bluuebunny/crossref_metadata_2025_split huggingface dataset:
P–286 Uterine vascularity in women with previous caesarean section and its potential role in implantation failure: a retrospective cohort study
Authors: Moliner B , Llacer J , Castillo J C , Cirillo P , Fuentes A , Bernabeu A , Bernabeu R 
Published: August 2021

Abstract

Study question
Does a previous Caesarean section affect uterine vascularisation the day of embryo transfer?

Summary answer
3D vascularisation parameters show less uterine irrigation in patients with previous Caesarean section

What is known already
A recent retrospective cohort study demonstrates that previous Caesarean section impairs live birth rates after assisted reproductive treatment (ART) compared to a previous vaginal delivery. Furthermore, it has been hypothesized about the mechanisms by which post-cesarean section niche may diminish clinical pregnancy rates. One of the hypothetical process mentioned has been a distorted contractility of the uterus caused by fibrosis, which can influence in the vascularisation of the endometrium.

Study design, size, duration
We retrospectively studied the uterine contractility and 3D vascularisation parameters in women who had an embryo transfer at the Instituto Bernabeu of Alicante, between 2018 and 2020 with one recurrent implantation failure (at least two good quality blastocysts transferred from egg donation treatment).

Participants/materials, setting, methods
Patients with large myomas (more than 4 cm), adenomyosis or polyp were excluded. In total, 196 patients were assessed on the day of embryo transfer which 12 patients had a previous caesarean section. Uterine contractility was analyzed using 4D ultrasound after 6 minutes of video recording. Vascularisation index and vascularisation flow index were assessed after the endometrial volume definition.

Main results and the role of chance
Baseline characteristics of both groups were comparable. 3D vascularization parameters were significantly lower in women with a previous caesarean section. Vascularization Index (VI) reached 0,8% in caesarean section group (CS group) versus 2,3% (p = 0,038) and vascularization flow index (VFI) was 0,2 in CS group versus 0,8 (p = 0,038) Despite uterine peristalsis showed less contractility in those patients with previous caesarean section (0,8 contractions per minute versus 1,1 contractions per minute), non-statistical differences were demonstrated (p = 0,154)

Limitations, reasons for caution
This study is limited by its retrospective design and the low number of cases.
Wider implications of the findings: The lower 3D vascularisation indexes support a post-Caesarean section vascular-related impaired perfusion as a hypothetical mechanism. Its correlation with a possible impairment in the embryo implantation after fertility treatments warrants further studies.

Trial registration number
Not applicable
P–317 Uterine cavity in patients with repeated implantation failure (RIF) and before the first IVFprogram
Authors: Rybina A , Lokshin V , Askar Y , Valiev R , Karibayeva S 
Published: August 2021

Abstract

Study question
What is the frequency of uterine pathology and histological analysis of chronic endometritis in the RIF group and in patients before the first IVF program?

Summary answer
We report a lower incidence of chronic endometritis in the group of patients just preparing for the first IVF program and higher effectiveness

What is known already
Chronic endometritis (CE) is one of the reasons for implantation failures in IVF cycles. The presence of chronic inflammation in the endometrium changes its susceptibility, resulting in failed implantations and loss of pregnancy. CE diagnostics is rather complicated. Visual examination during hysteroscopy allows one to suspect CE in 20–70%, routine histology - in 10–20%. The new gold standard is immunohistochemistry (IHC).

Study design, size, duration
A continuous study of 2003 hysteroscopies was carried out, conducted in 1944 patients from May 2018 to January 2020. All patients were divided into 2 groups: 1 - 650 patients preparing for IVF for the first time; 2 - 1294 with repeated implantation failures.

Participants/materials, setting, methods
All included patients had diagnostic office hysteroscopy (OH) with biopsy and IHC CD 138, CD 20, and CD 8. We compared the frequency of CE detection by visual examination during hysteroscopy, routine histology and IHC of the two groups, as well as the effectiveness of 1 course of antibiotic therapy with CE.

