bluuebunny/crossref_metadata_2025_split huggingface dataset:
#154 : The Creation of a New Embryo Culture Medium with 31 Optimal Components Derived from Human Oviduct Fluid: A Prospective Multicenter Randomised Trial
Authors: Utsunomiya Takafumi , Yao Tatsuma , Itoh Hiroko , Kai Yufuko , Kumasako Yoko , Setoguchi Miwa , Nakagata Naomi , Tsutsumi Osamu , Yanagida Kaoru , Fukuda Yoshinori , Kono Tomohiro 
Published: January 2024

Background and Aims: Although culture conditions were recognized as key points, an optimal culture medium formulation, which closely resembles natural human oviduct fluid (HOF), has not been obtained yet. Our aim is to make an ideal embryo culture medium close to HOF components, and to evaluate the quality of this medium with embryo quality and clinical outcomes in assisted reproductive technology (ART) by a prospective randomized controlled trial (RCT). Method: Study I: HOF was collected laparoscopically from patients (n = 28) with normal pelvic findings. According to HOF analysis results, the new medium ‘OVIT’ was designed. Study II: Embryos (2 pronuclei (2PN) = 9,633) were assigned from 1,435 patients. The blastulation rate (BR), good BR (gBR), utilized (transferred/cryo-preserved) BR (uBR), pregnancy rate (PR), and miscarriage rate (MR) were compared between the OVIT and control groups by RCT. Study III: The neonatal healthiness who were concepted by ART using OVIT and /or control medium was compared between two groups. Results: The novel medium ‘OVIT’ was produced according to 31 HOF components. The concentrations of essential amino acids (e-AAs) were lower in OVIT than in current media, yet the opposite was true for non-e-AA concentrations. gBR and uBR were higher in the OVIT group than in the control group. In the older female group, gBT and uBR were significantly higher in the OVIT group. The neonatal conditions of those who were born by ART using OVIT and/or control medium were similar. Conclusion: HOF components and AA concentrations were analysed, and the results indicated numerous differences between OVIT and current media. This medium provides a better culture condition and improves embryo quality. This study has found novel perspectives for older patients having difficulties in producing embryos of good quality and indicated the superior quality of OVIT compared with the quality of traditional media.
#208 : The Adverse Effects of Vitrification on Embryo Development and Metabolic Health in Mice Offspring
Authors: Chen Qiaoyu , Chen Miaoxin 
Published: January 2024

Background and Aims: Embryo vitrification is widely applied as a routine procedure of assisted reproductive technology. Cohort studies showed frozen embryo transfer (FET) was associated with an elevated risk of adverse maternal and neonatal outcomes compared with fresh embryo transfer. This study aimed to explore the effects of blastocyst vitrification on embryo development and long-term metabolic health in mice. Method: Mitochondrial function, apoptotic levels and cell numbers were examined in blastocysts with/without vitrification. Implantation rates, fetal growth and placentation were analysed after fresh and frozen blastocyst transfer. Energy consumptions were measured by indirect calorimetry. Metabolic tests were performed in adult mice offspring, including glucose tolerance, insulin tolerance and pyruvate tolerance. Serum lipid profiles were examined, and fetal and adult hepatic transcriptome status were detected by RNA-sequencing and qRT-PCR. Results: Mitochondrial dysfunction increased apoptotic levels and decreased cell numbers were observed in vitrified blastocysts. The implantation and live pup rates on embryonic day18.5 were not significantly different between the fresh and frozen groups. However, fetal weights and placental efficiencies such as the ratio of labyrinth layer/ junctional zone and microvascular density were significantly reduced after FET. Offspring aged 36 weeks in the FET group had decreased whole energy consumption, impaired glucose and pyruvate tolerance, insulin resistance, higher serum triglyceride, low-density lipoprotein and total cholesterol levels compared with the fresh group. However, these metabolic effects were not observed in mice offspring aged 14 weeks. The FET group also had altered hepatic gene expression and signaling pathways related to metabolic regulation, apoptotic cell clearance, and regulation of response to reactive oxygen species etc. Conclusion: The data indicated that blastocyst vitrification has short-term and long-term adverse effects in the mouse model. Further studies are needed to optimize vitrification procedure.
#233 : Deep Learning Classification Integrating Embryo Images with Associated Clinical Information from IVF Treatments
Authors: Salih Mohamed 
Published: January 2024

