bluuebunny/crossref_metadata_2025_split huggingface dataset:
#73 : Common Problems Faced by Indian Assisted Reproductive Technologies Laboratory Professionals
Authors: Leong William , Varghese Alex , Wang Rui , Catt Sally 
Published: January 2024

Background and Aims: There has been tremendous growth in the offering of Assisted Reproductive Technologies (ART) in India creating a critical shortage of experienced clinical embryologists thus inevitably leading reduced training opportunities. The aim of this study was to investigate problems faced by laboratory professionals in the ART industry in India. Method: An online questionnaire survey was distributed to ART laboratory professionals globally through professional societies, social media, and email databases. The questionnaire included demographic questions and open-ended questions on problems faced by ART laboratory professionals at the clinic level, professional level, and personal level. The survey was active from May 2016 until February 2017. The Indian data was collected and analysed as a global sub-population. The identified common problems were used to categorise the responses and the percentage distribution was calculated. Results: Among 136 survey responders, 79 provided responses on problems faced by ART laboratory professionals, including 11 junior embryologists, 19 embryologists, 31 senior embryologists, 18 managers and directors. The problems identified from the responses were ‘overworking’ (18%), ‘respect / recognition’ (16%), ‘clinician and embryologist relationship’ (14%), ‘management’ (12%), ‘lack of training’ (11%), ‘regulation / certification’ (7%), ‘blamed for clinical outcomes’ (7%), ‘decision making’ (6%), ‘salary’ (5%), ‘staffing’ (3%). When stratified into roles, the top problems for junior embryologists were ‘overworking’ (21%), ‘respect / recognition’ (21%), and ‘lack of training’ (21%), for embryologists was ‘overworking’ (21%), for senior embryologists was ‘respect / recognition’ (18%) and ‘management’ (18%), for managers and directors was ‘respect / recognition’ (21%). Conclusion: The problems faced in the Indian ART industry are broad but are prioritised differently by staff members depending on their roles. Future research should investigate reasons underlining these problems and strategies to improve staff wellbeing particularly considering the recently introduced government regulations on ART in India.
#88 : Correlation Between AMH Levels and Aneuploidy Rates in Patients Over 40 Years of Age: A Novel Finding
Authors: Alhelou Yousef , Hamdan Mukhri , Razali Nuguelis , Ali Jaffar 
Published: January 2024

Background and Aims: AMH is a crucial biomarker of ovarian reserve and predictor of ovarian response to stimulation. Ovarian reserve is inversely proportional to women’s age, consequently lower AMH levels are seen in older women particularly at [Formula: see text]40 yrs of age. A correlation between age and embryo aneuploidy was established but not with AMH level. We hypothesize that older women with good ovarian reserve produce less aneuploid embryos and produce the same blastocyst rate. Method: A retrospective study was undertaken involving 507 IVF cycles in patients aged [Formula: see text]40 years who had ICSI with PGT-A using NGS. The cycles were categorized into three main cohorts based on the patient’s AMH level: low (< 1.1 ng/mL), moderate (>1.1 to [Formula: see text] 3.0 ng/mL) and high (> 3.0 ng/mL). Each cohort was subdivided into 3 age sub-cohorts as follow: (40 to <42), (42 to <44), and (>44). Our primary outcome was aneuploidy rate whereas the secondary outcome was blastulation rate. Results: The results will be mentioned in sequence: low AMH, moderate AMH and, high AMH levels. In the [Formula: see text]40 to < 42 age group, the aneuploidy rates were 78.2%, 72.3% and, 67.2%, respectively (n = 232; p = 0.027). The blastulation rates were 53.8%, 47.7% and, 48.5% respectively (p> 0.05). In the [Formula: see text]42 and <44 age group, the aneuploidy rates were 89.2%, 83.2% and, 81.5% respectively (n = 136 p=0.039). The blastulation rates were 45.2%, 46.2% and, 43.8% respectively p> 0.05. In the [Formula: see text]44 age group, the aneuploidy rates were 93.9%, 91.2% and, 89.4% respectively (n = 139; p = 0.043). The blastulation rates were 41.2%, 39.2% and, 38.8% respectively (p>0.05). Conclusion: The aneuploidy rates rises when AMH levels decreases; whereas the blastulation rates was not associated with AMH levels in the population studied.
#89 : Higher Euploidy Rate in Embryos Generated by ICSI Using Sperm Obtained After Microfluidics Sperm Sorting (MFSS). A Randomised Controlled Trial
Authors: Alhelou Yousef , Hamdan Mukhri , Razali Nuguelis , Ali Jaffar 
Published: January 2024