Main results and the role of chance
In group 1 of women preparing for IVF for the first time, during visual examination by hysteroscopy, CE was detected in 17% (110/650), in group 2 RIF - in 27% (349/1294), p &lt; 0.001. Routine histology also more often detected CE in the RIF group, 42% (543/1294) compared with group 1 - 23% (149/650), p &lt; 0.001. IHC markers of CE were detected in 81.8% (1058/1294) of samples from RIP group than in group 1 - 71.4% (464/650), p &lt; 0.001. At the same time, IHC mild CE was more common in group 1 in 320/650 (49.2%), p &lt; 0.001. In the second group, mild, moderate and severe CE occurred with the same frequency (33.2%, 36.5%, 30.3%, respectively). The frequency of CE detection by IHC in the groups after 1 course of antibiotic therapy with fluoroquinolones was 31.2% (145/464) and 43.2% (457/1058), respectively, p &lt; 0.001. The pregnancy rate (PR) also differed and was the lowest in the RIF group: in group 1 after treatment with CE PR = 42.7% (198/464), in group 2 after treatment with CE PR = 27.2% (288 / 1058), p &lt; 0.05.

Limitations, reasons for caution
The limitations are related to study design. More research is also needed.
Wider implications of the findings: The question of overdiagnosis of CE using IHC remains open. Therefore, well-designed prospective studies or RCTs should be conducted to clarify possible correlations between ChE and poor reproductive outcomes and the effectiveness of endometrial interventions and treatments.

Trial registration number
not avaliable
P–319 Measuring intraobserver and intermethod reliability of endometriotic cyst volumes: a comparison between MRI and 3D transvaginal ultrasound
Authors: Bergwerff J , Schreurs A M F , Lier M C I , Va. Waesberghe J H T M , Va. de. Houwen L E E , Mijatovic V 
Published: August 2021

Abstract

Study question
Are three-dimensional imaging techniques, MRI and three-dimensional transvaginal ultrasound reliable for the volume measurement of endometriotic cysts?

Summary answer
MRI and XI VOCAL 3D-transvaginal ultrasound both provide a very good intraobserver reliability. The imaging techniques are however not advised to be used interchangeably.

What is known already
Two-dimensional transvaginal ultrasound (2D-TVUS) and MRI are commonly used in endometriosis care. However, three-dimensional ultrasound (3D-US) has gained more attention in recent years. The use of 3D-US, more specifically VOCAL and XI VOCAL software has proven to be a reliable tool in the measurement of volumes such as splenic volumes and uterine niche volumes. Up to date, 3D-TVUS has not been evaluated for volume measurements in endometrioma.

Study design, size, duration
A prospective case-control study was performed in an academic endometriosis centre. In total, 23 endometriosis cysts from 16 patients were included.

Participants/materials, setting, methods
Women diagnosed with endometriosis through laparoscopy with histological confirmation presenting with uni- or bilateral endometrioma on TVUS were included in this study. All women had a regular menstrual cycle (28 days ± 3 days). Women were seen for examinations at two time points during one menstrual cycle: on cycle day 2–4 (T0) and cycle day 20–22 (T1). At both time points a 2D and 3D TVUS and an MRI at 1,5T were performed.

Main results and the role of chance
The intraclass correlation for intraobserver reliability is good to very good for all three techniques ranging from the lowest value of 0.953 to the highest of 1.000. MRI has the most narrow limits of agreement (–3.93 to 4.53), followed by XI VOCAL (–5.16 – 5.65) while VOCAL has the widest limits of agreement (–10.22 to 11.39). Intraclass correlations are poor in the comparison of XI VOCAL to MRI, moderate between VOCAL and XI VOCAL, and good for the comparison between VOCAL and MRI. The limits of agreement are widest for XI VOCAL versus MRI (–36.96 –10.54). Similar limits of agreement are found between VOCAL versus XI VOCAL (–7.80 –23.40) as between VOCAL versus MRI (–18.27–8.96).

Limitations, reasons for caution
No absolute volume measurements were obtained during subsequent surgery to compare the imaging data to. This makes it more difficult to determine an acceptable error margin for the 3D imaging techniques used.
Wider implications of the findings: Being able to determine (small) volumetric changes in endometrioma can give more insight into the development and circumstances under which endometrioma grow or decrease in size. For reliable and accurate follow up of endometrioma a single measuring technique must be used as three-dimensional imaging techniques are not interchangeable.

