Influence Pregnancy Rates Research Articles

P-231 How many blastocysts are necessary to reach pregnancy with preimplantation genetic testing?

Abstract Study question What is the influence of the number of blastocysts before biopsy on the prognosis of pregnancy in preimplantation genetic testing for aneuploidy (PGT-A) cycles? Summary answer The number of pre-biopsy blastocysts seems to be a parameter that can be used as a prognostic factor for the pregnancy chance in PGT-A cycles. What is known already Advances in embryo cryopreservation techniques have allowed for a greater use of PGT. Studies showed that PGT-A has improved live birth rates while reducing the number of embryos transferred. There is a lot of information about the role of the oocyte number as a predicting factor for pregnancy rate. However, little information is available about the influence of the number of blastocysts before performing PGT-A on the chance of achieving a pregnancy. Study design, size, duration Retrospective study performed in a reproductive medicine center using the first IVF cycle from 2016 to 2023, including 682 patients with at least one blastocyst before undergoing PGT-A. All patients performed a single embryo transfer in each procedure, in up to 4 transfers. Participants/materials, setting, methods The sample was divided into four groups according to the blastocyst number: G1, 1 to 2 blastocysts (n = 324); G2, 3 to 4 (n = 197); G3, 5 to 9 (n = 137); and G4, ≥ 10 blastocysts (n = 24); each group was divided according to female age (≤ 37 and > 37) Variables: female age, and euploidy, clinical pregnancy per transfer and cumulative clinical pregnancy rates. Data were compared between groups. Statistical analysis: Chi-square test (Bonferroni correction) and Anova (p < 0.05). Main results and the role of chance The results in G1, G2, G3 and G4 were, respectively: female age, yo (40 vs. 38.4 vs. 37.2 vs. 34.7, p < 0.01); euploidy rate (34.6 vs. 67.2 vs. 83.2 vs. 100.0, p < 0.0001), clinical pregnancy rate per transfer, % (45.5 vs. 58.6 vs. 72.8 vs. 95.8 p < 0.0001 ), cumulative clinical pregnancy rate, % (15,7 vs. 39.4 vs. 60.6 vs. 95,8% p < 0.0001). Women with 1 to 2 blastocysts before biopsy had a cumulative pregnancy rate more than 3-fold lower than those with 3 to 4 blastocysts (%, 39.6 vs. 15.3, p < 0.001, OR 3.59, CI 95% 2.32 to 5.57) and more than 8-fold lower than those with 5 to 9 blastocysts (%, 60,6 vs. 15.3, p < 0.001, OR 8.42, CI 95%: 5.20 to 13.64). The comparison in each group according to female age showed that until 9 blastocysts, the younger women had a pregnancy rate higher than the older, respectively (%): G1: 30.8 vs. 12.5, p = 0.001; OR 3.1, CI 95%: 1.44 to 6.48; G2: 57.4 vs. 30.2, p < 0.001; OR 3.10, CI 95%: 1.61 to 5.98; G3: 72.6 vs. 50.7, p = 0.009. OR 2.58; IC 95%: 1.19 to 5.67; and G4: 93.8 vs. 87.5, p = 0.268. Limitations, reasons for caution As a retrospective study, data collection and filling limitations should be considered. Wider implications of the findings The number of pre-biopsy blastocysts appears to be a parameter that can be used as a prognostic factor for the pregnancy chance in PGT-A cycles. Even transferring 1 embryo, the pregnancy rate/transfer was higher with more blastocysts. In patients with less than 10 blastocysts before PGT, age influences pregnancy rates. Trial registration number Not Applicable

Factors influencing pregnancy rate and loss after laparoscopic artificial insemination with frozen-thawed semen in Lohi sheep under sub-tropical conditions.

This study evaluates factors influencing pregnancy rates per artificial insemination (P/AI) and pregnancy loss in Lohi ewes undergoing laparoscopic AI with frozen-thawed semen under sub-tropical conditions. Data from three experiments comprising ewes (n = 358) of mixed parity (nulliparous; NP and parous; P), various body condition score (BCS) and assigned to long-term (LTP, 11 days) and short-term (STP, 5 days) oestrus synchronization regimen across high breeding season (HBS) and low breeding season (LBS) were analysed. Laparoscopic insemination was conducted 54 h post-sponge removal. Pregnancy diagnosis and loss were evaluated on days 35 and 90 post-insemination via ultrasonography. Results showed parity significantly influenced P/AI, with nulliparous ewes achieving higher pregnancy ratios than parous ewes (p = .001). BCS significantly influenced P/AI (p < .05), with a quadratic relationship observed between BCS and season (BCS*BCS*Season; p = .07). Progestin treatment did not significantly influence the ratio of pregnant ewes (p = .07). Pregnancy losses were significantly higher during LBS than HBS (p < .05), irrespective of progestin treatment. In conclusion, parity and BCS significantly influenced P/AI, with BCS demonstrating a quadratic association with season. Ewes bred during LBS experienced higher pregnancy losses than HBS, irrespective of progestin treatment.

