bluuebunny/crossref_metadata_2025_split huggingface dataset:
#84 : Should Women Who Had Recurrent Miscarriage be Offered Karyotyping Analysis of the Product of Conception: A Survey of Patients’ View
Authors: Cheung Wing Ching , Chung Pui Wah Jacqueline 
Published: January 2024

Background and Aims: Recurrent miscarriage (RM) affects 2-3% of couples. Approximately 60% of miscarriages result from fetal aneuploidy. Current international guidelines do not recommend routine genetic analysis of product of conception (POC). Nevertheless, a national survey reported that 78% of women wanted to know the cause of their miscarriage. In addition, a majority of patients thought they had done something wrong, leading to miscarriages. The identification of the cause of their miscarriages may help to reduce their guilty feelings. This study aims to assess women’s views on the karyotyping of the POC to determine if the existing guideline should be amended. Method: Women who attended the Obstetrics and Gynecology outpatient clinic were recruited. They were asked to fill in a questionnaire consisting of 24 questions. Results: A total of 149 women were recruited. The desire to know the karyotype of POC, which was assessed by a 100 mm Visual analogue Scale, was 85.1 ± 24.3 (mean ± SD). 77.6% of women expressed that they wanted to perform karyotyping of POC even though they were informed that there was no apparent beneficial effect of genetic testing of POC on the prognosis. Nevertheless, only 10.7% of women were given the option to check the karyotype. More than one-third of women were willing to spend equal to or more than two thousand Hong Kong dollars on a karyotyping test, which is comparable to the current market price (Figure 1). Conclusion: Our findings suggested that women had a strong desire to know the karyotyping of POC even though they were well informed of the limitation of the karyotype test. To respect and empower our clients, physicians should consider offering the karyotype of POC.
#156 : Patient Decision Making and Trends in Embryo Disposal
Authors: Mitchell Nicole , Johnson Kerri , Zhang Shelley , Sorby Kelli 
Published: January 2024

Background and Aims: Embryo cryopreservation is common in IVF, allowing for surplus embryos to be utilised in subsequent cycles. As such, for a variety of reasons, patients may need to contend with embryo disposition decisions. This study looked at trends surrounding patient decisions to dispose of cryopreserved embryos. Method: A retrospective study was conducted on the consented embryo disposals of 230 patients between 2019 and 2023. Variables analysed included number of live births, number of embryos for disposal, embryo mosaicism, and reasons behind the decision to dispose of their embryos. The length of time between the date the consent was signed and the last IVF cycle, IVF live birth and initial contact with the clinic was also established. Results: A large proportion of patients (43.9%) did not specify why they chose to discard their embryos, however of those who did, there were three main categories (embryos reaching their expiry (27.9%), the return of mosaic PGT results (24.0%), and patients completing their family (22.5%). Of the 57 patients who chose to discard after being contacted regarding their embryo expiry, 19.3% initially chose to extend their storage before opting to discard. Surprisingly, only 62.2% of patients had at least one live birth prior to submitting their disposal consent, and waited, on average, 1.6 years from the date of their most recent live birth to discard. Furthermore, there was an average of 1.8 years between patients’ last IVF cycle and the decision to discard, with an average of 86.5 days elapsing from the point of initial contact with the clinic until the date the disposal consent was signed. Conclusion: Many patients retain their embryos in storage until their expiry, and this point of contact prompts them to make decisions regarding the disposition of their biomaterial, and the reasons behind discard decisions are not solely associated with achieving a live birth.
#174 : Preconception Risk Factors and Interventions to Prevent Adverse Maternal, Perinatal, and Child Health Outcomes
Authors: Padhani Zahra Ali , Avery Jodie , Tessema Gizachew , Damabi Negin Mirzaei , Lassi Zohra 
Published: January 2024

