bluuebunny/crossref_metadata_2025_split huggingface dataset:
#86 : Use of Triptorelin Versus Human Chorionic Gonadotropin as Ovulation Trigger
Authors: Ng Karen , Chung Pui Wah Jacqueline , Cheung Lai Ping 
Published: January 2024

Background and Aims: Gonadotropin releasing hormone agonist (GnRH-a) trigger has been shown to be associated with significantly lower risk of moderate or severe ovarian hyperstimulation syndrome (OHSS) when compared among women at high risk of OHSS. However, trigger failure has been shown to occur in 2% of cycles using GnRH-a as trigger. This study aims to review the use of GnRH-a as ovulation trigger. Method: Retrospective review of records in antagonist cycles from an ART unit in a tertiary hospital from 2017-2021 was performed. Follicles were considered mature when they reach [Formula: see text] 15 mm. Ovulation triggered with urinary human chorionic gonadotropin (uhCG) (5000-10000 IU), recombinant hCG (rhCG) 250 mcg, or triptorelin 0.2 mg when there were [Formula: see text] 3 mature follicles. All embryos obtained from cycles using triptorelin were cryopreserved. Outcome including the number of oocytes retrieved, the follicle to oocyte index, ovarian hyperstimulation syndrome were reviewed. Results: 1378 cycles were included. 1089 cycles had uhCG or rhCG as trigger, while 284 cycles had triptorelin as trigger. Women in the triptorelin group were significantly younger with a lower basal follicle stimulating hormone level and a higher antral follicle count (Table 1). In the triptorelin group, the total number of mature sized follicles, estrogen level at trigger, oocytes retrieved, number of blastocysts were significantly higher compared to the hCG group (Table 2). Follicle to oocyte index was significantly higher in the triptorelin group but the proportion of mature oocytes were similar in both groups. There were no cases of trigger failure and OHSS in the triptorelin group, but 30 cases of OHSS, with18 cases early onset, 12 cases late onset, amongst them 10 cases (1%) were severe OHSS) in the hCG group. Conclusion: GnRH-a trigger is a good candidate as ovulatory trigger in women at risk of OHSS without hampering the laboratory outcome.
#93 : Analysis of 126 Uterine Adenomyosis Patients in 360 Cycles of Art Treatment Over 12 Years and Future Prospects
Authors: Tanaka Atsushi , Nakajima Daisuke , Nagayoshi Motoi , Izumi Tanaka Phar.B. , Yamaguchi Takashi 
Published: January 2024

Background and Aims: Adenomyosis has low clinical outcomes and is common among older patients. There are three types of treatment, drug administration and surgery to eliminate or alleviate symptoms, and assisted reproductive technology (ART) to achieve pregnancy. However, there are no uniform selection criteria or priorities. We report the clinical outcome of treatments of uterine adenomyosis in 360 cycles following ART over 12 years and propose future treatment of the condition. Method: We retrospectively analyzed the clinical pregnancy, live birth, and miscarriage rates of 126 patients with uterine adenomyosis (Ut-Ad) who received ART at our hospital and compared them with non-Ut-Ad individuals as controls. Results: There were no significant differences in the fertilization rate [70.3%(1316/1872), 69.8%(15570/22309)], cleavage rate [68.9%(1289/1872), 68.5%(15274/22309)] and blastocyst formation rate [42.6%(560/1316), 43.0%(6693/15570)] between the two groups. Ut-Ad group showed significantly lower clinical pregnancy rate, live birth rate and higher miscarriage rate than. Conclusion: The main factors of lower clinical outcome of ART of Ut-Ad were not clear. Kinetic alteration of uterine wall seems to be caused by ectopic endometrial tissues invasion.
#133 : Hysteroscopy Guided Embryo Transfer, a Newer Approach for Difficult Embryo Transfer
Authors: Singh Pratibha 
Published: January 2024