130 Moon cycle influences pregnancy rate and pregnancy losses following transfer of bovine embryos produced in vitro

130 Moon cycle influences pregnancy rate and pregnancy losses following transfer of bovine embryos produced in vitro

Comparison of the Administration of 150 or 75 IU of Recombinant LH in Agonist ICSI Cycles Stimulated with Recombinant FSH in Women Aged 35-39: A Comparative Study.

The purpose of the study was to assess whether the coadministration of 150 IU of recombinant LH instead of 75 IU in women aged 35-39 improves the results in agonist ICSI cycles stimulated with 300 IU of recombinant FSH. In this study, two ovarian stimulation protocols coexisted which were identical except in the administered dose of recombinant LH, for which some patients received 150 IU (n=231) and some received 75 IU (n=216). Both groups received 300 IU of recombinant FSH. Gonadotropins were reimbursed by the National Health System. Statistical analysis was performed by Student's t test, χ2, and ANCOVA. Significance level was established at p=0.05. The number of retrieved oocytes was slightly higher in the 300/150 group (9.06±5.53 vs. 8.61±5.11), but the differences were not significant. Results were similar with the number of metaphase II oocytes (7.18±4.86 vs. 6.72±4.72) and the number of fertilized oocytes (4.64±3.2 vs. 4.23±2.72). The per-transfer clinical pregnancy rates exhibited close similarity between both groups (32.84% vs. 32.46%), as did the per-transfer live birth rates (29.90% vs. 30.37%) and the implantation rate. The rate of hyperstimulation syndrome (OHSS) as well as the rate of cancellation due to OHHS risk was similar in both groups. There was also no difference in the miscarriage rate. When results were expressed by per started cycle or by oocyte pick-up, the results remained very similar in both groups. In women aged 35-39 undergoing ovarian stimulation with recombinant FSH in agonist cycles, the coadministration of 75 or 150 UI of recombinant LH did not influence pregnancy rates. However, a slight increase in the number of retrieved oocytes should not be disregarded.

Health insurance and fertility among low-income, childless, single women: evidence from the ACA Medicaid expansions.

Expansions of Medicaid family planning services have been associated with decreases in pregnancy rates. Access to a broader range of medical, non-family planning services may influence pregnancy rates as well if the increased exposure to medical services spills over to other kinds of behaviour. Using a difference-in-difference approach, I examine the impact of the Affordable Care Act (ACA) Medicaid expansions on the propensity of low-income, single women to become single mothers. Previous expansions of Medicaid family planning services allow us to also investigate the influence of access to other medical services (i.e. non-family planning). I find that although access to contraceptives is associated with a reduction in the propensity of becoming a single mother among adult, low-income women, medical services beyond access to contraceptives can provide additional impacts.

P-482 Bacterial vaginosis in a subfertile population undergoing fertility treatments: a prospective cohort study

Abstract Study question Does bacterial vaginosis (BV) influences pregnancy rates during fertility treatments? Summary answer BV does not significantly impact ongoing pregnancy or live birth rates but could affect miscarriage rates. What is known already BV is known to influence several obstetric outcomes, such as preterm delivery and endometritis. Only few studies investigated the effect of BV in subfertile women, and studies found a negative effect of BV on fecundity especially in the in vitro fertilisation (IVF) population. Study design, size, duration Observational prospective study, 76 couples attending a fertility clinic in the Netherlands between July 2019 and June 2022, undergoing a total of 133 attempts of intra uterine insemination (IUI) or IVF. Participants/materials, setting, methods Participants undergoing IUI, IVF or intra cytoplasmatic sperm injection (ICSI). Vaginal samples taken at oocyte retrieval or insemination were analysed on qPCR BV and 16S rRNA gene microbiome analysis of V1-V2 region. Logistic regression with a Generalized Estimated Equations (GEE) analysis was used to account for multiple observations per couples. Main study outcome was defined as ongoing pregnancy at 12 weeks. Secondary outcomes were miscarriage rate and live birth rate. Main results and the role of chance A total of 26% of the 133 samples tested positive for BV. No significant differences were observed in ongoing pregnancy or live birth rates based on BV-status (OR 0.50 (0.16-1.59), aOR 0.32 (0.09-1.23)) or microbiome community state type (CST). There was a tendency of more miscarriages based on positive BV status (OR 4.22 (1.10-16.21), aOR 4.28 (0.65-28.11)) or microbiome CST group III/IV. Sample outcomes of qPCR BV were in accordance with their microbiome analyses. On baseline groups significantly differed on smoking status and body mass index (BMI). Odds ratios were adjusted for smoking status, BMI and socioeconomic status. Limitations, reasons for caution Numbers of the initial sample size calculation were not met. Therefore, numbers may be too small to draw firm conclusions. Wider implications of the findings This study describes the influence of BV or an abnormal microbiome in a subfertile population undergoing fertility treatments. A possible effect of lifestyle factors on BV-status is shown. Combining qPCR and microbiome results and analysing both IUI and IVF/ICSI treatments can contribute to better generalisability to the consulting room. Trial registration number Z21.031

