bluuebunny/crossref_metadata_2025_split huggingface dataset:
O-154 Genetic screening in male infertility: time for new guidelines?
Authors: Oud M 
Published: June 2022

Abstract
Approximately 1 in 7 couples wishing to conceive fail to do so after one year of trying. About half of the cases can be assigned to male factors. Currently, genetic causes explain approximately 4-9% of all cases of male infertility, with strong variation among the different subtypes of infertility. Presently a majority of all infertile males (60-70%) remain without a clear diagnosis, despite the expectation that genetic causes explain a substantial fraction of these patients. Without a genetic diagnosis, it is impossible for a clinician to accurately provide counseling to couples with questions about the causes of their infertility, possible co-morbidities, the potential success of ART treatment and the reproductive health of their offspring. Hence, knowing and understanding the genetic causes of infertility is of enormous value to patients and clinicians.
Already for more than 25 years, genetic testing is recommended for patients with severe oligozoospermia or azoospermia. These tests typically include karyotyping, azoospermia factor (AZF) deletion screening and/or CFTR mutation testing (in case of CBAVD). For a long time, further genetic testing was time-consuming and expensive, resulting in slow progress to unveil novel causes of male infertility in both research and clinic. The uptake of next-generation sequencing (NGS) methods has revolutionized genetic testing for a plethora of disorders, allowing for cost-effective screening of variants in limited gene panels, all coding parts of genes (exome), or the entire genome. NGS is now routinely used by many laboratories for genetic testing in diagnostics and research. Using these new technologies, we and others have identified numerous novel causal variants in genes indispensable for human fertility.
Although the use of NGS in male infertility research is skyrocketing in recent years, it has not yet broadly found its way into diagnostics. This means that 1) numerous patients with over a hundred newly discovered monogenic causes of male infertility are presently left undiagnosed and 2) large groups of patients with phenotypes such as globozoospermia or multiple morphological abnormalities of the sperm flagellum do not routinely receive genetic testing, even though diagnostic yields of up to 60% can be expected.
The field of genetics of male infertility is rapidly evolving and it is time for patients to benefit from these advances. This talk will cover the steps we and others are taking towards bringing NGS methods such as whole exome sequencing to the clinic for male infertility and will show the first results on the validation of our whole exome sequencing-based test for male infertility.
O-166 Alterations of stimulation in the face of endometriosis
Authors: Cedars M 
Published: June 2022

Abstract
Endometriosis is a common diagnosis in women with infertility. As IVF is increasingly being utilized as the most effective treatment for infertility, the implication of a prior endometriosis diagnosis on the ovarian stimulation portion of the process becomes of paramount importance. Early studies suggested pre-treatment with GnRH agonist improved pregnancy outcome. These studies were in a time when stimulation, retrieval, fertilization and culture, and transfer occurred in a single cycle. This was considered to improve “oocyte health” decreasing the inflammatory environment in which the follicle develops. However, increasingly, information has evolved about the impact of endometriosis on eutopic endometrium. So, the relevance of this treatment in the current model, whereby stimulation and transfer are frequently separated, has not be considered in detail. Other common dogma regarding the role of endometriosis in fertility, IVF and pregnancy are beginning to be questioned. In this presentation, we discuss the implication of endometriosis on all aspects of ovarian stimulation including pre-cycle evaluation and management and how these treatments may impact ovarian reserve and ovarian reserve assessment. We then discuss current data regarding benefits and potential risks of pre-treatment suppression. We will consider stimulation specifics and adjuvants and whether stimulation itself may have an impact on the progression of endometriosis. In a time when surgery, the prior mainstay of diagnosis and management for endometriosis, is performed less commonly, will non-invasive markers of endometriosis increase identification and treatment indications? Are there data that these treatments actually improve outcome of ovarian stimulation? How does endometriosis impact oocyte and embryo “quality”? Our goal is to harmonize data, as applied in modern fertility care, regarding endometriosis evaluation, treatment and impact on IVF outcome.
O-167 Microfluidics to mimic female reproductive tract
Authors: Xiao S 
Published: June 2022

