bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Poor Ovarian Response
Authors: Kaul - Mahajan Nalini 
Published: January 2024

Poor ovarian response (POR) occurs in approximately 9-24% of patients in ART. It presents a challenge to the reproductive consultant and causes immense emotional distress to the couple. Over the last few decades, ART has seen an improvement on both the clinical and embryological front however, adequate management of POR remains elusive. Etio-pathogenesis of the condition is poorly understood and varying definitions of POR have been used in studies. In recent years the POSEIDON criteria have been proposed to define this group of ‘low-prognosis’ patients and to optimize management. POSEIDON groups are assigned based on age and ovarian reserve. The patient groups are thus the unexpected poor responder’s having a normal ovarian reserve and the expected poor responders who have a poor ovarian reserve, to begin with. Management strategies to improve oocyte numbers and quality include manipulation of pituitary suppression and OS regimes, addition of LH and use of mild stimulation. The Duo- stim protocol has proved successful in increasing egg numbers, using the follicular and luteal phases of the same cycle. Adjuvant therapies which have shown promise in recent years are the use of Testosterone gel, Growth hormone, Co-enzyme Q10. Ovarian rejuvenation using Intra-ovarian platelet-rich plasma, ovarian activation and use of autologous stem cells is exciting and ongoing research in this area may yield evidence in future. The speaker will share her experience with the use of IOPRP for improving ovarian reserve during the lecture.
#124 : Microtubule Stability is Associated with the Functional Activity of Mitochondria for the Mouse Preimplantation Embryo Development
Authors: Lee Jae Ho , Kim Yu Jin , Cho Min Jung , Koo Yun Dong , Chang JuYi 
Published: January 2024

Background and Aims: Mitochondria have a pivotal role in the quality of embryos and good development to a healthy embryo pregnancy. Also, mitochondrial dysfunction increases during the aging of the embryos. But there is still a debate about the main cause of mitochondrial dysfunction in the aged embryos. We investigate that effect of microtubule stabilizer (MTS) as Taxol, EpD and microtubule disturber (MTD) as VNB in the preimplantation embryo of the mouse. Method: We performed preimplantation embryo culture with MTS and MTD. Then we assess development ratio and mitochondria functional activity between control and MTS and MTD. We performed comparable analysis of mitochondrial motility between MTS treated and MTD treated embryos by confocal live imaging. Results: In the MTS treated embryos, well-developed embryos with microtubules formation were present in the ooplasm. However, in the MTD treated embryos group, less development and poor microtubule polymer formation was observed in the ooplasm. Microtubules was also demonstrated by depolymerization and the clustering form in the ooplasm of MTD treated embryos. The high dynamic movement of the cytoskeleton with a mitochondrion compared to the MTD treated embryos. Conclusion: Our data suggest that the new function of MTS as Taxol, EpD shows promoting competence of embryo development with enhanced activity of a mitochondrial function. Therefore, MTS is useful as a supplement in vitro culture media of embryos.
#364 : Precision Medicine and Artificial Intelligence in the Area of Infertility: Update Applications and Perspectives
Authors: Sellami Afifa , Daoud Salima , Abdelkafi Olfa , Amor Maroua Ben , Moalla Faradis , Rebai Tarak 
Published: January 2024

Background and Aims: Artificial intelligence (AI) is performing an important role in different fields of medicine and is gradually converting medical practices in patient management. With growing progress in digital technologies and computing infrastructure, numerous applications in reproductive medicine and Assisted Reproductive Techniques (ART) have currently emerged. In this review, we outline recent breakthroughs in AI technologies, their applications in the management of male infertility and the challenges for further progress in assisted reproductive technology. Method: A non-systematic review of the literature was performed by screening PubMed up to August April 2023. We used the search terms including “artificial intelligence”, “male infertility”, “female infertility”, “Reproduction”, “precision medicine” and “Assisted Reproductive Technology”. Results: New digital systems for semen analysis can offer potential applications in male infertility diagnosis, clinical decisions and medical research. Predictive models for sperm quality using alternative algorithmic models is promising as a first step to evaluate male fertility. The use of new robotic microsurgical tools could represent an optimal approach for testicular sperm retrieval with important reduce in time and efforts involved in the surgery procedure. Also, AI algorithms may help physicians to more accurate diagnosis and individualized treatment of infertile women. AI integration in Assisted Reproductive Technology is promising for the best embryos selection with more developing potential and prediction of pregnancy outcomes. Precision medicine involves not just looking at genes but also in proteomics and molecular cell levels. Conclusion: There are still many challenges on how Artificial intelligence could be implemented in reproductive medicine.
#383 : The Correlation Between Serum Estradiol, Luteinizing Hormone (LH), and Progesterone on Day Human Chronic Gonadotropin (hCG) with In Vitro Fertilisation (IVF) Outcome
Authors: Azzahra Tiara Berliana , Susanto Sarah , Riayati Oki , Iffanolida Pritta Ameilia , Mutia Kresna , Wiweko Budi 
Published: January 2024