Multivariable analysis to investigate factors associated with day 14 to 16 pregnancy rate in Thoroughbred mares on an intensively managed UK stud farm

Reproductive losses limit the output of the Thoroughbred mare. Identifying factors that influence pregnancy rates could help inform practices aimed at maximizing productivity. The most recent UK-based study to identify factors influencing day 14-16 pregnancy rates utilized only univariable analysis and was conducted on data from over 20 years ago. The aim of this study was to use multivariable analysis to investigate associations between mare and cycle level factors and day 14-16 pregnancy rates (PRs) on an intensively managed UK Thoroughbred stud farm. A retrospective cohort study was performed on all available reproductive data from farm and veterinary records for the 2017-2021 breeding seasons. Information was collected on season, month of cover, stallion, mare age, status, parity, location at cover, covered cycle number (within the season), number of coverings and ovulations (within the covered cycle), and all reproductive therapeutics (estrous induction agents, ovulatory agents, and pre-and post-covering treatments) administered. Multivariable mixed effect logistic regression modelling, with mare included as a random effect in all analyses, was used to identify factors associated with a positive pregnancy diagnosis at days 14-16 post-cover. Data were available for 1098 covered estrous cycles in 360 mares over 5 breeding seasons. The overall day 14-16 PR (proportion of coverings with a positive pregnancy diagnosis at day 14-16 post-cover) for the study period was64.5% (708/1098; 95% confidence interval (CI) =61.6, 67.3). In the final multivariable model (adjusted for the effect of the mare (Theta 0.39, P=0.003) increasing mare age (OR 0.93 per year increase in mare age, 95% CI 0.89, 0.98 P=0.01), a course of altrenogest pre-cover (administered to n=61/833 cycles OR 0.47, 95% CI 0.26, 0.85 P=0.01), treatment with intrauterine hyperimmune plasma pre-cover (n=61/829 OR 0.39, 95% CI= 0.21, 0.75 P=0.005), and the use of sole -oxytocin therapy post-cover (n=183/829 OR 0.59, 95% CI 0.40, 0.87 P=0.007) were all associated with reduced likelihood of a positive pregnancy diagnosis at days 14-16 post-cover. Although therapeutic agents could directly influence PRs, it is also likely that their use represents conditions such as acyclicity, subfertility and/or post-breeding endometritis, which may themselves affect PR. Controlled studies to further evaluate the efficacy of these treatments, particularly concerning the use of oxytocin and/or carbetocin, are therefore recommended. In conclusion, this study has provided up-to-date estimates of day 14-16 PRs in Thoroughbred broodmares in a UK setting and enhanced understanding of factors that may be associated with these rates. In addition, knowledge gaps around the rationale and efficacy of some therapeutic agents have been identified; these can help inform future research priorities.

MP30-12 HIGHER TESTOSTERONE SERUM LEVELS ARE ASSOCIATED WITH A HIGHER CHILDBIRTH IN PATIENTS TREATED FOR TESTICULAR CANCER