Background and Aims: With the advent of artificial intelligence (AI), there is potential for AI applications in areas limited by human subjectivity, such as embryo selection. Therefore, we aimed to develop an AI model that integrates the advances of computer vision for embryo images with machine learning for clinical information. Method: Three AI models were developed, trained, and tested using a database comprised of a total of 1503 international treatment cycles (Thailand, Malaysia, and India): 1) A Clinical Multi-Layer Perceptron (MLP) for patient clinical data. 2) An Image Convolutional Neural Network (CNN) AI model using blastocyst images. 3) A fusion model using a combination of both models. All three models were evaluated against their ability to predict clinical pregnancy and live birth. Each of the models were further assessed through a visualisation process where the importance of each data point clarified which clinical and embryonic features contributed the most to the prediction. Results: The experiments achieved the following results for predicting clinical pregnancy, the MLP model achieved a strong performance of 81.76% accuracy, 90% average precision and 0.91 AUC, the CNN model achieved a performance of 66.89% accuracy, 74% average precision and 0.73 AUC, the Fusion model achieved 82.42% accuracy, 91% average precision and 0.91 AUC. From the visualisation process we found that female age and female BMI to be the most clinical factors, whilst Trophectoderm to be the most important blastocyst feature. Conclusion: The fusion AI model integrating clinical features and embryo images made more informed predictions, achieving better performance than separate models alone. This study demonstrates that AI for IVF applications can increase prediction performance by integrating blastocyst images with patient clinical information.
#252 : Granulosa Cell Metabolism is Differentially Impacted by Obesity and Aging and Correlated With Oocyte Competence
Authors: Morimoto Atsushi , Rose Ryan , Smith Kirsten , Dinh Doan ‘Thao’ , Umehara Takashi , Winstanley Yasmyn , Morimoto Yoshiharu , Russell Darryl , Robker Rebecca 
Published: January 2024

Background and Aims: Aging and obesity are associated with female infertility, with mitochondrial dysfunction proposed as an underlying factor; but our understanding of energy metabolism within the ovary remains limited. Method: This study focused on the granulosa cells surrounding the oocyte and investigated mitochondrial function, glycolytic function, total ATP production, and fatty acid metabolism using real-time metabolic analysis (Seahorse XFe96) to understand the effects of obesity and aging on energy metabolism. Mouse models were used to precisely isolate the effects of aging and obesity, with parallel studies conducted on human granulosa cells. Results: In mice, aging impaired both mitochondrial function and glycolytic function, while obesity primarily reduced mitochondrial function. Mice with both aging and obesity showed massively impaired granulosa cell metabolism. Next, the metabolic profile of granulosa cells in the follicular fluid of a cohort of 130 women who underwent IVF/ICSI cycles was measured. Aging primarily impaired mitochondrial function, with ATP production biased towards glycolysis, and no correlation was found with glycolytic function. Obesity primarily affected ATP production efficiency in mitochondria. Correlations between granulosa cell energy metabolism and embryonic development were also found. Mitochondrial spare capacity was associated with more retrieved oocytes, glycolytic reserve capacity was associated with Day 3 embryo quality, and mitochondrial ATP production was associated with improved blastocyst formation rates. Analysis of patient diagnoses revealed that in patients with normal ovarian function, only ATP production efficiency was decreased by aging, whereas in patients diagnosed with conditions of impaired ovarian function, mitochondrial function was more important. Interestingly, patients with adequate mitochondrial function showed good embryonic development, whereas those with very high mitochondrial and glycolytic energy metabolism showed a negative correlation with embryonic development, which was also observed in patients with ovarian dysfunction. Conclusion: These results provide new insights into the underlying metabolic dysfunction that occurs with female infertility.
#375 : Sperm Quality and its Association with Embryonic Aneuploidy Outcomes in Preimplantation Genetic Testing for Aneuploidies (PGT-A)
Authors: Susanto Sarah , Azzahra Tiara Berliana , Iffanolida Pritta Ameilia , Mutia Kresna , Riayati Oki , Wiweko Budi 
Published: January 2024

