bluuebunny/crossref_metadata_2025_split huggingface dataset:
P–657 Prostaglandin D2 is correlated with follicles development and a reliable marker of ovarian reserve of poor ovarian responder patients
Authors: Choi K H , Kim Y J , Kang K Y , Park E A , Kim Y S , Kim M J , Kim H O , Koong M K , Kim Y S , Yoon T K , Ko J J , Lee J H 
Published: August 2021

Abstract

Study question
Is the prostaglandin D2 (PGD2) associated with growing follicles and ovarian reserve of poor ovarian responders?

Summary answer
PGD2 is correlated with ovarian stimulation activity and follicle growth. Especially, poor ovarian responders show a significant decrease in the level of follicular fluid.

What is known already
Prostaglandins (PGs) are involved in the female reproductive process, mainly ovulation, fertilization, and implantation.

Study design, size, duration
We investigated the PGD2 level in the follicular fluid of poor ovarian responders. The collection of human follicular fluid was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. Follicular fluid was collected from patients with normal ovarian response and patients with POR.

Participants/materials, setting, methods
We studied whether prostaglandin has related to POR in the clinical key factor by measuring human follicular fluid. Follicular fluid was collected from patients with normal ovarian response and patients with POR. The concentration of PGD2 in follicular fluid was determined with ELISA kits following the manufacturer’s protocol.

Main results and the role of chance
We analyzed the level of PGD2 in the follicular fluid of patients with normal ovarian response and patients with POR using an ELISA. The PGD2 concentration was significantly lower in the follicular fluid of patients with POR than in the follicular fluid of young and old patients with normal ovarian response.

Limitations, reasons for caution
This study has an identification of biomarker of the clinical samples as POR criteria patients. Therefore, further investigations aimed at specific recovery of low PGD2 metabolic activity in the CCs during control ovarian stimulation.
Wider implications of the findings: Until now there is no specific biomarker of POR. AMH is just an ovary reserve marker for an indication of ovary function. PGD2 is one of the metabolites in steroid metabolism in the ovary. Therefore, we can find some cure through further study for improved PGD2 production to POR patients.

Trial registration number
none
P–665 Influence of premature progesterone elevation on embryo development
Authors: Lefebvre T , Duval G , Loubersac S , Lammers J , Barriere P , Freour T , Reignier A 
Published: August 2021

Abstract

Study question
Does a serum progesterone level higher than 1.3 ng/mL on the day of ovulation trigger have an impact on blastocyst development?

Summary answer
Elevated progesterone level has no significant impact on top blastocyst rate, usable blastocyst rate and on morphokinetics.

What is known already
Premature elevation of progesterone level on the day of ovulation trigger prior to IVF is common and causes a decrease in endometrial receptivity. A freeze all strategy is then recommended. However, cumulative live birth rates have also been described as lower in cases of high progesterone levels.

Study design, size, duration
This was a retrospective bicentric cohort follow-up study, including 1150 IVF/ICSI cycles performed between 2016 and 2018 with at least 1 day–5 blastocyst available for transfer or freezing. Among these cycles, 524 were performed with use of a time-lapse system (Embryoscope). Serum Progesterone level was measured on the day of ovulation trigger, and a value &gt;1.3 ng/ml was used to identify premature progesterone elevation.

Participants/materials, setting, methods
The cycles were divided into 2 groups according to serum progesterone level: 1335 cycles were allocated in the normal progesterone group (P &lt; 1,3) and 215 in the progesterone premature elevation group (P &gt; 1.3). Patient’s characteristics, ovarian stimulation characteristics, IVF cycles characteristics and embryology parameters were anonymously recorded and compared between the 2 groups.

Main results and the role of chance
Female age, smoking status, AFC and AMH levels were comparable between the 2 groups. Female BMI was significantly higher in the P &lt; 1,3 than in the P &gt; 1.3 group (26.1 versus 24.7 kg/m² respectively). Total FSH dose, estradiol level, number of follicles &gt;11mm and number of retrieved oocytes were significantly higher in the P &gt; 1.3 group than in P &lt; 1.3 group No difference was observed between the 2 groups in terms of top blastocyst rate per mature oocyte and usable blastocyst rate per mature oocyte. When morphokinetic analysis was available, time to blastulation was the only significantly different parameter between the 2 groups (110.4 hours in P &lt; 1.3 versus 107.9 hours in P &gt; 1.3, p = 0.04). Cumulative live birth rate per cycle was not statistically different between the two groups (23.1% for P &lt; 1.3 versus 28.7% for P &gt; 1.3) (p &gt; 0.05).