You have accessJournal of UrologyCME1 Apr 2023MP30-12 HIGHER TESTOSTERONE SERUM LEVELS ARE ASSOCIATED WITH A HIGHER CHILDBIRTH IN PATIENTS TREATED FOR TESTICULAR CANCER Cosimo De Nunzio, Riccardo Lombardo, Antonio Nacchia, Giorgio Guarnotta, Aldo Brassetti, Gabriele Tuderti, Antonio Luigi Pastore, Yazan Al Sahli, Giuseppe Simone, Antonio Carbone, and Andrea Tubaro Cosimo De NunzioCosimo De Nunzio More articles by this author , Riccardo LombardoRiccardo Lombardo More articles by this author , Antonio NacchiaAntonio Nacchia More articles by this author , Giorgio GuarnottaGiorgio Guarnotta More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Yazan Al SahliYazan Al Sahli More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Antonio CarboneAntonio Carbone More articles by this author , and Andrea TubaroAndrea Tubaro More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Aim of our study was to assess fertility of patients treated with orchifunicolectomy for testicular cancer. METHODS: A retrospective analysis of patients undergoing orchifunicolectomy for testicular cancer was conducted in three centers from 2000 to 2019. Demographic, clinical and histological characteristics of the patients were recorded. Adjuvant treatments were recorded. Number of pregnancies, number of children, cryopreservation, in vitro fertilization were recorded as well as post-operative testosterone serum level. Risk factors for pregnancy were evaluated. Univariate and multivariate analysis were performed to evaluate factors influencing pregnancy rates. RESULTS: Overall 271 patients were enrolled with a median age of 31 (25/35) years and a median BMI of 25 (23/28 Kg/m2). Overall 187 of 271 (69%) presented a seminoma, 61 of 271 (22%) presented advanced stage (≥pT2), 4 of 271 (1%) presented metastasis, 13 of 271 (5%) underwent lymphadenectomy. 112 of 271 (41%) underwent adjuvant chemotherapy and 35 of 271 (13%) underwent adjuvant radiotherapy. 71 of 271 (26%) patients had at least one child, 165 of 271 (60%) performed cryopreservation, 9 of 271 (3%) performed fertilization in vitro and out of them 8 of 9 (89%) had at least one child. Patients with at least one child presented higher levels of testosterone and performed more often in vitro fertilization (Table). On multivariate analysis testosterone levels (OR=1,94; 95% CI: 1,35-2,80, p=0,001) were associated with a higher probability of having a child after testicular cancer surgery. Table 1. Patients characteristics according to Child status CONCLUSIONS: In our experience, patients undergoing testicular cancer surgery have 25% probability of having a child. Higher testosterone levels increase the probability of having a child in patients treated for testicular cancer. Source of Funding: No one © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e395 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cosimo De Nunzio More articles by this author Riccardo Lombardo More articles by this author Antonio Nacchia More articles by this author Giorgio Guarnotta More articles by this author Aldo Brassetti More articles by this author Gabriele Tuderti More articles by this author Antonio Luigi Pastore More articles by this author Yazan Al Sahli More articles by this author Giuseppe Simone More articles by this author Antonio Carbone More articles by this author Andrea Tubaro More articles by this author Expand All Advertisement PDF downloadLoading ...

Timing of ICSI with Respect to Meiotic Spindle Status

The aim of this study was to evaluate the efficiency of using meiotic spindle (MS) visibility and relative position to the polar body (PB) as indicators of oocyte maturation in order to optimize intracytoplasmic sperm injection (ICSI) timing. This was a cohort study of patients younger than 40 years with planned ICSI, the timing of which was determined by MS status, compared with those without MS evaluation. The angle between PB and MS and MS visibility were evaluated by optical microscope with polarizing filter. Oocytes with MS evaluation were fertilized according to MS status either 5-6 h after ovum pick-up (OPU) or 7-8 h after OPU. Oocytes without MS evaluation were all fertilized 5-6 h after OPU. For patients over 35 years visualization of MS influenced pregnancy rate (PR): 182 patients with MS visualization had 32% PR (58/182); while 195 patients without MS visualization had 24% PR (47/195). For patients under 35 years, visualization of MS did not influence PR: 140 patients with MS visualization had 41% PR (58/140), while 162 patients without MS visualization had 41% PR (66/162). Visualization of MS therefore appears to be a useful parameter for assessment of oocyte maturity and ICSI timing for patients older than 35.

Is Cleavage Stage Multinucleation Indicative of Lower Pregnancy Potential in Euploid Blastocysts?

Background: Cleavage stage multinucleation is a morphological assessment IVF labs may use to rank embryos for transfer, as blastocysts that were multinucleated at the 2-cell or 4-cell stage have a lower live birth rate (LBR) compared to blastocysts that were mononucleated 1 . However, when these blastocysts are PGT-A tested, the euploidy rate is similar 2 , indicating that the poorer pregnancy outcomes may not be due to aneuploidy. It is unknown if multinucleation is indicative of a lower likelihood of pregnancy for euploid blastocysts. Aim: To determine if LBR following transfer of euploid blastocysts is lower when blastocysts were multinucleated at the 2-cell or 4-cell stages. Method: Retrospective study on 360 euploid blastocysts cultured in the EmbryoScope or EmbryoScope+ between March 2018 and October 2019, and individually transferred. Time-lapse images were retrospectively assessed for multinucleation at the 2-cell and 4-cell stage. A multinucleated embryo was defined as having [Formula: see text] 1 cell with [Formula: see text] 2 nuclei. Results: Blastocysts that were multinucleated at the 2-cell stage (n=139) had a similar LBR to mononucleated embryos (40.3% vs 41.6%). Multinucleation at the 4-cell stage (n=43) also did not significantly affect LBR (37.2% vs 43.6%). Multivariate logistic regression analysis found no significant effect of multinucleation on LBR. Biochemical pregnancy, clinical pregnancy (fetal heart), and miscarriage rates were also similar between multinucleated and mononucleated embryos. Conclusion: This study found no evidence that multinucleation at the 2-cell or 4-cell stage influences pregnancy rate in euploid blastocysts. As such, the assessment of cleavage stage multinucleation for PGT-A tested embryos may not be useful in ranking PGT-A tested embryos for transfer. Further work is required with larger numbers of embryos to confirm how the degree of multinucleation may influence LBR.

