has led to the emergence of diverse online communities, presenting unique challenges in terms of patient autonomy and quality of care within the field of uterine transplantation. This research delves into the psychosocial implications of social media communities throughout the uterine transplant patient journey. The absence of standardized guidelines in these virtual spaces presents a novel landscape for healthcare professionals to navigate. This study sheds light on the evolving nature of social media and its impact on the uterine transplant journey, emphasizing the need for healthcare providers to adapt to these unfamiliar territories. Moreover, social media communities introduce additional complexities by increasing the risk of undue influence and coercion on potential donors and transplant candidates. This study will highlight the importance of exploring these themes to ensure the integrity of the transplant process.

This study aims to examine the social media discourse surrounding the experiences of both donors and recipients who have undergone uterine transplant surgery.

Method: A qualitative research design was employed to observe and reflect on social media posts related to donor and recipient surgeries enrolled in our uterine transplant research study program. Thematic analysis was utilised to identify recurring themes and patterns within the data collected from both recipients and donors.

Results: The analysis of social media posts revealed a range of experiences shared by donors and recipients undergoing uterine transplant surgery. Both recipients and donors often expressed mixed feelings associated with their unique transplant experience.

Conclusion: Future research and guidelines are needed to navigate the evolving landscape of social media in the uterine transplantation field, safeguarding the well-being of all stakeholders.
#64 : Developmental Elasticity and Self-Correction: How Much Can Human Embryos “Stretch”?
Authors: Liu Yanhe , Natalwala Jay , Chapple Vincent
Published: January 2024

Background and Aims: The recent clinical application of time-lapse videography has enabled detection of abnormal cleavage (ABNC) in in vitro cultured human embryos and the quantification of their developmental speed. However, growing evidence has highlighted the inter-laboratory transferability issue when involving morphokinetics measures for embryo selection, as different culture conditions and patient profiles are known to alter embryo morphokinetics. Having originally reported several ABNC phenomena, our recent birth outcome data also implied a potential self-correction mechanism in ABNC affected embryos. In this abstract, we review the most up-to-date evidence in this field and highlight the elastic nature of embryo development.

Method: Literature review.

Results: In this abstract, data from both our group and others are analyzed from 2 different aspects. First, we discuss both embryo and patient factors that have been shown to alter embryo morphokinetics. We also share evidence supporting the ability of embryos to be elastic in morphokinetics without losing the ability to implant. We therefore stress that caution ought to be taken when applying morphokinetics based embryo selection, especially when such models were developed using an external dataset. Secondly, we present the various impacts of ABNC when it occurs at different developmental stages and with different number of occasions. We also present the live birth rates and neonatal outcomes of ABNC embryos that had successfully achieved blastulation. Based on that, we propose blastulation as a self-correction milestone, supported by time-lapse footage showing exclusion/extrusion of ABNC-affected cells.

Conclusion: Human embryos demonstrate detectable developmental elasticity which may be related to their ability to stand physical and chemical stress during in vitro culture. Embryos affected by ABNC can self-correct at blastulation by excluding/extruding affected cells. However, the limits of such elasticity in human embryos before losing their viability remain unknown.
#67 : Fatty Acid Supplementation into Warming Solutions Improves Outgrowth Competence Human Vitrified Blastocysts
Authors: Sawado Ayano , Ezoe Kenji , Ohata Kazuki , Miki Tetsuya , Amagai Ayumi , Shimazaki Kiyoe , Okimura Tadashi , Kato Keiichi
Published: January 2024

Background and Aims: The vitrification procedure decreased intracellular lipid content and subsequent developmental competence. Furthermore, a recent study reported that fatty acid (FA) supplementation into warming solutions increased intracellular lipid content and improved developmental competence by stimulating the beta-oxidation pathway in mice and bovines. However, in humans, the effects of FA addition to warming solutions on the viability of vitrified blastocysts remain unclear. In this study, we examined the implantation competence of blastocysts warmed by using the FA-supplemented solutions by comparing the in vitro outgrowth.

Method: A total of 216 discarded human vitrified blastocysts donated for research by consenting couples were randomly allocated, to be warmed in solutions either with (FA, n = 98) or without FA (control, n = 118). Vitrified blastocysts were cultured for 120 min after warming. The blastocysts were plated on fibronectin-coated dishes and cultured for 96 h to assess the blastocyst competency for adhesion and outgrowth.

