bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-336 Progesterone receptor is not downregulated in the endometrial epithelial compartment of women without embryo implantation during frozen thawed embryo transfer cycles
Authors: Palomino W , Rivas M.P , Godoy A , Villarroel C , Sequeira K , Salinas A , Savaris R 
Published: June 2022

Abstract

Study question
Is the mean endometrial progesterone receptor (PGR) expression in the endometrial epithelial compartment different between women with and without embryo implantation failure?

Summary answer
PGR expression is higher in epithelial endometrial compartment of women with embryo implantation failure, during mock hormonal endometrial preparation preceding frozen thawed embryo transfer cycles.

What is known already
PGR downregulation is critical for embryo implantation. Downregulation takes place during the window of implantation in the EEC, while, in stromal cells, it is highly expressed. Embryos are unable to attach to the maternal surface when PGR expression remains expressed in epithelial endometrial compartment (EEC). Limited information is available whether PGR is downregulated during hormonal endometrial preparation for frozen thawed embryo transfer cycles.

Study design, size, duration
In this cohort study, 47 endometrial biopsies were obtained between 2016-2017

Participants/materials, setting, methods
Infertile women (n = 47) submitted to frozen thawed embryo transfer (FET) cycles had an endometrial biopsy after 5 days of intravaginal progesterone supplementation during mock hormonal endometrial preparation (HEP) preceding FET and prospectively followed until confirmation of an intrauterine pregnancy. PGR immunostaining was performed using standard immunohistochemical technique (clone BSB2 - BS2126, BIO SB). PRG expression was quantified using the histologic score (HScore, range from 0 - 4). Ethical approval was obtained from local ethical committee.

Main results and the role of chance
Age, body mass index, endometrial thickness, and the number of embryos transferred were not significantly different between women who became or not pregnant. PGR Hscore (mean ± SD) in EEC was significantly lower in pregnant women (1.2 ± 0.8; n = 14 ) compared to women without pregnancy (2.8 ± 0.6; n = 33 ) Student t-test p &lt; 0.0001. The AUC was 0.90 ± 0.05 (95% CI: 0.7-1) p &lt; 0.0001 displaying 94.2 % sensitivity and 80.4% specificity for a 1.65 PGR cut-off value.

Limitations, reasons for caution
This is an observational study to determine if a difference in PGR expression was identified in these cases

Wider implications of the findings
The mean PGR expression is abnormally higher in EEC of women with embryo implantation failure using HEP for FET cycles. The 1.65 cut-off may be used in future studies to investigate whether high PGR expression is a risk factor for failure of blastocyst implantation in HEP for FET.

Trial registration number
not applicable
P-415 Study of the incidence of herpes viruses in the endometrium of women with evidence of chronic endometritis and reproductive problems
Authors: Blazheva S 
Published: June 2022

Abstract

Study question
What is the prevalence of herpes viruses in endometrial mucosa in women with chronic endometritis and without bacterial causative agents and reproductive problems.

Summary answer
In our study in 12.5% were found to be positive for herpes viruses in endometrial sample.

What is known already
Herpes viruses affect the genital tract and can lead to chronic inflammation of the genital system. They are represented by over 100 different species, 8 of which affect humans. After the initial infection, they usually enter a latent stage as integrated DNA or as an extrachromosomal form. There are various causes that lead to reactivation of herpes viruses in the genital tract, such as decreased immune reactivity, cyclic hormonal changes associated with the menstrual cycle, hypothermia or hyperthermia, infections, invasive gynecological interventions, disturbed psychoemotional status. This can lead to the development of persistent chronic infections in the endometrial lining.

Study design, size, duration
Prospective cohort study at a Medical Center Institute for Reproductive Medicine, Pleven, Bulgaria. Data collection took place between June 2020 to January 2022.

