bluuebunny/crossref_metadata_2025_split huggingface dataset:
O-120 The role of CatSper in male infertility - from bench to bedsite and back
Authors: Strünker T 
Published: July 2024

Abstract
Infertility is on the rise, but the underlying causes still remain mostly unknown. In fact, for about one third of infertile men, semen parameters are within reference limits. This so called ‘unexplained male infertility’ seems to rest on elusive functional defects of the sperm undetectable by semen analysis, precluding early diagnosis of the infertility and evidence-based treatment by medically assisted reproduction (MAR). As a result, affected couples often experience failed MAR attempts, subjecting the ‘healthy’ female to recurring medical risks. We set out to gain insight into the pathomechanisms underlying unexplained male infertility. To this end, we systematically assessed the function of the sperm-specific multisubunit CatSper-channel complex in sperm of 2,300 men undergoing a fertility workup at our center, using a simple motility-based ‘CatSper-Test’ combined with [Ca2+]i fluorimetric and electrophysiological recordings. Thereby, we identified a group of men with normal semen parameters, but defective CatSper function. These men or couples failed to conceive naturally and upon MAR via intrauterine insemination and in vitro fertilization. Intracytoplasmic sperm injection (ICSI) was, ultimately, required to conceive a child. We revealed that the defective CatSper function was caused by variations in CATSPER genes. Moreover, we unveiled that CatSper-deficient human sperm were unable to undergo hyperactive motility and, therefore, failed to penetrate the egg coat. Thus, we provide the experimental evidence that sperm hyperactivation is required for human fertilization, explaining the infertility of CatSper-deficient men and need of ICSI for medically assisted reproduction. Finally, our study also revealed that defective CatSper function and ensuing failure to hyperactivate represents the most common cause of unexplained male infertility known thus far and that this sperm channelopathy can readily be diagnosed, enabling future evidence-based treatment of affected couples.
O-169 Advances in oocyte freezing: implications for donors, recipients, counsellors and clinics
Authors: Hudson N 
Published: July 2024

Abstract
Much of the attention given to the introduction of oocyte vitrification has focused on the implications for autologous freezing – i.e. freezing by those who wish to store their own eggs for later use. Such debates have considered, for example, the individual motivations of freezers and the ethics and practicalities of state and employer funding. Much less attention has been given to the impact of egg vitrification on the landscape of egg donation. Whilst use of frozen eggs for donation varies by country and clinic, data show that in general the practice is growing; with Spain an early and enthusiastic adopter within Europe.
The advent of egg vitrification has led to or accelerated a number of changes in the landscape of donation. More efficient and reliable freezing allows clinics to ‘batch’ eggs and store them for potential use by multiple recipients thereby increasing clinic revenue. Vitrification can also facilitate the creation of a store of eggs and associated donor profiles; providing more choice for recipients at the time of treatment and giving rise to the emergence of commercial egg banks within Europe. There have also been changes to the regulatory landscape catalyzed by the introduction of oocyte vitrification; for example, a recent extension to legal storage periods in the UK in response to the newly established technical potential. In a broader sense, the possibility to vitrify and store eggs has developed at a time when fertility treatment in general is rapidly transforming and commercializing; with the introduction of a range of novel and highly commercialized practices in the same period: e.g. methods of gamete/donor selection which use AI and expanded carrier screening for donors. The management and use of frozen eggs has therefore developed along a different sociotechnical trajectory to that of frozen sperm; acquiring differing meanings, practices and moral, cultural and economic value in the process.
In this talk, I draw on data from a recent, large-scale study of egg donation in Europe to consider how oocyte vitrification maybe reshaping the landscape of egg donation. I consider how changing practices associated with vitrification (egg batching and banking, for example) may be reconfiguring how egg donation is constructed and perceived by those involved, as well as how it is regulated. Specifically, I consider the implications that an increase in use of frozen eggs raises for donors, recipients, clinics and their staff, including counsellors.
O-170 The next generation of adolescents will consider more and more multiparenthood, poliparenthood
Authors: Leunens L 
Published: July 2024

