bluuebunny/crossref_metadata_2025_split huggingface dataset:
O-280 Cycle programming prior to IVF
Authors: Blockeel C 
Published: June 2022

Abstract
The GnRH antagonist protocol has become increasingly popular for ovarian stimulation (OS), thanks to a number of advantages over the long GnRH agonist protocol: a reduced duration of stimulation with lower consumption of gonadotrophins and a lower rate of the ovarian hyperstimulation syndrome (OHSS), without any compromise in delivery rates.
Despite the clear benefits associated with the GnRH antagonist protocol, the long GnRH agonist protocol allows a more flexible and controlled schedule of oocyte retrievals: this is important both for the patient, who wants to undergo reproductive treatment at her own convenience, and for the IVF clinic. Cycle scheduling allows not only a more equal distribution of the work load, but can also avoid the vast majority of oocyte retrievals during weekend days.
To circumvent this shortcoming, the use of oral contraceptive pills (OCP) has been advocated as a programming method for IVF cycles using the GnRH antagonist protocol. Although the published evidence is clear about the negative impact of this method of programming, it is still widely used over the globe. Nevertheless, there are other possibilities of scheduling the oocyte retrievals, such as the use of estradiol, a pretreatment of GnRH antagonists, and other approaches. These options will be highlighted in the lecture.
P-047 The effects of dietary branched-chain amino acids on mice semen parameters and plasma amino acids profile
Authors: Sefidabi R , Kamali R , Shahverdi A , Pezeshki A , Ghasemi Z , Rashki Ghaleno L , Alizadeh A 
Published: June 2022

Abstract

Study question
Are there any differences between the effect of each member of the branched-chain amino acids (BCAAs) on sperm parameters and plasma amino acids profile?

Summary answer
Valine supplementation had destructive effects on sperm parameters and viability. However, blood amino acids profile were similar among treatments.

What is known already
BCAAs, a group of three essential amino acids, have a crucial role on protein synthesis, besides being strongly associated with impaired glucose and fat metabolism. Although BCAAs supplements are one of the most demanding products for the fitness industry to increase the lean body mass and boost exercise performance, little information exists on the advantages and disadvantages of dietary BCAAs on male fertility.

Study design, size, duration
Fifty NMRI mature male mice were divided into five groups and were fed diets as follow: Control (CTR): 2.4% Beta-alanine, Leucine (Leu): 1.18% Leu + 1.2% Beta-alanine, Isoleucine (Ile): 0.58% Ile + 1.8% Beta-alanine, Valine (Val): 0.65% + 1.7% Beta-alanine, and BCAAs (Leu:Ile:Val ratio of 2:1:1): 2.4% BCAA: 1.18% Leu + 0.58% Ile + 0.65% Val. After 5 weeks, testes and epididymides were dissected, and sperm parameters and plasma amino acids profile were assessed.

Participants/materials, setting, methods
Semen parameters were evaluated by a Computer-Aided Semen Analysis (CASA) system. Plasma amino acids concentrations were determined by HPLC. Data were analyzed using SPSS and statistical differences among various groups were determined by ANOVA and Tukey’s post-hoc test.

Main results and the role of chance
Higher BCAAs intake, particularly Val, increased the destructive mechanisms on sperm viability. The results showed no significant difference on body weight after 40 days. Sperm concentration (8.4 vs. 4.5 ×106), progressive motility (51.5 vs. 27.2 %), and viability (67 vs. 56 % for CTR and Val group, respectively) decreased dominantly in the Val group compared to CTR (p≤0.05). The immotile parameter was significantly higher in the Val group compared to the CTR (p≤0.05). In addition, there were no significant differences on plasma amino acids profile.

Limitations, reasons for caution
The current study's limitation is that only one level of BCAAs was used. Given the potential role of Val on sperm cell death, further data on different levels of all BCAAs, especially Val administration and evaluation of the related mechanisms are needed.

Wider implications of the findings
The findings of our study show, for the first time, that individual levels of Ile and Leu have different effects on sperm parameters compared with all BCAAs or Val. More attention should be given to BCAAs supplementation and semen quality that was previously ignored.

Trial registration number
not applicable
P-053 Sperm chromatin integrity in men from infertile couples with teratozoospermia and normozoospermia
Authors: Bozhedomov V , Lipatova N , Bozhedomova G , Kamarina R , Shomarufov A , Kamalov A 
Published: June 2022

Abstract

Study question
What is the relationship between sperm morphology and sperm chromatin integrity (SCI) in patients with normal sperm concentration (SC) and motility (SM)?

