How Can the Implementation of Ethical Norms Be Guaranteed in Biomedical Studies? 2 1 2 The development of medical sciences is due to efforts of scientists and clinicians to conduct various studies to answer questions and solve the health problems. Currently, scientists in organizations, institutes, and universities are trying for recognizing priorities in scientific discovery and improving medical sciences through increasing their scientific output, as well as raising their national and international rankings. Therefore, the role of scientific studies and subsequently published articles in the progress and development of countries is obvious to everyone. But the history of scientific studies during the last century shows that human standards, human rights and ethical considerations have not been met in a large number of human researches particularly in the field of medicine and biosciences. Also, it sometimes led to irreparable damage to the scientific body of society and even to the scientific position of academic staff. Therefore, ethical obligation of submitted manuscript is a critical criterion for acceptance and publication of biomedical findings. In addition to numerous daily errors in medical practice worldwide, a large number of unsuccessful and useless clinical studies were the main reason for the development of global rules, documents and guidelines which evolved into ethical norms and code of practice. The ethics in research was established in anthropology field at first to support and protect the rights of cases under investigation, as well as to protect researchers from unreliable and unsafe events that jeopardize their comfort. The first major effort for protection of human rights was made in June 1964 as The Declaration of Helsinki. It was followed by seven subsequent revisions (The most recent one in October 2013); consequently, 11 paragraphs in the original version reached to 37 paragraphs in the 2013 version. It is the most important document of ethics in research, which forms the basis for many subsequent documents (1). Most of scientific journals follow the standard ethical guidelines such as the ones established by the International Committee of Medical Journal Editors (ICMJE) for standardizing the ethics, preparation and formatting of manuscripts submitted for publication by biomedical journals. They banned acceptance and publication of articles which neglect ethical issues such as informed consent, ethical committee approval, confidentiality of study participants, conflict of interest, double publications, plagiarism, uncertainty in the authorship, unethical research behaviors, data falsification, deliberate misbehavior in data presentation that may lead to harms for community and ultimately the trust to scientific society (2). Publication of an article is the final phase of a scientific project that has been performed for a long period following various evaluations and consuming a lot of budget and resource which is borne to society. Therefore, scientists are expected to publish the results of their work in complete honesty and trust. However, a large number of submitted manuscripts violate ethical standards and most of them are rapidly rejected by journal’s editorial board. Ethical behavior in biomedical journals is the greatest responsibility of the authors, in the first place, and the reviewers, editor and publishers, in the second, although it should be understood that unintentional errors are inevitable and must be distinguished from deliberate practice. In addition, the ethical committees are also responsible for supervision of their own approved researches and creating a healthy environment for conducting ethics norms (3). Most of prepared manuscripts are free of ethical misconducts and errors. However, despite careful supervision of ethical committees and peer review process, ethical norms have been compromised in some published articles, which have been identified over the time through reanalysis of articles by the audit trails or editorial board. Few of them may be corrected through formats such as "Expression of Concern", "Erratum" Corrigendum or, the cases with deliberate gross error are retracted. If it was allowed to publish the results of studies lacking ethical norms, it could increase the motivation of some researchers to circumvent and disregard ethical norms in their research, or at least it could act as a deterrent to prevent unethical research. On the other hand, the current trend of some journals to publish editorials and criticism for not adhering to ethical codes in research seems to be ineffective, since with the online publication of the most journals, most of people search their articles in the databases and are less likely to look for editorial, comments or letters to editor (4). So raised question is that whether the method of blaming researchers who violate ethical norms in their study is an optimal deterrent to prevent the occurrence of such research in the future, especially in deliberate cases. Surely, the answer to this question is negative, as there are numerous editorial comments, amendments, erratum, and letters to the editor on the necessity of ethics in biomedical research. In spite of this, we are faced with a great deal of manuscripts that due to ethical misconducts are quickly rejected or quite reverse, accepted with great ignorance and even may be hidden from the view of referees and editors and subsequently they are published. So again, the point at issue is about the useful strategies which the journals may put into practice in dealing with such articles to have a greater preventive effect. Perhaps, one of the suggested solutions is to publish such manuscripts submitted for publication in academic journals, but not like the usual papers. Rather, designing and creating a specific database seems to be an optimal strategy. Such database can be created by the World Association of Medical Editors (WAME), ICMJE, Cope, PubMed, or any other international organization in the field of publishing scientific researches, for publishing articles with major ethical issues. The database will also require an expert team and reviewers to evaluate and verify the allegations and provide views and commentary on documents for audience education. On the other hand, the number of papers of a researcher submitted to the database can be recorded as a negative index for their academic status. Currently, indicators such as H.Index, G.Index, Cumulative IF, etc. have their place as a positive index that researchers are trying to promote them. In contrast, academic staff will try to be bound to ethical norms in their researches in order not to harm their scientific position. The publication of such articles, as well as the deterrent role for researchers and clinicians will provide useful practical training on how to apply ethical norms in future studies for other researchers. In addition, universities, institutes and ethics committees will be more focused and motivated on the evaluation, approval and monitoring of referred proposals. Ultimately, it will prevent waste of resources for conducting useless and futile research and also the potential harm to individuals due to false results of such studies. 069 71 Mohammad Reza MR Sadeghi محمدرضا صادقی Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR Iran sadeghi@ari.ir No Keyword 70075.pdf Woods S, McCormack P. Disputing the ethics of research: the challenge from bioethics and patient activism to the interpretation of the declaration of Helsinki in clinical trials. Bioethics. 2013;27(5):243-50.##Wiedermann CJ. Ethical publishing in intensive care medicine: a narrative review. World J Crit Care Med. 2016;5(3):171-9.##Gasparyan AY, Yessirkepov M, Voronov AA, Gorin SV, Koroleva AM, Kitas GD. Statement on publication ethics for editors and publishers. J Korean Med Sci. 2016;31(9):1351-4.##Hunter D. The publication of unethical research. Res Ethics. 2012;8(2):67-70.##

Effects of Bariatric Surgeries on Male and Female Fertility: A Systematic Review 2 1 2 Background: Morbid obesity has been known to decrease fertility in both men and women. This review aimed to examine current evidence of the effects of bariatric surgeries on fertility parameters including sex hormones in both men and women, seminal outcomes in men, menstrual cycle, PCOS symptoms, and pregnancy in women, and sexual function in both men and women. Methods: Three databases (PubMed, Web of Science, and Academic Search Premier) were used with key terms of bariatric surgery, bariatric surgical procedures, infertility, reproductive health, pregnancy, and fertility. Studies with male and/or female patients were included. Study types included retrospective chart reviews, observational, qualitative, cross-sectional, cohort, and longitudinal studies published in January 2008–June 2018. The search was performed on June 21-26, 2018. Quality assessment and data synthesis were conducted. Results: A total of 18 articles were included in the final review. Seven studies included only men, ten included only women, and one included both men and women. Bariatric surgery significantly improved hormonal balance and sexual functions in both males and females, sperm count in males, and pregnancy in females. The strongest evidence was found on bariatric surgery’s effects on sex hormones. No study with males asked whether the participants actually conceived a child with their partners after the bariatric surgery. Most weaknesses in all articles reviewed were lack of discussion on confounding variables and many did not differentiate surgical types. Conclusion: Bariatric surgery most effectively improved sex hormones. Further research is needed on direct pregnancy outcomes for both men and women. 071 87 Luz L Moxthe Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa USA Rachel R Sauls Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa USA Michelle M Ruiz Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa USA Marilyn M Stern Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa USA Xavier XV Gonzalez Advent Health Medical Group, Bariatrics at Tampa, Tampa Advent Health Medical Group, Bariatrics at Tampa, Tampa USA Heewon L HL Gray College of Public Health, University of South Florida, Tampa College of Public Health, University of South Florida, Tampa USA hlgray@usf.edu Bariatric surgeryFertilityInfertilityObesityReproductive healthSystematic review 70074.pdf Laurino Neto RM, Herbella FA, Tauil RM, Silva FS, de Lima SE Jr. Comorbidities remission after Roux-en-Y Gastric Bypass for morbid obesity is sustained in a long-term follow-up and correlates with weight regain. Obes Surg. 2012;22(10):1580-5.##Lucchese M, Maggi M. Hypogonadism as a new comorbidity in male patient's selection for bariatric surgery: towards an extended concept of metabolic surgery? Obes Surg. 2013;23(12):2018-9.##Brennan AM, Mantzoros CS. Drug insight: the role of leptin in human physiology and pathophysiology--emerging clinical applications. Nat Clin Pract Endocrinol Metab. 2006;2(6):318-27.##Beard JH, Bell RL, Duffy AJ. Reproductive considerations and pregnancy after bariatric surgery: current evidence and recommendations. Obes Surg. 2008;18(8):1023-7.##Craig JR, Jenkins TG, Carrell DT, Hotaling JM. Obesity, male infertility, and the sperm epigenome. Fertil Steril. 2017;107(4):848-59.##Kissler HJ, Settmacher U. Bariatric surgery to treat obesity. Semin Nephrol. 2013;33(1):75-89.##Hopkins JC, Howes N, Chalmers K, Savovic J, Whale K, Coulman KD, et al. Outcome reporting in bariatric surgery: an in-depth analysis to inform the development of a core outcome set, the BARIACT Study. Obes Rev. 2015;16(1):88-106.##Carelli AM, Ren CJ, Youn HA, Friedman EB, Finger AE, Lok BH, et al. Impact of laparoscopic adjustable gastric banding on pregnancy, maternal weight, and neonatal health. Obes Surg. 2011;21(10):1552-8.##Vrebosch L, Bel S, Vansant G, Guelinckx I, Devlieger R. Maternal and neonatal outcome after laparoscopic adjustable gastric banding: a systematic review. Obes Surg. 2012;22(10):1568-79.