Human reproduction最新文献

{"title":"O-073 The DNA damage-sensing cGAS-STING pathway is critical in specific Telomere Variant Sequence synthesis in men with nonobstructive azoospermia and individuals with Differences of Sex Development","authors":"M Krivega, J Zimmer, A Slezko, J Kirscht, P Frank-Herrmann, M Bettendorf, T Strowitzki","doi":"10.1093/humrep/deaf097.073","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.073","url":null,"abstract":"Study question We aimed to investigate the common molecular mechanisms linking high DNA damage levels and impaired telomere maintenance in human infertility. Summary answer We identified a general molecular mechanism driving genome instability through altered Telomere Variant Sequence, imbalance in telomerase complex components, Androgen Receptor dysfunction, and disrupted autophagy. What is known already We previously reported increased DNA damage in the blood and gonads of men with nonobstructive azoospermia (NOA) and individual with Differences of Sex Development (DSD), which were unexpectedly associated with increased telomere length (TL). Additionally, autophagy inhibition led to TL elongation and DNA damage rescue in blood leukocytes and lymphoblastoid cell lines, linking this process to the regulatory network of the Androgen Receptor (AR) and the cytoplasmic DNA-sensing cGAS-STING signaling. Recent studies have identified Telomere Variant Sequences (TVS) that disrupt telomerase assembly and telomere maintenance, highlighting the need for investigation into their role in genome instability and infertility-related pathological phenotypes. Study design, size, duration We analyzed TVS presence in blood leukocytes of infertile individuals (n = 36). We applied GAR1-siRNA in the presence of inhibitors of AR- Enzalutamide (ENZ) and autophagy-Bafilomycin A1 (BafA1) to estimate dependance of TVS from telomerase complex protein GAR1 in DSD derived lymphoblastoid cell lines (n = 4). Third, we treated blood from DSD (n = 6) with drugs rescuing DNA damage and activating (G10) and inhibiting STING (H151) to establish interaction between cGAS-STING regulation of telomerase GAR1 and TVS synthesis. Participants/materials, setting, methods Cell lines and blood leukocytes of NOA study groups (abnormal/normal embryo development after ICSI; Spermatogonia Arrest (SGA), Sertoli Cells Only (SCO) syndrome), and DSD study groups (Swyer, Complete Androgen Insensitivity Syndromes (CAIS), Germ Cell Tumors (DSD-GCT) were analyzed with PCR for normal Telomere Sequence (TS: TTAGGG) and TVS (TVS1: TGAGGG; TVS2: GTAGGG; TVS3: TTGGGG; TVS4: TTTGGG; TVS5: TTCGGG), TL with quantitative real-time PCR. Proteins were analyzed with immunoblotting. Unpaired t test was applied for statistics. Main results and the role of chance This study demonstrates that infertile Individuals experiencing genotoxic stress, such as men with NOA and individuals with DSD, exhibit Telomere Variant Sequences (TVS) in elongated telomeres. This was linked to an increased presence of the telomerase complex protein GAR1 (Swyer: p = 0,0022; Turner, p = 0,0401; abnormal ICSI group, p = 0,0270, SGA, p = 0,0176). Despite phenotypic variability, the consistent presence of TVS3 in the blood of all infertile study groups, but its absence in controls, was notable. We observed that inhibiting both autophagy and AR signaling was associated with GAR1 upregulation in DSD cell lines (ENZ (100 nM)/BafA1 (100 mM), p = 0,","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"46 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O-148 Miscarriage prevalence and factors: a multi-source approach in France","authors":"M C Compans, H Väisänen, H Malmanche","doi":"10.1093/humrep/deaf097.148","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.148","url":null,"abstract":"Study question How do medical records, survey data and qualitative interviews provide complementary insights into the epidemiology of miscarriage in France? Summary answer A comprehensive understanding of miscarriage prevalence and its socioeconomic risk factors needs triangulation of data from various sources. What is known already Miscarriage prevalence and its risk factors have mainly been estimated with Nordic health (often hospital) records, showing a decline in medically managed miscarriages and suggesting the woman’s age and previous miscarriages as the main risk factors. Population-based surveys can capture miscarriages that did not lead to hospital management and allow the investigation of more factors than medical records. However, miscarriages are also deemed misreported in such data, with little knowledge of the extent, patterns and reasons. Qualitative approaches can help understand miscarriage experiences, what is reported as a miscarriage in a survey