Fertilization Success Research Articles

Impact of maternal hormone profile and paternal sperm DNA fragmentation on clinical outcomes following assisted reproduction

Success of assisted reproductive techniques depends on multiple factors including maternal endocrine status, hormonal balance, and paternal sperm quality. A comprehensive pre-treatment evaluation allows better prediction of outcomes and avoidance of unnecessary procedures and expenses. To examine the impact of female hormonal profiles and sperm DNA damage on the success of assisted reproduction, medical data were extracted from the clinical records of infertile couples including couples' age and levels of maternal anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL), as well as the DNA fragmentation index (DFI) in men. Any correlation between these parameters and clinical outcomes was investigated. DFI and FSH independently influenced the rate of high-quality embryos. A decrease in maternal age and PRL levels increased the rate of these embryos. On the other hand, an increase in maternal body mass index (BMI) or AMH levels was associated with a reduced chance of achieving high quality embryos. In addition, any reduction in PRL levels could be associated with a higher fertilization rate. FSH levels above the normal range contribute to a reduced rate of high-quality embryos. Overall, our findings demonstrate the complex interplay between different factors and their influence on fertilization success and emphasize the importance of optimizing these variables to achieve the best possible outcome. Several factors can influence the outcome of infertility treatment. These factors include paternal DFI, maternal age, BMI, AMH, FSH, and PRL levels.

Advanced treatment-resistant ovarian germ cell tumor (yolk sac tumor) with successful fertility realization 20 years after combined treatment: a case report

Background. Yolk sac tumors (YST) are classified as rare malignant germ cell tumors of the ovaries, most commonly found in young patients interested in preserving fertility. YST is characterized by large size, predominantly unilateral involvement, and increased production of alpha-fetoprotein, which can be used as an important diagnostic criterion for this condition. Among all germ cell tumors, YST has the least favorable prognosis. The primary goals of YST treatment are not only to improve prognosis and quality of life but also to enable the patient to fulfill her reproductive plans in the future.Description of the clinical case. We present a clinical case of an aggressive course of yolk sac tumor in the ovary of a 15-year-old girl, requiring multiple surgeries, repeated courses of high-dose drug therapy, and bone marrow transplantation.Conclusion. This is a rare case of YST with successful preservation of reproductive function due to modern medical technologies despite aggressive treatment.

Oncological microdissection testicular sperm extraction (Onco-microTESE) outcomes for fertility preservation of patients with testicular cancer with azoospermia or severe oligoasthenoteratozoospermia.

To determine the success rate of oncological microdissection testicular sperm extraction (onco-microTESE) in patients with testicular cancer (TC) with azoospermia and severe oligoasthenoteratozoospermia (OAT; <1 million/mL sperm) and to explore any factors that may predict success. Case series of outcomes from all consecutive patients (42 testes in 38 patients) that presented or were referred to a single specialist tertiary referral centre for fertility management in the context of TC with severe OAT or azoospermia between August 2015 and August 2022. Biochemical, radiological, and histological parameters were collected for all patients. All patients underwent onco-microTESE (simultaneous radical inguinal orchidectomy with ex vivo microTESE of the affected testis). Those with unsuccessful surgical sperm retrieval (SSR) from the affected testis underwent contemporaneous contralateral microTESE, if no contraindication was present. The primary outcome was successful SSR from the affected testicle sufficient for assisted reproductive techniques. Secondary outcomes included contralateral microTESE success, the time from referral to procedure, and the total successful fertility preservation rate. Initial onco-microTESE was successful in 19 of 31 patients (61%) with azoospermia. Contralateral microTESE was successful in a further two of eight patients with azoospermia with failed onco-microTESE. Overall, 22/31 patients with azoospermia (71%) had successful fertility preservation in this series. In addition, six of seven patients with severe OAT had further sperm harvested by onco-microTESE to maximise their fertility preservation. All surgery was performed within median (interquartile range) of 7 (5-13) days from presentation. Onco-microTESE represents an effective method of fertility preservation for sub-fertile patients with TC without delaying oncological treatment. Knowledge of the fertility status at first presentation is essential to allow for such additional options for optimal fertility preservation in TC.

