bluuebunny/crossref_metadata_2025_split huggingface dataset:
O-125 How to evaluate the tubal function before and during surgery
Authors: Ojha K 
Published: July 2024

Abstract
Role of assessment of Fallopian tubes in the modern era of highly effective ART remains essential. Both prior to deciding if ART is needed to exclude tubal damage and also in those where ART is needed to exclude hydrosalpinges. The question remains how one should assess tubal function. It is now well established that not all patients needed invasive surgical techniques to assess fallopian tubes. Clinical history of pelvic infection or positive test for STI such as chlamydia and a baseline scan are soft markers indicating the need for an early tubal assessment. Non surgical techniques are the first line approach for tubal assessment such as HyCoSy ( HyFoSy) or HSG. Surgical method such as laparoscopy and dye test are generally recommended when results are inconclusive or pathology has been observed where surgery is indicated. These methods can check tubal patency but not tubal function. Where as tubal function can be assessed either with falloposcopy during laparoscopy or Fertiloscopy through transvaginal route by looking inside the fallopian tube.
O-160 Age at menarche is a marker for increased time to pregnancy
Authors: Warp M , Grindstad T , Magnus M  C , Page C  M , Håberg S  E , Morken N  H , Romundstad L  B , Hanevik H  I 
Published: July 2024

Abstract

Study question
Is age at menarche a marker for increased time to pregnancy later in life?

Summary answer
Very early (&lt;11 years) and very late (&gt;15 years) menarche is associated with decreased fecundability.

What is known already
Several factors such as age, body mass-index and gynecological diseases influence female fecundability. Early or late menarche is associated with increased risk of several negative health outcomes later in life. Previous studies have shown conflicting results regarding if age at menarche is associated with time to pregnancy, a measure of female fecundability.

Study design, size, duration
82 471 pregnant women with complete, self-reported information on age at menarche and time to pregnancy were included in a large retrospective cohort study between 1999 and 2008.

Participants/materials, setting, methods
Among 67 613 women with planned pregnancies participating in the Norwegian Mother, Father and Child Cohort Study we calculated fecundability ratios which indicate the cycle-specific probability of conception, by categories of age at menarche. We adjusted for pre-pregnancy body mass index, highest completed or ongoing education level and age at initiation of trying to conceive.

Main results and the role of chance
We observed a 9% lower probability of conception during any given menstrual cycle up to 12 cycles in women with very early (&lt;11 years) menarche, and a 4% lower probability among those with very late (&gt;15 years) menarche compared to women with onset of menarche in the reference category (12-14 years). Among women with menarche &lt;11 years the adjusted fecundability ratio was 0.91 (95% CI: 0.86-0.96) and among women with menarche &gt;15 years the adjusted fecundability ratio was 0.96 (95% CI: 0.92-0.99).

Limitations, reasons for caution
We didn’t have information about partner characteristics such as sperm quality, nor data on early life exposures such as early nutrition and pre-menarcheal body mass index. Since all participants were pregnant, the results could have limited generalizability to those who never conceive.

Wider implications of the findings
By identifying reduced fecundability as yet another negative health outcome associated with very early or very late menarche, the results from this study further underline the clinical importance of age at menarche as a readily available marker for later reproductive health.

Trial registration number
not applicable
O-163 The effect of ambient exposure to air pollutants on live birth rates in frozen embryo transfer cycles
Authors: Solsona Caba M , Leathersich S , Donno V , Rodriguez I , Polyzos N 
Published: July 2024

Abstract

Study question
Do air pollutants during oocyte retrieval (OPU) and frozen embryo transfer (FET) affect in vitro fertilization (IVF) outcomes?

Summary answer
Environmental exposure to increased concentrations of CO either on oocyte retrieval or embryo transfer day negatively influences clinical outcomes in FET cycles.