and the reasons for disclosing it or not. Study design, size, duration This study compares multiple data sources. The primary one is the French National Health Data System, which contains exhaustive medical records for 13,632,246 pregnancies, including inpatient (2009-23) and outpatient care (2013-23). This is compared to the FECOND survey (2010-11), a nationally representative sample of women of reproductive age in France (N = 7,196 pregnancies). We will also conduct around 50 in-depth interviews about miscarriage experiences, to better understand potential misreporting of miscarriages in the quantitative data sources. Participants/materials, setting, methods 1) Regression analyses estimating miscarriage risk by year and women’s characteristics in medical records (age at the start of the pregnancy, social security insurance indicating financial precarity, use of assisted reproduction, prior miscarriages). 2) Event-history analyses estimating miscarriage risk in the FECOND survey using similar information and women’s education, socioeconomic position and partnership stability at the start of the pregnancy. 3) Thematic analysis of qualitative interviews pertaining to reasons for misreporting miscarriages in surveys. Main results and the role of chance Our multi-source approach reveals significant discrepancies in miscarriage prevalence across data sources. Medical records show a decline in hospital-managed miscarriages from 6.9% to 5.1% of all clinically recognized pregnancies between 2009 and 2023. Including primary care data, these rates range from 9.9% in 2013 to 8.9% in 2023. This is below the 14% miscarriage rate estimated with self-reported pregnancy outcomes in the FECOND survey, and contrasts with the increasing reporting across women’s birth cohorts (HR = 1.419, p < 0.001 for those born in 1980–85 vs. 1961–69). Both data sources confirm established risk factors: maternal age and prior miscarriages. Interestingly, neither source shows significant socioeconomic disparities","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"51 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O-234 Monitor all parameters","authors":"A Racca","doi":"10.1093/humrep/deaf097.234","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.234","url":null,"abstract":"Ovarian stimulation in assisted reproductive technology (ART) is performed with the goal of obtaining multiple follicles and oocytes. To achieve this, FSH (follicle-stimulating hormone) is administered through various types of medications. The stimulation dose is typically determined based on the woman’s ovarian reserve parameters, age, and the specific objectives of the treatment. Normally, during ovarian stimulation (OS), monitoring is carried out to assess the response to the treatment, determine if adjustments to the dose, medication, or treatment plan are necessary, and decide the optimal time for oocyte retrieval. Monitoring is typically performed using ultrasound and/or serum hormone levels. Recent advancements, including GnRH agonist triggering, vitrification, freeze-all for genetic testing, progestin-primed ovarian stimulation (PPOS), random start and luteal phase stimulation are transforming COS protocols and opening new avenues and possibilities. Therefore, whether multiple ultrasound and hormonal assessment are necessary for all patients is a matter of debate, especially considering that nowadays most cycles result in a freeze-all approach (FA). It must be acknowledged that one of the most common questions among nearly all patients who choose to undergo an IVF journey is how much time ovarian stimulation will require. Given that monitoring often requires patients/donors to travel, which may involve taking time off work, the best possible solution would likely be to schedule all monitoring sessions in advance, minimize these visits as much as possible and allow the monitoring to take place at their home. At this point, it is important to ask ourselves whether, given the recent shift in approach toward FA, it still makes sense to apply the same strategy to all patients, or if we can consider personalizing the monitoring. This could involve monitoring all parameters only in patients who will undergo a fresh transfer or those who have had previous cycles with results below expectations. Additionally, a review of the current state of the art regarding the possibility of measuring hormones and performing ultrasounds at home should be conducted.","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"143 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-138 Effects of caffeine supplementation prior to fertilization on oocyte quality and euploidy rates in aged women","authors":"S Kim, H Jang, M Moon, J Beak, S Lee, J Eum, S J Kim, H Jeon, Y Ko, J