Participants/materials, setting, methods
Of all the patients who underwent the Medical Center “Institute of Reproductive Medicine”, we found that in 24 of them (mean age 35.56±3.86 years) there was no evidence of pathogenic microorganisms in the endometrial biopsy. The results of flow cytometric analysis showed a high percentage of CD138+ plasma cells. These were included for further investigation of herpesviruses by Multiplex Real-Time PCR. The endometrial biopsy study was performed mandatorily after negative microbiological result of vaginal swab.

Main results and the role of chance
The results of this study indicate that 12.5% of women with reproductive problems have herpes virus found in the endometrial mucosa. Demonstration of herpes viruses in endometrial biopsy in women with reproductive problems directs the assisted reproduction specialist to the possible cause of pregnancy loss and helps to prepare and adopt the right strategy for subsequent pregnancies. Endometrial biopsy testing may facilitate the choice of antibacterial or antiviral therapy, which helps to limit the antibiotic effect on the balance of microorganisms forming the genital microbiome.

Limitations, reasons for caution
The insufficient number of patients.

Wider implications of the findings
Developing a diagnostic and treatment plan for patients with evidence of chronic endometritis.

Trial registration number
1
P-435 Diagnosing ectopic pregnancy using the Bayes theorem, a classic that is good as new: a retrospective cohort study
Authors: Savaris R , Maissiat J , Mol B.W , Barnhart K.T , Link C.A 
Published: June 2022

Abstract

Study question
What is the accuracy of an algorithm using Bayes' theorem for diagnosing ectopic pregnancy (EP) having hCG, ultrasound, and clinical data in a real cohort?

Summary answer
The accuracy of the algorithm is 98.9% (95%CI=98.4% to 99.3%)

What is known already
The Bayes' theorem describes the probability of an event after the input of prior knowledge of conditions that might be related to the event. Ectopic pregnancy has been diagnosed using clinical aspects, transvaginal ultrasound (TVUS) and serial measurement of hCGs

Study design, size, duration
The Bayes' theorem describes the probability of an event after the input of prior knowledge of conditions that might be related to the event. Ectopic pregnancy has been diagnosed using clinical aspects, transvaginal ultrasound (TVUS) and serial measurement of hCGs.

Participants/materials, setting, methods
First-trimester patients who attended the Gynaecologic Emergency Unit were included. Clinical signs and symptoms, the presence of risk factors for ectopic pregnancy (EP), ultrsound findings and hCG levels were independent variables. Pre-test probability, based on clinical presentation and risk factors, likelihood ratio (LR) of variable were calculated, yielding a post-test probability (PTP). EP was the main outcome. EP was excluded with PTP &lt;1%, while a PTP ≥ 95% warranted a treatment.

Main results and the role of chance
The incidence of ectopic pregnancy was 8.5% (212/2495;95%CI=7.4% to 9.6%); 310 patients were excluded because they were submitted to surgery with decision thresholds &lt;95%. The algorithm was applied in 2185 patients. Just one case remained inconclusive after 3 consultations, and it was considered as an error in prediction. The sensitivity, specificity, and accuracy values (95%CI) of the algorithm were 98.9% (96.1% to 99.8%), 98.9% (98.3% to 99.2%), and 98.9% (98.3% to 99.2%), respectively.

Limitations, reasons for caution
These results were based on a single centre, and β-hCG were measured using the 4th International Standard in Cobas HCG+ β Elecsys 2010 Modular Analytics E170 machine

Wider implications of the findings
An online and customizable algorithm was developed to be used by different centers

Trial registration number
not applicable
P-515 An Exploration of Young Women’s Process of Adjustment in Spontaneous Premature Ovarian Insufficiency: A Grounded Theory Study
Authors: Banat S 
Published: June 2022

Abstract

Study question
How do young women process their condition?

Summary answer
Throughout the women's adolescence and early twenties, they continually reconceptualised their menopausal body, until they achieved a sense of being developmentally ‘fully grown’.

What is known already
Premature Ovarian Insufficiency (POI) is the decline of ovarian function before the age of 40 (Cooper et al., 2011) Prevalence rates of POI can reach 3-6% of women aged between 12 and 40 and for the majority of cases no known cause will be found. This is referred to as spontaneous or idiopathic POI and can be a life changing diagnosis with profound physical and psychological consequences (Webber., 2017). However, little is known about younger women's experiences of receiving a diagnosis, treatment and overall experiential nature of the condition by women of their age.

