ART Outcomes Research Articles

Microfluidic in compared with Zeta potential, MACS and swim up methods, resulted in improved chromatin integrity and high quality sperms.

Sperm parameters and DNA integrity are crucial factors in ART outcomes. This study compared four sperm preparation methods (microfluidics, MACS, zeta potential, and swim-Up) for sorting spermatozoa with normal parameters and chromatin integrity. This study evaluated semen samples from 25 couples with male factor infertility. The semen samples were divided into four portions: one prepared by MACS, one by zeta potential, the other by microfluidics, and the last by swim-up. After preparation, sperm viability, motility, and morphology were assessed based on the WHO guidelines. DNA intergrity was assessed by SDF assay, and the CMA3 staining test was used to evaluate sperm chromatin packaging. Compared to other preparation techniques, microfluidic preparation significantly improved sperm parameters, including motility, viability, morphology, and DNA integrity as well as chromatin packaging (p-value <0.05). The results also demonstrated that sperm motility, viability, and sperm DNA integrity as well as chromatin packaging, were not significantly different after preparation with MACS and Zeta potential methods. However, the MACS and Zeta methods produced improved sperm parameters and better DNA integrity than the swim-up method. Our results indicate that microfluidics can improve sperm quality compared to other methods of sperm preparation. When the microfluidic chip is not available, considering the similar results of sperm preparation by MACS and Zeta potential methods, it is preferred to use the Zeta method for the ART cycle due to its simplicity and cost-effectiveness.

IMPACT OF BLASTOCYST GRADES TO IMPLANTATION AND LIVE-BIRTH RATES IN WOMEN LESS THAN 30 YEARS WITH SINGLE EMBRYO TRANSFERS

Background:Morphological evaluation of blastocysts focusing on key factors such as expansion, inner cell mass (ICM) quality, and trophectoderm (TE) quality have been most widely used for embryo selection. The study emphasizes the importance of detailed blastocyst evaluation, highlighting that morphological variations can have substantial implications for ART outcomes. Methods:A total of 115women aged less than 30 years undergoing SET from from January 2023 to June 2023 were included in this study.The patients were divided into three groups based on their morphologic grading before embryo transfer: good-quality (n = 53), average-quality (n = 52) and poor-quality blastocysts (n = 10). The three morphologic groups pregnancy outcomes were examined, and the implantation rate was logistically regressed. Results:Good-quality blastocysts yielded a statistically significantly higher implantation rate (77%) than average / poor-quality blastocysts (44% and 20% respectively). Average-quality blastocysts still yielded in higher implantation rates (44%) compared to poor-quality blastocysts (20%). The baseline characteristics were analysed for significance using the Pearsons Chi-squared test. A P-value &lt; 0.05 was considered statistically significant. All the statistical analyses were performed using the social science statistics website with SPSS software. Conclusions:Higher blastocyst morphologic grading was associated with increased implantation rate for single embryo transfers. These findings suggest that evaluating blastocyst morphology is critical when selecting the best blastocyst.

Mental imagery in education: What impact on the relationships with visuospatial processing and school performance in junior high school students?

This study examined the relationship between mental imagery, visuospatial processing, and academic performance among junior high school students. The influence of these variables on learning outcomes in Italian, mathematics, art, and music was also investigated. Third-year students were tested using the Mental Imagery Test and Raven's Progressive Matrices. Gender differences were explored, revealing no significant differences in mental imagery and visuospatial processing. Higher mental imagery correlated with better academic performance, particularly in Italian and mathematics. Visuospatial processing mediated the relationship between mental imagery and academic performance in Italian and mathematics, suggesting its significant role in these subjects. However, this mediation was not significant for music and art, suggesting the involvement of alternative cognitive mechanisms. These findings highlight the importance of mental imagery and visuospatial processing in academic success, particularly in abstract subjects, and advocate for educational strategies targeting these cognitive domains to enhance not only student performance but also creativity and thinking skills.

Reply: Emerging evidence of endometrial compaction in predicting ART outcomes.

Reply: Emerging evidence of endometrial compaction in predicting ART outcomes.