Ha, S Y Han","doi":"10.1093/humrep/deaf097.447","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.447","url":null,"abstract":"Study question Could caffeine supplementation before fertilization improve the clinical outcomes in women over 40? Summary answer Caffeine supplementation significantly improved the rates of oocytes with normal spindle location, top-quality blastocyst and euploidy in women over 40. What is known already In aged oocytes, caffeine could inhibit Myt1/Wee1 activity, leading to a reversible switch from inactive to active MPF. Consequently, caffeine increases MPF activity which inhibits oocyte aging. Subsequently, many studies have reported that caffeine treatment can inhibit oocyte aging in several species. However, the effect of caffeine on human oocytes has not been studied. We investigated the effect of caffeine supplementation prior to fertilization on clinical outcomes in aged human oocytes. Study design, size, duration The retrospective data collected from June 2022 to December 2024 on 10474 oocytes from 783 patients were analyzed. To eliminate the influence of genetic background factors, the same patients were divided into a group of previous cycles without caffeine (previous group; 5313 oocytes) and a group of cycles with caffeine (caffeine group; 5161 oocytes). Participants/materials, setting, methods The inclusion criteria were the patients aged over 40 years, with a history of previous IVF. The caffeine group had 1.25mM caffeine added to fertilization medium for 4 hours following ovum pick up. Oocytes were washed and transferred to a new fertilization medium. Subsequently, mature oocytes were fertilized by ICSI and cultured. Spindles were imaged using the Polscope and biopsy was conducted on blastocyst stage embryos (PGT-A). Main results and the role of chance A total of 783 patients were divided into caffeine group and previous group, and the two groups were similar in age (41.8 vs 41.3, p = 0.2780) and number of previous IVF procedures (6.1 vs 6.0, p > 0.05, p = 0.4788). In 205 out of 783 patients, the meiotic spindle was visualised and examined using the Polscope prior to ICSI in both groups. The normal localization of spindle (under 30 degrees angle) in oocytes was significantly higher in caffeine group compared to previous group (79.2% vs. 58.6%, p < 0.0001). Also, the incidence of spindles with an angle over 30 degrees and the absence of visible spindle was significantly lower in caffeine group (20.8% vs. 41.4%, p < 0.0001). The caffeine group had significantly higher incidence of fertilization, top-quality cleavage rate on day 3 and blastocyst utilization rate than previous group (77.5% vs. 71.8%, 64.0% vs. 57.7%, 39.5% vs. 32.8%, p < 0.0001). In particular, the rate of top-quality blastocysts was 10.2% higher in caffeine group than in previous group (40.4% vs. 30.2%, p < 0.0001). The rate of euploidy was significantly higher in caffeine group than in previous group (23.5% vs. 15.6%, p = 0.02) and the rate of mosaicism was significantly lower in caffeine group than in previous group (18.6% vs. 29.4%","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"103 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-774 Interim analysis: Association Between Early Pregnancy Progesterone Levels and Intrauterine Growth Restriction in In Vitro Fertilization Pregnancies","authors":"R Kaiyal","doi":"10.1093/humrep/deaf097.1078","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.1078","url":null,"abstract":"Study question Does early pregnancy progesterone level influence the risk of intrauterine growth restriction (IUGR) in pregnancies conceived through in vitro fertilization (IVF)? Summary answer Interim results showed inverse correlation between higher early pregnancy progesterone levels and lower birthweight, potentially indicating an effect on placental development and fetal growth restriction. What is known already IVF increases the risk of IUGR, likely due to epigenetic changes, but the role of supraphysiologic progesterone remains unclear. A supraphysiologic progestin exposure in HRT could initiate excessively deep placentation, potentially influencing birth weight and obstetric outcomes. Previous studies have linked artificial cycle FET to higher rates of obstetric complications, including hypertensive disorders, placenta accreta, post-term birth, and macrosomia, compared to natural cycle FET. These studies suggest that adverse outcomes may be related to the absence of endogenous progesterone from a functional corpus luteum. However, no study has directly examined whether high early supraphysiologic progesterone levels contribute to IUGR. Study design, size, duration This is an interim analysis of a retrospective cohort study, evaluating 580 IVF pregnancies