bluuebunny/crossref_metadata_2025_split huggingface dataset:
#21 : Letrozole Can Be a Good Adjuvant for In Vitro Fertilization (IVF) Procedure in Patient with Ovarian Endometriosis
Authors: Choo Chang-Woo , Lee Won-Don , Lim Jin-Ho 
Published: January 2024

Background and Aims: To evaluation the pregnancy rate in IVF procedure with letrozole in patient with ovarian endometrioma. Method: Prospective study performed by single physician at primary fertility center. From August 2016 to November 2019, 109 cycles of IVF were performed from couples who were diagnosed as endometrioma. 40 women were diagnosed during ovarian cystectomy, 69 were by transvaginal ultrasonography. In 64 cycles, gonadotrophic releasing hormone (GnRH) antagonist protocol was used, and in another 45 cycles, gonadotrophin releasing hormone agonist (GnRHa) protocol were applied. In every cycle, 10 mg of letrozole was added from the start of gonadotrophin till the end of ovarian stimulation. Results: Women’s age was 36.10±3.67, and the number of their previous IVF cycle was 2.66±1.63. AMH was 2.30±2.31, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) on the third day of menstruation were 9.40±5.26, 7.81±4.60 and 54.1±44.2. Start dosages and total dosages of recombinant FSH were 314.32±74.99 and 2541.37±992.77, and serum E2 and progesterone on trigger day were 1220.06±1072.49 and 0.92±0.79. The endometrial thickness was 9.20±1.46. The number of obtained oocytes was 9.05±5.94 and metaphase II(M2) oocytes were 6.71±4.12. 1.91±0.42 embryos were transferred to the uterine cavity and 2.68±2.58 surplus embryos were cryopreserved. Pregnancy rate was diagnosed if serum beta human chorionic gonadotrophin (hCG) level was above 5 ng/ml on 14th day after oocyte retrieval, and the result was 44.95% (49/109). Clinical pregnancy rate which was defined if gestational sac was visualized by transvaginal ultrasonography after at least 21st days after oocyte retrieval, and the result was 24.77% (27/109). Conclusion: In IVF procedure for the patients with ovarian endometrioma, just adding letrozole to conventional controlled ovarian hyperstimulation protocol can reduce serum peak E2 level without make harmful effect on uterine endometrium, and result in comparable pregnancy rate.
#53 : Pregnancy Outcome After Hydrosalpinx Aspiration in In-Vitro Fertilization Cycle
Authors: Ong-Jao Ednalyn , Mendiola Rudie Frederick , Perillo Gayla , Francisco Fides Marie 
Published: January 2024

Background and Aims: Hydrosalpinx is a severe manifestation of tubal disease-causing infertility in women. It has an adverse effect on the outcome of in vitro fertilization (IVF), reducing live birth rate (LBR) by 50% compared to other tubal factors. Laparoscopic salpingectomy can effectively improve IVF outcome but is contraindicated in some women. It can also be expensive and is not without complications. Ultrasound-guided hydrosalpinx aspiration is a cheaper, less invasive procedure alternative to salpingectomy. It has been shown to improve clinical and ongoing pregnancy rates compared to patients with no aspiration. However, the published literature on the effectiveness of hydrosalpinx aspiration is equivocal. Method: This retrospective study aimed to evaluate the outcome of minimal stimulation (mild) IVF cycles wherein the women underwent hydrosalpinx aspiration prior to embryo transfer at a private fertility clinic in the Philippines. Results: A total of 98 IVF cycles satisfied the inclusion criteria. The average patient age was 35.22 ± 4.57 and average duration of infertility was 5.87 ± 3.70 years. The biochemical pregnancy rate was 48% and the clinical pregnancy rate was 39.8%. Live birth rate was 35.7%, which is comparable to that of mild IVF patients without hydrosalpinx. There was a negative correlation between patient age and biochemical pregnancy rate, clinical pregnancy rate, and LBR, however, the correlations were statistically insignificant (Pearson correlation, P = 0.081, 0.197, and 0.344, respectively). Binary logistic regression analyses showed that age, infertility type, infertility factor, basal hormone levels, and number of eggs retrieved were not predictive of the success of IVF among the women in the study. Conclusion: Our results show that hydrosalpinx aspiration is a safe and effective option in improving pregnancy and live birth rates in women undergoing mild IVF.
#113 : Transdermal Oestrogen (GEL) for Endometrial Preparation in Frozen-Thawed Embryo Transfer
Authors: Shukri Rahilah Ahmad , Zain Murizah Mohd , Mohammad Nurul Mawaddah 
Published: January 2024