Summary answer
SCI violations in form of sperm DNA fragmentation (SDF) and incomplete protamination (IP) are more common in teratozoospermia, even when SC and SM are normal

What is known already
Deterioration of sperm chromatin integrity in the form of SDF and IP are the significant factors affecting male reproductive potential (WHO, 2021).

Study design, size, duration
This multicenter retrospective cross-sectional study included 479 men aged 18-45 years who were observed for infertility for more than 1 year.

Participants/materials, setting, methods
Only men: 1) with sperm concentration and motility that were not lower than the 5% centile according to WHO-2021 (16 million/ml and 30%, respectively), 2) without any inflammatory processes in genitourinary organs, 3) with obtained tests for SCI were included in the study. The men were divided into 3 groups (gr.) depending on the percentage of morphologically abnormal forms: I - 86-95% (n = 229), II - 96-99% (n = 228), III - 100% (n = 22).

Main results and the role of chance
The mean SDF in groups I, II, III were 9.0% (6-15), 12.0% (8-16) and 16.5% (13-20) (pI-II = 0.009; pII-III = 0.002; pI-III = 0.001), respectively. SDF index (Halosperm® Assay) in groups I, II, and III were 1.3 (1.2-1.5), 1.4 (1.3-1.5), and 1.5 (1.4-1.7), respectively (pI-II = 0.004; pII-III = 0.001; pI-III = 0.009). In 23% (I), 27% (II), and 55% of cases (III) the SDF value exceeded the threshold value (&gt;15%) (pI-II &gt; 0.05; pII-III &lt;0.02; pI-III &lt;0.005). Histone-positive sperm were revealed in 17% (12-23), 19.5% (13-27), and 31% (19-42) of cases in groups I, II, and III, respectively (pI-II &gt; 0.05; pII-III = 0.014; pI-III = 0.02); The 30% of SDF threshold value was exceeded in groups I, II, and III, in 12%, 20%, and 52% of cases (pI-II &lt; 0.05; pII-III &lt; 0.005; pI-III &lt; 0.001).

Limitations, reasons for caution
The reference values of SDF and the proportion of histone-positive sperm have not yet been determined properly, even in WHO 2021, therefore, the prevalence of SCI abnormalities in various spermiological diseases needs to be clarified in the future.

Wider implications of the findings
SCI and IP can be applied more widely in the investigation of men from infertile couples, especially, men with teratozoospermia. It should also be considered in men from infertile couples with normal semen parameters.

Trial registration number
Not applicable
P-058 Risk factors associated with sperm DNA fragmentation in Tunisian subfertile men
Authors: Boussabbeh M , Ben Jmaa M , Sallem A , Belghaieb I , Ammar O , Mehdi M 
Published: June 2022

Abstract

Study question
The aim of the study was to investigate risk factors for sperm DNA fragmentation to determine which factors influence significantly the sperm DNA fragmentation.

Summary answer
Obesity seems to lead to higher risk of sperm DNA damage in Tunisian subfertile men.

What is known already
A positive association between lifestyle conditions, varicocele, advanced age and exposure to toxicants and DNA fragmentation has been documented.

Study design, size, duration
It’s a retrospective case control study. 61 Patients registered from October 2018 to December 2021 were divided into two groups: group “C” with good quality sperm DNA (n = 20) and group “F” with fragmented sperm DNA (n = 41).

Participants/materials, setting, methods
DNA fragmentation was measured using terminal deoxynucleotidyltransferase dUTP nick and labeling assay. The Odds Ratio (OR) and their 95% CI were calculated using univariate logistic regression in order to quantify the association between the variable of interest “Sperm DNA fragmentation” and the various risk factors: lifestyle conditions (e.g. tobacco smoking, alcohol consumption, and obesity), age, professional exposure to high temperature and toxic products and urological history (e.g. varicocele, testicular hypotrophy or hypertrophy).

Main results and the role of chance
Our results showed that tobacco, professional exposure to high temperature and toxic products and urological history are risk factors that may alter sperm DNA with an odds ratio (OR) of 2.1, 1.9 and 1.5, respectively. Interestingly, we demonstrated that obesity seems to be the most significant risk factor of DNA fragmentation with an OR of 4.2 (p = 0.002).

Limitations, reasons for caution
Further studies are needed to investigate the mechanism by which obesity occur sperm DNA damage.