at a tertiary medical centre. luteal phase support was achieved by intravaginal micronized progesterone. Progesterone levels were measured at 4–5 weeks of gestation, with neonatal birthweight percentiles used to assess the risk of IUGR. The final analysis will include a larger cohort, with ongoing data collection. Participants/materials, setting, methods Singleton IVF pregnancies with available serum progesterone measurements (two time points) 14 days after embryo transfer were included. Birthweight percentiles were analyzed to classify IUGR cases (<10th percentile vs. ≥10th percentile). Statistical methods included: Spearman’s rho test for correlation Mann-Whitney U tests for between-group comparisons ROC analysis to determine potential progesterone cutoffs predicting IUGR risk Main results and the role of chance A moderate but statistically significant inverse correlation was found between first progesterone measurement and birthweight percentile (R.s = -0.407, p = 0.016). A similar trend was observed for second progesterone measurement and birthweight percentile (R.s = -0.487, p = 0.032). Median first progesterone levels were significantly higher in the IUGR group (<10th percentile) compared to the non-IUGR group (p = 0.038, one-sided). Second progesterone measurements showed a non-significant trend (p = 0.057). ROC analysis identified a progesterone cutoff of 48.75 pmol/L for predicting IUGR, with an AUC of 0.603 for the first progesterone measurement and 0.610 for the second progesterone. Limitations, reasons for caution The study is retrospective, and potential confounders (e.g., maternal BMI, embryo quality, placental function) may impact fetal growth. Wider implicati","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"18 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O-038 Early fragile X screening for fertility preservation: a cost-effective strategy to enhance reproductive outcomes","authors":"M Rosenberg Friedman, Y Cohen, B M B Tali, M Mira, A Foad","doi":"10.1093/humrep/deaf097.038","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.038","url":null,"abstract":"Study question Is early screening (age 18) for Fragile X mutations more cost-effective than later screening (age 30) when considering fertility preservation outcomes? Summary answer Early screening at age 18 proves cost-effective at 9,330 Euro per quality-adjusted life year, primarily due to better fertility preservation success compared to delayed screening. What is known already Fragile X premutation carriers may experience reduced fertility, facing an increased risk of primary ovarian insufficiency (up to 15%). Although the ideal timing for screening is uncertain, early detection could facilitate proactive fertility preservation. While techniques for fertility preservation exist, the cost-effectiveness of early screening and intervention has not yet been established. Study design, size, duration A Markov decision model was developed to evaluate the cost-effectiveness of early screening (age 18) versus later screening (age 30) for Fragile X mutations. The model simulates a cohort over a 50-year period using annual cycles and applies a 3% discount rate to costs and health outcomes. Key inputs include the prevalence of Fragile X premutation carriers, fertility preservation costs, probabilities of achieving biological children, and quality-of-life utilities associated with having versus not having children Participants/materials, setting, methods The model incorporated key parameters including Fragile X premutation carriers' prevalence (1 in 110), probability of having biological children with late screening (84%) versus early screening (100%), fertility preservation costs (10,800 Euro), and utilities for having (1.0) versus not having (0.7) biological children. One-way sensitivity analyses were performed on key parameters. Fertility preservation costs are based on Israeli pricing, converted into euros Main results and the role of chance Early screening at age 18 was associated with an incremental cost of 98 Euro and an incremental effectiveness of 0.01053 per quality-adjusted life year (QALY) compared to no screening, resulting in an incremental cost-effectiveness ratio (ICER) of 9,330 Euro per QALY gained. This ratio means that for each additional year of healthy life gained, about 9,330 Euro is spent. In simpler terms, the ICER of 9,330 Euro per QALY shows how much extra cost is required to secure one extra year of good-quality life through early screening. Since interventions are generally considered cost-effective if the cost per additional QALY is below a certain threshold (often around 20,000 Euro or more), an ICER of 9,330 Euro per QALY indicates that early screening is a cost-effective strategy. Sensitivity