Pre-Treatment Physical Activity Could Positively Influence Pregnancy Rates in IVF despite the Induced Oxidative Stress: A Cohort Study on Salivary 8-Hydroxy-2'-deoxyguanosine.

(1) Background: This study was designed to define whether pretreatment habitual physical activity (PA)-induced oxidative stress (OS) influences outcome measures by using 8-hydroxy-2′-deoxyguanosine (8-OHdG) in saliva samples of patients undergoing in vitro fertilization (IVF). (2) Method: In this cohort study, samples were obtained from 26 patients (age: 34.6 ± 5.5 years, BMI: 25.3 ± 5.1, infertility: 51.0 ± 28.7 months) before the treatment and a follow-up of outcome measures of IVF/ICSI. The 8-OHdG was evaluated by Abcam’s ELISA (ab201734), PA patterns by GPAQ-H and ActiGraph GT3X; (3) Results: The number of matured oocytes was positively influenced by the GPAQ-H recreation MET (R2 = 0.367, F = 10.994, p = 0.004; β = 0.005, p = 0.004, B Constant = 4.604) and a positive significant relationship (R2 = 0.757, F = 17.692, p < 0.001, B Constant = 1.342) was found with GPAQ-H recreational PA MET (β = 0.004, p < 0.001), and Grade 1 embryos and higher very vigorous activity (GT3X) were accompanied (R2 = 0.958, F = 408.479, p < 0.001) by higher ß-hCG levels (β = 63.703, p ≤ 0.001). Unanticipated positive correlation between 8-OHdG and ß-hCG level (R = 0.467, p = 0.028) was noticed, and there were significant differences in 8-OHdG in biochemical pregnancies (pregnant: 54.82 ± 35.56 ng/mL, non-pregnant: 30.06 ± 10.40 ng/mL, p = 0.022) as well. (4) Conclusions: Pretreatment PA could positively influence reproductive performance in IVF/ICSI despite the induced OS. However, a more sensitive biomarker and the recommended amount of activity should be further investigated.

Sperm selection with hyaluronic acid improved live birth outcomes among older couples and was connected to sperm DNA quality, potentially affecting all treatment outcomes.

Sperm selection with hyaluronic acid improved live birth outcomes among older couples and was connected to sperm DNA quality, potentially affecting all treatment outcomes.

How Can We Predict Success in Poor Responders?

Objectives: The aim of this study was to evaluate how can we predict success in poor responder patients in terms of pregnancy rate and live birth rate. Material and method: This study is a review of the newest papers that have in the center the poor responders undergoing treatment involving assisted reproductive techniques (ART). Outcomes: The results show that the most reliable factors when counseling a poor responder patient are age and Anti-Müllerian hormone (AMH) level. Conclusions: The most important factors that influence pregnancy rate are age and ovarian reserve, but other factors such as male pathology and laboratory techniques must be studied deeper.

Service Sire Effects on Body Condition Score, Milk Production, and Rebreeding of Mixed-Aged Dairy Cows Bred to Angus and Hereford Bulls—A Case Study in New Zealand

Beef-breed bulls are used in dairy herds to produce a calf of greater value for finishing than calves sired by dairy bulls. There is limited research about which beef-breed bulls are most appropriate, and whether any negative impact on cow performance in terms of milk production and rebreeding should be considered. The aim of this case study was to compare the body condition score, milk production, and rebreeding performance of mixed-aged dairy cows bred to a selection of Angus and Hereford beef-breed bulls. Body condition score, post-calving live weight, milk production, rebreeding performance, and survival of 952 mixed-aged dairy cows artificially bred to 65 Angus and Hereford bulls were compared. There was no effect of service sire on post-calving live weight, days in milk, milk production, or inter-calving intervals of mixed-aged cows. Service sire had an effect on the calving day due to differences in gestation length (p &lt; 0.001), although this did not translate into an effect on days in milk. A longer gestation length negatively influenced pregnancy rates, and greater birth weight of the calf negatively influenced survival to rebreeding (p &lt; 0.05), indicating the potential for an effect of service sire. Selection of beef-breed service sires for dairy cows should include emphasis on lighter calves and shorter gestation lengths. The general absence of the service sire effect on the parameters measured in this study indicated that any of the service sires used in this experiment would be appropriate for use over dairy cows.

Intrauterine insemination with donor sperm: only the number of motile spermatozoa inseminated influences both pregnancy and live-birth rates.