Wider implications of the findings
Our finding are in accordance with several retrospective studies demonstrating that obesity is liable to sperm DNA damage

Trial registration number
not applicable
P-146 Blastocyst morphometry and morphology predict ploidy
Authors: Shapiro B , Garner F , Kaye L , Rasouli M , Verma K , Bedient C 
Published: June 2022

Abstract

Study question
Are objective measurements and subjective assessments of blastocysts predictive of aneuploidy?

Summary answer
Aneuploidy was predicted equally well by lower trophectoderm cell count (objectively measured morphometry) or by a lower subjective trophectoderm grade.

What is known already
Blastocyst morphological grade has been reported to be moderately predictive of embryo ploidy. However, due to its subjective nature, morphological grade may be significantly more difficult to code into artificial intelligence algorithms when compared to objective measurements.

Study design, size, duration
This retrospective cohort study included all 1409 blastocysts that were subject to pre-implantation genetic testing (PGT) in a 30-month study period.

Participants/materials, setting, methods
Per clinic routine, embryos from oocyte were cultured to the blastocyst stage following conventional ovarian stimulation, oocyte retrieval, and intracytoplasmic sperm injection. If the patients opted for PGT, a laser was used to open the zona at the cleavage stage, trophectoderm biopsies were collected at the blastocyst stage, and biopsies were analyzed by next-generation sequencing. Inner cell mass sizes were measured by ocular micrometer and trophectoderm cells were counted in one plane of focus.

Main results and the role of chance
The mean patient age (including oocyte donors) was 31.9±6.4 years and the mean number of collected oocytes was 23.0±12.9. In multivariable logistic regression, greater patient age was the best available predictor of blastocyst aneuploidy (P &lt; 0.0001). Along with age in the model, the observation of fewer trophectoderm cells (P = 0.0019) was also predictive of aneuploidy. Alternatively, the failure to have an A-grade trophectoderm (P = 0.0007) was also predictive of aneuploidy, also with age in the model. Neither the objectively measured inner cell mass size nor subjective inner cell mass grade were significant predictors of ploidy. Overall, objectively measured blastocyst morphometry was about equally predictive of ploidy as was subjective blastocyst grading, and area under the receiver operating characteristic curve was 0.62 for each model.

Limitations, reasons for caution
This study was retrospective, allowing the possibility of selection bias among patients and among embryos chosen for biopsy.

Wider implications of the findings
Artificial intelligence algorithms assessing embryos might benefit from the similar performance of subjective grading and objective measurements, because it is much easier to code objective measurements into the algorithms.

Trial registration number
None.
P-157 Embryo culture under high humidity conditions in time lapse system does not improve ongoing pregnancy rates: a retrospective propensity score model study 299 ICSI cycles
Authors: Lagalla C , Bartolacci A , Coticchio G , Intra G , Dell'Aquila M , Parodi F , Patria G , Zacà C , Borini A 
Published: June 2022

Abstract

Study question
Does culture in high relative humidity conditions (HC) improve ongoing pregnancy rates when using a time-lapse system (TLS) for embryo culture?

Summary answer
Using The use of a TLS under HC does not increase the likelihood a pregnancy in comparison with cultured in dry condition (DC).

What is known already
Factors potentially affecting embryo development demand precise control in the IVF laboratory environment, especially for correct incubator usage. TLS provide stability during embryo culture, which is a well-known key factor for undisturbed embryo development. The humidity content of embryo culture atmosphere is especially relevant to prevention of oscillations in culture media osmolality. Previous data suggest that culture under HC has a significant effect on embryo quality and morphokinetics. However, studies assessing the effect of HC on clinical outcome are rare and inconclusive.

Study design, size, duration
A retrospective study of 299 women undergoing their first ICSI cycle from April 2021 to December 2021, of whom patients assigned to dry or humid conditions were 184 and 115, respectively.

Participants/materials, setting, methods
We used a GERI incubator, with 6 separated chambers for individual patients (3 HC, 3 DC). The effect of HC on ongoing pregnancy rate was assessed by the propensity matched sample, to reduce potential differences between women undergoing either HC or DC and to obtain unbiased estimation of treatment effect. Variables included in the propensity score model were female age, AMH, FSH, BMI, partner’s age, sperm quality and number of embryos transferred.

Main results and the role of chance
Patient demographics were homogeneously distributed in the two study groups. After adjusting for several confounding variables and applying the Propensity Score, no statistically differences were observed for embryo quality on day 3 [51,64 ± 34,33 (DC) Vs 53,83 ± 30,71 (HC)], blastulation rate [45,5% ± 22,60 (DC) Vs 45,9 ± 22,80 (HC)] and ongoing pregnancy rate. A trend was observed of increased ORs for ongoing pregnancy in HC conditions [OR = 1.56, 95% CI (0,77-3,15), p=0.21].