Background and Aims: Serum estradiol, LH, and progesterone have been studied for many years as they were considered to have relation with the pregnancy outcome in IVF procedure. The aim of this study is to determine the serum estradiol, LH, progesterone, biochemical pregnancy, clinical pregnancy, and ongoing pregnancy distribution of IVF patients; and to determine the correlation between serum estradiol, LH, and progesterone on day hCG with IVF outcome. Method: This is an observational study that was conducted in Yasmin IVF Clinic from 2013 until 2021. There were 416 samples. The serum estradiol, LH, and progesterone were collected from the IVF patient on day hCG. The IVF outcomes were collected by hCG blood test (biochemical pregnancy), USG (clinical pregnancy), and being checked after several months (ongoing pregnancy). The statistical analysis used IBM SPSS Statistics 26. Results: The serum estradiol, LH, progesterone, biochemical pregnancy, clinical pregnancy, and ongoing pregnancy were distributed abnormally. There is no significant difference between serum estradiol on hCG day with biochemical pregnancy (p=0.81), clinical pregnancy (p=0.205), and ongoing pregnancy (p=0.117). There is no significant difference between serum LH on hCG day with biochemical pregnancy (p=0.606), clinical pregnancy (p=0.45), and ongoing pregnancy (p=0.396). There is no significant difference between serum progesterone on hCG day with biochemical pregnancy (p=0.363), clinical pregnancy (p=0.942), and ongoing pregnancy (p=0.352). Conclusion: There is no significant difference between serum estradiol, LH, and progesterone on day hCG with IVF outcome.
#18 : Risk Factors for Placenta Accreta Spectrum in Pregnancies Conceived after Frozen-Thawed Embryo Transfer in a Hormone Replacement Cycle
Authors: Fujita Tomoyuki , Yoshizato Toshiyuki , Mitao Hiroshi , Shimomura Takuya , Fukagawa Mayumi , Ushijima Kimio 
Published: January 2024

Background and Aims: Assisted reproductive technology (ART), especially frozen–thawed embryo transfer (FET) in a hormone replacement cycle (HRC) is a risk factor for placenta accreta spectrum (PAS). This study aimed to clarify the risk factors for PAS related to the maternal background and ART techniques in pregnancies conceived after FET in an HRC. Method: We performed a case–control study in two tertiary perinatal centers in Japan. Among 14,028 patients who delivered at ≥24 weeks of gestation or were transferred after delivery to two tertiary perinatal centers between 2010 and 2021, 972 conceived with ART and 13,056 conceived without ART. PAS was diagnosed in patients 1) with histopathological findings of placenta increta/percreta, 2) those requiring manual evacuation of the placenta after delivery, or 3) those with retained placental tissue. Among women who conceived after FET in an HRC, 62 with PAS and 340 without PAS were included in this study. Multivariate logistic regression models were used for case–control comparisons, with adjustment for maternal age at delivery, parity, endometriosis or adenomyosis, the number of previous uterine surgeries of cesarean section, myomectomy, endometrial polypectomy or endometrial curettage, placenta previa, the stage of transferred embryos and endometrial thickness at the initiation of progestin administration. Results: PAS was associated with [Formula: see text]2 previous uterine surgeries (adjusted odds ratio [OR], 3.57; 95% confidence interval [CI], 1.60–7.97) and the number of blastocysts transferred (adjusted OR, 2.89; 95% CI, 1.15–7.26). In patients with <2 previous uterine surgeries, PAS was associated with an endometrial thickness of <7.0 mm (adjusted OR, 5.18; 95% CI, 1.10–24.44). Conclusion: A history of multiple previous uterine surgeries, the number of blastocysts transferred and a thin endometrium before ET are risk factors for PAS in pregnancies conceived after FET in an HRC.
#267 : The Spindle Localization ICSI (SL-ICSI) Improves the Fertilization Rate Decreased by Aging
Authors: Kawano Hiroomi , Takai Aya , Abe Mutsumi , Iimura Yuki , Nakajima Naotsuna , Chen Mo , Ochi Azusa , Yamauchi Akihiro , Shinoda Mari , Yoshida Masato , Yamashita Naoki 
Published: January 2024