Limitations, reasons for caution
The retrospective design of the study should lead to careful analysis of the results. The progesterone threshold refers to a specific assay, and should not be generalized to other assays.
Wider implications of the findings: Premature elevation of serum progesterone level on the day of ovulation trigger does not seem to affect embryo developmental competence. This further supports the relevance of freeze all strategy in this situation.

Trial registration number
Not applicable
P–704 Does the type of ovarian stimulation scheme and dose matter when calculating the amount of gonadotropins used to obtain an egg?
Authors: Lorenzo F , Youn. Obejero E , De. Camp. Echegoyen M J , Garcia J , Felici M 
Published: August 2021

Abstract

Study question
Is the controlled ovarian stimulation protocol important to determine the ovarian sensitivity index (number of oocytes retrieved / total gonadotropin dose)?

Summary answer
OSI in an interesting tool in estimating the ovarian sensitivity to exogenous gonadotropins and can be adjusted when different kinds of COS procotols are used.

What is known already
In our country, Argentina, as the fertility treatments are financed by different health care insurance companies, COS protocols may vary depending on the drugs provided. The objective of our study is to assess the oocyte retrieval number in patients undergoing COS, for IVF or fertility preservation (egg freezing), on the basis of the kind of protocol and the average gonadotropin dose.

Study design, size, duration
This is a retrospective and descriptive study in which 684 cycles, performed between November 2018 and March 2020, were evaluated. Patients underwent COS for IVF or fertility preservation purposes.

Participants/materials, setting, methods
COS protocols were analysed including different parameters such as: number of mature follicles (17mm or more) the trigger day, number of oocytes retrieved, number of M2 retrieved, follicle to oocyte index (FOI), and the kind of protocol.Each of these groups were divided into four groups depending on the protocol used. Group A: FSHr; Group B: FSHr/LHr; Group C: FSHr + HMG; Group D: Clomiphene citrate + HMG. Oocyte donors and incomplete medical records were excluded

Main results and the role of chance
The total number of cycles analysed was 684. There were 135(19.7%) cycles in the under 35 age group; 340(42%) in the 35 to 39 group; 209(38%) in the older than 40 group. They were subdivided in Group A: 54(6.67%) cycles; Group B 93(11.11%) cycles; Group C 465(71.72%); Group D 72(10.5%). A total number of 11351 oocytes were retrieved, with a mean average of 4.6 +- 2.5 SD per patient. Assessment of dose of gonadotropin per oocyte retrieved in each different group: GROUP A 360IU+–38 SD; GROUP B 390IU+–43 SD; GROUP C 375IU +–44 SD; GROUP D 479+–36 SD.

Limitations, reasons for caution
This is a retrospective study. Further prospective studies and a higher sample size are needed to confirm whether the OSI is a useful tool to adjust gonadotropins doses related to an specific COS protocol and improve the oocyte pick up.
Wider implications of the findings: The main conclusion obtained was that the average dose of gonadotropin needed to obtain one mature oocyte was 360 to 390 IU. The HMG and clomiphene citrate protocol needed the highest dose of gonadotropin (479 IU) but no significant stadistical differences were observed.

Trial registration number
NA
P–710 The possible relation between kisspeptin and apoptosis on granulosa cells of PCOS patients
Authors: Erener E , Kocaman A , Ayas B 
Published: August 2021

Abstract

Study question
Does kisspeptin administration affect the apoptotic factors of granulosa cells of Polycystic Ovary Syndrome (PCOS) patients?

Summary answer
Kisspeptin administration significantly increased apoptosis related factors.

What is known already
Kisspeptin plays a critical role in central gonadotropin secretion by acting on GnRH neurons in the hypothalamus. Kisspeptin receptors are also expressed on the ovaries. Kisspeptin–54 has recently been known as a prominent agent in oocyte maturation. Although there are many studies on the possible roles of kisspeptin administration in vivo on hypothalamic gonadotropin secretion and ovarian function and the possible roles of these effects in the pathogenesis of PCOS, there is not enough information about the effect of in vitro application of kisspeptin on ovarian function and conditions that lead to the development of PCOS.