analyses demonstrated that the model’s results were most influenced by the utility value assigned to not having biological children, the probability of having children with late screening, and the time horizon. Early screening remained cost-effective across a wide range of parameter values, and wide range of fertility preservation cycl","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"36 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O-285 Reproductive hormones at 7-10 years of age in children born after assisted reproductive technology","authors":"M L Vestager, A S Lebech Kjær, L Laub Asserhøj, I Mizrak, T Holm Johannsen, H Frederiksen, A Juul, T Dalsgaard Clausen, E Hoffmann, G Greisen, K M Main, P Lav Madsen, A Pinborg, R Beck Jensen","doi":"10.1093/humrep/deaf097.285","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.285","url":null,"abstract":"Study question Do reproductive hormones and pubertal development differ at 7-10 years of age in children conceived after frozen embryo transfer, fresh embryo transfer or natural conception? Summary answer Pubertal development, reproductive hormones, and the prevalence of precocious puberty was not altered in the children conceived after ART. What is known already The global rise in the use of assisted reproductive technology (ART) reflects the declining fertility rates. Investigation of the long-term health of children born after ART is therefore important. A former registry-based study found a higher risk for early puberty in girls and late puberty in boys conceived after ART. Study design, size, duration The Health in Childhood following Assisted Reproductive Technology (HiCART) cohort included children conceived after ART with frozen embryo transfer (FET) n = 200, fresh embryo transfer (Fresh-ET) n = 203 and natural conception (NC) n = 203. The study was conducted from January 2019 to September 2021. Participants/materials, setting, methods Pubertal development and serum concentrations of reproductive hormones were evaluated in 606 singletons (292 boys) aged 7-10 years from the HiCART cohort. Concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and sex hormone-binding globulin (SHBG) were measured by immunoassays, and concentrations of estradiol (E2), testosterone (T), dehydroepiandrosterone sulfate (DHEAS), androstenedione and 17-hydroxyprogesterone (17-OHP) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Main results and the role of chance Among girls, clinical signs of puberty (Tanner ≥ B2) were found in 14% (16/107) in the FET-group, in 16% (15/98) in the fresh-ET-group and in 23% (23/98) in the NC-group, with no difference between the three groups (Chi-square p = 0.35). Clinical signs of puberty below the age of 8 (precocious puberty) years were found in 6/314 girls (median age 7.79 [range 7.46-7.87]), of whom three were in the FET-group and three in the NC-group. The concentration of LH was below 0.3 IU/L in all six girls, while four out of six girls had measurable estradiol. Among boys, clinical signs of puberty (testicular volume >3 ml) were absent in boys in the FET-group (0/86), while present in 2% (2/99) in the fresh-ET group and in 1% (1/101) in the NC-group. No significant difference was found in concentrations of hormones (LH, FSH, SHBG, E2, T, DHEAS, Androstenedione and 17-OHP) when comparing respectively girls and boys born after FET, Fresh-ET and NC, neither in the entire cohort nor after excluding pubertal children. Limitations, reasons for caution A slight risk of selection bias remains due to the lack of information on the cause of infertility. In addition, since the birth of the included children, today vitrification is the preferred freezing method in contrast to slow-freezing, which constitutes the most frequent method in our study. Wider implications of the f","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"316 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-118 The critical novel quality control parameter for successful oocyte vitrification: Maintaining solution temperature","authors":"M Serdarogullari, Z Atayurt, G Raad, H Karakaya, Y Yilancilar, O Ammar, Z Yarkiner, B Yuksel, M Meseguer, G Liperis","doi":"10.1093/humrep/deaf097.427","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.427","url":null,"abstract":"Study question Does the working solution temperature of vitrification solutions affect oocyte survival and subsequent embryo development to the blastocyst stage? Summary answer Maintaining a working vitrification solution temperature rather than relying on ambient conditions, significantly improves oocyte vitrification efficiency and pre-implantation embryo development parameters. What is known already Vitrification is a widely used method for oocyte cryopreservation, requiring a