##Hutch CR, Sandoval D. The role of GLP-1 in the metabolic success of bariatric surgery. Endocrinology. 2017;158(12):4139-51.##ASGE Bariatric Endoscopy Task Force; ASGE Technology Committee, Abu Dayyeh BK, Edmundowicz SA, Jonnalagadda S, Kumar N, et al. Endoscopic bariatric therapies. Gastrointest Endosc. 2015;81(5):1073-86.##Maggard MA, Yermilov I, Li Z, Maglione M, Newberry S, Suttorp M, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300(19):2286-96.##Al-Nimr RI, Hakeem R, Moreschi JM, Gallo S, McDermid JM, Pari-Keener M, et al. Effects of bariatric surgery on maternal and infant outcomes of pregnancy-an evidence analysis center systematic review. J Acad Nutr Diet. 2019;119(11):1921-43.##Moran LJ, Norman RJ. The effect of bariatric surgery on female reproductive function. J Clin Endocrinol Metab. 2012;97(12):4352-4.##Best D, Avenell A, Bhattacharya S. How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? a systematic review and meta-analysis of the evidence. Hum Reprod Update. 2017;23(6):681-705.##Galazis N, Docheva N, Simillis C, Nicolaides KH. Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014;181:45-53.##Karmon A, Sheiner E. Pregnancy after bariatric surgery: a comprehensive review. Arch Gynecol Obstet. 2008;277(5):381-8.##Costa MM, Belo S, Souteiro P, Neves JS, Magalhães D, Silva RB, et al. Pregnancy after bariatric surgery: Maternal and fetal outcomes of 39 pregnancies and a literature review. J Obstet Gynaecol Res. 2018;44(4):681-90.##Jans G, Matthys C, Bogaerts A, Lannoo M, Verhaeghe J, Van der Schueren B, et al. Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review. Adv Nutr. 2015;6(4):420-9.##Kjaer MM, Nilas L. Pregnancy after bariatric surgery--a review of benefits and risks. Acta Obstet Gynecol Scand. 2013;92(3):264-71.##National heart, lung, and blood institute (NHLBI). Quality assessment tool for observational cohort and cross-sectional studies. Bethesda, MD: National institutes of health; 2014.##El Bardisi H, Majzoub A, Arafa M, AlMalki A, Al Said S, Khalafalla K, et al. Effect of bariatric surgery on semen parameters and sex hormone concentrations: a prospective study. Reprod Biomed Online. 2016;33(5):606-11.##Legro RS, Kunselman AR, Meadows JW, Kesner JS, Krieg EF, Rogers AM, et al. Time-related increase in urinary testosterone levels and stable semen analysis parameters after bariatric surgery in men. Reprod Biomed Online. 2015;30(2):150-6.##Samavat J, Cantini G, Lotti F, Di Franco A, Tamburrino L, Degl'Innocenti S, et al. Massive weight loss obtained by bariatric surgery affects semen quality in morbid male obesity: a preliminary prospective double-armed study. Obes Surg. 2018;28(1):69-76.##Reis LO, Zani EL, Saad RD, Chaim EA, de Oliveira LC, Fregonesi A. Bariatric surgery does not interfere with sperm quality--a preliminary long-term study. Reprod Sci. 2012;19(10):1057-62.##Hammoud A, Gibson M, Hunt SC, Adams TD, Carrell DT, Kolotkin RL, et al. Effect of roux-en-Y gastric bypass surgery on the sex steroids and quality of life in obese men. J Clin Endocrinol Metab. 2009;94(4):1329-32.##Facchiano E, Scaringi S, Veltri M, Samavat J, Maggi M, Forti G, et al. Age as a predictive factor of testosterone improvement in male patients after bariatric surgery: preliminary results of a monocentric prospective study. Obes Surg. 2013;23(2):167-72.##Luconi M, Samavat J, Seghieri G, Iannuzzi G, Lucchese M, Rotella C, et al. Determinants of testosterone recovery after bariatric surgery: is it only a matter of reduction of body mass index? Fertil Steril. 2013;99(7):1872-9.##Nilsson-Condori E, Hedenbro JL, Thurin-Kjellberg A, Giwercman A, Friberg B. Impact of diet and bariatric surgery on anti-Müllerian hormone levels. Hum Reprod. 2018;33(4):690-3.##Legro RS, Dodson WC, Gnatuk CL, Estes SJ, Kunselman AR, Meadows JW, et al. Effects of gastric bypass surgery on female reproductive function. J Clin Endocrinol Metab. 2012;97(12):4540-8.##Kjær MM, Madsbad S, Hougaard DM, Cohen AS, Nilas L. The impact of gastric bypass surgery on sex hormones and menstrual cycles in premenopausal women. Gynecol Endocrinol. 2017;33(2):160-3.##Jamal M, Gunay Y, Capper A, Eid A, Heitshusen D, Samuel I. Roux-en-Y gastric bypass ameliorates polycystic ovary syndrome and dramatically improves conception rates: a 9-year analysis. Surg Obes Relat Dis. 2012;8(4):440-4.##Khazraei H, Hosseini SV, Amini M, Bananzadeh A, Najibpour N, Ganji F, et al. Effect of Weight Loss After Laparoscopic Sleeve Gastrectomy on Infertility of Women in Shiraz. J Gynecol Surg. 2017;33(2):43-6.##Edison E, Whyte M, van Vlymen J, Jones S, Gatenby P, de Lusignan S, et al. Bariatric surgery in obese women of reproductive age improves conditions that underlie fertility and pregnancy outcomes: retrospective cohort study of UK national bariatric surgery registry (NBSR). Obes Surg. 2016;26(12):2837-42.##Goldman RH, Missmer SA, Robinson MK, Farland LV, Ginsburg ES. Reproductive outcomes differ following roux-en-Y gastric bypass and adjustable gastric band compared with those of an obese non-surgical group. Obes Surg. 2016;26(11):2581-9.##Musella M, Milone M, Bellini M, Fernandez ME, Fernandez LM, Leongito M, et al. The potential role of intragastric balloon in the treatment of obese-related infertility: personal experience. Obes Surg. 2011;21(4):426-30.##Musella M, Milone M, Bellini M, Fernandez LMS, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surg Obes Relat Dis. 2012;8(4):445-9.##Luyssen J, Jans G, Bogaerts A, Ceulemans D, Matthys C, Van der Schueren B, et al. Contraception, menstruation, and sexuality after bariatric surgery: a prospective cohort study. Obes Surg. 2018;28(5):1385-93.##Hair WM, Gubbay O, Jabbour HN, Lincoln GA. Prolactin receptor expression in human testis and accessory tissues: localization and function. Mol Hum Reprod. 2002;8(7):606-11.##Saldanha CJ, Remage-Healey L, Schlinger BA. Synaptocrine signaling: steroid synthesis and action at the synapse. Endocr Rev. 2011;32(4):532-49.##De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol. 2016;14(1):38.##

A Study on the Presence of Osteopontin and α3β1 Integrin in the Endometrium of Diabetic Rats at the Time of Embryo Implantation 2 1 2 Background: Embryo implantation is a critical and multifactorial phenomenon which can be affected by any alteration in molecular micro construction of endometrium. The aim of the current study was to evaluate the effects of diabetes on osteopontin (OPN) and α3β1 integrin proteins level at the time of endometrial receptivity. Methods: Twenty-eight female rats were divided into control, diabetic, pioglitazone-treated and metformin-treated groups. Western blot was performed to determine the OPN and α3β1 integrin proteins in rats’ endometrium at the time of implantation. Data were analyzed by analysis of variance (ANOVA) and p<0.05 was considered statistically significant. Results: OPN increased significantly in the diabetic group in comparison with control (p<0.001), metformin-treated (p=0.008) and pioglitazone-treated groups (p<0.001). Furthermore, α3β1 integrin protein level in diabetic group had a significant difference in comparison with that of the control (p<0.001), metformin-treated (p=0.026) and pioglitazone-treated groups (p<0.001). Conclusion: OPN and α3β1 integrin proteins are involved in embryo implantation and their changes in diabetic condition can affect fertility. Treatment with pioglitazone and metformin improved the level of OPN and α3β1 integrin proteins while pioglitazone was more effective. 087 94 Yasaman Y Zarrin Isfahan Medical Student Research Center, Faculty of Medicine, Isfahan University of Medical Sciences Isfahan Medical Student Research Center, Faculty of Medicine, Isfahan University of Medical Sciences Iran Abbas A Bakhteyari Department of Anatomical Sciences, Faculty of Medicine, Isfahan University of Medical Sciences Department of Anatomical Sciences, Faculty of Medicine, Isfahan University of Medical Sciences Iran Parvaneh P Nikpour Department of Genetics and Molecular Biology, Faculty of Medicine, Isfahan University of Medical Sciences Department of Genetics and Molecular Biology, Faculty of Medicine, Isfahan University of Medical Sciences Iran Fatemeh Sadat FS Mostafavi Department of Anatomical Sciences, Faculty of Medicine, Isfahan University of Medical Sciences Department of Anatomical Sciences, Faculty of Medicine, Isfahan University of Medical Sciences Iran Nahid N Eskandari Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences Iran Mohammad M Matinfar Department of Internal Medicine, Faculty of Medicine, Isfahan University of Medical Sciences Department of Internal Medicine, Faculty of Medicine, Isfahan University of Medical Sciences Iran Roshanak R Aboutorabi روشنک ابوترابی Department of Anatomical Sciences, Faculty of Medicine, Isfahan University of Medical Sciences Department of Anatomical Sciences, Faculty of Medicine, Isfahan University of Medical Sciences Iran aboutorabi.r@gmail.com Diabetes mellitusEndometriumOsteopontinα3β1 integrin 60074.pdf Mays L. Diabetes mellitus standards of care. Nurs Clin. 2015;50(4):703-11.##Ramachandran A, Snehalatha C, Shetty AS, Nanditha A. Trends in prevalence of diabetes in Asian countries. World J Diabets. 2012;3(6):110-7.##Fal AM, Jankowska B, Uchmanowicz I, Sen M, Panaszek B, Polanski J. Type 2 diabetes quality of life patients treated with insulin and oral hypoglycemic medication. Acta Diabetol. 2011;48 (3):237-42.##Amaral S, Oliveira PJ, Ramalho-Santos J. Diabetes and the impairment of reproductive function: possible role of mitochondria and reactive oxygen species. Curr Diabetes Rev. 2008;4(1):46-54.##Kumar D. Prevalence of female infertility and its socio-economic factors in tribal communities of central India. Rural Remote Health. 2007;7(2):456.##Practice committee of the American society for reproductive medicine. Effectiveness and treatment for unexplained infertility. Fertil Steril. 2006;86(5 Suppl 1):S111-4.##Elnaggar A, Farag AH, Gaber ME, Hafeez MA, Ali MS, Atef AM. AlphaVBeta3 integrin expression within uterine endometrium in unexplained infertility: a prospective cohort study. BMC Womens Health. 2017;17(1):90.##Miller E, Hare JW, Cloherty JP, Dunn PJ, Gleason RE, Soeldner JS, et al. Elevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in infants of diabetic mothers. New Engl J Med. 1981;304(22):1331-4.##Anderson JL, Waller DK, Canfield MA, Shaw GM, Watkins ML, Werler MM. Maternal obesity, gestational diabetes, and central nervous system birth defects. Epidemiology. 2005;16(1):87-92.##Peyghambari F, Amanpour S, Fayazi M, Haddadi M, Muhammadnejad S, Muhammadnejad A, et al. Expression of α4, αv, β1 and β3 integrins during the implantation window on blastocyst of a mouse model of polycystic ovarian syndromes. Iran J Reprod Med. 2014;12(9):623-32.##Aplin JD, Ruane PT. Embryo-epithelium intera-ctions during implantation at a glance. J Cell Sci. 2017;130(1):15-22.##Hosseiny ZS, Nikpour P, Bakhteyari A, Mostafavi FS, Matinfar M, Jahani M, et al. Evaluation of osteopontin gene expression in endometrium of diabetic rat models treated with metformin and pioglitazone. Int J Fertil Steril. 2019;12(4):293-7.##Fukuda MN, Sugihara K. Cell adhesion molecules in human embryo implantation. Sheng Li Xue Bao. 2012;64(3):247-58.##Lessey BA. Endometrial receptivity and the window of implantation. Best Pract Res Clin Obstet Gynaecol. 2000;14(5):775-88.##Ballas J, Moore TR, Ramos GA. Management of diabetes in pregnancy. Curr Diab Rep. 2012;12(1):33-42.##Jensen DM, Korsholm L, Ovesen P, Beck-Nielsen H, Moelsted-Pedersen L, Westergaard JG, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care. 2009;32(6):1046-8.##Geisert R, Fazleabas A, Lucy M, Mathew D. Interaction of the conceptus and endometrium to establish pregnancy in mammals: role of interleukin 1β. Cell Tissue Res. 2012;349(3):825-38.##Lessey B. Endometrial integrins and the establishment of uterine receptivity. Hum Reprod. 1998;13 Suppl 3:247-58.