bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-035 Effect of Varicocelectomy on normal semen in patients undergoing the procedure for indications other than fertility: evidence needed for counseling
Authors: Khalafalla K , Mahdi M , Majzoub A , Elbardisi H , AlSaid S , Arafa M 
Published: June 2023

Abstract

Study question
Does microsurgical varicocelectomy impact normal semen parameters in fertile patients undergoing the procedure for indications other than infertility?

Summary answer
Micro surgical varicocelectomy does not alter the fertility potential of men with normal semen.

What is known already
Varicocele repair results in improvement in semen parameters and fertility potential in sub fertile patients with clinical varicocele. However, the procedure is also offered to patients with indications other than infertility including testicular pain, testicular size affection, or before army recruitment. Queries about the effect of varicocelectomy on fertility potential in this patient population have been raised but unfortunately not strongly backed by literature.

Study design, size, duration
A retrospective study of 1521 patients who underwent microsurgical sub inguinal varicocelectomy in our center from 2011–2021.

Participants/materials, setting, methods
A total of 435 patients with normal semen parameters and underwent varicocelectomy for indications other than infertility were included. Exclusion criteria were patients with infertility, abnormal semen parameters, and prior varicocelectomy. Patient demographics, clinical and laboratory data were collected. Semen analysis (WHO 5th edition), sperm DNA fragmentation (Halosperm) & hormonal assay were performed pre-operative and up to 6 months post-operative. Data were compared using Wilcoxon Signed Ranked Test. A p value &lt;0.05 was considered significant.

Main results and the role of chance
The mean age was 32.8±7.7 years. Varicocelectomy was performed on left side in 373 patients and bilateral in 62 patients. The majority of the study population had grade III varicocele on the left side. There were no statistically significant changes in semen volume, concentration, total & progressive motility, sperm DNA fragmentation, and hormonal profile after 6 months post varicocelectomy in comparison to initial baseline parameters (table 1). Only a statistically significant improvement in morphology was observed.

Limitations, reasons for caution
The main limitation is the retrospective design of the study. Long-term effect and conception rate were not evaluated.

Wider implications of the findings
Results of this work are beneficial during preoperative counseling of patients with normal semen undergoing varicocelectomy for non-fertility indications. Patients can be reassured that the procedure would not affect their fertility potentials negatively.

Trial registration number
not applicable
P-085 Reactive molecules drive sperm capacitation via protein posttranslational modifications
Authors: Řimnáčová H , Iniesta Cuerda M , Moravec J , Nevoral J 
Published: June 2023

Abstract

Study question
Are S-sulfenylation and S-nitrosylation, two essential posttranslational modifications (PTMs), increased during sperm capacitation? Which proteins are subjected to S-sulfenylation?

Summary answer
S-sulfenylation and S-nitrosylation increase during sperm capacitation. S-sulfenylation affects certain proteins, including A-kinase anchor protein 13, Fibrilline-1, and Spermatogenesis-associated protein 7.

What is known already
There is a significant increase in reactive oxygen species (ROS) and reactive nitrogen species (RNS) production within sperm capacitation. In contrast to tyrosine phosphorylation, a well-established mark of sperm capacitation, ROS, and RNS lead to PTMs themselves and modify thiol groups of cysteines. Despite these facts, the dynamics of ROS/RNS-derived PTMs during sperm capacitation remain unknown. Therefore, we consider both S-nitrosylation and S-sulfenylation of sperm proteins as novel modifications associated with the capacitation.

Study design, size, duration
C57BL6 mouse sperm were isolated from the caudae epididymae of 12-20-week-old males (n = 5). The study compared non-capacitated and capacitated spermatozoa using proteomic profiling.

Participants/materials, setting, methods
Sperm proteins were extracted into RIPA buffer. The protein lysate was incubated with 5mM dimedone, a hapten that specifically labels S-sulfenylated proteins, and immunogenically detected with an anti-dimedone antibody (Merk, Germany). Alternatively, S-nitrosylated proteins were detected by the anti-nitrosocysteine antibody (Merk, Germany). S-sulfenylated and S-nitrosylated proteins were visualized by western blotting. S-sulfenylated proteins were simultaneously identified by mass spectrometry.

Main results and the role of chance
We demonstrated an increase in S-sulfenylation and S-nitrosylation along with sperm capacitation. In addition, both S-sulfenylation and S-nitrosylation are positively correlated with tyrosine phosphorylation. Using mass spectrometry, we identified S-sulfenylated proteins, mostly belonging to the cytoskeleton: A-kinase anchor protein 13, Fibrilline-1, Spermatogenesis-associated protein 7, and Rab-like protein 2A.