Background and Aims: MFSS is a state-of-the-art technology that has the ability to sort a subpopulation of sperm cells with lower DNA fragmentation index (DFI), higher motility and higher normal forms without the need for centrifugation. Methods: A randomised controlled trial that included 925 couples that were planned for ICSI with day 5/6 biopsy, PGT-A with Next Generation Sequencing (NGS) and blastocyst vitrification. The embryo transfer was planned for future cycles. The inclusion criteria for women were age (18–45), BMI (18–30), AMH level more than 1.1 ng/ml, regular menstrual cycle and normal uterine ultrasound. Whereas the inclusion criteria for men were age (18–50), fresh semen sample with count more than 10 million/ml and total motility more than 30%. Semen samples were randomly assigned with 1:1 ratio to either preparation by routine density gradient (DG) or (MFSS). The primary outcome of the study is PGT-A aneuploidy results. The secondary outcome is the fertilisation rate, and blastocyst development rate. Results: The study was performed between January 2020 and July 2021. 463 semen samples were prepared with density gradient and 462 semen samples were sorted with microfluidic sperm sorting. All of the prepared semen samples were used for ICSI. The euploid embryo rate for the embryos resulted from density gradient preparation was 53.1% versus 59.3% for the embryos resulted from microfluidics sperm sorting (p=0.0034). The fertilisation rate was 77.9% for density gradient group versus 78.3% microfluidics group (p=0.063) and blastocyst rate was 51.6% for the density gradient group versus 59.2% for the microfluidics group (p=0.058). Conclusion: Semen samples prepared with MFSS for ICSI generated higher euploidy embryos following PGT-A with NGS.
#142 : “No Result” Embryos After PGTA: Should They Be Disposed?
Authors: Cam Van Nguyen Thi 
Published: January 2024

Background and Aims: Sometimes the preimplantation genetic testing for aneuploidy (PGTA) results return with “no result” (NR) even though the percentage of this type of result is quite small. Our desire was to rebiopsy these embryos and reanalysis, then determining whether it is efficient to perform reanalysis in “no result” embryos with different embryo qualities and evaluating the efficacy of rebiopsied blastocyst transfers. Materials and Methods: Performing trophectoderm rebiopsy for inconclusive blastocysts after PGTA test. The blastocysts would be transferred if the second analysis was eligible. Results: From September 2020 through December 2022, 2838 embryos were biopsied and tested for PGTA, 95 samples were returned as “no result”, accounting for 3.3%. There was no difference between the embryo quality grades in NR embryos (p>0.05), but the NR day 5 embryos was statistically higher than the group of day 6 embryos (85.3% vs 14.7%, p<0.05). The rate of ICM grade A was significantly higher than the rate of ICM grade C (42.1% vs 23.2%, p<0.05). However, TE grade B group was significantly higher than the group of TE grade A and TE group C. We performed re-biopsy and repeated PGTA test for 67 eligible embryos, 66/67 (98.5%) samples had results. The euploid rate after the second analysis was 46.3%. 16 euploid cases were transferred after the second analysis, the warming survival rate was 100% and the ongoing pregnancy rate was 56.3% (9/16) and there were 7 live births. The ongoing pregnancy rate in the group of good blastocyst grade (grade 1, 2) was higher than those in the group of poor blastocyst grade (grade 3) (44.4% vs 11.2%, respectively). Conclusions: Performing re-biopsy and repeat PGTA testing can reduce the risk of embryo wastage, increasing the chance of embryo transfer for patients indicated for PGTA. However, in cases of poor-quality embryo re-biopsy, the pregnancy rate after embryo transfer is very low even though the biopsy result is euploid. Therefore, it is necessary to weigh the benefits and risks of rebiopsy in cases where embryo quality is not eligible to optimize efficiency of time and cost for the patients.
#175 : Cohort Study of Post-Thawed Blastocyst Morphology is Associated with the Clinical Pregnancy of the Single Embryo Transfer Cycle
Authors: Sugianto Sally Kurnia , Alawiyyah Tuthi , Annas Jimmy Yannuar , Arifin Benediktus , Afdlal Szeifoul , Boediono Arief , Sini Ivan R 
Published: January 2024

