bluuebunny/crossref_metadata_2025_split huggingface dataset:
Donor Recruitment and Recipient Experience of a Newly Implemented Identity Release Donor Sperm Program
Authors: NOWOWEISKI Sarah , HYLAND Bernadette , OLIVER Laura , HEALEY Martin , OSIANLIS Tiki 
Published: November 2022

Background: A shortage of donor sperm exists in Victoria. In combination with COVID-19 affecting cross border reproductive care, the lack of donor availability necessitates increased attention to factors affecting recipient decision making. Aim: Newlife IVF launched their Identity Release Donor (IR; previously known as clinic recruited) Sperm Program in September 2020. Our aim is to examine donor recruitment and key factors in donor selection in an IR donor sperm program. Method: Data collected through routine interactions with potential donors and recipients, including donor allocation and reasons for decision making were examined. Qualitative data collected through counselling sessions with recipients were analysed using thematic content analysis. Results: From September 2020 to May 2021, 308 men responded to an online advertisement requesting more information about our IR program. Of these, 41% (N=126) completed an intake phone call wishing to proceed, however only 7% (N=22) undertook investigative testing. Ultimately 2.5% (N=8) of the initial cohort completed all requirements to date. To date, 106 recipient women/couples completed the compulsory counseling session and accessed the IR profiles. Seventy-five percent (N=80) selected a donor. Also, 75% stated there was more information in donor profiles than expected, and valued interviewer impressions of donor (international donor profiles). Recipients referred to the ‘letter to the offspring’, a hand-written note by the donor for potential offspring, as providing the most insight and weighed heavily in decision making. Of the 25% (N=26) who have not selected a donor to date, the majority (N=16) were undecided, disliked profiles (N=5), delaying treatment (N=2), or changing clinics (N=3). Conclusion: A small proportion of men who express interest via an online advertisement, translate to sperm donors. A high proportion of recipients who view donor sperm profiles select a donor and proceed with treatment. Recipients are motivated to learn about a donor and value the donor’s personal connection to a potential donor conceived offspring.
Patient Experience During COVID-19: How the Introduction of Telehealth has Influenced Patient Practices
Authors: NOWOWEISKI Sarah , HEALEY Martin , OSIANLIS Tiki 
Published: November 2022

Background: Melbourne underwent one of the strictest lockdowns in the world in 2020, with the swing to telehealth-based appointments, bringing into focus the effectiveness of communication between staff and patients. Due to the ongoing provision of a hybrid model of in-person and telehealth appointments, it is important to learn how this shift in delivery of service has impacted patient experiences. Aim: To examine patient experiences with telehealth appointments, and to assess any associations between self-reported personality traits and preferred communication method. Method: Data was collected from a patient satisfaction survey administered in May 2021 (N=127). The patient satisfaction survey consisted of 5-point Likert scale responses regarding specific aspects of IVF care, self-reported personality trait descriptions and qualitative responses. Frequencies and ordinal logistic regression analyses was used to examine associations between personality traits and satisfaction responses. Results: Overall 80% (N=101) of patients liked the flexibility of telehealth appointments. However 68% (N=87), while understanding the need for telehealth during COVID-19, preferred face to face communication. Exploring self-reported personality traits, patients who described themselves as assertive were more likely to prefer succinct written information, whereas patients who described themselves as anxious and/or shy preferred both verbal and written communication. Patients who described themselves as optimistic, were more likely to rate themselves as pleased with their overall experiences at Newlife IVF and felt emotionally supported during treatment. Conclusion: Despite shifting to a majority telehealth service provision, most patients reported high levels of satisfaction with communication, and have continued to actively use telehealth since the lifting of lockdown, indicating that it doesn’t introduce significant barriers to patient and clinic communication. Inadvertently, necessary change due to COVID-19 has spontaneously broadened the scope of patient centered care providing further insight into patient preferences. Further exploration into using heuristics to identify links between personality types and mode of communication is warranted.
Pronuclear Differences Between Male and Female Human Zygotes: A Time-Lapse Study
Authors: OREVICH Lee-Sarose , WATSON Kate , ONG Kee , KORMAN Irving , TURNER Ross , SHAKER David , LIU Yanhe 
Published: November 2022