##Chung TW, Park MJ, Kim HS, Choi HJ, Ha KT. Integrin αVβ3 and αVβ5 are required for leukemia inhibitory factor-mediated the adhesion of trophoblast cells to the endometrial cells. Biochem Biophys Res Commun. 2016;469(4):936-40.##Singh H, Aplin JD. Adhesion molecules in endometrial epithelium: tissue integrity and embryo implantation. J Anat. 2009;215(1):3-13.##Tabibzadeh S. Patterns of expression of integrin molecules in human endometrium throughout the menstrual cycle. Hum Reprod. 1992;7(6):876-82.##Chen Q, Shou P, Zhang L, Xu C, Zheng C, Han Y, et al. An osteopontin‐integrin interaction plays a critical role in directing adipogenesis and osteogenesis by mesenchymal stem cells. Stem Cells. 2014;32(2):327-37.##Wesson JA, Johnson RJ, Mazzali M, Beshensky AM, Stietz S, Giachelli C, et al. Osteopontin is a critical inhibitor of calcium oxalate crystal formation and retention in renal tubules. J Am Soc Nephrol. 2003;14(1):139-47.##Lund SA, Giachelli CM, Scatena M. The role of osteopontin in inflammatory processes. J Cell Commun Signal. 2009;3(3-4):311-22.##Asaumi S, Takemoto M, Yokote K, Ridall AL, Butler WT, Fujimoto M, et al. Identification and characterization of high glucose and glucosamine responsive element in the rat osteopontin promoter. J Diabets Complications. 2003;17(1):34-8.##Gong Q, Chipitsyna G, Gray CF, Anandanadesan R, Arafat HA. Expression and regulation of osteopontin in type 1 diabetes. Islets. 2009;1(1):34-41.##Apparao K, Illera MJ, Beyler SA, Olson GE, Osteen KG, Corjay MH, et al. Regulated expression of osteopontin in the peri-implantation rabbit uterus. Biol Reprod. 2003;68(5):1484-90.##von Wolff M, Strowitzki T, Becker V, Zepf C, Tabibzadeh S, Thaler CJ. Endometrial osteopontin, a ligand of β3-integrin, is maximally expressed around the time of the “implantation window”. Fertil Steril. 2001;76(4):775-81.##Apparao KB, Murray MJ, Fritz MA, Meyer WR, Chambers AF, Truong PR, et al. Osteopontin and its receptor αvβ3 integrin are coexpressed in the human endometrium during the menstrual cycle but regulated differentially. J Clin Endocrinol Metab. 2001;86(10):4991-5000.##Kostidou E, Koliakos G, Kaloyianni M. Increased monocyte alphaL, alphaM and beta2 integrin subunits in diabetes mellitus. Clin Biochem. 2009;42(7-8):634-40.##He L, Wondisford FE. Metformin action: concentrations matter. Cell Metab. 2015;21(2):159-62.##Viollet B, Guigas B, Sanz Garcia N, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: an overview. Clin Sci (Lond). 2012;122(6):253-70.##Zou C, Hu H. Use of pioglitazone in the treatment of diabetes: effect on cardiovascular risk. Vasc Health Risk Manag. 2013;9:429-33.##Gross B, Staels B. PPAR agonists: multimodal drugs for the treatment of type-2 diabetes. Best Pract Res Clin Endocrinol Metab. 2007;21(4):687-710.##Zabihi S, Wentzel P, Eriksson UJ. Altered uterine perfusion is involved in fetal outcome of diabetic rats. Placenta. 2008;29(5):413-21.##Kokil GR, Veedu RN, Ramm GA, Prins JB, Parekh HS. Type 2 diabetes mellitus: limitations of conventional therapies and intervention with nucleic acid-based therapeutics. Chem Rev. 2015;115(11):4719-43.##Basmatzou T, Konstantinos Hatziveis M. Diabetes mellitus and influences on human fertility. Int J Caring Sci. 2016;9(1):371-9.##Agbaje IM, Rogers DA, McVicar CM, McClure N, Atkinson AB, Mallidis C, et al. Insulin dependant diabetes mellitus: implications for male reproductive function. Hum Reprod. 2007;22(7):1871-7.##Platt MJ, Stanisstreet M, Casson IF, Howard CV, Walkinshaw S, Pennycook S, et al. St Vincent’s declaration 10 years on: outcomes of diabetic pregnancies. Diabet Med. 2002;19(3):216-20.##Seaward AV, Burke SD, Croy BA. Interferon gamma contributes to preimplantation embryonic development and to implantation site structure in NOD mice. Hum Reprod. 2010;25(11):2829-39.##Tsilibary P-E, Charonis AS, Setty S, Mauer M. Analysis of alpha integrins for the diagnosis of diabetic nephropathy. Google Patents; 2004.##Shanmugam N, Reddy MA, Guha M, Natarajan R. High glucose-induced expression of proinflammatory cytokine and chemokine genes in monocytic cells. Diabetes. 2003;52(5):1256-64.##Sawada K, Toyoda M, Kaneyama N, Shiraiwa S, Moriya H, Miyatake H, et al. Upregulation of α3β1-integrin in podocytes in early-stage diabetic nephropathy. J Diabetes Res. 2016;2016:9265074.##Jin DK, Fish AJ, Wayner EA, Mauer M, Setty S, Tsilibary E, et al. Distribution of integrin subunits in human diabetic kidneys. J Am Soc Nephrol. 1996;7(12):2636-45.##Setty S, Wayner E, Kim Y, Tsilibary E. Changes in the profile of integrins from human mesangial cells following exposure to high glucose. J Am Soc Nephrol. 1993;4:665.##Zhang X, Chee WK, Liu S, Tavintharan S, Sum CF, Lim SC, et al. Association of plasma osteopontin with diabetic retinopathy in Asians with type 2 diabetes. Mol Vis. 2018;24:165-73.##Abu El-Asrar AM, Nawaz MI, De Hertogh G, Alam K, Siddiquei MM, Van den Eynde K, et al. S100A4 is upregulated in proliferative diabetic retinopathy and correlates with markers of angiogenesis and fibrogenesis. Mol Vis. 2014;20:1209-24.##Fischer JW, Tschöpe C, Reinecke A, Giachelli CM, Unger T. Upregulation of osteopontin expression in renal cortex of streptozotocin-induced diabetic rats is mediated by bradykinin. Diabetes. 1998;47(9):1512-8.##Towler DA, Bidder M, Latifi T, Coleman T, Semenkovich CF. Diet-induced diabetes activates an osteogenic gene regulatory program in the aortas of low density lipoprotein receptor-deficient mice. J Biol Chem. 1998;273(46):30427-34.##Giannelli G, Sgarra C, Di Naro E, Lavopa C, Angelotti U, Tartagni M, et al. Endometriosis is characterized by an impaired localization of laminin‐5 and α3β1 integrin receptor. Int J Gynecol Cancer. 2007;17(1):242-7.##Roth T, Podesta F, Stepp MA, Boeri D, Lorenzi M. Integrin overexpression induced by high glucose and by human diabetes: potential pathway to cell dysfunction in diabetic microangiopathy. Proc Natl Acad Sci USA. 1993;90(20):9640-4.##Qi QR, Xie QZ, Liu XL, Zhou Y. Osteopontin is expressed in the mouse uterus during early pregnancy and promotes mouse blastocyst attachment and invasion in vitro. Plos One. 2014;9(8):e104955.##Franchi A, Zaret J, Zhang X, Bocca S, Oehninger S. Expression of immunomodulatory genes, their protein products and specific ligands/receptors during the window of implantation in the human endometrium. Mol Hum Reprod. 2008;14(7):413-21.##Gales C, Zamfir C, Stoica B, Nechifor M. Zinc and pioglitazone effects on ovaries and endometrium in diabetes. Farmacia. 2015;63(1):52-6.##

The in vitro Analysis of Quality of Ovarian Follicle Culture Systems Using Time-Lapse Microscopy and Quantitative Real-Time PCR 2 1 2 Background: The aim of ovarian follicle in vitro culture is to obtain mature oocytes. To evaluate the efficiency of in vitro culture system, the status of the cultured oocyte can be analyzed. Methods: The preantral ovarian follicles retrieved from 14-day-old C57Bl/6J mice were cultured in 3D alginate hydrogel. The status of oocytes obtained from mature (3 months old, group A) and immature (3 weeks old, group B) mice was compared to the status of oocytes retrieved from ovarian follicles cultured in vitro (Group C) using qRT-PCR analysis and time-lapse microscopy. In the qRT-PCR analysis, 8 samples for group A (80 oocytes), 8 samples for group B (80 oocytes), and 6 samples for group C (60 oocytes) were included. Time-lapse analysis was performed in group A (oocytes n=31), group B (n=45), and group C (n=21). Statistical analysis was done by Kruskal-Wallis and chi-square tests and differences were considered statistically significant if p<0,05. Results: The diameter of group C oocytes is lower in comparison to group A oocytes (67 μm vs. 75 μm, correspondingly). Groups B and C oocytes exhibited delayed meiosis in comparison to group A oocytes. Expression levels of six oocyte maturation genes (Ccnb, CDK1, Ccnh, Wee2, Mos and Epab) were evaluated using qRT-PCR analysis. Expression levels of Ccnh and Epab are lowered in group C oocytes compared to the expression levels of these genes in groups A and B oocytes (p<0.05). Conclusion: Oocytes obtained after ovarian follicles in vitro culture have reduced development competence, future fundamental changes of in vitro culture systems can be expected. 094 107 Maxim MA Filatov Faculty of Biology, Lomonosov Moscow State University Faculty of Biology, Lomonosov Moscow State University Russia maxfilat@yandex.ru Denis DA Nikishin Faculty of Biology, Lomonosov Moscow State University Faculty of Biology, Lomonosov Moscow State University Russia Yulia YV Khramova Faculty of Biology, Lomonosov Moscow State University Faculty of Biology, Lomonosov Moscow State University Russia Maria ML Semenova Faculty of Biology, Lomonosov Moscow State University Faculty of Biology, Lomonosov Moscow State University Russia AlginateIn vitro cultureMiceOocyteOvarian follicleReal-time PCRTime-lapse microscopy 60075.pdf Filatov MA, Khramova YV, Kiseleva MV, Malinova IV, Komarova EV, Semenova ML. Female fertility preservation strategies: cryopreservation and ovarian tissue in vitro culture, current state of the art and future perspectives. Zygote. 2016;24(5):635-53.##Dunning KR, Akison LK, Russell DL, Norman RJ, Robker RL. Increased beta-oxidation and improved oocyte developmental competence in response to l-carnitine during ovarian in vitro follicle development in mice. Biol Reprod. 2011;85(3):548-55.##Hornick JE, Duncan FE, Shea LD, Woodruff TK. Multiple follicle culture supports primary follicle growth through paracrine-acting signals. Reproduction. 2013;145(1):19-32.##Jiao ZX, Woodruff TK. Follicle microenvironment-associated alterations in gene expression in the mouse oocyte and its polar body. Fertil Steril. 2013;99(5):1453-59.e1.##Gook DA, Edgar DH, Lewis K, Sheedy JR, Gardner DK. Impact of oxygen concentration on adult murine pre-antral follicle development in vitro and the corresponding metabolic profile. Mol Hum Reprod. 2014;20(1):31-41.##Makanji Y, Tagler D, Pahnke J, Shea LD, Woodruff TK. Hypoxia-mediated carbohydrate metabolism and transport promote early-stage murine follicle growth and survival. Am J Physiol Endocrinol Metab. 2014;306(8):E893-903.##Filatov MA, Khramova YV, Semenova ML. In vitro mouse ovarian follicle growth and maturation in alginate hydrogel: current state of the art. Acta Naturae. 2015;7(2):48-56.##Xu M, Kreeger PK, Shea LD, Woodruff TK. Tissue-engineered follicles produce live, fertile offspring. Tissue Eng. 2006;12(10):2739-46.##Wang X, Catt S, Pangestu M, Temple-Smith P. Successful in vitro culture of pre-antral follicles derived from vitrified murine ovarian tissue: oocyte maturation, fertilization, and live births. Reproduction. 2011;141(2):183-91.##Mochida N, Akatani-Hasegawa A, Saka K, Ogino M, Hosoda Y, Wada R, et al. Live births from isolated primary/early secondary follicles following a multistep culture without organ culture in mice. Reproduction. 2013;146(1):37-47.##Higuchi CM, Maeda Y, Horiuchi T, Yamazaki Y. A simplified method for three-dimensional (3-D) ovarian tissue culture yielding oocytes competent to produce full-term offspring in mice. PLoS One. 2015;10(11):e0143114.##Kreeger PK, Deck JW, Woodruff TK, Shea LD. The in vitro regulation of ovarian follicle development using alginate-extracellular matrix gels. Biomaterials. 2006;27(5):714-23.##Xu M, West E, Shea LD, Woodruff TK. Identification of a stage-specific permissive in vitro culture environment for follicle growth and oocyte development. Biol Reprod. 2006;75(6):916-23.##Shikanov A, Xu M, Woodruff TK, Shea LD. Interpenetrating fibrin-alginate matrices for in vitro ovarian follicle development. Biomaterials. 2009;30(29):5476-85.##Xu M, Banc A, Woodruff TK, Shea LD. Secondary follicle growth and oocyte maturation by culture in alginate hydrogel following cryopreservation of the ovary or individual follicles. Biotechnol Bioeng. 2009;103(2):378-86.##Jin SY, Lei L, Shikanov A, Shea LD, Woodruff TK. A novel two-step strategy for in vitro culture of early-stage ovarian follicles in the mouse. Fertil Steril. 