Undescended testes (UDTs) are common in male infants. Untreated UDT poses risks such as infertility (IF), testicular cancer (TC), and testicular torsion (TT). Retractile testes (RTs) sporadically ascend from the scrotum. UDT requires early surgical correction, whereas RT requires only periodic follow-up. Differentiating these conditions is challenging, making clinical biomarkers potentially useful. The aim of our study was to examine the use of miRNAs as biomarkers in the differential diagnosis of UDT and RT which are difficult to differentiate. This prospective pilot/exploratory study included 10 boys with UDT (operated), 9 with RT (followed), and 9 controls. Only palpable (unilateral or bilateral) UDT cases were included, excluding nonpalpable types. To ensure accurate RT diagnosis, initial physician examinations were performed in three positions (supine, semi-supine, standing), followed by a 1-month parental examination (twice daily). Only RT patients whose testes spent > 50% of their time in the scrotum were included. The exclusion criteria also included prior inguinal/scrotal surgery, defective datasets, or unsuitable serum samples. Parent consent and serum samples were collected to evaluate miR-210, miR-34c, and miR-449a expression via real-time PCR. Statistical analysis revealed no significant difference in miR-34c (p = 0.157) or miR-210 (p = 0.950) expression. However, the miR-449a level differed significantly between the groups (p = 0.033). Dunn-Bonferroni post hoc correction revealed significantly greater miR-449a in the RT group than in the UDT group (p < 0.05). No difference in miR-449a expression was found between the control and UDT groups (p > 0.05). Serum miR-449a demonstrated significant diagnostic potential in differentiating UDT from retractile testis (AUC: 0.822, p = 0.017) with 90.0% sensitivity and 77.8% specificity. These findings suggest that miR-449a could serve as a promising non-invasive biomarker to distinguish true undescended testis from its clinical mimics. Serum miRNA levels represent a potential tool for differentiating UDT from RT. Our pilot/exploratory study partially corroborates this, but comprehensive prospective randomized trials with larger cohorts are essential to definitively clarify miRNA alterations for precise distinction. This prospective case-control study was registered to clinicaltrials.gov database, 'retrospectively'. The trial registration number is: NCT07315737, the unique protocol ID is: 2022/25.

THE CANCER SURVIVORSHIP CLINIC IN FERTILITY CARE: DEMOGRAPHICS AND MEASURES OF OVARIAN RESERVE

BREAKING BARRIERS IN FERTILITY TESTING: COMPLETION TRENDS IN MAIL-IN SEMEN ANALYSES ACROSS FLORIDA

ACCESS TO INFORMATION IN FERTILITY PRESERVATION: EVALUATING THE UTILITY OF LARGE LANGUAGE MODELS

Introduction: Chromosomal polymorphisms are variations in chromosomes in normal populations, generally affecting heterochromatic regions, which are poor in protein-coding genes. Several international studies associate the influence of chromosomal polymorphisms with pregnancy loss.Objective: To analyze and characterize the frequency and types of chromosomal polymorphisms found in these patients, as well as to explore possible correlations between these variations and the different reproductive disorders observed.Methods: Patients with reproductive disorders who had a polymorphic variant of chromosomes 1, 9, 16, or Y and acrocentric chromosomes 13, 14, 15, 21, or 22 were selected. They were analyzed in different groups: recurrent pregnancy loss (I) and infertility (II). Results: Of 549 patients with reproductive disorders, chromosomal polymorphisms were detected in 61 (11%). The most frequent polymorphisms were 1qh-, 9qh+, 21pstk+, inv 9, and 16qh+. The group with recurrent miscarriages presented 45.4% of the most frequently found polymorphisms. Cases of infertility alone accounted for only 24.2%. In both groups analyzed, female patients predominated over males.Conclusions: The percentage of chromosomal polymorphisms found in the study sample is consistent with international reports on this topic. An unusual chromosomal polymorphism of chromosome 1 was found with relative frequency, which could constitute an inherent characteristic of the population studied. Chromosomal polymorphisms of chromosome 9 are the most recurrent finding involved in reproductive disorders.