Emerging evidence of endometrial compaction in predicting ART outcomes.

Emerging evidence of endometrial compaction in predicting ART outcomes.

Peripheral fatty acids and outcome of assisted reproduction

IntroductionThe present study investigates the relationship between the fatty acid levels in whole blood, in women undergoing IVF and four successive ART outcomes. Material and methodsA cross-sectional study was performed on data from a prospective cohort study conducted between 2014 and 2016. ResultsParticipants were 238 women undergoing in vitro fertilization (IVF) and participating in a study on the role of lifestyle habits and diet on ART outcomes. Blood PUFAs were measured by gas chromatography. Overall, higher blood levels of monounsaturated fatty acids, oleic acid, higher n6/n3 ratio and arachidonic/docosahexaenoic acid ratio were associated with more favorable ART outcomes. On the contrary, higher concentrations of long-chain PUFAs tended to be negatively associated with the considered outcomes. ConclusionsFurther prospective studies are needed to determine the ranges of fatty acid concentrations that are optimal for women with sub-fertility.

Effect of blastomere cell number on ART outcome of fresh single day 3 embryo transfer

PurposeExplore the effect of blastomere cell number on ART outcome of fresh embryo transfer on day 3.MethodsRetrospective analysis of 540 fresh single day 3 embryo transfer cycles at the Reproductive Center of the Third Affiliated Hospital of Guangzhou Medical University from January 1, 2018 to October 31, 2022. Patients were divided into 5–6 cell group (n = 55), 7–9 cell group (n = 457), and ≥ 10 cell group(n = 28) based on the number of blastomeres. Single factor analysis of variance and Pearson's chi square test were used to compare the basic data, cycle information, pregnancy outcome and neonatal outcome. Univariate logistic regression was used to correct for confounding factors and analyze the influencing factors of pregnancy outcome.ResultsThe positive HCG rate were 20%, 43%, 25% for the 5–6-cell, 7–9 cell and ≥ 10 cell groups respectively, with statistically significant differences (P < 0.001). The clinical pregnancy rate was 18%, 42%,21%, respectively (P < 0.001). The live birth rates were 13%, 34%,21% with P-value less than 0.05 which is statistically significant. In order to exclude the influence of confounding factors, multivariable logistic regression analysis was performed, and the outcomes were consistent with previous findings. There were no significant differences found in neonatal outcome between groups (P > 0.05).ConclusionThe results suggested that intermediate cleaving embryos (7–9 cell) still presents the highest clinical potential. Fast and slow cleaving embryos are not conducive to the ART outcome.

Microfluidics-A novel technique for high-quality sperm selection for greater ART outcomes.

Microfluidics represent a quality sperm selection technique. Human couples fail to conceive and this is so in a significant population of animals worldwide. Defects in male counterpart lead to failure of conception so are outcomes of assisted reproduction affected by quality of sperm. Microfluidics, deals with minute volumes (μL) of liquids run in small-scale microchannel networks in the form of laminar flow streamlines. Microfluidic sperm selection designs have been developed in chip formats, mimicking invivo situations. Here sperms are selected and analyzed based on motility and sperm behavioral properties. Compared to conventional sperm selection methods, this selection method enables to produce high-quality motile sperm cells possessing non-damaged or least damaged DNA, achieve greater success of insemination in bovines, and achieve enhanced pregnancy rates and live births in assisted reproduction-in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Besides, the concentration of sperm available to oocyte can be controlled by regulating the flow rate in microfluidic chips. The challenges in this technology are commercialization of chips, development of fully functional species-specific microfluidic tools, limited number of studies available in literature, and need of thorough understanding in reproductive physiology of domestic animals. In conclusion, incorporation of microfluidic system in assisted reproduction for sperm selection may promise a great success in IVF and ICSI outcomes. Future prospectives are to make this technology more superior and need to modify chip designs which is cost effective and species specific and ready for commercialization. Comprehensive studies in animal species are needed to be carried out for wider application of microfluidic sperm selection in invitro procedures.

Effect of Urolithin A on Bovine Sperm Capacitation and In Vitro Fertilization.