Background and Aims: Preconception period allows to explore and intervene how women’s health conditions and certain risk factors could affect the mother and newborn’s health, once she becomes pregnant. Limited studies have been conducted on adolescents and young adults, and relatively little is known about the factors underlying the continued increase in the adverse outcomes. Thus, we aimed to identify existing evidence on preconception risk factors and interventions to improve the health of adolescents, young adults, and their children. Method: We conducted a scoping review following the 2020 PRISMA guidelines by systemically populating the searches identified from online databases such as Medline, Embase, Cochrane Library etc. We included studies looking at preconception risk factors and interventions among adolescents and young adults and their impact on perinatal, maternal, and child outcomes. We included systematic and scoping reviews and overview of reviews published in the last 10 years. Two review authors independently evaluated and screened studies for eligibility and extracted data on Covidence software; followed by a descriptive and thematic analysis. Results: The study identified several preconception risk factors such as malnutrition, teen-pregnancy, substance abuse, violence, infections, poor oral health, and chronic diseases. Preconception risk factors contributed to high risk of preterm birth, pre-eclampsia, gestational diabetes, congenital malformation, and neural tube or congenital heart defect. Interventions such as women empowerment, psychological counselling, food fortification; integration of nutrition initiatives, nutritional supplementation, preconception management of epilepsy, and phenylketonuria, pre-pregnancy diabetic care have contributed to improving these outcomes. Conclusion: The findings of the study helped in identifying existing interventions and its impact on perinatal, maternal, and child outcomes. It highlighted the research gaps on preconception risk factors and interventions in different contexts and geographical settings. It suggests prioritisation of future research by development of strategies to improve preconception health at adolescence.
#309 : Menstrual Pain Related Endometriosis in Indonesia: Assessing Information Access Gap Through Social Media
Authors: Kusumaningtyas Intan , Kusuma Berli , Prasetyo Yohanes Danang , Sawarno Anto , Kusumaningtyas Tiara 
Published: January 2024

Background and Aims: In Indonesian culture, most of us forced by wrong believed that menstrual pain is something normal and not a sign of pathology. While most Indonesian women in the past have a little access to gain the right information about menstrual pain that contribute to the delay treatment. In this era of social media like Instagram. Some use for seeking medical information like menstrual pain related to endometriosis symptoms. This study aims to know the role of social media to give Indonesian woman an access to gain right information about menstrual pain as one of endometriosis symptoms in Bahasa. Method: We searched several Bahasa hashtags “nyerihaid” and “nyerimenstruasi” (menstrual pain), “nyeriendometriosis” (endometriosis pain), “endometriosisinindonesia” (endometriosis in Indonesia). Results: We found that “nyerihaid” as the most common symptoms of endometriosis resulting to the most uploaded posts (156.196 posts) and “nyerimenstruasi” (3487 posts). Most of the information were related to herbal and other products marketing information that claimed can reduce menstrual pain (80.45%) and recipes for herbal mixture (5.45%). The reliable information sources about menstrual pain from health practitioner only (14.14%). For “nyeriendometriosis” has only (15 posts) and all from reliable health practitioner sources (100%). For “endometriosisinindonesia” (1120 posts), we found reliable information sources from health practitioners and health facility (54.05%), that consist of personal account (37.84%) and business account (16.22%). We also found endometriosis community forum information (17.57%) and herbal product marketing information (28.37%). Conclusion: Our study shows social media as an effective platform to educate woman about menstrual pain related to endometriosis, considering the coverage of population in Indonesian geographical barrier. Yet this potency of social media for educating and empowering woman in Bahasa using common symptoms like menstrual pain from the reliable sources is still very limited.
#355 : “No One Asked Me If I’m Alright”: A Mixed Methods Study Exploring Information/Support Needs and Challenges Engaging Men Diagnosed with Male-Factor Infertility
Authors: Obst Kate , Oxlad Melissa , Turnbull Deborah , McPherson Nicole 
Published: January 2024

