bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-470 Prediction of the cumulative live birth rate of IVF using a human embryonic stem cells-derived trophoblastic spheroid implantation model
Authors: Ng E , Cherie L , Ruan H , Lee K C , Fong S W , Yue C , Chen A , Lee C , Lam M T , Yeung W , Li R 
Published: June 2023

Abstract

Study question
Can the attachment rate of a human embryonic stem cell-derived trophoblastic spheroids (BAP-EB) onto endometrial epithelial cells predict the cumulative live birth rate of an IVF cycle?

Summary answer
The BAP-EB attachment rate offers modest prediction of the cumulative live birth rate of women aged ≥35 years undergoing IVF.

What is known already
Implantation failure is one of the major causes leading to a low IVF success. There is no reliable tool for assessing endometrial receptivity in IVF.

Study design, size, duration
Prospective observational study of 240 infertile women from 2017 to 2021.

Participants/materials, setting, methods
Infertile women with regular cycles attending IVF centres were recruited. Endometrial aspirates were collected from a natural cycle one month before IVF for the BAP-EB attachment rate. The cumulative live birth rate of a stimulated cycle and its derived frozen embryo transfer cycles within 6 months of ovarian stimulation were obtained.

Main results and the role of chance
The BAP-EB attachment rate in women with a cumulative live birth was similar to those who failed to have a live birth. When women were stratified by age into &lt;35 years and ³35 years, the BAP-EB attachment rate was significantly higher only in women aged ³35 years who had a live birth when compared to those without a live birth. The receiver operating characteristic (ROC) curve analysis of BAP-EB attachment rate in predicting cumulative live birth showed the area under the curve (AUC) of 0.559 (95% CI 0.479 – 0.639, p = 0.151), 0.448 (95% CI 0.310 – 0.585, p = 0.461) and 0.613 (95% CI 0.517 – 0.710, p = 0.026) for all ages, age &lt;35 and ≥35 respectively.

Limitations, reasons for caution
BAP-EB and the isolated endometrial epithelial cells may not fully represent the in vivo developed human blastocysts and endometrial cells, respectively. The in vitro nature of the experiments and the limited sample size in this study may also limit the interpretation of the data.

Wider implications of the findings
Implantation failure is one of the major reasons contributing to the low success rate of IVF. The BAP-EB-endometrium attachment assay could potentially be used by reproductive medicine specialists to better counsel the couples who fail in IVF treatment.

Trial registration number
NCT02713854
P-474 Association between subchorionic hematoma’s size and miscarriage rate in IVF/ICSI patients
Authors: Chen P , Manchao L , Lei J , Cong F 
Published: June 2023

Abstract

Study question
What is the risk factor for miscarriage in patients undergoing IVF/ICSI with subchorionic hematoma(SCH) in the first trimester?

Summary answer
The size of SCH is a risk factor for miscarriage in patients undergoing IVF/ICSI. Miscarriage rate increases as the size of SCH grows.

What is known already
SCH is a frequently observed pathology during routine ultrasound examinations in early pregnancy. Its clinical significance has been unclear. Some studies believed that SCH found in first trimester was not correlated with adverse pregnancy outcome; Other studies believed that SCH in early pregnancy can cause a significant increase in the incidence of late pregnancy complications, such as preterm labor, preeclampsia, and postpartum hemorrhage. Besides, what are the risk factors for miscarriage in pregnant women with SCH? Answers to these questions are urgently needed.

Study design, size, duration
Retrospective cohort study with 646 patients undergoing IVF/ICSI at a tertiary care university hospital, between February 2017 and November 2020.

Participants/materials, setting, methods
All patients who underwent IVF/ICSI from February 2017 to November 2020, achieved pregnancy and underwent transvaginal ultrasound at our center during first trimester were included. Risk factors for miscarriage in patients with SCH were explored. Miscarriage rates in patients with different SCH sizes which was expressed as its' ratio to the area of the gestational sac were compared.

Main results and the role of chance
Patients with SCH who had more embryos transferred (P=0.01), earlier detection of IUH (P=0.003), a smaller GS area (P=0.03) was prone to miscarry. The size of SCH is a risk factor for miscarriage (P = 0.016). Miscarriage rate increased with increasing size of SCH (P for trend: 0.003).

