bluuebunny/crossref_metadata_2025_split huggingface dataset:
#52 : Cumulative Live Birth Rates (CLBR) According to the Number of Oocytes Retrieved in Minimal Stimulation In Vitro Fertilization (IVF) Treatment
Authors: Ong-Jao Ednalyn , Mendiola Rudie Frederick , Perillo Gayla , Francisco Fides Marie 
Published: January 2024

Background and Aims: Ovarian stimulation is necessary for IVF in order to stimulate the development of multiple follicles in a single cycle. To optimize ovarian stimulation, there is a need to know the optimum number of oocytes retrieved to achieve a live birth. This retrospective study aimed to evaluate the relationship between the number of oocytes retrieved and the cumulative live birth rates among patients undergoing mild stimulation IVF treatment in a private fertility clinic in the Philippines. Method: Ovulation was induced using clomiphene citrate in combination with lower doses of gonadotropins. Final oocyte maturation was triggered with hCG or GnRHa. Mature eggs were fertilized using intracytoplasmic sperm injection. Only 1 to 2 embryos were transferred per cycle. Results: A total of 1,431 patients that had 1,817 fresh and frozen transfer cycles were included. Average age of women was 35.70 ± 3.97 (min. 20, max. 46). Binary logistic regression shows that age is a predictor of live birth, with a critical value of 34.6 years. CLBR was estimated using Kaplan-Meier survival analysis, with the number of oocytes as the time factor. The estimated mean number of oocytes retrieved for cases that had live birth was 8.90 ± 0.30. Half of the cases that had live birth had an estimated oocyte number of 7.0 ± 0.194. Live birth steadily increased with the number of oocytes but declined beyond 25 oocytes. Retrieval of 6 to 9 oocytes was enough to achieve 40-60% CLBR. In comparison, conventional IVF recommends 8 to 15 oocytes to achieve similar CLBR. Conclusion: Retrieval of lower numbers of oocytes with minimal stimulation IVF can produce desirable success rates comparable to rates achieved with higher numbers of retrieved oocytes in conventional IVF.
#114 : Is Mild Stimulation IVF Better for Women with Previous Poor Outcome Following Conventional High-Dose Stimulation?
Authors: Ponusamy Sharmila Thevi , Lim Michelle Sheng Rong , Chen Jang Jih , Wong Pak Seng 
Published: January 2024

Background and Aims: With the aim of yielding higher number of oocytes, high gonadotrophin doses are often used in ovarian stimulation protocols which may have a detrimental impact on oocyte and subsequently embryo quality. Alternatively, mild stimulation (MS) protocols mimic physiological folliculogenesis with a low dosage of gonadotropins and aims to produce better-quality oocytes with a reduced aneuploidy rate. This study investigates the clinical outcome of patients who had multiple attempts of IVF cycles with both MS and high-dose conventional stimulation (HS) protocol. Method: A retrospective analysis was carried out on 26 patients who had a total of 108 IVF cycles from 2017-2022. The MS protocol involves administration of Letrozole/Clomiphene from Day 2 for 5 days followed by highly purified menotrophin (150-225IU) on alternate days starting after Day 3 whereas in HS protocol, [Formula: see text]300IU of daily dose of gonadotrophins were given. ICSI was performed for all mature oocytes and the resulting embryos were cultured to blastocyst stage for preimplantation genetic testing for aneuploidy (PGT-A). Clinical outcomes such as the rate of fertilisation, degeneration, blastocyst utilisation, aneuploidy, clinical pregnancy, and live birth were analysed with Chi-square and Fisher’s exact test. Results: The fertilisation rate (p=0.00140) and blastocyst utilisation rate (p=0.00966) are significantly higher with MS compared to the HS protocol. The degeneration rate did not differ among the treatments (p=0.50248). The pregnancy and live birth rates are higher following MS compared to HS but this is not statistically significant due to low number of patients. Aneuploidy rate is shown to be significantly higher in HS compared to MS (p=0.00975). On average, 3 cycles of MS are required to produce a live birth. Conclusion: Patients with poor outcome to conventional hyperstimulation cycles may benefit from MS protocols. MS is cost-effective with lower treatment burden and has been shown in this small study to produce better clinical outcomes.
#132 : Outcomes and Related Risk Factors of Heterotopic Pregnancy in IVF-ET Cycles
Authors: Dong Xianghua , Gao Mingxia 
Published: January 2024

