bluuebunny/crossref_metadata_2025_split huggingface dataset:
P–285 Controlling semi-invasive activity of human endometriotic stromal cells by inhibiting NF-kB signaling pathway using aloe-emodin or aspirin
Authors: Nasiri N , Babaei S , Moini A , Eftekhari-Yazdi P 
Published: August 2021

Abstract

Study question
Does inhibiting nuclear factor-kB (NF-kB) signaling by aloe-emodin (AE) or aspirin (Asp), as anti-inflammatory compounds, suppress the invasive activity of stage IV human endometriotic stromal cells?

Summary answer
Eutopic endometriotic stromal cells (EuESCs) seem to have a semi-invasive activity which is largely suppressed by AE or Asp.

What is known already
Inflammation and its master regulator, NF-kB, have been implicated in the development of endometriosis. Inhibition of NF-kB pathway using small molecules ameliorated disease progression and reduced the lesion size; nevertheless, underlying mechanism is not fully understood.

Study design, size, duration
In this cross-sectional study, a total of 8 infertile patients with proven endometriosis and 8 women without endometriosis (Control group) undergoing infertility treatment cycles, were enrolled between October 2018 and December 2019. The invasiveness of collected endometriotic stromal cells before and after treatment with AE or Asp, was analyzed and compared with the control group.

Participants/materials, setting, methods
The eutopic endometriotic and healthy endometrial biopsies were digested and the single cells were cultured. Gene and protein expression of proliferation, adhesion, and invasion markers of eutopic endometriotic stromal cells (EuESCs) with and without treatment with AE or Asp, as well as control endometrial stromal cells (CESCs) were analyzed using q-PCR and immunofluorescence staining, respectively. Cell migration capacity was assessed by wound closure assay.

Main results and the role of chance
We observed an association between NF-kB overexpression and higher proliferation/adhesion capacity in EuESCs. TNF-α, as a known NF-kB inducer, further potentiated this association. EuESCs at stage IV, displayed silent invasive and migratory behaviors. Pretreatment of EuESCs with AE or Asp significantly attenuated NF-kB expression and reduced proliferative, adhesive, invasive and migratory activity.

Limitations, reasons for caution
Due to some adverse effects observed following treatment with AE or Asp on the normal activity of EuESCs, more investigations on possible toxicity of the treatment, must be considered.
Wider implications of the findings: We suggest that both Asp and AE (as potent NF-kB inhibitors) may be useful as a supplement to conventional endometriosis treatments.

Trial registration number
Not applicable
P–350 Utilizing indocyanine green (ICG)-enhanced fluorescence to localize the ureter during robotic surgery for DIE and a concomitant crossed renal ectopia
Authors: Joukhadar R , Woeckel A , Altides A , Balafoutas D 
Published: August 2021

Abstract

Study question
Feasibility of (ICG)-enhanced fluorescence in visualizing the atypical course of the ureter during surgery for (DIE) of pelvic sidewall with a concomitant crossed renal ectopia.

Summary answer
Near-infrared fluorescence after transurethral injection of ICG enables localization of the ureter during surgery, thus facilitating complete excision of the lesions while enhancing patient’s safety.

What is known already
Existing case series refer to the transurethral injection of ICG and visualization under near-infrared (NIR) light during robotic surgery for real-time delineation of the ureter, which helps to prevent iatrogenic ureteral injury during complex surgery. The ICG reversibly stains the inside lining of the ureter by binding to proteins on urothelial layer. The consequent green fluorescence allows its identification throughout the entire case.
The presented case of a DIE of pelvic side wall along with an ipsilateral concomitant crossed renal ectopia (residual function 27%) resembles an utmost challenge for surgery. To our knowledge no similar case has been reported in literature.

Study design, size, duration
Demonstration of the Robotic technique by means of a step-by-step tutorial

Participants/materials, setting, methods
29-year-old patient referred after preceding laparoscopic surgery for DIE of left pelvic sidewall and abortion of surgery due to lack of accessibility/ severeness of the case. We performed renal scintigraphy, pelvic MRI and urological consultation.
Surgery was performed using an XI-da-Vinci robotic system. After cystoscopic placement of mono-Js we injected 4 ml. of ICG-solution (2,5 mg/ml). Visualization of the pelvic kidney was achieved 4 minutes after injection and of the complete ureter after 7–8 Minutes.