Abstract
The female reproductive tract (FRT) consists of major organs of the ovary, the female gonad, and downstream fallopian tube, uterus, and cervix. There are intimate relationships between cells in each reproductive organ as well as between each organ to sustain women’s menstrual cycle and fertility. So far, there are few effective in vitro or ex vivo models that both faithfully recapitulate the hallmarks of female reproduction and possess scalability. In this presentation, I will first introduce how we used an alginate hydrogel-based 3D encapsulated in vitro follicle growth (eIVFG) system to engineer a mini-ovary, which can recapitulate key ovarian functions as occurring in vivo, including gonadotropin-dependent folliculogenesis, oocyte maturation, ovarian steroidogenesis, ovulation, and luteinization. Next, I will introduce how we used the emerging microfluidic technology to engineer an FRT-on-a-chip. The FRT-on-a-chip allows organ-organ integration of hormonal signaling, which simulates women’s 28-day menstrual cycle and also the pregnancy-like endocrine loops. In summary, the engineered mini-ovary and FRT-on-a-chip are new powerful tools for studying female reproductive biology, disease, contraception, drug development, and toxicology.
O-169 A CV of trying
Authors: Lukkarinen A 
Published: June 2022

Abstract
Anna Lukkarinen shares real patient experiences from treatments along the infertility path. Focusing on the key points learned from these experiences, she highlights the important role that professionals have as contributors to patients’ emotional and physical well-being. In particular, she addresses the following themes:
• Public side vs. private side treatments
• Patient-professional power structures
• Patient-patient encounters
• Dealing with fear, sorrow, and longing
• The encounters’ long-term effects
It is important to remain aware that most patients enter the infertility path non-knowledgeable and inexperienced. For these outcomes of experiential learning to become accessible to all patients, old and new, they need to be internalized by patient-serving professionals.
O-195 Disease-free survival is not impacted by fertility preservation techniques for breast cancer women
Authors: Grynberg M , Amsellem N , Mayeur A , Laup L , Pistilli B , Delaloge S , Sifer C , Sonigo C 
Published: June 2022

Abstract

Study question
Do fertility preservation (FP) strategies using ovarian stimulation or not, impact long-term disease-free survival of breast cancer (BC) patients?

Summary answer
The disease-free survival of BC patients is not impacted by FP techniques whatever the timing of chemotherapy (neoadjuvant /adjuvant) and the use of ovarian stimulation.

What is known already
Fertility is often impaired in young women treated for BC. Therefore, FP has become a major issue in this population. Cryopreservation of oocytes or embryos after controlled ovarian hyperstimulation (COH) represents the most established method in this clinical situation. However, the hormonal consequences of COH protocols still raise safety concerns, often leading oncologists to contraindicate the use of this FP technique. Although alternative FP options without exogenous hormone administration may be considered, they remain suboptimal for treating the putative future infertility.

Study design, size, duration
Retrospective bicentric cohort study including including 740 BC women, 18-43 years of age, referred for FP between 2013 and 2019.

Participants/materials, setting, methods
Overall, 328 underwent at least one ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (No STIM group). Log Rank test was used to compare both groups and Cox proportional-hazard model was applied for multivariable analyses.

Main results and the role of chance
Women of the No STIM group were significantly younger and present with more severe disease. Follow-up data for recurrences were available for 80.9% of the cohort and the median time to follow-up was 4.2 [2.9-5.8] vs. 5.6 [4.1-6.7] years between STIM and No STIM group (p &lt; 0.0001). According to log-rank test, the risk of recurrence did not differ between the two groups (p = 0.09) even after adjustment on age, SBR grade, triple negative status or type of planned chemotherapy.

Limitations, reasons for caution
The retrospective nature of the study represents the main limitation. The median follow-up of 4.2 to 5.6 years, might be considered short to assess the long-term safety of FP techniques. The heterogeneity between oncological centers regarding the use of COH and specific protocols may lalso be a reason for caution.

Wider implications of the findings
Our findings provide reassuring safety data on the use COH for FP in BC patients, whatever the timing of chemotherapy. However, further investigations with a longer follow-up are needed to definitely consider COH safe in particular in neoadjuvant situations. In addition, the benefit of letrozole supplementation during COH requires confirmation.