Background: Embryo transfer (ET) is a crucial step in IVF process. Therefore, difficult ET can significantly impact the odds of implantation. We propose that hysteroscopy guided ET might be a feasible alternative to conventional ultrasound guided ET in such cases. Case Report: This is the case of a 27-year-old woman with six years of primary infertility with severe dysmenorrhoea and menorrhagia. TVS showed a bulky adenomyotic uterus with multiple fibroids primarily in the posterior wall distorting the endometrial cavity and bilateral huge endometriomas. She underwent laparoscopic adenomyomectomy, myomectomy and bilateral Tubo-ovarian mass removal. Subsequently, she underwent IVF with donor eggs after 5 months therapy with long-acting GnRH agonist. Mock ET was attempted but was unsuccessful due to acute anterior flexion of the cervix. So, she was planned for ET under general anaesthesia, but the ET catheter could not be negotiated through the internal os. A 30∘ 3 mm hysteroscope was then inserted through the cervical canal using saline as distension media. Additionally, a small polyp was noted at the internal os blocking the entry of ET catheter. Once the endocervical canal was distended the catheter was negotiated from the side of hysteroscope into the cervical canal and it passed through the internal os easily under direct vision of hysteroscope. The hysteroscope was then withdrawn holding the catheter at its place. Complete evacuation of saline from endometrial cavity was confirmed by trans abdominal USG and a double ET was done under USG guidance. The routine post ET medication protocol was followed. Her Serum [Formula: see text]-hCG result was positive and after an uneventful pregnancy, she delivered healthy twin babies at 35 weeks. Conclusion: The introduction of hysteroscopy guided ET may be a suitable alternative in cases of difficult ET.
#186 : Ultra-Long Protocol During IVF Outcome in Infertile Women with Endometriosis
Authors: Yulinda Dafi , Regan Louis , Siregar Fahreza Akbar , Jovito Axel , Wiweko Budi 
Published: January 2024

Background and Aim: Endometriosis issue with infertility may require ART and long-term GnRH agonist therapy prior to frozen embryo transfer was associated with a greater rate of clinical pregnancy. The aim of the study is to assess pregnancy outcomes in endometriosis patients who have received GnRH-a ultra-long protocol prior to IVF. Method: A retrospective cohort study was conducted at the Yasmin IVF Center, Dr. Cipto Mangunkusumo General Hospital in Jakarta. The study included all Patients diagnosed with endometriosis and underwent IVF procedure with GnRH-a ultra-long protocol was used for ovarian stimulation from July 2021 to January 2023. Parameters observed were maternal age, body mass index, oocytes retrieved, fertilization rate, blastocyst rate, and pregnancy rate. Result: There were 12 patients who underwent IVF and received ovarian stimulation with ultra long protocol. The average oocyte retrieved in this study was 12 ± 5,3 with the average fertilization rate was 66,2 ± 18,2. We found a pregnancy rate was 58,3% and total live born child was 3 out of 7 patients (42,8%). We assessed based on the presence of intrauterine gestational sac with fetal heartbeat at ultrasound examination. Conclusion: Ultra long protocol for stimulations in patients with endometriosis have a chance to improve oocytes retrieval, fertilization rate, and pregnancy rate.
#188 : Platelet-Rich Plasma in Patients with In-Vitro Fertilization
Authors: Regan Louis , Yulinda Dafi , Jovito Axel , Siregar Fahreza Akbar , Wiweko Budi 
Published: January 2024

Background and Aims: Successful embryo implantation requires the presence of a receptive endometrium, and unsuccessful implantation frequently results from a thin endometrial wall. A new approach of treating thin endometrium, platelet-rich plasma (PRP), has been shown to increase endometrial thickness, vascularity, and implantation rate. The aim of this study is to assess PRP’s efficacy as a treatment for infertile women undergoing in vitro fertilization and its benefit for ART. Method: This retrospective study data was implemented by collecting 26 infertile women who were sent to the Yasmin IVF Center at the Dr. Cipto Mangunkusumo General Hospital in Jakarta and had a history of unsuccessful implantation. Results: There were 26 patients who underwent IVF and received PRP infusion prior to FET. The clinical pregnancy rate in this study was 87,5% for women <35 years old and 47% for women >35 years old. The clinical pregnancy rate was determined by dividing the number of fetal poles with a heartbeat seen on the 6-week-old ultrasound by the overall number of transplanted embryos. Conclusions: Autologous PRP injections have shown a highly effective treatment for RIF and refractory thin endometrium.
#200 : The Impact of Serum Progesterone(P4) Level on the Day of Embryo Transfer on Art Outcome
Authors: Murdia Kshitiz , Bhoi Nihar , Chandra Vipin 
Published: January 2024