Background and Aims: The position of meiotic spindle in metaphase II oocyte can be different from the underneath of the first polar body. In order to prevent the meiotic spindle damage during ICSI, confirming the position of the spindle is effective. In this study, we analyzed the meiotic spindle deviation and outcomes of ICSI with the patient age. Method: From 2017 to 2022, 5620 oocytes with the first polar body underwent SL-ICSI were analyzed. SL-ICSI was performed 4-5 hours after oocyte retrieval. Furthermore, the meiotic spindle deviation from the polar body was classified according to the angle; Group A: 0-5∘, Group B: 6-45∘, Group C: 46-90∘, Group D: 90∘<. The spindle invisible oocytes were regarded as group E. The average age, the fertilization rate and good blastocyst rate in each group were analyzed. Statistical analysis was performed by one-way ANOVA and Tukey’s post-hoc test. Results: The proportions of spindle-visible oocyteswere 98.7%; 41.2%, 36.1%, 14.6%, 6.8%, and 1.3% respectively, in group A to E. The mean agesin each group were 39.0, 39.6, 40.1, 40.6, and 40.7, respectively. In addition, the correlation between the age and the location of spindle was revealed (A-BCDE: [Formula: see text] < 0.001). The fertilization rates were 84.8%, 84.9%, 84.7%, 83.5%, 50.7%, respectively, and significantly decreased in group E ([Formula: see text] < 0.001). Abnormal fertilization rates were 4.3%, 5.1%, 6.4%, 7.3%, 20.5%, respectively, and significantly increased in group E ([Formula: see text] < 0.001). Good blastocyst rates were 49.8%, 52.4%, 47.6%, 50.5%, 3.3%, respectively, and significantly decreased in group E ([Formula: see text] < 0.001). Conclusion: The introduction of SL-ICSI can be effective for elderly patients. The meiotic spindle of oocytes is highly likely to deviate from the first polar body by aging. Furthermore, if the spindle-invisible oocyte is observed, ICSI should be carefully carried out.
#270 : Single-Center Retrospective Cohort Analysis: Preimplantation Genetic Testing for Monogenic Disorders (PGT-M) for Monogenic Nephropathy
Authors: Liu Xinyu , Zhang Qian , Zhao Qing , Cao Kexin , Zhou Wei , Ni Tianxiang , Sun Shuzhen , Yan Junhao 
Published: January 2024

Background and Aims: Hereditary nephropathy, including monogenic nephropathy, is an important cause of renal insufficiency and end-stage renal disease. Therefore, genetic blockade is necessary for couples with monogenic nephropathy. Following routine application of prenatal diagnosis, preimplantation genetic testing for monogenic disorders (PGT-M) has been applied to the genetic blockade of monogenic disease patients. The purpose of this study is to retrospectively analyze genetic counseling process for patients with nephropathy-related disease and provide clinical overviews of patients with monogenic nephropathy who underwent PGT-M. Method: A single-center retrospective cohort study was conducted at Center for Reproductive Medicine, Shandong University from January 2014 to December 2022. 352 couples with nephropathy-related disease were included in the cohort totally. Statistical analysis was performed using Statistical Package for Social Science software 26.0. Results: Of the 352 couples with nephropathy-related disease, 291 underwent genetic counseling, followed by 180 accepting genetic screening. 104 couples with monogenic nephropathy indications proceeded with PGT-M, including 91 of autosomal dominant inheritance, 9 of autosomal recessive inheritance, 3 of X-linked dominant inheritance, and one of X-linked recessive inheritance. 498 blastocysts were tested by PGT-M combined with preimplantation genetic testing for aneuploidy (PGT-A), making 72 transferable embryos, 249 non-transferable embryos, 72 genetic counseling embryos and 7 amplification failedembryos. Finally, 80 vitrified-thawed single blastocyst transfer cycles were performed. Live births occurred in 38 women, of which 37 transferred embryos with non-pathogenic genotypes. The results of prenatal diagnosis of all newborns were consistent with the testing results for embryos transferred. The cumulative live birth, biochemical pregnancy, clinical pregnancy, ongoing pregnancy and pregnancy loss rates were 36.54%, 56.73%, 49.04%, 7.69%, and 22.03% respectively. Conclusion: PGT-M is an effective means of genetic blockade for couples with monogenic nephropathy. The absence of genetic abnormalities detected by prenatal diagnosis in healthy newborns without monogenic nephropathy also underscore its validity.
#284 : Impact of Dosage and Duration of Exogenous Gonadotropins on Embryonic Genetic Status and Cumulative Live Birth Rate: A Secondary Analysis of a Multicenter, Randomized Controlled Trial
Authors: Liu Yingbo , Zhou Wei , Zhang Qian , Ni Tianxiang , Yan Junhao , Chen Zijiang 
Published: January 2024

