bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-196 PIEZO-intracytoplasmic sperm injection (P-ICSI) can improve the clinical outcomes of ICSI
Authors: Lim C K , Cha H J , Shin S H , Kim G W , Ryu H , Han S , Choi W 
Published: June 2023

Abstract

Study question
Can P-ICSI improve the clinical outcomes of ICSI, such as degeneration, fertilization and development to blastocyst, compared to conventional ICSI (C-ICSI)?

Summary answer
P-ICSI can improve the clinical outcomes of ICSI by increasing the number of fertilized oocytes and decreasing the number of degenerated oocytes after ICSI.

What is known already
In human IVF-ET, some of oocytes are damaged after ICSI when retrieved oocytes are inseminated by ICSI. The application of P-ICSI has been limited although it was developed over 30 years ago. Recently, it has been reported that P-ICSI can decrease damage after ICSI and improve fertilization and embryonic development compared to C-ICSI.

Study design, size, duration
This study included 50 subjects undergoing IVF and was performed between April and October 2022. Sibling oocytes were randomly assigned to C-ICSI and P-ICSI.

Participants/materials, setting, methods
A total of 1,207 oocytes were retrieved from 50 patients. Among them, 852 oocytes with visible spindle were inseminated by C-ICSI or P-ICSI in sibling oocytes. Four hundred twenty-five oocytes were inseminated by C-ICSI and 427 oocytes were by P-ICSI. Fertilization, degeneration after ICSI and blastocyst development on day 5 or day 6 were compared between the P-ICSI and C-ICSI. The differences between C-ICSI and P-ICSI were statistically analyzed using Mann-Whitney U test.

Main results and the role of chance
Normal fertilization rate of P-ICSI (78.2 ± 16.5%) were higher than that of C-ICSI (71.2 ± 18.9%). The difference was statistically significant (P = 0.0447). The oocyte degeneration rates after ICSI were 9.3 ± 11.8% (C-ICSI) and 4.8 ± 9.4% (P-ICSI). The degeneration rate of C-ICSI was significantly higher than that of P-ICSI (P = 0.04338). Blastocyst formation rate of C-ICSI was 58.6 ± 25.0% and that of P-ICSI was 64.3 ± 26.3%. The blastocyst formation rate of P-ICSI was higher than that of C-ICSI but the difference was not statistically significant (P = 0.2113). The rates of blastocysts that were available for embryo replacement or cryopreservation were higher in P-ICSI (56.0 ± 25.4%) than in C-ICSI (50.4 ± 24.7%) although the difference was not significant (P = 0.26272).

Limitations, reasons for caution
Pregnancy outcomes data were not available. The data of this study were obtained from single fertility center. More large-scale multicenter studies will be needed to confirm the effectiveness of P-ICSI.

Wider implications of the findings
Consistent with other studies, these results show that P-ICSI reduces the damage rate of oocytes after ICSI. The implementation of P-ICSI has the potential to improve clinical outcomes of human IVF although it is more complicated and takes longer than that of C-ICSI.

Trial registration number
not applicable
P-211 “Survival rates after vitrification of oocytes obtained after luteal phase vs follicular phase ovarian stimulation”
Authors: Lopez Feijoo C , Cerrillo M , Kohls G , Bronet F , Molina M J , García Velasco J A 
Published: June 2023

Abstract

Study question
Do the oocytes retrieved after luteal phase ovarian stimulation (OS) have the same survival rate as those retrieved after follicular phase (OS)?

Summary answer
Oocyte survival rate after vitrification is similar in oocytes retrieved in a follicular phase OS compared to those in luteal phase.

What is known already
Oocytes retrieved in luteal phase have recently captured scientific interest as dual stimulation is gaining popularity. Oocytes obtained in luteal phase OS added to those obtained in follicular phase shorten time to pregnancy per intention to treat in poor responders. Embryos obtained with these oocytes show similar ploidy rates, as well as clinical outcomes.