Transcriptome and Metabolome Analyses Reveal a Complex Stigma Microenvironment for Pollen Tube Growth in Tobacco

In flowering plants, the success of fertilization depends on the rapid polar extension of a pollen tube, which delivers sperm cells to the female gametophyte for fertilization. Numerous studies have shown that the microenvironment in planta is more conducive to the growth and development of pollen tubes than that in vitro. However, how stigma factors coordinate to regulate pollen tube growth is still poorly understood. Here, we demonstrate that in tobacco, mature stigma extract, but not immature stigma extract, facilitates pollen tube growth. Comparative transcriptomic and qRT-PCR analyses showed that the differentially expressed genes during stigma maturation were mainly enriched in the metabolism pathway. Through metabolome analyses, about 500 metabolites were identified to be differently accumulated; the significantly increased metabolites in the mature stigmas mainly belonged to alkaloids, flavonoids, and terpenoids, while the downregulated differential metabolites were related to lipids, amino acids, and their derivatives. Among the different kinds of plant hormones, the cis-form contents of zeatin were significantly increased, and more importantly, cis-zeatin riboside promoted pollen tube growth in vitro. Thus, our results reveal an overall landscape of gene expression and a detailed nutritional microenvironment established for pollen tube growth during the process of stigma maturation, which provides valuable clues for optimizing in vitro pollen growth and investigating the pollen–stigma interaction.

Cumulus cell DNA damage linked to fertilization success in females with an ovulatory dysfunction phenotype

Intracytoplasmic sperm injection (ICSI) is a widely used technique in fertility centers. ICSI success depends on both nuclear and cytoplasmic oocyte maturation. Cumulus cells, which surround the oocytes, play a pivotal role in oocyte competence. However, the significance of DNA damage in cumulus cells as a marker of fertilization success remains largely unexplored. This study aims to investigate the relationship between DNA damage in cumulus cells of females undergoing ICSI, and oocyte competence, with a focus on in vitro fertilization (IVF) outcomes. We employed the alkaline comet assay to assess DNA damage levels (%TDNA) in cumulus cells and whole blood from 22 potentially fertile females and 35 infertile females, including 20 with an ovulatory disfunction phenotype. Our results revealed significant differences between the levels of %TDNA in cumulus cells and blood. Females with an ovulatory dysfunction phenotype exhibited higher levels of %TDNA in cumulus cells compared to potentially fertile females. Additionally, within the group of females with ovulatory dysfunction, a significant correlation was observed between %TDNA levels and the number of oocytes with two pronuclei. Our findings suggest that blood does not accurately reflect DNA damage in cumulus cells, which was correlated with the fertilization success in females with ovulatory dysfunction. High levels of %TDNA in cumulus cells were associated with a higher likelihood of successful fertilization. Moreover, our results imply that low levels of %TDNA may be linked to oocytes that fail to complete maturation and, consequently, do not fertilize (oocytes with zero pronuclei). Further research with larger cohorts is necessary to validate these findings and to explore potential applications in female fertility. However, our study provides evidence that DNA damage in cumulus cells may serve as a valuable biomarker for predicting fertilization success and oocyte competence.

Investigation of the effect of serotonin-activated semen washing medium on sperm motility at the molecular level: a pilot study.