Trial registration number
Not applicable
O-222 Surveillance of scientific research integrity in medically assisted reproduction: a systematic review of the retracted literature
Authors: Minetto S , Zanirato M , Pisaturo V , Makieva S , Esposito S , Cermisoni G.C , Rabellotti E , Viganò P , Candiani M , Papaleo E , Alteri A 
Published: June 2022

Abstract

Study question
How many retracted papers are there in the medically assisted reproduction (MAR) literature and, more importantly, what are their particulars?

Summary answer
Article retraction within MAR literature is increasing and the most common reasons for retraction are errors in data and duplicate publications.

What is known already
Article retraction accounts for one of the most serious consequences of research misconduct. Articles may be subject to retraction whenever the findings are found to be unreliable, redundant, plagiarised or the authors are found to have performed unethical research or hidden

Trial registration number
N/A
O-224 Novel bio-markers of Immunological response to the implanting embryo
Authors: Li T.C 
Published: June 2022

Abstract
Embryos, as allograft, will fail to implant unless they can escape rejection by maternal immune response. It is postulated that embryos escape Immune surveillance using a mechanism similar to that of cancer cells via Immune check point pathways: (a) via producing a surface protein called PD-L1, which binds to PD-1 receptor in T-cells; and (b) via producing a surface protein called Galectin-9 which binds to T-cell immunoglobulin and mucin domain 3 (TIM-3). The binding of these ligands to the corresponding receptors in the T-cells would prevent the latter from recognizing them as foreign, hence escape destruction. In a prospective, longitudinal, observational cohort study involving subjects undergoing blastocyst transfer, it was found that among women who conceived, there was an instant, transient and significant reduction of Tim-3 expression on the surface of peripheral NK cells, T cells and NK-like T cells on days 3 and 6 after ET, which returned to baseline level by day 9 after ET. The change in women who did not conceive appeared in an opposite direction. Furthermore, reduction in Tim-3 expression in pNK cells predates the occurrence of miscarriage by 3 weeks in women with miscarriage when compared with those with live birth. These observations are accompanied by significant changes in peripheral blood cytokine profiles which may be used as clinically useful biomarkers to monitor the maternal immunological response to successful implantation.
O-282 Is the poly parenthood the new type of parenthood?
Authors: Herbrand C 
Published: June 2022

Abstract
Is multi-parenthood the new type of parenthood?
Conceiving and raising a child with someone who is not a committed conjugal partner has long been disapproved of and is still regarded by some with concern or disdain. However, this way of having children, also referred to as ‘co-parenting’, has increasingly become a family-building option in itself. Originally describing the cooperation of parents in raising their children after divorce, this term now also designates people who deliberately pursue this type of family arrangement and commit to raising a child together, possibly with their respective partners. This parental path is usually chosen to provide a child with a mother and a father with whom they can develop long-lasting relationships.
This paper explores some of the opportunities and challenges presented by co-parenting involving more than two parental figures, by focussing on the experiences and accounts of lesbian women and gay men engaged in such family arrangements in Belgium. Drawing on work by social theorists of the family, the main features and advantages of these arrangements are examined to show that while co-parenting might at first seem marginal and complicated, it appears particularly well adapted to contemporary social constraints and parenting expectations. It can facilitate the achievement of a number of ideals and expectations valued in contemporary society, including: the biological heteronormativefamily model; the possibility to negotiate and implement reflexive parentalpractices; the need for a committed but personalised parenthood; and the desire for a betterand more flexible life-balance. Despite these advantages for those involved, multi-parental arrangements raise a set of social, ethical and legal questions that challenge broader legal and ideological family norms.
O-316 From insult to injury: war and cross border reproductive care (CBRC). Difficulties for patients and collaborators
Authors: Shenfield F 
Published: June 2022

