bluuebunny/crossref_metadata_2025_split huggingface dataset:
O-111 Premature ovarian insufficiency: new data and updated guidance
Authors: Panay N , Anderson R , Bennie A , Cedars M , Davies M , Ee C , Gravholt C H , Kalantaridou S , Kallen A , Kim K , Misrahi M , Nappi R , Rocca W , Ruan X , Teede H , Vermeulen N , Vogt E , Vincent A 
Published: July 2024

Abstract
Premature ovarian insufficiency (POI) presents a significant challenge to women's health, with significant implications both physically and emotionally. Despite its life-altering impact, there remain substantial unknowns in the causes this condition and how to optimally manage its various sequelae While such unknows provide direction for future research, they also underscore the need for clinical guidance.
In 2015, under the auspices of ESHRE, a group of experts evaluated the existing best evidence and published the first European guideline on the management of premature ovarian insufficiency. The update of this Guideline was performed in an international collaboration of experts representing American Society for Reproductive Medicine (ASRM), International Menopause Society (IMS), and the Centre for Research Excellence in Women’s Health in Reproductive Life (CRE WHiRL).
The recent update of the POI guideline covers 40 clinical questions on diagnosis of the condition, the different sequelae, including musculoskeletal health, cardiovascular health, neurological health, sexual function and general well being, and treatment options, including hormone therapy. The list of clinical questions was expanded from the questions included in the guideline from 2015. Based on a scoping survey and appreciation of emerging knowledge of POI, questions were added on the role of AMH in the diagnosis of POI, fertility preservation, muscle health, and specific considerations for hormone treatment in iatrogenic POI. Additionally, the topic on complementary treatments was extended with specific focus on non-hormonal treatments and lifestyle management options.
The draft guideline published for stakeholder review includes a total of 142 recommendations. One third of these recommendations were formulated as good practice points. Of the evidence-based recommendations, almost 80% were formulated as strong recommendations, even if the evidence base for most evidence-based recommendations was limited to observational data (level very low or low), supporting a call for future research.
The guideline group hope that the new POI Guideline will improve the clinical management of this devastating condition.
O-113 Non-invasive evaluation of embryo metabolic activity through hyperspectral microscopy
Authors: Dunning K 
Published: July 2024

Abstract
Current approaches for assessing embryo quality are subjective (morphology) or invasive (biopsy) and are not always predictive of live birth. Development of an accurate and non-invasive method to assess embryo quality would likely improve IVF success.
We have taken a different approach towards developing a non-invasive diagnostic for embryo quality: optical imaging. We use low levels of light to illuminate the embryo and obtain spatial information on cell metabolism as well as biophysical properties of the embryo. Here I will present our work showing that hyperspectral imaging can be used to accurately discriminate between euploid and aneuploid mouse embryos, and in light sheet mode, able to generate 3D metabolic maps of developing embryos. Importantly, we show that this form of imaging is safe: compared to embryos that were not imaged, hyperspectral imaged embryos had similar, and not significantly different, pregnancy and implantation rates, with offspring weight at weaning also comparable.
Another potential optical approach to assess embryo quality is digital holographic imaging. To date, little attention has been paid to the physical parameters of an embryo and whether these could be markers of embryo quality. One such physical parameter is refractive index. We have shown that digital holographic microscopy is able to measure very small changes in refractive index between good and poor-quality mouse embryos.
Importantly, these optical approaches occur in the absence of stains or exogenous tags. Used alone, or in combination, such optical approaches may prove beneficial in developing an accurate, non-invasive diagnostic for embryo quality.
O-116 Fertility in transmasculine people
Authors: Van Mello N 
Published: July 2024

Abstract
Transgender and gender diverse (TGD) people apply for gender-affirming care at any age to manage gender identities or expressions that differ from the gender socially attributed to their sex assigned at birth. Gender-affirming hormonal treatment (GAHT) and gender-affirming surgery (GAS) may alter reproductive function and/or anatomy, limiting future reproductive options to varying degrees, if persons have the wish to either give birth and, or to become a biological parent. The desire to have children in TGD people does not differ from that of the cis population.
In those persons assigned female at birth but who identify as male or genderdivers medical transition often comprises testosterone to induce masculinisation. The effect of testosterone on the uterus and ovaries and further reproductive outcome has not been fully clarified so far. There are several histological studies showing ovarian cortical and stromal changes following testosterone exposure, it is uncertain what the consequences for future fertility may be. It seems there is persistent activity in folliculogenesis by the descriptions of follicle count, distribution and oocyte retrieval. However, there are studies showing a negative effect on fertilization rate in presence of testosterone. Reports on successful ovarian stimulation, fertilizations, pregnancies and live births have been published, with and without testosterone discontinuation.
In this lecture an overview will be given of the recent literature and guidelines on fertility outcome in TGD people assigned female at birth, specifically the effect of medical transition. Recommendations on counseling and ways of fertility preservation will be discussed.
O-124 What is the role of tubal surgery in the era of ART?
Authors: Watrelot A 
Published: July 2024

