bluuebunny/crossref_metadata_2025_split huggingface dataset:
#150 : Do Women with a History of Recurrent Miscarriage Have a Higher Risk of Obstetric and Perinatal Complications in a Subsequent Pregnancy? A Cohort Study
Authors: Chen Xiaoyan , Li Tin Chiu 
Published: January 2024

Background and Aims: To examine if there are any adverse obstetric and perinatal outcomes associated with a history of recurrent miscarriage (RM) among a large cohort of Chinese women in Hong Kong. Method: It is a retrospective study using prospectively collected data from 2000 to 2019. Data of obstetric and perinatal outcomes from 3112 women with history of recurrent miscarriage was collected from the Clinical Data Analysis and Reporting System database and compared to 108,012 deliveries within the same time period. Logistic regression analyses were performed, adjusting for potential confounding factors. Results: For obstetric outcomes, women with RM had significantly increased odds of gestational hypertension (OR 1.28, 95% CI 1.09-1.51) and Caesarean section (OR 1.47, 95% CI 1.36-1.60). After adjusting confounding factors, there was significantly increased odds for only Caesarean section (adjusted OR 1.55, 95% CI 1.32-1.77). For perinatal outcomes, women with a history of RM were more likely to deliver preterm (OR 1.67, 95% CI 1.47-1.91; adjusted OR 1.72, 95% CI 1.50-1.99). The incidence of small for gestational age was also significantly higher in women with a history of RM (OR 1.64, 95% CI 1.39-1.94; adjusted OR 1.70, 95% CI 1.41-1.98). There was a significant difference in the incidence of perinatal death from all causes (OR 1.48, 95% CI 1.03-2.12; adjusted OR 1.52; 95% CI, 1.11-2.32). Conclusion: An increased risk of several obstetric and perinatal complications was found in a large cohort of Chinese women with a history of two or more miscarriages, who should be offered specialist obstetric care from the start of pregnancy with an emphasis on strategies to manage the increased risk of preterm birth small for gestational age and perinatal death.
#153 : Sperm Motility: Effect on Fertilization Rate and Embryo Quality in Patients Undergo Intracytoplasmic Sperm Injection in Indonesia
Authors: Laurus Geraldo , Margiana Ria , Wen Maitra Djiang , Wibowo Suwaspodo Henry , Kamaroekmi Maya Sri , Supardi Supardi 
Published: January 2024

Background and Aims: Progressive motility may be an indicator of adequate metabolic activity of the sperm; it is important in ICSI as it helps embryologists in picking a viable and best spermatozoa for injection. Studies evaluating the relationship between sperm motility and fertilization rate and embryo quality in ICSI showed inconclusive results. This study aimed to assess the correlation between sperm motility and fertilization rate and embryo quality in patients undergo ICSI in Indonesia. Method: This retrospective study included couples who underwent ICSI at 2 fertility clinics in Surabaya and Tangerang, Indonesia, between 1 January 2022 to 31 December 2022. Exclusion criteria were patients with incomplete medical record and cycles using surgically retrieved or frozen sperm. Data of sperm motility (progressive and total motility) and normal fertilization rate and embryo quality on day 3 (D3) were analyzed using Spearman correlation test. Results: 98 out of 150 ICSI cycles were analyzed in this study. The mean±SD of progressive and total motility were 36,8±18,7% and 48,6±19,5%, respectively. While the percentage of fertilization rate ranged from 0% to 100% (median 70%) and percentage of good D3 embryo quality ranged from 0% to 100%, (median 7,7%). Spearman test showed a significant correlation between progressive motility and fertilization rate (p=0.00, r=0.279), progressive motility and good D3 embryo quality (p=0.000, r=0,372), total motility and fertilization rate (p=0.00, r=0.323), and total motility and good D3 embryo quality (p=0.000, r=0.404). Conclusion: Progressive motility has a weak positive correlation with the fertilization rate and the percentage of good D3 embryo quality. Total motility has a weak positive correlation with the fertilization rate and moderate positive correlation with good D3 embryo quality. These results allow adjusting our strategy in maximizing the sperm motility before ICSI cycle as sperm motility is correlated with fertilization rate and embryo quality.
#182 : Pharmacokinetics of Ovarian Stimulation for Projected Poor Responder Patients in IVF. A Randomised Trial Comparing a Corifollitropin Alfa Agonist Flare Protocol with a Corifollitropin Alfa Antagonist Protocol
Authors: Arulpragasam Kaushalya , O’Neil Mary , Sweeten Prudence , Lieberman Devora , Rodgers Rachael , Choi Shannon , Tan Joan , Briggs Nancy , Ledger William L. 
Published: January 2024