Study design, size, duration
We analyzed data from a randomized, non-inferiority Duo Stim Preimplantation Genetic Testing for aneuploidies (PGT-A) trial performed from 2017 to 2021 in women &gt;38 years old. Only cycles with at least one oocyte retrieved in both follicular and luteal were included.
We compared survival rates from oocytes obtained in after follicular phase OS (n = 154 oocytes) versus luteal phase OS (n = 201 oocytes) within the same patient.

Participants/materials, setting, methods
A subtotal of 38 patients were included who underwent 2, 3, or 4 OS cycles to accumulate oocytes for subsequent ICSI with PGT-A. After retrieval and decumulation, oocyte vitrification was performed with Kitazato vitrification protocol (Kitazato, Japan) and Cryotop device, same as subsequent thawing.

Main results and the role of chance
Mean of age in the selected patients was 39,7 years. In total, 195 cumulus-oocyte complexes were retrieved after follicular phase OS vs 245 in luteal phase. From this group of oocytes, 145/195 were mature (78.97%) vs 201/245 (82.04%), respectively.
No statistically significant differences were observed in survival rate whether oocytes came from a follicular phase OS 81.16 % (125/154) versus luteal phase 87.06% (175/201) (p = 0.3312).
Our results confirm that survival rate of oocyte obtained in a luteal phase OS is comparable to conventional follicular phase OS, validating oocyte accumulation strategy in a Duo Stim protocol.

Limitations, reasons for caution
The limited sample size was due to the nature of the randomized, controlled trial. Our results need to be replicated in larger series for validation.

Wider implications of the findings
Luteal phase OS oocytes showed similar survival rates after thawing than conventional OS cycles, opening a new venue for oocyte vitrification in oncological patients or poor responders accumulating oocytes. This approach might be of interest as well in patients or countries where ethical/legal limitations may limit embryo accumulation.

Trial registration number
not applicable
P-231 The effect of warming blastocysts in Vitrolife media previously vitrified in Cook media on reproductive potential and clinical outcome
Authors: Withey A , Craig J , Watkins J 
Published: June 2023

Abstract

Study question
Does the use of a different manufacturer’s media for vitrification and warming of blastocysts affect pregnancy, miscarriage and live birth rates.

Summary answer
Warming blastocysts in Vitrolife media, previously vitrified in Cook media, does not significantly affect the pregnancy or live birth rate.

What is known already
Current good practice is to vitrify and warm blastocysts in media manufactured by the same company. This is due to the optimisation of the protocols and media composition intending to maintain high survival rates and associated pregnancy rates. However, circumstances can arise, such as supply and production issues, whereby it is not possible to source the same media for warming vitrified blastocysts as the media they were vitrified in.

Study design, size, duration
This retrospective cohort study was conducted at TFP-Oxford Fertility. Frozen embryo transfer (FET) cycles included in the study were performed between 2018 and 2022. Embryos that had undergone genetic testing were excluded from the study. The mean women's age was 35 in the control group (Cook warming media) and 36 in the study group (Vitrolife warming media). The average number of embryos transferred was 1.06 vs 1.17 in control vs study group.

Participants/materials, setting, methods
For the present study 817 patients underwent FET between 2016 and 2018 whereby blastocysts were vitrified in cook media (Sydney IVF Blastocyst Vitrification Kit, K-SIBV-5000) and warmed in cook media (Sydney IVF Blastocyst Warming Kit, K-SIBW-5000). In comparison 704 patients underwent a FET between 2018 and 2022 whereby blastocysts were vitrified in cook media and warmed in vitrolife warming media (Rapidwarm™ Blast, 10120). The pregnancy, clinical pregnancy and live birth rates were compared.

Main results and the role of chance
Fisher’s exact test was used to calculate the p value and a level of 0.05 was used for significance. The results showed that there was no significant difference in the pregnancy rate, clinical pregnancy rate or live birth rate for blastocysts warmed in Vitrolife media vs Cook media (59.0% vs 57.0% p = 0.56, 47.2% vs 43.9% p = 0.44, 39.3% vs 37.0% p = 0.72)

Limitations, reasons for caution
This is a retrospective study at a single centre. The number of previous treatment cycles per couple was not included in the study. The study only looked at a comparison of Cook and Vitrolife warming media, no other commercially available media was tested.