Limitations, reasons for caution
The main limitation of this study is its retrospective nature and relatively small sample size.

Wider implications of the findings
Extra clinical attention needs to be paid to the miscarriage risk of in IVF/ICSI patients with large SCH. There is urgent need for future research on SCH affecting pregnancy outcome and the underlying pathophysiological mechanisms.

Trial registration number
Not applicable
P-475 Effect of transdermal estradiol on endometrial preparation in frozen-thawed embryo transfer: A randomized control study.
Authors: Tran T T T 
Published: June 2023

Abstract

Study question
Is patient usage of transdermal estradiol more effective than oral estradiol on endometrial preparation in frozen-thawed embryo transfer cycles?

Summary answer
This study showed no significant differences in clinical pregnancy rates between the 2 groups. Transdermal gel have advantage of better patient comfort, lesser side effects.

What is known already
Estrogen and progesterone are crucial factors for endometrial preparation in frozen embryo transfer (FET) cycles. Studies assessing different forms of estradiol in FET have already been published. However, literature and studies in Vietnam are still limited to evaluating, research evaluating transdermal estrogen in ART. This study aimed to evaluate the use of transdermal estradiol gel and compare it with oral estradiol for the endometrium preparation in frozen-thawed embryo transfer (FET) cycles.

Study design, size, duration
This randomized clinical trial (RCT) included 380 frozen embryo transfer (FET) cycles from February 2020 to August 2021 at the IVF Department, Hung Vuong Hospital.

Participants/materials, setting, methods
They were randomized into one of the two groups. Group A (n = 190) received oral estradiol and group B (n = 190) received estradiol gel. In both groups, medication was started on day 2 of the menstrual, and endometrial thickness was monitored by ultrasound. Main outcomes were the following: serum estradiol level , endometrial thickness,.... Secondary outcomes were CPR, MR, and side effects in the 2 groups. Statistical testing was performed with Stata 14.

Main results and the role of chance
There was a significant difference in estradiol level on the day of progesterone administration and embryo transfer between the two groups (270.5 pg/ml versus 186.5 pg/ml, p, p. &lt;0.001). According to the comparison, the two groups were not significantly different in the endometrial thickness on the day of progesterone administration (p = 0.85). as the data suggest, the total dose of estradiol used and the total number of days of dosing were similar in the two groups. The biochemical and clinical pregnancy rates were similar between the two groups and did not a significantly differ (56.2% vs. 52.2%, p = 0.474). The rate of miscarriage was higher than in the study group, but it was not statistically significant. Almost 20.3% of patients (n = 37) in group A had mild adverse effects when compared with only 10.1% (n = 18) in group B, and this was clinically significant (P = 0.007).

Limitations, reasons for caution
The limitation of our study was not asses ongoing pregnancy rate and live-birth rate.

Wider implications of the findings
Patients who estradiol valerate is contraindicated such as, high risk for deep vein thrombosis, hyperlipidemia, and clotting disturbance we can use oestrogel to be safe. It is suggested that estradiol transdermal patches be used instead of oral estradiol in FET cycles

Trial registration number
ISRCTN15301227
P-482 Bacterial vaginosis in a subfertile population undergoing fertility treatments: a prospective cohort study
Authors: Van den Tweel M , Van den Munckhof E , Van der Zanden M , Molijn A , Van Lith J , Le Cessie S , Boers K 
Published: June 2023

Abstract

Study question
Does bacterial vaginosis (BV) influences pregnancy rates during fertility treatments?

Summary answer
BV does not significantly impact ongoing pregnancy or live birth rates but could affect miscarriage rates.

What is known already
BV is known to influence several obstetric outcomes, such as preterm delivery and endometritis. Only few studies investigated the effect of BV in subfertile women, and studies found a negative effect of BV on fecundity especially in the in vitro fertilisation (IVF) population.

Study design, size, duration
Observational prospective study, 76 couples attending a fertility clinic in the Netherlands between July 2019 and June 2022, undergoing a total of 133 attempts of intra uterine insemination (IUI) or IVF.