precise balance of cryoprotectant concentration, temperature, and exposure time. Temperature control is critical, as the meiotic spindle in oocytes is highly sensitive to suboptimal conditions. Vitrification working solution temperature can be affected by multiple parameters such as dish type and volume, prolonged exposure, and airflow all contributing to heat loss. While room temperature is commonly emphasised during vitrification, the impact of the vitrification solution temperature on oocyte survival and embryo development remains underexplored. Study design, size, duration The study included donor oocyte cycles at single private IVF Center, Cyprus (March–December 2024). A total of 157 mature metaphase II (MII) oocytes donated for research were divided into two experimental groups based on temperature conditions consisting of the warm temperature group (n = 70) and the cold temperature group (n = 87). The following outcomes were analysed: oocyte survival and preimplantation embryo development parameters. Statistical analysis included Z-test and t-test for proportion and means comparisons respectively. Participants/materials, setting, methods The study was conducted in a controlled laboratory environment. Cold temperature conditions were maintained with an average room temperature of 22.85±0.84 °C and vitrification solution temperatures at 19.65±0.84 °C. Warm temperature conditions were maintained at an average room temperature of 24.56±0.89 °C, with vitrification solution temperatures at 24 °C. Solution and Room temperatures were recorded using the UNI-T UT322 thermometer, validated with an NIST-traceable mercury-calibrated thermometer. Main results and the role of chance The donor characteristics, including age, BMI, stimulation protocols, and retrieved oocytes, showed no significant differences between groups (p > 0.05). Oocyte survival was significantly higher in the warm group (70/70,100%, 95% CI [1, 1]) compared to the cold group (80/87 (92%), 95% CI [0.8624, 0.9767]; p = 0.0155). Fertilisation rates were comparable between groups (cold:70/80,87.5%, 95% CI [0.8025, 0.9475]; warm: 59/70,84.3%,95% CI [0.7576, 0.9281]; p = 0.575).The cold group showed significantly higher developmental arrest rates at multiple stages: pronuclear (10/70,14.3%, 95% CI [0.0609, 0.2248] vs 0/59,0%, 95% CI [0, 0]; p = 0.0025), zygote (20/70,28.6%, 95% CI [0.1799, 0.3915] vs 0/59,0%, 95% CI [0, 0]; p < 0.001),and cleavage (35/70,50%, 95% CI [0.3829, 0.6171] vs 0/59,0%, 95% C","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"70 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-275 Physiological Intracytoplasmic Sperm Injection (PICSI) fails to improve ongoing pregnancy rates: a matched case-control study in advanced maternal age patients","authors":"I De Croo, S De Gheselle, F Vanden Meerschaut, L Dhaenens, C De Roo, A S Rottiers, F Vandierendonck, B Heindryckx, K Tilleman, D Stoop","doi":"10.1093/humrep/deaf097.583","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.583","url":null,"abstract":"Study question Does physiological intracytoplasmic sperm injection (PICSI) using hyaluronic acid binding prior to ICSI improve ongoing pregnancy rate in advanced maternal age patients? Summary answer No differences in ongoing pregnancy rates or miscarriage rates were observed between ICSI and PICSI cycles in patients of advanced maternal age. What is known already Sperm genomic integrity plays a crucial role in the outcomes of intracytoplasmic sperm injection (ICSI), particularly during the post-implantation stage. However, selecting spermatozoa based solely on motility and morphology does not ensure genomic integrity. Hyaluronic acid (HA), a biologically active molecule and a key component of the extracellular matrix surrounding the oocyte-cumulus complex, has been explored as a selection tool for sperm. Recent randomized controlled trials (RCT) investigating the efficacy of HA-based sperm selection prior to ICSI, have demonstrated a reduction in miscarriages after PICSI compared to conventional ICSI (Miller et al., 2019, West R. et al, 2022). Study design, size, duration A retrospective, matched case-control study was conducted between January 2020 and November 2024. A total of 288 cycles were included, 144 PICSI cycles were matched with 144 ICSI cycles. The PICSI group was matched with the ICSI group according to female age, cycle rank, number of injected oocytes and number of previous pregnancies with a 1:1 ratio. Participants/materials, setting, methods The primary outcome was ongoing pregnancy rate after the first transfer, either fresh or frozen-thawed (70 and 35 for ICSI, 66 and 38 for PICSI, respectively). Ongoing pregnancy was defined as a pregnancy showing a positive heartbeat at ultrasound after 12 weeks