Background: The use of tubectomy contraception is one way to control birth rates and improve reproductive health. Tubectomy is a permanent form of contraception that involves blocking or sealing the fallopian tubes to prevent the egg from reaching the uterus for fertilization. This article analyzes the factors that influence the use of tubectomy contraception among couples of childbearing ages. Objective: This literature review aims to identify factors that influence the use of the tubectomy method in fertile couples. Design: This research design is a literature review. Data Sources: Search for articles using three journal databases, namely Google Scholar, PubMed, and ScienceDirect. Reviews Methods: Used PRISM flow diagram to find a total of 6 articles that meet the inclusion criteria reviewed. Results: Inclusion criteria include full text articles from 2015-2024 published from national or international journals. Article types are quasi-experimental and case studies. Five articles meet the inclusion criteria. the various techniques used in tubectomy, the benefits and risks associated with the procedure, and its effectiveness in preventing pregnancy. Tubectomy can be done through different methods. Conclusion: Tubectomy is crucial to recognize and address the social stigmas surrounding tubectomy in order to create a more supportive and understanding environment for individuals seeking this form of birth control. By promoting open dialogue and challenging misconceptions, we can work towards creating a more inclusive society where individuals feel empowered to make informed decisions about their reproductive health.

GENERATIVE AI SOLUTIONS FOR OVERCOMING INFORMATION RETRIEVAL CHALLENGES IN FERTILITY CARE

DISPARITIES IN FERTILITY PRESERVATION COUNSELING AND REFERRALS FOR PATIENTS SEEKING GENDER-AFFIRMING CARE

Introduction:Abnormal uterine bleeding is any significant deviation from a woman’s established menstrual pattern including menorrhagia, metrorrhagia, and polymenorrhea. Abnormal uterine bleeding (AUB) is a common complaint in the female population, with an estimated prevalence of 10 to 30% in fertile age. Trans vaginal ultras onography (TVUS) has been used as an initial diagnostic tool in AUB, because it proved safe and cost-effective, generally painless and virtually complication free. Compared with appropriate gold standards including histopathology, the sensitivity and specificity of sonography support its use. TVUS plays a key role in the diagnosis of structural causes of AUB such as polyps, adenomyosis, leiomyoma and endometrial cancer (PALM) and can also be used for the evaluation of nonstructural causes such as ovulatory dysfunction. In fact, American college of obstetricians and gynecologists describes TVUS as the ‘‘primary imaging test of the uterus for the evaluation of abnormal uterine bleeding.’’Aim of the Work:The aim of this study was to evaluate the efficacy of trans vaginal ultrasound in assessment of abnormal uterine bleeding in fertile Egyptian patients.

(267) SPERM EXTRACTION IN MEN INTERESTED IN FERTILITY AFTER RADICAL PROSTATECTOMY

Abstract Study question Can we monitor post-oocyte retrieval ovarian hyperstimulation syndrome (OHSS) in the French national health data system to complement the French ART vigilance system? Summary answer Medico-administrative databases offer a more comprehensive view of post-oocyte retrieval complications and can be used to detect abnormal increases in frequency and outlier ART centers. What is known already Assisted reproductive technology (ART), widely used in Europe, accounts for about 3% of births in France. The various studies of ART complications are reassuring, showing relatively low overall complication rates. Nonetheless, the European Union has established a vigilance system to monitor these complications. However, this system is not an exhaustive source of information and does not provide a complete overview of post-ART complications. Study design, size, duration The study population was identified from the comprehensive French National Hospital discharge database and included 53,490 women under 46 years old who underwent 65,924 oocyte retrievals in 2022. Women were classified into three population subgroups according to the indication of oocyte retrieval: infertility (IF), fertility preservation (FP), and oocyte donation (OD). Participants/materials, setting, methods Hospital stays for OHSS within two months post-retrieval were analyzed and characterized according to various characteristics (age, comorbidities, indication of oocyte retrieval, type of hospital stay, length of hospital stay...). Multivariate analysis was performed to determine the relation between the occurrence of OHSS and women’s characteristics, and results are expressed as odds ratios (ORs) and 95% CI. A funnel plot was used to compare the OHSS rate per center with the national average. Main results and the role of chance Hospitalized OHSS accounted for 1.1% of retrievals in 2022 (n = 718). The mean age of the women was 31.6 years (SD 4.5). Women with Polycystic Ovary Syndrome (PCOS) accounted for about 4% of the women with OHSS. More than half of OHSS hospital stays lasted less than two days (54%). Of these stays, 2% of women were in intensive care. Multivariate analysis showed a significantly higher OHSS risk in women under 30 and those with PCOS. Other risk factors are currently introduced into the model, such as a history of OHSS or pregnancy. Funnel plot analysis showed that one ART center has an OHSS rate significantly higher than the national average. In the centers that stand out from all the others, the objective is to return to these centers to understand the possible reasons for this observed rate and to implement corrective measures. Limitations, reasons for caution Despite all its advantages, the French national health data system presents some limitations, such as the risk of inappropriate coding. Moreover, the unavailability of personal or clinical information prevented us from considering certain risk factors. Wider implications of the findings Despite the limits of using medico-administrative databases, this approach provides a better representation of post-ART complications and is a promising way to complement the ART vigilance reporting system. This concept will also be generalized to other complications with regular feedback to professionals. Trial registration number not applicable