Reactive oxygen species (ROS) play a critical role in the functional competence of sperm cells. Conversely, excessive generation of ROS can impair sperm function, including their fertilization ability. Urolithin A (UA), a gut bacteria-derived metabolite produced from the transformation of ellagitannins, with anti-aging and antioxidant properties, was investigated for the first time in bovine sperm cells in the present study. Firstly, different doses of UA (0, 1, and 10 μM; 8-16 sessions) were used during the capacitation process of frozen-thawed bovine sperm. Sperm motility was assessed using optical microscopy and CASA. Sperm vitality (eosin-nigrosin), ROS, and ATP levels, as well as mitochondrial membrane potential (JC1) and oxygen consumption were evaluated. A second experiment to test the effect of different doses of UA (0, 1, and 10 μM; 9 sessions) in both the capacitation medium, as above, and the fertilization medium, was also implemented. The embryonic development and quality were evaluated. UA, at a concentration of 1 μM, significantly improved sperm movement quality (p < 0.03). There was a trend towards an increase in the oxygen consumption rate (OCR) of capacitated sperm with 1 μM and 10 μM UA supplementation. Moreover, an increase in ATP levels (p < 0.01) was observed, accompanied by a reduction in ROS levels at the higher UA concentration. These results suggest that UA may enhance spermatozoa mitochondrial function, modifying their metabolic activity while reducing the oxidative stress. Also, the number of produced embryos appears to be positively affected by UA supplementation, although differences between the bulls may have mitigated this effect. In conclusion, presented results further support previous findings indicating the potential therapeutic value of UA for addressing reproductive sub/infertility problems and improving ART outcomes. In addition, our results also reinforce the important bull effect on ART and that male sperm bioenergetic parameters should be used to predict spermatozoa functionality and developmental potential.

Pengaruh Penerapan Metode Snowball Throwing terhadap Hasil Belajar Pengetahuan Tari pada Pembelajaran Seni Tari di Kelas XI.MIPA SMA Negeri 1 Rambatan Kabupaten Tanah Datar

This study aims to prove the influence of the application of snowball throwing on the learning outcomes of dance-cultural arts, namely by analyzing the influence of differences in higher learning outcomes after a learning treatment using the snowball throwing method in learning cultural-dance arts in class XI, MIPA-2 SMA Negeri 1 Rabatan, Tanah Datar Regency. This research uses quantitative type with quasi-experimental method. The population is all students of class XI of SMAN 1 Rambatan totaling 183, with a study sample drawn in a simple cluster on 32 students of class XI-MIPA-2 (being an experimental class) and 32 students of class XI-MIPA-4 (being a control class). Data collection techniques with tests and observations. The data analysis technique uses the analysis of the difference in class mean in the final test-test results at the end of learning. . Hypothesis testing was performed with a T-test using the SPSS version 16 program, to test differences in the mean significance of the final test results in the experimental class and control class. The test results proved that the calculated t value at a score of 7.625 proved to be greater than the table t at a score of 1.69552. So statistically the value of t counts &gt; t of the table. The results of this test also proved significant because t count &gt; t this table was accepted at a critical value in the T-table at df= 31 and a confidence level of 95%, or at an alpha level of 0.05. The conclusion of the results of this study is that there is a significant difference in dance knowledge learning outcomes between the use of the snowball throwing method and conventional discussion methods in dance learning in class XI.MIPA SMA Negeri 1 Rambatan, Tanah Datar Regency.'. This means that H1 is accepted and H0 is rejected.