Participants/materials, setting, methods
Participants undergoing IUI, IVF or intra cytoplasmatic sperm injection (ICSI). Vaginal samples taken at oocyte retrieval or insemination were analysed on qPCR BV and 16S rRNA gene microbiome analysis of V1-V2 region. Logistic regression with a Generalized Estimated Equations (GEE) analysis was used to account for multiple observations per couples. Main study outcome was defined as ongoing pregnancy at 12 weeks. Secondary outcomes were miscarriage rate and live birth rate.

Main results and the role of chance
A total of 26% of the 133 samples tested positive for BV. No significant differences were observed in ongoing pregnancy or live birth rates based on BV-status (OR 0.50 (0.16-1.59), aOR 0.32 (0.09-1.23)) or microbiome community state type (CST). There was a tendency of more miscarriages based on positive BV status (OR 4.22 (1.10-16.21), aOR 4.28 (0.65-28.11)) or microbiome CST group III/IV. Sample outcomes of qPCR BV were in accordance with their microbiome analyses. On baseline groups significantly differed on smoking status and body mass index (BMI). Odds ratios were adjusted for smoking status, BMI and socioeconomic status.

Limitations, reasons for caution
Numbers of the initial sample size calculation were not met. Therefore, numbers may be too small to draw firm conclusions.

Wider implications of the findings
This study describes the influence of BV or an abnormal microbiome in a subfertile population undergoing fertility treatments. A possible effect of lifestyle factors on BV-status is shown. Combining qPCR and microbiome results and analysing both IUI and IVF/ICSI treatments can contribute to better generalisability to the consulting room.

Trial registration number
Z21.031
P-493 Bleeding during early pregnancy after Hormone Replacement Therapy Frozen Embryo Transfer (HRT-FET) – is it more common than we think?
Authors: Nielsen J , Humaidan P , Alsbjerg B , BrixJensen M 
Published: June 2023

Abstract

Study question
How common is bleeding in early pregnancy after HRT-FET? And does bleeding affect the reproductive outcome in this population?

Summary answer
A total of 47% of HRT-FET patients experience bleeding before the 8th week of gestation, however, bleeding does not seem to affect the reproductive outcome.

What is known already
Bleeding occurs in 20% of spontaneously conceived pregnancies. Most pregnancies will proceed to term although episodes of heavy bleeding are associated with an increased risk of miscarriage. The prevalence of bleeding after assisted reproductive technology including in vitro fertilization seems to be higher and, in some reports, up to 36%. However, the knowledge is scanty and in particular the knowledge regarding bleeding during HRT-FET is sparse. As HRT-FET in clinical practice increases, knowledge on the occurrence of early bleeding during pregnancy and the impact on the reproductive outcome in this population is needed.

Study design, size, duration
We performed a cohort study including 489 patients undergoing HRT-FET. The trial was conducted from January 2020 to November 2022 in a public fertility clinic.

Participants/materials, setting, methods
Patients with autologous vitrified blastocyst were treated in a standard HRT-FET protocol. In the event of a positive HCG-test an early pregnancy scan was performed around 8 weeks of gestation. During this visit the women answered a questionnaire covering pregnancy related symptoms, wellbeing, and if bleeding occurred, the type and duration of the bleeding. The information was verified through medical files.

Main results and the role of chance
In this HRT-FET cohort we found that a total of 47% (150/322) of patients with a positive pregnancy test experienced bleeding before 8 weeks of gestation. Mostly the bleeding was described as spotting with a median of 2 days (range 0.5—16 days). Out of 150 patients with one or several bleeding episodes, a total of 107 patients (71 %) had an ongoing pregnancy at 12 weeks of gestation. In comparison, 172 patients reported no bleeding episodes and a total of 115 (67%) of these patients had an ongoing pregnancy at 12 weeks of gestation. This difference was found to be non-significant (p = 0,39).

Limitations, reasons for caution
The patients in our study were treated in a standard HRT-FET protocol. The results may not be transferable to other treatment protocols. Also the data is based on patients self-reported symptoms. Therefore some degree of recall bias may be present.