Main results and the role of chance
The robotic surgery could be completed safely and achieve a complete resection of the DIE of the pelvic sidewall including adhesiolysis of a broadly adherent bowel, opening of the rectovaginal space, ureterolysis of the distal portion of the ureter, partial excision of the left sacrouterine ligament and deperitonealization of the pelvic sidewall.
Postoperative controle revealed normal renal function and an adequate postoperative course.

Limitations, reasons for caution
ICG cannot be used in patients with iodine allergy.
Wider implications of the findings: Our report underlines the possibility to utilize indocyanine green (ICG)-enhanced fluorescence to localize the ureter during complex surgery for DIE, even in cases with atypical anatomy of the lower urinary tract.

Trial registration number
Not applicable
P–378 Using a machine learning tool (72% accuracy with 64% PPV) to predict multiple live birth when transferring multiple embryos, based on embryo specific data
Authors: Pena C A , Chambost J , Hickman C , Jacques C , Wiemer K , Kelley K 
Published: August 2021

Abstract

Study question
Can Machine Learning predict multiple pregnancy based on data specific to the embryos and the patient?

Summary answer
Embryo data are useful in determining which embryos are likely to lead to multiple pregnancy. Patient age has low predictive value compared to embryo data.

What is known already
Our previous assessment of the HFEA data demonstrated that single embryo transfer (SET) in the UK occurred in a minority (45%) of fresh cycles, with a marginal increase in live birth rate (LBR) in some patient cohorts in favor of multiple embryo transfer (MET). Current policies on determining number of embryos for transfer tend to be generic and do not account for detailed embryology data. Generic policies may compromise LBR for some patients that would benefit from MET. Artificial Intelligence has the potential to assist in this decision process.

Study design, size, duration
Retrospective cohort analysis from 2013 to 2020 of 193 cycles with 386 embryos used in double ETs on day 5 at POMA fertility clinic with positive live birth outcome. ML model, xgboost, was trained to predict multiple live birth (N = 54) versus single live birth (N = 139). Detailed embryology data from day 1 to day 5 were used as input.

Participants/materials, setting, methods
Input of the machine learning model included patient age and 18 morphological parameters collected on days 1, 2, 3 and 5 (symmetry, number of cells, blastocyst status, fragmentation, ICM and troph grades) from the two transferred embryos. An xgboost algorithm was trained on 80% of the data (n = 154) and tested on 20% of blind data (n = 39).

Main results and the role of chance
Xgboost machine learning algorithm predicted multiple live birth on the blind dataset with an accuracy of 72%, with an AUC of 0.60, showing better results than random. PPV (true prediction of multiple births) was 64% and NPV (true prediction of single birth) was 75%.
The following parameters ranked high in the predictive power of the machine learning (in order of predictive power): blastocyst status on day 5 of both embryos, symmetry on day 3, number of cells on day 2, scores on day 2 and 3. Limitations, reasons for caution: The dataset was derived from a single clinic with manual annotations and may not be transferable to other clinics. The risk of bias is important as the model was trained only àon embryos that were transferred and led to at least one birth
Wider implications of the findings: A tool to help identify which patients are at increased risk of MP with MET would be clinically useful to help patients and clinical team make the best personalised decision for a specific embryo, finding the balance between maximising success rate whilst minimising multiple pregnancy rate and its associated risks.

Trial registration number
Not applicable
P–390 The intrauterus administration of peripheral blood mononuclear cells increase the pregnancy rates for the patients with advanced maternal age after single euploid embryo transfer
Authors: Zhylkova E , Feskov O , Feskov V , Somova O , Zin Y , Yegunkova O 
Published: August 2021

Abstract

Study question
Does the intrauterine administration of peripheral blood mononuclear cells (PBMCs) effect the outcome of IVF for patients with advanced maternal age when the euploid embryos after PGT-A are transferred?

Summary answer
The implantation rates were significantly higher after the intrauterine application of PBMCs in patients with advanced maternal age (AMA) before transfer of the euploid embryo.