Intrauterine insemination with donor sperm (IUI-D) is an assisted reproductive technology (ART) offered to couples with definitive male infertility or risk of genetic disease transmission. Here, we sought to evaluate our practice in IUI-D and identify factors that influenced the success rate. We performed a retrospective, single-center study of all IUI-D procedures performed at Lille University Medical Center (Lille, France) between January 1, 2007, and December 31, 2017. Single and multivariate analyses with a mixed logistic model were used to identify factors associated with clinical pregnancies and live births. We included 322 couples and 1179 IUI-D procedures. The clinical pregnancy rate was 23.5%, and the live birth rate was 18.9% per IUI-D. In a multivariate analysis, the women's age was negatively associated with the live birth rate. The number of motile spermatozoa inseminated was the only factor associated with both clinical pregnancies and live births, with a chosen threshold of 0.75 million. The clinical pregnancy and live birth rates were, respectively, 17.3% and 13.0% below the number of motile spermatozoa inseminated threshold and 25.9% and 21.0% at or above the threshold (all P = 0.005). The number of motile spermatozoa inseminated was the only factor that significantly influenced both pregnancies and live-birth rates after IUI-D. Indeed, below a threshold of 0.75 million motile spermatozoa inseminated, those rates were significantly lower. Application of this number of motile spermatozoa inseminated threshold may help centers to allocate donations more effectively while maintaining reasonable waiting times for patients.

OVULATION SYNCHRONIZATION PROTOCOLS AND FACTORS ASSOCIATED WITH PREGNANCY RATE OF ZEBU FEMALES

&lt;p&gt;&lt;strong&gt;Background.&lt;/strong&gt; Fixed time artificial insemination is an important tool for the reproductive management of cattle. &lt;strong&gt;Objective.&lt;/strong&gt; To determine the effect of two ovulation synchronization protocols and factors associated with the pregnancy rate of Zebu females using fixed time artificial insemination (FTAI) under tropical conditions. &lt;strong&gt;Methodology&lt;/strong&gt;. Data of estrous and pregnancy from 129 multiparous Zebu cows and 257 heifers were used. All animals received an intravaginal device (new or used) CIDR&lt;sup&gt;®&lt;/sup&gt; or DIB&lt;sup&gt;®&lt;/sup&gt;, which remained &lt;em&gt;in situ&lt;/em&gt; per 7 days. On the day of device removal, two treatments were established. I) Estradiol cypionate (EC; n = 192): 25 mg prostaglandin F2 alpha and 0.5 mg EC (estradiol cypionate); II) Estradiol benzoate (BE; n = 194): 25 mg PGF&lt;sub&gt;2α&lt;/sub&gt; and 24 hours later (day 8), 1 mg BE. Estrous was detected by 1-hour; three times a day, and females inseminated 54-56 hours after removal of device, using thawed semen. Pregnancy diagnosis was by transrectal palpation with real-time ultrasound, 60 days after FTAI. Data were analyzed using Chi-square tests. &lt;strong&gt;Results.&lt;/strong&gt; The overall estrous rate was 73.32%. The ovulation synchronization protocol affected the presence of estrous, where EC had a higher rate (79.39%) compared to EB (67.19%). Pregnancy rate for the females inseminated with thawed semen was 54.40%. All factors affected the pregnancy rate (p&amp;lt;0.05). &lt;strong&gt;Implications.&lt;/strong&gt; This study provides an alternative for increasing estrous and pregnancy rate of Zebu females, using EC synchronization protocol. It also shows that female type, device and BCS change influence pregnancy rate. &lt;strong&gt;Conclusion&lt;/strong&gt;. The highest rate was observed in heifers showing estrous, synchronized with a new intravaginal device, using EC and gaining body condition score.&lt;/p&gt;

O-140 Uterine septum: clinical implications on fertility and obstterics outcomes. A systematic review and meta-analysis

