bluuebunny/crossref_metadata_2025_split huggingface dataset:
#330 : Factors Affect Infertile Woman to Access Infertility Services in Central Java, Indonesia
Authors: Putrinadia Aninditya V , Budihastuti Uki Retno , Melinawati Eriana , Dafhonsa Meycha 
Published: January 2024

Background and Aims: Infertility is defined as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse and approximately one in every six people of reproductive age worldwide experience infertility in their lifetime. However, infertility has a strong social impact in the culturally and socioeconomically diverse Indonesia, both in cities and rural areas. A woman who experiences infertility is seen as an abnormality or weakness of that person because it is closely related to her deterministic nature to conceive and give birth. The high percentage of female factors in relation to infertility and the existing studies on the infertility related factors in women leads to the researcher interest to study the factors influencing infertility in women. In this study we analyzed some factors affect access to infertility services, especially for the women. Method: This method of research is cross sectional study. An interviewer-administered survey was conducted with 30 infertile women recruited in Moewardi Hospital between April until June 2023. Participants were randomized-selected, and data was described to statistical analysis. Inclusion criteria: Women aged 20-45 years, experiencing infertility problems >1 year, willing to be interviewed, seeking infertility treatment, able to conduct interviews, not currently undergoing an IVF program. Exclusion criteria: malignant disease, moderate IVF program, pregnancy. The data was analyzed using SPSS 25 and significant if the p value <0.05. Results: There was a significant relationship between several factors such as discrimination (p=0.003), culture (p=0.015), and knowledge (p=0.019) to access infertility services. Meanwhile, there was no significant association between financial factors (p=0.766) and gender sensitivity (p=0.064) with access ability to infertility services among infertile women. Conclusion: Infertile women who experience discrimination, cultural pressure, and have better knowledge related to infertility will find it easier to access infertility services.
#331 : Bilateral Endometriomas Masquerading Synchronous Endometrial and Ovarian Cancer (SEOC) in an Infertile Female
Authors: Kathuria Priyanka 
Published: January 2024

Background and Aims: Endometriomas are diagnosed in clinical practice by imaging (mostly ultrasound) in females presenting with infertility. CA-125 level is an adjuvant investigation which may be indicative of endometriosis. A few research questions that are yet to be answered. Is ultrasound a sufficient modality to diagnose endometrioma? Is there any cut off as far as the measurement of endometrioma is concerned to step up the imaging modality to MRI? Synchronous endometrial and ovarian cancer (SEOC) is a rare phenomenon with an incidence of 1.4 - 3.8%. Mostly in SEOC, the ovarian endometroid carcinoma arises in background of endometriosis with endometrial carcinoma of lower stage and grade in premenopausal age group. Method: A 32-year-old female with Severe Dysmenorrhea and Secondary infertility had clinical evidence of bilateral endometriomas of 4-5 cm on ultrasound. She underwent hysterolaparoscopy. On hysteroscopy, endometrium was polypoidal and vascular, looking suspicious for malignancy. Hence endometrial biopsy was taken. On laparoscopy, B/L ovaries were enlarged, multiloculated, solid-cystic with granular surface and adhered in POD, decision for staging laparotomy with frozen section was taken. Frozen section was suggestive of Borderline tumor. Eventually, fertility sparing surgical staging was done (BSO + infracolic omentectomy + peritoneal biopsies). Peritoneal cytology was negative for malignant cells. Results: Histopathological examination revealed Endometriod adenocarcinoma grade 1a/1a in both endometrial and ovarian components with no involvement of omentum and peritoneum. Immunohistochemistry demonstrated P53 to be moderately positive in endometrium and strongly positive in ovary, whereas ER, PR was positive in both tumors of endometrium and ovary and WT-1 negative in ovaries. Hence diagnosed as SEOC and not metastatic tumor. Mirena was inserted in follow up and repeat biopsy is awaited. Conclusion: Suspicion of ovarian endometroid carcinoma must born in mind in cases with large bilateral endometriomas with long-standing endometriosis.
#366 : Adjuvants to Prevent Reformation of Adhesions Following Adhesiolysis for Asherman Syndrome
Authors: Guo Jun , Shi Xiaoyu , Yu Fei , Cao Jinghong , Xia Enlan , Zhai Jianjun , Mol Ben W.J. , Li Tin-Chiu 
Published: January 2024