Wider implications of the findings
Although good practice to vitrify and warm blastocysts in the same manufacturer media, our results show that the reproductive potential and clinical outcome may not be adversely affected by using a different manufacturer’s media. However, composition of the media and protocol should be considered and further studies should be conducted.

Trial registration number
not applicable
P-255 Increased time in thawing solution improves human oocyte warming outcomes
Authors: Schlenker T , Schoolcraft W , Swain J 
Published: June 2023

Abstract

Study question
Can increased time in thaw solution improve oocyte survival and outcomes following vitrification/warming?

Summary answer
Exposing vitrified oocytes to the first step thawing solution for 90 seconds improved oocyte survival compared to 60 second exposure.

What is known already
Oocytes are a sensitive cell type and careful handling of the cells is required to obtain high outcomes following vitrification and warming. Carefully timed exposure to various vitrification solutions is required to avoid toxicity and ensure proper vitification. Similarly, proper and carefully timed exposure to warming solutions is required to avoid oocyte damage upon warming. Recent reports suggest a modified and rapid warming protocol may be beneficial for vitrified blastocysts. However, oocytes are unique cells and may require unique considerations to optimize warming.

Study design, size, duration
Retrospective analysis of donor oocyte warming outcome data within a single IVF lab over a 12 month period comparing a 60 second first step during oocyte warming (control n = 637 oocytes) versus a very consistent 90 second exposure (n = 672 oocytes) to the first step thawing solution.

Participants/materials, setting, methods
Human donor oocytes were vitrified using the standard Kitazato protocol with ES drop merging and loading on CryoTop devices using the wicking method prior to plunging into liquid nitrogen. Warming was performed using the standard protocol of 60 seconds in thaw solution (TS) or 90 seconds exposure. All cycles utilized ICSI and excluded testicular sperm samples. Survival, fertilization and blastocyst development were compared between the two exposure groups. Data were analyzed utilizing Fisher’s Exact Test.

Main results and the role of chance
Oocyte survival differed between the two timing treatments, with exposure to TS for 90 seconds yielding higher oocyte survival (96.1%) than 60 secondsTS exposure (92.0%), p &lt; 0.002. No differences in fertilization following ICSI (78.3.0% vs. 79.0%) orin good quality blastocyst conversion (≥3BB) on day 5 (22.1% vs. 25.1%) or by day 7 (55.3% vs. 55.7%) were apparent. The aneuploidy rate of blastocysts were similar, with 28.5% in the 90 second TS treatment group and 27.3% in the 60 second TS exposure group.

Limitations, reasons for caution
Data were examined retrospectively and sibling oocyte splits were not utilized. Clinical outcomes following resulting embryo transfer were not examined.

Wider implications of the findings
These data may help improve oocyte warming protocols and resulting outcomes.

Trial registration number
not applicable
P-307 Is multinucleation as bad as we ever thought?
Authors: Granell Martínez M 
Published: June 2023

Abstract

Study question
Could the presence of multicleation at early stages influence further embryo development?

Summary answer
The presence of multinucleation at 2 cell stages is independent on the success, but not at 4 cell stage.

What is known already
The presence of multinucleated blastomeres (MNB) in the cleaving embryo has been linked to poor embryo development and adverse in vitro fertilization (IVF) outcomes, when detecte on days 2 and 3 of embryo culture under inverted microscope inspections once a day. Multinucleation has been associated with a lower rate of blastocyst formation, increased rates of aneuploidy and chromosomal abnormalities, leading to chromosomal chaos and a decreased rate of implantation and arrested embryo development. With the introduction of Time-Lapse (TL) technology, it is been demostrated that multinucleation at the 2 cell stage is a very frequent issue.

Study design, size, duration
It is a retrospective observational study. 195 embryos from 28 patients that underwent and IVF treatment at the Unit of Medicine Reproductive of the Hospital General Universitario de Valencia were included in this study from 2017 to 2021 to study embryo development. Those patients whose embryos could be visualized with quality in a Time-lapse incubator were selected.

