bluuebunny/crossref_metadata_2025_split huggingface dataset:
P–544 The results of embryo transfer cycles with low mosaic embryos: A case report
Authors: Göktolga U , Rama A , Mesic A , Göktaşılarla C , Fetahovic M 
Published: August 2021

Abstract

Study question
What are the results of embryo transfer cycles with low mosaic embryos?

Summary answer
The clinical and ongoing pregnancy rates were 50%. The results of Amniocentesis were reported as normal karyotype for all the pregnant women.

What is known already
Many current studies, quote the rates of mosaicism in blastocyst biopsies to be higher at 20–30%. Embryonic mosaicism was found to result from mitotic errors occurring after fertilization, occasionally in the first cleavage but more commonly in the second or third cleavage. The increased reporting of mosaicism in embryos has given rise to new challenges in PGS results interpretation and patient counseling. Previously, embryos were diagnosed as either euploid or aneuploid, and in most cases only euploid embryos were considered for transfer. Now, if mosaic embryos are considered to represent a third category of results.

Study design, size, duration
Case Report for The results of 10 embryo Transfer Cycles with Low Mosaic Embryos Participants/materials, setting, methods: We are presenting the results of ten embryo transfer cycles with low mosaic embryos at Bahceci BIH IVF Center, Sarajevo BIH, between January 2019 – October 2020. All the patients have been informed by a written informed consent form, and had genetic counseling before embryo transfer. Amniocentesis has been performed for all the pregnant women between 14–18 weeks of the pregnancy as prenatal testing.

Main results and the role of chance
Out of the total ten patients, 5 had pregnancy, and the 5 other were not pregnant. The average age of the whole group was; 34.0 ± 5.49 years. The average age of the pregnant women was ; 30.6 ± 5.54 years, and 37.40 ± 2.88 years who were not pregnant

Limitations, reasons for caution
There are limited number of papers in literature about transferring of the low mosaic embryos. The strength of our presentation is, amniocentesis have been performed as prenatal testing for all the pregnancies.
Wider implications of the findings: There were no correlation between the type of low mosaicism and pregnancy. Since all the pregnant women were 35 years of age or less, It was the only factor which is influencing the pregnancy.We hope that, the results of our cases will improve the management protocols for these cases.

Trial registration number
Not applicable
P–570 Embryos originating from oocytes with smooth endoplasmic reticulum clusters have a lower euploidy rate via PGT-A testing using next-generation sequencing
Authors: Li C J , Chang C L , Huang H Y , Soong Y K , Wu H M 
Published: August 2021

Abstract

Study question
Does the presence of smooth endoplasmic reticulum clusters (sERCs) in oocytes affect the human embryo ploidy?

Summary answer
The euploidy rate of embryos originating from sERCs + oocytes is lower

What is known already
While an expert panel strongly recommended that sERCs+ oocytes should not be inseminated, some normal healthy babies derived from sERCs+ oocytes have been reported. In previous studies have shown that declined fertilization rate and lower proportions of good quality embryos are found in oocytes showing sERCs. The updating findings of the molecular status of sERC+ oocytes elucidated the sERCs+ oocytes may have impaired chromosomal segregation ability. However, no study reveals the relation between sERCs and embryo ploidy.

Study design, size, duration
A retrospective study enrolled 129 preimplantation genetic testing (PGT) cycles from January 2017 to March 2020 at Chang Gung Memorial Hospital, Lonkou.

Participants/materials, setting, methods
ICSI fertilization rate, Day5 usable blastocyst rate (D5UBR), total usable blastocyst rate (TUBR), euploidy rate, mosaic rate, and aneuploidy rate are investigated between embryo originating from sERCs+ and sERCs- oocytes.

Main results and the role of chance
Although higher TBUR in blastocyst derived from sERCs+ oocytes than sERCs- group (73.7% vs. 62.5%) but accompanied lower euploidy rate (7% vs. 29%) and higher aneuploid rate (79% vs. 54%).