Background and Aims: Frozen Embryo Transfer is the final step in undergoing IVF treatment. One of the important parts in the success of the FET cycle is the quality of the transferred embryos. The ability of blastocyst post-thawed recovery indicated embryo potential. However, there is limited understanding of the factors that influence recovery of post-thawed blastocyst embryos. This study aims to examine whether blastocyst morphology post-thawed correlates with clinical pregnancy rate. Method: In a retrospective cohort study, analysis data of Morula IVF Surabaya was conducted from January 2022 – February 2023, thawed blastocyst with a post-thaw cell survival rate of 50%–100% were observed for morphological characteristics prior to transfer. Then, recovery of blastocoel expansion was graded as A, fully expanded; B, re-expanded; and C, not expanded. Results: The primary outcome was the clinical pregnancy rate per cycle. In the 134 cycles reviewed, the clinical pregnancy rate (CPR) reached 5.5% of the not expanded; 29.4% of the re-expanded; and 56.92% of the full expanded blastocyst group (p<0.005). Conclusion: Post-thawed fully expanded blastocysts are associated with a higher clinical pregnancy rate. However, embryos with a poor morphology post-thawed still demonstrate a considerable probability of clinical pregnancy.
#253 : Administration of Umbilical Cord-Derived Mesenchymal Stem Cells Secretome to Sperm Preparation Medium: A Pilot Study
Authors: Margiana Ria , Lestari Silvia Werdhy , Wibowo Theresa Devi Siswani Tjandra , Saoemi Huriyah Adani , Supardi Supardi 
Published: January 2024

Background and Aims: As previously known, umbilical cord-derived mesenchymal stem cells (UC-MSCs) secretome has antioxidant potential that can reduce oxidative and nitrosative stress. This study is very important because understanding the effect of the UC-MSCs secretome on spermatozoa can assist in the development of sperm quality improvement techniques. This study aims to examine the sperm concentration and velocity before and after the addition of UC-MSCs secretome as a modification in sperm preparation with time duration and concentration variation. Method: A pilot study used a secretome produced at Dr. Cipto Mangunkusumo Hospital. Ejaculate samples were collected from married couples who already had children and the results of the semen analysis showed normozoospermia and DNA fragmentation index examination at a good level (15%). Sperm preparation was done using the Swim-up method. Samples were divided into 7 treatments with different ratios of secretions and ejaculate and washing medium (1:1 and 1:2) with incubation time durations (30, 45, and 60 minutes) to find optimal conditions to be used in further studies. The sperm concentration and velocity were observed before and after incubation. Results: Based on the results, it can be observed differences in sperm concentration and velocity from various incubation methods using UC-MSCs secretome. The 1:1 (v/v) secretome treatment had the highest spermatozoa concentration (68 million/mL), while the 1:2 (v/v) secretome treatment had the fastest spermatozoa velocity (30.51 μm/s), with the same incubation time of 45 minutes. The treatment group that was given UC-MSCs secretome 1:1 (60 minutes) and 1:2 (60 minutes) had slower spermatozoa velocity (22.91 μm/s and 21.45 μm/s, respectively) compared to the control group (26.39 μm/s). Conclusion: The administration of UC-MSCs secretome to the sperm preparation medium could increase the concentration and velocity of spermatozoa after incubation. However, this conclusion is provisional and needs further study to support this technique’s development.
#269 : Replacing Crude ICSI: Improving Poor Egg Reserve and Poor Responder Patient Outcomes by Replacing Conventional ICSI with Positive Rheotaxis Extended Drop (PRED-ICSI) Technique
Authors: Kandari Sayali , Kadam Kaushal 
Published: January 2024

Background and Aims: Positive rheotaxis extended drop (PRED) has been described by Martin et al, 2017 showing sperm with <1% DFI index. Our results on 25 embryonic failure patients presented in WebRepro 2021 PRED showed improved outcomes. (18% vs 45% Utilized blastocyst rate) vs Conventional-ICSI (C-ICSI) To evaluate effects in poor egg reserve we designed a prospective comparative pilot study of patients with low AMH or poor responder status evaluating PRED-ICSI vs C-ICSI Method: PRED-ICSI vs C-ICSI alternated every cycle of poor responder or poor egg quality for a period of 3 months from Jan 23[Formula: see text], 2023, to March 23[Formula: see text], 2023. Results: Age of male partner and female partner were higher in PRED-ICSI. The egg reserve and attempt number were similar. Semen parameters trended higher in conventional ICSI vs PRED ICSI group. PRED-ICSI had higher fertilization than C-ICSI (74% C-ICSI vs 80% PRED ICSI). Results trend higher in utilized blastocyst rate (47% C-ICSI vs 64% PRED ICSI). In the C-ICSI group 4 patients who had D3 frozen or with Embryo transfer had only grade b or lower embryos available vs No patients with grade b or lower embryos in the PRED-ICSI group. 3 patients had cycle cancellation due to no embryos in C-ICSI group vs 1 patients in PRED-ICSI group. Patients with grade AA/AB blastocysts were 7 out of 12 in Conventional ICSI group (50%) vs 8 out of 12 in PRED-ICSI (66.67%). Conclusion: This data furthers proof that PRED-ICSI can replace C-ICSI in patients with poor egg reserve or poor responder status. PRED-ICSI can effectively replace C-ICSI as a superior zero additional cost technique for selection of spermatozoa with an improved sperm chromatin pool vs Conventional ICSI which is a crude method of sperm selection.
#316 : Improved Time to Pregnancy When Combining an Artificial Intelligence Score and Morphology Grading for Embryo Selection During IVF
Authors: Storr Ashleigh , Diakiw Sonya , Hall Jonathan , Nguyen Tuc , Moreton Jarrod , Perugini Don , Perugini Michelle 
Published: January 2024