Background and aims: Two international guidelines published on the management of Asherman syndrome (AS) have made recommendations on various adjuvant methods to prevent intrauterine reformation. Nevertheless, the effectiveness of these methods when used in primary or secondary prevention settings is different. Our aim is to assess the effectiveness of various adjuvant methods for the secondary prevention of intrauterine adhesions (IUAs). Methods: Articles were considered eligible if they included subjects with AS before surgery and compared a chosen method with either a control or a comparison group (using another method). The primary outcome was IUA reformation rate at follow-up hysteroscopy. Results: A total of 29 studies [15 randomised controlled trial (RCTs)] and 14 cohort studies) were included. Adhesion reformation with various methods to prevented IUA reformation when compared with controls were: second-look hysteroscopy:[risk ratio(RR) 0.21, 95% confidence interval (CI) 0.05 to 0.90 (P=0.02)];intrauterine contraceptive device: RR: 0.64, 95% CI: 0.36 to 1.12 (P=0.12);continuous intrauterine balloon: RR: 0.18, 95% CI: 0.05 to 0.68 (P=0.01);intermittent intrauterine balloon: RR: 0.50, 95% CI: 0.31 to 0.80 (P=0.004);anti-adhesion gel: RR: 0.80, 95% CI: 0.58 to 1.10 (P=0.17);amnion graft:RR:0.63, 95% CI:0.44 to 0.91 (P=0.01). Conclusions: In conclusion, among various adjuvant therapies in secondary prevention of IUA, second look hysteroscopy and IUB can be considered as an option to reduce adhesion recurrence.
#122 : Extrapolating Endometriosis Diagnosis Using Imaging and Machine Learning: The Imagendo Project
Authors: Avery Jodie , Zhang Yuan , Wang Hu , O’Hara Rebecca , Condous George , Leonardi Mathew , Knox Steven , Carneiro Gustavo , Hull Mary-Louise 
Published: January 2024

Background and Aims: Currently, it takes an average of 6.4 years to obtain a diagnosis for endometriosis. To address this delay, the IMAGENDO project combines ultrasounds (eTVUS) and Magnetic Resonance Images (eMRI) using Artificial Intelligence (AI). Our preliminary data has shown that a multimodal AI approach objectively assesses imaging data from eTVUS and eMRIs and improves diagnostic accuracy for endometriosis. Our first example shows how automated detection of Pouch of Douglas (POD) obliteration can be augmented by a novel multimodal approach. Aim: To improve eMRI detection of POD obliteration, by leveraging detection results from unpaired eTVUS data. Method: Retrospective specialist private and public imaging datasets of the female pelvis were obtained. After pre-training a machine learning model using 8,984 MRIs from a public dataset, we fine-tuned the algorithm using 88 private eMRIs, to detect POD obliteration. We then introduced another 749 unpaired eTVUSs to further improve our diagnostic model. Results: To resolve confounding problems with our eMRI datasets due to artefacts, mislabelling, and misreporting, we used model checking, student auditing and expert radiology review. Our results illustrated effective multimodal analysis methods which improved the POD obliteration detection accuracy from eMRI datasets. This model improved the Area Under the Curve (AUC) from 65.0% to 90.6%. Conclusion: We have been able to improve the accuracy of diagnosing endometriosis from eMRIs using a novel POD obliteration detection method. Our method extracts knowledge from unpaired eTVUSs and applies it to eMRI datasets. The detection of POD obliteration is automated from eMRI data. Combining images for corresponding endometriosis signs using algorithms, is the first step in improving the imaging diagnosis of endometriosis, when compared to surgery, and allows extrapolation of results when either imaging modality is missing. This will enable women to obtain a faster diagnosis, where adequate scanning is available, prior to undertaking surgery.
#128 : Is Non-Closure Suitable as a Skin Closure Technique for 5 mm Laparoscopic Port-Site? - A Randomised Controlled Trial of Non-Closure Versus Transcutaneous Suture
Authors: Hamdan Mukhri , Zulkifli Nusaibah 
Published: January 2024