Study design, size, duration
This basic research study was an in vitro experimental approach involving the use of granulosa cell from a PCOS and normal cases between July to December in 2020. 32 women were included in both control and PCOS groups.

Participants/materials, setting, methods
Women with (n = 16) and without (n = 16) PCOS were included in the study. Granulosa cells, follicular fluids and blood samples were collected on oocyte pick-up day. Cells were isolated from follicular fluids. Kisspeptin–54 levels were determined by ELISA in serum and follicle fluids. Also, FSH and LH levels were determined in serum. Kisspeptin–54 administrated in vitro to the half of the samples. Fluorescence spectrophotometer and laser scanning confocal microscope were used to evaluate calcium concentrations

Main results and the role of chance
The serum kisspeptin level was found significantly higher in PCOS patients compared to the control group (p &lt; 0.05). Also, the level of kisspeptin in follicular fluid was statistically significantly higher in PCOS patients compared to the control group (p &lt; 0.05). The mean serum FSH level of PCOS patients was found to be significantly lower than the control group (p &lt; 0.05). Furthermore, the mean serum LH level of PCOS patients was significantly higher than control groups (p &lt; 0.05). The intracellular calcium concentration in granulosa cells obtained from PCOS patients was significantly lower than the control group (p &lt; 0.05).

Limitations, reasons for caution
The KISS1, KISS1R, BCL–2, CASPASE–3, FSHR, LHCGR, STAR, ESR1, ESR2, INHBA gene expression levels of apoptotic process is still under analyses. The protein expression analyses of these genes may strength the results.
Wider implications of the findings: Using kisspeptin antagonists may be supposed as an additional treatment for patients with PCOS.

Trial registration number
OMU KAEK 2019 /724
P–717 Where do cryopreserved embryos end up after a positive pregnancy test?
Authors: Young E , Argibay S Garci , Isa L , Zappacost. Villarroel M P , Inza R , Valcarcel A 
Published: August 2021

Abstract

Study question
What is the destination of supernumerary embryos after a positive pregnancy test?

Summary answer
Half of the surplus cryopreserved embryos in assisted reproduction treatments are not transferred.

What is known already
Many of the surpernumerary cryopreserved embryos in assisted reproductive technologies are not transferred. This is a constant issue in many fertility centers around the world. Our objective was to report what happens with vitried surplus embryos after IVF in patients with a positive pregnancy test, carrying out an analysis according to age and final evolution of the pregnancy.

Study design, size, duration
This is a retrospective descriptive study. We analyzed 245 embryo transfer cycles, performed between January 2013 to December 2017, in 235 patients with a positive pregnancy test and who vitrified surplus embryos.

Participants/materials, setting, methods
All the patients underwent treatment with their own oocytes. The variables studied were: age, miscarriage rate (MR) and live birth rate (LBR). We compared the destination of the cryopreserved embryos according to the patient’s age and pregnancy evolution. Statistical analysis was performed with Fisher’s exact test.

Main results and the role of chance
20% of the IVF cycles (n = 49) were performed in women older than 40 years, 42% between 35 and 39 (n = 103) and 38% in women younger than 35 (n = 94). Average age was 35.8 ± 4.1 years. 859 embryos were cryopreserved (3.5 ± 1.9 cryopreserved embryos/patient). Average search time for surplus embryos was 20.5 ± 17.9 months, rising to 36.9 ± 14.9 months after delivery and decreasing to 8.7 ± 7.8 months after miscarriage (P &lt; 0.0001). Up to date there are 118 (48.2%) patients whose cryopreserved embryos have not been transferred yet. Signficant differences were found in the three groups in using the cryopreserved embryos according to whether or not they had delivery. Almost half of the surplus cryopreserved embryos are not transferred. Regardless of the age of the patient, all groups showed the same behavior regarding the utilization of the cryopreserved embryos after delivery. It is essential to advise couples who perform assisted reproductive technologies, with a good probability of success (regardless of the patient’s age), about the responsibility that embryonic cryopreservation entails. Argentine legislation has limitations regarding the availability of cryopreserved surplus embryos.