Background and Aims: In vitro fertilization-embryo transfer (IVF-ET) has demonstrated significant success in treating infertility, but it can also introduce complications and risks such as heterotopic pregnancy (HP), which can lead to ectopic pregnancy rupture and bleeding, potentially endangering the patient’s life and fertility. This study aims to investigate the outcomes and associated risk factors of HP following IVF-ET, providing clinical insights for HP treatment. Methods: A retrospective analysis was conducted on the clinical data, treatment, and pregnancy outcomes of patients with HP after IVF-ET admitted to First Hospital of Lanzhou University from Jan. 2012 to Dec. 2022. Statistically significant risk factors were identified and subjected to logistic regression analysis. Results: Our data revealed a HP incidence of 1.27%. Among the 66 patients with HP, 5 underwent conservative treatment (7.58%, 5/66) with a live birth rate of 25.00% (1/5). Laparoscopic surgery was performed on 61 cases (92.42%, 61/66), with a live birth rate of 77.05% (47/61). Among patients receiving laparoscopic surgery, 49.18% (30/61) had a history of pelvic surgery, 39.34% (24/61) underwent a fresh IVF cycle, and 60.66% (37/61) had a freeze-thaw cycle. The live birth rate was 83.67% (41/49) for those with a visible fetal germ and 85.37% (35/41) for those with a visible fetal heartbeat prior to surgery. Further logistic regression analysis revealed that the average diameter of the intrauterine gestational sac prior to laparoscopic surgery, the absence of a fetal germ and fetal heartbeat within the intrauterine gestational sac, and an extended duration of laparoscopic surgery were risk factors affecting pregnancy outcomes (P<0.05). Conclusion: The incidence of HP in IVF-ET is much higher than in natural conception. Laparoscopic surgery is an effective treatment for HP, which does not seem to impact the ongoing pregnancy and live birth rates of the intrauterine gestational sac. However, the patient’s pregnancy outcome can be influenced by several factors, such as the average diameter and development of the intrauterine gestational sac prior to surgery, as well as the duration of the surgery.
#167 : Role of Endometrial Receptivity Using 3D Doppler Ultrasound on Pregnancy Outcome of IVF-FET Cycles
Authors: Gul Rohina , Khan Haroon Latif , Nisar Rameen , Sardar Saba 
Published: January 2024

Background: The success of in vitro fertilization and embryo transfer (IVF-ET) cycles depends primarily on the quality of the embryo and the receptivity of the uterus. In addition to embryo quality the receptivity of the endometrium plays a role in the implantation process. Uterine receptivity is widely accepted as one of the main limiting factors in IVF outcomes. Endometrial thickness and endometrial pattern have been regarded as indicators for endometrial receptivity. Objective: To compare the ultra-sonographic endometrial characteristic in relation to blood flow on Doppler between pregnant and non-pregnant groups of FET patients in IVF/ ICSI cycles. Methods: This cross-sectional study is approved by the Institutional Ethical Committee (IEC) of Hameed Latif Hospital. Our study consists of 200 women who have come for FET cycle. On 18th day of period cycle, endometrial thickness, resistance index was obtained by transvaginal sonography. In the combined analysis, endometrial thickness groups (group 1: <9 mm; group 2: [Formula: see text]9 mm) were subdivided into two endometrial patterns (triple-line and diffused). The women were divided into the [Formula: see text]-HCG positive and [Formula: see text]-HCG negative groups. For statistical analysis chi-square and Fisher’s exact tests was used. Multiple logistic regression analysis and the receiver operating characteristic (ROC) curve analysis were applied to determine the best predictive variables. Results: The women in [Formula: see text]-HCG positive group were significantly younger as compared to [Formula: see text]-HCG negative group. Endometrial thickness was ¿ 9mm and RI was lower in group 1. A significant association was found between endometrial pattern and pregnancy outcome. (p-value = 0.01. ROC curve revealed that for ultrasound parameters the area under the curve was around 0.5. Conclusion: Endometrium pattern and thickness and resistive index on Doppler may better predictor for pregnancy; combined endometrial characteristics do not predict outcomes.
#295 : Comparison of In Vitro Fertilization in Couples with HIV Infection with Negative Viral Load Versus Non-Infected Couples: A Case-Control Study
Authors: Muharam Natadisastra R , Wiweko Budi , Pratama Gita , Yuningsih Tita , Bagastoro Aswan , Abigail Anindita , Maidarti Mila , Harzif Achmad Kemal , Sumapraja Kanadi , Hestiantoro Andon 
Published: January 2024