Limitations, reasons for caution
Limited sample size, need a large-scale study to confirm the conclusion. The live-birth rate per embryo transfer cycle was not included for analysis. As we did not perform polar body analysis, we cannot state for sure that embryonic aneuploidy was related to the oocyte.
Wider implications of the findings: This study demonstrates that embryos originating from sERCs+ oocytes have a lower euploidy rate.

Trial registration number
CMRPG3H0751
P–585 The influence of omega–3 fatty acids on female fertility in assisted reproductive technology
Authors: Buch S 
Published: August 2021

Abstract

Study question
Is there evidence that the intake of omega–3 fatty acids has a positive effect on probability of clinical pregnancy in women undergoing IVF/ICSI treatment?

Summary answer
No significant correlation was found between omega- 3 fatty acid intake (neither supplemental or as fish intake) and clinical pregnancy. What is known already: Omega–3 fatty acids are important substrates in metabolism and the supplement of omega–3 fatty acids have been thought to have a positive effect on semen quality in infertile men. Studies have shown that the intake of omega–3 fatty acids might also have a direct effect on oocytes, the quality of the embryos, and implantation of the embryo in the uterus at conception. However, the role of omega–3 fatty acids in female fertility still remains unclear as the relationship between omega–3 fatty acids and successful IVF treatment in women has shown conflicting results.

Study design, size, duration
Systematic review. Systematic literature research (PRISMA) on PubMed, Embase, and Cochrane identifying clinical studies focusing on omega–3 fatty acid intake amongst women receiving IVF treatment, using good scientific practice for literature search and management. 5 articles meeting inclusion criteria were found, with a total of 1.100 women undergoing IVF/ICSI treatment. Participants/materials, setting, methods: Population: women in fertility treatment Intervention: omega–3 fatty acid and/or fish intake Comparison: No/low intake of omega–3 fatty acid and/or fish intake Outcome: Primary: clinical pregnancy rate, Secondary: number of follicles, embryo quality, live birth rate

Main results and the role of chance
Number of follicles was found to be inversely associated to omega–3 intake in a single study. Higher levels of total omega–3 intake were found to be positively associated to embryo morphology scores, and thus quality, independent on energy intake. None of the four studies considering clinical pregnancy found any statistical significance in the association between fish intake and clinical pregnancy. Regarding live birth as an endpoint, fish intake, but not fish oil supplements, was seen to significantly increase the probability in one study with a dose-response relationship. A similar association was not found by the only other study also examining live birth. Limitations, reasons for caution: Only five studies were found to meet inclusion criteria. None of the included studies were randomized controlled trials. No meta-analysis was carried out due to the heterogeneity of the studies.
Wider implications of the findings: The need for further studies, including randomized controlled trials of high quality with larger population sizes, is critical in order to thoroughly investigate and conclude any possible association of the beneficial effect of omega–3 fatty acids on female fertility in regard to IVF treatment.

Trial registration number
Not applicable
P–596 Association of oleic acid production in cumulus-granulosa cells with glutathione of in vitro matured oocytes
Authors: Fayezi S , Ghaffar. Novin M , Norouzian M , Nouri M , Farzadi L 
Published: August 2021

Abstract

Study question
Does oleic acid production in cumulus-granulosa cells affect glutathione levels of in vitro matured oocytes?

Summary answer
Oleic acid availability in cumulus-granulosa cells is associated with a higher glutathione level in in vitro matured oocytes.

What is known already
The monounsaturated fatty acid oleic acid is de novo synthesized by desaturation of stearic acid and can promote steroidogenesis and oocyte development in vitro. The endogenous antioxidant glutathione content in metaphase II oocyte is significantly higher than immature stages and is related to the normal oocyte maturation.

Study design, size, duration
Mouse germinal vesicles were co-cultured for 24 hours, during in vitro maturation, with granulosa cells treated with a specific inhibitor of oleic acid synthesis alone or in combination with oleic acid.

Participants/materials, setting, methods
Fluorescence staining was used to assess the glutathione content of mouse metaphase II oocytes following in vitro maturation as an indicator of cytoplasmic maturation. Glutathione was stained using Cell Tracker Blue –CMAC for 30 min at 37 °C. After being washed in fresh media, stained oocytes were photographed by a fluorescence microscope. Cell area and associated fluorescence were quantified in 20 metaphase II mouse oocytes randomly chosen from in vitro matured oocytes for each condition.