Abstract
Although there are a variety of ways in which people navigate their intimate lives, theories of human development and intimacy often implicitly assume a preference for monogamy to be universal (Seltzer, 2000; Conley et al., 2017; Moors et al., 2017). While many people around the globe indeed engage in serial monogamy, remarkable transformations in relationship and family demography have occurred over the past several decades (Glick, 1988; Fisher, 1989; Finkel et al., 2014; Foster, 2016, in Moors et al. 2021) Studies show that 1 out of 6 people (16.8%) desire to engage in polyamory, and 1 out of 9 people (10.7%) have engaged in polyamory at some point during their life. (Moors et al 2021). Besides seeking hypotheses on the reason for this change away from the monogamous relationship form, and based on these data, we can try to make a prediction about the willingness of people to also consider parenthood in consensual non-monogamous or polyamorous relationships and thus engage in polyparenthood in the future.
In the fertility centre too, we are past an era in which heterosexual infertile couples form the majority of our patient population. The need for donor material is increasing, although demand grossly exceeds supply. In addition, in many countries donor anonymity is still enshrined in law, which poses a problem for a growing number of acceptors. Many patients desire information about the donor and an increasing number of patients anticipate the perspective of the future child, which has a right to know its origins. Other patients wish the donor would also include parental involvement, and fundamentally desire the genitor to be a co-parent for their child at some point. As a result, some patients seek refuge in non-regulated open donation arrangements outside the fertility clinic. Indeed, internet websites dedicated to facilitating contact between individuals who want to meet people with the common aim of having a child are mushrooming. Such websites make elective co-parenting accessible to large numbers of people, including both singles and those with partners. Furthermore, these websites are not restricted to LGBTQ+ individuals; heterosexual men and women can also become members and contact potential reproductive partners who may be of a different sexual orientation to themselves.
This could trigger a paradigm shift in the fertility clinic; is co-parenting, multi-parenting and poly-parenting the future? It could resolve problems of donor shortage, and the often difficult search for roots still faced by donor-conceived children as a consequence of donor anonimity.
At Brussels IVF, we anticipated this paradigm shift and developed a procedure to counsel candidates for co-parenting. Welfare of the child is the guiding principle leading to a joint parenting project worked out together with the co-parents. This procedure and counseling topics to be addressed by the fertility centre will be presented.
O-282 Detection and elimination of malignant cells from cryopreserved testis and ovarian tissue?
Authors: Jahnukainen K 
Published: July 2024

Abstract
For young patients receiving treatments that might impair their reproductive functions, gonadal tissue cryopreservation emerges as a technique to preserve their future fertility. The reimplantation of cryopreserved prepubertal gonadal tissue is currently the most promising strategy for restoring fertility in these individuals. There have been reports of successful births after autotransplanting ovarian tissue harvested at peri-puberty. In males, although autotransplantation of testicular tissue has not yet led to the production of viable sperm, successful reproduction has been documented in primate studies following such procedures.
The preservation of gonadal tissue in the setting of cancer introduces concerns regarding the potential for malignant cell contamination, leading to worries about the future reimplantation of contaminated tissue. Recent analysis shows significant contamination rates with cancer cells in cryopreserved gonadal tissues from children with leukemia and lymphoma — 37% in testicular tissues and 12% in ovarian tissues. The risk of contamination extends beyond hematological cancers with documented cases of cancer cell contamination in ovarian tissue from patients with apparently localized sarcoma, and detection of neuroblastoma cells in cryopreserved testicular tissue. Such significant contamination rates prompt discussions about harvesting tissue post-chemotherapy, although gonadotoxic treatments may adversely affect the quality of the cryopreserved germ cells.
Emerging diagnostic techniques, especially molecular methods, are being investigated for their ability to more accurately detect residual maliganat disease. While traditional histology and immunohistochemistry have been the norm, their sensitivity is relatively low. More precise molecular-genetic techniques, such as Polymerase Chain Reaction (PCR) and Reverse Transcriptase-quantitative PCR, demonstrate greater sensitivity. Moreover, advanced methods like next-generation sequencing offer even higher precision in detecting minimal residual disease. Xenotransplantation of gonadal tissue into immunodeficient animals may also provide some insights as a preclinical method for relapse prediction. Future research is essential to refine these diagnostic techniques to achieve the necessary sensitivity for clinical application.
This presentation aims to explore the current knowledge on gonadal tissue contamination rates for both hematological cancers and solid tumors in prepubertal patients and to review strategies for decontaminating gonadal tissues. A critical examination of existing knowledge gaps will be conducted with the objective of identifying secure methods for fertility restoration in cancer survivors.
O-288 Pro
Authors: Vassena R 
Published: July 2024