Background and Aims: The global prevalence of infertility is approximately 12% of couples worldwide. An epidemiological study by the World Health Organization (WHO) revealed the prevalence of infertility in low- and middle-income countries is 16.5%.1About 50% of the cases of infertility was found to be male infertility. Only one-third of patients that underwent IVF leads to clinical pregnancy. Sperm characteristics has been shown to contribute to IVF failure. The embryo developed through IVF may be aneuploid. The chromosomal composition can be examined using PGT-A.[Formula: see text] This study aims to determine the relationship between aneuploidy findings and poor-quality sperm, in terms of volume, concentration, morphology, motility, and DNA Fragmentation Index (DFI). Methods: This is a cross-sectional study. Sperm analysis data from 25 patients at Yasmin Fertility Clinic from 2020-2023 and 63 embryonic PGT-A results from the same patients obtained from Indonesian Reproductive Medicine Research and Training Center was included. Normality and correlation analysis was done using SPSS. Results: This analysis included data from 25 couples and 63 embryos. From the samples of embryo, about 66.67% (0.00-100.00%) were aneuploid with either monosomy, trisomy, or mosaic. The most common sperm abnormalities are oligoastenoteratozoospermia with 11 (17.46%) cases, followed by oligozoospermia (N = 7(11.11%)) and oligoteratozoospermia (N= 7(11.11%)). Infertility among 31 (49.2%) couples are caused by maternal condition. Sperm morphology is negatively correlated with aneuploidy percentage along withits types. Negative correlation can be seen in between sperm concentration and mosaicism, and between sperm DFI with number of aneuploid chromosome, monosomy, and mosaicism. However, the only statistically significant finding correlation is between sperm motility and mosaicism, which is correlated positively (r = 0.260, p = 0.043). Conclusion: A significant positive association was found between sperm motility and chromosomal mosaicism.
#40 : Correlation Between Pre-Trigger Estradiol Levels and the Number of Mature Oocytes in Patients Who Underwent In Vitro Fertilization
Authors: Shafira Nadia , Wijaya Liva , Halim Ayang , Abidin Boy , Hasmoro Tri Bowo , Wiweko Budi 
Published: January 2024

Background and Aims: Strong association between pre-trigger estradiol levels on the day of human Chorionic Gonadotropin (hCG) administration and the number of mature oocytes retrieved was widely reported. Consequently, higher estradiol levels measured might give a prediction of the higher number of mature oocytes retrieved on Ovum Pick Up (OPU) procedure. This study was done to investigate the correlation between pre-trigger estradiol levels and number of mature oocytes retrieved in patients who underwent In Vitro Fertilization (IVF) cycles in Indonesian population. Method: A cross sectional study was done at Mbrio IVF Clinic, Mitra Keluarga Hospital Kelapa Gading, Jakarta, Indonesia. Data was collected from the medical records of 77 patients who underwent IVF cycles between September 2021 and March 2023. The level of estradiol on the hCG administration day and the number of mature oocytes retrieved were analysed to find any correlation between both variables using the Spearman Test. Results: There were 77 women who underwent IVF procedures with the age range between 27 and 45-year-old (mean 35,5 ± 4,52). Most of them (83%) had primary infertility and had infertility between 1 to 14 years (mean 5,5 ± 3,48). These subjects came to the clinic mostly due to both male and female factors (49,4%), followed by male factor only (27,3%). E2 on hCG day ranged between 194 to 13.000 pg/ml with the median 2.709 pg/ml, and the mature oocytes retrieved ranged between 0 and 31 with a median of 8 oocytes. A statistically significant correlation (r = 0.827; p<0.01) was found between the estradiol level and mature oocytes retrieved. Conclusion: Pre-trigger Estradiol level can be used as a predictor for the number of mature oocytes retrieved in IVF cycle as these two variables are strongly correlated to each other. A multi-centre study with larger sample size is needed to validate current data.
#57 : A Prediction Model of Low Birthweight in Singleton Pregnancies Reduced from Dichorionic Twin Pregnancies
Authors: Tang Minyue , Wang Guiquan , Zhu Yimin 
Published: January 2024

