bluuebunny/crossref_metadata_2025_split huggingface dataset:
#23 : Correlation of Multinucleated Embryo and Pregnancy Outcome
Authors: Razali Nuguelis , Tan Siew Yin , Ramly Ruhaima , Idris Siti Khadijah , Hamdan Mukhri 
Published: January 2024

Background and Aims: Single embryo transfer is increasingly done in practice to avoid multiple pregnancy. Therefore, it is important to ensure the embryo with the best pregnancy outcome is selected. Although new criteria involving genomic, transcriptomic, and proteomic have been developed to predict embryo outcome, morphology of the embryo remains as the main indicator because it is easy to implement and less controversial. To study the correlation of multinucleated embryos and pregnancy outcomes Method: This is a retrospective review of a total of 411 embryos from 225 women undergoing their first IVF or ICSI cycle in University Malaya Medical Centre, Kuala Lumpur between January 2019 and October 2021. Multinucleation was defined as the presence of more than one nucleus within at least one of the blastomeres of a 2-cell embryo and a time-lapse imaging system was used to observe embryo development (Embryoscope; Unisense Fertilitech). Group allocation was based on the presence or absence of multinucleation on day 2 after egg retrieval. Embryos with evidence of one or more blastomere having multinucleation were included in the studied group (n = 67 embryos). Embryos without any blastomere exhibiting multinucleation were included in the control group (n = 344 embryos). Results: The data were based on 225 transfers of 411 embryos consisting of 16.3% (n = 67) from studied group and 83.7% (n = 344) from the control group. The biochemical pregnancy rate and implantation rate is lower in the studied group compared to the control group although not statistically significant (Table 1). Conclusion: Multinucleated embryos reduce the implantation rate and clinical pregnancy rate although not statistically significant.
#50 : Effect of Dual vs. Single (hCG) Trigger in Maturation Rate of Oocytes in ART
Authors: Wijaya Liva , Shafira Nadia , Abidin Boy , Halim Ayang , Hasmoro Tri Bowo , Wiweko Budi 
Published: January 2024

Background and Aims: Due to its similar molecular structures and biological activities, human chorionic gonadotropin (hCG) is used as a substitute for luteinizing hormone (LH) in ART. The weaknesses of using hCG as a trigger are the possibility of ovarian hyperstimulation syndrome in high responders and lacked FSH activity which promotes LH receptor formation in luteinizing granulosa cells, nuclear maturation, and cumulus expansion. GnRH agonist (GnRHa) reduces the development of OHSS and induces a physiological surge similar to the natural menstrual cycle. Because of shorter amplitude and duration of GnRHa-induced LH surge, GnRHa-alone trigger results in a higher early miscarriage rate. Combining these two agents; dual trigger increases oocyte maturation with reduced OHSS. Here we present reports in our clinic to differentiate the dual vs. hCG trigger results. Method: We retrospectively analyzed the data from 68 patients who had undergone antagonist protocol from January 2021-January 2023. The final oocyte maturation was undertaken with a dual trigger with GnRHa (Buserelin 0.3 mg) combined with hCG (r-hCG 250 [Formula: see text]g) ([Formula: see text] = 33) or hCG alone ([Formula: see text] = 35). Results: The mean age of both groups was 34 years old. The AMH level of the dual group ranged from 0.06 – 7.17 ng/mL, and in hCG alone group ranged from 0.16 – 12.3 ng/mL. Women in both groups got similar amounts of follicles and MII oocytes; dual group (14.8 and 12.72 vs. 14.9 and 13). The retrieval rate of oocytes was identical in both groups (86.6% vs. 89.9%). However, the maturation rate of dual group was slightly lower than the hCG group (77% vs. 82%), but it was statistically insignificant (independent t-test p 0.99). Conclusion: We showed that dual trigger was not superior to hCG-alone trigger in terms of maturation rate of oocytes. Analysis of larger data is needed to show the real advantages.
#138 : Effect of Endometriosis on Human ICSI, and Endometriosis Follicle Fluid on Mouse Oocyte Maturation and Mitochondria
Authors: Adnyana Ida Bagus Praja Putra , Sudiman Jaqueline , Adnyana Ida Bagus Putra , Chandragiram Tjokorda , Dewi Ni Nyoman Ayu , Suardika Anom , Widianti I Gusti , Suwiyoga Ketut , Surya Udayana I Gusti Ngurah Bagus 
Published: January 2024