Background and Aims: Men desire to be actively involved in preconception care. However, health systems do not consistently or proactively engage men and there is little acknowledgement of their needs during this time. The lack of gender-specific service provision in infertility treatment likely contributes to men’s poorer mental wellbeing following infertility diagnosis and infertility treatment. This research sought to understand males’ psychosocial and support needs when diagnosed with male-factor infertility. Method: Mixed methods design, assessing men who had undergone diagnosis and/or treatment for male-factor infertility in past five years within Australia. Study comprised: 1) online survey (assessing psychological functioning, fertility knowledge, information sources, social support and perception of resources) and 2) semi-structured interviews to further explore participants’ lived experiences of male-factor infertility. Participants were recruited through Andrology clinics, social media, infertility support pages and ANZICA counsellors. Results: During their infertility journeys, participants mostly received information fertility doctors/nurses and the internet. However, their preferred method of informational knowledge would be through a verified male infertility website. Qualitative data were analysed by reflexive thematic analysis, which resulted in three key themes, each with two sub-themes, summarising pertinent aspects of men’s lived experiences when diagnosed with male-factor infertility (Figure 1). The majority of participants were in later stages of their fertility journey, indicating they felt more prepared to discuss their experiences given most (or all) of the initial-stage emotional and physical intensity of their diagnosis and active treatment had passed. Conclusion: There is a clear need for in/fertility services to implement proactive support approaches that engage directly with male patients and acknowledge the complexity of lived experiences when receiving a diagnosis of male-factor infertility.
#25 : The Prediction Value of EEVA in the Timelapse GERI Incubator for the Blastocyst Morphology
Authors: Dinh Hop Vu , Lien Huong Nguyen Thi , Mai Huong Tran , Manh Cuong An , Thuy Linh Nguyen Thị , Tu Anh Phi Thi 
Published: January 2024

Background and Aims: Time-lapse monitoring of embryo development may represent a superior way to culture and select embryos in vitro. The EEVA Test records the development of each embryo with a cell-tracking system and predicts the potential (High, Medium or Low) that an embryo will form a blastocyst based on automated detection and analysis of time-lapse imaging information of early cell division stage. The blastocyst grade will help clinicians in selecting the best embryos for transfer to increase pregnancy rates and reduce multiple pregnancies. The aim of this study is to determine the correlation between EEVA score and some blastocyst morphological parameters. Methods: Retrospective analysis study on 2522 embryos with indication for prolonging embryo culture to the blastocyst stage in time-lapse GERI incubator from January 2020 to June 2022. Results: Embryos with E1 and E2 score had significant higher morphological ratios of ICM A, ICM B, TE A, TE B, blastocoele expansion ratios of BL5,6 and lower morphological ratios of ICM D, TE D,compared with embryos having E3, E4, E5 score, p<0.01. Embryos with E3 score had significant higher morphological ratios of ICM A, ICM B, TE A, TE B, blastocoele expansion ratios of BL5,6 and lower morphological ratios of ICM D, TE D, compared with embryos having E4, E5 score, p<0.01. Conclusions: The blastocyst morphological parameters were associcated with the EEVA score. The rate of blastocyst with the ICM A, ICM B, TE A, TE B, BL 5,6 tended to decrease and the rate of blastocyst with ICM D; TE D tended to increase for embryos with low EEVA score. In other words, the good quality blastocyst rate tended to decrease, and the bad quality blastocyst rate tended to increase for embryos with low EEVA score.
#37 : Improved Pregnancy Prediction Performance in an Updated Deep-Learning-Based Embryo Selection Model: A Retrospective Independent Validation Study Using 3,960 Single Blastocyst Transfer Cycles
Authors: Ueno Satoshi , Okimura Tadashi , Kato Keiichi 
Published: January 2024

Background and Aims: Generally, the performance of deep learning models is improved by increasing the size of the training dataset. However, to the best of our knowledge, there has been no study on the effect of increasing training data on the performance of pregnancy prediction using the same deep-learning model. Method: A total of 3,960 blastocyst transfer cycles (1 patient, 1 cycle) were retrospectively analyzed. Embryos were stratified according to SART age groups. The quality and scoring of embryos were assessed by iDAScore v2.0 (iDA-V2; Vitrolife, Sweden), v1.0 (iDA-V1; Vitrolife, Sweden), and Gardner grading (GG). The discriminative performance of pregnancy prediction for each embryo scoring model was compared using the area under the curve (AUC) of the receiver operating characteristic curve for each maternal age group. Results: In the AUCs of the < 35 years age group (n = 757) for pregnancy prediction, the AUC of iDAV2 was significantly higher than that of GG (0.718 vs. 0.694, p = 0.015). For the 35-37 years age group (n = 821), the AUC of iDA-V2 was significantly higher than that of iDA-V1 (0.712 vs. 0.696, p = 0.035). In the AUCs of the 41–42 years age group (n = 715), the AUC of iDA-V2 was significantly different from that of GG (0.745 vs. 0.696, P = 0.007). In the > 42 years age group (n = 660) and 38–40 years age group (n = 1,007), there were no significant difference among the groups. Conclusion: The present study suggests that the performance of deep learning models for pregnancy prediction will be improved by increasing the size of the training data. Therefore, in a deep-learning model for pregnancy prediction, continuously collecting training data is an important step for improving the performance of updated AI models.
#38 : Maternal Age Affects Morula Compaction and Cell Polarity of Human Embryos
Authors: Ezoe Kenji , Miki Tetsuya , Kato Keiichi 
Published: January 2024