Abstract Study question How does the septate uterus and his metroplasty influence pregnancy rate (PR), live birth rate (LBR), spontaneous abortion rates (SA) and preterm labour rates (PL)? Summary answer Uterine septum is associated with a poor reproductive outcome. Metroplasty reduce the rate of SA but non-conclusive evidence can be extrapolated about PR and PL. What is known already Different studies evaluated the correlation between uterine septum and reproductive outcomes. On one hand, studies reported its association with poor obstetrics outcomes. On the other hand, recent studies raised doubts about the effectiveness of septum metroplasty to improve reproductive outcomes, although recent position papers continue to propose metroplasty in patients with a septate uterus and a history of infertility or miscarriages. Debate is still ongoing on reproductive outcomes of uterine septum on infertile patients and especially on patients with recurrent miscarriage, leading to an unanswered question whether or not these women should be treated. Study design, size, duration Systematic review and meta-analysis of published studies that evaluated the clinical impact of uterine septum and its metroplasty on reproductive and obstetrics outcomes. The meta-analysis included study with infertile patients or patients with a history of recurrent miscarriage. Searches were conducted using the following search terms: uterine septum, septate uterus, metroplasty, pregnancy rate, live birth rate, spontaneous miscarriage, infertility, preterm delivery. Primary outcomes were PR and LBR. Secondary outcomes were SA and PL. Participants/materials, setting, methods The meta-analysis was written following the PRISMA guidelines. Fifty-nine full-text articles were preselected based on title and abstract. Endpoints were evaluated in three subgroups: 1) infertile/recurrent miscarriage patients with septum versus no septum 2) infertile/recurrent miscarriage patients with treated versus untreated septum 3) infertile/recurrent miscarriage patients before-after septum removal. Odds-ratios (OR) with 95% confidence intervals (CI) were calculated for outcome measures. Random-effect meta-analysis was performed and a p-value less than 0.05 was considered statistically significant. Main results and the role of chance Data from 37 articles were extracted. In the first subgroup (10 studies), a lower PR and LBR were associated with septate uterus vs. controls, respectively (OR 0.39, 95% CI 0.26 to 0.58; p &amp;lt; 0.000; low-heterogeneity and OR 0.21, 95% CI 0.12 to 0.39; p &amp;lt; 0.0001; small-heterogeneity) and a higher proportion of SA and PL was associated with septate uterus vs. controls, respectively (OR 4.17, 95% CI 2.83 to 6.15; p &amp;lt; 0.000; moderate-heterogeneity and OR 2.18, 95% CI 1.27 to 3.76; p = 0.005; low-heterogeneity). In the second subgroup (8 studies), PR and PL were not different in removed vs. unremoved septum, respectively (OR 1.10, 95% CI 0.49 to 2.49; p = 0.82; moderate heterogeneity and OR 0.44, 95% CI 0.18 to 1.08; p = 0.08;low-heterogeneity) and a lower proportion of SA was associated with removed vs. unremoved septum (OR 0.40, 95% CI 0.17 to 0.95; p = 0.001; substantial-heterogeneity). In the third subgroup (19 studies), the proportion of LBR was higher after the removal of septum (OR 49.58, 95% CI 29.93 to 82.13; p &amp;lt; 0.0001; moderate-heterogeneity) and the proportion of SA and PL was lower after the removal of septum, respectively (OR 0.02, 95% CI 0.02 to 0.04; p &amp;lt; 0.000; moderate-heterogeneity and OR 0.05, 95% CI 0.03 to 0.08; p = &amp;lt;0.000; low-heterogeneity). Limitations, reasons for caution The present meta-analysis is limited by the observational design of included studies because, in literature, there are no prospective randomized controlled trials (RCTs). In the second and third subgroup of analysis clinical heterogeneity within and between studies represents another limitation. Wider implications of the findings The results of this meta-analysis confirm the detrimental effect of uterine septum on PR, LBR, SA and PL. Its treatment seems to reduce the rate of SA. Metroplasty should still be considered as good clinical practice in patients with a history of infertility and recurrent abortion. Trial registration number Not applicable © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.

Effect of Sperm Morphology in Intrauterine Insemination: Analysis of 115 Cycles and Literature Review.

The value of morphology as a sperm parameter remains uncertain. Many studies have addressed the importance of morphology to predict the success of intrauterine insemination (IUI), but with conflicting results. The aims of this study were to review the current literature, to query our own clinical experience via a retrospective, descriptive study, and to determine whether the diagnosis of isolated teratozoospermia influences pregnancy rate after IUI. We identified a large number of studies addressing this question. All were retrospective and most used different criteria to assess sperm morphology. Further complicating matters, the cutoff for normal morphology decreased from 15% to 4%. In our patient population, we found 12 cases of isolated teratozoospermia (10.43%). Only one of these produced an ongoing pregnancy and live birth. In all other cases, alteration of other sperm parameters coexisted (89.57%). These cycles produced a pregnancy rate of 13%, a nonsignficant difference. Pregnancy rates also were analyzed according to the percentage of normal morphology: 35.71% for less than 4%, 50% for 5% to 9%, and 14.29% for 10% to 14%. These rates did not differ significantly. No consistent effect of sperm morphology on pregnancy rate was found in either the published literature or our own clinical experience. Larger and prospective studies are needed to identify any subtle effects of morphology on IUI outcomes that might exist.