Background and Aims: Endometriosis is the common cause of infertility. Assisted Reproductive Technology has become a promising choice for women with endometriosis, however, there is no consensus concerning the impact of endometriosis on the success rate. Our study was aimed to assess the impact of endometriosis on ICSI and to investigate the effect of endometriosis follicle fluid (FF) on mouse oocytes maturation and mitochondrial activity. Methods: Hormonal stimulation, embryo quality and success rate from moderate-severe and minimal-mild endometriosis were compared with tubal infertility patients as controls. Then animal experiments were carried out involving the co-culturing of mouse oocytes with FF from moderate-severe endometriosis patients to assess mitochondrial dye, oocyte maturation, and protein levels of cytochrome C and cyclin B1 using ELISA. Results: The number of follicles, mature oocytes, and fertilization rates were significantly lower in moderate-severe endometriosis group compared to control and minimal-mild endometriosis groups. This led to significantly decreased pregnancy rates in moderate-severe endometriosis group compared to minimal-mild endometriosis and control groups [26/72 (36.1%); 27/47 (57.4%); 85/152 (55.9%), p<0.05, respectively]. Implantation rates in moderate-severe endometriosis group decreased significantly compared to control group [31/166 (18.7%) vs 113/392 (28.8%), OR 1.76; 95% CI 1.14 to 2.79; p<0.05). Mitochondrial dye was significantly lower in mouse oocytes cultured with endometriosis FF compared to control and oocytes cultured with tubal factor FF. Cyclin B1 protein level was lower in oocytes cultured with endometriosis FF compared to control and oocytes cultured with tubal factor FF. There was no difference in cytochrome C protein level among groups. Conclusions: Our results showed that moderate-severe endometriosis is associated with reduced quality of oocyte and embryo and leads to lower success rates of ICSI. This research also showed FF could impair mouse oocytes nuclear maturation which may be related to reduced cyclin B1 level and decrease activity of mitochondria.
#243 : Comparison of IVF Outcome Following Follitropin Alfa and Follitropin Delta Utilization at Melati Clinic, Harapan Kita Women and Children Hospital
Authors: Supriyadi Agus , Prasetiawati Novita , Sjarbaini Hadi , Tarigan Sudirmanto , Suardana Gde , Haekal Mohammad , Indah Deana Rosaria , Pariyanti Gangsar 
Published: January 2024

Background and Aims: Follitropin delta is the third recombinant FSH (rFSH) preparation developed with an individualized dosing regimen based on patient’s body weight and AMH level. According to the existing report, a daily dose of follitropin delta provides an equivalent ovarian response to that of follitropin alfa. However, the effect of follitropin delta on the resulting embryo and biochemical pregnancy remains to be elucidated. Hence, the present study aims to evaluate the effect of follitropin delta on embryo quality and biochemical pregnancy rates compared with that of follitropin alfa in an in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle. Methods: A retrospective cohort study was conducted between January and December 2022 at Melati Clinic, Harapan Kita Women and Children Hospital. A total of 59 IVF/ICSI cycles stimulated with follitropin alfa and 26 IVF/ICSI cycles treated with follitropin delta were subsequently analyzed. Results: After analysis, no significant difference was observed regarding the embryo quality of both treatments (P>0.05). The median of the good, moderate, and poor embryos in the follitropin alfa and follitropin delta group was 2 vs. 3, 1 vs. 2, and 2 vs. 2, respectively. Similarly, the biochemical pregnancy rate between the follitropin alfa and follitropin delta group was comparable (25% vs. 15%, P>0.05). Conclusions: In conclusion, our study suggests that stimulation with follitropin delta in IVF/ICSI cycles yields a similar embryo quality and biochemical pregnancy rates to those of follitropin alfa.
#42 : Comparison of Fertilization, Blastocyst Utilization, Clinical Pregnancy Rate (cPR), Implantation Rate (IR) and On-Going Pregnancy Rate Using Fresh and Frozen-Thawed Micro-Epididymal Sperm Aspiration (MESA) Sperm
Authors: Yong Kai Boon , Heong Chee San , Chew Mee Fong , Tee Sze Tian 
Published: January 2024