Results: The embryo characteristics were comparable between the control and FA groups. The adhesion rate at 96 h after the outgrowth culture in the FA group (74.5%) was comparable with that in the control group (74.6%). The 1.3-fold increase in the outgrowth area was observed in the FA group, compared to the control group ([Formula: see text] = 0.0371). Furthermore, the sub-group analysis demonstrated that a more beneficial effect of FA supplementation on blastocyst outgrowth was observed when the trophectoderm was evaluated as grade A ([Formula: see text] = 0.0065).

Conclusion: The FA supplementation into warming solutions increased the outgrowth competence of vitrified human blastocysts. These results suggest that the pregnancy outcomes, including the implantation rate, after frozen blastocyst transfers would be improved by using the FA-supplemented solutions.
#112 : Obstructed Hemivagina with Ipsilateral Renal Anomaly (OHVIRA) with Ureteric Remnant in an Adolescent Female
Authors: Tumbaga Kariza , Manzano Dianne , Tabora Carolyn
Published: January 2024

Background and Aims: Müllerian duct anomalies are a group of uncommon entities, which cause specific symptoms in adolescent females. OHVIRA is a very rare congenital anomaly of the urogenital tract characterized by the triad of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis.

This paper describes a case of OHVIRA with ectopic ureteral insertion to the obstructed hemivagina and non-functional urinary bladder who was diagnosed and treated early. This study aimed to increase awareness regarding mullerian anomalies, discuss the ideal diagnostic tools and management of OHVIRA, and promote early diagnosis and treatment to avoid long-term complications.

Method: A case of 12-year-old came for a consult with cyclic pelvic pain and palpable pelvic mass after her menarche. A series of diagnostic tests were done which were compatible with the diagnosis of OHVIRA with an associated finding of ectopic ureteral insertion into the obstructed hemivagina and non-functional urinary bladder. The patient underwent resection of the non-communicating longitudinal vaginal septum, drainage of hematocolpos, diagnostic hysteroscopy, and cystoscopy, which are the main treatment of patients with OHVIRA.

Results: One week after discharge, the patient followed up with no hypogastric pain, dysuria, and no vaginal bleeding. One month after, she had a menstrual period soaking 2-3 pads per day with no associated hypogastric pain nor recurrence of a pelvic mass with on digital rectal examination. Her subsequent menses were unremarkable occurring every month.

Conclusion: OHVIRA should be suspected in cases with cyclic pelvic pain in adolescents and also in neonatal cases with any renal malformations. The delay in its diagnosis and management is inevitable due to its rarity; however, the complications can be devastating.

Overall, timely surgical removal of the obstructing vaginal septum can provide rapid relief of symptoms, prevention of complications, and preservation of fertility in the majority of cases.
#185 : Embryos Derived from Prepubertal Hyperglycemic Mice Show Differential Response to Oxygen Tension In Vitro
Authors: Predheepan Dhakshanya , Salian Sujith Raj , Daddangadi Akshatha , Uppangala Shubhashree , Kalthur Guruprasad , Kovacic Borut , Adiga Satish Kumar
Published: January 2024

Background and Aims: Response of preimplantation embryos to varying oxygen tensions, when cultured in vitro, has shown conflicting results. Though physiological or low oxygen culture is gaining popularity in IVF programs, how oxygen tension influences the behavior of embryos derived from pathological conditions is unknown. Since there has been an increasing trend in the incidence of diabetes in children and young adults, this study is aimed to look at the functional ability of embryos derived from experimentally induced hyperglycemic mice at the prepubertal phase of life to varying oxygen tension in vitro.

Method: The experimentally induced hyperglycemic state was monitored in the prepubertal phase (3 to 6 weeks), followed by oocyte quality assessment, in vitro maturation potential, mitochondrial status, and spindle integrity analysis. Oocytes were then fertilized and cultured at high/atmospheric ([Formula: see text] 19%) and low/physiological ([Formula: see text]5%) oxygen tension until 96 h in vitro. Embryo quality and developmental progression, blastocyst rate, apoptosis, inner cell mass (ICM) outgrowth proliferation, and expression of Hif1[Formula: see text] were assessed.

Results: Prepubertal hyperglycemia did not affect the ovarian reserve significantly; however, the maturation potential (P<0.001), mitochondrial integrity (P<0.01), and meiotic spindle assembly (P<0.05–0.001) in oocytes were altered significantly. Importantly, such oocytes showed better functional ability during the preimplantation phase of development when cultured at low oxygen tension. Hif1[Formula: see text] transcripts in ICM outgrowths were significantly higher (P<0.05) in low oxygen tension compared to atmospheric oxygen tension.