Study design, size, duration
Women that received a diagnosis between the ages of 12 to 20 years old (adolescence) were interviewed.

Participants/materials, setting, methods
Semi-structed interviews were conducted over Zoom, with twelve women that had experienced a diagnosis of POI/POF during their adolescence (now aged 21 to 35 years old). The interviews were transcribed and analysed following constructivist Grounded Theory methods.

Main results and the role of chance
The gradual awareness of physical developmental differences from their peers evoked a strong desire to recreate naturally occurring ‘womanly' milestones, such as the development of hips and breasts, menstruating, and future family planning. The young women described an all consuming compulsion to ‘keep up' with their peers following their diagnosis, during their teenage years and into their twenties, falling a sense of "falling behind". This required the young women to continually reconceptualize their menopausal body, how they perceived its purpose and its appearance, allowing them to eventually maturate their self-perception of their body. Viewing themselves as ‘fully grown' women and no longer developmentally different to other women.

Limitations, reasons for caution
The research findings are limited to the confines of qualitative research and therefore larger studies are suggested, moving forward.

Wider implications of the findings
The research suggests that psychological support aimed at supporting the menopausal transition at this early age would be greatly beneficial to young women that have received a diagnosis. This may protect against the later development of body dysmorphic presentations and depression related conditions.

Trial registration number
N/A
P-523 rs2277698 Single nucleotides polymorphisms in tissue inhibitors of metalloproteinases 2 (TIMP2) affected clinical outcomes of women undergoing in vitro fertilization
Authors: Lee C.I , Lee Y.J , Cheng E.H , Tsao H.M , Huang C.C , Lee T.H , Lin P.Y , Chen C.I , Yang S.F , Lee M.S 
Published: June 2022

Abstract

Study question
Is there any association between clinical outcomes of women undergoing in vitro fertilization (IVF) and the polymorphic variants of matrix metalloproteinases (MMPs) or tissue inhibitors of metalloproteinases (TIMPs)?

Summary answer
Our findings suggested that clinical outcomes of women undergoing IVF were associated with rs2277698 SNPs in TIMP2.

What is known already
The extracellular matrix proteolytic machinery is one of the most important mechanisms for regulating trophoblast invasion. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), which are involved in the extracellular matrix proteolysis process, have the ability to regulate the degradation of the extracellular matrix and play a critical role in trophoblast invasion.

Study design, size, duration
A prospective study was composed of 1014 women undergoing their first fresh IVF cycle with non-donor from January 2014 to December 2015.

Participants/materials, setting, methods
The present study was carried out in Lee Women’s Hospital, Taiwan. DNA was extracted from the peripheral blood of all participants, and the SNPs were genotyped by real-time polymerase chain reaction. The effects of the following three single nucleotide polymorphisms (SNPs) on IVF outcomes were explored: TIMP1 (rs4898 C/T), TIMP2 (rs2277698 C/T) and MMP2 (rs243865 C/T). The SNP genotype, correlation with clinical pregnancy, embryo implantation, abortion and live birth rates of IVF were analyzed.

Main results and the role of chance
In the analysis of 1014 patients attempting their first cycle of IVF, the genotypes frequencies of the study population showed a statistically significant association between TIMP2 (rs2277698 C/T) and clinical outcome. For TIMP2 polymorphisms, women with wild genotype (CC) hadhigher clinical pregnancy rate (34.8% v.s 28.0%; p = 0.032), embryo implantation rate (19.4% v.s 15.4%; p = 0.009), live birth rate (29.8% v.s 22.1%; p = 0.006), and lower abortion rate (7.0% v.s 17.1%; p = 0.005) compared women with CT/TT genotype. On the other hand, the clinical outcomes in different TIMP1 or MMP2 gene polymorphisms groups were no statistically significant difference.