Background and Aim: To compare the fertilization, blastocyst utilization, clinical pregnancy rate (cPR), implantation rate (IR) and on-going clinical pregnancy rate between fresh versus frozen-thawed micro-epididymal aspirated sperm (MESA) in intra-cytoplasmic sperm injection (ICSI) cycle. Methods: A retrospective study of a total of 27 MESA-ICSI cycles done from the year 2019 to 2022 was carried out. Patients were categorized into fresh MESA-ICSI group (n=16) and frozen-thawed MESA-ICSI group (n=11). The maternal mean age of both groups was 33.0 and 32.5 respectively. For fresh MESA-ICSI group, retrieved sperm were being injected on the same day while frozen-thawed MESA-ICSI group, sperm sample were being frozen after the MESA procedure and utilized in the future. Sample was processed using sperm medium (COOK MEDICALⓇ). All embryos were cultured in time-lapse monitoring incubator and assessed according to modified Gardner’s grading system. On day 5/6, blastocyst range from grade A to C will be vitrified for frozen embryo transfer (FET). A total of 22 FET procedures were done, and statistical analysis was performed using Fisher’s exact test, p<0.05. The mean number of embryos transferred for MESA-ICSI group and frozen-thawed MESA-ICSI group are 1.43 and 1.13 respectively. Results: There is no significant difference in the fertilization rate between fresh MESA-ICSI, 71.1% (106/149) and frozen-thawed MESA-ICSI group, 65.4% (70/107). The blastocyst utilization rate between fresh and frozen-thawed MESA-ICSI group are also similar, 45.3% (48/106) and 51.4% (36/70) respectively. Besides, the cPR shown higher in the fresh MESA-ICSI group, 64.3% (9/14) compared to frozen-thawed MESA-ICSI group, 37.5% (3/8). The IR, 50.0% (10/20) and on-going pregnancy rate, 57.1% (8/14) were higher in the fresh MESA-ICSI group compared to frozen-thawed MESA-ICSI group, 33.3% (3/9) and 12.5% (1/8) respectively, p<0.05. Conclusion: The results show the trend of higher cPR, IR and on-going pregnancy rate in fresh MESA-ICSI group compared to frozen-thawed MESA-ICSI group. However, further study is required to conduct in a larger population in order to obtain a significant result.
#103 : The Clinical Outcomes of Lasered Assisted Hatching on Single Frozen-Thawed Blastocyst Cycle: A Retrospective, Observational Study
Authors: Chong May Kee , Ng Sue Hwee , Sim Poo Keen 
Published: January 2024

Background and Aims: The ultimate goal in assisted reproductive field is to achieve a pregnancy. For embryo to implant, embryo must be hatched from zona pellucida. Therefore, pregnancy began. Lasered assisted hatching (LAH) has been proposed as one of the interventions to increase the success rate, yet the efficacy remains uncertain. Hence, the aim of this study was to evaluate the effect of LAH toward clinical outcomes including clinical pregnancy, miscarriage, and ectopic pregnancy rate on single frozen-thawed blastocyst cycle. Method: A total of 1553 single frozen-thawed blastocyst cycles (LAH, n=116; non-LAH, n=1417) with patient’s mean age of 35 ± 0.06 were recruited from 2018 to 2022. The exclusion criteria were as follows: (a) gamete/embryo donation cycle and (b) PGT cases. Assisted hatching procedure was performed on LAH group with 1.46-[Formula: see text]m noncontact diode laser (LYKOSⓇ Laser) prior to embryo transfer. Result: The clinical pregnancy, miscarriage and ectopic pregnancy rates for LAH and non-LAH groups were 44.8% versus 48.7%, p = 0.35, 17.3% versus 16.2%, p = 0.86 and 0% versus 0.7%, respectively. No statistically significant difference was found on these clinical outcomes. Conclusion: This study demonstrated the use of LAH has no impact on the clinical outcomes and did not increase miscarriage and ectopic pregnancy. Therefore, it can be a useful tool for patients with recurrent implantation failure or embryo with thick zona pellucida.
#302 : Shorter Centrifugation Time Leads to Better Sperm Quality in Swim-Up Processing Technique
Authors: Novia Diana , Halim Binarwan 
Published: January 2024

Background and Aims: Centrifugation is one of the many factors that cause sperm DNA damage in IVF semen preparation. This can occur due to the formation of reactive oxygen species (ROS) that are uncontrollable, so that the quality of sperm DNA can be damaged. This study aims to compare sperm quality results with swim-up technique under centrifugation times of 5 and 10 minutes. Method: This study involved 50 patients at the Halim Fertility Center clinic from June 2020 to October 2020. The samples obtained were processed using the swim-up method. Samples were divided into 3 groups, namely control, 5 and 10 minutes of centrifugation. Sperm quality recorded was concentration, total motility, progressive motility and DNA fragmentation index (DFI). Results: The sperm concentration after 5- and 10-min centrifugation before swim-up (27.78-39.79 and 35.36–51.09, respectively; p [Formula: see text] 0.05) was significantly higher compared to control (24.85–32.33). The total motility before and after 5- and 10-min centrifugation were 43.78–51.08, 97.66–98.20, and 97.86–98.20, respectively. The progressive motility after 5- and 10-min centrifugation (0–41 and 0–54, respectively) was significantly higher than control (0–24; p < 0.05). The DFI was significantly better after 5 min centrifugation (3.82–6.98) compared to control and after 10 min centrifugation (13.48–19.04 and 1–25, respectively; p < 0.05). Conclusion: Shorter centrifugation times indicate lower progressive motility than long centrifugation times, but considering the lower DFI level, shorter centrifugation times must be used in sperm preparation for IVF to produce better sperm quality.
#178 : Sexual Function in Women from Migrant and Refugee Backgrounds
Authors: Damabi Negin Mirzaei , Avery Jodie , Begum Mumtaz , Padhani Zahra Ali , Lassi Zohra 
Published: January 2024