Wider implications of the findings
Episodes of early bleeding during pregnancy are associated with distress for the pregnant woman – especially in previously infertile patients. Knowledge about the frequent occurrence of bleeding during early pregnancy after HRT-FET and that this does not affect the reproductive outcome will help the clinician reassure and guide the patient.

Trial registration number
2019-001539-29
P-509 Genomic characterization of couples and their embryos/fetuses with idiopathic recurrent pregnancy loss
Authors: Wang W J , Wang L , Sun J , Qing Z , Liu Z 
Published: June 2023

Abstract

Study question
To what extent do genomic variants contribute to idiopathic recurrent pregnancy loss (RPL)?

Summary answer
Pathogenic uniparental disomy, copy number variations, and single nucleotide variants were identified in 18 of 83 couples and their embryos/fetuses with idiopathic RPL.

What is known already
RPL is defined as the loss of two or more pregnancies before 24 weeks gestation. The etiologies of RPL include antiphospholipid antibody syndrome, and anatomic, endocrinological and chromosomal abnormalities. About 50% of RPL is unexplained and is termed as idiopathic RPL. Chromosomal aberrations and genetic variants have been identified to be associated with idiopathic RPL, demonstrating that genomic factors underlie idiopathic RPL.

Study design, size, duration
We applied genome sequencing to study genomic variations that causing idiopathic RPL. Couples and their embryos/fetuses were collected and sequenced. Genomic variations from women and men experiencing RPL and their embryos/fetuses were analyzed to fully characterize the genomic contribution to idiopathic RPL.

Participants/materials, setting, methods
We recruited 83 Chinese couples with idiopathic RPL and collected 249 samples from their embryos/fetuses and peripheral blood. Genomic DNA of those samples were sequenced, and pathogenic chromosomal abnormalities and genetic variants were identified.

Main results and the role of chance
Generally, pathogenic variants were identified in RPL females, males and embryos/fetuses. One uniparental disomy, 9 copy number variations, and 1 homozygous and 1 de novo single nucleotide variants (SNVs) were identified pathogenic in 12 RPL embryos/fetuses. Five and three pathogenic SNVs were identified in 4 RPL females and 2 RPL males respectively. Many SNVs affect the genes involved in sexual development. In total, 18 of 83 (21.69%) couples with idiopathic RPL could be explained by genomic variation, providing information for clinical treatments.

Limitations, reasons for caution
The sample size is relatively small, and they are from one medical center.

Wider implications of the findings
Genomic variations in females, males and their embryos/fetuses can cause RPL, and identification of genetic causes will facilitate further precision intervention.

Trial registration number
not applicable
P-510 Low neighbourhood socioeconomic status is associated with lower cumulative ongoing pregnancy rate after in vitro fertilization treatment
Authors: Speksnijder J , Marion E , Baart E , Steegers E , Laven J , Bertens L 
Published: June 2023

Abstract

Study question
Is there an association between neighbourhood socioeconomic status (SES) and cumulative ongoing pregnancy after 2.5 years of in vitro fertilization (IVF) treatment?

Summary answer
Low and middle neighbourhood SES is associated with lower odds of an ongoing pregnancy within 2.5 years of IVF treatment than high neighbourhood SES.

What is known already
Low SES is known to have a negative impact on general health and a variety of medical conditions, including perinatal health. However, not much data is available on the impact of SES on IVF treatment outcome.

Study design, size, duration
This is a retrospective observational study of 3720 couples undergoing IVF or IVF-ICSI treatment between 2006 and 2020.

Participants/materials, setting, methods
Neighbourhood SES was assigned to each couple based on the postal code of residence. Subsequently, SES was categorized into low (&lt;p20), medium (p20-p80), and high (&gt;p80). Multivariable logistic regression analyses were performed with cumulative ongoing pregnancy within 2.5 years as outcome variable, SES category, female age, BMI, smoking status (yes/no), and interaction terms for age*SES and BMI*SES were used as covariates.