A High Sperm DNA Fragmentation Index Negatively Affects Pregnancy Outcomes in ART

A High Sperm DNA Fragmentation Index Negatively Affects Pregnancy Outcomes in ART

Surgery for Severe Endometriosis and ART Outcome and Effect of Time Interval Between Surgery and FET

Surgery for Severe Endometriosis and ART Outcome and Effect of Time Interval Between Surgery and FET

Upaya Meningkatkan Hasil Belajar Mata Pelajaran Seni Budaya dan Prakarya (SBdP) dengan Memanfaatkan Lingkungan Sekolah

This research discusses efforts to improve the learning outcomes of the subject Arts, Culture, and Crafts (SBDP) by utilizing the school environment at SD Negeri 13 Kota Pagaralam. The approach used in this study is descriptive and qualitative. Data collection methods include documentation, observation related to the improvement of learning outcomes in SBdP by utilizing the school environment, and interviews conducted with SBdP teachers about the learning process utilizing the environment, the principal about his role as a leader in managing the educational process at school, and students related to the learning process they undergo in the SBdP subject. The sequential data collection process, data presentation, data verification, and conclusion drawing are part of the data analysis techniques used. The researcher used triangulation techniques, namely time, method, and source triangulation, to ensure data accuracy. Based on the results and discussion, the efforts made in the SBdP learning process at SD Negeri 13 have not been successfully implemented, particularly in grade IV. The teaching methods used by the teachers are still monotonous and tend to be very boring, indicating that the efforts to improve SBDP learning outcomes by utilizing the school environment still require much evaluation.

Penerapan Metode Diskusi-Demonstrasi dalam Pembelajaran Seni Budaya (Tari) di SMAN 1 Kuantan Mudik

This research is motivated by the low learning outcomes of cultural arts. The reason is that the use of the learning model and students' understanding of learning is not optimal. The purpose of this study is to describe the improvement of cultural arts learning outcomes by using the Discussion-Demonstration method in class XI.1 of SMA Negeri 1 Kuantan Mudik. This research is a Class Action Research (PTK) that uses qualitative and quantitative approaches. It is carried out in two cycles, namely cycle I consists of 2 meetings and cycle II consists of 1 meeting. Each cycle includes four stages, namely planning, implementation, observation and reflection. The subjects of this study are teachers and students of class XI.1 of SMA Negeri 1 Kuantan Mudik with a total of 36 people. The results of the study showed an increase in: a) the implementation in the aspect of teachers in the first cycle of meeting 1 with an average of 3.06 with good criteria, the first cycle of meeting 2 with an average of 3.41 with good criteria and the second cycle of 3.93 (very good), while in the aspect of students in the first cycle of meeting 1 with an average of 1.87 (not good), the first cycle of meeting 2 with an average of 3.31 (good) and the second cycle of 3.87 (very good), b) Assessment of student learning outcomes in cycle I with an average score of 66 and cycle II with an average score of 90. Based on these results, it can be concluded that using the Discussion-Demonstration Method can improve the learning outcomes of cultural arts in class XI.1 students of SMA Negeri 1 Kuantan Mudik.

Communicative Competence in English Among Junior High School Students

Developing communicative competence is one of the expected outcomes of the Language Arts and Multiliteracies Curriculum (LAMC). This study evaluates the communicative competence among Junior High School students at Vinapor National High School. Employing descriptive quantitative and qualitative methods, it examines the grammatical, sociolinguistic, and discourse competence and identifies factors that either facilitate or hinder these competencies. A combination of grammatical, speaking, and writing tests was used to assess student’s performance, which revealed that the majority did not meet expectations across the evaluated competencies. Semi-structured interviews further provided insights into both facilitating and hindering factors from the perspectives of 21 students and four teachers. Facilitating factors included teaching methods, peer interaction, extracurricular activities, access to resources, and teacher support, whereas hindering factors encompassed challenges and barriers such as lack of interest, lack of comprehension, lack of confidence, fear of committing mistakes, negative perception, curriculum and resource limitations, and distractions. The study proposed an intervention program to guide teachers in helping students achieved communicative competence.

Liberal Arts Graduates in the Labour Market: A Comparative Study of Dutch University Colleges and Conventional Bachelor’s Programmes

This paper compares the employment outcomes of liberal arts graduates from Dutch university colleges with those of their peers who pursued conventional, subject-specific bachelor’s degrees. Using data from the Dutch National Alumni Survey, the analysis includes 14,933 respondents who completed a master’s programme at a research university, with 210 of them holding a university college degree. Logistic, multinomial, and OLS regression analyses were performed on six labour market outcomes: employment status, time to first paid job, vertical match, horizontal match, vertical and horizontal match combination, and hourly wage from regular work. Propensity score matching was used as a robustness check. The results show that holding a university college degree is not associated with any distinct advantages or disadvantages in the job market. While a liberal arts bachelor’s degree has a negative effect on obtaining employment in STEM professions, no statistically significant differences, neither negative nor positive, were found in other outcomes. This suggests that university colleges do not lack the capacity to prepare students for the labour market.