Limitations, reasons for caution
The study is limited by its retrospective design, although a propensity score model may mitigate such a limitation. The lack of data on live birth rate is an additional limitation.

Wider implications of the findings
These results suggest that HC conditions does not increases the likelihood of embryos to achieve an ongoing pregnancy with respect to those cultured in dry conditions. Further data collection and analysis are ongoing to investigate more thoroughly and extended clinical outcome results.

Trial registration number
N.A.
P-217 Laboratory and clinical outcomes for fresh and vitrified-warmed oocytes after Piezo-intracytoplasmic sperm injection (Piezo-ICSI)
Authors: Low S.Y , Lim A.Y.X , Lee C.S.S 
Published: June 2022

Abstract

Study question
How is the performance of Piezo-ICSI on vitrified-warmed oocytes compared to fresh oocytes in human IVF?

Summary answer
Laboratory outcomes for fresh and vitrified-warmed oocytes after Piezo-ICSI were comparable.

What is known already
ICSI is utilized as the fertilization method for 60-80% IVF patients undergoing assisted reproductive technology (ART) worldwide. In the past 3 decades, Piezo-ICSI (Prime Tech Ltd, Japan), a refined ICSI methodology had shown increased fertilization and survival rates. The fertilization rate (2PN, 1PN, and &gt;2PN) achieved via Piezo-ICSI was reported as high as 84-91% in previous publications.

Study design, size, duration
This retrospective cohort study included 12,195 fresh and 1,065 vitrified-warmed oocytes retrieved or warmed from 1334 and 93 patients respectively between January 2020 and November 2021. Mean age was 35.9 (ranged 19-49) for fresh oocytes and 27.3 (ranged 18-49) for vitrified-warmed oocytes. The vitrified-warmed oocytes were mainly originated from young donors and thus reflected in lower maternal age in this cohort

Participants/materials, setting, methods
All oocytes fertilized using Piezo-ICSI technology during the study period were included. Piezo-ICSI is performed using a piezo impact drive unit (MB-S; Prime Tech Ltd, Japan) driven by a controller (PMM4G; Prime Tech Ltd, Japan). The ultrathin walled micropipette (PINU06-25FT; Prime Tech Ltd, Japan) filled with 1-1.5cm operation liquid (Flourinert FC-770; Sigma, Belgium) was used for microinjection. For vitrified-warmed oocytes, Cryotec Method (Reprolife, Japan) was used for both vitrification and warming of oocytes.

Main results and the role of chance
The two groups (fresh and vitrified-warmed oocytes) were comparable (p &gt; 0.05) in terms of fertilization (2PN and &gt;2PN) rate (81.5% vs 80.0%), post-ICSI oocytes survival rate (93.3% vs 92.8), blastocyst-formation rate from 2PN oocytes (74.6% vs 71.0%) and blastocyst-utilization rate from 2PN oocytes (53.2% vs 49.3%).
This study demonstrated that fresh and vitrified-warmed oocytes achieved comparable laboratory outcome following the use of Piezo-ICSI technique and ultrathin walled injection pipette.

Limitations, reasons for caution
The methodology in performing Piezo-ICSI differs compared to conventional ICSI, hence training is required to achieve optimal results.

Wider implications of the findings
Our data resonates with previously published data using the same Piezo-ICSI platform.

Trial registration number
Not applicable
P-309 Endometriosis does not compromise early embryonic development as well as live birth: a retrospective analysis of 716 standard in vitro fertilization cycles
Authors: Borini A , Dell' Aquila M , Bartolacci A , Intra G , Parodi F , Patria G , Zacà C , Borini E , Coticchio G 
Published: June 2022

Abstract

Study question
Does endometriosis compromise early embryonic development and/or clinical outcome in standard in vitro fertilization (sIVF) cycles?

Summary answer
Endometriosis does not compromise embryo development or clinical outcome in sIVF cycles characterised by normal semen parameters.

What is known already
IVF is an elective approach to overcome endometriosis-related infertility. The notion that IVF outcomes are altered in women with endometriosis the is scarce and conflicting. Different meta-analyses reached diverging conclusions concerning a possible impact of endometriosis on clinical outcome. With reference to laboratory outcomes, a reduced fertilization rate with sIVF was observed in several but not all studies.