Background: Recent time-lapse studies have investigated potential live birth prediction by pronuclei (PN) associated morphometric and morphokinetic measures. Whether there is gender associated difference in such measures is unknown. Aim: To determine if morphometric and morphokinetic profiles of PN vary between male and female zygotes. Method: This retrospective study included 94 consecutive autologous single day 5 transfers leading to a singleton live birth (43 males and 51 females) at Monash IVF Gold Coast between January 2019 and March 2020. Timing parameters included 2nd polar body extrusion (tPB2), sperm-originated PN (tSPNa) or oocyte-originated PN (tOPNa) appearance (differentiated by proximity to PB2) and PN fading (tPNF). Morphometrics were evaluated at 8 (stage 1), 4 (stage 2) and 0 hour before PNF (stage 3), measuring PN area (um2), PN juxtaposition, and nucleolar precursor bodies (NPB) arrangement. Results: Male zygotes had longer time intervals of tPB2_tSPNa than female (4.8±0.2 vs 4.2±0.1 h, p=0.044), but not tPB2_tOPNa and tPB2_tPNF. SPN increased in size from stage 1 through 2 to 3 (435.3±7.2, 506.7±8.0, and 556.3±8.9 um2, p=0.000) and OPN did similarly (399.0±6.1, 464.3±6.7, and 513.8±6.5 um2, p=0.000), with SPN being significantly larger than OPN at each stage (p[Formula: see text]0.05 respectively). However, their relative size difference (SPN-OPN) was similar between male and female zygotes at all 3 stages. More male than female zygotes reached central PN juxtaposition at stage 1 (76.7% vs 51.0%, p=0.010), stage 2 (97.7% vs 86.3%, p=0.048) and stage 3 (97.7% vs 86.3%, p=0.048). Furthermore, more OPN showed aligned NPBs than in SPN at stage 1 (44.7% vs 28.7%, p=0.023). No gender associated differences were detected in NPB alignment in either SPN or OPN (p[Formula: see text]0.05 for each comparison). Conclusion: Zygotes with different genders display different morphokinetic and morphometric features. Embryo selection using such parameters may lead to unbalanced sex ratio in the resulting offspring.
No, They’re Mine: Who Owns the Embryos?
Authors: PAGE Stephen 
Published: November 2022

Background: Disputes between couples who have stored embryos are becoming more and more common. Where has the law come to with who can own or use the embryos- and how can a dispute be resolved to make it clear to a clinic as to who can and cannot use the embryo? Aim: To set out for practitioners who owns the embryos, or at least the right to possess them- and practical ways to resolve disputes, so that it is clear who has the right to store, use, and discard, and who does not. Method: A paper would be prepared setting out the law, along with practical tips. Results: As above. Conclusion: Clarity will be provided to practitioners so that they are aware of issues that arise when separating couples have embryos in storage- and can act protectively of themselves and of the embryos.
My Vital Cycles™: An Ovulatory-Menstrual Health Literacy Program for the Whole Person
Authors: ROUX Felicity , BURNS Sharyn , HENDRIKS Jacqueline , CHIH Jun 
Published: November 2022

Background: A high prevalence of adolescent girls experience ovulatory-menstrual (OM) health difficulties such as painful periods, premenstrual symptoms, irregular cycles and abnormal bleeding patterns. These difficulties are associated with school absenteeism and reduced concentration in class. In addition, there is also an association with mental health challenges such as a negative body image, the onset of eating disorders and non-suicidal self-injury. A review of school-based resources suggests that this stigmatized subject is not only couched in biology, but it can be presented negatively. Aim: This research project aimed to develop and trial a school-based OM health literacy program that positively addresses the biopsychosocial aspects of the OM cycle. Method: A Delphi Panel was convened with experts in medicine, education, and public health. Together with a systematic literature review of OM health programs, they informed a draft program to teach adolescent girls and a draft questionnaire to test their OM health literacy. These drafts were reviewed by adolescent girls, parents, teachers and school healthcare professionals in focus groups and one-on-one interviews. The draft questionnaire was then test-retested to establish its validity. Results: The Delphi Panel validated the content of the draft program. Based on the principles of Positive Education, the program was mapped to the Western Australian curriculum, Nutbeam’s Health Literacy Model and the WHO’s Health Promoting School framework. The focus groups and one-one-one interviews face validated the program and questionnaire, and suggested additional refinements (e.g. website, animations, videos, and the name My Vital Cycles™). Conclusion: My Vital Cycles™ recognizes the OM cycle as a biopsychosocial phenomenon. It practically addresses common OM health difficulties with the aim of improving OM health literacy using Positive Education principles. The program has been registered for clinical trial.
Multinucleation in the Two-Cell Stage Embryo Matters
Authors: LAZZARO Leah , HEALEY Martin , OSIANLIS Tiki 
Published: November 2022