Conclusion: Embryo culture in low oxygen tension appears beneficial for embryos derived from hyperglycemic mothers with respect to developmental competence and retaining genetic integrity. ART clinics need to customize their embryo culture strategies based on patient’s physiological and pathological conditions.
#239 : Granulocyte-Macrophage-Colony Stimulating Factor Improve Embryo Development, Mitochondrial Function and Spindle Alignment in a Mouse Model of Advanced Maternal Age
Authors: Saini Anmol , McPherson Nicole , Smitz Johan , Nottle Mark
Published: January 2024

Background and Aims: We have previously shown that GM-CSF can improve embryo development when added during in vitro oocyte maturation (IVM) as well as increase pregnancy and birth rates following embryo transfer in mice. The aim of the present study was to determine whether GM-CSF during IVM can improve embryo development in a mouse model of advanced maternal age (AMA)

Method: 12–14-month-old CBAF1 female mice were injected with 5IU of PMSG and cumulus-oocyte complexes (COCs) aspirated 46–48 h post-injection. Ten COCs were cultured per 50 [Formula: see text]L drop in bicarbonate-buffered [Formula: see text]-MEM containing 3 mg/ml BSA, 1 mg/ml Fetuin and 5 mIU/mL FSH plus 0 or 10 ng/ml of GM-CSF. Zygotes were cultured in Cleave Media and cleavage and blastocyst rates were determined. Blastocysts were differentially stained on Day 5 to determine cell numbers. To determine mitochondrial membrane potential (MMP) COCs were incubated for 15 minutes in HEPES buffered alpha-MEM media with JC-1 dye for 15 minutes. To examine spindle formation and chromosomal alignment, MII oocytes were fixed and then incubated with FITC conjugated mouse anti-[Formula: see text]-tubulin for 40 minutes at 25°C and chromosomes stained using Hoechst. Fluorescence was visualised using Cell Voyager CV1000 Confocal Scanner and Z-stack images were analysed using Fiji Image J software. Data were analysed using a univariate general liner model in IBM SPSS.

Results: GM-CSF during IVM increased Day 5 blastocyst rate by 21% (P<0.01) and the proportion of expanded blastocysts by 75% (P<0.05). Blastocyst inner cell mass was increased by 23% (P<0.05) and total cell number by 14% (P<0.05). MMP was increased across all fields by three-fold (P<0.05). GM-CSF did not affect spindle formation but tended to reduce chromosomal misalignment by 17% (P>0.05).

Conclusion: We have shown that the addition of GM-CSF during IVM can improve embryo development and mitochondrial activity in a mouse of AMA.
#39 : Identification of Pharmacologically Active Small Molecules that Induce Spheroid Attachment and Embryo Implantation In Vitro and In Vivo
Authors: Nguyen Truong Thai Ha , Huynh Bao G , Nguyen Duy L , Dao Thuy TH , Ho Tuong M
Published: January 2024

Background and Aims: Human endometrium is receptive to embryo implantation during the mid-secretory phase of the menstrual cycle. The in vitro spheroid-endometrial epithelial cells co-culture model was used in this study. We hypothesized that the small molecules from thelibrary of pharmacologically active compounds (LOPAC) can effectively enhance embryo implantation.

Method: We established a high-throughput in-vitro spheroid-endometrial epithelial (BeWo-Ishikawa) cells coculture model to screen 1280 LOPAC. The top 20 small molecules which increased spheroid attachment rate were further studied in the non-receptive cell lines (HEC-1B and AN3CA). Endometrial cells were either treated with 1% DMSO (vehicle control), AZA at 20 μM (positive control) or LOPAC at 10 μM for 48 h. The trophoblastic BeWo spheroids were generated by AggreWell and the number of attached spheroids after coculture were counted. The effect on mice was studied by trans-cervical injection of LOPAC on 1.5-day postcoital (dpc) and the number of implantation sites on 5.5 dpc were evaluated.

Results: Screening of 1280 LOPAC identified 255 molecules increased, and 173 molecules significantly decreased the spheroid attachment rate. The top 20 potential molecules were further studied and three of them were found to significantly increase spheroid attachment in the HEC-1B cells. Another molecule J was found to suppress spheroid attachment in receptive Ishikawa and RL95-2 cells while increase spheroid attachment significantly in non-receptive HEC-1B and AN3CA cells. In mice, molecule J could significantly increase the number of implantation sites on the treated sides when compared with non-treated sides.

Conclusion: Three molecules were found to increase spheroid attachment in receptive Ishikawa cells and non-receptive HEC-1B cells. Another molecule J can increase the spheroid attachment in non-receptive HEC-1B and AN3CA cells and increase embryo implantation in ICR mice. [This study is partially supported by the GRF grants 15162211 and 17120720 to KFL]