Trial registration number
Trial NL2106 (NTR2223)
P–344 Clarifying tubo-ovarian abscess management: a risk score for predicting antibiotic failure
Authors: Yongue G , Mollier J , Reshmi S , Ibeto L , Ross C , Ayim F , Guha S 
Published: August 2021

Abstract

Study question
Can antibiotic treatment failure of tubo-ovarian abscesses (TOA) be predicted based on clinical features at the time of diagnosis?

Summary answer
We propose a risk score including patient temperature, c-reactive protein and TOA size that could predict which patients are likely to fail parental antibiotic treatment.

What is known already
Current guidance is that the first line management of non-ruptured TOA is with parental antibiotics. However, it is reported that treatment failure rate is 20–30%. Alternative treatment modalities include radiological drainage or laparoscopic/open surgery. In patients who require intervention, outcomes, such as morbidity, length of hospital stay and fertility, are improved when this is performed early rather than later in their hospital admission. However, our current guidance is scant with regards to the decision making for interventional TOA management.

Study design, size, duration
This is a multicentre retrospective cohort study over 81 months (01/01/13- 30/09/19) identifying 214 consecutive patients admitted to hospitals in North-West London with diagnosed TOA. Participants/materials, setting, methods: Demographics, medical history, presenting symptoms, laboratory results, radiological findings, treatments administered, hospital length of stay and follow up data was collected. The patients were chronologically split with the first 150 being used for the development of our risk score. Univariate and bivariate analyses were employed to ascertain statistically significant variables in the failure of parental antibiotic. The remaining 64 patients were used for risk score validation.

Main results and the role of chance
Statistically significant variables were: temperature at admission (median= 37.1 °C vs 38.2 °C, p = 0.0001), C-reactive protein (CRP) at admission (151mg/L vs 243mg/L, p = 0.0001) and size of TOA (6.0cm vs 8.0cm, p = 0.0001). Those requiring intervention, stayed in hospital twice as long as those who did not (4 days vs 8 days, p &lt; 0.001). A scoring system was formulated using the statistically significant variables. A score of ≥ 4 was associated with requiring radiological/surgical intervention (p &lt; 0.001), with sensitivity 69% and specificity 88% (AUC 0.859) when tested on the validation cohort.

Limitations, reasons for caution
Being a retrospective study, which puts the data at risk of information and selection bias. Although there are merits to a multi-centre study, variation in patient management will invariably cause data heterogeneity.
Wider implications of the findings: TOA patients may have their hospital management tailored early according to the postulated tool, alleviating uncertainty in their treatment as well as possibly reducing morbidity and length of hospital stay.

Trial registration number
Not applicable
P–376 S100P in syncytiotrophoblast regulates lipid metabolism during early pregnancy
Authors: Zhou H , Zhu H , Zhang S 
Published: August 2021

Abstract

Study question
Does S100P involve in the regulation of lipid metabolism in trophoblast syncytialization during the early stage of pregnancy?

Summary answer
S100P suppressed lipid droplets overloading in trophoblast syncytialization during the early stage of pregnancy.

What is known already
S100P is a 95-amino acid protein belongs to the large family of S100 calcium-binding proteins and is exclusively expressed in syncytiotrophoblast layer of placenta, enhancing trophoblast cells proliferation, motility and invasion. Recent studies indicated S100P was aberrantly expressed in various malignant tumors, promoting their proliferation, survival, the formation and invasion of vessels, and has a close relationship with their grade malignancy, hormone dependency and the drug-resistance. Syncytialization is trophoblast cells differentiated from cytotrophoblasts fused into multinucleated cell clusters with cell boundaries deficiency.

Study design, size, duration
Tissues were collected from elective first trimester pregnancy terminations of healthy people and patients with recurrent spontaneous abortion. Human trophoblast stem cells (hTSCs) were isolated from Week 6 to Week 8 of fresh placental tissues (n = 8) and use forskolin to induce syncytialization.

Participants/materials, setting, methods
Tissues were collected from elective first trimester surgical pregnancy terminations to determine localization, abundance and function of S100P. The level of S100P protein and gene was measured by Real-time quantitative PCR (RT-qPCR), western blot, ELISA and immunofluorescence in hTSC induced ST(2D)-TSCT. The lipid droplets were assessed by Oil red O stain, BODIPY and electron microscope. Serum S100P concentration in normal and recurrent miscarriage patients were measured by ELISA.