Background and Aims: The development of Advanced Reproductive Technology (ART) changes many aspects and perspectives towards reproductive health. Current in vitro fertilization (IVF) protocols reduce the risk of Human Immunodeficiency Virus (HIV) transmission to their partners and offspring. This study compares IVF outcome in couples in which at least one partner is HIV positive with negative viral load versus couples in which neither partner is diagnosed with HIV. Method: A total of 100 couples undergoing IVF were categorized into two groups. HIV-positive with negative viral load group in which at least one partner is infected (n = 50) and non-HIV group in which neither partner is diagnosed with HIV (n = 50) are collected from medical record in our center during the same period. The main outcomes were total oocyte retrieved, normal fertilized egg or 2 pronucleus (2PN) one day after fertilization and good quality embryos based on number of embryos that transferred and frozen for IVF procedure. Differences between groups were determined statistically using the Mann-Whitney test. Results: There is a significant difference between HIV-positive with negative viral load groups compared to non-HIV groups in terms of total oocyte retrieved (p = 0,005) and normal fertilized egg one day after fertilization (p = 0.017). There is no significant difference in the number of good quality embryos (p = 0.076) between two groups. Conclusion: The data suggested that couples with HIV-positive women have poorer total oocyte retrieved and normal fertilized egg outcome compared to non-HIV couple. HIV infection might affect success rates of IVF treatments.
#317 : The Clinical Outcome of Ovarian Stimulation Undergoing Intrauterine Insemination with Follitropin Delta in Indonesian Women
Authors: Lubis Hilma Putri , Halim Binarwan , Adenin Ichwanul 
Published: January 2024

Background and Aims: Intrauterine insemination (IUI) has been widely used as a common treatment for infertile couples due to its simplicity and low cost. Numerous studies have shown that IUI cycles with controlled ovarian stimulation (COS) result in higher pregnancy rates compared to those without COS. Follitropin delta, a novel recombinant FSH (rFSH) can be used for controlled ovarian stimulation in women undergoing assisted reproductive technologies (ART) and was dosed individually based on serum anti-Müllerian hormone (AMH) concentration and body weight. In this study, we used a simplified dosage equivalent method. The aim of this study was to compare the efficacy and safety of follitropin delta in its simplified dosage equivalent regimen with follitropin alfa in a conventional dose regimen in Indonesian women undergoing intrauterine insemination. Method: A single-center, retrospective observational study from January 2020 to December 2022 was performed in 228 IUI cycles in Halim Fertility Center, Indonesia. Controlled Ovarian Stimulation was performed during IUI cycles and divided into two groups: group I received follitropin delta with a simplified dosage equivalent regimen, and group II received follitropin alfa with a conventional dose. The baseline characteristics, cycle parameters, and IUI outcomes of both groups were compared. Results: Our study included 228 IUI cycles with the follitropin delta group (114 IUI cycles) and the follitropin alfa group (114 IUI cycles). The clinical pregnancy rate was higher in the follitropin delta than the follitropin alfa but there was no significant difference between the groups (p>0.05). The multiple pregnancy rate and Ovarian Hyperstimulation Syndrome (OHSS) rates were lower in follitropin delta than follitropin alfa but there was no significant difference between the groups (p>0.05). Conclusion: Follitropin delta with a simplified dosage equivalent regimen showed higher efficacy and similar safety compared with follitropin alfa in conventional dosing regimen in Indonesian women undergoing Intrauterine insemination.
#30 : Optimal Number of Fresh and Cryopreserved Mature Oocytes to Achieve at Least One Top-Quality Blastocyst
Authors: Hoang Thuy , Le Thao , Nguyen Quynh , Nguyen Loc , Huynh Nhu 
Published: January 2024

