bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scoping Appropriate Quality of Life Dimensions for the Development of a Meaningful Quality of Life Tool for PCOS. The “HERAQoL-P”
Authors: AVERY Jodie , PIROTTA Stephanie , JISKOOT Geranne , GIBSON-HELM Melanie 
Published: November 2022

Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine condition in women, with a range of symptoms related to problems with fertility, weight gain, mental health and sleep, and is not a stable condition over the life course. Women with PCOS have different experiences of Quality of Life (QoL) depending on their age, ethnicity, socio economic status, severity and phenotype. QoL is an important health outcome, yet measures include predefined items, that may be unimportant to individuals. Existing PCOS QoL measures may not capture the full physical, emotional, and social impact of PCOS, all of which need to be addressed within person-centred care in order to achieve the best possible health outcomes in both the short and long term. Aim: We aim to scope and understand priorities for quality of life (QoL) dimensions from women with PCOS throughout life, to provide a conceptual framework for the creation of a meaningful, scientifically validated quality of life tool in the future. Method: Based on the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) questionnaire, we are surveying 200 women and interviewing 20-30 women diagnosed with PCOS about aspects of life important for their quality of life. Questions in the interview include the impact of this condition on physical, mental and emotional health, and understand whether PCOS affects women differently according to their profile of symptoms and background. Results: This work provides the basis for developing a new QoL tool, reflecting the diverse PCOS features with the greatest impact, enabling better evaluation of Patient Reported Outcomes. Conclusion: A high-quality QoL questionnaire could highlight women’s specific priorities, and then measure whether their healthcare addresses such priorities. We will then create the HERAQol-P, with extensive potential to have impact, in both research and clinical care, adding to the evidence base for PCOS.
ANZARD Data Linkage – Agreement Between Births Recorded by Clinics and in NSW Perinatal Data Collection
Authors: CHAMBERS Georgina M. , CHOI Stephanie K.Y. , IRVINE Katie , VENETIS Christos , HARRIS Katie , HAVARD Alys , NORMAN Robert J. , LUI Kei , LEDGER William , JORM Louisa R. 
Published: November 2022

Background: Fertility clinics submit treatment data on all ART cycles to the Australian and New Zealand Assisted Reproductive Technology Database (ANZARD) as part of their accreditation. The National Perinatal Epidemiology and Statistics Unit (NPESU), who manages ANZARD, is undertaking a study involving the linkage of ANZARD to state and commonwealth datasets to investigate health outcomes of infants born from fertility treatments. Aim: To describe the creation and performance of the linked dataset and to evaluate the agreement between births recorded by clinics and those recorded in state perinatal data collections (PDC). Method: The linked dataset was created by linking the ANZARD to NSW and ACT administrative datasets (performed by NSW Centre for Health Record Linkage (CHeReL)) and to Medicare Benefits Scheme and Pharmaceutical Benefits Schedule (performed by AIHW). The CHeReL’s Master Linkage Key (MLK) was used as a bridge between ANZARD’s statistical linkage key and state administrative datasets. Linkage rates and concordance between births recorded in ANZARD and PDCs was evaluated. Results: A 96.7% linkage rate was achieved between women recorded in ANZARD and CHeReL’s MLKs. A reconciliation of ANZARD-recorded births among NSW residents found that 94.2% (95% CI: 93.9-94.4%) of births were also recorded in NSW/ACT PDCs. A proportion of the missing births could be to women who had ART treatment in NSW but birthed in a different Australian state or country. A high concordance rate (>99%) was found in plurality status and birth outcome between ANZARD and PDCs. Conclusion: High linkage rates can be achieved with partially identifiable data and population spines, such as the CHeReL’s MLK, can be successfully used to link clinical registries and administrative datasets. This linkage resource will provide invaluable information on the safety of the ART and non-ART treatment, and the role of subfertility on the fertility treatments for Australia and beyond.
Developing and Implementing a Core Outcome Set for Ectopic Pregnancy
Authors: CHONG Krystle , MOL Ben 
Published: November 2022