Abstract
Currently and globally, the majority of ART treatments are performed either fully in the private medical sector or are partially subsidized in the public sector but with common treatments spill-over to the private sector; countries where there is sufficient public coverage of ART are in fact rare. While private clinics and hospital have been the norm in ART for decades, in recent years the field has undergone significant consolidation, and this has resulted in an influx of large financial players such as private equity (PE) firms. The results are a series of mergers and acquisitions that are shaping the geography of ART provision.
In this debate, I will take on the “pro” side and I will highlight the scholarship around the changes in care brought about by PE ownership of medical practices, bringing examples from branches of medicine such as dermatology, dentistry, long term care or Ob&Gyn that have experienced market consolidation in the last decades. I will show that available evidence indicate that the change in ownership to PE of private medical practices is associated with an increase in the number of patients treated and a net increase in payments to clinicians. Moreover, PE ownership has been repeatedly associated with a perception of higher quality care by patients, while clinical KPIs have not gotten worse and, if anything, have improved. This is usually due to greater intentional focus on standardization and quality control, streamline and protocolization of treatments, and centralization of certain administrative areas.
I will further argue that, in large PE owned networks, best practices tend to be enhanced by peer to peer sharing and central medical boards, while centralization and digitalization of patient data collection favors research and development in a field that sorely lacks public funding for reproductive research.
P-744 A new hysteroscopic-assisted mock embryo transfer (HAMET) to predict success in ART cycles
Authors: Manzi A , Tabanelli C , Ferraretti A  P , Balicchia B , Rossi S , Magli M  C , Gianaroli L 
Published: July 2024

Abstract

Study question
Could HAMET increase pregnancy rates in predicted and unexpected difficult transfer patients?

Summary answer
Data of this study show a strong correlation between HAMET and pregnancy rates.

What is known already
Mock embryo transfer is regularly performed to adequately plan the correct strategy for positioning embryos inside the uterus of patients predicted to have difficult access to uterine cavity procedure.

Study design, size, duration
This is a single-center, observational, retrospective study conducted at S.I.S.Me.R. center in Bologna, Italy. 1184 consecutive diagnostic hysteroscopies were performed for patients suffering for primary or secondary infertility before ART. All patients from 18 to 49 years old underwent a mock embryo transfer performed with 10 to 15 μl of methylene blue dye. Diagnostic hysteroscopy was performed immediately after mock embryo transfer to assess if the dye has entered the uterine cavity.

Participants/materials, setting, methods
Out of the 1184 patients who underwent hysteroscopy, in 617 patients 1118 transfers were executed after IVF-ICSI cycles. Patients were subdivided in: group A where whole cavity including fundus was filled by blue; group B where cavity but not fundus was filled by methylene blue; group C patients with partial captation or with no captation at all of dye. The difficulty of mock embryo-transfer (scale 1 to 3) was also recorded by the physician.