Background and Aims: Frozen-thawed embryo transfer (FET) requires a synchronization between endometrium and embryo. Pregnancy and live birth rates are proven to be significantly higher with FET due to better endometrial receptivity. In this study, we look at effectiveness oftwo oestrogen preparations in hormone replacement therapy (HRT) FET cycle on the pregnancy outcomes. Method: This is a retrospective analysis of 200 HRT FET cycles from 1st Jan 2020-31st December 2021, divided into 2 groups. Group 1 (n=100) received T Progynova 6 mg/day and Group 2 (n=100) received Oestrogel 6 mg/day (17B oestradiol 0.06% gel Besins France) starting on day 1 of menses, without GnRH agonist pituitary downregulation. The oestrogen dose was adjusted accordingly to achieve endometrial thickness (ET) of minimum 8 mm, prior to initiation of vaginal progesterone. The pregnancy outcomes (biochemical pregnancy, clinical pregnancy, ongoing pregnancy, early pregnancy loss and ectopic pregnancy rates), duration of oestrogen usage and endometrial thickness measurement prior to embryo transfer were analysed. Results: The biochemical pregnancy rate in this study was 39%, with a clinical pregnancy rate of 31%. Comparing both preparations, the biochemical pregnancy rate (p=0.562), clinical pregnancy rate (p=0.705), ongoing pregnancy rate (p=0.623), and early pregnancy loss rate (p=0.705) were not statistically significant. The duration required to achieve optimal endometrial thickness (p=0.212), and endometrial thickness measurement prior to vaginal progesterone commencement (p=0.335) were comparable. Conclusion: Oestrogel is a non-inferior option to oestradiol valerate for endometrial preparation in HRT FET cycles, especially for patients with high risk of venous thromboembolism due to its safety profile.
#162 : Effect of r-LH Supplementation in Controlled Ovarian Stimulation in Antagonist Protocol of IVF
Authors: Wijaya Liva , Shafira Nadia , Abidin Boy , Halim Ayang , Hasmoro Tri Bowo , Wiweko Budi 
Published: January 2024

Background and Aims: Adding LH to FSH can increase the mean of retrieved oocytes and cumulative embryos. LH stimulates the theca cells to secrete androgens, which are converted to estrogens during folliculogenesis. Women with long GnRH agonist downregulation, GnRH antagonist protocol, poor ovarian reserve, and patients with hypogonadotropic hypogonadism may have advantages in using exogenous LH. Here we show our experience using r-LH in our clinic concerning oocyte retrieval and maturity rates. Methods: We retrospectively took data from patients who underwent antagonist protocol from January 2021- January 2023 in Mbrio IVF Clinic Jakarta. Forty-three patients were stimulated by r-FSH (n=9) and a combination of r-FSH and r-LH (co-treatment) (n = 34) for 9-11 days and triggered by r-HCG or dual trigger (r-HCG and GnRHa). We statistically analyzed the retrieval rate, maturation rate, and OSI (ovarian sensitivity index) by independent-T and Mann-Whitney U tests. The level of significance was set at p < 0.05. Results: The mean age (33 vs. 35 yo), estrogen level, and trigger treatment were similar in both groups. The median AMH level in group r-FSH was higher than the co-treatment group (p 0.012; 4.44 vs. 1.75). The median retrieval and mean maturation rates were equivalent in both groups (100% vs. 90.9%; 78.5% vs. 80%). The OSI was higher in r-FSH than the second group but statistically insignificant. (p 0.20; 5.42 vs. 3.29). Conclusions: Adding LH to FSH in antagonist protocol gives both groups the same retrieval and maturity rate. Although they had comparable OSI, the AMH level in the co-treatment was lower than in the first group. The lower AMH level group gets advantages from the co-treatment in this data. We need larger data and complex analysis to validate the result.
#184 : Dual Triggers of Ovidrel and Buserelin Improves the Outcome of In Vitro Fertilization in Yasmin Fertility Clinic
Authors: Jovito Axel , Siregar Fahreza Akbar , Yulinda Dafi , Regan Louis , Wiweko Budi 
Published: January 2024