In Assisted Reproductive Technologies (ART), efficient sperm preparation is vital for successful fertilization, with washing media enhancing the process. This pilot study examines the molecular-level impact of a new serotonin-containing sperm-washing medium (Prototype) on sperm motility and ROS metabolism, comparing it with commercially available media (Origio and Irvine). Semen samples from thirty-one individuals underwent preparation using the swim-up method post-semen analysis. Each sample was separately washed with the Prototype, Origio and Irvine mediums. ROS formation was determined through flow cytometric, and AT2R and PRDX2 protein levels, associated with sperm motility, were assessed via Western blot. Statistical evaluation compared the findings among the three outlined media. Significant differences were found among three washing media in terms of total and progressive motility. The Prototype medium showed the highest increase in both total (66%) and progressive motility (59%), while the control group exhibited the lowest increases (41% and 27.7%, respectively). Regarding ROS levels, the prototype (11.5%) and Origio (10.7%) groups demonstrated a notable decrease, contrasting with Irvine (25.8%). Molecular assessment revealed a significant elevation in AT2R protein levels in the prototype medium (59%), compared to other media. Additionally, an increase in PRDX2 protein levels was observed in the prototype medium, although this didn't reach statistical significance. Serotonin-activated washing media for sperm preparation can be a suitable choice for selecting high-quality sperm in ART. A broader molecular analysis with a larger sample size is required to explore the mechanisms and effectiveness of using a serotonin-containing sperm-washing medium in routine ART.

Anti-Müllerian hormone as a predictor of oocyte yield following controlled ovarian stimulation in the rhesus macaque.

Anti-Müllerian hormone (AMH) is widely used in the clinic as a biomarker for ovarian reserve and to predict ovarian response to gonadotropin stimulation. Patients with higher AMH levels tend to yield more oocytes and have better outcomes from assisted reproductive technology (ART) procedures. The goal of this study is to determine if AMH can be used to predict the outcome of controlled ovarian stimulation in rhesus macaques, which are commonly used in biomedical research, to refine animal use while maximizing oocyte yield. We hypothesized that pre-stimulation AMH values can be used to predict oocyte yield and quality. Regularly cycling adult macaques underwent controlled ovarian stimulation and baseline (pre-stimulation) plasma AMH levels were determined using an AMH-specific enzyme-linked immunoassay. Oocytes were collected by laparoscopic or ultrasound-guided aspiration, then counted and evaluated for quality and stage of meiosis. Sperm from established fertile males were used to inseminate the oocytes in vitro with fertilization success checked 14 - 16 hours later. Females were grouped by oocyte yield: low ≤ 17; mid = 18 - 41; high ≥ 42. We found that high and mid yielders had significantly higher AMH than low yielders (p<0.0001) and the percent of mature oocytes was greater in the high and mid yielders. There were no significant differences in oocyte quality or ova fertilization rate. These data suggest that AMH is a useful measure for controlled ovarian stimulation success in rhesus macaques and can be used to identify suitable animals for oocyte donation before entering them into a stimulation protocol.

Melatonin supplementation attenuates cuproptosis and ferroptosis in aging cumulus and granulosa cells: potential for improving IVF outcomes in advanced maternal age

BackgroundAdvanced maternal age is associated with decreased oocyte quantity and quality and in vitro fertilization (IVF) success rates. This study aimed to investigate whether melatonin supplementation can improve IVF outcomes in women of advanced maternal age by modulating cuproptosis and ferroptosis.MethodsThis prospective cohort study included 161 women aged 35–45 years undergoing IVF-frozen embryo transfer cycles. Participants were assigned to either melatonin (n = 86, 2 mg daily for ≥ 8 weeks) or control (n = 75) groups. Cumulus cells were analyzed for cuproptosis and ferroptosis-related gene expression. Additional experiments were conducted on the HGL5 human granulosa cell line to assess mitochondrial function and metabolic reprogramming.ResultsMelatonin supplementation significantly improved IVF outcomes in women aged ≥ 38 years, increasing clinical pregnancy rates (46.0% vs. 20.3%, P < 0.01), ongoing pregnancy rates (36.5% vs. 15.3%, P < 0.01), and live birth rates (33.3% vs. 15.3%, P < 0.05). In cumulus cells from patients, gene expression analysis revealed that melatonin modulated cuproptosis and ferroptosis-related genes, including ATP7B and GPX4, with more pronounced effects in the ≥ 38 years group. This suggests melatonin enhances cellular resilience against oxidative stress and metal-induced toxicity in the ovarian microenvironment. In vitro studies using HGL5 cells showed melatonin reduced oxidative stress markers, improved mitochondrial function, restored expression of glycolysis and TCA cycle-related genes and modulated cuproptosis and ferroptosis-related gene expression. These findings provide mechanistic insight into melatonin’s protective effects against regulated cell death in ovarian cells, potentially explaining the improved IVF outcomes observed.ConclusionsMelatonin supplementation significantly improved IVF outcomes in women of advanced maternal age, particularly those ≥ 38 years old, likely by modulating cuproptosis and ferroptosis and enhancing mitochondrial function in cumulus and granulosa cells. These results suggest that melatonin could be a promising adjuvant therapy for improving IVF success rates in older women.