What is known already
Exposure to air pollution is linked to adverse perinatal outcomes and reduced fecundity, yet its effect on fertility and IVF cycles is inconclusive. Previous studies explored associations between air pollutant concentrations and IVF outcomes with conflicting results. Nevertheless, few assessed different pollutants’ effects either on oocyte retrieval or embryo transfer days on live birth rates. While Asian and American studies suggest that pollutants affect pregnancy rates, from European studies failed to show meaningful differences in live birth rates. Considering varying pollutant levels globally, we aimed to evaluate their impact on a European population’s fertility outcomes.

Study design, size, duration
A retrospective cohort study analysed 1960 FET cycles conducted by a university affiliated fertility center in Europe between January 2017 to December 2022.

Participants/materials, setting, methods
Daily average ambient concentrations of five air pollutants (PM2.5, NO, SO2, CO, and O3) were obtained from an urban air quality monitoring station on the day of oocyte retrieval and the day of FET. Tertiles (T1, T2, T3) of each pollutant served as cut-off levels. Multiple logistic regression analysis assessed associations between pollutant exposure and pregnancy outcomes, adjusted for confounders.

Main results and the role of chance
Overall pregnancy and live birth rates following FET were 52.55% and 40.71%, respectively. When analysis the results according to air pollutants on the day of FET, ambient exposure to CO was significantly associated with up to 36% lower live birth (T2, OR: 0.64, 95% CI: 0.49—0.84; T3, OR: 0.67, 95% CI: 0.51—0.88; both compared to T1). Higher CO concentrations on the FET day were positively associated with increased miscarriage rates of up to 75% (T2, OR: 1.75, 95% CI: 1.12—2.75; T3, OR: 1.63, 95% CI: 1.04—2.56; both compared to T1).

Limitations, reasons for caution
The retrospective nature of the study and the omission of various potential covariates including environmental and patient factors that could affect IVF outcomes, limit our findings. Exposure assessment exclusively considered specific IVF days, and reliance on data from one air quality station reduces accuracy. Caution advised when interpreting the results.

Wider implications of the findings
This study highlights the potential impact of air quality on IVF cycle outcomes. Further investigations are needed to determine vulnerable IVF cycle phases and clarify mechanisms underlying fertility impairment.

Trial registration number
not applicable
O-171 Apicobasal RNA asymmetries regulate cell fate in the early mouse embryo
Authors: Hawdon A , Geoghegan N  D , Mohenska M , Elsenhans A , Ferguson C , Polo J  M , Parton R  G , Zenker J 
Published: July 2024

Abstract
Assessing the morphological appearance of an embryo as it progresses from zygote to blastocyst is the primary method used by embryologists to evaluate embryo viability and developmental potential. Standard embryo grading techniques, using time-lapse microscopy, analyse morphological characteristics such as size, shape, number, and appearance of blastomeres. The aim of this study was to determine how individual cells of the embryo function on a subcellular level to build a healthy embryo.
RNA localisation plays indispensable roles in establishing asymmetries and coordinating cell fate decisions during early embryogenesis across various non-mammalian species. To direct the spatiotemporal distribution of RNA within the cells of an embryo, the microtubule cytoskeleton provides highly sophisticated trafficking pathways. Yet, it remains unknown whether subcellular heterogeneities exist during mammalian preimplantation development and how they contribute to cell fate determination.
Using advanced live imaging, we visualised global RNA transcripts at high spatiotemporal resolution from fertilisation to the blastocyst stage in living preimplantation mouse embryos. We discovered apicobasal RNA asymmetries specific to outer cells of the 16-cell stage mouse embryo, coinciding with cell fate decisions and the emergence of the pluripotent inner cell mass. Highly clustered RNAs accumulated proximal to the basal membrane, while more dispersed RNA foci were identified apically as the embryo reaches the late 16-cell stage. The targeted distribution of membrane-less RNA molecules was facilitated by the microtubule cytoskeleton, associated with lysosomes which serve as RNA transport vehicles.
We discovered that apically located RNA foci were more dynamic and accompanied an enrichment of translation components. Furthermore, we uncovered that the established RNA asymmetries enhanced translation capacity in apical regions compared to basal regions. These spatiotemporal RNA heterogeneities were unevenly inherited by outer and inner daughter cells during subsequent cell divisions. Notably, embryos that were unable to establish RNA asymmetries failed to allocate cells to the trophectoderm and inner cell mass.
Our study provides insights into a subcellular mechanism driving asymmetric RNA localisation and compartmentalised translational regulation in outer cells of the 16-cell stage embryo, which may contribute to cell fate decisions during mammalian preimplantation embryogenesis. We envision that when paired with classical morphological assessment criteria of the embryo, these findings may assist with selecting the embryo with the highest developmental potential.
O-176 Hoping for the best, expecting the worst: pregnancy after loss
Authors: Bailey S 
Published: July 2024