Introduction: Controlled ovarian stimulation (COS) is a technique used in in vitro fertilization (IVF) to stimulate multiple ovarian follicles at the same time before oocyte retrieval. “Dual triggering” for final oocyte maturation using a gonadotropin-releasing hormone agonist (GnRHa) and human chorionic gonadotropin (hCG) can improve clinical outcomes during in vitro fertilization. We thought that further investigation regarding the efficacy of dual triggers was warranted. In this study, we aim to investigate the outcome of dual triggering in IVF with a combination of a single dose of a GnRH agonist (Buserelin) and rhCG (Ovidrel). Methods: This retrospective study subjected 22 women who underwent IVF with dual triggers of Ovidrel and Buserelin in Yasmin IVF Center, Dr. Cipto Mangunkusumo General Hospital in Jakarta. Demographic data was gathered from paper-based patient treatment medical records. Result: Patients who received dual triggers therapy, the average oocyte obtained in the study sample was 11.83 in women under 35 years old (group 1) and 8.27 in women above 35 years old (group 2). The average of embryo day 3 was (7.29 vs 4.40). The average BMI in our study sample was (21.54 vs 24.60), the duration of infertility average was (6.14 vs 8). For the average blastocyst, fertilization rate, cleavage rate, and blastocyst rate consecutively (4.86 vs 3.07, 66.76 vs 66.18, 101.78 vs 87.83, 83.57 vs 73.90). We found the pregnancy rate was 34,28% (14,28% vs 20,0%) which we assessed based on a positive bHCG result and a P4 value after fresh embryo transfer. No cases of ovarian hyperstimulation syndrome were reported in either group. Conclusion: Dual triggering of Ovidrel and Buserelin may be a useful maturation treatment to maximize the outcome of mature oocytes in IVF patients. However, further investigation will be needed.
#245 : The Clinical Outcome of Different Embryo Transfer Strategies After Late Rescue ICSI Procedure
Authors: Yang Rui , Tian Tian , Zhu Xiaxuan , Li Rong , Liu Ping , Qiao Jie 
Published: January 2024