Background & Aims: Approximately 10% of patients have a sub-optimal response to controlled ovarian stimulation. Many different protocols for superovulation have been developed for this group of patients but the optimal approach for “poor responder” patients is yet to be determined. Use of corifollitropin alfa (Elonva) in a flare (EF) protocol is a novel approach to ovarian stimulation for predicted poor responder patients. We hypothesised that the unique pharmacokinetic and pharmacodynamic profiles of corifollitropin alfa would maximise FSH exposure and follicular recruitment in the critical early follicular phase due to the initial suprathreshold release of bioactive FSH in the initial 2-3 days of exposure to Elonva, in combination with the ‘flare’ of endogenous FSH release. Method: Twenty-one women aged 31-41 were identified as predicted poor responder patients according to the Poseidon criteria. Each participant was randomised to treatment with Elonva/Synarel flare or Elonva/Orgalutran antagonist. Serum FSH and E2 were measured daily for five days following injection of Elonva. The study was approved by the Southeastern Sydney HREC. Results: Serum FSH concentrations were significantly higher at each time point in the EF group when compared with the antagonist group (p=0.022). Peak FSH two days after injection of Elonva, was also significantly higher 27 vs 11 IU/L. Serum E2 concentrations were also significantly higher in the EF group at each time point (p=0.039). On day seven of stimulation, E2 concentrations were 3000 vs 1850 pmol/L. Conclusion: The corifollitropin alfa agonist flare protocol produces significantly higher FSH and E2 concentrations than a standard corifollitropin alfa antagonist protocol for projected poor responder patients, with reduced patient burden for a group who may need multiple ovarian stimulation cycles to achieve a pregnancy. A larger RCT is required to study embryology and pregnancy outcomes, costs and patient burden.
#183 : The Use of Follitropin-Delta in Indonesia: Current Evidence and Development
Authors: Siregar Fahreza Akbar , Jovito Axel , Yulinda Dafi , Regan Louis , Wiweko Budi 
Published: January 2024

Background and Aims: The current success of IVF treatments was aided by the fulminant ascent of recombinant DNA technologies. Follitropin delta (FD) is used to promote ovarian follicular proliferation. This research was aimed to investigate the current evidence and development of follitropin delta in its novel in Indonesia. Method: This prospective cohort study was conducted at the Yasmin IVF Center, Dr. Cipto Mangunkusumo General Hospital Jakarta from January 2021 to October 2022. All IVF/ICSI cycles in which follitropin delta (RekovelleⓇ, FE 999049; Ferring Pharmaceuticals, St. Prex, Switzerland) was used for ovarian stimulation. The outcome data were collected, including initial dose, and total dose of follitropin delta, retrieved oocytes, fertilized eggs, blastocyst day 3-5, embryo transfer, clinical pregnancy rates, and clinical implantation rates. The collected patients’ data (n = 20) who underwent IVF and received follitropin delta ovarian stimulation were divided into 2 groups by age (under 35 years and above 35 years). Results: The average oocyte, blastocyst, and embryo day 3 obtained in the study sample were higher in women under 35 years old. The pregnancy rate was higher in group 1 (33,30% vs. 25,0%) which was assessed based on a positive b-HCG results and a P4 value after receiving FET. Patients who followed follitropin delta ovarian stimulation had a pregnancy rate of 30%. Follitropin delta can be used in patients to successfully obtain a pregnancy in both groups, as it achieves higher result in women under 35 years old (33.3% vs. 25%). Conclusion: Optimizing ovarian response in IVF by using a program of follitropin delta dose achieved considerable rise in the quantity of good-quality, usable blastocysts. Assessing follitropin delta in individualized protocols and improving understanding of the dosages can help clinicians in evaluating follitropin delta in their conventional protocols.
#198 : When to Transfer Day 6 Vitrified Embryos? On Day 5 vs Day 6 of Progesterone, a Retrospective Analysis
Authors: Bhoi Nihar , Chandra Vipin , Murdia Kshitiz 
Published: January 2024