A comparative study on semen quality and cryopreservation ability in Italian native chicken breeds

This study provides a comparative assessment of fresh semen quality and sensitivity to cryopreservation in several Italian chicken breeds. The research involved 145 roosters from 13 breeds. The results showed a wide variability in all the parameters considered among the different breeds, especially in the quantitative variables of fresh semen, such as volume and concentration. For the qualitative characteristics (sperm membrane integrity and motility parameters), the variability across breeds was more pronounced for frozen than fresh semen. Interestingly, apart from total motility in fresh semen, breed had a significant effect on all semen quality parameters in both fresh and thawed ejaculates. Considering the overall qualitative characteristics, the Robusta maculata, Siciliana, and Mericanel della Brianza breeds produced ejaculates with better semen quality compared to other Italian breeds. By evaluating the main parameters of semen quality, our results underline the potential of these traits to influence the reproductive success and genetic conservation. The Bionda piemontese, Bianca di Saluzzo, Livorno bianca, Pepoi, and Siciliana breeds showed better resilience to cryopreservation, suggesting the need for breed-specific protocols to optimise semen quality after thawing. Importantly, the research highlights the central role of semen quality for both immediate fertilisation success and long-term conservation efforts. Future studies integrating OMICS technologies could elucidate molecular markers influencing breed-specific differences, helping to refine cryopreservation techniques and improve conservation strategies for indigenous Italian chicken breeds. This work contributes valuable insights to global efforts aimed at safeguarding poultry genetic diversity and sustainability.

Catalyzing IVF outcome prediction: exploring advanced machine learning paradigms for enhanced success rate prognostication

This study addresses the research problem of enhancing In-Vitro Fertilization (IVF) success rate prediction by integrating advanced machine learning paradigms with gynecological expertise. The methodology involves the analysis of comprehensive datasets from 2017 to 2018 and 2010–2016. Machine learning models, including Logistic Regression, Gaussian NB, SVM, MLP, KNN, and ensemble models like Random Forest, AdaBoost, Logit Boost, RUS Boost, and RSM, were employed. Key findings reveal the significance of patient demographics, infertility factors, and treatment protocols in IVF success prediction. Notably, ensemble learning methods demonstrated high accuracy, with Logit Boost achieving an accuracy of 96.35%. The implications of this research span clinical decision support, patient counseling, and data preprocessing techniques, highlighting the potential for personalized IVF treatments and continuous monitoring. The study underscores the importance of collaboration between gynecologists and data scientists to optimize IVF outcomes. Prospective studies and external validation are suggested as future directions, promising to further revolutionize fertility treatments and offer hope to couples facing infertility challenges.

The Impact of Laparoscopic Treatment on Fertility Outcomes in Patients with Severe Endometriosis