Main results and the role of chance
The intracellular glutathione content was profoundly lower in metaphase II oocytes obtained from co-cultures with inhibitor-treated cumulus-granulosa cells than with the control cumulus cells (–50%, p &lt; 0.01). Oleic acid effectively recovered the negative effect of inhibitor on glutathione level nearly up to the level of the mock-treated cells.

Limitations, reasons for caution
The findings are limited to metaphase II. Measurement at more advanced stages of oocyte development is of interest. Inhibition of cellular fatty acid synthesis was performed solely with a specific chemical.
Wider implications of the findings: Involvement of the oleic acid availability for cumulus-granulosa cells in normal oocyte maturation may be of relevance in reproductive disorders, particularly in the pathological mechanism of impaired oogenesis.

Trial registration number
400/3226
P–611 Innovative controlled ovarian stimulation (COS) for polycystic ovary syndrome (PCOS) produces high-quality oocytes and no ovarian hyper stimulation syndrome (OHSS)
Authors: Yanagihara Y , Tanaka A , Nagayoshi M , Yamaguchi T , Tanaka I , Ohno M , Itakura A 
Published: August 2021

Abstract

Study question
How can we find an ovarian stimulation method that does not cause hyper stimulation syndrome but can produce a high pregnancy rate at one cycle?

Summary answer
This newly developed method for PCOS has a higher accumulative clinical outcome for one trial and no OHSS.

What is known already
Almost all conventional treatments for PCOS have managed to avoid OHSS by reducing the number of growing follicles, which are associated with high Estradiol levels and stimulate the production of vessel endothelial growth hormone (VEGF), leading to increased vessel permeability. Low dose FSH administration, In vitro maturation (IVM), Ovarian Drilling and Coasting have been performed to achieve this. However, their actual clinical outcome is still unsatisfactory.

Study design, size, duration
Evaluation of the efficiency of this method was conducted retrospectively at St. Mother Clinic. The embryonic development and the clinical outcome were studied for 34 PCOS patients during the period between November 2018 and December 2019.

Participants/materials, setting, methods
We started injections of FSH (150iu/ml), then we did ultrasound follicle monitoring. GnRH antagonist shots were started when the leading follicle reached 18mm and continued until the largest follicle was 22–24mm and the E2 value was over 4000pg/ml. Letrozole (2.5mg) and leuprorelin acetate (1.88mg) was injected as trigger. Two tablets each of Letrozole, Cabergoline and GnRH antagonist were given for 5 consecutive days after the oocyte retrieval. All embryos were cryopreserved.

Main results and the role of chance
Number of patients and cycles were 34 and 59. Average number of cryopreserved blastocysts was 6.12 (1–16). The frequencies of OHSS (mild, moderate, severe) were 29.4% (10/34), 0% (0/34), 0% (0/34). Average days between oocyte collection and withdrawal hemorrhage was 5.44(5–7). Cryopreservation rate was 100.0% (34/34). Clinical pregnancy rate and miscarriage rate was 42.3% (25/59) and 16.0% (4/25). The cumulative pregnancy rate was 73.7% (25/34). The four remaining unsuccessful cases still have 10,6,3 and 7 frozen embryos. So, there is a high possibility that they become successful, that would bring the cumulative pregnancy rate up to 82.3% (28/34).

Limitations, reasons for caution
This COS for PCOS seems promising, however it is premature to conclude that this method is established. This method requires caution monitoring for hormone level, follicle size and number and coagulant function. It also accompanied with the risk of ovarian hemorrhage on aspiration of a great number of oocytes.
Wider implications of the findings: This COS seems viable for PCOS cases. It could control the cohort of antral follicles with different doses of Letrozole to find the optimal COH method and it could become the first option for COS of PCOS.