Background and Aims: The age of cryopreserved embryos impacts the ART outcome of frozen embryo transfer cycles. The development potential of embryos is not uniform. Though the days of progesterone exposure before transfer of D5 blastocyst is so far standardized, there is lack of standardization on transfer of Slow growing embryo i.e. D6 blastocysts. So, this study aims to compare the clinical outcomes of D6 blastocyst transferred on the 5th day or 6th day of progesterone supplementation. Method: The retrospective data were collected from the central registry of Indira IVF Hospital Private Limited to analyze 62227 frozen cycles from April 2019 to July 2021, divided into two groups: D6-Frozen embryos transferred on P+5 (Group A) vs P+6 (Group B). Results: There were 1212 cycles in Group A, and 189 cycles in the Group B arm in the final analysis). The propensity scores were calculated using binary logistic regression and the nearest neighborhood technique based on the following variables at baseline: Wife Age, Husband Age, Body max Index (BMI), Anti mullerian hormone (AMH), and Endometrial thickness. The clinical pregnancy rate was significantly higher in Group A than in Group B (CPR 70.5% vs. 63.0%, p=0.037). No significant differences were observed in the biochemical pregnancy rate (72.6% vs. 66.1%; p=0.066), biochemical loss rate (3.0% vs. 4.8%; p=0.271), clinical miscarriage rate (15.9% vs. 13.4%; p=0.485), live birth rate (59.2% vs. 54.5%; p=0.218) and multiple live birth rate (16.5% vs. 14.8%; p=0.559). Conclusion: In this study Frozen Embryo Transfer of D-6 blastocysts on the day-5 of progesterone results in better pregnancy outcomes than the day-6 of progesterone.
#210 : The Comparison of Agonist Trigger and Dual Trigger in Our IVF Population - A Single Center Retrospective Study
Authors: Pandey Seema , Vaishnav Pratik , Yadav Akhileshwar 
Published: January 2024

Background: For years, human chorionic gonadotropin (hCG) has been the trigger of choice for oocyte maturation due to its molecular and biological similarity with LH, but its longer half-life compared to LH contributes to the ovarian hyperstimulation syndrome (OHSS) in hyper responders. Besides, hCG lacks FSH activity, which plays a role in the in vitro maturation of oocytes. Gonadotropin-releasing hormone (GnRH) agonists which can bring endogenous release of both FSH and LH and have a shorter mean duration of LH surge, and effectively reduce the incidence of OHSS in high responders. However, the substitution of agonist as trigger is associated with the risk of empty follicle syndrome, increased early pregnancy loss and decreased rates of ongoing pregnancy. The idea of a dual trigger where hCG component could serve as a rescue in case of poor response to GnRH-agonist, occurring in about 2.71% of ART population, and agonist bringing FSH & LH surge simultaneously leading to improved oocyte quality was the basis for present study. Aim & objective: To observe the difference between agonist trigger and dual trigger in various ovarian reserve groups. Materials & Methods: Retrospective cohort study in patients attending Eva fertility clinic & IVF center between 2021-2022. Total patients =157 agonist trigger =57 dual trigger = 100 Age: 24 years to 41 years Average BMI 26 AMH :2.0 ng-6.6 ng/ml Primary outcome: Clinical pregnancy rate & ongoing pregnancy rate Secondary outcome: Blastocyst formation rate Total M2 achieved. Result: Pregnancy’ in (AMH: <2 ng/mL)- no significant difference between the various groups in terms of distribution of Pregnancy ([Formula: see text]2= 0.209, p = 1.000). (Table 1) Pregnancy’ in (AMH: 2-5 ng/mL)- no significant difference ([Formula: see text]2= 0.023, p = 0.880). (Table 2) Pregnancy’ in (AMH: >5 ng/mL)- no significant difference ([Formula: see text]2= 0.286, p = 0.711). (Table 3) Limitation of the study- small sample size, lack of plain hCG trigger group to compare as an arm 3. Conclusion: Dual trigger treatment with GnRH agonist and hCG is not inferior in terms of live birth rate, blastocyst, & M2 oocytes compared to GnRH agonist & hCG trigger apart from avoiding the danger of OHSS.
#212 : Does Hyaluronic Acid-Containing Transfer Media Improve the Live Birth Rate in Frozen Embryo Transfer Cycles?
Authors: Chandra Vipin , Aggrawal Ritesh , Shah Naval 
Published: January 2024