Background: Endometriosis, a prevalent gynecological disorder affecting women of reproductive age, is a significant cause of infertility, especially in severe cases involving extensive adhesions, endometriomas, and deep infiltrating lesions. In Bangladesh, the delay in diagnosis and limited access to advanced treatments, including laparoscopic surgery, poses challenges to improving fertility outcomes for women with severe endometriosis. Objective: This study aimed to assess the impact of laparoscopic treatment on fertility outcomes in patients with severe endometriosis, particularly in a resource-limited healthcare setting in Bangladesh. Methods: This retrospective cohort study included 78 women with severe endometriosis from tertiary hospitals in Dhaka and Khulna, Bangladesh. All participants had previously experienced unsuccessful in vitro fertilization (IVF) attempts and subsequently underwent laparoscopic surgery between 2015 and 2024. Data collection involved reviewing primary and secondary data from these tertiary hospitals, including medical records and operative reports, and was supplemented by follow-up interviews for comprehensive analysis. Variables such as patient age, infertility duration, previous IVF cycles, operative findings, and postoperative fertility outcomes were analyzed using SPSS, with statistical significance set at P &lt; .05. Results: The mean age of patients was 34.3 years, and the average duration of infertility was 52.9 months. Post-laparoscopic surgery, 42.3% (33/78) of women successfully delivered, with 7% achieving spontaneous conception. Younger age, fewer prior IVF cycles, and a normal uterine appearance on transvaginal ultrasound were significantly associated with improved fertility outcomes. Salpingectomy was more common among those who delivered (70%), though the removal of ovarian endometriomas did not significantly impact fertility success. Conclusion: Laparoscopic treatment significantly improves fertility outcomes in Bangladeshi women with severe endometriosis, even in a resource-limited setting. Age, normal ovarian function, and uterine appearance were key factors influencing reproductive success. These findings underscore the importance of timely surgical intervention for endometriosis-related infertility, highlighting the need for improved access to laparoscopic surgery in low-resource healthcare systems.

Male Factor Infertility and the Rural—Urban Continuum

OBJECTIVETo examine the association between male factor infertility and the Rural—Urban continuum. MATERIALS AND METHODSSingle institution retrospective cohort study using the Utah Population Database (UPDB), which combines demographic, medical, and residential data for patients residing in Utah and links to the Subfertility Health Assisted Reproduction and Environment (SHARE) database, which houses fertility data from 1998-2017. The data was divided by metropolitan (metro-) [large, medium, small], and non-metropolitan (non-metro-) [urban, rural] status, based on United States Department of Agriculture (USDA) rural-urban continuum codes (RUCC). RESULTSNon-metro urban/rural males were less likely to be a racial/ethnic minority (91.3% non-Hispanic white vs 85.7%), or use assisted reproductive technology (ART) (13.4% vs 18.5%). Multivariate regression controlling for race/ethnicity, age, semen analysis category (oligozoospermic vs normozoospermic), previous successful fertility outcome, and use of ART, demonstrated complete rurality was associated with decreased likelihood of successful fertility outcome (Hazard Ratio [HR] 0.63, 95% CI 0.44–0.91, n=65). Non-metro urban individuals trended towards lower likelihood of successful fertility outcome ([HR] 0.93, 95% CI 0.85–1.01). Complete rurality was associated with longer time for 50% cohort successful fertility outcome (>60 months vs approximately 34 months both metro). All comparisons p<0.001. CONCLUSIONSAcross the rural—urban continuum, residing in a metro area was associated with higher rates of racial/ethnically diversity, fertility treatment utilization, and successful fertility outcomes (live births). Given approximately 18% of the United States resides with a rural community (12% in Utah), these findings can provide more informed infertility care.

Outcome of Endometriosis Treatment In Infertile Patients In A Tertiary Level Hospital