Background and Aims: The incidence of twin pregnancies has risen over the last few decades, mainly attributed to assisted reproduction techniques (ART). Fetal reduction (FR) can significantly reduce low birthweight (LBW) risk in twins. However, the LBW risk is still higher in singletons reduced from twins than for primary singletons. Many factors, such as maternal factors, FR timing and approach may affect LBW risks after FR and no relevant prediction models have been reported to date. The main objective of this study is to develop a nomogram to predict LBW risk in singleton pregnancies reduced from dichorionic (DC) twins. Method: We retrospectively reviewed and analyzed the data on women with (DC) twin pregnancies who underwent FR in Women’s Hospital, Zhejiang university, School of medicine in July 2005 to August 2021. Logistic LASSO regression was used to identify the most relevant variables associated with LBW. The nomogram was constructed and receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, and decision clinical analysis were used for model performances assessment and visualization. The model was evaluated by cohorts produced by 500 resampling bootstrap analysis to testify the stability. Results: A total of 471 patients were enrolled in the analysis. At last, seven independent predictive factors for LBW were identified and integrated to construct the nomograms, including maternal height, nulliparous, conception mode, reasons for FR, gestational age at FR, gestational diabetes, pregnancy hypertensive disease. The AUC of our prediction model was 0.793, which was validated by internal (AUC 0.762) confirmation with bootstrap analysis. The nomogram had well-fitted calibration curves. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusion: We made the first attempt to develop a reliable predictive nomogram for the risk of LBW in DC twin pregnancies reduced to singletons, providing a useful guide for clinicians and patients in making appropriate FR decisions.
#74 : Rare Presentation of Bilateral Haemorrhagic Pleural Effusions in Ovarian Hyperstimulation Syndrome
Authors: Cheong Yee Tsing , Tarmizi Hatta , Wahab Ana Vetriana A , Loh Yoke Ling 
Published: January 2024

Background and Aims: Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of controlled ovarian hyperstimulation. Pleural effusions seen in OHSS usually are accompanied by marked ascites. Isolated pleural effusion without ascites is extremely rare. Here, we report a case of severe OHSS with rare presentation of isolated bilateral haemorrhagic pleural effusions following controlled ovarian hyperstimulation in in vitro fertilization (IVF). Method: We present a case of a 31-year-old lady with polycystic ovarian syndrome (PCOS) undergoing IVF where antagonist regime was used. To reduce OH SS risk, agonist trigger was given followed by cryopreservation. The patient was discharged well after oocyte retrieval. She needed admission the following day due to worsening abdominal pain. Cabergoline was started together with analgesia. On day 4 admission, she developed left haemorrhagic pleural effusion which was drained. Her condition improved initially but pleural effusion recurred after a few days and this time was bilateral. Pleural fluid drainage was repeated. Results: Patient recovered and was discharged well after 3 weeks of hospitalization. Five months later, we performed frozen embryo transfer where two day-3 embryos were transferred (both 8-cell Grade 1). She had a successful singleton pregnancy. At 38 weeks of gestation, she delivered a healthy boy weighing 3.67 kg via Caesarean section. Conclusion: Pleural effusion as sole presentation of severe OHSS is a very rare occurrence. Despite close monitoring during ovarian stimulation and rigid guidelines, OHSS still occurs. Early detection and prompt intervention by a multidisciplinary team are crucial to ensure successful management of this serious complication.
#105 : Single Day 5 Versus Day 6 Euploid Blastocyst Transfer: The Impact of Embryo Quality on Pregnancy Outcomes
Authors: Le Thang , Nguyen Thuy , Phan Quy , Phi Anh , Giap Phuong , Nguyen Huong , Le Hoang 
Published: January 2024

Background and Aims: Selecting embryos with the highest implantation potential is crucial to in vitro fertilization (IVF) success. The day of biopsy, Day 5 (D5) or Day 6 (D6), and embryo quality have been suggested as influential factors in determining the clinical outcomes of single euploid blastocyst transfers. However, evidence supporting the superiority of D5 over D6 blastocysts remains inconclusive. This study aims to compare clinical outcomes following transfer of euploid blastocysts of varying quality biopsied on day 5 versus day 6. Methods: A retrospective cohort study was conducted at an Assisted Reproductive Center, analyzing 774 patients with Day 5 biopsies and 155 patients with Day 6 biopsies who underwent embryo transfer between January 2019 and February 2022. Results: The live birth rate was significantly lower in the euploid D6 group than in the euploid D5 group (38.71% vs. 55.04%, RR=0.70, 95% CI=0.57-0.87). The outcomes were significantly influenced by the quality of the embryos. Excellent embryos yielded live birth rates of 62.14% and 53.61% for D5 and D6 biopsies, respectively, while good embryos demonstrated live birth rates of 45.18% (D5) and 32.21% (D6). For fair embryos, the live birth rates were 28.64% (D5) and 19.32% (D6). The outcome difference was statistically significant across embryo quality categories (p<0.05). The adjusted risk ratios of clinical outcomes indicated that excellent euploid Day 5 embryos consistently outperformed other types of embryos. Conclusions: Our study supports that the biopsy day and embryo quality are crucial factors in determining the success of single euploid blastocyst transfers. Excellent euploid Day 5 transfers yielded superior outcomes, providing valuable insights for clinicians and patients when selecting embryos for transfer in IVF cycles.
#127 : Case Series of 26 Pregnant Women with Tuberculosis Recurrence After IVF-ET
Authors: Li Hongwei , Gao Mingxia 
Published: January 2024