Can we monitor post-oocyte retrieval infections in the French national health data system to complement the French ART vigilance system? Medico-administrative databases provide a more comprehensive view of post-oocyte retrieval infections and can be used to detect abnormal increases in frequency and outlier ART centers as a complementary tool to the ART vigilance system. The various studies of ART complications are reassuring, showing relatively low overall complication rates. Nonetheless, the European Union has set up a vigilance system to monitor these complications. However, this system is not an exhaustive source of information and does not provide a complete overview of post-ART complications. The study population was identified from the comprehensive French national hospital discharge database. It included women under 46 years of age undergoing an oocyte retrieval in 2019, classified into three population subgroups according to the indication of oocyte retrieval: infertility (IF) , fertility preservation (FP), and oocyte donation (OD) . The study population included 52 098 women who had undergone 65 948 oocyte retrievals in 2019. Hospital stays and delivery of antibiotics within 31 days after oocyte retrieval were analyzed. Women and infections were characterized according to various characteristics (age, comorbidities, indication of oocyte retrieval, type of hospital stay, length of hospital stay, type of antibiotherapy, etc.). Multivariate analysis was performed to determine the relation between the occurrence of infection and women's characteristics, and results are expressed as odds ratios (ORs) and 95% CI. A funnel plot and a box plot were used to compare the infection rate per center with the national average and to detect outliers. Infections in the month following the oocyte retrieval represented 6.9% of the procedures in 2019 (n = 4522). Of these infections, 112 were hospitalized (0.2% of oocyte retrievals), and 4410 were non-hospitalized (6.7% of oocyte retrievals). The hospitalized infections were essentially gynecological infections (40.9%) and urinary tract infections (23.5%). In 87.9% of non-hospitalized infections, a single antibiotic therapy was prescribed. Mixed-effect model analysis showed that the risk of infection was significantly higher in women under 30 years of age, in the FP population, in supplementary universal health coverage (CMU-C) beneficiaries, and women with endometriosis. Funnel plot and box plot analysis showed that three ART centers have an infection rate significantly higher than the national average. In the three centers that stand out from all the others, the objective is to return to these centers to understand the possible reasons for this observed rate and to implement corrective measures. Despite all its advantages, the French national health data system presents some limitations, such as the risk of inappropriate coding. Another limitation of this study is that we cannot confirm an attributable relation between the infection and the ART procedure, even if the delay of 31 days after oocyte retrieval is consistent with the occurrence of a post-retrieval complication. In addition, antibiotics may be prescribed as a 'precautionary' measure in certain situations (women with a susceptibility to infection, complicated procedures), or as antibiotic prophylaxis for embryo transfer. Despite the limits in identifying post-ART infections in medico-administrative databases, this approach is a promising way to complement the ART vigilance reporting system. This concept developed for infections will also be generalized to other complications with regular feedback to professionals. No specific funding was sought for the study. The study was supported by the Agence de la biomédecine, France. The authors declare that they have no conflict of interest. N/A.