Background: Diagnosis of ectopic pregnancy (EP) has improved significantly in the last few decades, and RCTs remain the mainstay of assessing the effectiveness and safety of treatments. The pooling of individual RCT data is likely to provide the best evidence to inform clinical practice. However, currently published data in ectopic pregnancy has reported many different outcomes, which are themselves often defined and measured in distinct ways. The lack of consensus and level of variation results in an inability to compare the results of individual RCTs, and consequently directly impacts the usefulness of research to inform patients and clinicians in clinical practice. Aim: The development of a core outcome set to ensure outcomes important to key stakeholders are collected consistently will guide future research in ectopic pregnancy. Methods and Analysis: We have established an international steering group of stakeholders, including healthcare professionals, researchers, and individuals with lived experience with EP. We have identified potential outcomes from a comprehensive literature review of published randomised controlled trials. We have utilised a modified Delphi method to prioritize outcomes. Results: Key stakeholders have been invited to score potential core outcomes on a nine-point Likert scale, ranging from 1 (not important) to 9 (critical). 424 enrolled participants, with 86% completing round 1, comprising of 117 (32%) healthcare professionals, 237(64%) individuals with lived experience, 14(4%) researchers. Highly rates outcomes included the resolution of EP, psychological impact, and future fertility outcomes. Conclusion: Repeated reflection and rescoring should promote whole and individual stakeholder group convergence towards consensus ‘core’ outcomes over 3 rounds. Implementation of a core outcome set will enable collection and reporting of data in a standardised fashion. This will allow standardisation of research to guide and inform clinical practice and enhance patient centred care.
Merging Motherhood and Medicine: A Qualitative Study Exploring Barriers and Enablers to Motherhood Among Australian Female Doctors
Authors: COLLIE Erika , LEW Raelia , PEATE Michelle 
Published: November 2022

Background: Despite the increasing ‘feminisation’ of the Australian medical workforce, female doctors remain under-represented in leadership positions, many specialty areas, and renumeration levels. A key factor implicated in this disparity is the unequal impact of parenthood on mothers. Australian research on this issue is lacking. Aim: To identify the barriers and enablers experienced by Australian female doctors, when combining motherhood with a medical career. Method: Semi-structured telephone interviews were conducted with 18 female Australian physician mothers, during March and May 2020. Interview data were examined using thematic analysis to extract key themes. Results: Six key barriers and seven key enablers were identified. Barriers (B1-6) largely reflected structural and cultural issues operating within health services and the wider medical profession, specifically the (B1) experience of working in medicine; (B2) demands of postgraduate specialty training; (B3) attitudes towards mothers in medicine; (B4) gender inequality; (B5) insufficient entitlements and support; and (B6) competing priorities, conflicting roles. Enablers (E1-7) were predominantly personal and interpersonal supports relating to (E1) supportive partnerships; (E2) non-traditional gender roles; (E3) capacity to outsource; (E4) doctors supporting doctors; (E5) flexible work arrangements; (E6) increasing acceptance and support; and (E7) capacity to combine career and family. Conclusion: This was the first Australian qualitative study to explore motherhood experiences among female doctors. The results indicate that Australian physician-mothers encounter considerable structural and cultural barriers during all stages of motherhood. To facilitate motherhood in medicine, further research is needed to inform policy development and support provisions within Australian health systems.
pHantastic Embryos and Where to Find Them: Can a Real-Time pH Monitoring System Represent the pH Environment of Culture Media?
Authors: DEAN Casey , GUNASEGARAN Kavyadharshini , GABRIEL Justine , IACOBELLI Daniela , SORBY Kelli 
Published: November 2022