Introduction: Prevalence of endometriosis is 6-10% in reproductive-age females. Around 25-35% of infertile women may be affected by endometriosis. Modalities of treatment for infertile patients depends on the stage of the disease. It starts from ovulation inducing drug to advanced ART. The objective of this study was to assess the outcome of surgical treatment in infertile, endometriosis patients. Materials and Methods: It was an observational study, which was conducted at Reproductive Endocrinology and infertility Unit, Dhaka Medical College. Total 144 patients were included during July 2018 to July 2021, aged 20-40 yrs. All the demographic variables, clinical and sonographic findings, and hormonal assessment were done. Then, staging was done by clinical pelvic assessment, and ultrasonographic findings. Patients who had ovarian endometrioma, more than 4 cm, were selected for laparoscopic surgery. In patients whose endometrioma was less than 4 cm, or had no ovarian endometrioma, were selected for ovulation induction with or without prior GnRH agonist therapy. Further infertility management were planned according to ovarian reserve, tubal patency, and male factor. Result: Mean age of the patients were 28.30±4.95 yrs. 75.0% patients had primary infertility. Dysmenorrhea was the most common symptom (86.96%), followed by chronic pelvic pain (81.16%). Bilaterality of endometrioma was associated with decreased serum AMH. Laparoscopic surgery was the mainstay of treatment, Cystectomy was done in 58% patients. Conservative treatment was done in remaining patients. Fertility enhancing treatment was done by ovulation inducing drug -letrozole, GnRH agonist, followed by controlled ovarian stimulation and followed by IUI. IVF was advised for fertility management in 26patients (18.06%). Conclusion: Endometriosis is not only associated with decreased ovarian reserve but also responsible for diminished response to ovarian stimulation. So, it is a great challenge to obtain successful fertility treatment for this group of patients. J Dhaka Med Coll. 2023; 32(1) : 9-15

Environmental microplastics compromise reproduction of the marine invertebrate Mytilus galloprovincialis: A holistic approach

The extensive presence of microplastics (MPs) in marine ecosystems constitutes a major threat to aquatic environments. The gametes of the marine invertebrate Mytilus galloprovincialis, which is essential for coastal ecosystems, are released directly into the water, potentially exposing them to environmental microplastics (EMPs). This study examined the effects of exposing M. galloprovincialis gametes to 50 or 100 µg/L EMP for 1 h on fertilization rates, larval quality, and the molecular mechanisms underlying the induction of apoptosis and shell growth. Our findings show that increased EMP concentrations correlate with reduced fertilization success and higher rates of larval malformations, indicating negative impacts on embryonic development. Additionally, DNA degradation in larvae is related to the EMP concentration. The apoptosis-associated proteins Bax, P53, and Cas-3 are upregulated, whereas Bcl-2 and DNA-ligase are downregulated with increasing EMP concentrations. Prothymosin-ɑ (PTMA), which is crucial for cell proliferation, also decreases with increasing EMP concentrations, contributing to impaired cell proliferation and growth imbalances. Reduced HRG gene expression is correlated with decreased shell growth and larval malformations. This study underscores the detrimental impact of EMPs on bivalve gametes, which impacts fertilization success and larval quality and highlights the potential risks to species survival and marine ecosystem stability.

The Effect of Biobased N and P Fertilizers in a Winter Wheat–Ryegrass Crop Rotation

Novel recycled fertilizers could help close environmental nutrient cycles in the circular economy. To better understand their performance and residual value, commercially available biobased nitrogen (N) and phosphorus (P) fertilizers (BBFs) were tested in a two-year crop cycle of winter wheat and ryegrass. The N fertilizer replacement value of N-BBFs ranged from 47 to 80% in the main crop. Not all BBFs led to a similarly high N concentration in the mineral reference wheat straw. However, full and early fertilization with incorporation could make the fertilizing effect of N-BBFs more reliable. The P fertilizer replacement value ranged between 105 and 161% for the crop cycle. We assume that the N contained in biobased phosphorus fertilizers can be seen as unproblematic for losses during winter and can serve as a starter fertilizer already present in the soil for the succeeding crop in spring. In general, biobased P fertilizers had a higher residual value than biobased N fertilizers. However, these residual values were comparable to those of mineral fertilizer references. While P-BBFs proved to be a sustainable and reliable nutrient source for a crop cycle, the N-BBFs used as the main crop fertilizer were found to be more prone to environmental influences.