Background and Aims: To evaluate the safety profile and effectiveness of freeze-all blastocyst transfer when applied in the late rescue intracytoplasmic sperm injection (r-ICSI). All participants reproductive Centre of Peking University Third Hospital received treatment from 2009 to 2019 were included. A total of 2,270 patients met the inclusion criteria who encountered an unexpected total fertilization failure (TFF) during 149,054 cycles of in vitro fertilization (IVF) and adopted a late r-ICSI procedure. Methods: Patients were grouped according to the transfer strategies (926 women in Group 1 performing fresh embryo transfer (ET), 365 women in Group 2 performing freeze-all ET, 716 women in Group 3 experiencing a blastulation failure, and another 263 women without available D3 embryos). Different embryo transfer strategies after r-ICSI procedure. Main outcome measure(s) The live birth rate (LBR), cumulative live birth rate (cLBR), and conservative cLBR. Results: The TFF occurred in 7.4% of all IVF cycles. Group 1 tended to be older at oocyte retrieval [33.00 (30.00-37.00) vs. 31.00 (29.00-35.00), P<0.001], with longer infertile years [5.00 (3.00-8.00) vs. 3.00 (2.00-6.00), P<0.001], higher FSH levels [7.10 (5.71- 8.69) vs. 6.61 (5.25-7.95) mIU/mL, P<0.001], more gonadotropin consumption [2850.00 (1950.00-4125.00) vs. 2325.00 (1800.00-3150.00) IU, P<0.001], and oocytes retrieved were also fewer [10.00 (6.00-15.00) vs. 13.00 (9.00-19.00), P<0.001]. Group 2 has achieved considerably better clinical outcomes both in LBR of the first ET cycle (37.53 vs. 4.64%) and cLBR (52.60 vs. 8.21%). After adjustment for covariates using binary logistic regression analyses, Group 2 was still linked to better obstetric performances in calculations for LBR [OR: 11.77, 95% CI (8.42-16.45)], cLBR [OR: 11.29, 95% CI (7.84-16.27)] and conservative cLBR [OR: 2.55, 95% CI (1.83-3.55)]. Two groups had a similar miscarriage rate, and no newborns with malformations or congenital diseases were reported. Conclusions: Our study highlighted r-ICSI as a safe and effective alternative when frustrated couples came up against unexpected TFF. Freeze-all blastocyst stage ET serves as the optimal strategy for late rescue ICSI. However, regarding women with limited oocytes available for r-ICSI use, weighing the benefits against the cost might be prudent before implementing in vitro blastulation.
#72 : Embryo Quality and Pregnancy Outcome from Oocytes with Smooth Endoplasmic Reticulum (SER) Aggregates
Authors: Adelia Reski , Hardiani Fitri , Boediono Arief , Sini Ivan 
Published: January 2024

Background and Aims: Calcium stored and released by the Smooth Endoplasmic Reticulum - SER which has an important role in oocyte maturation, fertilization, and embryo development. The presence of SER aggregate result in the disturbance of calcium stores and its occillation which in turn affect fertilization, embryo develompent, and increasing risk of abnormal cromoseme outcome. Alpha-ESHRE Consensus (2011), strongly recomended to not perform insemination on any oocytes with SER. In the other hand, some previous studies show that healthy babies had been born from oocytes presenting this dymorphism. The aim of this study was to evaluate embryo quality and pregnancy outcome patients derived from oocytes with SER. Method: This study was a crosssectional analysis from 2017-2019 of 223 MII oocytes with SER from 82 women underwent Intra cytoplasmic sperm injection - ICSI. Prior to ICSI, each oocyte was evaluated for the presence of SER Aggregates. The embryological outcome measures were the fertilization rate, embryo quality day 3 and day 5, and pregnancy rates. Results: This study result shown that from 223 oocytes with SER, 89.5% oocytes can be fertilized. Day 3 embryo 66.6% ± 0.000 qualified as good embryo, but only 29.1% ± 0.000 on day 5 embryo. The Pregnancy rate was 30.0%, with 2 miscarriages. It is important to give a well information to the patients on the risk of birth malformations as well as whether a decreased chance of pregnancy exists. Conclusion: Oocyte with SER still has the ability to develop and has the potential to support pregnancy.
#79 : Triptorelin Triggered Cycles Improve Embryo Viability Compared to HCG Triggered Cycles
Authors: Lim Adelle Yun Xin , Zepeda Alexa , Hickman Cristina 
Published: January 2024