Background and Aims: Laparoscopy has become the access of choice even in complex abdomino-pelvic surgery cases and more abdominal access ports have been used to assist with the surgery. Systematic review done on skin closure of 5 mm laparoscopic port-site showed comparable outcome between sutured and sutureless technique. Transcutaneous suture is better than subcuticular suture in the sutured group sub-analysis. No RCT were found comparing skin closure versus non-closure technique using simple dressing only. Method: Randomised controlled trial – non superiority in Gynaecology Department, University Malaya Medical Centre in 2019. Based on power calculation, 40 subjects are needed. Each patient act as their own control – each will receive NC and TS for comparison. 40 patients (n=80) were included for final analysis. The 5 mm port site will be assigned with skin closure using NC versus TS where the surgical incision wound is covered with routine dressing after the operation. The primary outcome is the scar appearance at day 90 from the patient and blinded surgeons’ point of view. Secondary outcomes are patient satisfaction and pain at day 14, and wound complications. Results: Cosmetic outcome in terms of scar appearance at day 90 showed no difference between NC and TS rated by the patient (MD 5.25 [0.07, 10.57], p 0.053) and the surgeon (MD 0.88 [0.08, 1.83], p 0.07). Pain is better perceived in NC group (MD 3.6 [0.19, 6.96], p 0.039) and patient satisfaction at day 14 is also better in NC group (MD 11.8 [4.18, 19.33], p 0.03). There was no significant difference in terms of wound complications and no surgical site infection were observed in both groups. Conclusion: NC and TS techniques have comparable cosmetic outcome and wound complications. Pain perception is better in NC than TS.
#250 : Patient Satisfaction with Ultrasound-Guided Manual Vacuum Aspiration in the Management of First Trimester Pregnancy Loss
Authors: Chau Olivia See Yung , Ng Karen , Ip Patricia , Law Tracy SM , Chung Jacqueline PW 
Published: January 2024

Background: Ultrasound-guided manual vacuum aspiration (USG-MVA) has been shown to be safe and effective alternative to traditional surgical evacuation in managing first trimester pregnancy loss. This study aims to determine patient satisfaction and acceptability of USG-MVA for the management of their first-trimester miscarriage. Methods: This was a single-center cross-sectional study conducted in a university-affiliated tertiary hospital. Patients with delayed miscarriage of [Formula: see text]12 weeks of gestation or incomplete miscarriage who underwent USG-MVA were invited to complete a questionnaire 2-hour post-procedure to evaluate their experience. The Client Satisfaction Questionnaire-8 (CSQ-8) was used to assess patient satisfaction and acceptability to USG-MVA in addition to questions evaluating patient’s perception to the procedure. Results: From 2018 to 2023, a total of 137 patients were recruited and all of which completed the questionnaire. Results indicate that patients were highly satisfied with the procedure, with CSQ-8 mean scores of 27 (SD 3.3, range 14-32). 135 (98.5%) patients were satisfied with the procedure, 129 (94.2%) of patients would wish to choose USG-MVA if they required surgical evacuation again and 128 (93.4%) patients would recommend USG-MVA to a friend. Conclusions: USG-MVA is a feasible, effective, safe and highly acceptable alternative to surgical treatment for the management of first-trimester miscarriage. The option of USG-MVA can be presented as a treatment option when counselling for the management of first trimester miscarriage.
#367 : The Use of Intrauterien Balloon Therapy in Reproductive Medicine and Surgery
Authors: Shi Xiaoyu , Guo Jun , Saravelos Sotirios , Huang Xiaowu , Xia Enlan , Feng Limin , Li Tin-chiu 
Published: January 2024

Background and Aims: The use of balloon therapy in obstetric practice, especially in postpartum haemorrhage is well established and has recently been reviewed. However, little attention has been drawn regarding the use of intrauterine balloon (IUB) in gynaecological practice. This study focuses on the various usage of IUB in gynaecological practice. Methods: An electronic literature search through Medline, EMBASE and Clinicaltrial.gov from inception to August 2022 was conducted with mesh combinations of the following keywords: balloon, uterus, gynaecology, Foley catheter, complication, tamponade, hysteroscopy and laparoscopy. Results: The study focuses on the 3 following areas: (1) Indications: prevention & removal of intrauterine adhesions, management of ectopic pregnancy, facilitation of endoscopic surgery and other clinical usages; (2) Practical aspects of balloon therapy including ultrasound guidance, choice of balloon, inflation volume, duration of balloon therapy; and (3) Potential complications including pain, infection, uterine rupture and how they can be avoided. Conclusions: IUB therapy is a simple, inexpensive and effective method that can be applied in various gynaecological conditions ranging from IUA to intrauterine haemorrhage. Complications are rare, but in most cases can be avoided with correct use.
#85 : Microdissection Testicular Sperm Extraction (Micro-Tese) in Men Non-Obstructive Azoospermia with Very Small Testicular Volume: A Case Series Report
Authors: Dang Tuan Anh , Nguyen Hoang , Cao Anh , Le Anh , Bui Len , Le Hoang , Nguyen Huong 
Published: January 2024