BEST PRACTICES FOR SPERM CRYOPRESERVATION PRIOR TO GONADOTOXIC TREATMENT: RECOMMENDATIONS FROM LEADERS IN FERTILITY PRESERVATION

DISTRIBUTION OF TESTOSTERONE TO ESTRADIOL RATIOS IN FERTILE AND SUBFERTILE MEN: A LARGE COHORT ANALYSIS

The study aims to access the variations in the levels of LH and FSH hormonal status in Obesity condition. Nowadays obesity is a very common condition we can see in most of the people living in developing countries. It causes so many other health problems along with their regular lifestyle habituates. In that infertility is one of the important problems occurs due to obesity by altering the hormonal levels in the female population. 30 obese patients and 30 healthy individuals from the OP of Saveetha Dental College. Serum samples were analysed for their hormonal status by using a kit method in auto analyser. There is a significant increase in LH (12.88 ± 6.69) and FSH (9.55 ± 4.8) as well as their ratio (LH/FSH- 1.93 ± 2.13) by the influence of obesity on them. The study states that a high risk of obesity may lead to hormonal imbalance which may lead to infertility in obese female patients.

Nowadays a huge number of people suffer from infertility throughout the world due to diabetes and irregular life-style. The number reaches 60-80 million globally. Diabetes mellitus is a chronic non-curable but manageable disease. According to the International Diabetes Federation (IDF) report released in November 2021, the number of adult people suffering from diabetes mellitus (DM) has risen from 108 million in 1980 to 537 million in 2021 and according to the previous IDF report, it was about 387 million in 2014 and 463 million in 2019. Type1 diabetes causes decrease in insulin level and degrades essential proteins of the body. Type 2 Diabetes Mellitus is the most common form of the diabetes mellitus and it was formerly known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. This T2DM comprises a cluster of dysfunctions that is generally characterized by hyperglycemia and it results from the combined effect of relative insulin insufficiency or insufficient secretion of insulin, insulin resistance and excessive or uncontrolled glucagon secretion. The study focuses on diabetes associated infertility and treatments. Throughout various physiological mechanisms type1 and type2 diabetes mellitus affect male and female infertility. This finding thus creates a relationship between diabetes mellitus and infertili ty and possible effective treatments.

The selection of sows that are reproductively fit and produce large litters of piglets is imperative for success in the pork industry. Currently, low heritability of reproductive and litter-related traits and unfavourable genetic correlations are slowing the improvement of pig selection efficiency. The integration of biomarkers as a supplement or alternative to the use of genetic markers may permit the optimization and increase of selection protocol efficiency. Metabolite biomarkers are an advantageous class of biomarkers that can facilitate the identification of cellular processes implicated in reproductive condition. Metabolism and metabolic biomarkers have been previously implicated in studies of female mammalian fertility, however a systematic analysis across multiple biofluids in infertile and high reproductive potential phenotypes has not been explored. In the current study, the serum, urinary and salivary metabolomes of infertile (INF) sows and high reproductive potential (HRP) sows with a live litter size ≥ 13 piglets were examined using LC-MS/MS techniques, and a data pipeline was used to highlight possible metabolite reproductive biomarkers discriminating the reproductive groups. The metabolomes of HRP and INF sows were distinct, including significant alterations in amino acid, fatty acid, membrane lipid and steroid hormone metabolism. Carnitines and fatty acid related metabolites were most discriminatory in separating and classifying the HRP and INF sows based on their biofluid metabolome. It appears that urine is a superior biofluid than saliva and serum for potentially predicting the reproductive potential level of a given female pig based on the performance of the resultant biomarker models. This study lays the groundwork for improving gilt and sow selection protocols using metabolomics as a tool for the prediction of reproductive potential.

ARE PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) OUTCOMES DIFFERENT IN INFERTILE (INF) AND FERTILE (FT) PATIENTS (PTS)?

A SMALL DIGITAL FOOTPRINT OF PSYCHOLOGICAL SERVICES IN FERTILITY CLINICS: A WEBSITE CONTENT ANALYSIS

LIFESTYLE COACHING APP MYFERTICOACH SHOWS HIGH ADHERENCE IN FERTILITY PATIENTS