Study design, size, duration
A retrospective analysis of 716 women undergoing their first sIVF cycles from 2015 to February 2021, 205 with in situ endometrioma (class IV) and 511 with tubal factor infertility.

Participants/materials, setting, methods
Diagnosis of endometriosis was based on ultrasound observation of cysts on at least two occasions at least two menstrual cycles apart. Women carrying atypical lesions, i.e., cysts with sonographic appearance compatible but not distinctive for endometriosis, were excluded. Multivariate analysis was conducted using the generalized estimating equation (GEE) approach, thus making it possible the analysis of variables with non-normal distribution. The primary study outcome was live birth rate.

Main results and the role of chance
After adjustment for maternal, paternal age, maternal body mass index (BMI), anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH) we found no significant difference in fertilization rate [78,69 ± 26,16 (Endo) Vs 79,5 ± 24,01 (Tubal)], embryo quality [33,33 (0 – 57,86) endometriosis vs. 33,40 (0 – 67,70) tubal factor], blastulation rate [52,00 ± 15,01 (endometriosis) vs. 55,49 ± 14,98 (tubal factor)], top quality blastocyst [38,15 ± 18,67 (endometriosis) vs. 34,62 ± 14,77 (tubal factor)], ongoing pregnancy [OR = 0,84, 95% CI (0,54 – 1,32)], live birth [OR = 0,89, 95% CI (0,53 – 1,48)], and miscarriage rate [OR = 0,68, 95% CI (0,27 – 1,74)]. The only significantly different outcome was the percentage of embryos with ≥ 8 blastomeres on day 3 [25,00 (0 - 60,00) endometriosis Vs 40,00 (0 - 67,00) tubal factor].

Limitations, reasons for caution
The retrospective design of the study and lack of data on cumulative live birth rates are additional limitations.

Wider implications of the findings
The results of our study suggest that in women with endometriosis fertilization rate, embryo quality, blastulation rate and live birth rate are not affected in sIVF cycles.

Trial registration number
N.A.
P-407 Pregnancy outcomes of different endometrial preparation in patients with a history of cesarean section
Authors: Gan R , Gong F 
Published: June 2022

Abstract

Study question
To investigate the efficacies of three cycle regimens in women receiving frozen embryo transfer with a history of cesarean section(CS).

Summary answer
In women undergoing frozen embryo transfer with a history of CS, hormone replacement therapy for endometrial preparation was associated with a higher early miscarriage rate.

What is known already
Rates of CS are rising worldwide. Many women with a history of a CS delivery conceived through assisted reproductive technology (ART) are in need of frozen embryo transfer (FET) for their second progeny. Various protocols for endometrium preparation have been used to provide an optimal uterine environment for the transfer of thawed embryos, but the evidence supporting the superiority of one protocol over another is insufficient.

Study design, size, duration
A retrospective cohort study of patients (N = 6,159) with a history of CS who fulfilled the inclusion criteria were enrolled in the study from January 2014 to December 2019 at the CITIC-Xiangya Hospital of Reproduction and Genetics.

Participants/materials, setting, methods
Reproductive outcomes of patients in the natural cycle （NC） (n = 4,306) versus hormone replacement therapy（HRT） (n = 1,007) versus gonadotropin-releasing hormone agonist （GnRH-a） + HRT groups (n = 846) were compared. Multiple logistic regression analyses were performed to investigate the potential confounding factors.

Main results and the role of chance
The unadjusted odds of the miscarriage rate of singleton pregnancies were also significantly higher in the hormone replacement therapy compared with the natural cycle (25.5% versus 20.4%, respectively). After adjusting for possible confounding factors, the early miscarriage rate and the miscarriage rate of singleton pregnancies remained significantly higher in the hormone replacement therapy than the natural cycle. The clinical pregnancy rates in the hormone replacement therapy, hormone replacement therapy and treatment with gonadotropin-releasing hormone agonist of women with a history of cesarean section was 48.8%, 48% and 47.1%, respectively, and the live birth rates were 37%, 34.1% and 35.7%, respectively.

Limitations, reasons for caution
This study is limited by its retrospective design. Furthermore, the detailed ultrasound information on uterine myometrial defects, complications related to CS and the number of previous CSs were unavailable in our study. Another limitation is that pregnancy-related complications and neonatal outcomes were not analyzed.

Wider implications of the findings
Our study could help physicians improve their understanding of the impact of different protocols on pregnancy outcomes in patients with a history of CS. Prospective randomized trials should be conducted to assess the efficacy of endometrial preparation protocols for FET in women with a history of CS.

Trial registration number
not applicable