Enhancing HIV treatment and support: a qualitative inquiry into client and healthcare provider perspectives on differential service delivery models in Uganda

BackgroundHIV/AIDS continues to be a significant contributor to illness and death, particularly in sub-Saharan Africa. In this study, we conducted a qualitative assessment to understand Client and Healthcare Provider Perspectives on Differential Service Delivery Models in Uganda. The purpose was to establish strengths and weaknesses within the services delivery models, inform policy and decision-making, and to facilitate context specific solutions.MethodsBetween February and April 2023, a qualitative cross-sectional study was utilised to gather insights from a targeted selection of individuals, including People Living with HIV (PLHIV), healthcare workers, HIV focal persons, community retail pharmacists, and various stakeholders. The data collection process included eleven in-depth interviews, nine key informant interviews, and eight focus group discussions carried out across eight districts in Central Uganda. The collected data was analyzed through inductive thematic analysis with the aid of Excel.ResultsThe various Differentiated Service Delivery Models (DSDMs), notably Community-Client-Led Drug Distribution (CCLAD), Community Drug Distribution Point (CDDP), Community Retail Pharmacy Drug Distribution Point (CRPDDP), and the facility-based Facility Based Individual Model (FBIM), were reported to have several positive impacts. These included improved treatment adherence, efficient management of antiretroviral (ARV) supplies, reduced exposure to infectious diseases, enhanced healthcare worker hospitality, minimized travel time for ART refills, stigma reduction, and decreased waiting times. Concern was raised about the lack of improvement in HIV status disclosure, opportunistic infection treatment, adherence to seasonal appointments, and sustainability due to the overreliance of the DSDMs on donor funding, suggesting potential discontinuation without funding. Doubts about health workers’ commitment surfaced. Notably, the CCLAD model displayed self-sustainability, with clients financially supporting group members to collect medicines.ConclusionCommunity-based DSDMs, such as CCLAD and CDDP, improve ART refill convenience, social support, and client experiences. These models reduce travel and waiting times, lowering infection risks. Addressing challenges and enhancing facility-based models is vital. In order to maintain funding after donor funding ends, sustainability measures like cross-subsidization can be used. If well implemented, the DSDMs have the potential to produce better or comparable ART outcomes compared to the FBIM model.

P-586 Mild ovarian stimulation using the aromatase inhibitor letrozole (LTZ) is an effective stimulation protocol to obtain euploid blastocysts for women of an advanced maternal age