Main results and the role of chance
the results of 1118 transfers are summarized in the table below.
While patients with whole cavity plus fundal captation (group A) had the highest implantantion rate (IR) compared to group B and C, reflecting the same difference in the clinical pregnancy rate (CPR), the live birth rate (LBR) was statistically superior only for group A when compared to group B.

Limitations, reasons for caution
Main limitation of these findings is the absence of control group.

Wider implications of the findings
HAMET is able to predict which patients have the higher chances to achieve a pregnancy and, even more important, a term pregnancy. The use of HAMET it is also useful to assess the capability of physicians to enter the uterine cavity when the cervical canal route is not regular.

Trial registration number
not applicable
P-047 Sperm moving pattern analysis with artificial intelligence solution predicts aneuploidy ratios of zygotes
Authors: Mun Young L , Yun Dong G , Jin Y , Min Jung C , Yu Jin K , Sangyong J , Jung Jae K , Jin Young P , Hoon J , Dea Keun K , Lee J  H 
Published: July 2024

Abstract

Study question
Can an analysis of sperm movements with artificial intelligence predict aneuploidy ratios of zygotes?

Summary answer
And sperm movement patterns analyzed by AI diagnosis predicted the aneuploidy ratios of zygotes.

What is known already
Sperm motilities present a specific pattern like strength, strength with curving, curving only and none progressive et al. Sperm movement patterns are determined by the sperm neck protein which is the centromere protein. Also, this centromere protein of the sperms was involved in the chromosome segregation in the zygote.

Study design, size, duration
A total of 8,000 clinical participants were recruited by CHA Infertility Center Seoul Station and 5 videos were taken from the semen sample of each participant. Machine learning with sperm moving clip for the diagnosis algorithm predicted aneuploidy ratios of fertilized embryos.

Participants/materials, setting, methods
We used YOLO_v8 and EfficientNet algorithm on the extracted sperm movement trajectory image to classify sperm into classes according to their motion pattern. This information was combined with the age of the patient to predict the possibility of infertility by analyzing the association with aneuploidy ratios of zygotes using deep learning model.

Main results and the role of chance
Deep learning AI algorithm utilized diagnosis for unexplained male infertility. No strength moving sperm pattern has shown association with male origin aneuploidy after fertilization. Especially high ratios of cycle moving sperm significantly increased the aneuploidy ratios in the zygote. But paternal aging has no correlation with aneuploidy ratios in the embryo. AI diagnosis have a 0.9 accuracy score. It is expected that the AI solution generated through this system can help overcome the problem of finding the cause of male infertility by predicting aneuploidy ratios of zygotes.

Limitations, reasons for caution
This study is designed for and performed with a minimum number of sperm move data. For clinical application, further mass data was set-up to increase accuracy of diagnosis.

Wider implications of the findings
Our AI solution was constructed to predict the possibility of aneuploidy ratios in the zygote by analyzing and classifying the movement patterns of sperm. Therefore, sperm movement-based AI diagnosis solution can be applied to define unexplained male infertility.

Trial registration number
non-clinical trials
P-210 A new insight into the effects of systemic lupus erythematosus on oocyte and embryo development and female fertility
Authors: Mao R 
Published: July 2024

Abstract

Study question
Does SLE affect oocyte and embryo development and female fertility in female patients?

Summary answer
Patients with SLE present worse outcomes in oocyte and embryonic development, thus yielding compromised female fertility and clinical pregnancy.

What is known already
Systemic lupus erythematosus (SLE) is often associated with adverse reproductive outcomes. However, it’s currently unclear regarding the role of SLE in oocyte and embryonic development. Also, it’s controversial whether SLE hurts fertility. There is a lack of comprehensive understanding and assessment of fertility in patients with SLE.

Study design, size, duration
This study retrospectively investigated oocyte and embryo development, ovarian reserve, and clinical outcomes in SLE patients who underwent in vitro fertilization (IVF) treatment from January 2013 to September 2022 at the University Hospital.