2010;93(8):2633-9.##Filatov M, Khramova Y, Semenova M. Molecular mechanisms of prophase I meiotic arrest maintenance and meiotic resumption in mammalian oocytes. Reprod Sci. 2019;26(11):1519-37.##West-Farrell ER, Xu M, Gomberg MA, Chow YH, Woodruff TK, Shea LD. The mouse follicle microenvironment regulates antrum formation and steroid production: alterations in gene expression profiles. Biol Reprod. 2009;80(3):432-9.##Parrish EM, Siletz A, Xu M, Woodruff TK, Shea LD. Gene expression in mouse ovarian follicle development in vivo versus an ex vivo alginate culture system. Reproduction. 2011;142(2):309-18.##Amoushahi M, Salehnia M, Mowla SJ, Ghorbanmehr N. Morphological and molecular aspects of in vitro culture of preantral follicles derived from vitrified ovarian. Cell J. 2017;19(3):332-42.##Sánchez F, Romero S, Albuz FK, Smitz J. In vitro follicle growth under non-attachment conditions and decreased FSH levels reduces Lhcgr expression in cumulus cells and promotes oocyte developmental competence. J Assist Reprod Genet. 2012;29(2):141-52.##Adhikari D, Zheng W, Shen Y, Gorre N, Ning Y, Halet G, et al. Cdk1, but not Cdk2, is the sole Cdk that is essential and sufficient to drive resumption of meiosis in mouse oocytes. Hum Mol Genet. 2012;21(11):2476-84.##Kong BY, Bernhardt ML, Kim AM, O’Halloran TV, Woodruff TK. Zinc maintains prophase I arrest in mouse oocytes through regulation of the MOS-MAPK pathway. Biol Reprod. 2012;87(1):1-12.##Yuan J, Xu BZ, Qi ST, Tong JS, Wei L, Li M, et al. MAPK-activated protein kinase 2 is required for mouse meiotic spindle assembly and kinetochore-microtubule attachment. PLoS One. 2010;5(6):e11247.##Sha QQ, Dai XX, Dang Y, Tang F, Liu J, Zhang YL, et al. A MAPK cascade couples maternal mRNA translation and degradation to meiotic cell cycle progression in mouse oocytes. Development. 2017;144(3):452-63.##Wilkie GS, Gautier P, Lawson D, Gray NK. Embryonic poly(A)-binding protein stimulates translation in germ cells. Mol Cell Biol. 2005;25(5):2060-71.##Guzeloglu-Kayisli O, Lalioti MD, Aydiner F, Sasson I, Ilbay O, Sakkas D, et al. Embryonic poly(A)-binding protein (EPAB) is required for oocyte maturation and female fertility in mice. Biochem J. 2012;446(1):47-58.##Ozturk S, Yaba-Ucar A, Sozen B, Mutlu D, Demir N. Superovulation alters embryonic poly(A)-binding protein (Epab) and poly(A)-binding protein, cytoplasmic 1 (Pabpc1) gene expression in mouse oocytes and early embryos. Reprod Fertil Dev. 2016;28(3):375-83.##Faramarzi A, Khalili MA, Agha-Rahimi A, Omidi M. Is there any correlation between oocyte polarization microscopy findings with embryo time lapse monitoring in ICSI program? Arch Gynecol Obstet. 2017;295(6):1515-22.##Truong T, Gardner DK. Antioxidants improve IVF outcome and subsequent embryo development in the mouse. Hum Reprod. 2017;32(12):2404-13.##Barberet J, Bruno C, Valot E, Antunes-Nunes C, Jonval L, Chammas J, et al. Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth? Hum Reprod. 2019;34(8):1439-49.##Cobo A, Coello A, Remohí J, Serrano J, de Los Santos JM, Meseguer M. Effect of oocyte vitrification on embryo quality: time-lapse analysis and morphokinetic evaluation. Fertil Steril. 2017;108(3):491-7.e3.##Belli M, Vigone G, Merico V, Redi CA, Garagna S, Zuccotti M. Time-lapse dynamics of the mouse oocyte chromatin organisation during meiotic resumption. Biomed Res Int. 2014;2014:207357.##Cavalera F, Zanoni M, Merico V, Sacchi L, Bellazzi R, Garagna S, et al. Chromatin organization and timing of polar body I extrusion identify developmentally competent mouse oocytes. Int J Dev Biol. 2019;63(3-4-5):245-51.##Cavalera F, Zanoni M, Merico V, Bui TTH, Belli M, Fassina L, et al. A neural network-based identification of developmentally competent or incompetent mouse fully-grown oocytes. J Vis Exp. 2018;(133).##Zenclussen ML, Casalis PA, Jensen F, Woidacki K, Zenclussen AC. Hormonal fluctuations during the estrous cycle modulate heme oxygenase-1 expression in the uterus. Front Endocrinol (Lausanne). 2014;5:32.##Riedel G, Rüdrich U, Fekete-Drimusz N, Manns MP, Vondran FW, Bock M. An extended ΔCT-method facilitating normalisation with multiple reference genes suited for quantitative RT-PCR analyses of human hepatocyte-like cells. PLoS One. 2014;9(3):e93031.##Mehlmann LM. Losing mom's message: requirement for DCP1A and DCP2 in the degradation of maternal transcripts during oocyte maturation. Biol Reprod. 2013;88(1):10.##Phelan JP, Austad SN. Selecting animal models of human aging: inbred strains often exhibit less biological uniformity than F1 hybrids. J Gerontol. 1994;49(1):B1-11.##Hartman JL, Garvik B, Hartwell L. Principles for the buffering of genetic variation. Science. 2001;291(5506):1001-4.##Hartwell L. Genetics. Robust interactions. Science. 2004;303(5659):774-5.##Cui X, Affourtit J, Shockley KR, Woo Y, Churchill GA. Inheritance patterns of transcript levels in F1 hybrid mice. Genetics. 2006;174(2):627-37.##Dunning KR, Cashman K, Russell DL, Thompson JG, Norman RJ, Robker RL. Beta-oxidation is essential for mouse oocyte developmental competence and early embryo development. Biol Reprod. 2010;83(6):909-18.##Oktem O, Buyuk E, Oktay K. Preantral follicle growth is regulated by c-Jun-N-terminal kinase (JNK) pathway. Reprod Sci. 2011;18(3):269-76.##Kohaya N, Fujiwara K, Ito J, Kashiwazaki N. Generation of live offspring from vitrified mouse oocytes of C57BL/6J strain. PLoS One. 2013;8(3):e58063.##Takeo T, Nakagata N. Superovulation using the combined administration of inhibin antiserum and equine chorionic gonadotropin increases the number of ovulated oocytes in C57BL/6 female mice. PLoS One. 2015;10(5):e0128330.##West ER, Xu M, Woodruff TK, Shea LD. Physical properties of alginate hydrogels and their effects on in vitro follicle development. Biomaterials. 2007;28(30):4439-48.##Tagler D, Makanji Y, Tu T, Bernabé BP, Lee R, Zhu J, et al. Promoting extracellular matrix remodeling via ascorbic acid enhances the survival of primary ovarian follicles encapsulated in alginate hydrogels. Biotechnol Bioeng. 2014;111(7):1417-29.##Pretty CG, Le Compte A, Penning S, Fisk L, Shaw GM, Desaive T, et al. Interstitial insulin kinetic parameters for a 2-compartment insulin model with saturable clearance. Comput Methods Programs Biomed. 2014;114(3):e39-45.##Nielsen TK, Højgaard M, Andersen JT, Poulsen HE, Lykkesfeldt J, Mikines KJ. Elimination of ascorbic acid after high-dose infusion in prostate cancer patients: a pharmacokinetic evaluation. Basic Clin Pharmacol Toxicol. 2015;116(4):343-8.##Boyle KL, Leech E. A review of the pharmacology and clinical uses of pimobendan. J Vet Emerg Crit Care (San Antonio). 2012;22(4):398-408.##Richard FJ, Tsafriri A, Conti M. Role of phosphodiesterase type 3A in rat oocyte maturation. Biol Reprod. 2001;65(5):1444-51.##Rossi DJ, Londesborough A, Korsisaari N, Pihlak A, Lehtonen E, Henkemeyer M, et al. Inability to enter S phase and defective RNA polymerase II CTD phosphorylation in mice lacking Mat1. EMBO J. 2001;20(11):2844-56.##Patel SA, Simon MC. Functional analysis of the Cdk7.cyclin H.Mat1 complex in mouse embryonic stem cells and embryos. J Biol Chem. 2010;285(20):15587-98.##Kolesnikova O, Radu L, Poterszman A. TFIIH: a multi-subunit complex at the cross-roads of transcription and DNA repair. Adv Protein Chem Struct Biol. 2019;115:21-67.##Zhu Q, Wani G, Sharma N, Wani A. Lack of CAK complex accumulation at DNA damage sites in XP-B and XP-B/CS fibroblasts reveals differential regulation of CAK anchoring to core TFIIH by XPB and XPD helicases during nucleotide excision repair. DNA Repair (Amst). 2012;11(12):942-50.##Compe E, Drané P, Laurent C, Diderich K, Braun C, Hoeijmakers JH, et al. Dysregulation of the peroxisome proliferator-activated receptor target genes by XPD mutations. Mol Cell Biol. 2005;25(14):6065-76.##Helenius K, Yang Y, Alasaari J, Mäkelä TP. Mat1 inhibits peroxisome proliferator-activated receptor gamma-mediated adipocyte differentiation. Mol Cell Biol. 2009;29(2):315-23.##Kalous J, Kubelka M, Motlík J. The effect of PD98059 on MAPK regulation in cumulus-enclosed and cumulus-free mouse oocytes. Zygote. 2003;11(1):61-8.##Chang HM, Qiao J, Leung PC. Oocyte-somatic cell interactions in the human ovary-novel role of bone morphogenetic proteins and growth differentiation factors. Hum Reprod Update. 2016;23(1):1-18.##Janas P, Kucybała I, Radoń-Pokracka M, Huras H. Telocytes in the female reproductive system: an overview of up-to-date knowledge. Adv Clin Exp Med. 2018;27(4):559-65.##Tagler D, Tu T, Smith RM, Anderson NR, Tingen CM, Woodruff TK, et al. Embryonic fibroblasts enable the culture of primary ovarian follicles within alginate hydrogels. Tissue Eng Part A. 2012;18(11-12):1229-38.##Choi JK, Agarwal P, He X. In vitro culture of early secondary preantral follicles in hanging drop of ovarian cell-conditioned medium to obtain MII oocytes from outbred deer mice. Tissue Eng Part A. 2013;19(23-24):2626-37.##Choi JK, Agarwal P, Huang H, Zhao S, He X. The crucial role of mechanical heterogeneity in regulating follicle development and ovulation with engineered ovarian microtissue. Biomaterials. 2014;35(19):5122-8.##Shikanov A, Xu M, Woodruff TK, Shea LD. A method for ovarian follicle encapsulation and culture in a proteolytically degradable 3 dimensional system. J Vis Exp. 2011;(49). pii: 2695.##

Outcomes of Preimplantation Genetic Testing for Single Gene Defects in a Privately Funded Period and Publicly Funded Period: A North-American Single Center Experience 2 1 2 Background: The purpose of this study was to assess whether the outcomes from IVF-preimplantation genetic testing (IVF-PGT) cycles for single gene defects (SGD) (PGT-M) differ between a privately funded period (PRP) and publicly funded period (PUP). Methods: A retrospective cohort study was conducted in a North-American single tertiary center. The PRP (March 1998 to July 2010) comprised 56 PGT-M cycles from 58 IVF cycles in 38 couples, and the PUP (August 2010 to May 2015) comprised 59 PGT-M cycles from 87 IVF cycles in 38 couples. One PGT-M cycle is defined as one biopsy procedure from one or serial IVF cycles. A p-value of 0.05 was considered statistically significant. Results: The clinical pregnancy rates (CPR) per PGT-M cycle were 30.4% and 52.5% in each period, respectively (p=0.021). The live birth rates (LBR) per PGT-M cycle were 21.5% versus 40.9% in each period, respectively (p=0.037). A sub-analysis within the PUP comparing 39 PGT-M cycles from 39 IVF cycles with 20 PGT-M cycles from 49 IVF cycles yielded CPRs per PGT-M cycle of 64.1% and 30.0% and LBRs per PGT-M cycle of 53.8% and 15.0%, in each group, respectively (p<0.05 for both). Conclusion: The transition from private to public funding and a single embryo transfer (ET) guideline has little impact on embryological and clinical outcomes of PGT-M cycles, and results in lower rates of multiple pregnancies. However, these two systems may serve different populations. 107 116 Talya T Shaulov MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal Canada Li L Zhang MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal Canada Jin-Tae JT Chung MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal Canada Weon-Young WY Son MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal Canada William W Buckett MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal Canada Asangla A Ao MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal MUHC Reproductive Centre, Department of Obstetrics and Gynecology, Montreal Canada asangla.ao@muhc.mcgill.ca In VitroPreimplantation genetic testingPublic fundingSingle embryo transferSingle embryo transfer 60079.pdf Bissonnette F, Phillips SJ, Gunby J, Holzer H, Mahutte N, St-Michel P, et al. Working to eliminate multiple pregnancies: a success story in Quebec. Reprod Biomed Online. 2011;23(4):500-4.##Velez MP, Connolly MP, Kadoch IJ, Phillips S, Bissonnette F. Universal coverage of IVF pays off. Hum Reprod. 2014;29(6):1313-9.