Limitations, reasons for caution
This is a retrospective study.
Wider implications of the findings: We believe that Public Health policies related to this issue should be re evaluated based on these results.

Trial registration number
Not applicable
P–718 Paternal smoking in the preconception period is associated with an increased risk of spontaneous miscarriage in a dose-dependent manner: a systematic review and meta-analysis
Authors: Fossé N. D , Va. de. Hoorn M L , Buisman N , Va. Lith J , Cessie S L , Lashley L 
Published: August 2021

Abstract

Study question
What is the association between paternal lifestyle factors in the preconception period and the risk of spontaneous miscarriage? Summary answer: Preconception paternal cigarette smoking is associated with an increased risk of spontaneous miscarriage, while no associations were found with paternal alcohol consumption and obesity.

What is known already
Although maternal lifestyle risk factors for miscarriage are well-established, studies on potentially contributing paternal factors remain sparse. Recently, a significant association was found between advanced paternal age and spontaneous miscarriage. Biological evidence indicates that smoking, excessive alcohol consumption and obesity may lead to sperm oxidative DNA damage, being a known risk factor for miscarriage. Study design, size, duration: Systematic review and meta-analysis.

Participants/materials, setting, methods
PubMed and Embase databases were searched in August 2020. Paternal factors examined were: cigarette smoking, alcohol consumption and Body Mass Index (BMI). A qualitative risk of bias assessment was performed for all included studies. Meta-analysis was performed if sufficient data was available from studies that controlled for maternal factors. PRISMA guidelines for systematic reviews were followed.

Main results and the role of chance
The systematic search included 3386 articles of which 11 articles met the inclusion criteria. In a meta-analysis of eight studies, paternal smoking of &gt; 10 cigarettes per day in the preconception period was found to be associated with an increased risk of spontaneous miscarriage, after adjustment for maternal smoking status (1–10 cigarettes per day: 1.01, 95% CI 0.97–1.06; 11–20 cigarettes per day: 1.12, 95% CI 1.08–1.16; &gt;20 cigarettes per day: 1.23, 95% CI 1.17–1.29). Based on five available studies, no clear association was found between paternal alcohol consumption and spontaneous miscarriage. No studies were retrieved that evaluated the association between paternal BMI and spontaneous miscarriage.

Limitations, reasons for caution
Investigating the relation between paternal lifestyle factors and spontaneous miscarriage is challenging and prone to different forms of bias, especially in retrospective studies.
Wider implications of the findings: Awareness of the association between heavy paternal smoking in the preconception period and the risk of spontaneous miscarriage should be raised. More well-designed studies are needed to further investigate the effects of other paternal lifestyle factors on the risk of spontaneous miscarriage.

Trial registration number
Not applicable
P–745 The efficacy of Buscopan® in reducing pain during ultrasound-guided manual vacuum aspiration (USG-MVA): A double-blind randomised placebo-controlled trial
Authors: Chung J P W , Law T , Sahota D , Mak J , Li T C 
Published: August 2021

Abstract

Study question
Does Buscopan® reduce abdominal pain experienced by women undergoing ultrasound-guided manual vacuum aspiration (USG-MVA)?

Summary answer
The addition of 20mg Buscopan® intravenous injection was not associated with a statistical reduction in pain score but leads to a higher patient satisfaction score.

What is known already
Ultrasound-guided Manual Vacuum aspiration is a feasible and effective out-patient treatment option for treating early pregnancy loss. However, it is associated with a moderate amount of pain due to uterine contraction.

Study design, size, duration
This randomised, double-blinded, placebo-controlled trial was conducted in a university-affiliated tertiary hospital. The study assessed whether 1 ml of 20mg Buscopan® intravenous injection 5 minutes before the USG-MVA will reduce the abdominal pain experienced by the women immediately and 2 hours after the procedure. Participants were randomised between June 2018 to January 2020 using a computer-generated number series in a 1:1 ratio.

Participants/materials, setting, methods
Women aged 18 years or older with first-trimester miscarriage undergoing the USG-MVA procedure were eligible. In total, 122 participants out of 128 eligible were included. Of whom, 111 underwent the USG-MVA procedure, 60 randomised to the Buscopan® group, and 62 to the placebo group.