Background and Aims: Testicular atrophy is a common clinical manifestation of NOA, with a rate of 79.1%. The results of sperm retrieval using the mTESE method in a special NOA for testicular atrophy with volume [Formula: see text]5ml are currently inconsistent. As a result, we present the results of sperm retrieval using the mTESE method to patient NOA, who has a bilateral testicular volume [Formula: see text]5ml. Methods: A case series report of NOA with bilateral testicular volume [Formula: see text]5ml that indicated mTESE surgery to collect sperm at the assisted reproductive technology center of Tam Anh Ha Noi General Hospital between January 2022 and December 2022. Results: Four of seven NOA patients (57.1%) had successful sperm retrieval using the mTESE method, with bilateral testicular volume [Formula: see text]5 ml and a mean FSH level of 40,5 ± 21,9 (24,1-87,6) mIU/mL. In which case, 3/4 of patients simply require surgery on the monolateral testicular is sufficient sperm. Conclusions: Testicular atrophy does not appear to impair sperm retrieval results by the mTESE method, even the sperm retrieval rate tends to be higher in NOA patients with bilateral testicular volume [Formula: see text] 5ml.
#110 : Diagnostic Approach and Clinical Recommendations for Non-obstructive Azoospermia: Global Andrology Forum Survey Results
Authors: Huang Zhongwei , Benny Paula , Sashidharan Shaili , Rambhatla Amarnath , Shah Rupin , Agarwal Ashok 
Published: January 2024

Background and Aims: Non-obstructive azoospermia (NOA) is the most common form of male infertility, characterized by an absence of sperm in ejaculate and is caused by testicular failure. While NOA afflicts 10-38.3% of infertile males, there is no specific recommendations in EAA/EAU guidelines on its clinical diagnosis or WHO guidelines on semen analysis. Therefore, we conducted a global survey to assess the standard approach of practitioners in the diagnosis and management of NOA. Method: The Global Andrology Forum (GAF) conducted a survey on 436 independent practicing entities from 55 countries. We compiled data from 336 respondents (andrologists, urologists, fertility specialists). Information collected included frequency of NOA, varicocele, frequency of obtaining semen, interval between obtaining semen samples, hormone evaluation (FSH, LH, prolactin, total/free testosterone, SHBG, estradiol, inhibin), genetic testing (karyotype, Y-chromosome deletion, CFTR, Kal1) and referral to genetic counsellors. Results: The majority of participants (80%) either reported <10% or 10-25% NOA frequency in their population (Fig. 1A). 40.6% of participants stated that 10-25% of men with NOA cases have a clinically significant varicocele (Fig. 1B). For NOA diagnosis, majority of participants cited the requirement of at least two semen samples, with a period of 14-29 days as the interval between two semen analyses. To achieve high-quality semen, consideration must be given to an abstinence period (2-7days) and the complete collection of ejaculates. The survey reported FSH (97%), LH (86.9%) and total testosterone (92.9%) tests as most frequently used for NOA patients (Fig. 2A). The initial hormonal evaluation of a patient with suspected NOA should include total testosterone levels and LH, as these hormones are the primary regulators of spermatogenesis. Karyotype analysis (86.2%), Y-microdeletion (88.3%), CFTR (21.9%) and Kal1 (2.7%) were most routinely performed genetic tests (Fig. 2B). Referrals to genetic counsellors is recommended as these defects have the potential to be passed to future generations. Conclusion: This global study evaluates NOA frequency, clinical diagnosis and management by specialists, in an effort to fill the gap in NOA research. Concomitantly, we provide GAF expert recommendations to enhance our collective understanding of NOA, optimize patient care and improve the management of NOA.
#255 : Disrupted CD147 Causes the Acrosomal Defects of Round Spermatids and Male Infertility
Authors: Chen Hao , Ye Mei 
Published: January 2024