Background and Aims: The final success of the IVF treatment cycle is to achieve a healthy baby. However, it depends on many factors, including the quality of the embryo transferred. Meanwhile, the number of high-quality embryos is correlated with the number of mature oocytes (both fresh and cryopreserved ones) for ICSI. Up to now, no study has yet established a cut-off value for the number of fresh and cryopreserved mature oocytes required for a successful cycle. The objective of this study is to assess the number of fresh and cryopreserved mature oocytes per cycle to achieve at least one good-quality blastocyst. Method: This is a descriptive cross-sectional study that included 126 cycles with at least one frozen-thawed oocyte cycle at Tam Anh General Hospital’s fertility center from March to October 2022. To determine the number of fresh and cryopreserved mature oocytes for at least one good-quality blastocyst, we built a multivariable linear regression model, combining ROC curve and Nomogram chart to evaluate the effectiveness of the influence of the variables (number of mature oocytes, age, AMH, and BMI). Results: At each cycle, the mean number of good-quality blastocysts (type 1 and type 2) was 1.95 ± 1.91 with a ratio of 37.57 ± 30.53%, in which there was no difference in blastocyst quality between fresh and cryopreserved oocytes. The number of fresh and cryopreserved mature oocytes for ICSI to achieve at least one good-quality blastocyst in the frozen-thawed cycle was seven mature oocytes. Conclusion: Our study presents that the optimal cut-off number of fresh and cryopreserved mature oocytes is seven oocytes to achieve at least one good-quality blastocyst. The results of our study can be a reference so doctors can predict the oocyte number to improve efficiency and reduce costs for patients during IVF treatment.
#242 : Correlation of Sperm DNA Fragmentation with Laboratory Performance in Good and Poor Prognosis Patient Groups at Morula IVF Jakarta
Authors: Hikmawati Nurul , Rahmawati Pitra , Boediono Arief , Sini Ivan Rizal 
Published: January 2024

BACKGROUND AND AIMS: Infertility in males contributes to about 40% of cases of infertility in couples, either as the main factor or along with female factors. Fragmentation of sperm DNA is known as a cause of male infertility, which impacts the failure of couples to undergo assisted reproductive programs, such as embryo development and recurrent miscarriage. However, some literature studies are still debating this. This research aims to determine the correlation between sperm DNA fragmentation and IVF laboratory performance. METHODS: Infertile couples undergoing an in vitro fertilization program at Morula IVF Jakarta in 2022 are the samples for this study. We divided them into two groups: good prognosis (maternal age [Formula: see text]38 years, AFC[Formula: see text]7; AMH[Formula: see text]1.1) and poor prognosis (maternal age > 38 years, AFC <7, AMH<1.1). Sperm DNA fragmentation was examined using the sperm chromatin dispersion (SCD) assay. Correlation statistical analysis using the Spearman test (p-value <0.05). RESULTS: Based on receiver operating characteristic (ROC) curve analysis, it was found that the sperm DNA fragmentation rate >14.9% had a significant negative correlation with IVF laboratory performance, particularly in the fifth-day embryo quality and blastocyst rate in the good prognosis group. Whereas in the group with poor prognosis, all laboratory performance parameters were not affected by high sperm DNA fragmentation values. CONCLUSIONS: Sperm DNA fragmentation rate > 14.9% correlated with fifth-day embryo quality and a lower blastocyst rate in the good prognosis group.
#80 : Barriers and Enablers to a Healthy Lifestyle in Couples with Infertility: A Mixed-Methods Systematic Review
Authors: Torkel Sophia , Wang Rui , Norman Robert , Zhao Lijun , Liu Kai , Moran Lisa , Cowan Stephanie 
Published: January 2024

