bluuebunny/crossref_metadata_2025_split huggingface dataset:
#287 : A Comparison of hCG Trigger Versus Dual Trigger for Final Oocyte Maturation in Poor Ovarian Responders Undergoing Minimal Stimulation
Authors: Ho Sy Hung , Nguyen Viet Quang , Duong Hoang Long , Hoang Thi Thanh Thuy , Tran Danh Cuong 
Published: January 2024

Background and Aims: Traditionally, hCG has been used for oocyte triggering. However, women with poor ovarian response manifest low oocyte yield and compromised occyte quality. More recently, a combination of hCG and GnRHa (dual trigger) has been shown to improve follcile collection yield and oocyte maturation. The aim of the study is tocompare the result of final oocyte maturation and the embryo formation between two groups of poor ovarian responders undergoing minimal stimulation after triggering by hCG alone versus dual trigger. Method: This randomized control trial was conducted at National Assisted Reproductive Center, National Hospital of Obstetrics and Gynecology. Patients defined as poor ovarian responders according to the Bologna criteria were equally divided into two groups: control (hCG trigger) and investigation (dual trigger) groups. The group received the hCG trigger (6500 IU) and the investigation group received the dual trigger (0.2 mg of Triptorelin plus 6500 IU of hCG). Minimal stimulation IVF protocols consist of 5 days of 100mg clomiphene citrate and small amounts of gonadotropin. Results: One hundred and two patients were included in the study, with 51 women in each treatment group. Dual triggering showed a significant higher number of retrieved oocytes (5.35 ± 3.13 vs 4.35 ± 2.44, P=0.038) and metaphase II oocytes (4.25 ± 3.12 vs 3.35 ± 2.02, P=0.043). Although not reaching statistical significances, increases in the number of fertilized oocytes, embryos, and number of top-quality embryos (TQE) were observed. Conclusion: Dual trigger for final oocyte maturation is associated with better IVF outcome in poor ovarian responders undergoing minimal stimulation. Acknowledgements: The authors are grateful to all physicians, administrative staff at the National Assisted Reproductive Technology Center, National Hospital of Obstetrics and Gynecology, Vietnam for allowing and supporting us to undertake this research.
#304 : Comparing GnRH Agonist and GnRH Antagonist Protocols for IVF-ET Outcomes in Patients with Endometriosis: A Meta-Analysis
Authors: Paik Haerin , Hong Yeon Hee , Kim Seul Ki , Lee Jung Ryeol 
Published: January 2024

Background and Aims: Endometriosis is known to have detrimental effects on fertility, but there is no consensus on the optimal stimulation protocol for IVF-ET in patients with endometriosis. The study aimed to compare the IVF outcomes of gonadotropin-releasing hormone (GnRH) agonist protocols versus antagonist protocols in patients diagnosed with endometriosis. Method: We performed a meta-analysis of studies that compared IVF outcomes of GnRH agonist versus antagonist protocols in patients with endometriosis. Through literature search, we retrieved 222 articles, and the last search date was April 7, 2023. Among them, six studies which met inclusion criteria were eligible for final analysis. The primary outcome was clinical pregnancy. Random effects and fixed effects models were applied according to I2 statistics. Results: The use of GnRH agonist was associated with higher clinical pregnancy rate (Odds ratio (OR) 1.61, 95% CI 1.35–1.93, 6 studies, [Formula: see text]<0.00001, I2=16%), higher live birth rate (OR 1.75, 95% CI 1.32–2.33, 3 studies, [Formula: see text]<0.0001, I2=12%), and similar miscarriage rate. The total dose of gonadotropin did not differ between the two methods, but the GnRH agonist protocol had a longer duration of stimulation (WMD 1.34, 95% CI 0.44–2.24, 5 studies, I2=98%), retrieved more oocytes (WMD 2.23, 95% CI 0.58–3.88, 3 studies, [Formula: see text]=0.0008, I2=97%), more MII oocytes (WMD 2.81, 95% CI 2.34–3.28, 3 studies, [Formula: see text]<0.00001, I2=0), and more embryos (WMD 1.90, 95%CI 1.13–2.67, 3 studies, [Formula: see text]<0.00001, I2=68%). Conclusion: Patients with endometriosis may benefit from using GnRH agonist protocol in the IVF-ET cycle, as it may be associated with a higher clinical pregnancy rate and live birth rate. Even though the stimulation duration is longer, more oocytes, mature oocytes, and embryos may be expected. Although the findings of this study may be potentially beneficial for clinicians, it is crucial to conduct additional randomized prospective trials with larger cohorts to further validate the results.
#314 : Comparison of Dual-Trigger and Human Chorionic Gonadotropin-Only Trigger Among Diminished Ovarian Reserve Who Underwent Intracytoplasmic Sperm Injection: A Retrospective Cohort Study
Authors: Nguyen Thanh H N T 
Published: January 2024