Limitations, reasons for caution
The limitation of this study is the instability of PTMs. ROS/RNS-derived PTMs hypothetically arise and cease during protein sample preparation. The experiment was limited to one animal model. Further experiments should be performed on other mammalian models.

Wider implications of the findings
Studying novel sperm PTMs and their mechanism of action may improve the diagnosis of male infertility. Further, it could bring a novel approach to modulate the fertilizing ability of sperm used for in vitro fertilization.

Trial registration number
260 536
P-151 In women with recurrent implantation failures, can hyaluronan enriched media optimize reproductive outcomes?
Authors: Thorat R , Mantravadi K , Gedela D R 
Published: June 2023

Abstract

Study question
To evaluate the efficacy of Hyaluronan Enriched Media (HEM) to optimize Reproductive Outcomes in women with Recurrent Implantation Failures (RIF)?

Summary answer
In women with RIF, HEM seems to offer beneficial and safer reproductive outcomes.

What is known already
HEM has shown to enhance the implantation process of an embryo in-utero. Efficacy of HEM to optimize reproductive outcomes is still not proven.

Study design, size, duration
This retrospective study comprises data of 430 women with two failed IVF cycles or had RIF undergoing infertility treatment between 2016 to 2021. Study group included Young women (&lt;37yrs) with RIF who opted elective-single blastocyst transfer (eSET) with HEM (n = 228). Control group had young women with RIF and eSET without use HEM (n = 202). Only self-gamete cycles with No PGT-A screening were included in this study. Women with known uterine pathologies were excluded from the study.

Participants/materials, setting, methods
All women had ICSI - freeze all culture strategy. In a FET, blastocyst showing 100% survival post warming was considered transfer. In study group, embryos were incubated in pre-equilibrated HEM for 10minutes before the intended embryo transfer. In control group embryo was transferred in single step media. ET procedure done as per the clinic’s SOP. Outcomes measured: Clinical Pregnancy Rates (CPR), Implantation rates (IR), Miscarriage Rates(MR), Live Birth rates(LBR) and Neonatal outcomes.

Main results and the role of chance
Following were the outcomes measured in HEM group Vs Control group:
CPR- 66.22% Vs 61.38% (p = 0.2938)
IR – 49.56% Vs 31.68% (p = 0.0002; Significant)
MR – 11.4% Vs 16.33% (p = 0.1359)
LBR – 54.82% Vs 45.05% (p = 0.0418; Significant)
There was no significant adverse events with neonatal outcomes between the groups and data looked comparable.
Use of HEM at embryo transfer for women with RIF seemed to be a beneficial intervention. It showed significant improvement with embryo implantation and live birth. Data in this study has also looked at Neonatal outcomes. Since HEM group had no reported adverse neonatal outcomes, it not only aids in improving reproductive outcomes but also is a safe intervention and can be considered for routine clinical use for indicated cases.

Limitations, reasons for caution
Retrospective data with small and unequal sample size.

Wider implications of the findings
Efficacy of various therapies is still unknown for women who had RIF. PGT-A and ERA (invasive therapies) have been tried for such cases, but its effectiveness is still up in question. Development for newer & safer therapies to improve embryo implantation and live birth for these patients is still awaited.

Trial registration number
Not applicable
P-153 Clinical outcome of different embryo transfer strategies after late rescue ICSI procedure: A cohort study based on over 140 thousand ART cycles
Authors: Zhu X , Yang R , Tian T , Li R , Liu P , Qiao J 
Published: June 2023

Abstract

Study question
How effective and safe is freeze-all blastocyst transfer in combination with late rescue intracytoplasmic sperm injection (r-ICSI)?

Summary answer
Freeze-all blastocyst stage embryo transfer (ET) serves as an optimal strategy to support late r-ICSI.

What is known already
Late r-ICSI has not been widely adopted due to the time-dependent in vitro deterioration of oocyte quality and endometrial growth not being synchronised with embryo development.

Study design, size, duration
This was a retrospective cohort study. All participants received treatment between 2009 and 2019. 2,270 patients in the aggregate encountered unexpected total fertilisation failure (TFF) during 149,054 cycles of in vitro fertilisation (IVF) and adopted a late r-ICSI procedure, whilst meeting the inclusion criteria for this study.