Main results and the role of chance
The median abdominal pain scores in the Buscopan® group were 16.0% and 21.2% lower than the placebo group immediately post-procedure and 2 hours after the procedure in the Buscopan® group. Repeated measures ANOVA indicated that the both vaginal and abdominal pain scores improved significantly with the time (Vaginal F(1,108)=180.1,p&lt;0.0001; Abdominal: F(1,108)=83.41,p&lt;0.001) but not with group. No difference was noted in the complications and side effects profile. The physiological stress measured by Log10 sAA levels reduced significantly with time (F(2.8,286.1)= 6.3, p &lt; 0.001) but not with group (F = 0.1, p = 0.96). Women randomised to Buscopan® had a significantly higher (p = 0.032) mean VAS satisfaction scores compared to those receiving placebo (79.0±17.3 vs 73.4±24.1).

Limitations, reasons for caution
This study was a single-centre study, thus one should be cautious in the overall generalisability of the results.
Wider implications of the findings: Few studies have evaluated the use of anti-spasmodic agents to minimise uterine contraction pain in women undergoing outpatient uterine evacuation. We consider Buscopan® a useful adjunct in the pain control of USG-MVA to specifically reduce uterine cramps. Further larger studies are required to evaluate its efficacy.

Trial registration number
ChiCTR1800014590
P–784 Neonatal follow-up of babies born derived from mono-pronuclear zygotes
Authors: Tsuji H , Kitasaka H , Fukunaga N , Asada Y 
Published: August 2021

Abstract

Study question
Are the neonatal outcomes normal of babies derived from the transfer of blastocysts derived from mono-pronuclear(1PN) zygotes?

Summary answer
There was no effect on growth or increase in congenital anomalies up to 18-months in babies of 1PN-derived births.

What is known already
1PN zygotes are observed in ART, albeit at a low rate. We have previously reported that 80.7% of 1PN zygotes derived from IVF or ICSI had a biparental chromosome using Live Cell imaging techniques, and some of these developed to the blastocyst stage (Tokoro et al. ASRM 2013). Furthermore, we have reported that these blastocysts can result in a viable pregnancy and healthy live birth (Tsuji et al. ASRM2020). However, there is some uncertainty about the developmental mechanism of 1PN zygotes, and there is no clear consensus on their clinical utility.

Study design, size, duration
This was a retrospective study which included 55 cases where there was a live birth after single embryo transfer of a blastocyst derived from 1PN zygote. The incidence of birth defects, birth weight was recorded as well as a physical development survey of 25 children who responded to the 18-months follow-up survey. The time period was 72 months (January 2013 to December 2018).

Participants/materials, setting, methods
Patients seeking fertility treatment at an established private IVF clinic. We compared the birth weight, birth after18-months height and weight of children born to 1PN zygotes with data from a control, 2PN group. Statistical significance was determined using the t-test (level of P &lt; 0.05).

Main results and the role of chance
The incidence of birth defects in 1PN embryo-derived infants was 1.8% (1/55). The average birth weight of boys in the 1PN group was 3105.6+/–360.3g, which was not significantly different from 3041.0+/–443.3 g in the 2PN group. In girls, the average birth weight was 3085.7+/–454.9 g in the 1PN group, which was not significantly different from the 2PN group (2938.9+/–311.5 g). The average height at 18-months, was 81.6+/–2.5 cm vs 80.5+/–3.4 cm for boys; 79.0+/–1.8 cm vs 79.0+/–3.4 cm for girls in the 1PN and 2PN groups, respectively. The average body weights of the 1PN and 2PN groups were 11.1+/–1.1 kg vs 10.7+/–1.1 kg for boys; 9.7+/–0.9 kg vs 10.1+/–1.0 kg for girls, respectively. There was no significant difference in average height and weight up-to the 18-months follow-up survey.

Limitations, reasons for caution
The incidence of 1PN derived births is low and the study was limited to cases of single blastocyst embryo transfer.
Wider implications of the findings: The incidence of congenital anomalies in Japan was around 1.7 to 2%, and the incidence was similar in the 1PN. There was no difference in the birth weight and 18-months follow-up survey of the 1PN compared with the 2PN. We have demonstrated that there is clinical utility of 1PN embryo.

Trial registration number
Not applicable