Background and Aims: Physiologically serum progesterone level fluctuates among different stages of pregnancy. The serum level and tissue level of P4 are poorly correlated and also affected by the route of administration, thus creating a challenge for monitoring. Our goal was to determine whether P4 levels on the day of embryo transfer predict pregnancy outcomes in artificial FET cycles. Method: This was a prospective cohort study conducted from Feb 2022 to Dec 2022. Around 337 patients who underwent IVF/ICSI, irrespective of single or double frozen embryo transfer in an HRT cycle, were analyzed. Results: The participant’s mean age was 32.29±4.50 years with a BMI of 24.68±3.82 kg/m2, single embryo transfer vs double embryo transfer was 64(19.0%) vs 273(81.0%) and Serum P4 on day of ET was 28.66±12.51. Pearson’s correlation showed that serum P4 was negatively correlated with BMI (r: -0.131; P = 0.017). The serum P4 grouping was done as per the quartile distribution: Q1: <21.4 ng/ml; Q2: 21.4-27.1 ng/ml; Q3: 27.2-38.1 ng/ml; Q4: [Formula: see text]38.2 ng/ml. Clinical Pregnancy Rate (CPR), 60.7%(Q1); 68.4%(Q2); 64.5%(Q3); 73.8%(Q4); p=0.312) was not significantly different between a female with serum P4 within different quartiles. Miscarriage rates (2.0%, 1.9%, 3.3%, 1.6%; p=0.935) & Ongoing Pregnancy Rates were (48.3%, 56.6%, 44.3%, and 65.2%, respectively, in each quartile. Conclusion: The serum level of Progesterone on the day of embryo transfer while using intramuscular formulation in an artificial cycle had no significant impact on the clinical pregnancy rate.
#203 : Amazing Low-Cost IVF/ICSI Induction Protocols in Developing Countries
Authors: Ahmed Sajida Shahnawaz 
Published: January 2024

Background and Aims: Basically, main cost of IVF is expensive use of gonadotrophins along with agonist or antagonist which are aimed mainly to avoid premature LH surge. Since LH surge is preceded by estrogen surge and inflammatory reaction, so all theory behind is avoiding estrogen surge by continuous aromatase inhibitors and continues use of anti-inflammatory drugs to avoid inflammatory reaction preceded by ovulation. By this expensive use of agonist and antagonist are completely avoided and at the same time dose of gonadotrophins is minimised. Method: RCT study conducted on 140 patients from 2011 to 2013. Serial follicular monitoring was done by ultrasonography till the day of LH surge. 140 patients were divided into two groups. The agonist group underwent long GnRH analogue protocol. Other groups received aromatase inhibitors with gonadotrophins & anti-inflammatory agent. Results: In group 1: In 20 patients (10-14) M2 oocytes retrieved with 4-6 embryos at blastocyst stage. 6 patients conceived. 5 ended in full term. In 40 patients (6-9) M2 oocytes retrieved with 3-5 embryos at blastocyst stage, 8 patients conceived, 6 ended in full term. In 10 patients (2-6) M2 oocytes retrieved with 0-3 embryos at blastocyst stage. 2 patients conceived & ended in full term. In group 2: In 30 patients (6-8) M2 oocytes retrieved with 2-4 embryos at blastocyst stage. 7 patients conceived. 6 ended in full term. In 40 patients (3-6) M2 oocytes retrieved with 1-4 embryos at blastocyst stage. 9 patients conceived. 7 ended in full term. Conclusion: Significant differences in gonadotrophins usage in both groups leading to marked economical saving for poor patients. According to results although mean number of oocytes retrieved were higher in group 1, but clinical pregnancy rate remained similar. Limitations are there regarding sample size & random selection of patients.
#290 : Does Extending the Time Interval Between hCG Trigger and Oocyte Retrieval from 36 to 37 Hours Affect the Rate of Euploid Blastocysts?
Authors: Barber Elad , Lantsberg Daniel , Mizrachi Yossi , Kelley Rebecca , Gurner Kathryn , Stock-Myer Sharyn , Gardner David 
Published: January 2024