Participants/materials, setting, methods
Patients were grouped according to transfer strategies (926 women in Group 1 underwent fresh ET, 365 women in Group 2 underwent freeze-all ET, 716 women in Group 3 experienced blastulation failure, and 263 women did not have available D3 embryos). Patients received different ET strategies after r-ICSI, with the main outcome measures included live birth rate (LBR), cumulative live birth rate (cLBR), and conservative cLBR.

Main results and the role of chance
TFF occurred in 7.4 % of all IVF cycles. Group 1 tended to be older at oocyte retrieval [33.00 (30.00–37.00) vs. 31.00 (29.00–35.00), P &lt; 0.001], with more infertile years [5.00 (3.00–8.00) vs. 3.00 (2.00–6.00), P &lt; 0.001], higher follicle-stimulating hormone (FSH) levels [7.10 (5.71–8.69) vs. 6.61 (5.25–7.95) mIU/mL, P &lt; 0.001], higher gonadotropin consumption [2850.00 (1950.00–4125.00) vs. 2325.00 (1800.00–3150.00) IU, P &lt; 0.001], and fewer oocytes retrieved [10.00 (6.00–15.00) vs. 13.00 (9.00–19.00), P &lt; 0.001]. Group 2 exhibited considerably better LBRs following the first ET cycle (37.53 % vs. 4.64 %) and cLBR (52.60 % vs. 8.21 %). After adjustment for covariates using binary logistic regression analyses, Group 2 still showed better obstetric performance in LBR (OR:11.77, 95 % CI (8.42–16.45)], cLBR (OR:11.29, 95 % CI (7.84–16.27)], and conservative cLBR (OR:2.55, 95 % CI (1.83–3.55)]. Additionally, the two groups showed similar miscarriage rates, whilst no new-borns with malformations or congenital diseases were reported.

Limitations, reasons for caution
This study was based on a retrospective cohort, which is inevitably associated with a skewed data distribution and inherent biases.

Wider implications of the findings
Our study highlights r-ICSI as a safe and effective alternate solution for unexpected TFF to aid frustrated couples. However, for women with limited oocytes available for r-ICSI use, weighing the benefits against the costs of the procedure might be prudent before implementing in vitro blastulation.

Trial registration number
NA
P-168 Follow-up survey of deliveries derived from Day 7 blastocysts
Authors: Murakami K , Tsuji H , Kitasaka H , Fukunaga N , Asada Y 
Published: June 2023

Abstract

Study question
Does Day 7 blastocyst-transfer affect prognosis of babies born?

Summary answer
There was no effect on growth up to 3 years of age in babies from Day 7 blastocyst-derived births.

What is known already
Culture medium and technology have advanced, and the efficiency to culture up to the blastocyst stage in order to obtain viable embryos has increased dramatically. As a result, blastocyst transfer is associated with higher clinical pregnancy outcomes than cleavage transfer. In 1998, it was first reported that some embryos may develop into blastocysts on Day 7. However, there are few reports on neonatal outcomes from Day 7 blastocyst transfer. Therefore, the utility of Day 7 blastocysts is controversial.

Study design, size, duration
This was retrospective study which included 23 cases where there was a live birth after single embryo transfer of a Day 7-derived blastocyst. The incidence of birth defects, birth weight was recorded as well as a physical development survey. The height and weight were recorded in 10 children aged 18-months and 4 children aged 3 who responded to follow-up survey. The time period was from January 2013 to December 2021.

Participants/materials, setting, methods
Patient seeking fertility treatment at an established private IVF clinic. We compared the birth weight, and birth after 18-months and 3 years height and weight of children born to a Day 7 blastocyst with data from babies born from Day 5 and Day 6 derived blastocysts. Statistical significance was determined using Kruskal-Wallis test.

Main results and the role of chance
The incidence of birth defects was 2.4% (115/4828), 1.7% (16/954) and 0% (0/23) in the Day 5, Day 6 and Day 7 groups, respectively. The average birth weight of the Day 7 group was 3057+/-532 g, which was not significantly different from 3024+/-472 g and 3041+/-480 g in the Day 5 and Day 6 groups. The average height at 18-months, was 80.0+/-5.3 cm, 79.8+/-5.1 cm, 77.8+/-6.9 cm in the Day 5, Day 6 and Day 7 groups, respectively. The average weight at 18-months, was 10.5+/-1.2 kg, 10.4+/-1.1 kg, 10.5+/-1.4 kg. The average height at 3 years old, was 93.2+/-4.8 cm, 92.9+/-4.7 cm, 93.4+/-5.9 cm. The average weight at 3 years old, was 13.9+/-1.6 kg, 13.8+/-1.4 kg, 14.1+/-2.6 kg, respectively. There was no significant difference in average height and weight up-to the 3 years old follow-up survey.