Trial registration number
N/A
P–627 Optimal timing of day 6 blastocyst transfer in artificially prepared frozen-thawed embryo transfer cycles
Authors: Kim H K , Ku S.-Y , Kim S H , Suh C S , Kim H 
Published: August 2021

Abstract

Study question
When is the optimal timing of day 6 (D6) blastocyst transfer between the 6thday (P6)and the 7th(P7) day of progesterone administration in artificially prepared frozen-thawed embryo transfer(FET) cycle

Summary answer
When transferring D6 blastocysts in artificially prepared FET cycles, live birth rate tended to be higher in P6 group than in P7 group.

What is known already
Blastocyst transfer in FET cycles has increased due to several reasons including convenience for optimization of endometrial synchronization, improvement of laboratory techniques and preimplantation genetic testing. Meanwhile, D6 blastocyst which cryopreserved on day 6 after being developed to the full blastocyst stage, presented lower pregnancy outcomes in FET cycle than D5 blastocysts. However, there have been few studies on the optimal duration of progesterone administration when transferring D6 blastocysts.

Study design, size, duration
This was a retrospective cohort study including patients who underwent frozen-thawed blastocyst transfer in artificially prepared cycles from January 2000 to May 2020. Patients with D6 blastocyst transfer on the 6th day of progesterone administration were included in D6-P6 group, and patients with D6 blastocyst transfer on the 7th day of progesterone administration were included in D6-P7 group.

Participants/materials, setting, methods
Increasing dose of estradiol valerate was administered from the 3rd day of menstruation: 4 mg/day for the first four days, 6 mg/day for next four days, and then 8 mg/day until the confirmation of pregnancy. Progesterone was administered from the 14th day of menstruation if the endometrial thickness reached ≥7 mm. The independent t-test or Mann-Whitney test, chi-square test, and logistic regression analysis were performed.

Main results and the role of chance
A total of 50 patients were included, and 13 patients underwent FET on P6 and 37 patients underwent FET on P7. Live birth rate was comparable between the P6 group and the P7 group (18.9% vs. 15.4%, p = 0.775). Live birth rate was higher in the D6-P6 group than in the D6-P7 group after adjusting for age, AMH, endometrial thickness on the starting day of progesterone administration and good embryo rate transferred with statistical significance (OR: 6.716, p = 0.005).

Limitations, reasons for caution
Limitations of the present study is the retrospective design and the small sample size. Caution is needed in extrapolating results of this study because only intramural and vaginal progesterone supplementations were included in this study.
Wider implications of the findings: Even if the duration of blastocyst formation was delayed, frozen-thawed D6 blastocyst may need to be considered for on P6 rather than P7. The difference of live birth rate is not statistically significant. This study should be acknowledged for the underestimation of the difference because of the small sample size.

Trial registration number
Not applicable
P–628 Predicting oocyte yield in patients with diminished ovarian reserve using basal antral follicle count
Authors: Balachandren N , Schwab S , Latif S , Foo X , Lukaszewski T , Mavrelos D 
Published: August 2021

Abstract

Study question
Is basal antral follicle count (bAFC) taken on day 1 to 3 of stimulation a useful predictor of oocyte yield in that cycle, in women with diminished ovarian reserve (DOR)?

Summary answer
Basal AFC has moderate correlation with final oocyte yield. A median 75% of the antral follicle count is collected as oocytes.

What is known already
The current theory of folliculogenesis suggests that all follicles available for recruitment are visible on ultrasound in the ovary at the point when ovarian stimulation is applied. This implies a tight correlation between the AFC on day 1–3 of a stimulation cycle (bAFC) and the eventual number of follicles collected. We hypothesise that in women with diminished ovarian reserve who receive maximum stimulation basal AFC would be a useful predictor of final oocyte yield in that cycle.

Study design, size, duration
This was a prospective single centre, observational study in a tertiary referral hospital in London. 125 women with DOR underwent controlled ovarian stimulation between December 2018 and January 2021.

Participants/materials, setting, methods
All study participants were given an antagonist cycle with a starting stimulation dose of 450iu and remained on the same dose throughout their treatment. We assessed the correlation between bAFC taken on day 1–3 of the stimulation cycle and the total number of oocytes collected.