Background and Aims: Women from migrant and refugee backgrounds are poorly studied when it comes to sexual function. These women face multiple barriers to accessing sexual and reproductive health services, including language barriers, socio-cultural beliefs, limited socioeconomic resources, and inadequate knowledge. This study conducted a scoping review of existing literature on sexual function and related knowledge in this population. Methods: This scoping review adhered to the 2020 PRISMA guidelines and systematically gathered information from online databases such as Medline, Embase, CINAHL, and Cochrane Library. Without applying any search limitations, the review included all studies that examined the sexual function of migrant and refugee women. Based on the eligibility criteria, two authors independently screened and extracted data from the included studies using the Covidence software. Afterwards, descriptive and thematic analyses were conducted. Results: The findings suggest that the sexual function status of migrants is a complex issue influenced by multiple factors, yet it remains understudied, with the majority of research focusing on sexual and reproductive health (SRH). Studies have shown that migrants may experience higher levels of sexual dysfunction; they tend to have less sexual knowledge, liberal attitudes, and lower rates of desire, arousal, and pleasure compared to non-migrant women. Additionally, factors such as acculturation, education, gender role ideology, and satisfaction with partner relationships can impact their sexual function. Conclusions: This study underscores the limitations of research on sexual function in migrants. It emphasises the need for culturally sensitive counselling and psychosocially focused programs aimed at addressing the sexual dysfunction inequities experienced by migrant and refugee women and catering to their unique needs in SRH health care sessions. Future research should focus on neglected populations and tailor effective care to enhance their sexual function and overall well-being.
#177 : Pregnancy in Partial Empty Sella Secondary to Infarction of Pituitary Microadenoma
Authors: Raguindin Erica Joy , Manzano Dianne 
Published: January 2024

Background and Aims: Hyperprolactinemia results from overstimulation of prolactin production which presents as gonadal dysfunction, cranial symptoms and maybe of different etiologies. The hormonal and somatic changes in pregnancy are predictable and affects all body systems, but the presence of pathologic condition in this altered state may require special attention to account for these changes and the life of the child being carried. Method: This is a case of a 34-year-old, G4P2(1122) with oligomenorrhea, difficulty in conception and headache. Her first pregnancy last December 2016 ended with an abortion. She was diagnosed with polycystic ovarian syndrome along with hyperprolactinemia. Cranial magnetic resonance imaging (MRI) revealed pituitary microadenoma and was treated with bromocriptine. A successful pregnancy was achieved 2 months after treatment with uneventful course and was lost to follow-up. A spontaneous abortion last December 2020 prompted work-up. Results: The patient underwent work-up and a repeat laboratory showed a return of hyperprolactinemia but with a partial empty sella on imaging. Resumption of Bromocriptine resulted in remission of prolactin after 2 months. Another successful pregnancy was achieved, and she delivered last 2021 with no complications. She was able to breastfeed postpartum with no subjective complaints. As of writing, the patient is asymptomatic. Conclusion: A thorough history is a critical step in identifying possible causes which may guide us in further investigations and treatment options for Hyperprolactinemia. A resolution of pituitary adenoma is caused by various pathological processes resulting in partial empty sella. Routine hormonal status assessment and regular follow-up are indicated since the prevalence of pituitary dysfunction is significant.
#332 : A Rare Case Report of Mixed Gonadal Dysgenesis with MOS 46, XY, 47,XY+21, 45,X Karyotype
Authors: Dafhonsa Meycha , Budihastuti Uki Retno , Melinawati Eriana 
Published: January 2024