Background: Maintaining optimal pH of culture media reduces environmental stressors on gametes and embryos, which has been shown to be critical in supporting embryo development. There are many options to determine pH but none are ideal for use in a laboratory setting. SignipHy™ is a system that monitors pH in real-time within the incubator environment without disturbing the incubator or exposing the media. Aim: To determine if SignipHy can provide an accurate representation of the dynamic pH in culture media across a range of environmental conditions. Method: pH of G1+ under Ovoil in a 5-well dish was measured using a blood gas analyser at regular intervals under multiple experimental conditions. Statistical analyses used repeated measures ANOVA, Pearson’s Correlation and Linear regression. Results: pH of media undergoing initial equilibration was found to decrease more rapidly in culture dishes (ΔpH 0.228/hr) than SignipHy cuvettes (ΔpH 0.160/hr) over a 6 hour period (p=0.0005). Full equilibration was achieved in the culture dishes after 4 hours, while the SignipHy cuvettes stabilised after 6 hours. When fully equilibrated dishes were exposed to 4% CO2, pH in the culture dishes increased more rapidly (ΔpH 0.098/hr) than SignipHy cuvettes (ΔpH 0.060/hr). Similarly, equilibrated media exposed to 2% CO2 showed an increase of pH in culture dishes of 0.171/hr compared with SignipHy cuvettes at 0.150/hr. Unsurprisingly when media in a culture dish without oil was exposed to a humified CO2 incubator the pH shift was rapid (ΔpH 0.258/hr). Laboratories should be conscious of rapid pH shifts in culture media without oil. Which can be optimal when needing to equilibrate media quickly, but of concern when handling dishes. Conclusion: SignipHy was found to be a viable representation of pH under multiple experimental conditions, however, the rate of change was found to be slower compared to culture dishes.
Biomarkers of Endometriosis
Authors: GARRETT Kerryn L. , KILLEEN Aideen P. , CASEY Tammy M. , ITO Jun , ISMAIL Deem , CHEN Lianzhi , RAJU Mufaidha , ANDRONIS Christina , BRINGANS Scott , LISPCOMBE Richard J. , ROGERS Peter A.W. , HOLDSWORTH-CARSON Sarah J. 
Published: November 2022

Background: Endometriosis is an under-recognised and often misdiagnosed chronic disease that affects one in ten women. It occurs when cells similar to those that line a uterus grow in other parts of the body, usually around the pelvis. The current gold standard for diagnosis of endometriosis is direct visualisation by histological analysis which can only be achieved by an invasive laparoscopy. It is estimated 176 million women and girls around the world are living with endometriosis. The condition costs $7.7 billion a year in direct medical expenses and lost productivity in Australia alone. Aim: To analyse a series of plasma samples from patients with clinically diagnosed endometriosis, others with gynaecological symptoms without endometriosis and otherwise healthy controls to identify biomarkers to differentiate these groups and potentially aid in endometriosis diagnosis. Method: A standard proteomic discovery workflow was used to search for unique biomarkers of endometriosis. Initially, pooled plasma samples from three distinct groups of patients were tested. The first group had symptoms of endometriosis with a laparoscopic/histology confirmed diagnosis. The second group also had symptoms, but the laparoscopy confirmed no endometriosis or an alternate diagnosis. The third group were healthy matched controls. The pooled plasma samples were quantitatively profiled against each other with a triplicate experiment. A validation of the biomarkers identified as significant in the discovery phase, was then undertaken in a larger clinical cohort (n=902) using a targeted multiplex mass spectrometry assay using multiple reaction monitoring (MRM). Statistical analyses were caried out using Stata and logistical regression was used to evaluate associations of biomarkers with binary clinical outcomes. Results: Out of the 943 proteins identified with [Formula: see text] 2 significant peptides in the initial discovery workflow, 47 were determined as being differential biomarkers across the three clinical groups. The derived targeted MRM assay was tested on the clinical validation cohort, and a number of candidate biomarkers were significantly associated, thereby indicating their potential for use in the diagnosis of endometriosis.
Non-Invasive Metabolic Live Cell Imaging of Early Embryo Development Using Novel Adapted Confocal Microscopy in Ageing
Authors: HORTA Fabrizzio , NEWMAN Hope , VARGAS-ORDAZ Erick J. , CADARSO Victor J. , NOSRATI Reza , NEILD Adrian , VOLLENHOVEN Beverly , CATT Sally 
Published: November 2022