Background and Aims: Diminished ovarian reserve (DOR) remains one of the greatest challenges for ART treatment. The objective of this study was to compare the laboratory outcomes of dual trigger and human chorionic gonadotropin (HCG) trigger alone in the final oocyte maturation for DOR patients. Methods: In this retrospective study,we evaluated 130 DOR women (dual group, n=75 and HCG group, n=45) underwent intracytoplasmic sperm injection (ICSI) between July 2020 and February 2023 at the Assisted Reproductive Department, Hung Vuong Hospital. DOR was defined as antral follicle count [Formula: see text]5 and serum anti-Müllerian hormone level [Formula: see text]1.2ng/mL. All patients using the GnRH antagonist protocolwith frozen embryo transfer. Baseline characteristics and cycle parameters, as well as IVF outcomes of both groups were compared. Generalized linear model (GLM) with negative binomial distribution for retrieved oocytes outcome and binomial distribution for other outcomes such as maturation rate, fertilization rate, rate of successfully achieving blastocytes and day-3 embryos. Results: Baseline characteristics were similar between the dual trigger group and the HCG group for age (p=0.2), AFC (p=0.44), AMH (p=0.76), BMI (p = 0.12), indication and number of priorARTcycles. The dual-trigger group had a significantly higher number of retrieved oocytes (95% CI 0.125–2.437, p=0.03), metaphase oocyterate (OR = 1.90, 95% CI 1.05–3.43; p=0.033). Fertilized oocyte rate (OR 1.42, 95% CI 2.015–0.795, p=0.967) andday-3 embryos (OR = 1.42, 95% CI 2.70–.73, p=0.294) were comparable in two groups. Conclusions: Our data suggests that dual trigger for final oocyte maturation might improve laboratory outcomes of IVF cycles in DOR patients.
#315 : Determination of Clinical Pregnancy and Live Birth Rates in Autologous Cycles for Women Between 40 and 46 Years Old
Authors: Owens Lucy , Ekanayake Tegan , Green Mark , Zander-Fox Deirdre , Vollenhoven Beverley 
Published: January 2024

Background and Aims: It is well-documented that fertility rates decline with maternal age, however there is limited information on the success rates for women between 40 to 50 years old using their own eggs. Many ART providers set differing maternal age limits for accessing treatment, with minimal clinical evidence to support these limits being set. The aim of this study was to identify clinical and live birth rates for women aged 40 to 46 at egg pick-up (EPU), who used autologous oocytes and ET (with or without pre-implantation genetic testing (PGT)). Method: A retrospective cohort study was performed on 7,521 autologous EPU cycles undertaken between 2015 and 2020 for women between 40 and 46 years old at clinics in Victoria, Australia. Maternal age was determined by age at the time of EPU. Clinical pregnancy rate (CPR) and live birth rate (LBR) outcomes were calculated following the transfer of a single fresh or frozen blastocyst stage embryo. Outcomes were also determined for PGT-tested compared with non-PGT-tested frozen embryo transfer (FET) cycles based on maternal age at time of embryo creation and analysed at each age by Fisher’s exact test. Results: CPR and LBR declined with increasing maternal age for both fresh and frozen single blastocyst ETs (Tables 1 and 2), with no live births for women who had eggs collected at 46 years old. Equally, outcomes were lower for fresh compared with frozen ET cycles (P<0.0001). In FET cycles, while LBR declined with age for non-PGT cycles, LBR remained steady and was higher between age 40 and 45 years than when a PGT-tested embryo was transferred (P<0.02). Conclusion: Increasing maternal age at EPU was negatively associated with clinical outcomes, especially after the age of 43 years. Transfer of a PGT-tested embryo did however maintain a high LBR irrespective of maternal age.
#336 : Improving Success of Intrauterine Insemination
Authors: Porag Mafruha Khanam 
Published: January 2024