Background and Aims: There is limited data on the outcomes of pregnancies complicated by tuberculosis (TB) recurrence following in vitro fertilization-embryo transfer (IVF-ET). This study aims to describe the diagnosis, treatment, and pregnancy prognosis of pregnant women with TB recurrence after IVF-ET. Methods: A review of 26 patients with TB recurrence after IVF-ET or during the gestation period was conducted. Results: Pregnancy with TB after IVF-ET was common in women with twin pregnancies and a history of TB, often presenting as fever and vaginal bleeding. Miliary nodules were the primary manifestation on chest imaging, indicating a serious condition. Some patients with extrapulmonary TB exhibited atypical symptoms, leading to missed or misdiagnoses. Among the 26 patients, 22 terminated their pregnancies, and one with tuberculous meningitis underwent a cesarean section 123 days after ET but died 28 days post-operation. Four patients had live births, but three neonates (including two twins) ultimately died after birth due to TB infection or dysplasia. Conclusion: The prognosis of pregnancies complicated by TB recurrence after IVF-ET is poor. For patients presenting with fever and TB-related symptoms, TB recurrence should be suspected, and multidisciplinary cooperation is advised to confirm the diagnosis and provide timely treatment. If acute miliary TB is diagnosed, pregnancy termination should be considered when necessary. Single embryo transfer is suggested for patients with a history of TB, and frozen embryo transfer may benefit patients at high-risk of TB.
#144 : Randomized Controlled Trial Evaluating Efficacy of Autologous Platelet-Rich Plasma Therapy for Patients with Recurrent Implantation Failure in Frozen-Thawed Embryo Transfer After PGT-A
Authors: Obidniak Diana , Gzgzyan Alexander , Niauri Dariko , Kogan Igor 
Published: January 2024

Background and Aims: Despite keen development of ART, recurrent implantation failure (RIF) remains a challenging dilemma for fertility specialists. As it contains significant growth factors involved in delicate process of implantation, platelet–rich plasma (PRP) therapy should promote endometrial receptivity and improve ART. Objective: To evaluate if the intrauterine perfusion with autologous PRP enhances frozen-thawed embryo transfer effectiveness in patients with RIF after PGT-A. Methods: Study type: Interventional. Design: randomized controlled study Intervention Model: Parallel Assignment Masking: open label After obtaining institutional review board approval, 232 women aged 28-42 years were involved. Matching criteria: RIF, normal karyotype, absence of uterine factors of infertility, availability of euploid embryos after PGT-A (NGS). 2 groups of patients: study group (N = 118): single IP with 2.0 ml of autologous PRP on day 10-11 of menstrual cycle; Control group: no therapy (N = 114). Endometrium preparation was carried out according to standardized protocol. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were pregnancy loss rate, endometrial thickness and adverse event. Results: The clinical pregnancy rate was higher in the study group (63.55% vs 38.59%) ([Formula: see text]2=14.462, OR=2.775, 95% CI 1.630 - 4.722, p<0,001). The endometrium thickness before intervention didn’t between groups (7.3 vs 7.4 mm), however, endometrium thickness measured just before embryo transfer was significantly higher in the study group (10.5 vs 8.4 mm, Student’s t-test value: 11.87; number of degrees of freedom f=230; Critical value of Student’s t-test=1.972, at significance level [Formula: see text]= 0.05). The pregnancy rate loss did not differ between groups ([Formula: see text]2=0.033, OR=0.908, 95% CI 0.324 – 2.546, p>0,05). No adverse event was noted. Conclusions : – The PRP intrauterine perfusion should be considered perspective, safe and cost-effective therapy method for patients with RIF. – PRP does not influence on pregnancy loss rate – Meta-analysis is required. Support: None