Background: Developing non-invasive methods that are reliable to assess embryo quality has been a significant aim for assisted reproductive technologies. Changes in metabolic activity could lead to abnormal embryo development and implantation potential which could be potentially predicted by incorporating non-invasive measurements of metabolism. Metabolic imaging of nicotinamide adenine dinucleotide (NADH) has been well studied in cell lines, however, evidence for its use in embryo development is limited. Measurements of NADH during advanced-reproductive-age could be a useful tool as the auto-fluorescence of NADH is a straightforward representation of mitochondrial function and cellular redox status. Aim: To determine potential differences in NADH levels associated in early embryo development from young and old mice using novel adapted confocal microscopy. Methods: Oocytes from two groups of 20 super-ovulated female mice (Young: 5-8 weeks old, n=10; Old: 45-52 weeks old, n=10) were inseminated through in-vitro fertilisation (IVF). Inseminated oocytes (Young:93; Old:64) were assessed for fertilisation and embryo development to the blastocyst stage. Early embryos (Young:44; Old:34) from both young and old groups were assessed for NADH levels during embryo development every 2 and 3 hours respectively in separated experiments, using arbitrary units of auto-fluorescence (AU). Results: IVF experiments showed no significant differences in fertilisation rates between age groups but with significant differences in blastocyst formation (Young: 90.9%; Old: 66.7%; p[Formula: see text]0.05). Embryos from young and old females showed significantly different NADH levels during embryo development (Young: 29,889 ±864AU; Old: 25,972 ±260AU; p[Formula: see text]0.0001). Zygotes that reached the blastocyst stage in old females had significantly decreased NADH levels compared to young females (Young: 31,508 ±853AU, Old: 26,417 ±186AU; p=0.0002). Conclusion: Our study indicates different levels of NADH activity during early embryo development associated to ageing and blastocyst formation. Non-invasive measurements of NADH could be applied to determine embryo metabolic activity associated to ageing using simple technology.
Validation of sORP, a Measure of Oxidative Stress, in Australian Population
Authors: SHIH Yu-Cih , ELLIOT Peter , AN Jing , LEUNG Pui Ying , KILLEEN Aideen 
Published: November 2022

Background: Excessive reactive oxygen species are normally eliminated by seminal plasma free radical antioxidant scavengers and enzymes. Assessing the oxidation reduction potential of seminal fluid (mV/million sperm/mL) enables the detection of an imbalance in this biological mechanism, and identifies patients exhibiting oxidative stress (OS). A novel technology, MiOX[Formula: see text], detects static Oxidation-Reduction Potential (sORP), providing a comprehensive measure of oxidants and reductants in semen, with the advantages of rapid, simple and less sample volume compared to the conventional chemiluminescence assay. Aim: This study aims to validate the MiOX[Formula: see text] analyser for the detection of OS in seminal fluid, in the Australian population. Method: Samples were collected from consenting patients attending the Royal Women’s Hospital Andrology Unit for semen analysis (n=144); those with [Formula: see text]1 million/ml were excluded. Semen analysis was carried out as per WHO 2010 guidelines, and replicate sORP measurements taken within 60 minutes of ejaculation. Results: Replicate sORP measurements from semen samples (n=20) demonstrated no significant differences between and within operators, and across days. sORP did not vary between samples incubated at 4[Formula: see text]C, room temperature, and 37[Formula: see text]C, or samples subjected to mechanical agitation. Freeze-thaw resulted in a significant increase in sORP (p=0.031). The stability of sORP measurements was demonstrated up to 4 hours after ejaculation, however, significant increases were observed after 24 and 48 hours (p[Formula: see text]0.05). Patients grouped according to normal and abnormal total motile sperm count (TMSC) demonstrated significantly different sORP (0.75 ± 0.86, 5.02 ± 5.32, p[Formula: see text]0.001). A preliminary ROC analysis, using TMSC, revealed a cut-off value of 1.07 mV/106 sperm/mL (AUC=0.904) with 81.1% sensitivity and 81.3% specificity. Conclusion: Results from the technical validation are consistent with other studies. The clinical reference range validation requires further patient samples to better reflect the distribution of results observed in the low TMSC group.
Post-Thaw Sperm Recovery Rates; A Retrospective Study
Authors: LEUNG Pui Ying , ELLIOT Peter , AN Jing , SHIH Yu-Cih , KILLEEN Aideen 
Published: November 2022