Background and Aims: IUI is one of the most used methods to treat various forms of infertility. The aims were to compare the success rate of IUI with that of timed intercourse, review the methods used to time the IUI with ovulation, identify the factors to determine IUI outcome, compare the success rate of double IUI vs single IUI. Method: This is a cross-sectional prospective study conducted at a Private Fertility Centre, Chattogram, Bangladesh over a period of 40 months from 996 patients who underwent IUI. Variables such as age of women, cause of infertility, drugs used for COH, number of mature follicles, endometrial thickness post wash sperm count, type of IUI (single IUI and double IUI) were recorded and statistically analyzed. Results: The age for females and males were 18-41 and 23-52 respectively. The mean endometrial thickness was 8.9 mm ± 0.2 mm. Pregnancy rate for total motile sperm count less than 10 million was 7.2%. The successful conception rate for females were the age 28 was 9.6% compared to the whole group at 12%. Among 996 patients, 109 patients (10.94%) had successful conception. 209 patients (20.98%) underwent double IUI out of which 40 patients (19.14%) had a successful conception while 787 patients (79.01%) underwent single IUI out of which 69 patients (8.76%) had successful conception. Conclusion: IUI is currently a successful treatment modality for infertility especially as invasive treatment for couples with unexplained infertility, male factor infertility, anovulation, female less than 30 years of age. The numbers of motile sperms, appropriate endometrial thickness, have a remarkable impact on the outcome of IUI. Double IUI increases the success rate significantly. Acknowledgment: The authors are grateful to all who participated in the preparation of this manuscript.
#344 : Intrauterine Platelet-Rich Plasma and Peripheral Blood Mononuclear Cells Doubles Clinical Pregnancy Rate in Recurrent Implantation Failure: Efficacies Obscured by Non-Randomized Controlled Trials - Two Meta-Analyses
Authors: Chow Ezri , Chow Tony K. F. 
Published: January 2024

Background and Aims: Recurrent implantation failure (RIF) is a frustrating problem confronting prospective mothers following embryo transfer. Two promising intrauterine immunotherapies, plasma-rich plasma (PRP) and peripheral blood mononuclear cells (PBMC) infusions, have been investigated with mixed results, leaving experts querying if these are “add-on treatments getting out of hand?”. The current meta-analyses aim to identify the source of the conflicting evidence and determine the true efficacy of IU-PRP and IU-PBMC. Method: A systematic search was conducted on April 30, 2023, using OVID Medline and Embase. Eligible articles pertaining to the efficacy of IU-PRP and IU-PBMC upon clinical pregnancy in fertility research were retrieved. Risk ratios and confidence intervals were calculated via the random effects model (Cochrane Review Manager). Results: IU-PRP Pooled data: 26 studies, 3016 participants, RR=1.64(1.41-1.90), X2=0.009, I2=44%, showing significant heterogeneity. RCTs: 15 studies, 1557 participants with RR=2.02(1.71-2.39), X2p=0.43, I2=2%. Non-RCTs: 11 studies, 1459 participants with RR=1.34(1.19-1.52), X2p=0.39, I2=5%. Subgroup analysis: homogenous effect sizes with non-overlapping 95%CI, X2p=0.0001, I2=93.4%. (Figure 1) IU-PBMC RCTs: 6 studies, 652 participants, RR=2.17(1.71-2.74), X2p=0.92, I2=0%. Non-RCTs: 6 studies, 866 participants, RR=1.43(1.20-1.70), X2p=0.69, I2=0%. Subgroup analysis: homogenous effect sizes with non-overlapping 95%CI, X2p=0.005, I2=87.4%. (Figure 2) Conclusion: Non-RCTs provide savings in cost and time that can lead to early awareness of innovative therapies. This may be counterproductive in RIF research due to flawed non-randomized controls: retrospective cohorts, women refusing consent to therapy, women without RIF or having first IVF attempt. Intervention groups therefore may have a higher baseline risk of failure, resulting in apples-to-oranges comparisons that obscure the actual efficacy. Randomization is fundamental in reducing patient selection bias and the RCTs in these analyses demonstrated that IU-PRP and IU-PBMC doubles the clinical pregnancy rate in RIF patients. A debate into the role of non-RCTs in RIF research is essential to avoid a potential systemic problem.
#387 : Enlightening the Management of Chocolate Cysts Before IVF Treatment: Case Reports of 3 Young Endometriosis-Associated Ovarian Cancer Patients with Ovulation Induction History
Authors: Zhao Yiwei , Zhu Jie , Ye Taiyang , Zhao Aimin 
Published: January 2024