110 Pregnancy rate and embryo viability in response to chorionic gonadotrophins given for oestrus induction and gonadotrophin-releasing hormone 5 days after timed laparoscope-aided insemination of lactating and non-lactating goats

Gonadotrophins are included in oestrous/ovulation synchronization (E/OS) regimens when breeding early in the transitional phase to promote follicular development. However, the time of use has been a matter of debate. Hence, the objective of this study was to determine whether equine and human chorionic gonadotrophins (eCG and hCG, respectively) given 24h before or 24h after concurrent removal of intravaginal progestagen (P4) and prostaglandin (PGF2α) delivery influences pregnancy rate (PR) and/or embryo viability (EV). Relatedly, the influence of gonadotrophin-releasing hormone (GnRH) 5 days post-breeding (dpb) on PR and/or EV was also considered. A prospective randomised control trial was conducted using lactating and non-lactating Alpine breed goats of different parity, average±s.e. age, and bodyweight (3.7±2.6), and (52.5±7), respectively. Goats were time-bred at 48h after P4 removal by laparoscopy (LAI; n=75) or by natural service (NS; n=29) during the early transitional breeding phase in mid-September through mid-December (corresponding to 12:12h daylight/darkness). E/OS used an intravaginal device containing 300mg of P4 for 12±1d. At P4 removal, 2mL of PGF2α was administered IM. Twenty-four hours before (E) or 24h after (L) P4 removal, an IM dose of 1.5mL containing 120IU of eCG and 60IU of hCG was given. A third control (C) group (n=38) was not exposed to gonadotrophins. GnRH analogue was given (n=51) 5 days after insemination, and the remaining goats (n=53) received an IM dose of 2mL of saline solution. PR was evaluated at 18 to 24 (dpb) by non-return to oestrus (NRE), at 30 dpb by pregnancy-specific protein B (PSPB), and at 40 dpb by ultrasound imaging (UI). EV was determined from the difference between pregnancy outcomes for NRE and PSPB, and PSPB and UI. Statistical analysis (JMP/SAS vs.11; SAS Institute Inc.) were obtained using logistic regression. All concomitant variables (i.e. parity, bodyweight, days of P4 exposure, and lactation were not influenced by PR or EV; P&amp;gt;0.07). The overall PR was 71% for LAI and 69% for NS and, as shown in Table 1, was similar (P&amp;gt;0.49) at all times (at 18 to 24, 30, and 40 dpb). Likewise, the breeding procedure did not influence the levels of EV at 30 or 40 dpb. E/OS protocol or the use of GnRH 5 dpb did not affect PR or EV at any of the time points evaluated. Table 1. Main effect mean comparisons and logistic model probabilities for pregnancy rate (PR) and embryo viability (EV) by main treatment effect Response variable (days post-breeding) Breeding procedure E/OS Protocol Gonadotrophin LAI NS P&amp;gt; Control Early Late P&amp;gt; GnRH Placebo P&amp;gt; PR at 18–24 77 72 0.49 76 73 78 0.83 78 74 0.49 PR at 30 68 66 0.65 66 65 70 0.82 71 64 0.43 PR at 40 69 69 0.78 66 69 73 0.77 73 66 0.43 EV at 30 89 90 0.94 86 94 90 0.65 92 87 0.46 EV at 40 88 95 0.42 86 89 94 0.73 92 87 0.43

Influence of clinical and paraclinical variables of the patient in the failure to achieve a pregnancy after embryotransfer: statistical analysis evaluation

We conducted this observational prospective study in order to establish to what extent do the clinical and paraclinical characteristics of the patient and the factors that determine infertility also negatively influence pregnancy rate (PR) per embryotransfer. We included 79 women who underwent 145 embryotransfers and we analyzed the positive β-hCG test result. We identified that the following parameters are not statistically significantly correlated to the failure rate: smoking (p=0.7230, OR=1.23), drug use (p=0.7850, OR=1.38), BMI (p=0.4210, OR=1.04), history of infertility, family illness (p=0.3212, OR=1.64), history of miscarriages (p=0.4438, OR=0.61) or abortions (p=0.9842, OR=0.99), previous ectopic pregnancy (p=0.6880, OR=1.30), dyspareunia (p=0.5400, OR=1.43), dysmenorrhea (p=0.4232, OR=0.65), endometriosis (p=0.1150, OR=2.43), impermeable fallopian tubes (p=0.1676, OR=2.11). AMH is not an independent risk factor for pregnancy failure either (p=0.1690, OR=0.79). Age and menarche are risk factors. Age predisposes to a 3.30 times higher failure rate to obtain a pregnancy (calculated cutoff: 34 years old; p=0.0210; OR=3.30). A patient who had menarche before 13 years old (calculated cutoff) has a four times higher risk of failure to obtain a biochemical pregnancy (p=0.0126, OR=3.91). As a conclusion, after reaching the embryo transfer point, the clinical and paraclinical characteristics of the patient are not independent negative factors on PR, except for patient’s age and menarche time.