Participants/materials, setting, methods
In this study, we collected data from 34 SLE patients who were previously diagnosed and in remission for a total of 44 IVF cycles and matched 102 infertile women with a total of 148 IVF cycles by Propensity Score Matching (PSM) of 1:3 ratio. We then evaluated baseline characteristics, ovarian reserve, IVF laboratory outcomes, and clinical outcomes between the two groups.

Main results and the role of chance
After PSM matching, baseline characteristics including age, infertility types, and duration, as well as infertility causes overall coincided between the two groups. Anti-müllerian hormone (AMH) was significantly lower in the SLE group vs comparison (1.9 vs. 3.3 ng/mL, P=0.001). The SLE group performed a significant reduction in available embryo rate (76.6% vs. 86.0%, P=0.001), good-quality blastocyst formation rate (35.1% vs. 47.0%, P=0.003), and blastocyst formation rate (51.0% vs. 67.7%, P=0.001) compared to the comparison. As for clinical outcomes, the implantation rate in the SLE group was notably lower (37.9% vs. 54.9%, P=0.022). The CLBR following every embryo-transfer procedure was distinctly lower (41.2% vs 68.6%, P=0.016) in the SLE group vs comparison. Also, the conservative and optimal CLBRs following every complete cycle procedure were significantly reduced in the SLE group vs the comparison (P=0.001, both)

Limitations, reasons for caution
It’s a retrospective and single-center study, which is relevant to an inevitable risk of bias. Due to its special population selection, the sample size of this study is quite small.

Wider implications of the findings
This study provides data support to explore further the impact of SLE or other autoimmune diseases on female fertility, and it also calls for more attention to be given to these special patients by reproductive physicians. Comprehensive fertility assessment and individualized fertility guidance are recommended for patients with SLE.

Trial registration number
TJ-IRB20211280
P-295 Impact of septate uteri on pregnancy and neonatal outcomes of IVF/ICSI–frozen embryo transfer
Authors: Su Z 
Published: July 2024

Abstract

Study question
What is the impact of septate uteri on reproductive and neonatal outcomes of IVF/ICSI–frozen embryotransfer?

Summary answer
septate uteri are associated with lower birthweight and worse fertility outcomes including lower Intrauterine implantation rate and lower live birth rates.

What is known already
Several studies have investigated the negative effects of septate uteri on pregnancy outcomes.However, an all-round and definitive conclusion has not been reached yet owing to the relatively low incidence of the disease and theheterogeneity of study populations, especially among women undergoing ART.

Study design, size, duration
This was a retrospective cohort study including 149 women with septate uteri and 13921 women with a normal uterus who underwent first frozen-thawed embryo transfer cycles of IVF/ICSI from january 2016 to December 2022. We compared reproductive outcomes.

Participants/materials, setting, methods
Reproductive outcomes of women with septate uteri were studied through propensity score-matched comparisons (patients with septate uterus respectively along with corresponding control group without uterine malformations). We also comparedpregnancy and neonatal outcomes.

Main results and the role of chance
Compared to the matched control group, women with septate uterus had asignificantly lower LBR(37.58% versus 50.56%, odds ratio (OR) 1.698 [95% CI: 1.161, 2.484], P = 0.006) and Intrauterine implantation rate(36.31% versus 45.67%, odds ratio (OR) 1.474 [95% CI: 1.06, 2.06], P = 0.021)

Limitations, reasons for caution
This was a single-centre, retrospective study in which neonatal data were extracted fromparental questionnaires. In patientswith uterine malformations, the number of babies with birth defects and twin pregnancies was relatively small, limiting the power of thestudy.

Wider implications of the findings
Compared to patients with a normal uterus, women with septate uterus have poorer reproductive outcomes. Pregnant women with a septate uterus need to be managed as high-risk pregnancies and followed withappropriate obstetric review.

Trial registration number
not applicable