Background and Aims: Endometriosis is a common estrogen-dependent disease that occurs mostly in women of childbearing age and is characterized by ectopic growth of endometrial glands and stroma. Endometriosis may present as malignant transformation and the two most common malignancies in this situation are ovarian clear cell carcinoma and endometrioid adenocarcinoma. Rare cases of endometriosis-associated ovarian cancer (EAOC) after in-vitro fertilization (IVF) treatment were reported before, and the relationship between the usage of ovulation induction medications and the development of ovarian cancer is controversial. This study aims to summarize the characteristics of EAOC patients with IVF treatment history. Method: All history, clinical data, imaging data, operative documents, and follow-up of 3 cases of endometriosis-associated ovarian cancer with IVF treatment history were reviewed, among the 793 patients undergoing surgeries for ovarian malignancy at the Gynecology Department, Renji Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, from 2019 to 2022. Results: 3 EAOC patients under the age of 40 who had undergone controlled ovarian hyperstimulation (COH) for IVF treatment were identified in the cases review. The 3 infertility women underwent 3, 4, and 6 cycles of ovulation induction and achieved 1, 0, and 1 time of pregnancy, respectively. Unfortunately, none of them reached a pregnancy outcome over 12 weeks. After staging surgery, the 3 patients were diagnosed with Stage IA clear cell carcinoma, Stage IIB clear cell carcinoma, and Stage IIB adenosquamous carcinoma, respectively. The latter two patients had undergone two times of needle aspiration and sclerosis for chocolate cysts, and the surgical records also showed more severe abdominal adhesion and poor prognosis. Conclusion: Patients with endometriosis cysts need to be very careful when seeking IVF treatment, especially in the order of treatment of cysts and ovulation induction. Repeated needle aspiration and sclerosis for ovarian cysts are not recommended.
#35 : Tail-First Sperm Injection Significantly Improved the Fertilization Rates More Than the Head-First Sperm Injection Regardless of the Elasticity of the Oocyte Membrane Following Piezo-ICSI
Authors: Hiraoka Kenichiro , Uchida Nozomi , Nakajo Hayata , Sato Moe , Ishikawa Saki , Sujino Toshio , Komiya Akira , Takayanagi Yuko , Nako Yurie , Tajima Makiko , Kawai Kiyotaka 
Published: January 2024

Background and Aims: Little information is available for investigating the effect of the direction of sperm injected into the cytoplasm on clinical results for human oocytes following intracytoplasmic sperm injection (ICSI). This study aimed to examine the impact of the direction of sperm (head-first or tail-first) injected into the cytoplasm on fertilization and embryo development for high-elasticity or low-elasticity human oocytes following the Piezo-ICSI. Methods: We retrospectively investigated 2717 high-elasticity oocytes and 907 low-elasticity oocytes between May 2016 and December 2022. Of 2717 high-elasticity oocytes, 1148 were injected sperm head-first, and 1569 were injected sperm tail-first into the cytoplasm by Piezo-ICSI. Of 907 low-elasticity oocytes, 480 were injected head-first, and 427 were injected sperm tail-first into the cytoplasm. The membrane of high-elasticity oocytes was robust and was ruptured artificially by the piezo-pulse. The membrane of low-elasticity oocytes was weak and spontaneously ruptured without the piezo-pulse. The rates of degeneration, fertilization (2PN), 0PN, 1PN, [Formula: see text]3PN, abnormal cleavage, and good-quality day-3 embryos were evaluated in both groups. Results: Table 1 shows the effect of sperm direction on fertilization and embryo development for high-elasticity oocytes. The fertilization rate of tail-first group was significantly higher than the head-first group. The 0PN rate of tail-first group was significantly lower than the head-first group. The good quality Day-3 embryo rate of tail-first group was significantly higher than the head-first group. Table 2 shows the effect of sperm direction on fertilization and embryo development for low-elasticity oocytes. The fertilization rate of the tail-first group was significantly higher than the head-first group. However, no significant difference was observed in other comparable items. Conclusions: Tail-first sperm injection significantly improved the fertilization rates more than the head-first sperm injection regardless of the elasticity of the oocyte membrane following Piezo-ICSI.
#55 : Ooplasm Diameter as a Predictor for Pre-Implantation Development in Intracytoplasmic Sperm Injection Cycles
Authors: Mendiola Rudie Frederick , Ong-Jao Ednalyn , Perillo Gayla , Francisco Fides Marie 
Published: January 2024