##El-Toukhy T, Kamal A, Wharf E, Grace J, Bolton V, Khalaf Y, et al. Reduction of the multiple pregnancy rate in a preimplantation genetic diagnosis programme after introduction of single blastocyst transfer and cryopreservation of blastocysts biopsied on day 3. Hum Reprod. 2009;24(10):2642-8.##Handyside AH, Kontogianni EH, Hardy K, Winston RM. Pregnancies from biopsied human preimplantation embryos sexed by Y-specific DNA amplification. Nature. 1990;344(6268):768-70.##Delhanty JD, Harper JC. Pre-implantation genetic diagnosis. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14(4):691-708.##Treff NR, Su J, Tao X, Levy B, Scott RT Jr. Accurate single cell 24 chromosome aneuploidy screening using whole genome amplification and single nucleotide polymorphism microarrays. Fertil Steril. 2010;94(6):2017-21.##Harper JC, Sengupta SB. Preimplantation genetic diagnosis: state of the art 2011. Hum Genet. 2012;131(2):175-86.##Harton GL, Munne S, Surrey M, Grifo J, Kaplan B, McCulloh DH, et al. Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization. Fertil Steril. 2013;100(6):1695-703.##Fiorentino F, Bono S, Biricik A, Nuccitelli A, Cotroneo E, Cottone G, et al. Application of next-generation sequencing technology for comprehensive aneuploidy screening of blastocysts in clinical preimplantation genetic screening cycles. Hum Reprod. 2014;29(12):2802-13.##Tobler KJ, Brezina PR, Benner AT, Du L, Xu X, Kearns WG. Two different microarray technologies for preimplantation genetic diagnosis and screening, due to reciprocal translocation imbalances, demonstrate equivalent euploidy and clinical pregnancy rates. J Assist Reprod Genet. 2014;31(7):843-50.##Navarro JL, Castilla JA, Martinez L, Hernandez E, Fontes J. Coverage and current practice patterns regarding assisted reproduction techniques. Eur J Obstet Gynecol Reprod Biol. 2008;138(1):3-9.##Castilla JA, Hernandez E, Cabello Y, Navarro JL, Hernandez J, Gomez JL et al. Assisted reproductive technologies in public and private clinics. Reprod Biomed Online. 2009;19(6):872-8.##Shaulov T, Belisle S, Dahan MH. Public health implications of a North American publicly funded in vitro fertilization program; lessons to learn. J Assist Reprod Genet. 2015;32(9):1385-93.##Zhang L, Yilmaz A, Chian RC, Son WY, Zhang XY, Kong D et al. Reliable preimplantation genetic diagnosis in thawed human embryos vitrified at cleavage stages without biopsy. J Assist Reprod Genet. 2011;28(7):597-602.##McCullagh P, Nelder JA. Generalized linear models. 2nd ed. New York: Chapman & Hall/CRC Press; 1989. 526 p.##Agresti A, Booth JG, Hobert JP, Caffo B. Random-effects modeling of categorical response data. Sociol Methodol. 2000;30(1):27-80.##De Rycke M. Singling out genetic disorders and disease. Genome Med. 2010;2(10):74.##De Rycke M, Belva F, Goossens V, Moutou C, SenGupta SB, Traeger-Synodinos J, et al. ESHRE PGD consortium data collection XIII: cycles from January to december 2010 with pregnancy follow-up to october 2011. Hum Reprod. 2015;30(8):1763-89.##De Sutter P, Van der Elst J, Coetsier T, Dhont M. Single embryo transfer and multiple pregnancy rate reduction in IVF/ICSI: a 5-year appraisal. Reprod Biomed Online. 2003;6(4):464-9.##Debrock S, Spiessens C, Meuleman C, Segal L, De Loecker P, Meeuwis L, et al. New belgian legislation regarding the limitation of transferable embryos in in vitro fertilization cycles does not significantly influence the pregnancy rate but reduces the multiple pregnancy rate in a threefold way in the Leuven University Fertility Center. Fertil Steril. 2005;83(5):1572-4.##Van Landuyt L, Verheyen G, Tournaye H, Camus M, Devroey P, Van Steirteghem A. New belgian embryo transfer policy leads to sharp decrease in multiple pregnancy rate. Reprod Biomed Online. 2006;13(6):765-71.##Ryan GL, Sparks AE, Sipe CS, Syrop CH, Dokras A, Van Voorhis BJ. A mandatory single blastocyst transfer policy with educational campaign in a United States IVF program reduces multiple gestation rates without sacrificing pregnancy rates. Fertil Steril. 2007;88(2):354-60.##Khalaf Y, El-Toukhy T, Coomarasamy A, Kamal A, Bolton V, Braude P. Selective single blastocyst transfer reduces the multiple pregnancy rate and increases pregnancy rates: a pre- and postintervention study. BJOG. 2008;115(3):385-90.##Kresowik JD, Stegmann BJ, Sparks AE, Ryan GL, van Voorhis BJ. Five-years of a mandatory single-embryo transfer (mSET) policy dramatically reduces twinning rate without lowering pregnancy rates. Fertil Steril. 2011;96(6):1367-9.##Kutlu P, Atvar O, Vanlioglu OF, Kutlu U, Arici A, Yilmaz S, et al. Effect of the new legislation and single-embryo transfer policy in Turkey on assisted reproduction outcomes: preliminary results. Reprod Biomed Online. 2011;22(2):208-14.##Esinler I, Bozdag G, Karakoc Sokmensuer L. Mandatory single embryo transfer policy dramatically decreases multiple pregnancy rates. J Obstet Gynaecol Res. 2014;40(1):75-9.##Henne MB, Bundorf MK. Insurance mandates and trends in infertility treatments. Fertil Steril. 2008;89(1):66-73.##Tur-Kaspa I. Clinical management of in vitro fertilization with preimplantation genetic diagnosis. Semin Reprod Med. 2012;30(4):309-22.##Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26(7):1768-74.##Ji J, Liu Y, Tong XH, Luo L, Ma J, Chen Z. The optimum number of oocytes in IVF treatment: an analysis of 2455 cycles in China. Hum Reprod. 2013;28(10):2728-34.##Steward RG, Lan L, Shah AA, Yeh JS, Price TM, Goldfarb JM, et al. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles. Fertil Steril. 2014;101(4):967-73.##Briggs R, Kovacs G, MacLachlan V, Motteram C, Baker HW. Can you ever collect too many oocytes? Hum Reprod. 2015;30(1):81-7.##Drakopoulos P, Blockeel C, Stoop D, Camus M, de Vos M, Tournaye H, et al. Conventional ovarian stimulation and single embryo transfer for IVF/ICSI. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos? Hum Reprod. 2016;31(2):370-6.##Vandervorst M, Liebaers I, Sermon K, Staessen C, De Vos A, Van de Velde H, et al. Successful preimplantation genetic diagnosis is related to the number of available cumulus-oocyte complexes. Hum Reprod. 1998;13(11):3169-76.##Verpoest W, Haentjens P, De Rycke M, Staessen C, Sermon K, Bonduelle M, et al. Cumulative reproductive outcome after preimplantation genetic diagnosis: a report on 1498 couples. Hum Reprod. 2009;24(11):2951-9.##Hu X, Wang J, Li Y, Wang Y, Ding C, Zeng Y, et al. Clinical considerations of preimplantation genetic diagnosis for monogenic diseases. PLoS One. 2015;10(9):e0139613.##

Multinucleation in Day Two Embryos Is Not Associated with Multinucleation in Sibling Embryos After Freezing and Thawing 2 1 2 Background: Multinucleated embryos exhibit impaired implantation potential, but whether the presence of multinucleated embryos in an embryo cohort reflects the quality of the entire cohort is controversial. No data exists on multinucleation rate among frozen-thawed embryos. Methods: De novo multinucleation and the number of multinucleated embryos on day two of embryo culture before freezing (D2) (n=415), at thawing (D2t) (n=320) and after an overnight culture after thawing (D3t) (n=265) was recorded. Associations between multinucleation before and after cryopreservation, female age and ovarian sensitivity to hormonal stimulation were assessed. Results: The occurrence of at least one multinucleated embryo per embryo cohort was 62.4% on D2, 16.3% on D2t and 31.7% on D3t. The presence of multinucleated embryos prior to freezing was not associated with de novo multinucleation during post-thaw culture (p=0.845). On D2, multinucleation was high in young women, irrespective of the number of collected oocytes (p=0.702). In older age groups, multinucleation was highest if >17 oocytes were obtained (p<0.001) and the odds for multinucleation was the lowest if the consumption of recombinant follicle-stimulating hormone was >238 IU/oocyte (In the age group of 30–35 years OR 0.25 [0.13–0.47], and the age group of 36–40 years OR 0.35 [0.20–0.63]. Conclusion: Multinucleation is commonly seen in embryos and good-quality day two embryo cohorts before freezing. The presence of multinucleated embryos prior to freezing does not illustrate multinucleation in sibling embryos after thawing. Embryo multinucleation is associated with factors related to good prognosis in assisted reproduction treatments. 116 124 Jaana J Seikkula Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä and University of Turku Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä and University of Turku Finland jaana.seikkula@fimnet.fi Päivi P Polo-Kantola Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Finland Harri H Mankonen Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Finland Harri H Mankonen Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Finland Leena L Anttila Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Finland Varpu V Jokimaa Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital Finland Cell nucleusCryopreservationICSIIVF 60084.pdf Hardy K, Winston RM, Handyside AH. Binucleate blastomeres in preimplantation human embryos in vitro: failure of cytokinesis during early cleavage. J Reprod Fertil. 1993;98(2):549-58.##Munné S, Cohen J. Unsuitability of multinucleated human blastomeres for preimplantation genetic diagnosis. Hum Reprod. 1993;8(7):1120-5.##Staessen C, Van Steirteghem A. The genetic constitution of multinuclear blastomeres and their derivative daughter blastomeres. Hum Reprod. 1998;13(6):1625-31.##De Cássia Savio Figueira R, Souza Setti A, Paes De Almeida Ferreira Braga D, Iaconelli A, Borges E. Blastomere multinucleation: Contributing factors and effects on embryo development and clinical outcome. Hum Fertil. 2010;13(3):143-50.##Jackson KV, Ginsburg ES, Hornstein MD, Rein MS, Clarke RN. Multinucleation in normally fertilized embryos is associated with an accelerated ovulation induction response and lower implantation and pregnancy rates in in vitro fertilization-embryo transfer cycles. Fertil Steril. 1998;70(1):60-6.##Van Royen E, Mangelschots K, Vercruyssen M, De Neubourg D, Valkenburg M, Ryckaert G, et al. Multinucleation in cleavage stage embryos. Hum Reprod. 2003;18(5):1062-9.##Yilmaz A, Zhang L, Zhang XY, Son WY, Holzer H, Ao A. Chromosomal complement and clinical relevance of multinucleated embryos in PGD and PGS cycles. Reprod Biomed Online. 2014;28(3):380-7.##Meriano J, Clark C, Cadesky K, Laskin CA. Binucleated and micronucleated blastomeres in embryos derived from human assisted reproduction cycles. Repro Biomed Online. 2004;9(5):511-20.##Moriwaki T, Suganuma N, Hayakawa M, Hibi H, Katsumata Y, Oguchi H, et al. Embryo evaluation by analysing blastomere nuclei. Hum Reprod. 2004;19(1):152-6.##Balakier H, Sojecki A, Motamedi G, Librach C. Impact of multinucleated blastomeres on embryo developmental competence, morphokinetics, and aneuploidy. Fertil Steril. 2016;106(3):608-14.e2.##Ergin EG, Calişkan E, Yalçinkaya E, Oztel Z, Cökelez K, Ozay A, et al. Frequency of embryo multinucleation detected by time-lapse system and its impact on pregnancy outcome. Fertil Steril. 2014;102(4):1029-33.e1.##Liu RH, Sun QY, Li YH, Jiao LH, Wang WH. Effects of cooling on meiotic spindle structure and chromosome alignment within in vitro matured porcine oocytes. Mol Reprod Dev. 2003;65(2):212-8.##Pickering SJ, Braude PR, Johnson MH, Cant A, Currie J. Transient cooling to room temperature can cause irreversible disruption of the meiotic spindle in the human oocyte. Fertil Steril. 1990;54(1):102-8.##Agerholm IE, Kølvraa S, Crüger DG, Berg C, Bruun-Petersen G, Ziebe S. Resumption of mitosis in frozen-thawed embryos is not related to the chromosomal constitution. Fertil Steril. 2008;90(5):1649-55.##Pelinck MJ, De Vos M, Dekens M, Van der Elst J, De Sutter P, Dhont M. Embryos cultured in vitro with multinucleated blastomeres have poor implantation potential in human in-vitro fertilization and intracytoplasmic sperm injection. Hum Reprod. 1998;13(4):960-3.##Kligman I, Benadiva C, Alikani M, Munne S. The presence of multinucleated blastomere’ s in human embryos is correlated with chromosomal abnormalities. Hum Reprod. 