What is known already
The aneuploidy rates of blastocysts in IVF is in range 45–70% depending on different factors. Besides that, the endometrium plays an important role in achieving optimal outcomes of assisted reproductive technologies. It has been proposed that intrauterine administration of peripheral blood mononuclear cells modulates maternal immune response to favor implantation.

Study design, size, duration
The effect of the intrauterine application of PBMCs to improve the implantation rates in the group of patients with advanced maternal age was studied. Two group of patients (PBMCs-group and non-PBMCs-group_ were formed. Single euploid embryo was transferred for each patient. Participants/materials, setting, methods: The ploidy status of 373 blastocysts from 82 AMA-patients was analyzed by the method of next generation sequencing (NGS). PBMCs were applied for 39 women with the mean age 39.2±3.2 y.o. before embryo transfer (Group 1). For 43 patients with the mean age 38.2±2.1 y.o. single euploid embryo transfers were performed without PBMCs administration (Group 2). Chi-squared test was used for data analysis. The study’s protocol was approved by the Center’s IRB.

Main results and the role of chance
Totally the rate of euploid embryos was 27.1% (101 blastocysts). In the mentioned study 55.0% of examined blastocysts were aneuploid (205 embryos) and 17.9% of blastocysts were detected as mosaic (67 embryos). Single euploid embryo was transferred in each case in the patients of both experimental groups. The implantation rate was significantly higher in Group 1 with PBMCs application comparing with non-PBMCs experimental Group 2 (38.5% (15 pregnancies) vs. 23.3% (10 pregnancies), df = 1, χ2 = 5.487, χ2critical = 3.841, P = 0.020).

Limitations, reasons for caution
The embryo biopsy was performed only for blastocyst with top-quality morphology.
Wider implications of the findings: The implantation rates were significantly higher when the intrauterine application of PBMCs in patients with advanced maternal age before the transfer of the euploid embryo (P = 0.020). The randomized studies to improve our knowledge in immunogenic therapy in reproductive medicine should be performed.

Trial registration number
-
P–404 Low serum progesterone on the day of frozen blastocyst transfer is associated with a diminished ongoing pregnancy rate in hormonal replacement therapy cycles
Authors: Maignien C , Mathilde B , Valérie B , Ahmed C , Charles C , Pietro S 
Published: August 2021

Abstract

Study question
Is there a relationship between progesterone levels on the day of frozen blastocyst transfer and ongoing pregnancy rate (OPR), in hormonal replacement therapy (HRT) cycles?

Summary answer
Women undergoing HRT-frozen embryo transfer with progesterone levels≤9.76ng/ml on the day of blastocyst transfer had a significantly lower OPR than those with progesterone levels&gt;9.76 ng/ml.

What is known already
The importance of serum progesterone levels around the time of frozen embryo transfer (FET) is a burning issue, in view of the growing number of FET worldwide. However, the optimal range of serum progesterone levels is not clearly determined and discrepancies arise from the current literature. Study design, size, duration: Observational cohort study with 915 patients undergoing HRT-FET at a tertiary care university hospital, between January 2019 and March 2020.

Participants/materials, setting, methods
Patients undergoing single autologous blastocyst FET under HRT using exogenous estradiol and vaginal micronized progesterone for endometrial preparation. Women were only included once during the study period. The serum progesterone level was measured in the morning of the FET, in a single laboratory. The primary endpoint was OPR beyond pregnancy week 12. Statistical analysis was conducted using univariate and multivariate logistic regression models.

Main results and the role of chance
Mean serum progesterone level on the day of FET was 12.90 ± 4.89 ng/ml). The OPR was 35.5% (325/915) in the overall population. Patients with a progesterone level ≤ 25th percentile (≤9.76ng/ml) had a significantly lower OPR and a higher miscarriage rate (MR) compared with women with progesterone level over Centile 25 (29.6% versus 37.4%; p = 0.033 and 34.8% versus 21.3%; p = 0.008, respectively). After adjustment for the potential confounders in a multivariate analysis, a serum progesterone level ≤ 9.76 ng/ml on the day of FETand FET of a Day 6-blastocyst (versus Day 5-blastocyst) were found as independent risks factor of lower OPR.