Background: Blastomere multinucleation (MN), defined as the presence of more than one nucleus per cell, in the cleavage-stage embryo, is a well-documented phenomenon 1 . This nuclear anomaly has become more visible with the introduction of time-lapse incubation and an understanding of the potential outcomes of these embryos is necessary to inform decision-making and manage patient expectations. Aim: To determine rates of blastocyst utilisation and euploidy for embryos with MN at the two-cell stage (MN2) in comparison to mononucleated and binucleated embryos. Method: A retrospective analysis was performed at a single IVF unit, of embryos with known two-cell nucleation status from October 2019 to March 2021. Blastomere nucleation was assessed, via time-lapse monitoring (EmbryoScope; UnisenseFertiliTech), and categorised as mononucleate, binucleate or MN in all fertilised oocytes. Blastocyst utilisation rates (number of embryos frozen+transferred/number of oocytes fertilised) were compared together with euploidy rates in embryos that had preimplantation genetic testing for aneuploidy. Outcomes were modelled using multilevel logistic regression to allow for lack of independence between embryos when grouped by patient and cycle, and adjusted for patient age. Results: Of the 4388 embryos included in this study, 68% were mononucleated, 14% binucleated and 18% MN. The likelihood of embryos becoming usable blastocysts based on nucleation status at the two-cell stage for mononucleated, binucleated and MN were 63%, 55%(p<0.001) and 35%(p<0.001) respectively. The euploidy rates for mono-, bi- and MN were 45%, 38%(p=0.09) and 31%(p=0.004) respectively. Predictive modeling, with adjusting for age, showed that a mononucleate two-cell embryo has 44% likelihood of becoming a euploid blastocyst, binucleate 36% and MN 28%. Conclusion: There was a clear reduction in rate of blastocyst utilisation and euploidy in binucleate and a further reduction in MN two-cell stage embryos, in comparison to mononucleate embryos, which should preferentially be prioritised for transfer.
Effects of COVID-19 Quarantine Period on Fertility Patients and IVF Clinic Management Worldwide
Authors: CUTTING Elizabeth , MOL Ben W. , VOLLENHOVEN Beverley , CATT Sally , HORTA Fabrizzio 
Published: November 2022

Background: The initial months of 2020 experienced a rapid spread of a new Coronavirus named SARS-2. The World Health Organisation declared a global pandemic on 11th March 2020. Due to the new strain of the virus, little was known regarding COVID-19 and its effects on fertility and pregnancy. Aim: To explore how fertility clinics and ART treatments proceeded post COVID-19 lockdowns and how this affected fertility patients. Method: We surveyed fertility clinics world-wide with an online questionnaire through the platform RedCap. The questionnaire contained 33 questions focusing on the differences of country responses to guidelines and regulations. Scientific directors, medical directors and lab managers were contacted via email with the questionnaire link. The questionnaire was approved by Monash Health Human Research Ethics Committee and focused on the initial COVID-19 lockdown. Results: There were 34 individual country responses, Asia (11), Europe (10), Africa (3), North America (3), Oceania (2) and South America (5). Of the 34 countries, 7 countries did not experience a complete cessation of all procedures. Most countries followed their government health recommendations and clinic policies. IVF/ICSI and frozen embryo transfer (FET) procedures proved to be the most delayed treatments. Sixteen countries reported to have an increase in freeze-all cycles compared to fresh transfers. Patients had to undergo a SARS-CoV-2 test in 50% of countries. Additional counselling for patients during the pandemic was implemented in 22 countries. Conclusion: During the COVID-19 pandemic most fertility services were suspended, allowing insight into the implications of a shutdown. In conclusion, a protocol for scenarios of this nature would benefit future events. A protocol including increased phycological support, continuation of care, including telehealth and guidelines for prioritizing couples who need treatment most urgently.
The Impact of Covid-19 Travel Restrictions on Gamete Shipping from Australian IVF Clinics
Authors: EVERINGHAM Sam , WHITTAKER Andrea 
Published: November 2022