Limitations, reasons for caution
The incidence of Day 7 blastocyst-transfer is low and the study was limited to cases of single blastocyst embryo transfer. The study was not separated by sex, because sample size was small.

Wider implications of the findings
There was no difference in growth up to a 3-year-old follow-up survey of the Day 7 blastocyst compared with the Day 5 and Day 6 groups. Transfer of a Day 7-derived blastocyst does not appear to affect infant development and should be considered in cases where blastocyst development is delayed.

Trial registration number
not applicable
P-180 Hyaluronidase used in oocyte denudation inhibits the proliferation and the viability of cumulus cells through the inhibition of midkine
Authors: Ergüven M , İrez T 
Published: June 2023

Abstract

Study question
Does hyaluronidase (HAse) have possible negative or positive effects on cumulus cells (CCs) during oocyte denudation before ICSI by altering midkine (MK) levels?

Summary answer
Hyaluronidase inhibits the proliferation of CCs via the inhibition of MK activity which may result in poor embryo quality and low ICSI success.

What is known already
MK is abundantly expressed in ovarian follicles. MK secreted from the cumulus-granulosa cells that surround oocytes was shown to promote the cytoplasmic maturation of oocytes. This effect of MK could be mediated via its' anti-apoptotic effect and some other mechanisms. The removal of CCs during oocyte denudation (OD) is done in order to select and grade the oocytes before ICSI. HAse is applied for ICSI to break down hyaluronic acid, which is present at high levels in the cumulus-oocyte complex during OD. To date, there have only been a few reported cases of the toxic effects of hyaluronidase on oocytes.

Study design, size, duration
This study is a prospective, randomized study done with 90 healthy women between September 2017 and September 2018.

Participants/materials, setting, methods
This study was done with women diagnosed as a male factor between the ages of 21 and 40 who underwent ICSI. HAse was applied to the cultured CCs at concentrations of 0.1 IU/ml, 1 IU/ml, and 10 IU/ml. The proliferation and apoptosis indices (Flow cytometry), structures [Transmissive electron microscopy (TEM)], and MK levels (ELISA) of CCs were evaluated every 24 hours for 48 hours. One way-Anova was used and p &lt; 0.05 was considered statistically significant.

Main results and the role of chance
The application of HAse at all concentrations decreased cumulus cell numbers for 48 hours (p &lt; 0.05). The highest decrease in cell number and cell viability with the highest number of apoptotic cells were detected at the 48th hour at the application of the highest concentration of HAse (p &lt; 0.05). The highest concentration of HAse application caused the highest decrease in MK levels at the end of 48 hours (p &lt; 0.05).

Limitations, reasons for caution
The effect of HAse on the CCs of women aged below 21 and above 40 could not be evaluated. Therefore, the overall resistance and fragility of CCs to these HAse concentrations could not be evaluated. In addition, the HAse effects should be evaluated in female infertility cases such as PCOS.

Wider implications of the findings
This is the first report to examine the effect of HAse on MK activity. 2-3 lines of CCs are commonly left during oocyte denudation in order to protect the oocyte from stress-induced reactions. The low number of CCs means low MK levels resulting in a loss in oocyte competence.

Trial registration number
Tthe Ethics Committee Directive on Non-Interventional Studies of Biruni University with the permission numbers 2017/5-1.
P-181 The impact of high proportion of immature oocyte in a cohort on the reproductive outcome following icsi
Authors: Kant G , Nayar K D , Prasad A , Sanan S , Miglani S , Sharma H , Nayar K 
Published: June 2023

Abstract

Study question
Whether high proportion of immature oocyte in a cohort impacts outcome of sibling mature oocyte in ICSI cycles.

Summary answer
Study demonstrate that if immature oocyte retrieved was more than 50% in a cycle then it reduces reproductive outcome with the remaining mature sibling oocytes.

What is known already
The selection of competent oocyte is crucial to assisted reproductive technique procedure outcome. In ICSI procedure where only metaphase II oocytes (MII) are injected correlates with number of MII oocytes available, embryo development and pregnancy outcome. Percentage of immature oocyte {Metaphase I (MI) and Germinal Vessicle (GV) } retrieved in a cycle is always a concern for stimulation protocol, patient response which affects IVF laboratory outcome.