Abstract
Recurrent pregnancy loss (RPL) is an extremely distressing condition and can be both physically and emotionally traumatising. The condition is compounded by the fact that even after diagnostic procedures, the majority of cases, remain unexplained.
The early waiting period of a new pregnancy, when confirmation by ultrasound scan of an ongoing and viable pregnancy is awaited, represent a particularly challenging time for those affected by this condition. This waiting period is associated with high levels of distress due to the anxiety of possibly experiencing a further miscarriage. However, there is a lack of understanding amongst some health professionals of the emotional burden of this difficult waiting period, furthermore, limited support and counselling is available, and many women are left to manage their distressing emotions without coping support. While some seek frequent confirmation of viability by ultrasound scans, this approach is not feasible in most clinical settings and, in any case, appears to be of limited efficacy in reducing anxiety. An alternative approach was to provide the woman with tools that could bolster their ability to cope with this challenging period.
Our programme of research has investigated the use of the Positive Reappraisal Coping Intervention (PRCI), a self- administered coping technique, based on the principles of positive reappraisal, as a method of providing much needed emotional support. Qualitative research findings have provided deep insight into the lived experience of RPL during the early waiting stages of a new pregnancy, establishing that for those with a history of RPL, this is a traumatic time of great uncertainty, emotional turmoil and immense personal significance, where those affected ‘hope for the best, but expect the worst.’
Whilst our programme of research is still ongoing, studies to date, have demonstrated that study participants were receptive to the use of the PRCI and that it appeared to convey benefits, with no apparent downside. It was a ‘go to’ resource in times of strong emotional need and one that stimulated positive coping, providing respite from the stressor of uncertainty.
There is a compelling need to provide those experiencing RPL with increased emotional support to help them manage the stressful early waiting period of a new pregnancy. Findings suggest that PRCI could provide a useful adjunct to care pathways and has the potential to be made more widely available as an effective, safe, convenient, and low-cost intervention to provide emotional support in RPL clinics.
O-245 Is AMH testing relevant for fertility preservation in young oncology patients?
Authors: Stern K 
Published: July 2024

Abstract
As the prevalence of cancer in young people rises, and with improved survival rates such that over 80% of young cancer patients can expect to recover, future fertility and having their own family has become an important consideration which needs to be addressed. Best-practice oncofertility management includes initial discussion, assessment of fertility risk and medical risk, and consideration of preservation strategies prior to commencement of potentially gonadotoxic therapy, where possible, as well as post cancer-treatment fertility care. The window of opportunity for oocyte cryopreservation and/or ovarian tissue cryopreservation may be very limited. Therefore it is of paramount importance that a patient’s medical condition, gonadotoxicity risk, and current reproductive health and potential are considered when planning fertility preservation. Antimullerian hormone (AMH) is one of a group of tests performed which can assist with planning treatment and with counselling regarding the likely yield of a cycle. Knowledge regarding pre-treatment AMH, along with a patient’s age and the type of cancer treatment, may also assist with counselling regarding the likelihood of recovery of fertility after completion of this treatment. However, there are many factors which affect AMH levels, and it is well-known that the results of stimulation can be very variable, as can be the long-term impact of the potentially gonadotoxic treatment. Hence an AMH test, while useful, needs to be contextualized as being only one of many factors to be considered when planning optimal (in terms of yield and safety) fertility preservation treatment and advising re future fertility.
P-466 The effect of Virtual Reality technology (VR) during oocyte pick up (OPU) in 100 IVF/ICSI patients - A randomised controlled trial (RCT)
Authors: Brock Spanggaard K , Byrum S , Jensen M  B , Jensen H  K , Sørensen L , Kyndi M , Lysdal A  M , Mailund S , Elbaek H  O , Humaidan P 
Published: July 2024