Background and Aims: Embryo quality is directly related to pregnancy rate as previously demonstrated by CHLOE-EQ. CHLOE-EQ Score is an automatic embryo viability score provided by CHLOE (Fairtility). It might provide key performance indicators (KPI) to measure how different protocols impact embryo quality. KPIs are objective measures for systematically monitoring and evaluating the IVF laboratory, a critical element of every IVF clinic Quality Management System. KPIs currently rely on definitions which are simple to assess (fertilisation, cleavage, blastulation), we do not routinely use other biomarkers to monitor operations. The aim of the study was to assess how trigger protocols influence CHLOE-EQ embryo viability score. Method: Retrospective comparative analysis with 1684 time-lapse videos collected between February-June 2022 in a single private clinic. Embryos were automatically assessed by CHLOE-EQ, an AI embryologist support tool. Assessment of trigger protocol, CHLOE-EQ Score and demographic bias was measured using t-test. Results: Embryos derived from cycles triggered with Triptorelin had better quality than those triggered with HCG (CHLOE EQ Score: 3.4±4.03, n=524 vs 3.02±3.85, n=1127, p=0.03). The difference could not be explained by age, PCOS, low ovarian reserve, fibroids, polyps. However, the type of trigger did not affect embryo utilisation [250/524 (47.70% vs 485/1127(43.03%), p>0.05]. CHLOE-EQ Score is predictive of utilisation (AUC=0.88, n=1677, baseline=45%, p<0.001), blastulation (AUC=0.90, n=1681, baseline=62.2%, p<0.001) and selection for transfer (AUC=0.92, n=1677, baseline=2.7%, p<0.001). Conclusion: Triptorelin triggered cycles improve embryo viability, as measured by CHLOE-EQ automatic score, compared to HCG triggered cycles. CHLOE-EQ provides monitoring of clinical practices to determine if protocols influence clinical outcomes and KPIs. CHLOE-KPI can provide KPI insights to detect and prevent non-conformances before they get a chance to affect clinical outcome. Early prevention of operational anomalies provides an opportunity to improve standards of care.
#172 : The Comparison of Intra-Cytoplasmic Sperm Injection (ICSI) Treatment Outcome for Patient Stimulated with Progestine-Primed Ovarian Stimulation (PPOS) and Gonadotrophin-Releasing Hormone Agonist (GnRHa) Long Protocol
Authors: Chee Fam May , Lee Su Xian , Tan Yien Tze , Tee Sze Tian 
Published: January 2024

Background and Aims: GnRHa long protocol is a traditional method with benefits such as synchronisation of follicular development, higher oocytes recovery, and improved endometrial thickness but it possesses higher fees with long injection timeline. However, PPOS is an ovarian stimulation protocol that can block the surge of luteinizing hormone (LH) through progesterone instead of the traditional method. This prospective randomized trial is to investigate whether PPOS can be as effective as GnRHa long protocol in ICSI treatment for patients. Method: A total of 55 patients with mean age 36.67 who underwent ICSI cycle in TMC Fertility Centre Ipoh, Malaysia from Jan 2015 to December 2022 was analysed between PPOS and GnRHa long protocol. The embryological and clinical outcomes were measured using statistical analysis T-test with a significant value at p<0.05. Patients above 42-years-old was excluded in this study. Results: Basic characteristics such as infertility duration, age, anti-mullerian hormone (AMH), antra-follicle count (AFC) and body mass index (BMI) were comparable in both groups. There was no significant difference found between PPOS and GnRHa long protocol in the number (mean± SD) oocytes retrieved [9.33±7.38 vs 8.55±7.44, p=0.352]; fertilized oocytes [5.79±4.92 vs 4.03±4.12, p=0.081]; number of blastocysts formed [4.35±2.82 vs 3.11±3.23, p=0.147] and utilized blastocysts [2.79±1.42 vs 2.35±2.66, p=0.300]. There was also no significant difference in clinical pregnancy rate (p=0.456) in both groups. No patient from either group experienced cycle cancellation due to the low number of oocytes expected. No ovarian hyperstimulation (OHSS) syndrome was reported from both groups as well. Conclusion: PPOS in combination with embryo cryopreservation as an ovarian stimulation regimen was as effective as GnRHa long protocol during controlled ovarian stimulation (COH) under different endocrinal mechanisms as it can achieve comparable embryological and clinical outcome. Hence, it can be an alternative treatment for infertile patients in ART in terms of cost and treatment timeline.
#319 : Blastocyst Formation Prediction Based on Deep Learning Model from 3-Day Embryo Images in Time-Lapse Incubator Using Data Augmentation
Authors: Lee Sangho , Choi Kyoung Hee , Hwang Sohyun , Kim Jihyang 
Published: January 2024