Background and Aims: Embryo selection is critical in determining IVF success yet continues to be challenging due to the subjectivity of morphology grading methods, especially when grading fair/average quality embryos. Improving embryo selection could optimise implantation rates and minimise financial/emotional burden on patients. Artificial Intelligence (AI) algorithms represent promising, non-invasive methods of standardising embryo grading and potentially increasing IVF success rates. This study assessed whether an AI algorithm (Life Whisperer Viability) for evaluating the likelihood of clinical pregnancy improves time to pregnancy (TTP) when compared to or combined with standard morphology grading. Method: 305 de-identified 2D images of day 5 blastocysts (121 fresh/184 frozen) with matched clinical pregnancy outcomes (fetal heartbeat at first scan) from women who underwent IVF treatment from 2020-2023 were retrospectively assessed. All images were taken prior to transfer/freezing. TTP was assessed using a simulated cohort ranking method, with TTP being defined as the average number of transfers needed to obtain a clinical pregnancy. Results: A positive linear correlation of LWV scores with pregnancy outcomes was observed (p<0.001). ROC-AUC results indicate that LWV is selecting embryos leading to pregnancy at least as well, if not better, than Gardner morphology grading (0.641 vs 0.624), with further improvement observed when LWV and Gardner grading were combined. The TTP analysis showed a 7.3% reduction in TTP when using LWV over Gardner grading. Combined use of LWV+Gardner grading reduced TTP by up to 10.8%, with the largest improvement (5.3%) seen in the frozen group, where there was a higher distribution of average quality embryos. Conclusion: LWV showed improved embryo rankingand reduction in the estimated average number oftransfers needed to achieveclinical pregnancy. Furthermore, evaluation of TTP supports the combined use of LWV+Gardner grading, showing that they work synergistically to further improve ranking performance when selecting average quality embryos.
#341 : Does Only the Stage Matters? Influence of a Blastocyst Scoring System on Clinical Pregnancy and Live Birth Outcomes with Fresh Set: A Concluding Study
Authors: Lim Cheryl , Chan Melinda , Phoon Jessie 
Published: January 2024

Background: Blastocyst culture with single embryo transfer (SET) is now routinely offered to our IVF patients at KK IVF. We have been using a simplified scoring system since 2016 in our routine assessment of blastocysts. Aims: This retrospective study aims to conclude our centre’s scoring system for fresh blastocyst for Day 5(D5) ET. Method: Data of 694 patients with fresh Intracytoplasmic Sperm Injection (ICSI) cycle and SET on D5 done between Jan 2018 and Dec 2020 were analysed. Only patients with 1[Formula: see text] cycle stimulation attempt and embryos cultured in single-step media under pre-mixed incubator conditions were included in this study. Rates of clinical pregnancy (CPR), multiple pregnancy (MPR), miscarriage (MISCR) and livebirth (LBR) were investigated. Data were classified into stage and grade of blastocyst transferred respectively as: Fully Expanded (FE), Early Expanded (EE), Early Blastocyst (EBL); A, B, C and Pseudo (P-; with at least 20% blastomeres excluded from the formation of blastocyst) and subjected to Chi-square test for significance, p<0.05. Blastocysts are scored in our centre first according to the stage of blastocyst development, followed by a grading assessment on the cohesion and cell number of the inner cellular mass (ICM) and trophectoderm cells (TE). The blastocyst grade equivalent by Gardner’s classification system of the ICM and TE is in parentheses - A=(AA), B=(AB, BA,BB) and C=(AC,CA,BC,CB). Blastocysts void of ICM are deemed non-transferrable. Results: CPR significantly different across stages of BL transferred (p = 0.00001). Transferring EBL is associated with a significantly higher MISCR (p=0.004). Multiple pregnancy was observed in groups with expanded blastocyst transferred only and MPR appears higher when top grade BL transferred (p=0.45). LBR is incremental with better quality BL transferred (p=0.000049). Conclusion: Stage of blastocyst development and a graded ICM at ET improve pregnancy and livebirth outcomes. Miscarriage risk is incremental with early blastocyst transferred. Suboptimal embryos remain transferrable as can still result in viable pregnancies and livebirths when there’s no better selection.
#353 : Microfluidic Preparation of Spermatozoa: A Potential Approach in Assisted Reproductive Technology
Authors: Ho Nguyet Minh , Do Thuy Huong , Ho Sy Hung , Nguyen Manh Ha 
Published: January 2024