Limitations, reasons for caution
The main limitation of our study is linked to its observational design. Extrapolation of our results to other laboratories, or other routes and/or doses of administering progesterone also needs to be validated.
Wider implications of the findings: This study suggests that a minimum serum progesterone level is needed to optimize reproductive outcomes in autologous blastocyst FET, in HRT-cycles. Further studies are needed to evaluate if modifications of progesterone routes and/or doses may improve pregnancy chances, in an approach to individualize the management of ART patients.

Trial registration number
NA
P–448 Clinical outcome of social oocyte cryopreservation at advanced age
Authors: Tsafrir A , Ben-Ami I , Eldar-Geva T , Gal M , Weintraub A , Goldberg D , Dekel N , Levi H , Schonbeger O , Srebnik N , Nabulsi R , Buhbut I , Hyman J 
Published: August 2021

Abstract

Study question
What are the success rates of social oocyte cryopreservation (SOC) at advanced age?

Summary answer
In this study, one in four women who underwent SOC above age 35 had a delivery.

What is known already
While SOC is gaining popularity, reports on delivery rates are limited due to low utilization rates.

Study design, size, duration
Retrospective data collection of all woman who underwent SOC between 2011–2018, and presented for treatment using cryopreserved oocytes until January 2021. Participants/materials, setting, methods: Review of patient records (including both IVF and antenatal/postnatal) and laboratory data in a university affiliated hospital-based IVF unit. Main results and the role of chance: A total of 448 women underwent SOC during 2011–2018. 50 (11.2%) women returned to use these oocytes until the end of January 2021. Women who returned to use their oocytes underwent cryopreservation at mean age of 38.2±2.2. 46 (92%) of participants were above 35 at time of cryopreservation. Number of oocytes cryopreserved was 11.3±9.7. Mean time from cryopreservation to thawing was 5.5±1.8years (range 1–9 years). and age at thawing was 43.4±2.1 (range 40–49). Nearly half of patients initially attempted to conceive before using their cryopreserved oocytes, mostly by ART using fresh oocytes. Mean number of oocytes thawed and oocytes survived per women was 9.7±6.2 and 6.1±4.9 respectively (post thawing survival rate 65.4±35%).
Mean number of embryos transferred, at one or more attempts was 2.6±2.1 per women. Eleven women gave birth or had an ongoing pregnancy &gt; 20 weeks at time of analysis. All deliveries resulted from cryopreservation at age 36 and older (delivery rate 23.9% per women). Limitations, reasons for caution: We report our initial experience of women who underwent SOC at a single center. Most women who returned to use their oocytes had undergone SOC at advanced age, therefore not necessarily reflecting outcome for younger patients attempting to preserve fertility using this technology. Wider implications of the findings: Considering modest success rates of SOC in our cohort, women considering SOC are advised to do so at an earlier age.

Trial registration number
Not applicable
P–518 Assessment of mitochondrial DNA viability ratio in day–4 biopsied embryos as an add-in to select euploid embryos for single embryo transfer
Authors: Metwalley A M , Hellani A , Esteves S , El-Damen A , Abde. Razik A , Dawood A A , Hamshary M E , Khamiss O 
Published: August 2021

Abstract

Study question
Is mitochondrial DNA viability ratio of day–4 biopsied embryos associated with embryo implantation potential?

Summary answer
The mitochondrial DNA viability ratio is significantly higher in embryos that implant. The score might help to select euploid embryos for single embryo transfer.

What is known already
Embryo euploidy is a critical factor for successful pregnancy outcomes. However, transfer of euploid embryos does not invariably result in implantation, thus indicating that other factors may play a role. Metabolic rates and adenosine triphosphate content vary significantly in oocytes and embryos and might affect embryo viability. Embryo function, indirectly measured by mitochondrial DNA viability ratio (mtV) has emerged as a potential quantitative biomarker for embryonic selection before the transfer, but clinical data remains limited. The purpose of this study is to characterize and compare mtV in euploidy day 4 embryos.