Abstract
Role of Tubal surgery in the era of art
Tubal surgery is not very popular these days due ti the amazing important and successes of ART. However:
• access to IVF is far for granted in a many countries for financial, cultural or religious reasons
• ivf is not always successful
• tubal surgery is sometimes necessary before ivf in case of hydrosalpinx and conservative surgery may be discussed being in some cases a very valid option.
• recently subtle tubal abnormalities has been studied and demonstrate their importance in infertility
Therefore it seems important to redefine the place of tubal surgery, taking in account the fact that ivf doctors have usually no surgical skills, and that surgeons with tubal skills are not numerous nowadays.
It is also important to recall the principles of tubal surgery: tubes are complex and fragile organs and deserved to be preserved. That is possible is the principles of microsurgery (today done by laparoscopy) are applied: magnification, selective hemostasis, irrigation, gentle handling of the tube with atraumatic instrumentation and microsutures when needed. A special attention must be observed when adhesions are present which is very often the case. Meticulous adhesiolysis and prevention of recurrence are essential.
If careful selection of cases and appropriate technique are used then we may expect very good results in term of pregnancy, similar which was is obtain with ivf
It seems very important to teach these principles of tubal surgery in medical school and to have at least one reproductive surgeon in every ART team.
O-195 Decreased embryo developmental potential and lower cumulative pregnancy rate in males with multiple morphological abnormalities of the sperm flagella
Authors: Long R , Jin L , Zhu L 
Published: July 2024

Abstract

Study question
Is there any association between the multiple morphological abnormalities of the sperm flagella (MMAF) patients and the comprehensive outcomes of assisted reproductive technology (ART) cycles?

Summary answer
Patients with MMAF presented compromised ART outcomes, including lower embryo developmental potential and impaired clinical outcomes, compared with the cohort of oligoasthenospermia.

What is known already
Several studies have reported a positive intracytoplasmic sperm injection (ICSI) outcome in the MMAF cohort, and others have opposite opinions. The association between MMAF and ART outcomes is still controversial and open for debate. Furthermore, the neonatal outcomes and the information regarding the mutations of MMAF patients were incomplete.

Study design, size, duration
A retrospective cohort study of MMAF patients was performed at a reproductive medicine center in China between January 2014 and July 2022.

Participants/materials, setting, methods
Thirty-eight MMAF individuals were recruited based on a typical MMAF phenotype (abnormal sperm flagella, including short, absent, coiled, bent, and/or irregular flagella) and 131 couples with male infertility undergoing in vitro fertilization (IVF)/ICSI treatments over the same period were included as the control pool. Whole exome sequencing (WES) was performed to confirm the genetic pathogenesis of MMAF.

Main results and the role of chance
Pathogenic variants in known genes of DNAH1, DNAH11, CFAP43, FSIP2, and SPEF2 were identified in MMAF patients. The ART outcomes, including the fertilization rate, 2PN cleavage rate, blastocyst formation rate, and available blastocyte rate, were all significantly lower in the MMAF group than those in the control group (P&lt;0.05). Moreover, the CLPR in the MMAF group was lower than that in the control group according to the embryo transfer times (68.6% vs. 86.5%, P=0.033) and complete cycles (66.7% vs. 84.2%, P=0.020), while no significant differences were found in the neonatal outcomes.

Limitations, reasons for caution
The sample size was limited due to the low incidence of MMAF and WES was not performed in all MMAF patients. Further exploration of the potential genetic mutations or underlying mechanisms in patients without identified mutations was needed. Moreover, long-term follow-up of neonates needs to be addressed in the future.

Wider implications of the findings
The current study identified the causative genetic mutations which were partly obligated to the pathogenesis of MMAF and presented the relationship between MMAF and compromised ART outcomes. These results may provide evidence support for clinicians in genetic counseling and clinical instruction in specific MMAF patients.

Trial registration number
the National Key Research & Development Program of China (2021YFC2700603)
O-240 Embryo assessment: the Istanbul consensus revised
Authors: Coticchio G , Ahlström A , Arroyo G , Balaban B , Campbell A , De Los Santos Molina M  J , Ebner T , Gardner D , Kovacic B , Lundin K , Magli C , Mcheik S , Morbeck D , Rienzi L , Sfontouris I , Vermeulen N , Alikani M 
Published: July 2024

Abstract

Study question
What are the current recommended criteria for morphological assessment of oocytes, zygotes and embryos?

Summary answer
The present ESHRE/Alpha Scientists in Reproductive Medicine consensus document provides several novel recommendations to assess oocyte and embryo morphology and rank embryos for transfer.