Background and Aims: The glue is typically composed of hyaluronan, a natural substance found in the female reproductive tract, and other nutrients that help to support the embryo. The glue is believed to improve the chances of successful implantation by helping the embryo adhere to the uterine lining and promoting communication between the embryo and the uterine environment. The effectiveness of embryo glue is still being studied, and limited evidence on its benefits is available. The objective of our study is to find the effect of hyaluronidase containing transfer media (Embryo Glue) on ART outcomes. Method: This retrospective study is based on central hospital recorded data between January 2015 and January 2022. The females aged 20-40 years and Body mass index (BMI) of 18.0 to 35 kg/m2 were included. Results: Univariate logistic regression showed that the duration of progesterone administration on (6-Days vs 7-days (OR 1.693; (1.045-2.740); P = 0.032), endometrial thickness on the day of P start (OR 1.167; (1.056-1.290); P = 0.002), Embryo Glue (ref. Standard treatment) (OR 1.700; 95% (1.364-2.118); P<0.001) were independent factors for predicting live birth. Multivariate logistic regression analysis showed that female age (OR 0.927; (0.893-0.963) P < 0.001), Number of blastocysts transferred (DET), (ref. SET) (OR 1.618; (1.086-2.410); P = 0.018), Endometrial thickness at the day of P start (OR 1.147; (1.014-1.298); P = 0.029) and Embryo Glue (ref. Standard treatment) (OR 1.593; (1.170-2.168); P = 0.003) were independent factors for predicting live birth. Conclusion: Embryo glue has shown significant outcomes in the present study and effectively improves IVF success and implantation rates. However, the decision to use embryo glue should be made on a case-by-case basis in consultation with a fertility specialist, and it may not be necessary or beneficial for all IVF procedures.
#244 : Reproductive Outcomes of Conventional In Vitro Fertilization and Intracytoplasmic Sperm Injection in Patients with Non-Severe Male Infertility Across Poor and Different Suboptimal Ovarian Response Categories
Authors: Yang Rui , Jiesisibieke Dina , Tian Tian , Li Rong , Liu Ping , Qiao Jie 
Published: January 2024

Background and Aims: For non-severe male factor infertility patients with poor and sub-optimal ovarian response, are there any differences in reproduction outcomes between IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) methods? Methods: Retrospective cohort study. Patients with non-severe male infertility and poor ovarian response who underwent in vitro fertilization or intracytoplasmic sperm injection at the Center for Reproductive Medicine, Peking University Third Hospital between 2009 and 2019 were included in this study (n = 30,352). Results: In all groups, intracytoplasmic sperm injection cycles involved older patients and a longer duration of infertility, while body mass index, AMH, and bFSH levels were similar. Independent of the number of oocytes retrieved, intracytoplasmic sperm injection significantly increased the fertilization rate, while in vitro fertilization cycles showed a higher implantation rate, clinical pregnancy rate, and live birth rate. No differences were observed in most obstetric outcomes, including abortion, early abortion, multiple fetus, cesarean delivery, gestational age, and congenital malformations rates. However, in vitro fertilization cycles showed higher preterm delivery rates and lower birth weights in groups with 4-6, and 7-9 oocytes retrieved. A higher female/male infant ratio was observed in intracytoplasmic sperm injection cycles when 4-6 oocytes were retrieved. Conclusions: In patients with non-severe male infertility and poor or suboptimal ovarian response, even if intracytoplasmic sperm injection increased the fertilization rate, in vitro fertilization exhibited significant advantages in implantation, clinical pregnancy, and live birth rates. Our study indicates that poor ovarian response is not an indication for intracytoplasmic sperm injection in couples with non-severe male infertility.
#262 : Clinical Outcomes of Embryo Transfer After micro-RNA Based Endometrial Receptivity Analysis (MIRA)
Authors: Hayashi Nao , Enatsu Noritoshi , Okamoto Eri , Kokeguchi Shoji , Shiotani Masahide , Yang Eric Pok , Hsu An , Hong Jun Jie , Wang Tiffany 
Published: January 2024