Factors Associated with In-Vitro Fertilization Success in Polycystic Ovary Syndrome

Factors Associated with In-Vitro Fertilization Success in Polycystic Ovary Syndrome

7119 Klinefelter Syndrome in a Tertiary Referral Clinic: A Case Series and Clinical Audit

Abstract Disclosure: J. Luo: None. S. Sarlos: None. R. Giri: None. I. Sim: None. R.I. McLachlan: None. C.A. Allan: None. R. Upreti: None. Background: Klinefelter syndrome, the most common chromosomal disorder in men, remains underdiagnosed in many of those affected. Klinefelter syndrome is associated with hypogonadism and infertility, as well as an increased risk for venous thromboembolism (VTE), cardiometabolic disease, osteoporosis and gynaecomastia in adults. We studied the clinical features and disease associations in a tertiary referral cohort, and audited the care provided. Methods: Following ethics approval, adult patients with Klinefelter syndrome attending a Clinical Andrology Service in a tertiary Australian institution since 1 January 2011 were recruited. A database was established and demographics, aspects of initial diagnosis, ongoing treatments and comorbidities were documented. We audited our care using the European Academy of Andrology 2021 Guidelines for Klinefelter Syndrome. Results: Of 94 patients eligible, 57 patients consented to participation. The median age of diagnosis was 28 years, with the most common karyotype being 47,XXY (74%), followed by mosaic (20%) and higher degree polysomy (6%). Infertility (44%) and hypogonadism (33%) were the most common reasons for diagnosis. Most patients (88%) were treated with testosterone. Five men (11%) had genetic children with seven (18%) having previously attempted surgical sperm extraction. VTE occurred in seven patients (12%), with five on long-term anticoagulation following VTE diagnosis. Cardiovascular risk factor prevalence assessed at a median age of 42 years included increased BMI (72%), hypertension (25%), dyslipidaemia (70%), tobacco use (26%), impaired fasting glucose (11%) and type 2 diabetes (22%), though only one patient had a previous cardiovascular event. Osteopenia and osteoporosis were present in 28% and 4% of patients respectively, though only two patients had minimal trauma fractures. The audit of longitudinal care showed that gynaecomastia status was underreported (42%) in our clinic, whilst assessment and management of other health domains were mostly in keeping with the current recommendations. Conclusions: Klinefelter syndrome diagnosis continues to be delayed until adulthood in many men, with presentations most commonly involving infertility and/or hypogonadism. Our tertiary cohort demonstrates low rates of fertility treatment and success, which is likely multifactorial. There is a high burden of VTE, cardiovascular risk factors and reduced bone density despite testosterone treatment. Low rates of cardiovascular events and fracture may be reflective of a younger cohort as well as more aggressive risk factor management in a sub-specialist service. Gynaecomastia identification, documentation and management are areas for potential improvement. Increased awareness of Klinefelter syndrome and research into its associated risks are essential for standardising care and improving long-term outcomes. Presentation: 6/1/2024

7119 Klinefelter Syndrome in a Tertiary Referral Clinic: A Case Series and Clinical Audit

Abstract Disclosure: J. Luo: None. S. Sarlos: None. R. Giri: None. I. Sim: None. R.I. McLachlan: None. C.A. Allan: None. R. Upreti: None. Background: Klinefelter syndrome, the most common chromosomal disorder in men, remains underdiagnosed in many of those affected. Klinefelter syndrome is associated with hypogonadism and infertility, as well as an increased risk for venous thromboembolism (VTE), cardiometabolic disease, osteoporosis and gynaecomastia in adults. We studied the clinical features and disease associations in a tertiary referral cohort, and audited the care provided. Methods: Following ethics approval, adult patients with Klinefelter syndrome attending a Clinical Andrology Service in a tertiary Australian institution since 1 January 2011 were recruited. A database was established and demographics, aspects of initial diagnosis, ongoing treatments and comorbidities were documented. We audited our care using the European Academy of Andrology 2021 Guidelines for Klinefelter Syndrome. Results: Of 94 patients eligible, 57 patients consented to participation. The median age of diagnosis was 28 years, with the most common karyotype being 47,XXY (74%), followed by mosaic (20%) and higher degree polysomy (6%). Infertility (44%) and hypogonadism (33%) were the most common reasons for diagnosis. Most patients (88%) were treated with testosterone. Five men (11%) had genetic children with seven (18%) having previously attempted surgical sperm extraction. VTE occurred in seven patients (12%), with five on long-term anticoagulation following VTE diagnosis. Cardiovascular risk factor prevalence assessed at a median age of 42 years included increased BMI (72%), hypertension (25%), dyslipidaemia (70%), tobacco use (26%), impaired fasting glucose (11%) and type 2 diabetes (22%), though only one patient had a previous cardiovascular event. Osteopenia and osteoporosis were present in 28% and 4% of patients respectively, though only two patients had minimal trauma fractures. The audit of longitudinal care showed that gynaecomastia status was underreported (42%) in our clinic, whilst assessment and management of other health domains were mostly in keeping with the current recommendations. Conclusions: Klinefelter syndrome diagnosis continues to be delayed until adulthood in many men, with presentations most commonly involving infertility and/or hypogonadism. Our tertiary cohort demonstrates low rates of fertility treatment and success, which is likely multifactorial. There is a high burden of VTE, cardiovascular risk factors and reduced bone density despite testosterone treatment. Low rates of cardiovascular events and fracture may be reflective of a younger cohort as well as more aggressive risk factor management in a sub-specialist service. Gynaecomastia identification, documentation and management are areas for potential improvement. Increased awareness of Klinefelter syndrome and research into its associated risks are essential for standardising care and improving long-term outcomes. Presentation: 6/1/2024