Abstract

Study question
Does VR technology improve patient experience in terms of nervousness, nausea, pain, and total experience as well as consumption of painkillers during the OPU procedure?

Summary answer
The use of VR technology seems to have a positive influence on patient experience during OPU. No effect was seen regarding consumption of painkillers.

What is known already
In recent years, the VR technology has received increasing attention for its suggested calming and pain-relieving effect during medical procedures. Thus, a previous study using VR technology in women undergoing hysteroscopy showed a significant difference in anxiety compared to women not using VR. We previously performed a small pilot study in patients undergoing OPU. That study suggested that VR technology had a positive effect on patients before OPU in terms of level of relaxation and stress. Importantly, in the pilot project patients solely used the VR technology before the OPU procedure.

Study design, size, duration
This RCT included a cohort of 100 IVF/ICSI patients undergoing OPU. Patients were computer randomized into two groups: an intervention group (VR) and a control group (no VR) during OPU. Randomization was performed on the day of ovulation induction. The study was conducted from April 2023 to December 2023 in a public university affiliated fertility clinic.

Participants/materials, setting, methods
10 minutes before the OPU procedure the VR headset was placed and remained in place during OPU in the intervention group. The control group was treated according to the standard procedure of the unit. Both groups answered a questionnaire, including 14 questions using VAS (Visual Analog Scale) before and after OPU regarding nervousness, nausea, pain and total experience. Moreover, blood pressure, heart rate, saturation, and consumption of medication was recorded.

Main results and the role of chance
The study showed that the use of VR technology in women undergoing OPU significantly (P = 0.01) lowered the patient’s systolic blood pressure before the procedure. Moreover, the study showed a trend towards a reduction in nervousness and consumption of painkillers. The comments of the patients regarding their total experience of the effect of VR were in favour of VR usage and several patients would choose VR technology for a possible future OPU.

Limitations, reasons for caution
The patient experience might have differed if the same nurse participated during all the OPUs. To find a possible significant effect of VR usage as regards nervousness and consumption of painkillers a future larger sample size is required.

Wider implications of the findings
The use of VR technology during OPU might be considered as a supplement for patients during OPU.

Trial registration number
NCT05826938
P-080 Unveiling the molecular determinants of sperm endpiece stabilization
Authors: Jonkers S 
Published: July 2024

Abstract

Study question
How are microtubules at the endpiece of the mammalian sperm tail stabilized?

Summary answer
SAX01 and SPACA9 are microtubule inner proteins that binds at the endpieces. In addition, singlet microtubules are capped by a complex of proteins.

What is known already
At the core of the sperm flagellum is the axoneme, a supramolecular assembly of nine doublet microtubules around a central pair of singlet microtubules. At the endpiece, axoneme structure is lost and only singlet microtubules remain. Using cryo-electron microscopy (cryo-EM) our group showed that the singlet microtubules contain species-specific microtubule inner proteins in a helical arrangement. Furthermore, we observed a protein density capping the microtubules plus-ends in pig, horse, and mouse sperm.

Study design, size, duration
To elucidate the function of the sperm endpiece plug and its associated proteins, we apply single-particle analysis cryo-EM.