Background and Aims: While there is a recognised role of optimising lifestyle (diet and physical activity) in the management of infertility, factors influencing the lifestyle behaviours of people with infertility are not well understood. The aim of this study was to describe the barriers and facilitators to achieving or prescribing a healthy lifestyle in the management of infertility from the perspectives of couples and health professionals. Method: Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL Plus were searched for quantitative and qualitative primary studies (12[Formula: see text] September 2022) that explored barriers and enablers to lifestyle behaviours for infertility management. Data were analysed by inductive thematic analysis with themes mapped to the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation and Behaviour model. Results: After screening 10703 citations and 82 full texts, there were 23 included studies (13 quantitative, 8 mixed-methods and 2 qualitative) with 18 studies including women with infertility, 10 men with infertility and 6 health professionals. From the perspectives of people with infertility, themes related to capability (e.g., strategies for behaviour change), opportunity (e.g., limited time, resources and money) and motivation (e.g., interplay between lifestyle and emotional state); themes mapped to 8 TDF domains. From the perspectives of health professionals, themes related to capability (e.g., identification of patients appropriate for lifestyle intervention), opportunity (e.g., time constraints and organisational factors) and motivation (e.g., professional responsibility); themes mapped to 6 TDF domains. Conclusion: Several interacting factors influence lifestyle behaviours in couples with infertility which can be targeted for optimisation of future interventions. There is a need for more qualitative research to gain insights into the perspectives of couples with infertility and health professionals for further exploration of the complex and interacting factors which shape lifestyle during the stressful journey of infertility and fertility treatment.
#91 : Development of a Combined Artificial Intelligence Score for Evaluating Both Embryo Ploidy and Viability to Aid in Embryo Selection During IVF
Authors: Diakiw Sonya , VerMilyea Matthew , Perugini Michelle , Nguyen Tuc , Perugini Don , Hall Jonathan 
Published: January 2024

Background and Aims: Artificial intelligence (AI) is being increasingly used for non-invasive evaluation of embryo quality during IVF. Previous studies described development of AI for selecting embryos likely to be euploid (genetics AI), or likely to lead to clinical pregnancy (viability AI), based on analysis of images of blastocysts on day 5 of development. The aim of this study was to determine if a combination of these AI scores could be used to effectively evaluate both outcomes. Method: 936 embryo images with pre-implantation genetic testing for aneuploidies (PGT-A) outcomes, and 479 embryo images with clinical pregnancy outcomes, were retrospectively obtained from 12 IVF clinics in 5 countries. Performance was evaluated for each AI score alone, and the average score of the two AIs. The ability to select euploid or viable embryos was evaluated using ROC-AUC analyses, and a simulated cohort ranking method reported in the literature. Results: The average score of the two AIs was generally as effective at selecting euploid embryos as the genetics AI, and just as effective at selecting viable embryos as the viability AI. Results for both analyses are presented below. Conclusion: An AI score that can evaluate both embryo ploidy and viability simultaneously is useful for selecting preferred embryos for analysis or transfer. These results suggest that it is feasible to generate a single score for evaluating overall embryo quality using a non-invasive approach.
#310 : Infertility Misperception and Improper Health Seeking Behavior Between Urban and Rural Area in Indonesia
Authors: Kusuma Berli , Harzif Achmad Kemal 
Published: January 2024

Background and Aims: The prevalence of infertility among reproductive-age couples in Indonesia is around 10-15%. Lack of understanding, misleading myths and negative attitude could result in improper behavior. This study aims to reveal the discrepancy between perception and behavior towards infertility in urban and rural area in Indonesia. Method: Cross-sectional study using internet-based questionnaire was given to 408 individuals which divided into two groups, Java and outside Java representing urban and rural population respectively. All participants were above 18 years old who completed the questionnaire from October 2020 to April 2021. Results: Half respondents from both groups consider infertility a disease. All respondents have excellent access to information. Although more than 80% of subjects from each group have been exposed to infertility information, better understanding was observed in urban community. The majority of each group answered smoking as the main risk factor for infertility, followed by stress and advanced age. More respondents in rural areas have the wrong perception that stress cause infertility. Furthermore, they seek unwarranted advice, as 19.5% came to midwives and only 9.1% came to general practitioners. This study showed 35.6% of subjects in urban group and 41.6% in rural group are considered late to seek healthcare assistance. Most respondents from both groups accept the use of Assisted Reproductive Technology and fertility enhancing drugs as treatment options. Conclusion: Misperceptions about infertility are more prevalent in rural groups compared to urban group. Fertility education among both groups needs to be improved in order to optimize the chance of conceiving and having a healthy baby.