Background and Aims: To date, more than 2,500 micro-RNAs (miRNAs) have been discovered and some of which are considered to play important roles in window of implantation (WOI). In this study, we aimed to evaluate the efficacy of a miRNA-based endometrial receptivity analysis (MIRA) in IVF patients. Method: Patients who were planning for frozen-thawed embryo transfer (ET) cycles with a good quality single-blastocyst after at least 1 previous implantation failure history were recruited for the study. Endometrial tissue samples were collected at the mock ET cycle of hormone replacement therapy on day 5 (120 hours) of progesterone administration. Embryo transfer was conducted at the consecutive or the next cycle by reference to the MIRA result. Results: 38 patient samples were collected along with their clinical information such as age, BMI, and implantation failure history. Out of the 38 samples analyzed, MIRA found 84.2% (32/38) to be receptive, 13.2% (5/38) to be pre-receptive, and 2.6% (1/38) to be post-receptive. A total of 33 patients underwent personalized-ET at the time of statistical analysis. The overall clinical pregnancy rate was 81.8% (27/33), and for each endometrial stages were 81.5% (22/27) for receptive, 80.0% (4/5) for pre-receptive, and 100% (1/1) for post-receptive. Higher rates of non-receptivity were seen in patients with higher BMI and patients who were 36 years old or older. Conclusion: Patients who utilized MIRA, have shown good pregnancy rates of 81.8%. Patients with an abnormal BMI have a higher likelihood of experiencing a displaced window of implantation. BMI could also be an additional factor to consider when recommending patients to undergo endometrial receptivity testing in the future, aside from implantation failure history.
#263 : Follitropin Delta for Controlled Ovarian Stimulation: Evaluating Dose Equivalence Approach
Authors: Alibasya Aerul Chakra , Hasmoro Tribowo , Yudha Christianti F. , Nurfadhilah Athiyya , Angella Gita 
Published: January 2024

Background and Aims: The use of Follitropin Delta (FD) according to ESTHER-1 study algorithm for controlled ovarian stimulation (COS) protocol yielded less sufficient ovarian response in our previous experience. On the other hand, phase II and III FD clinical dose-response trials have provided dose equivalence concept between FD and Follitropin Alpha (FA) in which 10 mcg of FD was equivalent to 150 IU of FA.[Formula: see text] This study, therefore, aimed to explore an alternative approach to dose individualization of FD according to dose equivalence with FA. Methods: This was a prospective observational study. Inclusion criteria were patients who underwent IVF with FD for COS. Starting dose of each patient was prescribed according to the investigator’s experience using conventional FA dose (IU) which was then converted to FD dose (mcg) based on dose equivalence data. Results: A total of 108 women were recruited in this study. 80% of the participants were good prognosis patients. The median daily dose and total dose of FD were 15 mcg and 162 mcg, respectively (Table 1). This study observed favorable laboratory outcomes including number of retrieved oocytes, mature oocytes, fertilization rate, number and top-quality embryos at either the cleavage or blastocyst stage. In addition, 75% of the subjects acquired a surplus of frozen embryos which could be transferred in the next cycle (Table 2). Remarkable clinical outcomes were noted as follows: biochemical pregnancy of 74.2%, clinical pregnancy of 67.7%, and lowincidence of ovarian hyperstimulation syndrome (OHSS) of 3.7% (Table 3). Conclusion: Dose equivalence approach of FD to FA during COS results in favorable IVF outcomes in relation to both the embryology laboratory and clinical outcomes. This result supports the establishment of dose equivalence concept between FD and FA for routine clinical practice of IVF.
#282 : Maximizing IVF Success Rates: Optimized Simulation Using a Novel Decision-Support Tool
Authors: Patel Nayana , Diwekar Urmila , Patel Niket , Patel Molina , Bhadarka Harsha , Ghoghari Paresh , Vyas Kairavi 
Published: January 2024

Background and Aims: A mathematical procedure and a decision support tool, Opt-IVF, were developed to overcome the shortcomings of the current IVF practice of dosage profile determination by trial and error, which can provide a personalized model and optimized drug treatment. This paper describes the decision support tool for improving outcomes of IVF treatment for both antagonist and agonist protocols used in real practice. We present the results of two clinical trials. Method: Our earlier work developed models for agonist and antagonist protocols based on an analogy between superovulation and batch crystallization. This model was customized for each patient using two days of follicular data, and the optimal control method was applied to optimize the dosage profile. Validation of the model was conducted with retrospective data from 150 patients from India and 50 from the United States. Opt-IVF reduced total hormone dosage by 20 to 60%, reduced US testing by 50 to 75%, and provided a higher number of oocytes and high-quality embryos. Results: The primary outcome measures studied for two clinical trials with Opt-IVF include total hormonal dosage, % follicles retrieved, MII oocytes, Embryos, and Grade A Embryos. Results showed that Opt-IVF reduces drug dosage and testing and increases the number of embryos, Grade A embryos, and high-quality blastocysts significantly. Subgroup analysis showed improvements in outcomes were more significant for both Poor-responder and PCOS patients than for normal responders. Pregnancy rates were significantly higher with Opt-IVF patients than with standard protocol control patients. Conclusions: A mathematics-based approach to dosage profile determination results in optimal mature follicles, better embryos, and higher pregnancy with reduced dosage and the need for testing.