Background and Aims: The safety of exogenous gonadotropins regarding its impact on embryos as well as pregnancy outcomes is still inconclusive. This study aimed to evaluate the effects of different doses and duration of gonadotropins on embryonic genetic status, pregnancy outcomes in infertile women with a good prognosis. Method: This is a secondary analysis of a multi-center, randomized controlled trial conducted from July 2017 through June 2018, which investigated the efficacy of preimplantation genetic testing for aneuploidy (PGT-A) in good-prognosis infertile population. Couples with PGT-A treatment were included in this study, and were divided into four groups according to the total dosage of exogenous gonadotropins and the duration of stimulation: Group1,2,3,4 with gonadotropins doses and stimulation duration [Formula: see text]1500 IU, <10 days; [Formula: see text]1500 IU, [Formula: see text]10 days; >1500 IU, <10 days; >1500 IU, [Formula: see text]10 days, respectively. Group 1 served as the control group. The main outcome measures were the rates of embryonic aneuploidy, mosaicism and cumulative live birth after transfers of euploid embryos. Results: A total of 579 couples were included, with 1737 embryos being genetically screened using NGS. After adjusting for confounding factors, embryo mosaicism rate was significantly increased in Group 2, 3, 4 in comparison with Group 1 (Group 2,3,4: 13.4%, 14.8%, 12.4%, respectively, vs. Group1: 8.9%; adjusted OR [95% CI]: 1.65[1.07, 2.54], [Formula: see text]=0.024; 1.76[1.02, 3.30], [Formula: see text]=0.041; 1.50[1.01, 2.22], [Formula: see text]=0.043; respectively). There was no association between gonadotropins dose or duration and embryo aneuploidy rate. The cumulative live-birth rate was significantly lower in Group 2, 3 and 4 than that in Group 1 (Group 2,3,4: 73.2%, 64.8%, 75.2%, respectively, vs. Group 1: 85.0%; adjusted OR [95% CI]: 0.50 0.28, 0.89], [Formula: see text]=0.019; 0.34[0.17, 0.68], [Formula: see text]=0.002; 0.59[0.35, 0.98], [Formula: see text]=0.043; respectively). Conclusions: High dose, prolonged ovarian stimulation may increase mosaic embryo rate and decrease cumulative live-birth rate after transfers of euploid embryos.in infertile women with a good prognosis.
#345 : Progestin-Primed Ovarian Stimulation Protocol Slightly Improves the IVF Funnel in Patients with Poor Ovarian Response
Authors: Thach Than Trong 
Published: January 2024

Background and Aims: Controlled Ovarian Stimulation (COS) is a crucial first step in the In Vitro Fertilization (IVF) or Intra-Cytoplasmic Sperm Injection (ICSI) process. Progestin-primed ovarian stimulation (PPOS) has been recently introduced as an alternative to traditional COS regimens. However, the efficacy of PPOS regimen among infertile women with poor ovarian response (POR) remains unclear. This study aims to evaluate the effect of PPOS regimen on the chance of success throughout the IVF process in Vietnamese infertile women with POR. Method: This randomized controlled trial included 120 infertile women with POR (according to POSEIDON criteria) who received IVF at Tam Anh Fertility Center (Hanoi, Vietnam). PPOS and GnRH_ant regimens were randomly applied to the participants (n=60 for each group). A chain of 4 successive Binomial regression models has been applied to estimate the chance of success for 4 steps: oocyte maturation, fertilization and achieving good quality day-3 and day-5 embryos. The effect of PPOS in comparison with GnRH_ant protocol was evaluated by marginal risk-ratio (RR) from each model. Results: Chances of successfully achieving the MII oocytes, fertilization, high-quality D3 and D5 embryos were all moderately higher when using the PPOS regimen, compared with those of GnRH_ant protocol (95% confidence intervals of RR were respectively 0.88–1.07, 0.89–1.14, 0.96–1.14 and 0.74–1.73). Conclusion: Although not yet reached a statistical significance, those results indicated that using PPOS protocol may slightly improve the chance of success in 4 first critical steps of the IVF process for infertile women with POR.
#27 : A Sibling Study: How Individual Culture Strategy Affects Embryo Ploidy Status in IVF/PGT-A Cycles?
Authors: Vu Anh , Nguyen Huong 
Published: January 2024