What is known already
A previous Alpha Scientists in Reproductive Medicine / ESHRE consensus on oocyte and embryo morphological assessment was published in 2011. After more than a decade, a thorough review and update was needed.

Study design, size, duration
A working group consisting of Alpha Scientists in Reproductive Medicine executive board members and ESHRE Special interest group of Embryology members formulated recommendations on oocyte and embryo morphological assessment.

Participants/materials, setting, methods
The working group included 17 internationally recognized experts with extensive experience in clinical embryology. Seven members represented Alpha Scientists in Reproductive Medicine and 8 members represented ESHRE, in addition to two methodological experts from the ESHRE central office. Based on a systematic literature search and discussion of existing evidence, the recommendations of the Istanbul Consensus (2011) were reassessed and, where appropriate, updated based on consensus within the working group. After stakeholder review, the final version will be approved by the working group, the Alpha executive board and the ESHRE Executive Committee.

Main results and the role of chance
This updated consensus paper provides 20 recommendations focused on the timeline of preimplantation developmental events and morphological criteria for oocyte, zygote, and embryo assessment. Based on duration of embryo culture, recommendations are given on the frequency and timing of assessments to ensure safety and effectiveness.

Limitations, reasons for caution
Several criteria relevant to oocyte and embryo morphology have not been well studied, leading to either a recommendation against their use for grading or for use in ranking rather than grading. Future updates may require further revision of these recommendations.

Wider implications of the findings
This document provides embryologists with clear advice on best practices when assessing oocyte and embryo quality based on the most recent evidence.
O-285 Incompatible gametes: implications for infertility diagnosis and treatment
Authors: Kekäläinen J 
Published: July 2024

Abstract
Sperm face intense selection in the female reproductive tract (FRT), and in humans usually only very few out of up to hundreds of millions of sperm cells can eventually proceed to the vicinity of an unfertilized oocyte. Traditionally, it has been thought that the primary function of female-induced sperm selection is to eliminate poor-quality sperm from reaching the oocyte. However, recent studies have demonstrated that in many species (including humans) FRT also mediate mate choice at the level of the gametes, which frequently bias fertilization towards the male, which is genetically compatible with the female. Furthermore, emerging evidence indicates that sperm phenotypic and genotypic variation within single ejaculates may allow gamete-level mate choice to act also among high-quality (‘healthy’) sperm and bias fertilization towards genetically compatible sperm haplotypes. I argue that both of these cellular-level mate choice processes can have important consequences for deeper understanding of the mechanistic basis of fertilization and infertility.
P-079 Bilateral versus unilateral orchidopexy: IVF/ICSI-ET outcomes
Authors: Liu S , Fan L 
Published: July 2024

Abstract

Study question
Does unilateral and bilateral cryptorchidism infertility have an impact on IVF/ICSI-ET results?

Summary answer
Unilateral and bilateral orchidopexy do not affect the final live birth rate in IVF.

What is known already
A study was compared ICSI-ET outcomes between bilateral and unilateral cryptorchidism in NOA patients. Although 90.36% of their study population have undergone orchidopexy to improve their conditions at around 9 to 10 years old, the fertilization rates of bilateral and unilateral cryptorchidism group were only at 46.8% and 46.5% respectively, which were slightly below the average ICSI fertilization rate. The other study showed that patients of bilateral cryptorchidism had lower implantation rate. Apart from the mentioned study, no other study has attempted to evaluate the IVF/ICSI-ET outcomes in infertile men who had undergone orchidopexy.

Study design, size, duration
A retrospective cohort study at a tertiary hospital, including a total of 99 infertile men who underwent orchidopexy to treat cryptorchidism and subsequently underwent their first IVF/ICSI-ET cycle from January 2014 to January 2022.

Participants/materials, setting, methods
Men are divided into unilateral fixation group and bilateral fixation group based on the laterality of the cryptorchidism and testicular fixation surgery they have received. Choose fertilization rate and live birth rate as parameters for evaluating the results.

Main results and the role of chance
The sperm concentration and viability were significantly higher in unilateral orchidopexy group than in bilateral orchidopexy group (28.09 ± 27.99 vs 7.99 ± 14.68, P=0.001; 33.34 ± 22.52 vs 11.95 ± 17.85, P=0.001). Unilateral orchidopexy group showed lower demand for ICSI (66.07% vs 95.35%, P&lt;0.001). Interestingly, both groups exhibited similar rates of fertilization, clinical pregnancy, live birth and birth defect. Boy birth ratio was lower in bilateral orchidopexy group as compared to unilateral orchidopexy group (27.27% vs 58.62%, P=0.026).