Study design, size, duration
Retrospective cohort study carried out between Jan. 2017 to Jan. 2020, involving 75 infertile couples undergoing IVF-ICSI with PGT-A and single embryo transfer (SET) of day 4 euploid embryos.

Participants/materials, setting, methods
We compared the mtV ratios of 34 non-pregnant patients with those of 41 patients who achieved clinical pregnancy after SET. The mtV ratio was obtained from a cohort of 75 euploidy embryos. The embryos were biopsied 80–85 hours post–ICSI and subjected to next-generation sequencing (NGS). The mtV was determined using Multiple of Mean (MoM) values, obtained by dividing the mtV ratio of individual embryos by the mean mtV value of all implanted embryos.

Main results and the role of chance
The mean mtV ratio (1.51; 95% confidence interval [CI] 1.25–1.77) of non-pregnant patients was significantly lower than those of pregnancy counterparts (2.5; 95% CI 1.82–2.68; p &lt; 0.01). At a 0.5 MoM cutoff, the sensitivity and specificity of mtV ratio to discriminate between implanted embryos versus non-implanted embryos were 35.3% and 78.2%, respectively., with a positive predictive value (PPV) of 41.4%.

Limitations, reasons for caution
Our study is limited by the small sample size and lack of stratification by causes of female/male infertility. Endometrial receptivity issues, which could have contributed to implantation failure, was not evaluated.
Wider implications of the findings: Assessment of mtV ratio could provide additional prognostic information for selecting euploid embryos for transfer in SET programs. Further research is warranted to establish the clinical utility of routine application of mtV evaluation in PGT programs.

Trial registration number
N/A
P–537 What is the attitude of gamete donors towards expanded genetic testing
Authors: Skytte A B , Pacey A , Rothma. Herrmann J , Mocanu E , Burke C , Pennings G 
Published: August 2021

Abstract

Study question
What is the opinion of gamete donors on extended carrier screening in Denmark and in US?

Summary answer
This study showed that the overwhelming majority of the donors were very positive towards genetic testing in general and the expanded carrier screening.

What is known already
There is a lack of empirical studies on the experiences of and attitudes of donors towards expanded carrier screening (ECS) (Amor et al. 2018). Oocyte donors in a Spanish clinic were surprised by the information on testing and the possibility of being carriers (Abuli et al., 2016). After adequate genetic counselling before and after the test, the results of testing did not seem to have a meaningful emotional or psychological impact on the donors.

Study design, size, duration
A questionnaire was emailed to all active sperm donors in a sperm bank in Denmark and in a sperm bank in US.

Participants/materials, setting, methods
A total of 393 donors received the email of which 233 donors completed the questionnaire, 196 in Denmark (response rate of 60.7%) and 37 in the United States (response rate of 52.9%).

Main results and the role of chance
We systematically compared the US and DK donors and ID-release versus non-ID-release donors for all characteristics and items. ID-release donors with a partner significantly more informed their partner about their donor status than non-ID-release donors (90.5% vs. 72.4%, p 0.027). ID-release donors significantly more intended to tell their own children (57.5% vs. 21.2%, p 0.001). ID-release donors significantly more thought about their potential donor children (56.2% vs. 35.0%; p 0.002) and significantly more likely to want information on whether a pregnancy occurred from their donation (70.6% vs. 55.0%, p 0.017). In addition, they also significantly more wished to obtain information about the children conceived with their sperm: the number of children (64.0% vs. 50.0%, p 0.048), their gender (40% vs. 26.2%, p 0.042), and their health (59.3% vs. 42.5%, p 0.018). The ID-release donors were much less likely than the other type not to want any information (19.3% vs. 32.5%, p 0.034). This general attitude is extended to the wish to be informed if a child with a hereditary disease is born after using their sperm. The ID-release donors were more likely to desire contact if their genetic child was diagnosed with a genetic disease (73.9% vs. 55.0%, p 0.003).

Limitations, reasons for caution
The main element that makes the study unique (i.e., the choice between ID-release and non-ID-release) also renders the generalization of the findings more difficult. Wider implications of the findings: A better understanding of the attitude among gamete doners will possibly guide future legislation and ensure the safety and welfare of the donors too.

Trial registration number
none