Background and Aims: With the exception of chromosome segregation errors, the molecular and biochemical mechanisms responsible for advanced maternal age (AMA)-related reduced embryo developmental competence remain unclear. In women of AMA, the blastocyst formation rate has been reported to decline due to an increase in embryo arrest at the morula stage. Therefore, we aimed to reveal the impact of AMA on cellular events during compaction, as assessed using morphokinetic analysis. We also assessed the possible influence of AMA on the expression of cell polarity markers, yes-associated protein (YAP) and protein kinase C-[Formula: see text] (PKC[Formula: see text]), during blastomere compaction. Method: We retrospectively analysed 2,058 fertilized oocytes, which were stratified by maternal age according to the Society for Assisted Reproductive Technology classification (< 35, 35-37, 38–40, 41–42, and > 42 years). The effects of AMA were assessed in relation to embryo morphokinetics and morphological alterations. Furthermore, 20 voluntarily donated human embryos were used for immunofluorescence staining of YAP and PKC-[Formula: see text]. Results: Delayed embryonic compaction and an increased number of extruded blastomeres post compaction were observed in the > 42-year group. The time interval from the eight-cell stage to compaction initiation was prolonged with increasing age. The number of YAP-positive cells in the outer cells of the morulae was significantly higher in the young age group than in the AMA groups. The PKC[Formula: see text] fluorescence intensity in the cortical region of the morulae was significantly lower in the AMA groups than in the young age groups. Conclusion: Delayed compaction and blastomere extrusion occur more frequently in embryos from women of AMA due to insufficient regulation of cell polarity, which may lead to morula arrest. Further research is required to reveal the impacts of AMA on the mechanism underlying the expression of cell polarity factors and develop methods to avoid AMA-associated morula arrest.
#63 : Clinical Prognosis of Human Blastocysts Showing Spontaneous Collapsing: A Systematic Review and Meta-Analysis
Authors: Bickendorf Kate , Qi Fang , Peirce Kelli , Natalwala Jay , Chapple Vincent , Liu Yanhe 
Published: January 2024

Background and Aims: Spontaneous collapsing (SC) is a relatively new viability biomarker of human blastocysts which is only detectable via time-lapse videography. However, the prognosis of affected blastocysts remains poorly understood, with systematic review and meta-analysis absent from literature. This study is the first to comprehensively evaluate the clinical prognosis of SC blastocysts, including ploidy status, pregnancy, live birth and miscarriage rates. Method: Systematic review and meta-analysis were performed according to PRISMA, with protocol registered with PROSPERO (CRD42022373749). Studies were searched for in PUBMED, EMBASE and the Cochrane Library on 10 October 2022, using key words relevant to “blastocyst collapse” and “Time-Lapse Imaging”. Data were summarised by risk ratios (RRs) and their 95% confidence intervals (CIs). All meta-analyses were performed with fixed-effect models using RevMan 5.4 Results: A total of 7 retrospective cohort studies were eventually included from 196 records identified through the initial search. The incidence of SC was 37.0% (2516/6801) amongst 7 studies (ranging from 17.4% to 56.2%). SC was associated with significantly lower clinical pregnancy rate (2 studies, n=736; RR=0.77, 95% CI=0.65-0.91; [Formula: see text]2=30%), ongoing pregnancy rate (4 studies, n=2147; RR=0.73, 95%CI=0.64-0.82; [Formula: see text]2=0%), live birth rate (2 studies, n=816; RR=0.78, 95%CI=0.65-0.94; [Formula: see text]2=56%), and reduced euploidy rate (3 studies, n=3569; RR=0.71, 95% CI=0.66-0.78; [Formula: see text]2 =69%). However, miscarriage rate was not significantly different between blastocysts with or without SC (4 studies, n=1358; RR=1.28, 95%CI=0.93-1.76; [Formula: see text]2=0%). Significant heterogeneity was detected between the studies included for evaluation of live birth rates ([Formula: see text]2=56%, P=0.13) and ploidy rates ([Formula: see text]2=69%, P=0.04). Further subgroup analysis according to (a) different definition of SC, (b) collapse occasions, and (c) whether the transferred blastocyst had been genetically tested; showed unchanged trends. Conclusion: Our results indicate strong negative implications following SC in human blastocysts. SC should be a recognised criterion for the deselection of blastocysts for intrauterine transfer.
#66 : Degree of Re-Expansion of Biopsied Blastocysts at Vitrification Affects the Developmental Competence of Blastocyst After Trophectoderm Biopsy
Authors: Miki Tetsuya , Ezoe Kenji , Aruga Mariko , Narisawa Mika , Okimura Tadashi , Kato Keiichi 
Published: January 2024