Background: Cross-border surrogacy and egg donor arrangements are an increasingly common means to family building. Establishing patterns of use has always been difficult in relation to Australian patients. Accurate data is stymied by lack of documentation of international third-party reproductive care available to Australian authorities. Since Australia’s international travel ban came into effect, it is hypothesised that those planning to use cross-border reproductive care have had to rely significantly more on local IVF clinics for services such as sperm freezing, embryo creation and gamete release procedures. Establishing the increase in gamete shipping as a result of the ban on non-essential travel will improve understanding of the resource impact on Australian IVF laboratories. Such data can also assist policymakers assess the utility of state-based regulations relevant to CBRC. Aim: Quantify and characterise the impact of the Covid-19-related travel ban on Cross-Border Reproductive Care amongst patients of Australian IVF clinics. Method: All Australian IVF clinics were invited to provide de-identified data on interstate and international gamete export applications from two 12 month time periods pre and during Covid-19 related international travel lockdowns. Each dataset included: patient age; type of gametes exported; destination country or state; and date gamete release was approved. Results: Results showed a very significant increase in gamete shipping in the twelve months after Covid-19 travel restrictions were enforced. They illustrate the comparative prevalence of shipping to established and newer destinations during the periods March 2019–February 2020 and June 2020–May 2021. The volume of shipping to the commonest destinations is quantified. Conclusion: The inability of involuntarily infertile patients to travel internationally, rather than halt cross-border reproductive care, has led to a significant increase in update of gamete shipping. This is likely associated with increased utilization of Australian IVF clinics for embryo creation purposes. The high proportion of internationally-shipped gametes going to the US and Ukraine is likely a reflection of the availability of surrogates and donors and the legal frameworks.
Studies of Fertility Smartphone Apps Reveal a Lack of Insight and Scientific Information
Authors: FORD Emmalee , PETERS Alexandra , ROMAN Shaun , MCLAUGHLIN Eileen , BECKETT Emma , SUTHERLAND Jessie 
Published: November 2022

Background: Female reproductive health and fertility smartphone applications have grown rapidly into a 400 million dollar “femtech” industry. As such, there has been increased interest in their functions and benefits. Claims of app participation in research is a marketing tool for consumers, however there is little known about the current scope of reproductive health app research and specifically how it is performed and reported. Aim: This study aimed to determine the nature and extent of the peer-reviewed literature presented on fertility-based apps, to identify the reliability of the information within the apps, and to determine the ability of this information to educate users. Method: A systematic search of six databases was conducted in April 2020, returning a total of 21,158 records. After duplicate removal, title and abstract screening exclusionary steps, 27 records were reviewed and charted. Results: Fertility smartphone apps covered a variety of reproductive health themes including contraception, sexual health, and family planning, and used a range of research methodologies including prospective, retrospective and observational. A majority (63%) of the studies on apps specified ovulation windows as the sole information on fertility given to users. Around 52% of studies in the review based fertile window algorithms on stringent menstrual cycle length and variability requirements (typically 20-40 day length; <5 day variability). Furthermore, a third of studies in the scoping review contained authors that were affiliates or developers from an app company, and of these studies, 15% did not have co-authors independent to the app advisory board or employees. Conclusion: Female reproductive health apps have the potential to fulfil a range of reproductive health needs. However, they currently do so with severe limitations when it comes to the menstrual cycle variability, and they do not adequately succeed in multi-functional capabilities. Furthermore, the scope of information available in apps via the user interface is a major barrier to independent review for accuracy. Our findings support the recommendation for open source sharing of app contents. This would ensure developers are accountable to consumers, healthcare professionals and researchers. This study highlights lack of research evaluating the effectiveness of an app’s contents to translate to knowledge or behaviour change in participants.
Is Cleavage Stage Multinucleation Indicative of Lower Pregnancy Potential in Euploid Blastocysts?
Authors: KELLEY Rebecca L. , CATTRALL Fleur , STOCK-MYER Sharyn , LEE Lisa Y. S. , GARDNER David K. 
Published: November 2022