Main results and the role of chance
S100P was exclusively localized in syncytiotrophoblast layer of the placental villous from gestational weeks 6–8 (n = 4); S100p serum concentration was increased markedly as the gestation progressed (n = 40, p &lt; 0.05); the protein abundance of S100P was increased during syncytialization of hTSCs; Lipid droplets increased during syncytialization and knockdown of S100P leads to trophoblast cell death with the overload of lipid droplet; The expression of S100P was down regulated and the amount of lipid droplets apparently accumulated in villus of recurrent miscarriage patients (n = 4).

Limitations, reasons for caution
The role of S100P on placenta lacks the evidence from animal models.
Wider implications of the findings: S100P is an important factor facilitating in trophoblast syncytialization in the first trimester of pregnancy and could be a biomarker of the early pregnancy sustenance.

Trial registration number
Not applicable
P–383 Cytogenetic analysis of products of conception from miscarriages following natural conception and IVF pregnancy: a comparative study
Authors: Kaderbhai F , Kalu E , Chan P 
Published: August 2021

Abstract

Study question
Do cytogenetic results from products of conception from miscarriages differ from patients conceiving by natural conception versus IVF? Summary answer: Cytogenetic results were similar, with no statistical difference from miscarriages following natural conception and assisted conception.

What is known already
Cytogenetic sampling of products of conception (POC) following recurrent miscarriages (RM) are recommended to rule out parental chromosomal rearrangements. The RCOG recommends cytogenetic testing in cases of recurrent miscarriages (3 consecutive miscarriages). However some units routinely request cytogenetic analysis following a single miscarriage following an IVF pregnancy. There is no evidence to support the routine sampling of POCs following assisted conception. Study design, size, duration: Retrospective cohort study of 117 cytogenetic samples, followed up by the outcome of parental karyotyping if applicable. Patients were categorised based on mode of conception into natural conception (NC) with recurrent miscarriages (≥3) or one miscarriage following IVF. Data collected between 2018–2020. Primary Outcome measure: Presence and type of cytogenetic abnormality; individual parental targeted G-band karyotyping result. Participants/materials, setting, methods: A total of 117 cytogenetic results were reviewed, of which 35 were unsuitable for analysis due to contamination (Total n = 79: NC = 60, IVF = 19). Main results and the role of chance: Cytogenetic analysis showed abnormal results in 59% of miscarriages following natural conception and 53% of miscarriages from IVF pregnancy (p = 0.46).
Abnormal cytogenetic results were mainly sporadic. Trisomy 16 was the commonest abnormality in both groups. Others included Trisomy 15, 22, 21, 8, 13, 5, 9, 10, 14, 18, single X (Turner’s), all occurring in the same frequency in both groups. As expected 35 out of 45 abnormal cytogenetic results occurred with a maternal age greater than 35 years.
One couple from the NC group were referred to a geneticist for a Trisomy 9 imbalance. All other parental karyotyping results were normal.

Limitations, reasons for caution
This study contains a small sample size, and would benefit from further data collection to account for a percentage of samples being inadequate for analysis. Wider implications of the findings: Cytogenetic results were similar from miscarriages following natural conception and assisted conception. IVF does not increase the risk of miscarriage from abnormal embryonic karyotype. Routine cytogenetic testing following one miscarriage in patients undergoing IVF is not cost effective.

Trial registration number
Not applicable
P–389 The relationship between serum hormone profiles and missed abortion in humans
Authors: Yang Y , Wu J , Wang X , Yao J , Lao K S , Xu Y , Hu Y , Pan Y , Feng Y , Shi S , Zhang J , Qiao Y , Li Q , Ye D , Wang Y 
Published: August 2021

Abstract

Study question
Are circulating profiles of metabolic-related hormones also associated with the missed abortion (MA) in humans?

Summary answer
Serum levels of fatty acid-binding protein–4 (FABP4) and fibroblast growth factor 21 (FGF21) are positively associated with MA.