Background and Aims: In recent years, preimplantation genetic testing (PGT) has frequently involved a trophectoderm (TE) biopsy at the blastocyst stage, followed by vitrification. However, the factors influencing the viability of biopsied blastocysts after warming are unknown. Thus, these factors should be determined before developing the vitrification protocol following TE biopsy. The present study aimed to analyze the association between the time intervals between biopsy and vitrification, morphological characteristics after the biopsy, and blastocyst outgrowth. Methods: In this study, we used discarded vitrified blastocysts donated for research by consenting couples. To observe the morphological changes, TE biopsies were performed and cultured in a time-lapse incubator. Based on the degree of re-expansion at vitrification, the blastocysts were classified into four groups: 0%, 1-49%, 50–99%, and ≥100%. The blastocysts were vitrified after 0–3 h of TE biopsy. The warmed blastocysts were cultured on fibronectin-treated dishes for 96 h to examine the competence of the outgrowth. Results: The outgrowth area was significantly less extensive in the blastocysts that were vitrified 2 h following the biopsy. The proportion of 50–99% of re-expansion was significantly higher in the blastocysts after 2 h of biopsy. Multivariate linear regression analysis showed that the blastocyst outgrowth area was substantially smaller when the degree of re-expansion was 50–99%. Conclusions: Vitrification of blastocysts in the late stages of re-expansion following TE biopsy impairs the developmental competence of the blastocyst. Therefore, while vitrifying blastocysts after TE biopsy, we should consider the time intervals after the biopsy as well as the progression of re-expansion.
#69 : Decline in Mitochondrial Function of Human Embryo with Maternal Aging
Authors: Hashimoto Shu , Morimoto Yoshiharu 
Published: January 2024

Background and Aims: Female fertility declines with age, due to increased chromosomal aneuploidy and possible reduced mitochondrial function in the embryo. Method: We outlined how mitochondrial function in human embryos, as predicted from oxygen consumption rate (OCR) measurements, changes in pre-implantation stage, and what factors, particularly maternal age, affect mitochondrial function in embryos. Results: The structure of the mitochondrial inner membrane and its respiratory function developed with embryo development, while the copy number of mitochondrial DNA per specimen was transiently reduced compared to that of the oocyte. The undifferentiated state of the inner cell mass cells appears to be associated with a low OCR. In contrast, the copy number of mitochondrial DNA increased in trophoblast cells and mitochondrial aerobic metabolism increased. The OCRs at morulae stage decreased with maternal age, but there was no relationship between maternal age and the copy number of mitochondrial DNA at any stages. The higher oxygen spent at the morula stage; the shorter time was needed for development to the mid-stage blastocyst. Conclusion: The mitochondrial respiratory function of human embryos developed along with embryonic growth. Mitochondrial function at morula stage declined with their maternal age and reduced mitochondrial function decreased the rate of development from morula to blastocyst.