Background and Aims: Mixed gonadal dysgenesis is a condition of unusual and asymmetrical gonadal development leading to an unassigned sex differentiation. A number of differences have been reported in the karyotype, most commonly a mosaicism 45, X/46, XY. We herein report an interesting case of mixed gonadal dysgenesis. Method: We present a rare patient case with mixed gonadal dysgenesis as a disorder of sex development (DSD) and a new pattern of chromosome in the karyotype, undergoing laparoscopic procedure for sex correction. Results: A 20-year-old person, reared as female presented with complaints of genital ambiguity and primary amenorrhoea along with lack of secondary sexual characters, but without short stature and Turner’s stigmata.Karyotype analysis revealed Mos 46, XY, 47,XY+21, 45,X karyotypeLuteinizing hormone (LH) was 18.3 mIU/ml and follicle-stimulating hormone (FSH) was 70,07 mIU/ml. Serum estradiol level was 35,9 pg/ml and prolactin was 25,8 ng/ml). Magnetic resonance imaging (MRI) pelvis with contrass (with ultrasonogrphy correlation) revealed uterus hypoplasia with right ovarian-like structures. View of corpus uteri measuring 1× 1.5× 0.8 cm with cervix building length 1 × 0.5 cm were visualized laparoscopically. The right tube and left tube (include bilateral fimbare) appear to be normal in shape and size. Right gonad with base in corpus uteri, white color, elongated ligament-like shape 0.5 × 0.3 × 0.8 cm, no follicle visible. The left gonad was seen with its base at the corpus uteri, white in color and elongated like a ligament uk 0.5 × 0.4 × 0.8cm, no follicles visible. Both gonads biopsied. Conclusion: Histopathology is still awaiting results. The patient was managed with a multidisciplinary approach and fertility issues discussed with the patient’s family.
#130 : Food Intolerance and Conception in Women Suffering Repeated Implantation Failure
Authors: Lee Li-Hsuan , Hsu Chao Chin 
Published: January 2024

Background and Aims: Food-specific immunoglobulins, in combination with the elevated reactive oxygen species and other inflammatory components, have been indicated to represent immunological response to food consumed. This study aimed to investigate the relationship of food intolerance and conception in women receiving IVF treatments. Method: Infertile women who had experienced at least two failed embryo transfer treatments were investigated between June 2017 and August 2021 in TUBE Fertility Clinic. The whole blood 20 mL was taken from cubital vein and complete food panel examination employing ELISA analyses were designed to assay food-specific IgG and IgE antibodies. The levels of IgG antibodies were presented through spectrophotometric analysis (Table 1). The IgG tests included 5 dairy components, 25 grains/legumes/nuts, 18 vegetables, 9 egg/meat/poultry, 21 fruits, 9 herbs/spices, 18 fish/crustacea/mollusk, and 9 miscellaneous foods including baker’s yeast. Infertile women were asked to refrain from those foods according to the level of hypersensitivity, six months were required for those with reaction class III to IV, and three months for those with reaction class II. Further IVF and embryo transfer cycles were then carried out afterwards. Results: In total, 67 infertile women enrolled in this study. Their mean age was 38.2 ± 4.3 years old. They had received 2.7 ± 1.6 previous IVF/ET cycles. All 67 women showed positive IgG and 14 (21%) women with positive IgE investigated. Grains/legumes/nuts (90%) and dairy products (86.6%) were the most common hypersensitive foods (Table 2). Thirty-one (46.3%) women conceived in their successive ET cycles after refraining from hypersensitive foods. Lower pregnancy rates were noted in those with hypersensitivity to fish/crustacea/mollusk and eggs/meat/poultry, even after refraining from those foods. Conclusion: High percentage of infertile women suffering repeated failed IVF/ET cycles presented with different levels of hypersensitivity to foods. Avoidance of hypersensitive foods may help them achieve future conception.
#348 : Primary Broad Ligament Endometrioid Carcinoma – A Case Report of a Rare Entity
Authors: Hamid Habibah Abdul , Rom Maryam Sakinah Mohamad , Jamil Amilia Afzan Mohd , Yahaya Zainab 
Published: January 2024

Background: Primary broad ligament epithelial malignancies are rare occurrence. Hence, the treatment options are uncertain. Therefore, an accurate diagnosis is warranted to manage this condition. Case report: We present a 61-year-old female with abdominal distension associated with significant weight loss for six months. A computed tomography (CT) scan of the abdomen and pelvis revealed a pelvic mass measuring 10.7 × 14.6 × 13.5 cm with omental caking. Result: An exploratory laparotomy and tumour debulking was performed. Histological examination revealed moderately differentiated endometrioid carcinoma of the broad ligament stage IC and an endometrioid carcinoma of endometrium, stage 1A. She received external beam radiotherapy; brachytherapy followed by adjuvant chemotherapy with a 6 monthly surveillance. Currently, she is healthy with no recurrence at 24 months postoperatively. Conclusion: The rarity of primary broad ligament endometrioid carcinoma may incline clinicians to suspect more common malignancies such as ovarian. However, with an accurate diagnosis, the treatment will allow a better prognosis to the patient.