What is known already
A cluster of endocrine hormones, including FABP4, FGF21, adiponectin, lipocalin–2 (LCN2), exhibit pleiotropic effects on regulating systematic metabolism. Serum levels of them are associated with gestational obesity and diabetes and affect pregnancy outcomes, however, the relationship between their circulating profiles and MA is under-investigated.

Study design, size, duration
78 patients with MA and 86 healthy pregnant subjects matching on maternal age and body mass index (BMI) were nested from a prospective cohort in the Chinese population.

Participants/materials, setting, methods
Fasting serum samples from all participants were collected to test their serum levels of FGF21, FABP4, adiponectin, and LCN2 by enzyme-linked immunosorbent assay method (ELISA).

Main results and the role of chance
There were no significant differences in circulating profiles of adiponectin and LCN2 between MA patients and healthy pregnant subjects. By contrast, circulating levels of FGF21 and FABP4 were significantly and independently elevated in patients with MA relative to control cases even after adjusting confounding factors (for FGF21: MA: 28.96 ± 2.17 ng/ml; HP: 19.18 ± 1.12 ng/ml, P &lt; 0.001, for FABP4: MA: 152.50 ± 9.31 pg/ml; HP: 90.86 ± 4.14 pg/ml, P &lt; 0.001). Linear regression analysis showed, FGF21 raised every 10 pg/ml contributed to a 24% (95% CI: 15% - 34%) increase in the risk of MA, whereas the OR of FABP4 for the risk of MA was 1.052 (95% CI: 1.022 –1.088). Furthermore, using serum FGF21 level or FABP4 levels discriminated MA from healthy controls with an area under the operating characteristic’s curve (AUROC) of 0.81 (95% CI 0.76–0.92) and 0.70 (95% CI 0.62 - 0.78), respectively.

Limitations, reasons for caution
The study is limited by the sample size. In addition, our results were based-on Chinese population, whether it could be observed in other ethics group remain to be investigated. Meanwhile, the cause-effect relationship between increased serum FGF21 level and MA remains to be explored.
Wider implications of the findings: Our data would suggest that serum levels of FGF21 and FABP4 are associated with MA. Moreover, circulating FGF21 levels may serve as a potential diagnostic biomarker for the recognition of M.

Trial registration number
IRB Ref. No.: KY201913
P–391 Role of subcutaneous granulocyte colony-stimulating factor infusion in thin endometrium
Authors: Banerjee K , Singla B 
Published: August 2021

Abstract

Study question
To assess the role of subcutaneous granulocyte colony-stimulating factor (G-CSF) in thin endometrium cases.

Summary answer
G CSF has beneficial role to improve the endometrium thickness in thin endometrium.

What is known already
Endometrium is very important for embryo implantation and the endometrial thickness is the marker of receptivity of the endometrium.

Study design, size, duration
Study design - Retrospective analysis
Size - 88 infertile females with thin endometrium (&lt; 7 mm) in the age group of 23 to 40 years Duration - one year.

Participants/materials, setting, methods
In the group 1 of 44 females, subcutaneous infusion of G CSF (300 mcg/ml) was added along with other supplements and if lining was not more than 7 mm in 72 hours, then second infusion was given. In the group 2 of 44 females, only estradiol valerate and sildenafil were given.The efficacy of G CSF was evaluated by assessing the endometrium thickness before embryo transfer, pregnancy rates and clinical pregnancy rates.

Main results and the role of chance
There was no difference between the two groups regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality. . The pregnancy rate was 60% (24 out of 40 cases) in the group 1 that was significantly higher than in-group 2 that was 31% (9 out of 29 cases) with p value &lt; 0.0001. The clinical pregnancy rate was also significantly higher in-group 1 (55%) as compared to group 2 (24%) with p value &lt; 0.0001.

Limitations, reasons for caution
Further larger cohort studies are required to explore the subcutaneous role of G CSF in thin endometrium.
Wider implications of the findings: Granulocyte colony-stimulating factor has beneficial role to improve the endometrium thickness in thin endometrium. In most of previous studies, the intrauterine infusion of G CSF was given to improve the uterine lining. This is one of the few studies done that showed subcutaneous role of G CSF in thin endometrium.

Trial registration number
Not applicable