1996;11:1492-8.##Egashira A, Yamauchi N, Tanaka K, Mine C, Otsubo H, Murakami M, et al. Developmental capacity and implantation potential of the embryos with multinucleated blastomeres. J Reprod Dev. 2015;61(6):595-600.##Van der Elst J, Van den Abbeel E, Vitrier S, Camus M, Devroey P, Van Steirteghem AC. Selective transfer of cryopreserved human embryos with further cleavage after thawing increases delivery and implantation rates. Hum Reprod. 1997;12(7):1513-21.##Desai N, Ploskonka S, Goodman L, Attaran M, Goldberg JM, Austin C, et al. Delayed blastulation, multinucleation, and expansion grade are independently associated with live-birth rates in frozen blastocyst transfer cycles. Fertil Steril. 2016;106(6):1370-8.##Guerif F, Bidault R, Cadoret V, Couet ML, Lansac J, Royere D. Parameters guiding selection of best embryos for transfer after cryopreservation: a reappraisal. Hum Reprod. 2002;17(5):1321-6.##Yakin K, Balaban B, Urman B. Impact of the presence of one or more multinucleated blastomeres on the developmental potential of the embryo to the blastocyst stage. Fertil Steril. 2005;83(1):243-5.##Hur YS, Ryu EK, Hyun CS, Yang SH, Yoon SH, Lim KS, et al. Retrospective study of single vitrified-warmed blastocyst transfer cycles according to the presence of morphokinetic variables. Clin Exp Reprod Med. 2018;45(1):52-5.##Aguilar J, Rubio I, Muñoz E, Pellicer A, Meseguer M. Study of nucleation status in the second cell cycle of human embryo and its impact on implantation rate. Fertil Steril. 2016;106(2):291-9.e2.##Desch L, Bruno C, Luu M, Barberet J, Choux C, Lamotte M, et al. Embryo multinucleation at the two-cell stage is an independent predictor of intracytoplasmic sperm injection outcomes. Fertil Steril. 2016;107(1):97-103.e4.##Hashimoto S, Nakano T, Yamagata K, Inoue M, Morimoto Y, Nakaoka Y. Multinucleation per se is not always sufficient as a marker of abnormality to decide against transferring human embryos. Fertil Steril. 2015;106(1):133-9.e6.##Tesarik J. Is blastomere multinucleation a safeguard against embryo aneuploidy? back to the future. Reprod Biomed Online. 2018;37(4):506-7.##Vázquez-Diez C, FitzHarris G. Causes and consequences of chromosome segregation error in preimplantation embryos. Reproduction. 2018;155(1):R63-R76.##Desai N, Goldberg JM, Austin C, Falcone T. Are cleavage anomalies, multinucleation, or specific cell cycle kinetics observed with time-lapse imaging predictive of embryo developmental capacity or ploidy? Fertil Steril. 2018;109(4):665-74.##Sekhon L, Shaia K, Santistevan A, Cohn KH, Lee JA, Beim PY, et al. The cumulative dose of gonadotropins used for controlled ovarian stimulation does not influence the odds of embryonic aneuploidy in patients with normal ovarian response. J Assist Reprod Genet. 2017;34(6):749-58.##Basile N, Vime P, Florensa M, Aparicio Ruiz B, Garcia Velasco JA, Remohi J, et al. The use of morphokinetics as a predictor of implantation: a multicentric study to define and validate an algorithm for embryo selection. Hum Reprod. 2014;30(2):276-83.##Li Z, Wang YA, Ledger W, Edgar DH, Sullivan EA. Clinical outcomes following cryopreservation of blastocysts by vitrification or slow freezing: a population-based cohort study. Hum Reprod. 2014;29(12):2794-801.##

Prevalence of Cytomegalovirus in Semen of Male Partners of Infertile Couples and the Virus Impact on Sperm Parameters 2 1 2 Background: Genital tract infection is one of the causes of male infertility. Several studies have shown a role for human cytomegalovirus (CMV) in this context. In the present study, the prevalence of CMV in a population of male partners of infertile couples was estimated and the impact of CMV on sperm parameters was determined. Methods: In this cross sectional study, CMV DNA and virus copy number were examined in the semen of 150 participants including 80 with normal semen analysis (SA) and 70 with abnormal SA, by quantitative Real-Time PCR. Sperm parameters were compared between CMV positive and negative groups. Comparisons with p-values under 0.05 were considered significant. Logistic regression was performed to control the effect of some variables with p<0.25 on sperm parameters. Results: CMV DNA was detected in the semen of 28 (18.6%) individuals. 21 men (30%) with abnormal SA and 7 (8.8%) with normal SA were positive for CMV DNA (p=0.001). The mean virus copy number was 883.1±4662.01 for the men with abnormal SA and 2525.7±12680.9 for those with normal SA (p=0.001). Sperm count was (32.1±23.5) x106 in CMV positive and (44.2±24.1) x106 in CMV negative groups (p=0.022). Normal sperm morphology was 2.73±2.83% and 5.99±5.44% in CMV positive and negative groups, respectively (p<0.001). After controlling some variables, the sperm morphology remains the only statistically significant sperm parameter that was reduced by CMV. Conclusion: The higher CMV prevalence in the semen of males with abnormal SA compared to normal SA and significant reduction of sperm morphology in the presence of CMV, are in favor of the negative impact of CMV on male fertility. 124 130 Bahia B Namavar Jahromi Infertility Research Center, Shiraz University of Medical Sciences Infertility Research Center, Shiraz University of Medical Sciences Iran Ramin R Yaghobi Shiraz Transplant Research Center, Shiraz University of Medical Sciences Shiraz Transplant Research Center, Shiraz University of Medical Sciences Iran Najmeh N Matlub IVF Section, Ghadir Mother and Child Hospital of Shiraz IVF Section, Ghadir Mother and Child Hospital of Shiraz Iran Arezou A Fazelzadeh Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences Iran Abolfazl A Ramzi Shiraz Transplant Research Center, Shiraz University of Medical Sciences Shiraz Transplant Research Center, Shiraz University of Medical Sciences Iran Zahra Z Anvar Infertility Research Center, Shiraz University of Medical Sciences Infertility Research Center, Shiraz University of Medical Sciences Iran zahraanvar2000@yahoo.com, namavarb@sums.ac.ir Najaf N Zare Infertility Research Center, Shiraz University of Medical Sciences Infertility Research Center, Shiraz University of Medical Sciences Iran Leila L Salarian Department of Pediatrics, Shiraz University of Medical Sciences Department of Pediatrics, Shiraz University of Medical Sciences Iran Jafar J Fallahi Molecular Medicine Department, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences Molecular Medicine Department, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences Iran CytomegalovirusMale infertilityPolymerase chain reactionSemen analysis 70076.pdf Habibi M, Bahrami A, Morteza A, Sadighi Gilani MA, Hassanzadeh G, Ghadami M, et al. Study of cytomegalovirus infection in idiopathic infertility men referred to Shariati hospital, Tehran, Iran. Iran J Reprod Med. 2014;12(2):151-4.##Malm G, Engman ML. Congenital cytomegalovirus infections. Semin Fetal Neonatal Med. 2007;12(3):154-9.##Mack I, Burckhardt MA, Heininger U, Prufer F, Schulzka S, Wellmann S. Symptomatic congenital cytomegalovirus infection in children of seropositive women. Front Pediatr. 2017;5:134.##Buxmann H, Hamprecht K, Meyer-Wittkopf M, Friese K. Primary human cytomegalovirus (CMV) infection in pregnancy. Dtsch Artztebl Int. 2017;114(4):45-52.##Stadler LP, Bernstein DI, Callahan ST, Turley CB, Munoz FM, Ferreira J, et al. Seroprevalence and risk factors for cytomegalovirus infections in adolescent females. J Pediatric Infect Dis Soc. 2013;2(1):7-14.##Jung JH, Kim MH, Kim J, Baik SK, Koh SB, Park HJ, et al. Treatment of leukocytospermia in male infertility: a systematic review. World J Mens Health. 2016;34(3):165-72.##Nasri F, Gharesi-Fard B, Namavar Jahromi B, Farazi-Fard MA, Banaei M, Davari M, et al. Sperm DNA methylation of H19 imprinted gene and male infertility. Andrologia. 2017;49(10).##Berek JS. Berek & Novak's gynecology. 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. 1671 p.##Parsanezhad ME, Namavar Jahromi B, Zare N, Keramati P, Khalili A, Parsa-Nezhad M. Epidemiology and etiology of infertility in Iran, systematic review and meta-analysis. J Womens Health Issues Care. 2014;2(6):1-6.##Gimenes F, Souza RP, Bento JC, Teixeira JJ, Maria-Engler SS, Bonini MG, et al. Male infertility: a public health issue caused by sexually transmitted pathogens. Nat Rev Urol. 2014;11(12):672-87.##Naumenko VA, Tyulenev YA, Yakovenko SA, Kurilo LF, Shileyko LV, Segal AS, et al. Detection of human cytomegalovirus in motile spermatozoa and spermatogenic cells in testis organotypic culture. Herpesviridae. 2011;2(1):7.##Eggert-Kruse W, Reuland M, Johannsen W, Strowitzki T, Schlehofer JR. Cytomegalovirus (CMV) infection--related to male and/or female infertility factors? Fertil Steril. 2009;91(1):67-82.##Naumenko V, Tyulenev Y, Kurilo L, Shileiko L, Sorokina T, Evdokimov V, et al. Detection and quantification of human herpes virus types 4-6 in sperm samples of patients with fertility disorders and chronic inflammatory urogenital tract disease. Andrology. 2014;2(5):687-94.##Neofytou E, Sourvinos G, Asmarianaki M, Spandidos DA, Makrigiannakis A. Prevalence of human herpes virus types 1-7 in the semen of men attending an infertility clinic and correlation with semen parameters. Fertil Steril. 2009;91(6):2487-94.##Bezold G, Politch JA, Kiviat NB, Kuypers JM, Wolff H, Anderson DJ. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertil Steril. 2007;87(5):1087-97.##Behboudi E, Mokhtari-Azad T, Yavarian J, Ghavami N, Seyed Khorrami SM, Rezaei F, et al. Molecular detection of HHV1-5, AAV and HPV in semen specimens and their impact on male fertility. Hum Fertil (Camb). 2018;22(2):133-8.##World health organization, department of reproductive health and research. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World health organization; 2010. 287 p.##Shaiegan M, Rasouli M, Zadsar M, Zolfaghari S. Meta-analysis of cytomegalovirus seroprevalence in volunteer blood donors and healthy subjects in Iran from 1992 to 2013. Iran J Basic Med Sci. 2015;18(7):627-34.##Eivazi-Ziaei J, Movassagpour A, Asgharzadeh M, Dastgiri S. Seroprevalence of cytomegalovirus in blood donors in the northwest of Iran. J Analyt Res Clin Med. 2013;1(2):96-100.##Dejucq N, Jégou B. Viruses in the mammalian male genital tract and their effects on the reproductive system. Microbiol Mol Biol Rev. 2001;65(2):208-31.##Kapranos N, Petrakou E, Anastasiadou C, Kotronias D. Detection of herpes simplex virus, cytomegalovirus, and Epstein-Barr virus in the semen of men attending an infertility clinic. Fertil Steril. 2003;79 Suppl 3:1566-70.##Mohseni M, Mollaei H, Arabzadeh SA, Mirshekari TR, Ghorbani P. Frequency of cytomegalovirus in fertile and infertile men, referring to Afzalipour hospital IVF research center, Kerman, Iran: a case-control study. Int J Reprod Biomed (Yazd). 2018;16(7):443-6.##Tafvizi F, Baghdadi K, Hayati Roodbari N. Lack of relatedness between human cytomegalovirus in semen and male infertility. Iran J Med Microbiol. 2016;10(3):39-46.##Klimova RR, Chichev EV, Naumenko VA, Gadzhieva ZS, Tsibisov AS, Adieva AA, et al. [Herpes simplex virus and cytomegalovirus in male ejaculate: herpes simplex virus is more frequently encountered in idiopathic infertility and correlates with the reduction in sperm parameters. Vopr Virusol. 2010;55(1):27-31.##Kanduc D. Describing the potential crossreactome between mumps virus and spermatogenesis-associated proteins. Endocr Metab Immune Disord Drug Targets. 2014:14(3):218-25.##Swanson EC, Schleiss MR. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatr Clin North Am. 2013;60(2):335-49.##Suganuma E, Oka A, Sakata H, Adachi N, Asanuma S, Oguma E, et al. 10-year follow-up of congenital cytomegalovirus infection complicated with severe neurological findings in infancy: a case report. BMC Pediatr. 2018;18(1):369.##Gantt S, Bitnun A, Renaud C, Kakkar F, Vaudry W. Diagnosis and management of infants with congenital cytomegalovirus infection. Pediatr Child Health. 2017;22(2):72-4.##Lanzieri TM, Dollard SC, Josephson CD, Schmid DS, Bialek SR. Breast milk-acquired cytomegalovirus infection and disease in very low birth weight and premature infants. Pediatrics. 2013;131(6):e1937-e45.##Gang MH, Chang MY. Breast milk-transmitted cytomegalovirus infection in preterm infants. Neonatal Med. 2018;25(2):58-65.##Ronchi A, Shimamura M, Malhotra PS, Sánchez PJ. Encouraging postnatal cytomegalovirus (CMV) screening: the time is NOW for universal screening! Expert Rev Anti Infect Ther. 2017;15(5):417-9.##Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 25 th ed. New York: McGraw-Hill; 2001. 1404 p.##