Biochemical analysis and fertilization success of Cirrhinus mrigala ova during induced spawning

Fish egg quality is very crucial in aquaculture sector for production of healthy seed. Egg yolk is an energy reservoir for growth and development of embryo. This study evaluated the biochemical composition and quality of Cirrhinus mrigala eggs at three different hatchery sites of Pakistan, (Site 1= Fish Seed Hatchery, District Pakpattan; Site 2= Sidhuwan Hatchery, Head Balloki, District Kasur; Site 3= Chenab Fish Hatchery, Rangpur, District Muzaffargarh) during induced breeding. For this, a total of 36 (18 males and 18 females) fish brooders, 12 (06 males and 06 females) from each site were utilized. Fatty acids analysis revealed significant differences among three different sites. Saturated fatty acids i.e., palmitic acid (C16:0) and stearic acids (C18:0) were higher at site 2 compared to the others sites. Monounsaturated fatty acids i.e., Oleic acid (C18:1) and polyunsaturated fatty acids i.e., Docosahexaenoic acid (DHA) (C22:6) exhibited considerably greater values at site 2 than those of other two sites. Egg mineral contents unveiled remarkable differences, particularly at site 2 indicating significantly higher mineral contents except copper (Cu) in comparison to the other sites. Significant variation exists in fertilization and hatching rates during induced spawning, with the highest values recorded at site 2. It is concluded that biochemical composition of egg especially fatty acid profile and mineral content greatly influences the embryonic development and hatching success of farm reared Cirrhinus mrigala.

Different Nitrogen Levels with Nano and Prilled Urea Spray on Productivity and Profitability of Maize (Zea mays L.) in alfisols of Jharkhand

A ground-breaking and enduring way to significantly reduce the use of conventional nitrogen fertilizer is to use nano-urea as a nitrogen supplement. The combination of nano and prilled urea was investigated in this study to address this issue and allowing for a 25% reduction in the recommended urea dosage. Research on rainfed maize during kharif season was conducted at ICAR-IARI Jharkhand. Twelve different combinations of conventional prilled urea, nano and prilled urea spray were investigated in the study. In the fields, the experiment used a randomized block design. Different treatments included applying prilled urea as a 2% solution in 150 liters of water per hectare and nano-urea at a rate of 1250 ml/acre applied twice through foliar application. Results showed that applying two additional applications of nano-urea along with 75% of the recommended dose of prilled-urea was the most successful fertilization strategy. This performed statistically equal with both the 100% recommended dose and the 100% recommended dose with two prilled urea spray applications in terms of yield, and cost-to-benefit ratio. The study's findings show that nano-urea can safely replace at least 25% of the dosage of prilled urea i.e. recommended, providing a more profitable and environmentally friendly method of cultivation.