Limitations, reasons for caution
The size number of the study samples.

Wider implications of the findings
This study showed that the TIMP2 SNP polymorphisms CT/TT was associated with low trend of clinical outcomes. The mechanism of TIMP2 gene T allele affected the outcomes of IVF remains to be determined. Further studies should focus on the mechanism of these associations in a larger, more heterogeneous cohort.

Trial registration number
CS13194
P-560 Diagnostic value of whole exome sequencing (WES) in case of recurrent pregnancy losses
Authors: Avdeichik S 
Published: June 2022

Abstract

Study question
Is it justified during genetic counseling to inform families with recurrent pregnancy losses about the possibility of testing abortion material using the WES method?

Summary answer
Informed families have the opportunity to find the monogenic cause of recurrent pregnancy losses with subsequent PGT-M analysis of embryos to prevent it.

What is known already
Despite WES is not recommended for recurrent pregnancy losses as a routine procedure, there are more and more data in favor of the practice.

Study design, size, duration
This is a retrospective study from 2019 to 2021 including 21 cases that were negative in case of routine karyotyping or aCGH. Three of them (14,3%) were found the cause of diseases by using WES. The study is ongoing.

Participants/materials, setting, methods
Whole exome sequencing of abortion material, chorionic villi specimens.

Main results and the role of chance
Family 1 has a history of euploid fetuses losses during the pregnancy. An autosomal recessive disease, Smith-Lemli-Opitz syndrome type II with early lethality (MIM 270400) was revealed by WES Trio at the 6th pregnancy loss case (mutations detected: c.964-1G&gt;C and c.651C&gt;A in DHCR7 gene in compound heterozygote state). The parents are Ashkenazi Jews and heterozygous carriers of a mutation in the same gene. The risk of pregnancy loss or stillbirth is 25%, and pregnancy planning by IVF with PGT-M is recommended.
Family 2 has recurrent pregnancy losses, happening up to 11 weeks. A child was born with cardioencephalomyopathy, fatal infantile, due to cytochrome C oxidase deficiency 1 (MIM 604377). Mutation: c.418G&gt;A in SCO2 gene in a homozygous state. The mutation was previously described as the cause of missed abortion.
For family 3 was performed WES of abortus with congenital pathology. Mutation c.8263delC in Ciliary dyskinesia, primary, 40 (MIM 618300) gene DNAH9 in homo/heterozygous state. The mutation can result in malformations and stops in pregnancy development. The family is suggested to perform IVF with PGT-M.

Limitations, reasons for caution
The low detection frequency of monogenic causes of pregnancy losses and the high cost of the testing does not allow the use of WES of abortion material as a screening method.

Wider implications of the findings
Performing the WES helps to identify the high risks of monogenic pathology in the families. Changing reproductive tactics and pregnancy planning by IVF with PGT-M is recommended for early prevention of severe congenital pathology, stillbirth, malformations during pregnancy, recurrent pregnancy losses and reduction of the time to achieve healthy childbearing.

Trial registration number
not applicable
P-625 In vitro maturation of oocytes: a breakthrough for treating infertility in inactivating mutation of the luteinizing hormone/choriogonadotropin receptor
Authors: Labrosse J , Sifer C , Cedrin I , Peigne M , Grynberg M 
Published: June 2022

Abstract

Study question
How can pregnancy and live birth be achieved in patients with inactivating homozygous luteinizing hormone/choriogonadotropin receptor (LHCGR) mutation?

Summary answer
We report the first live birth after in vitro maturation (IVM) in a patient with a novel homozygous inactivating LHCGR mutation (exon 6, c.470 A&gt;G).

What is known already
LH plays a fundamental role in female reproductive physiology and is responsible for steroidogenesis, oocyte maturation, ovulation and subsequent progesterone production by the corpus luteum. LH binds to the LHCGR located on the membrane of theca cells and mature granulosa cells. Inactivating mutations of the LHCGR lead to the impossibility to obtain final oocyte maturation both during natural cycles and after ovarian stimulation for in vitro fertilization purposes. Therefore, egg donation represents the only option for treating their infertility.