Background: Cryopreservation is currently the only fertility preservation option available to patients undergoing gonadotoxic treatment. Much research in the field focusses on techniques, media and equipment employed to cryopreserve cells, and demonstrating cell viability after using such. Comparatively, there is a death of information available on the procedures and equipment used to thaw cryopreserved cells, or estimates for post-thaw recovery. Aim: This is a retrospective study assessing semen parameters in post-thawed specimen from patients who attended the Royal Women’s Hospital Andrology Unit for sperm cryopreservation prior to gonadotoxic or other treatments. The study aims to examine the relationship between sperm cryopreservation technique, media and period of storage with post-thaw sperm parameters. Method: Patients with written consent to discard their stored semen were selected for inclusion in the study (n=59); samples with sperm concentration [Formula: see text]1 million/ml prior to freezing (n=11) were excluded. Semen samples were thawed accordingly: 5 minutes at room temperature followed by incubation at 37[Formula: see text]C for sperm straws; vials were transferred directly to a mixer incubator at 37[Formula: see text]C. All samples were immediately assessed for sperm concentration and motility. Recovery rates were calculated and data were analysed using SPSS (IBM, USA) version 25. Results: Progressive motility recovery was 32.4% ± 20.6. Patients were divided into groups according to period of storage, and showed no significant differences for recovery of motility and concentration (p=0.44, 0.96, respectively). Furthermore, progressive motility recovery rates were not significantly different between freezing techniques (p=0.116) and media (p=0.099). Conclusion: Data from this study are preliminary and further study is warranted to fully extrapolate the relationship between sperm cryopreservation protocols and period of storage on recovery rates. The lack of relationship between these factors exhibited in the data could suggest that research and development in thaw technologies may be more pertinent to improving sperm recovery rates.
Surrogates’ and Intended Parents’ Experiences of Surrogacy: A Systematic Review
Authors: KNEEBONE Ezra , BEILBY Kiri , HAMMARBERG Karin 
Published: November 2022

Background: Surrogacy arrangements can be conducted domestically, where the surrogate and intended parents live in the same country, or internationally, where the intended parents engage a surrogate in a foreign destination. Understanding the experiences of people participating in surrogacy arrangements can inform policy to protect the best interests of all parties. Aim: To review the evidence relating to surrogates’ and intended parents’ experiences of surrogacy arrangements. Method: Studies of surrogates’ and intended parents’ experiences of a surrogacy arrangement, published since 2005 in English language peer reviewed journals were identified by searching Embase, Medline, PsycInfo and Scopus. Data relating to each participant group were synthesised separately using thematic analysis. Methodological quality of the studies was assessed using the QualSyst scoring system. Results: 67 articles were included in the synthesis. The mean QualSyst score was 0.78/1. Four themes relating to surrogates’ (exercising agency, making sense of their maternal identity, forming a relationship with the intended parents’, and accessing information and support) and intended parents’ experiences (navigating the law, rationalising the financial transaction, forming a relationship with the surrogate, and accessing information and support) were identified. Intended parents faced legal barriers when seeking domestic arrangements and difficulties when obtaining legal parenthood and citizenship for their child after an international arrangement. Having a close relationship between participants contributed to a positive experience for both parties. Conversely, a distant relationship, whether emotionally or geographically, negatively impacted participants’ experiences. Conclusion: Legal barriers in the home country lead some to seek international surrogacy which limits opportunities for intended parents and surrogates to form a close relationship and poses legal challenges when they return home. Removing the legal barriers to domestic surrogacy would allow more arrangements to be conducted where participants have a better prospect of forming close relationships and can avoid the challenges inherent in international arrangements.