Background: Cleavage stage multinucleation is a morphological assessment IVF labs may use to rank embryos for transfer, as blastocysts that were multinucleated at the 2-cell or 4-cell stage have a lower live birth rate (LBR) compared to blastocysts that were mononucleated 1 . However, when these blastocysts are PGT-A tested, the euploidy rate is similar 2 , indicating that the poorer pregnancy outcomes may not be due to aneuploidy. It is unknown if multinucleation is indicative of a lower likelihood of pregnancy for euploid blastocysts. Aim: To determine if LBR following transfer of euploid blastocysts is lower when blastocysts were multinucleated at the 2-cell or 4-cell stages. Method: Retrospective study on 360 euploid blastocysts cultured in the EmbryoScope or EmbryoScope+ between March 2018 and October 2019, and individually transferred. Time-lapse images were retrospectively assessed for multinucleation at the 2-cell and 4-cell stage. A multinucleated embryo was defined as having [Formula: see text] 1 cell with [Formula: see text] 2 nuclei. Results: Blastocysts that were multinucleated at the 2-cell stage (n=139) had a similar LBR to mononucleated embryos (40.3% vs 41.6%). Multinucleation at the 4-cell stage (n=43) also did not significantly affect LBR (37.2% vs 43.6%). Multivariate logistic regression analysis found no significant effect of multinucleation on LBR. Biochemical pregnancy, clinical pregnancy (fetal heart), and miscarriage rates were also similar between multinucleated and mononucleated embryos. Conclusion: This study found no evidence that multinucleation at the 2-cell or 4-cell stage influences pregnancy rate in euploid blastocysts. As such, the assessment of cleavage stage multinucleation for PGT-A tested embryos may not be useful in ranking PGT-A tested embryos for transfer. Further work is required with larger numbers of embryos to confirm how the degree of multinucleation may influence LBR.
Improving Interpretation of Biopsies During Microsurgical Testicular Sperm Exploration in Azoospermic Patients: Use of Davidson’s Fluid
Authors: AARON GALEA Laurence , STURROCK Sue , APPU Sree , LANTSBERG Daniel , KATZ Darren 
Published: November 2022

Background: Histological interpretation of testicular biopsies in the investigation of infertility in men with azoospermia requires adequate tissue fixation to preserve the nuclear and cytoplasmic detail, as well as the architectural organisation of germ cells in different phases of maturation within seminiferous tubules. Research Aims/Objectives: The aim of the study was to assess the histomorphological quality of testicular biopsies using Davidson’s fluid (DF) as fixative and compare it to standard 10% neutral buffered Formalin. Methodology: Concurrent testicular biopsies from the same testis from patients undergoing microsurgical testicular sperm exploration (m-TESE) were separately fixed in DF and Formalin and processed for histological examination. Histological parameters including sloughing of cells, cytoplasmic shrinkage of seminiferous tubular cells, nuclear chromatin detail, cytoplasmic graininess and overall clarity of morphological detail were graded on a scale of 0 to 4 (0=none, 1=minimal, 2=slight, 3=moderate, 4=marked). The effect of DF on biopsy diagnoses was assessed by comparison with corresponding Formalin fixed biopsy diagnoses. Results/Findings: 87 testicular biopsies from 27 patients were examined. DF fixation resulted in significantly less luminal sloughing of cells (1.59±1.34 vs. 3.44±0.83, p = [Formula: see text] 0.00001), less cytoplasmic shrinkage of seminiferous tubular cells (1.58±1.11 vs. 3.11±1.07, p = [Formula: see text] 0.00001), better nuclear chromatin detail (3.06±0.91 vs. 1.92±0.48, p = [Formula: see text] 0.00001), less cytoplasmic graininess (2.11±0.96 vs. 2.86±0.87, p = 0.0014) and better overall clarity of morphological detail than Formalin fixation (3.14±0.69 vs. 2.14±0.58, p = [Formula: see text] 0.00001). The diagnostic concordance between DF fixed and Formalin fixed biopsies was 90.8%. Conclusions: This study supports the use DF as a superior alternative fixative to Formalin for histological assessment of testicular biopsies.