Study design, size, duration
A case report.

Participants/materials, setting, methods
A 35 year-old nulliparous patient referred to our university hospital for primary infertility.

Main results and the role of chance
The 35-year-old nulliparous patient presented with primary spaniomenorrhea but timely and spontaneous onset of secondary sexual characteristics. Serum LH levels were high (ranging from 15 to 30 IU/L) and to a lesser extent so were FSH levels. The ovarian reserve was normal for age, as assessed by serum AMH levels and ultrasound. There was no argument for polycystic ovarian syndrome, 21-hydroxylase deficiency, Cushing’s syndrome or hyperprolactinemia. Two previous attempts of controlled ovarian stimulation with gonadotropins and ovulation trigger with hCG and GnRH-agonist trigger had failed, resulting in low estradiol levels despite correct follicular growth on ultrasound and absence of ovulation after trigger. However, genetic analysis identified a novel homozygous inactivating LHCGR mutation (exon 6, c.470A&gt;G) which had never been described previously. IVM was performed. A total of 7 oocytes were obtained after IVM, resulting in 4 Day 3 embryos. All embryos were frozen. Subsequently, 2 Day 3 embryos were replaced after endometrial preparation by hormone replacement therapy. The patient became pregnant and gave birth to a healthy baby. Two Day 3 embryos remain.

Limitations, reasons for caution
By definition, a case-report requires further studies to confirm our findings.

Wider implications of the findings
We describe a novel inactivating LHCGR mutation with subsequent live birth after IVM. As a growing number of gonadotropin receptor mutations are identified, this successfully achieved live birth places IVM as the only reliable option for these patients to conceive with their own eggs.

Trial registration number
Not applicable.
P-632 Evaluation of low AMH levels in young women
Authors: Martin B 
Published: June 2022

Abstract

Study question
The primary objective was to evaluate impact of a low AMH level on the live birth rate in a population of young women IVF/ICSI .

Summary answer
Low AMH level in young women in FIV/ICSI is not expected to have an impact on the live birth.

What is known already
AMH is an important criterion for defining ovarian reserve. The majority of studies have shown that the AMH level in the general population is not correlated with the chances of spontaneous pregnancy.
The management remains a challenge and must be individualized taking into account the new quantitative and qualitative criteria to be defined (POSEIDON classification). Finally, we know that the pregnancy rate is correlated to the rate of euploid embryos, and that the rate is higher before 35 years of age.

Study design, size, duration
In this single-center retrospective study from January 2015 to December 2020, 1824 IVF/ICSI attempts were analyzed.
We analyzed the live birth rate according to 2 categories of young women matched by AMH level.

Participants/materials, setting, methods
We analyzed the live birth rate according to 2 categories of young women managed in IVF/ICSI protocol.
A first group was ≤30 years old and a second group was between 31 and 35 years old.
Then, we matched each of these groups to an AMH level, AMH&lt;1ng/mL and AMH ≥1ng/mL.
We analyzed the live birth rate of 4 groups of young women.

Main results and the role of chance
1824 IVF/ICSI attempts were analyzed in this study. We have 539 women under 30 years of age and 1285 women between 31 and 35 years of age.
For women aged ≤30 years, the group with AMH&lt;1ng/mL had a non-statistically significant live birth rate compared to those with AMH≥1ng/mL (31% vs 32.7% p = 1).
For women aged 31-35 years, the group with AMH&lt;1ng/mL, has a statistically significant lower live birth rate compared to those with AMH≥1ng/mL (14.5% vs 29.3% p = 0.001).

Limitations, reasons for caution
The main limitation of our study is the few number of patients.

Wider implications of the findings
This study tries to demonstrate that low AMH levels in young women do not predict a poor IVF/ICSI success rate. Conclusions should not be drawn too quickly for low AMH in this population. However, the threshold AMH level is still debated in the studies and should be further adjusted.

Trial registration number
not applicable