Abstract
From Insult to Injury: War and Cross Border Reproductive Care (CBRC) after Covid
Ukraine has had a thriving fertility sector for many years, both for its citizens and foreigners, for whom it has been a very popular destination for cross-border commercial surrogacy, with an estimate of between 2000 and 2500 babies born each year. Such cross border reproductive activities had already been complicated by the Covid pandemics of the last 2 years, but when Russia invaded the country in February 2022, intended parents, surrogates, egg donors, agencies and local clinics faced an emergency which led to acute distress in addition to that already felt by all with a sudden war in Europe.
We discuss the available facts with regards to the disruption to fertility services for all concerned, as well as the complex legal and ethical issues surrounding this emergency. Neighboring countries have been accepting (mostly women) refugees, who may need health care in a system stressed by extra numbers of patients. Intended parents have been trying to ensure their plans are confirmed whilst their surrogate has probably moved to a different jurisdiction. Above all, the voice of collaborators may have been overwhelmed by that of the (future) families they are contracted to help. All this, will leave its mark on CBRC in an area which has been a traditional European and recently Chinese hub for years to come.
P-083 The incidence of sperm DNA damage in men with chronic reproductive health issues
Authors: Nyantakyi A , Al-Hussini M , Ramsay J , Minhas S , Lewis S , Haddock L , Yap T 
Published: June 2022

Abstract

Study question
What is the incidence of sperm DNA damage in men attending tertiary (urological) healthcare with long histories of infertility?

Summary answer
The majority of these men (95%), all with normal semen analyses had high levels of sperm DNA damage.

What is known already
Conventional semen analysis assesses sperm concentration, motility, and morphology but with a high degree of biological variability. Around 25% of men are given a diagnosis of unexplained infertility by normal semen analysis. The World Health Organisation (WHO) stated in 2021 that ‘clinically there is a growing awareness that chromosomal anomalies and gene mutations underlie a diverse spectrum of male infertility,’ so now recommends that sperm DNA is determined as an extended analysis. Sperm DNA damage occurs more often in infertile men and DNA damage is associated with recurrent pregnancy loss and decreased live birth rates following fertility treatment.

Study design, size, duration
A retrospective study of men attending a tertiary centre with productive failure had been offered a standard semen analysis and sperm DNA fragmentation using SpermComet technology.

Participants/materials, setting, methods
Results from 148 men tested between April 2017 and September 2021 were recruited from a tertiary urological database in the UK. Alongside a semen analysis, they also had a sperm DNA fragmentation test.
Sperm DNA quality for the participants was assessed and reported as average, low and high DNA damage as a percentage compared with clinical thresholds used by Examen from their sperm data bank of 74 fertile sperm donors with recently achieved clinical pregnancies.

Main results and the role of chance
The average comet score was 37.8% +/-0.5, low comet score was 35.3% +/- 1.5 and high comet score was 20.2% +/-1.2. These values were all significantly outside ( p &lt; 0.001, Mann Whitney test)) fertile parameters.
95% of these men presenting for infertility investigations had a significantly raised DNA damage across their semen sample with low proportions of healthy sperm and high levels of sperm with genomic damage.

Limitations, reasons for caution
Retrospective design, small sample size, lack of randomisation and low power analysis.

Wider implications of the findings
Sperm DNA damage was found in most of these men who, over years of investigation hadn't been offered tests other than semen analysis or therapy to improve their sperm quality. Thus, this tool could be a useful adjunct to semen analysis to guide the men to reproductive health.

Trial registration number
not applicable
P-124 The impact of Fragile x premutation carrier state on embryo morphokinetic development, A comparison between genetically normal and abnormal embryos
Authors: Shulman Y , Kalma Y , Malcov M , Kopel R , Azem F , Almog B , Cohen Y 
Published: June 2022

Abstract

Study question
Does inheritance of FMR1 pre mutant allele affect embryos morphokinetic development?

Summary answer
Embryos that inherit the FMR1 pre-mutant allele are of a lower morphokinetic quality at the blastocyte stage compared to those with the normal allele.

What is known already
Previous studies suggest lower oocyte yield and blastulation rate in FMR1 premutation carriers undergoing preimplantation genetic testing for monogenic diseases (PGT-M). Yet, data is lacking concerning embryo morphokinetic development in this group.

Study design, size, duration
Retrospective analysis, on 529 embryos from 126 in vitro fertilization (IVF)- PGT-M cycles of 39 FMR-1 premutation women carriers.