Abstract Study question Does MOS with LTZ produce higher numbers of good-quality blastocysts compared with the use of clomiphene citrate (CC) for women of an advanced maternal age? Summary answer MOS using LTZ is a good ovarian stimulation protocol for a higher number of good-quality blastocysts for women of an advanced maternal age (AMA) What is known already The clinical pregnancy rate with a good blastocyst should be 40% or more among younger women, but about 35% for AMA women (≥40 years). Therefore, high-dose gonadotropins are usually used for AMA women. However, the best efforts for both patients and clinicians are sometimes in vain. Many AMA women show a lower ovarian reserve where ovarian stimulation with a lessened dose of gonadotropins is preferred. Taking CC or LTZ with MOS can reduce the amount of gonadotropins used, but it remains uncertain whether it is better to administer LTZ or CC together for MOS. Study design, size, duration This retrospective study was conducted between January 2020 and April 2021. A total of 288 women received MOS. Of course, 153 used CC (CC group) and 133 used LTZ (LTZ group). The ART outcomes were compared between these two groups. Among them, the women who were ≥40 years old were divided into two groups: CC-O40 (n = 61) and LTZ-O40 (n = 54). The ART outcomes were compared between the two groups. Participants/materials, setting, methods All women took either 100 mg of CC or 5 mg of LTZ daily for 7 days between menstrual cycle 3 (MC3) and MC9, and 225 IU of recombinant-FSH were administered on MC3, MC5, MC7 and MC9. On MC 10, when 3 or more well-developed follicles (≥ 20 mm in diameter) were confirmed, a dual-maturation trigger was performed using rec-hCG and GnRH agonist nasal spray, and then oocyte-pick up (OPU) was performed 35-36 hours afterward. Main results and the role of chance The number of retrieved oocytes in the CC group averaged 7.5 ± 5.3 (mean ± S.D.), which was significantly higher than that in the LTZ group (6.3 ± 4.7; p &amp;lt; 0.05). The average number of blastocysts and morphologically good blastocysts was comparable in the CC and LTZ groups (CC group; 2.8 ± 3.0 and 1.8 ± 2.4; LTZ group; 2.4 ± 2.7 and 1.4 ± 2.0, respectively, [P=NS]). For AMA women, the average number of blastocysts in the CC-O40 group was 1.7 ± 1.8, which was similar to that in the LTZ-O40 group (1.7 ± 1.8, P=NS). The blastocyst formation rate in the LTZ-O40 group was 58.5%, which was significantly higher than that in the CC-O40 group (46.6%; P &amp;lt; 0.05), but the rate for good blastocysts in the LTZ-O40 group (30.8%) was comparable to that in the CC-O40 group (23.3%, P=NS). The euploid rates in the LTZ group was 53.4%, which was significantly higher than that in the CC group (38.0%; P &amp;lt; 0.05), and the difference was significant even for AMA women (LTZ-O40; 40.5%, CC-O40; 16.7%, respectively, p &amp;lt; 0.05). Limitations, reasons for caution The study was a controlled trial with a limited number in the study population. Additionally, all cases had not received a trophectoderm (TE) biopsy. Further study is needed to determine the effect that an aromatase inhibitor exerts on obtaining either morphologically good blastocysts or euploid blastocysts. Wider implications of the findings AMA women showed blastocyst formation rates from LTZ with MOS significantly higher than that of the CC group, and euploid rates in the LTZ group were also significantly higher. The characteristics of an LTZ such as aromatase inhibitor enhanced the development of embryos. Trial registration number not applicable

P-124 Machine learning scores reveal mosaic embryo quality as the key predictor for live births, outperforming mosaicism characteristics in ART success