Prediction of Gestational Diabetes by Measuring the Levels of Pregnancy Associated Plasma Protein-A (PAPP-A) During Gestation Weeks 11-14 2 1 2 Background: The present study aimed to determine the association between pregnancy-associated plasma protein A (PAPP-A) and Gestational Diabetes Methods (GDM) to detect a risk factor for predicting GDM at gestational weeks 11-14. Methods: This analytical prospective study recruited 284 pregnant women presenting to six healthcare centers of Qazvin, Iran from February to December 2016. PAPP-A was measured at gestational weeks 11-14 and glucose tolerance test was conducted at gestational weeks 24-28. The participants were assigned into two groups of exposure (reduced PAPP-A) and non-exposure (normal PAPP-A). The association between GDM and PAPP-A was studied. The number of women in exposure group were 201 and 83 in the non-exposure group. Differences between groups were assessed by the Mann–Whitney, Chi-square, T test, logistic regression analysis and ROC Curve with a significance level of 0.05. Results: Twenty eight (33.73%) patients of the exposure group and 17 (8.46%) of non-exposure group developed GDM. There was a significant difference between the two groups in terms of GDM (p<0.001) and the risk of GDM was 3.98 fold higher in the exposure group (reduced PAPPA mu/L) than that of the non-exposure group (CI=2.39-6.65, p<0.001). Also, 53.3% of the exposure group and 46.7% of the non-exposure group were diagnosed with GDM (p=0.02). There was a significant difference in GDM between the groups and the risk of GDM was 1.85 times higher in the exposure group (reduced PAPPA MOM) than that in the control group (CI=1.09-3.15, p=0.020). According to the ROC curve results, PAPP-A and MOM are acceptable indicators for predicting GDM. Conclusion: A low PAPP-A level (MOM, MU/L) as a new risk factor for GDM can help early prediction and prevent maternal and fetal complication by timely treatment. 130 138 Somayeh S Ramezani Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences Iran Mahboubeh M Ahmadi Doulabi Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences Iran mah1372@yahoo.com Hamid H Saqhafi School of Paramedical Sciences, Qazvin University of Medical Sciences School of Paramedical Sciences, Qazvin University of Medical Sciences Iran Mahmood M Alipoor Department of Biostatistics, Faculty of Medicine, Qazvin University of Medical Sciences Department of Biostatistics, Faculty of Medicine, Qazvin University of Medical Sciences Iran Gestational diabetesPregnanciesPregnancy associated plasma protein A 60076.pdf American diabetes association. Classification and diagnosis of diabetes. Diabetes Care. 2015;38(Suppl 1):S8-16.##Bloom SL, Corton MM, Spong CY, Dashe JS, Leveno KJ. Williams Obstetrics. 24 ed. USA: McGraw Hill education; 2014. 1376 p.##del Rosario-Capellan ML, Carlos-Raboca J, Litonjua AD. Total sialic acid and other inflammatory markers as predictors of gestational diabetes. Philos J Intern Med. 2009;47:11-7.##Baptiste-Roberts K, Barone BB, Gary TL, Golden SH, Wilson LM, Bass EB, et al. Risk factors for type 2 diabetes among women with gestational diabetes: a systematic review. Am J Med. 2009;122(3): 207-14.e4.##Ahi Z, Kariman N, Zahedi S, Shakeri N. Relationship between maternal serum C-reactive protein concentration and gestational diabetes mellitus. Adv Nurs Midwifery. 2015;24(85):31-8.##Reece EA. The fetal and maternal consequences of gestational diabetes mellitus. J Matern Fetal Neonatal Med. 2010;23(3):199-203.##Coustan DR, Lowe LP, Metzger BE, Dyer AR, International association of diabetes and pregnancy study groups. The hyperglycemia and adverse pregnancy outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol. 2010;202(6):654-e1-6.##Kampmann U, Madsen LR, Skajaa GO, Iversen DS, Moeller N, Ovesen P. Gestational diabetes: a clinical update. World J Diabetes. 2015;6(8):1065-72.##Vild As. Screening in obstetrics and gaynocology disease. Zahrani F, Behbahani B, Tehrani T. qhom: Fanose Roshan; 2011.##Protocol of screening and diagnosis of gestational diabetes [internet]. 2013[cited2016 october 6]: [about 3 p.].available from health .behdasht.gov.ir##Inan C, Varol FG, Erzincan SG, Uzun I, Sutcu H, Sayin NC. Use of prokineticin-1 (PROK1), pregnancy-associated plasma protein A (PAPP-A) and PROK1/PAPP-A ratio to predict adverse pregnancy outcomes in the first trimester: a prospective study. J Matern Fetal Neonatal Med. 2018;31(20):2685-92.##Beneventi F, Simonetta M, Lovati E, Albonico G, Tinelli C, Locatelli E, et al. First trimester pregnancy‐associated plasma protein‐A in pregnancies complicated by subsequent gestational diabetes. Prenat Diagn. 2011;31(6):523-8.##Beneventi F, Simonetta M, Locatelli E, Cavagnoli C, Badulli C, Lovati E, et al. Temporal variation in soluble human leukocyte antigen‐G (sHLA‐G) and pregnancy‐associated plasma protein A (PAPP‐A) in pregnancies complicated by gestational diabetes mellitus and in controls. Am J Reprod Immunol. 2014;72(4):413-21.##Huynh L, Kingdom J, Akhtar S. Low pregnancy-associated plasma protein A level in the first trimester. Can Fam Physician. 2014;60(10):899-903.##Lovati E, Beneventi F, Simonetta M, Laneri M, Quarleri L, Scudeller L, et al. Gestational diabetes mellitus: including serum pregnancy-associated plasma protein-A testing in the clinical management of primiparous women? a case–control study. Diabetes Res Clin Pract. 2013;100(3):340-7.##Giudice I, Benintende G, Di Nicolò AM, Mangiameli D, Carrara G, Randazzo C, et al. Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study. J Perinat Med. 2015;43(2):227-32.##Ledesma AM, Yuste MG, Bújez AR, et al. Low Maternal Serum PAPP-A Levels in the First Trimester of Gestation and the Risk of Gestational Diabetes. In18th world congresson controversies in obstetrics obstetric, gynecology & infertility (COGI) 2014 (p. 183).##Schaas C, Titianu M, Visinari R, Berescu A, Carp A, Onofriescu M. PAPP‐A—a marker for gestational diabetes? Ultrasound Obstet Gynecol. 2012;40(S1):192.##Husslein H, Lausegger F, Leipold H, Worda C. Association between pregnancy-associated plasma protein-A and gestational diabetes requiring insulin treatment at 11–14 weeks of gestation. J Matern Fetal Neonatal Med. 2012;25(11):2230-3.##Spencer K, Cicero S, Atzei A, Otigbah C, Nicolai-des KH. The influence of maternal insulin‐de-pendent diabetes on fetal nuchal translucency thickness and first‐trimester maternal serum biochemical markers of aneuploidy. Prenat Diagn. 2005;25(10):927-9.##Jelliffe-Pawlowski LL, Baer RJ, Currier RJ, Lyell DJ, Blumenfeld YJ, El-Sayed YY, et al. Early-onset severe preeclampsia by first trimester pregnancy-associated plasma protein A and total human chorionic gonadotropin. Am J Perinatol. 2015; 32(07):703-12.##Spencer K, Cowans NJ, Avgidou K, Molina F, Nicolaides KH. First‐trimester biochemical markers of aneuploidy and the prediction of small‐for‐ gestational age fetuses. Ultrasound Obstet Gynecol. 2008;31(1):15-9.##Spencer K, Cowans NJ, Molina F, Kagan KO, Nicolaides KH. First‐trimester ultrasound and biochemical markers of aneuploidy and the prediction of preterm or early preterm delivery. Ultrasound Obstet Gynecol. 2008;31(2):147-52.##Ong CY, Liao AW, Spencer K, Munim S, Nicolaides KH. First trimester maternal serum free beta human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications. BJOG. 2000;107(10):1265-70.##Iversen KK, Dalsgaard M, Teisner AS, Schoos M, Teisner B, Nielsen H, et al. Pregnancy-associated plasma protein-A, a marker for outcome in patients suspected for acute coronary syndrome. Clin Biochem. 2010;43(10):851-7.##Sweeting AN, Wong J, Appelblom H, Ross GP, Kouru H, Williams PF, et al. A novel early pregnancy risk prediction model for gestational diabetes mellitus. Fetal Diagn Ther. 2019;45(2):76-84.##Donovan BM, Nidey NL, Jasper EA, Robinson JG, Bao W, Saftlas AF, et al. First trimester prenatal screening biomarkers and gestational diabetes mellitus: A systematic review and meta-analysis. PloS one. 2018;13(7):e0201319.##Shah K, Sultana R, Bhat R, Bhat P, Bhat S. Impact of high levels of pregnancy associated plasma protein-A on pregnancy. J Clin Diagn Res. 2018;12 (9):9-13.##Sweeting AN, Wong J, Appelblom H, Ross GP, Kouru H, Williams PF, et al. A first trimester pre-diction model for gestational diabetes utilizing aneuploidy and pre-eclampsia screening markers. J Matern Fetal Neonatal Med. 2018;31(16):2122-30.##Ramezani S, Ahmadi M, Saghafi H, Alipoor M. Association of pregnancy association plasma protein A (PAPP-A) and gestational diabetes. Iran J Obstet Gynecol Infertil. 2017;20(1):61-9.##Maymon R, Meiri H, Svirski R, Weiner E, Cuckle H. Maternal serum screening marker levels in twin pregnancies affected by gestational diabetes. Arch Gynecol Obstet. 2019;299(3):655-63.##Xiao D, Chenhong W, Yanbin X, Lu Z. Gestational diabetes mellitus and first trimester pregnancy-associated plasma protein A: a case–control study in a Chinese population. J Diabets Investig. 2018;9 (1):204-10.##Pellitero S, Reverter JL, Pizarro E, Pastor MC, Granada ML, Tàssies D, et al. Pregnancy-associated plasma protein-a levels are related to glycemic control but not to lipid profile or hemostatic parameters in type 2 diabetes. Diabetes Care. 2007;30 (12):3083-5.##Savvidou MD, Syngelaki A, Muhaisen M, Emelyanenko E, Nicolaides KH. First trimester maternal serum free β‐human chorionic gonadotropin and pregnancy‐associated plasma protein A in pregnancies complicated by diabetes mellitus. BJOG. 2012;119(4):410-6.##Nanda S, Savvidou M, Syngelaki A, Akolekar R, Nicolaides KH. Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks. Prenat Diagn. 2011;31(2):135-41.##Teede HJ, Harrison CL, Teh WT, Paul E, Allan CA. Gestational diabetes: development of an early risk prediction tool to facilitate opportunities for prevention. Aust N Z J Obstet Gynaecol. 2011;51 (6):499-504.##