Participants/materials, setting, methods
The study of the 195 embryos from the 28 patients was carried out in the MIRI® TL6 Time-Lapse incubator. These embryos were checked at the 2-cell, 4-cell and blastocyst stages. The Shapiro-Wilk test was used to determine whether the sample had a normal distribution. and the Pearson test was used to determine if there were significant differences between the samples. Besides, the Chi-square test was used to determine the correlation between 2 qualitative variables.

Main results and the role of chance
108 fertilized embryos were studied, 78.7% of them did develop blastocyst formation; 50% did not show multinucleation and 28.7% did, the analysis indicated that there was no correlation between blastocyst formation and the presence of multinucleation at 2 cell-stage (p = 0.364). The analysis indicated that multinucleated cells showed a prolongation of the division time, the analysis indicated that it had a normal distribution (p &lt; 0.001) and it exist significant differences (p &lt; 0.001). Pregnancy was obtained in 5% and 9% of the embryos with multinucleation at 2 cell-stages. Finally, analysis of autocorrections on day 2 showed that these occurred in 60% and 40% of 2 cell-stage.

Limitations, reasons for caution
As these data correspond to patient profiles from our unicenter study, the data could be different in other assisted reproduction centers. In addition, a larger study sample size is necessary in order to confirm our results.

Wider implications of the findings
These results can help us to decide the fate of the embryos and not to penalize those embryos that present multinucleations at the 2-cell stage.

Trial registration number
not applicable
P-322 Single-cell transcriptome analysis reveals endometrial immune microenvironment in minimal/mild endometriosis
Authors: Huang X , Huang W 
Published: June 2023

Abstract

Study question
This study aimed to systematically understand the endometrial leukocyte types, inflammatory environment, and impaired receptivity at single-cell resolution.

Summary answer
These results provide new insights into the endometrial immune microenvironment and impaired endometrial receptivity in infertile women with minimal/mild endometriosis.

What is known already
Endometriosis is a common inflammatory disorder in women of reproductive age due to an abnormal endometrial immune environment and is associated with infertility.

Study design, size, duration
We profiled single-cell RNA transcriptomes of 138,057 endometrial cells from endometriosis patients (n = 6) and control (n = 7), respectively, using 10x Genomics platform.

Participants/materials, setting, methods
We profiled single-cell RNA transcriptomes of 138,057 endometrial cells from endometriosis patients (n = 6) and control (n = 7), respectively, using 10x Genomics platform.

Main results and the role of chance
We found that one cluster of epithelial cells that expressed PAEP and CXCL14 was mostly from the control during the window of implantation (WOI). This epithelial cell type is absent in the eutopic endometrium during the secretory phase. The proportion of endometrial immune cells decreased in the secretory phase in the control group, whereas the cycle variation of total immune cells, NK cells, and T cells was absent in endometriosis. Endometrial immune cells secreted more IL-10 in the secretory phase than in the proliferative phase in the control group; the opposite trend was observed in endometriosis. Proinflammatory cytokines levels in the endometrial immune cells were higher in endometriosis than in the control group. Trajectory analysis revealed that the secretory phase epithelial cells decreased in endometriosis. Ligand–receptor analysis revealed that 11 ligand-receptor pairs were upregulated between endometrial immune and epithelial cells during WOI.

Limitations, reasons for caution
Our study had some limitations, such as the small sample size and lack of validation experiments. Further studies are needed to demonstrated the conclusions of our bioinformatic analysis, like in situ validation of receptor-ligand pairs analysis. Therefore, more evidence is needed to clearly state the pathogenesis of endometriosis-associated infertility.

Wider implications of the findings
This database will provide an essential resource for understanding the eutopic endometrial inflammatory environment and defective endometrial receptivity in patients with endometriosis-associated infertility.

Trial registration number
82071625
P-414 Trends in patient age at planned oocyte cryopreservation
Authors: Hasson J , Shavit T , Hyman J , Tsafrir A 
Published: June 2023

Abstract

Study question
Did the age of women who underwent Planned Oocyte Cryopreservation (POC) change in the last decade?