Background and Aims: CD147 is a well-known cancer cell migration and metastasis regulator. In the reproductive tract, our previous results revealed that CD147 regulates the apoptosis of spermatocytes and migration of spermatogonia and spermatocytes in the testis. However, the spermatogenesis process was inhibited at the round spermatid stage in our CD147-Stra8-Cre conditional knockout mice. We then further explored the mouse phenotypes and its underlying mechanisms. Method: CD147-Stra8-Cre conditional knockout mice (CD147-cKODDx4) were generated by cross-breeding the CD147 flox mice and DDx4-Cre male mice. Testis were collected for histological and molecular analyses. Results: The testis size and weight were significantly decreased in CD147-cKODDx4 mice compared to the control mice. There were no elongated spermatozoa in the CD147-cKODDx4 seminiferous tubules and cauda epididymis. PNA staining demonstrated the acrosomal defects on 3-5 stage of round spermatids. Consistent with morphological results, single cell-seq also demonstrated the round spermatid development loss. Mechanically, the IPO5 was identified as the interaction protein with CD147 and affected the round spermatids developments. Conclusion: The present study reveals a novel role of CD147, uncovers new mechanism underlying male infertility, and provides promising targets for the development of infertility diagnosis and treatment.
#305 : Preparation of Epididymal/Testicular Spermatozoa; Technical Aspects and Its Impact on Success
Authors: Eltemimy Hesham , Gwynn Alexander , Ozcan Fulya , Ferraro Joanna , Sjoblom Cecilia 
Published: January 2024

Background and Aims: The introduction of ICSI 30 years ago paved the way for epididymal/testicular spermatozoa to be used to fertilise oocytes in couples undergoing ART. Currently, spermatozoa is recovered from the epididymis or testis using varying approaches, including micro-surgery and fine-needle aspiration, mostly in men with obstructive and nonobstructive azoospermia. The samples delivered to the laboratory for processing are of varying quality with regards to amount of material/tissue, presence of spermatozoa, and other cells. The success of processing the tissue can have a direct impact on the outcome of the subsequent ICSI and our aim for this review was to identify ways to improve the preparation techniques for epididymal/testicular samples. Ethics approval was obtained from WSLHD HREC Ref 5583QA. Methods: The review included 527 ICSI cycles for 311 patients (2016-2022) where epididymal/testicular spermatozoa had been used. Approaches for sample preparation included mini-gradient centrifugation and removal of red blood cells using erythrocyte lysis buffer (ELB). In cases with severe oligoasthenozoospermia (105 cycles, 79 patients), a phosphodiesterase inhibitor (PI) was added to induce motility. Results: Employing mini-gradient centrifugation or adding ELB did not result in lost spermatozoa for any cases, but vastly reduced sample debris allowing for easier identification of spermatozoa. Fertilisation rate after ICSI was 57.9±1.2%. Motile spermatozoa were found and injected in all 105 samples after addition of PI and the fertilisation rate after ICSI was 55.3±2.7. To date cycles with PI have resulted in 26 live births with no abnormalities and all infants were of appropriate weight for gestational age. Conclusions: Employing precise preparation techniques for epididymal/testicular samples is paramount to allow for timely identification of motile spermatozoa for ICSI and assure optimal overall outcome. Sharing and discussing successful approaches with the wider embryology community allows for discussion and refining of techniques which can benefit all.
#139 : Outcomes of IVF-ET in Overweight/Obese and Normal-Weight Women with PCOS
Authors: Huang Shuo , Yang Rui , Wang Yuanyuan , Li Rong , Qiao Jie 
Published: January 2024

Background and Aims: Overweight/obese women with polycystic ovary syndrome (PCOS) have poorer pregnancy outcomes, compared to normal-weight women. Body mass index (BMI) is a risk factor of in vitro fertilization-embryo transfer (IVF-ET). This study is to compare the outcomes of IVF-ET between the overweight/obese and normal-weight women with PCOS. Method: We performed a retrospective cohort study in a large reproductive center of a university hospital. The participants were the women with PCOS who underwent IVF-ET. We compared live birth, miscarriage and other clinical outcomes between the women with BMI ≥25 (overweight/obese group) and 18≤BMI<25 (normal-weight group). Results: We included 3733 women with PCOS who underwent the first IVF-ET cycle from Jan 2016 to Dec 2020. 1693 of them were overweight/obese and had longer stimulation days and more doses of gonadotropins, while less numbers of oocytes retrieved and good quality embryos. Live birth rates were significantly lower in overweight/obese women, compared with normal-weight women (29.8% vs. 36.2%, OR 0.8 (0.7, 0.9)). Clinical pregnancy rates were significantly lower (38.5% vs. 43.0%, OR 0.8 (0.7, 0.9)). Miscarriage rates were significantly higher in overweight/obese women, compared with normal-weight women (21.5% vs. 14.6%, OR 1.6 (1.2, 2.1)). Multivariate logistic regression analysis showed BMI was an independent risk factor. Conclusion: Overweight/obese women with PCOS had poorer outcomes of IVF-ET, compared to normal-weight women with PCOS.