Determinants of Child Size at Birth and Associated Maternal Factor in Gurage Zone 2 1 2 Background: Birth weight plays an important role in infant mortality and mor-bidity, child development, and future health of the child. Reports showed that low birth weight is one of the critical issues in Gugare zone that causes many babies short-term and long-term health consequences and tends to have higher mortality and morbidity. This study examined and identified the determinants of weight of children at birth in Gurage zone. Methods: The survey or the information has been collected on a total of 735,109 reproductive mothers in Gurage zone. Children with age less than 59 months were considered in this study. Ordinal logistic regression techniques used for data analysis using maternal and socio- demographic variables as explanatory variables and size of a baby at birth as the response variable and statistical package for social science (SPSS) version 23 and STATA were used for data analysis purpose. Results: According to our study, from the sampled children, 30.1%, 44.4% and 25.5% were small in size, medium in size and large in size, respectively. Mater-nal related variables were statistically significant like uneducated mother (β=0.26, p= 0.013), mothers who get antenatal visit care 2-3 times (β=-0.210, p=0.10), source of drinking water (β=0.844, p<0.001) and malaria affected mothers (β=0.344, p< 0.001). Conclusion: Children from rural mothers, uneducated families, mothers who did not get more antenatal care visits, poor families, mothers who drink non-improved water, mothers who are affected by malaria during pregnancy, teenager mothers are small in size at birth. 138 146 Gedif GM Alemayehu Department of Statistics, College of Natural and Computational Science, Injibara University Department of Statistics, College of Natural and Computational Science, Injibara University Ethiopia gedifmulat@gmail.com Ayele AG Chernet Department of Statistics, College of Natural and Computational Sciences, Wolkite University Department of Statistics, College of Natural and Computational Sciences, Wolkite University Ethiopia Kassahun KT Dumga Department of Statistics, College of Natural and Computational Sciences, Wolkite University Department of Statistics, College of Natural and Computational Sciences, Wolkite University Ethiopia Infant morbidityInfant mortalityProportion odds modeWeight of child at birth 60080.pdf Central statistical agency (CSA) of Ethiopia and ICF. Ethiopia demographic and health survey 2011. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2017 Mar. 452 p.##Barnard KE, Douglas HB, Bee HL, Eyres SJ, Hammond MA. Child health assessment. US department of health, education, and welfare, public health service, health resources administration, bureau of health resources development, division of nursing; 1974.##World Health Organization, Unicef. Low birth weights: country, regional and global estimates. 1st ed. Geneva: WHO; 2004. 27 p.##Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663-737.##Betew W, Muluneh EK. Determinants of low birth weight among children aged 0 to 59 months in Ethiopia. Int J Pure Appl Sci Technol. 2014;25(1):14.##Magadi M, Diamond I, Madise N, Smith P. Pathways of the determinants of unfavourable birth outcomes in Kenya. J Biosoc Sci. 2004;36(2):153-76.##Tuntiseranee P, Olsen J, Chongsuvivatwong V, Limbutara S. Socioeconomic and work related determinants of pregnancy outcome in southern Thailand. J Epidemiol Community Health. 1999;53(10): 624-9.##Siza JE. Risk factors associated with low birth weight of neonates among pregnant women attending a referral hospital in northern Tanzania. Tanzan J Health Res. 2008;10(1):1-8.##Khatun S, Rahman M. Socio-economic determinants of low birth weight in Bangladesh: a multivariate approach. Bangladesh Med Res Counc Bull. 2008; 34(3):81-6.##Hirve SS, Ganatra BR. Determinants of low birth weight: a community based prospective cohort study. Indian Pediatr. 1994;31(10):1221-5.##Alexander GR, Korenbrot CC. The role of prenatal care in preventing low birth weight. Future Chil. 1995;5(1):103-20.##Hollander MH, van Hastenberg E, van Dillen J, Van Pampus MG, de Miranda E, Stramrood CA. Preventing traumatic childbirth experiences: 2192 women’s perceptions and views. Arch Womens Ment Health. 2017;20(4):515-23.##Magadi M, Diamond I, Madise N. Individual and community level factors associated with premature births, size of baby at birth and caesarean section deliveries in Kenya. Kenya: African population and health research center; 2000. 40 p.##Dharmalingam A, Navaneetham K, Krishnakumar CS. Nutritional status of mothers and low birth weight in India. Matern Child Health J. 2010;14 (2):290-8.##Ipadeola OB, Samson B, Adebayo SB, Anyanti J, Jolayemi ET. Poverty levels and maternal nutritional status as determinants of weight at birth: an ordinal logistic regression approach. Int J Stat Appl. 2013;3(3):50-8.##

Enhancing a Successful Pregnancy and Delivery After ICSI in Advanced-Age Woman with Concurrent Disorders: A Case Report 2 1 2 Background: The objective of this case presentation was describing a live birth in an advanced-age woman with an extremely enlarged uterus, an ovary with blocked fallopian tubes, hypothyroidism and generalized anxiety disorder caused by childbirth following intracytoplasmic sperm injection/embryo transfer (ICSI-ET) with autologous oocytes. Case Presentation: A 47-year-old patient with an enlarged uterus due to recurrent multiple fibroids following myomectomy was referred to clinical laboratory with a high level of desire to follow the prescribed recommendations and approaches to retrieve her fertility. The patient underwent two cycles of oocyte retrieval and two rounds of frozen-thawed embryo transfer. To achieve a successful pregnancy after oocyte retrieval (birth weight of 3300 g at 38 weeks of gestation), a frozen/thawed embryo in the second cycle of ET was transferred. Conclusion: Usage of efficient planning and management of ICSI treatments in patient with autologous oocytes and concurrent disorders, can be used as a new approach to cure the affected individuals. 146 151 Faranak F Aghaz Fertility and Infertility Research Center, Kermanshah University of Medical Sciences Fertility and Infertility Research Center, Kermanshah University of Medical Sciences Iran Zahra Z Mokari Department of Social Sciences, Razi University Department of Social Sciences, Razi University Iran Mitra M Bakhtiari Infertility Research and Treatment Center, Motazedi Hospital, Kermanshah University of Medical Sciences Infertility Research and Treatment Center, Motazedi Hospital, Kermanshah University of Medical Sciences Iran miana512000@yahoo.com Advanced maternal ageAutologous oocytesEmbryo transferIntracytoplasmic sperm injectionLive birth 60081.pdf Kenny LC, Lavender T, McNamee R, O’Neill SM, Mills T, Khashan AS. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PloS one. 2013;8(2):e56583.##Su YY, Wang SH, Chou HC, Chen CY, Hsieh WS, Tsao PN, et al. Morbidity and mortality of very low birth weight infants in Taiwan-Changes in 15 years: a population based study. J Formos Med Assoc. 2016;115(12):1039-45.##Elizur SE, Lerner-Geva L, Levron J, Shulman A, Bider D, Dor J. Factors predicting IVF treatment outcome: a multivariate analysis of 5310 cycles. Reprod Biomed Online. 2005;10(5):645-9.##Vander B, Mélodie, Christine W. Fertility and infertility: definition and epidemiology. Clin Biochem. 2018;60(4):2-10.##Deatsman S, Vasilopoulos T, Rhoton-Vlasak A. Age and fertility: a study on patient awareness. JBRA Assist Reprod. 2016;20(3):99-106.##Ajayi R, Parsons JH, Bolton VN. Live births after intracytoplasmic sperm injection in the management of oligospermia and azoospermia in Nigeria. Afr J Reprod Health. 2003;7(1):121-4.##Rani G, Goswami S, Chattopadhyay R, Ghosh S, Chakravarty B, Ganesh A. Live birth in a 50-year-old woman following in vitro fertilization–embryo transfer with autologous oocytes: a rare case report. Fertil Steril. 2015;103(2):414-6.##Orazulike N, Oriji VK, Fiebai PO. Live birth after in-vitro fertilization (IVF) in a 53 year old woman: a case report. Nigerian Health J. 2013;13(3):142-5.##Ciavattini A, Di Giuseppe J, Stortoni P, Montik N, Giannubilo SR, Litta P, et al. Uterine fibroids: pathogenesis and interactions with endometrium and endomyometrial junction. Obstet Gynecol Int. 2013;2013:173184.##Drayer SM, Catherino WH. Prevalence, morbidity, and current medical management of uterine leiomyomas. Int J Gynecol Obstet. 2015;131(2):117-22.##Ikhena DE, Bulun SE. Literature review on the role of uterine fibroids in endometrial function. Reprod Sci. 2018;25(5):635-43.##Verma I, Sood R, Juneja S, Kaur S. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. Int J Appl Basic Med Res. 2012;2(1):17-9.##Krassas GE. Thyroid disease and female reproduction. Fertil Steril. 2000;74(6):1063-70.##Pushpagiri N, Gracelyn LJ, Nagalingam S. Prevalence of subclinical and overt hypothyroidism in infertile women. Int J Reprod Contraception Obstet Gynecol. 2017;4(6):1733-8.##Collict M, Baron YM, Gatt M, Calleja N. Maternal risks associated with pregnancy in women with advanced maternal age. Malta Med J. 2018;30(2):5-13.##Klipstein S, Regan M, Ryley DA, Goldman MB, Alper MM, Reindollar RH. One last chance for pregnancy: a review of 2,705 in vitro fertilization cycles initiated in women age 40 years and above. Fertil Steril. 2005;84(2):435-45.##Dal Prato L, Borini A, Cattoli M, Preti MS, Serrao L, Flamigni C. Live birth after IVF in a 46-year-old woman. Reprod Biomed Online. 2005;11(4):452-4.##Jansen RP. The effect of female age on the likelihood of a live birth from one in-vitro fertilisation treatment. Med J Aust. 2003;178(6):258-61.##Somigliana E, Vercellini P, Daguati R, Pasin R, De Giorgi O, Crosignani PG. Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update. 2007;13(5):465-76.##Gianaroli L, Gordts S, D'Angelo A, Magli MC, Brosens I, Cetera C, et al. Effect of inner myometrium fibroid on reproductive outcome after IVF. Reprod Biomed Online. 2005;10(4):473-7.##Volgsten H, Skoog Svanberg A, Ekselius L, Lundkvist Ö, Sundström Poromaa I. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Hum Reprod. 2008;23(9):2056-63.##

Abdominal Wall Leiomyoma: A Case Report 2 1 2 Background: Fibroma or leiomyoma is the most common benign tumor of the female reproductive system, which is usually found in the uterus, but may also occur in other places, such as the ovary, the broad ligament, and in rare cases in the abdominal wall. The formation of the abdominal wall leiomyoma may result from the implantation of myometrium tissue following surgical removal of the uterine leiomyoma, but sometimes these masses occur in a person who has no history of myomectomy. Case Presentation: This case was a patient who became a candidate for laparoscopy due to abnormal uterine bleeding and pain in the right upper quadrant of the abdomen and ovarian mass. The patient underwent laparotomy due to the inability of surgeons to insert the veress needle because of the presence of mass in the abdominal wall. The pathologic report of the abdominal mass was leiomyoma. This article has been approved by the Ethics Committee of the University (6562276). Conclusion: The formation of myoma on the abdominal wall is rare but given the fact that leiomyoma can be created at each part of the body with smooth muscles, including the anterior abdominal wall, this diagnosis should be considered for the differential diagnosis of abdominal masses. 151 155 Leili L Hafizi لیلی حفیظی Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences Iran Seyedeh Azam SA Pourhoseini Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences Iran pourhoseinia@mums.ac.ir Abdominal wallLeiomyomaMassSmooth muscle tumor 60082.pdf Stewart EA. Uterine fibroids. Lancet. 2001;357 (9252):293-8.##Moon HS, Koo JS, Park SH, Park GS, Choi JG, Kim SG. Parasitic leiomyomain the abdominal wall after laparoscopic myomectomy. Fertil Steril. 2008;90 (4):1201.e1-2.##Khan AT, Shehmar M, Gupta JK. Uterine fibroids: current perspectives. Int J Womens Health. 2014;6:95-114.##Al-Wadaani HA. Anterior abdominal wall leiomyoma arising de novo in a perimenopausal woman. Oman Med J. 2012;27(4):323-5.##Lalor PF, Uribe A, Daun GS: De novo growth of a large preperitoneal lipoleiomyoma of the anterior abdominal wall. Gynecol Oncol. 2005;97(2):719-21.##Sreelatha S, Ashok K, Vedavathy N, Sahana P, Nirmala H. A rare case of primary parasitic leiomyoma. Int J Reprod Contracept Obstet Gynecol. 2013;2(3):422-4.##Midya M, Dewanda NK. Primary anterior abdominal wall leiomyoma- a diagnostic enigma. J Clin Diagn Res 2014;8(10):NJ01-2.##Ono M, Inoue Y, Yokota M, Uehara I, Kamijo S, Hattori Y, et al. Abdominal wall leiomyoma in a reproductive age woman without antecedent pelvic surgery. Eur J Obstet Gynecol Reprod Biol. 2010;151(2):225-6.##Goyal N, Khurana N. Leiomyoma of rectus sheath: an uncommon entity: report of two cases. Indian J Pathol Microbiol. 2010;53(3):591-2.##Igberase GO, Mabiaku TO, Ebeigbe PN, Abedi HO. Solitary anterior abdominal wall leiomyoma in a 31-year-old multipara woman: a case report. Cases J. 2009;2(1):113.##Patterson GK, Winburn GB. Abdominal wall endometriomas: report of eight cases. Am Surg. 1999;65(1):36-9.##Sel G. Case of an atypical located leiomyoma arising from rectus sheath. J Surg Med. 2018;2(3):408-9.##Ernest Ong CW, Siow SL. Case report: leiomyoma of the anterior abdominal wall Med J Malaysia. 2016;71(2):81-2.##Khan A, Shawl A, Leung PS. Parasitic leiomyoma of the greater omentum presenting as small bowel obstruction. J Surg Case Rep. 2018;2018(7):rjy164.##