Participants/materials, setting, methods
-

Main results and the role of chance
We revealed that the microtubule inner proteins in the singlets are SAX01 and SPACA9. Our high-resolution structure shows that SPACA9 forms a discontinuously intraluminal spiral. It consists of a bundle of alpha helices that binds across the intradimer α/β-tubulin interface as well as between adjacent protofilaments. Specifically, SPACA9 interacts with both α- and β-tubulin within a dimer while also interacting with the M-loop of α-tubulin from the neighbouring protofilament. Our structure further shows that SAX01 binds longitudinally along individual protofilaments with its Mn motif, a 5- to 6-residue helix flanked by a Tyr/Phe residue on one end and by a Ser/Thr on the other that binds the shoulder of the α -tubulin S9/S10 loop. We further observed that microtubule termini are capped with yet to be identified protein complexes. Taken together, we show that microtubule inner proteins longitudinally and laterally reinforce the microtubule lattice, while capped in their termini.

Limitations, reasons for caution
Limitations include species-specific variations as we previously observed between mouse sperm endpieces and porcine or horse. Cryo-EM structures represent averages across singlet microtubules, so individual variation within particles may be lost.

Wider implications of the findings
Investigating the mechanism behind stabilization of the endpiece singlet microtubules using cryo-EM provides better understanding of sperm tail stabilization that holds potential for progress in understanding male infertility and can be utilized for a development of male contraception.

Trial registration number
not applicable
P-018 Study of sperm DNA fragmentation in the infertile population before, during and after the SARS-CoV-2 pandemic: a nationwide retrospective cohort study
Authors: Lara-Cerrillo S , Lacruz-Ruiz T , Rosado-Iglesias C , Serrano-Berenguer L , Garcia-Peiro A 
Published: July 2024

Abstract

Study question
Did the values of single- and double-strand sperm DNA breaks (SSB and DSB) increase during the SARS-CoV-2 pandemic?

Summary answer
During the SARS-CoV-2 pandemic (2020), the mean values of SSB and DSB in infertile patients were statistically higher compared to the periods 2018-2019 and 2021-2022.

What is known already
Some studies have found lower sperm concentration and motility in patients during and after SARS-CoV-2 infection (COVID-19). These effects appear to be reversible, with significant improvements being observed after three months post-infection (complete spermatogenesis cycle). On the contrary, vaccination against this virus does not seem to affect semen parameters. The objective of the study was to compare the values of SSB and DSB sperm DNA fragmentation in the periods before the pandemic (2018-2019), during (2020, highest number of infections and social confinement), and after (2021-2022, lower infection rate, end of social confinement and vaccination period).

Study design, size, duration
The average SSB and DSB sperm DNA fragmentation values of 11,215 patients referred from 74 fertility centres throughout Spain from January 2018 to December 2022 were retrospectively compared.

Participants/materials, setting, methods
Semen samples from infertile patients were analysed using the Comet assay in alkaline or neutral pH conditions to evaluate SSB or DSB, respectively. Three periods were compared (two years before, during 2020, and two years after). Mean SSB and DSB values were statistically compared among these periods using the Kruskal-Wallis and Mann-Whitney tests. Differences were established at the 99% confidence interval.

Main results and the role of chance
The average SSB values obtained were: 41.67%±15.33 in 2018-2019; 43.92%±17.84 in 2020, and 41.68%±18.58 in 2021-2022. The average DSB values obtained were: 65.64%±14.27 in 2018-2019; 67.77%±13.90 in 2020, and 65.23%±15.18 in 2021-2022. The SSB and DSB values were statistically higher in 2020 compared to the periods 2018-2019 and 2021-2022 (p &lt; 0.001 in both cases). No differences were detected between the previous period (2018-2019) and the following period (2021-2022) (p = 0.101 and p = 0.235, respectively).

Limitations, reasons for caution
The observed increase in SSB and DSB values during 2020 cannot be directly attributed to the SARS-CoV-2 infection (COVID-19). It is possible that it is associated with other concurrent factors. The studied samples were only from infertile patients, not from the general male population.

Wider implications of the findings
Given that the SARS-CoV-2 virus still exists in 2021-2022 but the social situation has normalized, the increase in fragmentation observed during 2020 could be more related to other aspects of the pandemic, such as social confinement, stress, among others.

Trial registration number
Not applicable