Main results and the role of chance
A total of 150 treatment cycles were included in the analysis. The median age was 37 (IQR 35 – 39). The median AMH was 6.0 (IQR 4.4 – 8.9) and the median FSH was 7.6 (IQR 5.7 – 9.4). The median bAFC at the start was 9 (IQR 6 – 11). The median total stimulation dose was 4050iu (IQR 4050 – 4500). The median oestradiol on day of trigger was 5906 (IQR 4166 – 7397) and median number of oocytes collected was 7 (IQR 5 – 9).
There was a moderate correlation between bAFC and the number of oocytes collected (r = 0.549, p = 0.005). The median ratio of oocytes collected over the number of antral follicles observed at the start was 72.7% (IQR 58.3 – 100).

Limitations, reasons for caution
We have standardised approach to AFC determination and have previously shown that AFC inter and intra-observer variability in our unit is low. Nevertheless, our study involved multiple operators for AFC determination which may introduce variability. Further variability may have been introduced at egg collection by varying technique.
Wider implications of the findings: Studies of antagonist protocol in good prognosis patients suggest poor correlation between basal AFC and oocyte yield. In contrast, our study shows that in a population of women with DOR basal AFC provides useful information which can be used to counsel women around the expected oocyte yield of their cycle.

Trial registration number
Not applicable
P–652 Higher live birth rates with controlled ovarian stimulation vs. natural cycles in donor sperm IUI
Authors: Lubamba C 
Published: August 2021

Abstract

Study question
Are pregnancy rates after intra uterine insemination-donor sperm (IUI-D) in good prognosis patients with controlled ovarian stimulation (COS) different from those in natural cycles?

Summary answer
In good prognosis patients, IUI-D cycles with COS provided higher pregnancy outcomes compared to IUI-D in natural cycles.

What is known already
There is no consensus about the systematic use of COS for IUI-D in good prognosis patients, considering efficacy, safety, and efficiency. The objective of this study is to compare the clinical pregnancy rate in good prognosis patients undergoing an IUI-D cycle with COS versus natural cycle (NC).

Study design, size, duration
Retrospective cohort study of 5,369 first IUI-D performed between January 2012 and September 2019 in one fertility center. IUI-D with COS (n = 4,417) versus natural cycles (n = 952) were compared. Differences in pregnancy outcomes between study groups were evaluated using a Pearson’s Chi2 test. A p &lt; 0.05 was considered statistically significant.

Participants/materials, setting, methods
Good prognosis patients were defined as women aged ≤38 years old, with a BMI ≤35 Kg/m2, and having regular menses. The indications for IUI-D were an absence of male partner or a sever partner male factor. COS consisted in a standard protocol of r-FSH or hMG-HP, in a dose between 25 IU to 75 IU, depending on the patient’s age and the acceptance of multiple pregnancy, to obtain between 1 to 2 follicles at ovulation.

Main results and the role of chance
Average age was slightly higher in COS patients (33.0±3.8 versus 31.6±4.1 years old in NC), as was BMI (23.7±3.6 in COS vs 23.08±4.1 in NC). Further, in the last follicular control, estradiol was higher (321±180 vs 244±108 pg/ml), LH was lower in (14 vs 28 UI/L), and the number of follicles &gt; 16mm was higher (1.06±0.5 vs 0.96±0.4) in COS vs NC, respectively. Progesterone levels did not differ between groups. Stimulated cycles provided significantly better results for all pregnancy outcomes (p &lt; 0.001): biochemical pregnancy rate was 27.8% in COS versus 23.0% in NC; clinical pregnancy rate was 20.5% versus 14.8%; ongoing pregnancy rate was 18.5% versus 13.3%; and live birth rate was 16.8% versus 12.3%. While the analysis was not adjusted for potential confounding factors, baseline characteristics between groups were very similar, so we could expect that the improved reproductive results were due to COS.

Limitations, reasons for caution
The main limitation of the study is its retrospective nature and the collection of data from one clinic. Differences found between study groups should be confirmed in a prospective controlled trial.
Wider implications of the findings: In good prognosis patients undergoing their first IUI-D, controlled ovarian stimulation provides better reproductive outcomes; further analysis of cumulative pregnancy rate after 3 cycles would provide information for recommendations on the complete treatment cycle.

Trial registration number
non applicable