of gestation. The secondary outcome measures miscarriage rate (defined as pregnancy loss after confirmation of clinical pregnancy). The c2 –test was used to compare categorical variables and Student’s t-test for continuous variables. Main results and the role of chance As a result of matching, the mean female age in both groups was 37.7 ± 4.0, male age was also similar in both groups (39.6 ± 5.3 years vs. 40.2 ± 6.7 years). ). Other baseline characteristics, including cycle rank and mean gravidity showed no significant differences. Sperm parameters such as concentration (49.3 ± 50.3 million/ml in the ICSI group vs. 48.1 ± 39.0 million/ml in PICSI), and progressive motility (18.6% ± 18.2% vs. 18.6% ± 18.6%) showed also no significant differences. Fertilization rates were comparable between ICSI and PICSI group (76.0% vs. 76.1%, p = 1.000), as was the embryo utilization rate (42.0% vs. 41.9%, p = 1.000). In the total, 76 cycles resulted in no transfer due to no fertilization or impaired embryo quality (27.1% (39/144) for ICSI vs 25.7% (37/144) for PICSI, p = 0.894). The ongoing pregnancy rate following the first transfer was 19.1% for the ICSI group and 23.1% for the PICSI group (p = 0.501). The miscarriage rate was also comparable betw","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"1 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-720 A Prospective study in Poor-Responders comparing the ART-Results using Dual-Trigger (GnRH-agonist and HCG ) with conventional HCG trigger","authors":"A Jindal, R Singh, M Singh","doi":"10.1093/humrep/deaf097.1025","DOIUrl":"https://doi.org/10.1093/humrep/deaf097.1025","url":null,"abstract":"Study question Does use of Dual-trigger (GnRH-agonist with HCG ) improve the ART Results in Poor-Responders as compared to HCG trigger alone ? Summary answer Yes, the use of Dual-trigger (GnRH-agonist with HCG ) improve the ART-Results in Poor-Responders with diminished ovarian reserve as compared to HCG trigger alone . What is known already The population of poor ovarian reserve has grown exponentially over the years and their management of ovarian stimulation remains one of the most challenging aspects. In GnRH antagonist down-regulated IVF-ICSI cycles, dual triggering for the final oocyte maturation with GnRH-a and a reduced dose of hCG improves the ART-Results in women with diminished ovarian reserve. Further more, the benefit of less cycle cancellation rate would also enable greater percentage of patients with diminished ovarian reserve to reach the final stage of their IVF-ICSI Cycles treatment, thereby enhancing their better ART-Results Evidence indicates that dual triggering combines the advantages of GnRHa and hCG. Study design, size, duration This RCT included GnRH antagonist ICSI cycles from 2021-24. 62 women with diminished ovarian reserve (AMH ≤ 1.1 ng/ml and AFC ≤5) were included. The primary outcome measured was the oocyte fertilization rate, implantation rate and clinical pregnancy rate per oocyte retrieval cycle. Secondary outcome measured was embryo transfer cancellation rate and abortion rate per oocyte retrieval cycle. Participants/materials, setting, methods 62 women with diminished ovarian reserve undergoing fresh embryo transfer were included and randomly divided in two groups - Group-A (hCG trigger/control group: n = 31); and Group-B (dual trigger/study group: n = 31). Both patient groups underwent controlled ovarian stimulation using antagonist. The final oocyte maturation was triggered either by recombinant hCG (Group-A) or by a combination of recombinant hCG and GnRH-agonist (Dual trigger) (Group-B). Main results and the role of chance The dual-trigger group had significantly higher fertilization rate , higher clinical pregnancy rate as compared to the recombinant-hCG trigger group. In addition, the abortion rate and embryo transfer cancellation rate were both significantly lower in the dual trigger group. The baseline characteristics for the control and the study group were similar and there was no significant difference in the patient age, serum AMH level, and cause of infertility. The total r-FSH dose, duration of stimulation, endometrial thickness, and serum hormone profile on the day of trigger were also similar between the control and the study group. The main advantage of triggering with GnRH-a is that it induces a mid-cycle FSH surge which resembles the natural ovulatory cycle hormonal changes. Study shows that in GnRH antagonist ART cycles, dual triggering with GnRH-a and hCG could significantly improve the ART-Results in Poor-Responders . Furthermore, the benefit of lowered cycle cancellation rate would also e","PeriodicalId":13003,"journal":{"name":"Human reproduction","volume":"7 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}