Background and Aims: The result of individual and group culture embryo studies remained conflicting. Several studies assumed that the blastulation rate was lower when culturing embryos separately. Meanwhile, there has been little information on whether individual culture can affect embryo ploidy status. This study was designed to find a relationship between culture strategies and the embryo’s ploidy status in IVF/PGT-A cycles. Method: 91 IVF/PGT-A cycles with at least four zygotes enrolled in a randomized control trial from September 2021 to June 2022 in Tam Anh general hospital. Zygotes from each cycle were randomly assigned to individual culture(10 ul/drop) or group cultured of 3-5 zygotes (50 ul/drop). Among those, 280 blastocysts derived from biopsy-all cycles (137 from individual culture and 143 from group culture) and already determined for ploidy status were to be analyzed. Information of the embryo, including maternal age, paternal age, day of the biopsy, embryo quality (excellent, good, fair, poor), blastocoele expansion (2-6), ICM score (A, B, C), TE score (A, B, C), and PGT-A result (euploid, aneuploidy or else) was collected and analyzed along with the type of culture. Simple and multiple regression analyses using generalized linear mixed model were applied to evaluate the relation between embryo ploidy status as the dependent variable and independent factors. Results: The rates of euploid, aneuploidy and other results of embryos cultured individually were 39.4%, 37.2%, and 23.4%, respectively. These results did not yield a significant difference compared with the cultured group. There was no relationship between culture strategies and the aneuploidy rate of the embryos (OR = 1.16, CI 0.64-2.13). However, biopsy days 6-7 and decreasing grade of TE might be related factors for a higher rate of aneuploidy. Conclusion: Culture embryos individually or in groups hadnot yet shown any effect on embryo’s ploidy status.
#48 : Blastocyst Versus Day-3 Embryo Transfers After In Vitro Maturation with Pre-Maturation Step (CAPA-IVM) in PCOS Patients
Authors: Pham Hoang Huy , Le Anh , Nguyen Tri , Pham Toan , Ho Tuong , Vuong Lan 
Published: January 2024

Background and Aims: IVM combined with a pre-maturation step known as capacitation IVM (CAPA-IVM) improves the competence of in-vitro matured oocytes. According to our previous study, the current clinical practice of transferring day-3 embryos resulted in a live birth rate of 35.2% after the first frozen embryo transfer (FET) following CAPA-IVM. Advances in embryo culture systems have allowed us to extend the duration of embryo culture to blastocyst. There is a lack of data on blastocyst transfer following CAPA-IVM. The aim of this study is to compare the effectiveness of blastocyst versus day-3 embryo transfer after CAPA-IVM in PCOS patients. Methods: A retrospective cohort study was conducted at two infertility centers in Vietnam from 1 January 2018 to 28 February 2022. The study compared two groups of PCOSwomen who had frozen embryo transferred (FET) with CAPA-IVM. Group 1 had blastocyst transfer and Group 2 had day-3 embryo transfer. The couples made the final decision on the stage of embryos transferred. The inclusion criteria were women aged between 18-40 years and had freeze-all their embryos. The primary outcome was the live birth rate after the first FET. Results: Out of 275 eligible women for the study, 87 of themhad blastocyst transfer, and 188 had day-3 embryo transfer. The mean number of embryos transferred for blastocyst transfer and day-3 embryo transfer were 1.27 and 1.93, p < 0.001, respectively. Live birth rate after the first transfer was comparable between blastocyst and day-3 embryo transfers (34.5% vs. 37.8%, p=0.696, respectively). The blastocyst transfer group had a significantly lower multiple pregnancy rate as compared to day-3 embryo transfer group (4.6% vs. 18.0%; p=0.005, respectively). Conclusions: Blastocyst transfer had comparable live birth rate but lower multiple pregnancy rate to day-3 embryo transfer after the first FET following CAPA-IVM in PCOS women.