Background and Aims: Data are lacking regarding the optimal time interval between human chorionic gonadotropin (hCG) administration and ovum pick-up (hCG-OPU interval), and its impact on blastocyst euploidy. Our aim was to compare the blastocyst euploidy rate between IVF cycles with hCG-OPU interval of 36 and 37 h. Method: In this historic cohort study, we reviewed all hCG-triggered, PGT-A, IVF cycles performed in a single clinic, between 2018 and 2022. Commencing in September 2021, clinicians gradually changed the hCG-OPU interval from 37 to 36 h. We compared the outcomes of cycles with hCG-OPU interval of 36 h (35.5-36.5) to 37 h (36.6-37.5). The primary outcome was the number of euploid embryos. Cycles with oocyte donation, and cycles utilized GnRH-agonist triggers or dual-triggers were excluded. Results: The euploidy rates were similar between the 36-h group (n=2,584) and 37 h group (n=5,575; 39.7% vs. 38.8%, respectively, p=0.42). Compared to the 36-h group, patients in the 37-h group were characterized by higher numbers of total oocytes collected (15.9±8.9 vs. 17.3±9.8, respectively, p<0.001), mature (MII) oocytes (8.3±8.2 vs. 9.6±9.6, respectively, p<0.001) and 2PN embryos (9.8±5.5 vs. 10.3±6.4, respectively, p<0.001). On multivariate logistic regression analysis, the hCG-OPU interval was not associated with euploidy (aOR 0.91, 95% CI 0.82-1.01), after controlling for female and male ages, female BMI, and number of oocytes collected. Conclusion: hCG-OPU intervals of 36 and 37 h resulted in similar blastocyst euploidy rates in IVF cycles. This finding has the potential to aid the decision-making processes when managing IVF procedures. The 37-h group was characterized by a lower female age and higher doses of gonadotropins and consequentially more eggs collected, mature eggs and 2PN embryos compared to the patients of the 36 h group. Nonetheless, the two groups had comparable rates of euploid embryos reinforcing our primary finding. Data are presented as mean ± standard deviation or n (%); hCG- Human chorionic gonadotropin; OPU- ovum pickup; BMI- BMI kg/m2, Gonadotropins- in IU; ICSI- Intra cytoplasmic sperm injection. Data are presented as mean ± standard deviation or n (%); hCG- Human chorionic gonadotropin; OPU- ovum pickup; 2PN- 2 Pronuclei.
#311 : Intrauterine Administration of Human Chorionic Gonadotropin in Women Undergoing IVF– An Individual Participant Data Meta-Analysis
Authors: Zou Haowen , Abdallah Karim , Wirleitner Barbara , Hong Kathleen , Thanaboonyawat Isarin , Laokirkkiat Pitak , Arabipoor Arezoo , Badehnoosh Bita , Kokeguchi Shojo , Makhlouf Ahmed , Gadalla Moustafa , Showell Marian , Li Wentao , Mol Ben , Wang Rui 
Published: January 2024

Background and Aims: Human chorionic gonadotropin (hCG) has been proposed as an intrauterine intervention around embryo transfer period due to its potential to enhance endometrium receptivity and implantation. Existing randomised controlled trials (RCTs) showed inconsistent findings and multiple meta-analyses on this topic showed high unexplained heterogeneity. Individual participant data meta-analysis (IPDMA) is considered the “gold standard” synthesis method due to its ability to standardise and harmonise the data reporting and analysis. In this IPDMA, we aimed to investigate the effectiveness and safety of intrauterine hCG before embryo transfer. Method: We searched Cochrane Gynaecology and Fertility Group Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase and PsycINFO without language restrictions up to November 2022. We included RCTs comparing intrauterine administration of hCG before embryo transfer versus placebo or no intervention in women undergoing IVF. The outcomes were live birth, clinical pregnancy and other fertility outcomes. We invited trial authors to share the de-identified IPD and established the IHABT collaboration. We performed a one-stage IPDMA as the main analysis. Results: Eight RCTs including IPD of 2338 participants were included. These RCTs were conducted in 6 different countries, with a dosage of intrauterine hCG between 500 IU and 1000 IU. In women undergoing IVF, compared to the control group, intrauterine administration of hCG before embryo transfer does not improve live birth rates (7 RCTs, 2245 participants, odds ratio [OR] 0.98, 95% confidence interval [CI] 0.82–1.17) or clinical pregnancy rates (8 RCTs, 2338 participants, OR 1.13, 95%CI 0.89–1.43). There was insufficient evidence of a difference between the two groups on any of the other fertility outcomes. Conclusion: Intrauterine administration of hCG does not improve live birth or clinical pregnancy rates in women undergoing IVF. Therefore, it should not be offered as an IVF add-on in clinical practice.
#384 : Effectiveness of Progesterone Monitoring and Rescue Protocol in Frozen Embryo Transfer Cycle
Authors: Nguyen Chien , Nguyen Ly , Nguyen Xuyen 
Published: January 2024