Background and Aims: The use of noninvasive measures such as ooplasm diameter (OD) for oocyte evaluation to predict the results of intracytoplasmic sperm injection (ICSI) is of great clinical importance. In this study, we determine whether OD is a significant predictor for pre-implantation development in intracytoplasmic sperm injection cycles in order to select good quality oocytes. Method: A total of 1,130 treatment cycles from 1,130 women who underwent oocyte retrieval during mild stimulation cycles between February 2018 to June 2019 were retrospectively reviewed. The correlation of OD with embryonic outcomes was analyzed. Results: The logistic regression analysis demonstrated that the OD was not correlated with embryonic outcomes. However, our preliminary analysis demonstrated that the embryonic outcomes in the oocytes with small or large OD tended to be lower than those oocytes with optimal OD. Therefore, we stratified the oocytes into six groups according to the OD using statistical software (Group A, OD < 110.19; B 110.19 [Formula: see text] OD < 112.22; C, 112.22 [Formula: see text] OD < 113.67; D, 113.67 [Formula: see text] OD < 115.01; E, 115.01 [Formula: see text] OD < 116.02; F, 116.02 [Formula: see text] OD). The highest blastocyst utilization rate was observed in Group D. The blastocyst utilization rate in Group A (the smallest-diameter group) and F (the largest-diameter group) were significantly lower than that in Group C and D. Conclusion: The optimal range of OD is associated with the higher blastocyst utilization rate after ICSI. These results suggest that OD might be used as a predictive parameter to select/de-select the oocytes for insemination, leading to better control of the quantity and quality of the embryos obtained, reducing to a minimum the ethical issues related to excess embryos.
#62 : Time-Lapse Imaging Analysis of Embryo Development: A Dynamic-Image-Based Prediction Model for Blastocyst Formation During Early 80 Hours Development
Authors: Zhao Mingpeng , Fan Jing , Li Xuemei , Lli Hanhui , Zhang Chaofan , Chan David Yiu Leung 
Published: January 2024

Background and Aims: The objective is to develop a novel algorithm for context learning through time-lapse imaging and compare its performance with static learning for blastocyst formation prediction. Method: Time-lapse imaging (TLI) was used to capture images of over 400 embryos between 19 to 80 hours after insemination with approximately 30,000 frames. The study employed two network input strategies for blastocyst formation prediction - utilizing static (A model) and dynamic image-based (B model) prediction models. The proposed algorithm for context learning through time-lapse imaging involves deep learning methods for identifying subtle changes in the embryo’s developmental stages through the time series of images. The convolutional neural network (CNN) and long short-term memory (LSTM) methods are leveraged to extract features and maintain context over the culture duration. Results: The study found that early-stage prediction of blastocyst formation was challenging, with both network input strategies achieving an overall prediction accuracy of less than 80%. However, B model prediction outperformed A model prediction, with a prediction value of 75% compared to 68% (p < 0.05). Moreover, the B model is more effective for detecting delayed blastocyst formation, with 45.5% of the delays (>1 days) being correctly predicted compared with 36.4% for the A model. Conclusion: In conclusion, the study demonstrated that a dynamic-image-based prediction model utilizing the proposed algorithm for context learning through TLI outperforms the static-image-based prediction model. The proposed algorithm enables a more comprehensive analysis of the embryos, considering subtle changes over time, which enables improved prediction of blastocyst formation with more robust performance in the future. This study represents a significant step forward in the development of advanced data mining methods that can enable reliable and accurate predictions of embryo development.