Abstract Study question Is it possible to score the mosaic embryos in order to prioritise them according to their pregnancy potencial? Summary answer The machine-learning score underscores the crucial role of embryo quality over mosaicism, prioritizing high-quality, day-5 biopsied embryos for enhanced live birth outcomes in ART. What is known already After embryo biopsy and PGT-A analysis, embryos can be classified as euploid, aneuploid, or mosaic, wherein a combination of chromosomally normal and altered cells is detected. The transfer of mosaic embryos has been controversial, but currently, the recommendations of international scientific societies, including ESHRE, advocate for their transfer. In case of pregnancy, a prenatal test is advised to rule out any chromosomal aberration. The non-transfer of these embryos reduces ART success chances, as chromosomally normal children may be born from them. Study design, size, duration The study design is observational and retrospective. A total of 8346 embryos from 2583 PGT-A cycles were considered (January-2017 to January-2023). Only transferred mosaic embryos (n = 263) were included in the study. The trophectoderm biopsies of D5, D6, or D7 blastocysts were analyzed by NGS using the Illumina platform (VeriSeq Illumina®, San Diego, CA, USA). The biopsied embryos were vitrified and transferred in a subsequent cycle. Participants/materials, setting, methods The primary indications for PGT-A included advanced maternal age, abnormal sperm FISH, and recurrent miscarriage or implantation failure. Clinical outcomes, along with variables related to progenitors, embryos, biopsy, ovarian stimulation, and adjuvant treatments, were recorded in a database. Machine learning models were conducted using R statistical software (v.4.3.1), and the ‘Caret’ library was utilized to implement different algorithms. ‘Autoscore,’ as an interpretable scoring tool, combined machine learning and regression modeling. Main results and the role of chance The mean maternal and paternal ages were 34.95±6.38 and 39.13±6.74 years. Biopsies were predominantly performed on day 5 (61%). Additionally, 44% of embryos were of A quality, and 49% were of B quality. Regarding clinical outcomes for mosaic embryos, biochemical, clinical pregnancy, and live birth rates were 51%, 41%, and 36%, respectively. The features used to generate the score included those related to embryo quality, biopsy, and mosaicism. Through 10-fold cross-validation, the study identified top-ranking predictors maximizing the AUC of the predictive model. The highest weight in the score was assigned to embryo quality (42%) and day of biopsy (34%), with lower weights for factors related to mosaicism: monosomy and/or trisomy (18%) and mosaicism level (6%). The machine-learning score indicates that, in transferring embryos with mosaicism, priority should be given to high-quality embryos biopsied on day 5. The type and level of mosaicism have a minor impact on the embryo’s gestational capacity, becoming relevant only when prioritizing embryos of identical quality. In such cases, embryos with lower mosaicism degrees and no monosomy demonstrate higher implantation potential. Limitations, reasons for caution The inherent limitations of a retrospective analysis highlight the need for prospective randomized studies to confirm the validity and usefulness of the mosaic embryo transfer score. Wider implications of the findings A scoring system has been developed to prioritize the transfer of mosaic embryos. The crucial variables are associated with embryo quality and the day of biopsy, reflecting the progression of embryonic development. Conversely, variables related to mosaicism play a secondary role. Trial registration number Not applicable

P-762 Discovery and quantification of microplastics in human cumulus granulosa cells

Abstract Study question The impact of microplastics (MPs) on human health has received increasing attention; their accumulation in female reproductive system and possible harms have not been quantified. Summary answer This study firstly reveals the contamination of human cumulus granulosa cells and follicular fluid by MPs and the effects of these contaminants on ART outcomes. What is known already MPs are ubiquitous in soil, sea, air, fresh water, and other environments. MPs are ingested by humans through the food chain, air and direct contact, resulting in various health problems, such as endocrine disruption, immune disturbance and reproductive toxicity. MPs exposure has been found to have a great impact on females, as MPs may accumulate in the ovaries and reduce the number of follicles, ovarian size, pregnancy rate, embryo production and fertility. To date, one study has found evidence of MPs in human placentas for the first time, but MPs contamination in other human reproductive systems has not been identified. Study design, size, duration The inclusion criteria comprised female patients of infertile couples excluding male factors who visited the outpatient department of the Reproductive and Genetic Hospital of CITIC-Xiangya between January 2019 and January 2021.We randomly selected 16 women who met the criteria and assessed their CCs and follicular fluid samples for the presence of MPs. Participants/materials, setting, methods In the present study, 16 cumulus granulosa cell samples and 2 follicular fluid samples were collected, and MPs were detected via pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS). Main results and the role of chance MPs were detected in both cumulus granulosa cells and follicular fluid, with an average abundance of 313.14±246.69 mg/kg in cumulus granulosa cellsand 12.88±15.54 mg/kg in follicular fluid. Polyethylene terephthalate was the predominant polymer in cumulus granulosa cells. There were no significant differences in the IVF fertilization rates, ICSI fertilization rates, IVF good-quality embryo rates, or ICSI good-quality embryo rates between the high-MP group and low-MP group. However, embryos in the high-MP group exhibited a lower normal cleavage rate than did those in the low-MP group, while the embryos in the high-MP group exhibited a greater proportion of noncleavage than did those in the low-MP group. Limitations, reasons for caution It is not clear how long these particles may persist in the human body. The method we used can detect only the concentration of MPs but not the size of MP particles. Moreover, our method cannot be used to quantify smaller-diameter nanoplastics, which are considered to pose greater risks. Wider implications of the findings This is the first study in which MPs were identified and characterized in human ovarian granulosa cells, providing reference data for evaluating their toxicity to the human female reproductive system. Trial registration number Not applicable