Study design, size, duration
A prospective study was conducted from 1st January 2020 to 1st December 2022 in the Department of Reproductive medicine at a tertiary infertility centre in India.

Participants/materials, setting, methods
Patients were divided into 3 groups on the basis of percentage of immature oocyte retrieved in a single cycle. Group A (n = 100), where percentage of immature oocyte (MI and GV) was between 0 to 20%, while Group B (n = 60) where percentage of immature oocyte was between 21 to 50% and Group C (n = 20) where percentage of immature oocyte was between 51 to 100%.

Main results and the role of chance
This study included all normal responder patients and cycles using in-vitro fertilisation (IVF) and poor responders were excluded. All blastocyst formed were vitrified and transferred in frozen embryo replacement cycle. All the 3 groups were compared on the basis of fertilisation rate, blastocyst formation rate, clinical pregnancy rate and miscarriage rate.
Group A and group B had no significant difference in fertilisation rate (82% vs. 78%, p &gt; 0.5), blastocyst formation rate (60% vs. 58%, p &gt; 0.5), clinical pregnancy rate (58% vs. 55%, p &gt; 0.5) and miscarriage rate (12% vs. 11%, p &gt; 0.5).
While significant reduction was observed in group C ( &gt; 50% MI & GV oocyte) in fertilisation rate (40%, p &lt; 0.1), blastocyst formation rate (28%, p &lt; 0.1), clinical pregnancy rate (15%, p &lt; 0.1).

Limitations, reasons for caution
Larger randomised control studies are needed to strengthen these results.

Wider implications of the findings
Percentage of immature oocyte can help in predicting the success of assisted reproductive technique. This will help in counselling patient about outcome.

Trial registration number
NA
P-194 Initial experience of using iDAScore as a tool to predict euploid blastocysts
Authors: Tan S H , Lim A Y X , Khoo C L , Yap W Y , Keith J M , Lee C S S 
Published: June 2023

Abstract

Study question
Can the annotationfree embryo scoring system (iDAScore) predict the likelihood of euploidy in embryos?

Summary answer
Our results have shown that there is a significant positive correlation between iDAScore and blastocyst euploidy.

What is known already
iDAScore (Vitrolife, Sweden) is an embryo ranking model that was developed by using artificial intelligence (AI) and deep learning. It does not require any user-dependent annotation which largely eliminates the subjectivity of manual annotation by embryologists. It has also been reported to be a robust predictor in likelihood of embryo implantation. However, the correlation between iDAScore and euploidy has not been extensively studied. Therefore, this study is to determine if iDAScore can be utilized as a predictor for embryo euploidy.

Study design, size, duration
A total of 860 blastocysts (mean age: 30.0; age range: 19.0-35.0) were assessed with iDAScore on day-5 and/or day-6 of embryo development from January 2022 to October 2022 at Alpha IVF & Women’s Specialists. The euploidy rates were analyzed based on the stratified iDAScores (Group A:0.0-4.9; Group B: 5.0-7.4; Group C:7.5-8.9; Group D:9.0-10.0).

Participants/materials, setting, methods
Scores were computed by the iDAScore software at the Vitrolife Technology Hub (Vitrolife, Gothenburg, Sweden) prior to trophectoderm biopsy for Preimplantation Genetic Testing for Aneuploidies (PGT-A) (Ion Torrent, USA). The ploidy status (euploid or aneuploid) based on PGT-A results were recorded and assessed with the corresponding iDAScore.

Main results and the role of chance
The euploidy rates of Group A, B, C and D were 56.7% (17/30), 60.0% (105/175), 65.9% (178/270) and 74.8% (288/385) respectively. Group D shows significantly higher euploidy rate compared to Group B and Group C (p = 0.0005, p = 0.0143). A weak significance was observed between Group D and Group A (p = 0.0505). This is probably due to smaller sample size in Group A. No significant differences were displayed among Group A, Group B and Group C (p = &gt; 0.005). Our results demonstrated an increasing trend between iDAScore and the proportion of euploid embryos.

Limitations, reasons for caution
Few of the blastocysts in Group A could be selected for biopsy so the sample size was only a fraction of the other groups. Further studies and larger sample sizes would allow the findings to be stated more confidently.

Wider implications of the findings
Although the iDAScore algorithm scores the chance of embryo implantation, we have demonstrated its potential to assist in predicting the embryo ploidy status in a non-invasive manner. This may be used to inform the decision of which and how many blastocysts to biopsy and transfer, thus reducing treatment costs.

Trial registration number
not applicable