Background and aim: Hormonal monitoring impact on overall pregnancy rate in frozen embryo transfer (FET) cycles and hence progesterone supplement adjustments remain debatable in current literature. This study aims to investigate the effect of monitoring and follow-up of serum progesterone level on the day of FET, and progesterone supplement adjustments effects on pregnancy outcomes for FET in programmed hormonal replacement therapy cycles. Methods: In this study, all patients who were scheduled for FET had their progesterone (P4) and estradiol (E2) level assessed in the morning of FEM and if their P4 level was less than 10 ng/ml, intramuscular progesterone was given for 7-10 days since the day of FET to rescue the cycle. Results: In 2022, in Vinmec IVF center, there were in total 659 FET cycles, all was single blastocyst transfer and applied the mention protocol to rescue the cycle in case P4 level was less than 10 ng/ml. The chemical (62,87% vs 59.94%), clinical (56,68% vs 54,83%) and ongoing pregnancy rate (46,25% vs 45,17%) were comparable between the two group (with and without parenteral progesterone), P<0,05. Conclusions: Monitor P4 level on the day of FET and use parenteral progesterone in case P4 level is less than 10 ng/ml could be an effective method to rescue the cycle and improve the outcome. Further studies are needed to draw a better conclusion and recommendation in this aspect.
#388 : Clinical Outcomes of Modified Natural Cycle Versus Hormone Replacement Therapy for Endometrial Preparation for Frozen Embryo Transfer
Authors: Pham My Thi , My Hanh Pham Thi , Thi My Pham , Sy Hung Ho , Thu Hien Le Thi 
Published: January 2024

Background and Aims: Frozen embryo transfer is a current trend in practice worldwide. Modified Natural Cycle, Hormone Replacement Therapy are common endometrial preparation protocols in Vietnam. The aim of this study was to compare the outcomes of a Modified Natural Cycle vs Hormone Replacement Therapy for Endometrial Preparation for Frozen Embryo Transfer. Method: This was a single center randomized clinical trial. It was conducted in the period between August 2022 and March 2023 in Andrology and Fertility Hospital of Hanoi. A total of 166 patients were randomly allocated to two groups, either the hormone replacement cycle (83 patients) (HRT group) or the modified natural cycle (83 patients) (mNC group). Results: The mean age was 31 vs 30 years in mNC and HRT. The endometrial thickness on the day of Progesterone administration in mNC was higher than HRT (10.99±1.46 và 10.70±1.06 mm), p>0.05. There was no significant difference between mNC group and HRT group regarding implantation rate, clinical pregnancy rate, on-going rate. After adjusting for age, BMI, duration of infertility, type of infertility, history of miscarriage, number of failed embryo transfers, endometrial thickness on the day of Progesterone administration, number of good-quality embryos transferred showed that the clinical pregnancy rate in the HRT was higher than that mNC, but the relationship was not statistically significant with p>0.05. Conclusion: The selection of regimen to use for endometrial preparation for frozen embryo transfer depends on individualized patient treatment, particularly with respect to the selection of the endometrial preparation method particularly with respect to the selection of the endometrial preparation method.
#155 : Embryo Thaw and Biopsy - A Clinical Guide for Patients
Authors: Leung Vivian , Zhang Shelley , Johnson Kerri , Sorby Kelli 
Published: January 2024

Background and Aims: Preimplantation genetic testing allows the selection of chromosomally normal embryos for transfer, and therefore may reduce the time required to live birth. Some patients request to perform biopsy on previously cryopreserved embryos. This includes situations where the embryos were frozen untested, or no result was obtained from the initial trophectoderm biopsy. Method: We analysed the outcomes of 108 embryos over 3 years in the effort to provide guidance to patients in terms of the expectations when considering performing thaw and biopsy on cryopreserved embryos. This includes 32 untested embryos (planned for PGT) (Group A), 45 embryos frozen without the intention of testing (Group B) and 34 embryos that had no results obtained in the first biopsy (Group C). The developmental timing of the embryos in the initial culture and the extended culture timing following thawing, was examined using timelapse footage. Results: Among the 108 embryos that were thawed and subsequently cultured, 78.7% embryos were suitable for biopsy with an average of 8.5 h in extended culture. Group A had the lowest proportion of embryos suitable to biopsy after extended culture (56.3%), which is significantly lower than Group B (83.3%, P=0.0181) and Group C (94.1%, P=0.0004). Interestingly, Group A had the lowest proportion of euploid embryos (16.7%), followed by Group B (40.0%) and Group C (46.9%). Interestingly, of the Group C embryos that previously failed to amplify only 26.7% were euploid, compared to 64.7% for those that previously amplified but failed to pass quality control. There was no correlation between time to blastulate, time to form full blastocyst or culture time and euploidy rate. At the time of our study, 18 of the 32 euploid embryos were thawed and transferred, resulting in 44.4% clinical pregnancy rate. Conclusion: This analysis provides important information to guide patients’ expectations at a clinical level.