Background and Aims: While density gradient centrifugation (DGC) is a conventional method in sperm preparation, this method can induce reactive oxygen species (ROS) which cause sperm dysfunction, sperm DNA damage, a recent advancement in sperm processing using microfluidic system is believed to reduce damage and to select the good quality sperm. The aim of this study was to evaluate the effectiveness of sperm preparation between DGC method and microfluidic system. Method: 30 semen samples were separated into 2 equal small samples, each sample was processed by DGC methods (control) and microfluidic (intervention) respectively. Pre- and post processing parameters was evaluated according to WHO-2010 and the DNA fragmentation index (DFI) was determined by flow cytometry technique. Results: The result showed that DFI values from the microfluidic preparation (0.67 ± 0.53%) was significantly lower than that of the DCG group (1.18 ± 13.73%). In particular, for semen samples with high DFI (>15%), the microfluidic system showed a noticeable reduction in DFI compared to the results from the DGC method. The progressive motile sperm recovery rate was higher in the intervention group (39.75 ± 19.20 vs 32.14 ± 18.14). Our data also showed that the vitality and mobility of sperm in the microfluidic group was higher than those of the DGC group (97.9 ± 2.21 vs 96.56 ± 4.11%, 96.36 ± 2.60 vs 95.06 ± 2.35%, respectively). However, there was no difference in sperm progressive motility and sperm morphology between two groups. Conclusions: There were significant improvement in sperm DFI and progressive motility in the microfluidic system. With this result, microfluidic system is a potential approach to reduce DNA fragmentation for ICSI procedures.
#24 : The Effect of the COVID-19 Pandemic on Levels of Stress, Anxiety, and Depression Among Infertile Couples. A Cross-Sectional Study
Authors: Chua Ai Chen , Hamdan Mukhri , Tan Albert Chao Chiet 
Published: January 2024

Background and Aims: Many infertile couples require assisted conception and success rate depends on patient’s age. Hence, time is a huge factor. Therefore, due to postponement of fertility services and fear of COVID-19 during the pandemic, we hypothesized that these couple would experience a heightened level of stress, anxiety and depression. Method: This cross-sectional study was done in the reproductive unit, University Malaya Medical Centre, Kuala Lumpur, between July 16, 2021, and December 17, 2021. 165 patients were included in the final analysis. Couples who were planned for fertility treatment were recruited and asked to answer an anonymous electronic survey that contained depression, anxiety, and stress scales (DASS-21). Results: From univariate analysis, stress was found to be significant in 20–30-year-old, Chinese patients, degree and postgraduate degree holders, patients with endometriosis, and those that have had infertility for 5 years. Anxiety was significant in 20–30-year-old, males, Chinese and Indian patients, diploma, degree, and postgraduate degree holders, and couples with infertility for at least 5 years and between 5–10 years. Depression was also prevalent among males, Chinese and Indian patients, degree holders, and patients with endometriosis. Multivariate logistic regression was subsequently performed, taking into account potential confounders in the prediction of clinically significant psychological distress. Mild 1.3E7 (2.2E6-8.0E7), p = 0.001 and moderate 2.7E7 (4.9E6-1.4E8), p = 0.001 stress levels were found to be significant among the 20–30-year-old age group. Other background variables, however, did not contribute significantly to the psychological distress. Conclusion: Disruption of fertility treatment during the COVID-19 pandemic was associated with a significant psychological impact on patients’ mental health, especially among the younger age group. Psychological assessment and counselling should be mandatory if there are prolonged unscheduled disruption in provision of fertility treatment to infertile couples.