Background and Aims: Current literature suggests that blastocyst ET (Embryo Transfer) at day 5 improves pregnancy outcomes compared with cleavage ET at day 3. However, blastocyst ET poses potential challenges due to the risk of developmental arrest at the cleavage stage. Therefore, accurately predicting blastocyst formation in embryos will help determining optimal days for embryo culture. The aim of our study is to develop a deep learning-based classification model that can predict blastocyst formation based on 3-day embryo images captured from Time-Lapse incubators. Method: A total of 200 embryo images were collected at 72 hours after ICSI (Intracytoplasmic Sperm Injection), with 100 forming blastocysts and 100 failing to do so. The images were annotated by RectLabel for object detection and segmentation, and data augmentation techniques were applied to enhance the dataset. A pre-trained ResNet model was used as the basis for our classifier model, and optimization was performed using the Adam optimizer and BCEWithLogitsLoss as the loss function. Model performance was evaluated through classification accuracy and AUC score. Results: The CNN-based classifier models demonstrated a considerable accuracy of 87.5% and an AUC of 0.896 in predicting blastocyst formation, with sensitivity and specificity of 91.7% and 81.3%, respectively. It was found that without data augmentation, the model degraded to an accuracy of 62.5% and an AUC of 0.631. Conclusion: Our study competently developed a classification model for predicting blastocyst formation using 3-day embryo images from a Time-Lapse incubator and demonstrated the effectiveness of data augmentation techniques in limited data sets. This deep learning-based model may contribute as a beneficial tool in IVF (In Vitro Fertilization) process.
#180 : Exploring the Understanding and Attitudes of Infertile Couples: An Insightful Survey from Five Central Java Hospitals
Authors: Budihastuti Uki Retno , Laqif Abdurahman , Melinawati Eriana , Prakosa Teguh , Pangestu Mulyoto , Wijayanti Agung Sari , Dafhonsa Meycha , Chasanah Meriska Dewi , Putrinadia Aninditya Verinda 
Published: January 2024

Background and Aims: In Indonesia, infertility is not only a medical issue but also a significant social problem. Childlessness often carries a stigma of failure, victimizing couples. This research aims to enhance our understanding of the health-seeking behavior patterns of infertility patients and their access to infertility treatment in Indonesia. Additionally, we aim to examine the factors contributing to difficulties in accessing infertility clinics for couples and analyze the impact of education level, gender, and culture on these challenges. Method: This research employs a cross-sectional study design. An interviewer-administered survey was conducted with 250 male and female infertility patients recruited from five hospitals in Central Java between April and June 2023. Participants were self-selected, and the data were subjected to descriptive statistical analysis. Subjects were handpicked and not chosen randomly. Inclusion criteria: women and men aged 20-45 years, experiencing infertility problems for more than a year, willingness to be interviewed, actively seeking infertility treatment, capable of participating in interviews, and not currently undergoing an IVF program. Exclusion criteria: malignant disease, ongoing moderate IVF program, and pregnancy. Data analysis was performed using SPSS 25. Results: In the univariate analysis, a significant relationship was found between gender differences and access to infertility services in aspects of discrimination (p=0.006), culture (p=0.006), gender sensitivity (p=0.027), and understanding (p=0.013). However, the multivariate analysis significantly associated only discrimination (p=0.037; OR=4.33) and understanding (p=0.021; OR=5.63). This research is still ongoing. Conclusion: Female infertility patients experience more discrimination related to their infertility and possess a greater understanding of infertility and access to infertility services than male infertility patients. The infertility conditions cause women to face more discrimination than men, leading them to be more inclined to seek solutions, such as infertility services. In addition, an increased understanding of infertility makes women more likely to access infertility services.