Limitations, reasons for caution
This study was limited in that the data source captured only patients from a single medical center, which could lead to selection bias, small sample size and limited external validity to the findings.

Wider implications of the findings
Our study suggested that blastocyst-stage ET is a good strategy for patients with history of orchidopexy.

Trial registration number
not applicable
P-107 Sperm DNA fragmentation impacts embryonic developmental potential but is not associated with PGT-A outcomes
Authors: Okubo T , Omi K , Tomoya S 
Published: July 2024

Abstract

Study question
Does sperm DNA Fragmentation Index (DFI) affect embryonic development and influence Preimplantation Genetic Testing for Aneuploidy (PGT-A) outcomes in IVF?

Summary answer
DFI adversely affects early embryonic development, diminishing blastocyst potential. Nonetheless, PGT-A outcomes are unaffected, underscoring the importance of selecting optimal sperm for enhanced IVF results.

What is known already
Several major factors are thought to cause DFI. The relationship between sperm DFI and IVF results remains debated.

Study design, size, duration
This study was conducted from January 2018 to March 2023, included 56 married couples undergoing IVF after performing a sperm DFI test. The DFI was assessed at the first semen examination and categorized into three groups: low (≤15%), moderate (15-30%), and high (≥30%).

Participants/materials, setting, methods
Intracytoplasmic sperm injection (ICSI) was performed on 1006 mature oocytes, followed by blastocyst culture. A total of 278 blastocysts meeting freezing criteria were vitrified. Trophectoderm biopsies from 216 blastocysts underwent Next-Generation Sequencing for aneuploidy analysis. Statistical analysis utilized the Cochran-Armitage test to compare outcomes among the DFI groups.

Main results and the role of chance
The average age of the husbands and wives who underwent IVF after the DFI examination was 42.3±4.2 and 41.4±2.4 years old. Normal fertility rates after ICSI in low, moderate, and high DFI were 85.5%, 84.5%, and 83.1%, with no significant difference. Similarly, the blastocyst freezing rates were 35.4%, 26.3%, and 29.6%, and tended to decrease as the DFI value increased (p &lt; 0.05). However, the euploid rates for PGT-A were 22.4%, 16.3%, and 18.2%. There were no statistically significant differences between the DFI groups in terms of euploidy.

Limitations, reasons for caution
Cases declining ICSI due to patient preference or historical medical reasons were excluded from this study.

Wider implications of the findings
This suggests that sperm DNA imperfections have a negative impact on the developmental process during the early stages of division, but during late stages of division, the ability to repair DNA works to differentiate into blastocysts with normal developmental potential.

Trial registration number
not applicable
P-340 Reconciling diversity in health and genomic data collection with the regulation of AI in clinical genomics
Authors: Shabani M 
Published: July 2024

Abstract

Study question
How far the existing and emerging EU regulations address concerns about lack of diversity in genomic databases which used to train AI in genomics?

Summary answer
The main regulations in the European Union provide no clear answers for reconciling the need for more diverse genetic data with regulatory standards.

What is known already
AI researchers need high quality genomic data that reflect the underlying diversity of human populations to develop and validate safe, effective, and equitable tools for genomic medicine. The problem is that most of the genomic data that are available to develop such tools are of insufficient quality, due to inappropriate use of population descriptors, and over representative of individuals of European ancestry. We used the example of developing algorithms to calculate polygenic risk scores ( PRS) and concerns about their accuracy for various sub-populations to illustrate our discussion.

Study design, size, duration
We have analysed the relevant EU regulations including, the upcoming AI Act, Medical Devices Regulation ( MDR), In Vitro Diagnostic Medical Devices ( IVDR) and the GDPR to assess how the concerns related to lack of diversity in genetic/genomic databases have been addressed.

Participants/materials, setting, methods
NA.

Main results and the role of chance
The main regulations for clinical AI in the European Union, namely those regulating medical devices, provide no clear answers for reconciling the need for more diverse genetic data with regulatory standards. On the other hand, some of the data protection regulation requirements arising from the EU General Data Protection Regulation (GDPR) may further challenge collection of sensitive attributes such as race/ancestry which might be needed for brining diversity to databases. On the other hand, several interesting impending new regulations addressing AI and algorithms such as the EU’s AI Act may help in some ways, but still fail to ultimately grapple with the fundamental obstacles in producing the diverse genomic data needed to achieve regulatory objectives. In particular, the proposed requirements related to data quality and transparency need to be accompanied by further guidance on how to define representativeness and how to address long-term impact on fairness concerns in the context of medical AI, when the developed tools are not of optimal use for populations not descending from European ancestry.

Limitations, reasons for caution
NA.

Wider implications of the findings
The legal analysis provided in this paper will provide insights for broader types of AI tools which may be implemented in the context of Assisted Reproductive Technologies and beyond.

Trial registration number
NA