Main results and the role of chance
There was no difference in ongoing pregnancy rates between SES groups after the first fresh embryo transfer or in the average number of IVF treatment cycles performed. However, the cumulative ongoing pregnancy rates differ significantly between SES groups (Low; 43.6%, medium; 50.9%, high; 54.1%). Low SES had significantly lower odds for achieving an ongoing pregnancy within 2.5 years (OR = 0.06 (95%CI 0.02-0.22)). The interaction terms age*SES and BMI*SES showed attenuation of this association with increasing age and BMI (OR = 1.07 (95%CI 1.022 – 1.12) and OR = 1.61 (95%CI 1.25 – 2.09), respectively). The associations with medium SES were similar, but less pronounced (OR = 0.16 (95%CI 0.05 – 0.50) with OR = 1.04 (95%Cl 1.00 – 1.09) and OR = 1.41 (1.12 – 1.77) for the interaction terms with female age and BMI respectively.

Limitations, reasons for caution
We were not able to perform additional analysis on individual characteristics like educational level, ethnicity or language proficiency due to lack of data.

Wider implications of the findings
In the Netherlands, health insurance is mandatory. Our study showed that even with equal access to fertility care, patients living in a low SES neighbourhood are disadvantaged. This underlines the importance of taking the whole wellbeing of the patient into account, before starting an IVF treatment.

Trial registration number
not applicable
P-517 Downregulated INHBB in endometrial tissue of recurrent implantation failure patients impeded decidualization through the ADCY1/cAMP signalling pathway
Authors: Zhang H , Zhang X , Wang Z 
Published: June 2023

Abstract

Study question
To identify the mechanism of Inhibin Subunit Beta B (INHBB) in the regulation of human endometrial stromal cells (HESCs) decidualization in recurrent implantation failure (RIF).

Summary answer
INHBB was decreased in endometrial stromal cells of women with RIF, which attenuated decidualization in vitro by suppressing ADCY1-induced cAMP production and cAMP-mediated signalling.

What is known already
INHBB encodes a preprotein subunit of inhibin/ activin, functional cytokines belonging to the transforming growth factor-β (TGF-β) family. INHBB mRNAs were expressed in human decidualized endometrium from the first trimester of pregnancy and increased as the gestation progressed. Furthermore, INHBB expression increases in the mouse uterus in areas undergoing decidualization. These studies indicated that INHBB might play an essential role in endometrial decidualization.

Study design, size, duration
The Medical Ethics Committee of Nanjing Drum Tower Hospital approved this study (No. 2013-081-01). Written informed consent was obtained from each participant. Between January 2020 and November 2021, 28 infertile and 18 fertile control women aged 20-40 years with normal and regular menstrual cycles (25-35 days) and no history of steroid hormone medication in the last 3 months were included in the study.

Participants/materials, setting, methods
RNA-seq was conducted to identify the differentially expressed genes in the endometria from control and RIF patients. RT-qPCR, WB, and immunohistochemistry were performed to analyse the expression levels of INHBB in decidualised HESCs. RT-qPCR and immunofluorescence were used to detect changes in decidualization after knockdown INHBB. Then, RNA-seq was used to dig out the mechanism of INHBB regulating decidualisation.

Main results and the role of chance
Our results showed significantly reduced expression of INHBB in endometrial stromal cells of women with RIF. In addition, INHBB was increased in the endometrium of the secretory phase and significantly induced in in-vitro decidualization of HESCs. Notably, with RNA-seq and siRNA-mediated knockdown approaches, we demonstrated that the INHBB-ADCY1-mediated cAMP signalling pathway regulates the reduction of decidualization. We found a positive association between the expression of INHBB and ADCY1 in endometria with RIF (R2= 0.3785, P = 0.0005).

Limitations, reasons for caution
Our results indicated that INHBB regulates cAMP level by inducing the expression of ADCY1, while the regulation mechanism between INHBB and ADCY1 in endometrial decidualization requires further exploration.

Wider implications of the findings
The decline of INHBB in HESCs suppressed ADCY1-induced cAMP production and cAMP-mediated signalling, which attenuated decidualization in RIF patients, indicating that INHBB is an essential component in the decidualization process.

Trial registration number
not applicable