Participants/materials, setting, methods
Morphological and morphokinetic parameters acquired by the time-lapse monitoring system were compared between embryos carrying the FMR-1 permutated allele (FMR1 group n = 271) to those who inherited the normal allele (Normal group n = 258). Outcomes measures were embryos morphokinetic parameters up to day 3, the start of blasulation time (tSB) for day 5 embryos, and the rate of top-quality embryos at days 3 and 5.

Main results and the role of chance
No differences were found between the groups in all morphokinetic parameters from the time of ICSI until biopsy on day 3. Blastulation rate was comparable between the groups. However, FMR1 embryos exhibited delayed start of blastulation compared to the genetically normal embryos (median tSB 104.2 hrs (99.3-110.3) vs 101.6 hrs (94.5-106.7), P = 0.01) and had lower top quality embryo rate (25.6% vs 38.8%, P = 0.04).

Limitations, reasons for caution
This study is limited by its retrospective design and inability to assess CGG expansion in the embryo.

Wider implications of the findings
This study offers new insight into the impact of permutated FMR1 gene in the early stages of embryo development. Further studies are needed in order to apply these results in clinical decision-making.

Trial registration number
not applicable
P-128 Role of PGT-A and ERA to optimise reproductive outcomes of couples with recurrent implantation failure
Authors: Mathew S.T , Chaitanya K , Rao D 
Published: June 2022

Abstract

Study question
In couples with Recurrent Implantation Failure (RIF), can Pre-implantation Genetic Testing for Aneuploidy (PGT-A) or Endometrial Receptive Array (ERA) help to optimise the reproductive outcomes?

Summary answer
In RIF patients PGT-A or ERA individually do not seem to optimize outcomes. PGT-A in-combination with ERA seems to be a beneficial intervention.

What is known already
Role of PGT-A and ERA to optimize reproductive outcomes has been ambigious. In this current study we wanted to evaluate their efficacy in RIF patients.

Study design, size, duration
This is a retrospective data of couples undergone treatment for RIF at our private fertility centre from January 2014 to July 2019. The study population was divided to four groups based on the treatments offered:
Group A: ERA (n = 47)
Group B: PGT-A (n = 54)
Group C: ERA+PGT-A (n = 49)
Group D: No PGT-A/ No ERA (n = 189)

Participants/materials, setting, methods
Couples with minimum two failed transfers were recruited. ICSI was the method of insemination. Blastocysts were subjected to genetic testing through Next-Generation Sequencing(NGS). All embryo transfers performed in a Frozen Embryo Replacement Cycle(FET). ERA was done as per our institutes Standard Operating Procedures(SOP) and for ERA patients ET was done as per the receptivity status.
Elective Single Euploid Blastocyst transfer (eSET) was done in grpB&C
un-screened double Blastocyst Transfer (DET) was done in grpA&D.

Main results and the role of chance
Clinical Pregnancy Rate (CPR), Miscarriage Rate (MR) Implantation Rate (IR), Multiple Pregnanacy rates (MPR) and Live Birth Rate (LBR) was evaluated in all groups.
Outcomes of groups A, B, C & D were as follows:
CPR – 68.09% Vs 62% Vs 68.42% Vs 70%
IR – 48.89% Vs 47.50% Vs 65.22% Vs 45%
MR – 12.77% Vs 9.25% Vs 5.26% Vs 17.89%
MPR – 16% Vs 0% Vs 0% Vs 17%
LBR – 51.06% Vs 46.8% Vs 63.16% Vs 45%
CPR was comaparble between all groups
ERA & PGT-A group seems to have the best IR, LBR with least miscarriage rates.
For RIF patients role of PGT or ERA when offered individually, doesn’t seem to optimize outcomes.
PGT-A in-combination with ERA seems to be beneficial to optimize outcomes.

Limitations, reasons for caution
This data is retrospective and there is a need for a well designed RCT to further validate the conclusion of this study. Caution needs to be exercised while offering PGT and ERA as they incurr additional financial burden to the patients.

Wider implications of the findings
Embryo Transfer cycles with a personalised window of implantation and transfer of a single Euploid embryo can help RIF patinets to have the best reproductive outcomes and can also help shorten the time to pregnancy.

Trial registration number
Not applicable