Summary answer
Mean age of women presenting for POC decreased from 38.2±2.8 to 35.6±2.7.
Proportion of women &lt;36 increased from 13% in 2011 to 51% in 2022.

What is known already
Mean age of women who had POC reported in the literature to date is 37-8.
Given that efficacy of POC is strongly related to age, some clinicians advice women considering POC to complete the procedure before age 35.

Study design, size, duration
Retrospective, observational multicenter study of all POC cycles from January 2011 to October 2022. Women who had oocyte cryopreservation for other indications were excluded.

Participants/materials, setting, methods
In all, 4021 women had at least one POC cycle in two large private IVF units belonging to the same medical organization in Israel. The main outcome measure was age at first cycle. Total number of women who underwent POC at each year and age at first cycle of every woman were recorded. Data was analyzed using SPSS version 23. ANOVA was used to test whether mean age differed significantly throughout the years.

Main results and the role of chance
Since 2011, when POC was first approved in Israel, until the end of October 2022, 4021 women underwent at least one cycle of POC in our units. The number of women who had POC per year increased gradually from 62 in 2011 to 979 in 2021 (last year with full data).
Mean age declined with each year, from 38.2±2.8 in 2011 to 35.6±2.7 in 2022. The proportion of women aged &lt; 36 increased gradually from 13% in 2011 to 35% in 2019 and further to 51% in 2022 (R = 0.20, p value&lt;0.01).

Limitations, reasons for caution
This study was performed in a high-socioeconomic catchment area of one country. This may limit the generalizability of our findings to other populations. In addition, the usage rate and delivery rates of these patients are not known yet.

Wider implications of the findings
The significant decrease in age of women presenting for POC and the increased proportion of women&lt;36 may present a growing awareness for age related infertility and possibly increased efficacy of POC in younger women.

Trial registration number
not applicable
P-451 Fertility awareness among Tunisian university students: A state-of-knowledge survey
Authors: Daoud S , Maalej M , Abdelkefi O , Benamor M , Sellami A , Chaabene K , Rebai T 
Published: June 2023

Abstract

Study question
To investigate the beliefs and knowledge of university students regarding fertility.

Summary answer
University students are aware of the impact of unhealthy lifestyle on fertility. There are however misconceptions about the ideal age for childbearing and treatment limits.

What is known already
The gradual decline in fertility is currently well documented. Furthermore, the mean age of first-time mothers is increasing, especially in groups with higher educational levels. However, the level of awareness (sensitization) of couples to infertility factors such as female age and environmental factors is not well-known.

Study design, size, duration
A 12 items-questionnaire on infertility aspects « 12QSI » was previously developed and validated. The questionnaire is divided into 3 sections: (i) epidemiology of infertility, (ii) causes and risk factors for infertility, and (iii) treatment of infertility. A seven-month online survey of a random sample of Tunisian students was conducted. Data collection was carried out via Google Forms® by sharing the link on social media platforms and groups.

Participants/materials, setting, methods
The survey was completed by 800 respondents. We retained 775 responses according to the inclusion criteria: complete response, being of childbearing age and attending university education. Statistics were obtained using SPSS® software.

Main results and the role of chance
Participants were 24.6 ± 5 years of age on average. Almost 57% were women. The average knowledge score was 56.7 ± 28%. The lowest scores were found for the questions on infertility treatment (only 15% of correct answers) with an overestimation of the chances of success of Assisted reproductive technology (ART). An underestimation of the impact of age on both male and female fertility was reported. The mean score was significantly better for the group of respondents studying medicine than for the rest (63 ± 32% vs. 48 ± 26%; p &lt; 0.001), and for respondents who have faced an infertility problem compared to those who have not (65 ± 28% vs. 56.3 ± 29%; p &lt; 0.001).

Limitations, reasons for caution
The representativeness of the sample is not ensured. Survey distribution only through social networks could be a limit.

Wider implications of the findings
Over-optimism regarding the importance of age and the effectiveness of infertility treatments is noted, which can lead to unintended infertility. Educational programs should be developed to address erroneous beliefs and to increase the population`s knowledge of fertility.

Trial registration number