Biography:

Lisa Skyggelund Wienecke has completed her Master of Health Science in 2017 from Copenhagen University. Before that she has worked for more than 15 years as a trained Bachelor of Midwifery at the University Hospital of Hvidovre, the largest birth unit in Denmark. She is now a full-time lecturer at University College Copenhagen, Midwifery. This presentation is based on her first published article.

Abstract:

Objective: To assess whether academic achievement among children conceived following fertility treatment is different from that of children born to fertile women while also considering the underlying infertility.

Design: Population-based cohort study.

Patient(s): The study population consisted of all 154,536 firstborns, live-born, singleton children in Denmark between 1995 and 2000 who completed their ninth grade with an examination.

Intervention(s): The Danish Infertility Cohort was used to identify children conceived after fertility treatment (n = 10,099), and information on mean school marks was obtained from Statistics Denmark.

Results: After adjustment for potential confounders, the overall mean marks were statistically significantly lower for children conceived after the various fertility treatment procedures (e.g., any fertility treatment: MD -0.13; 95% CI -0.18, -0.08) compared with children born to fertile women. No difference was observed (aOR 1.15; 95% CI 0.89, 1.49) for not passing the ninth-grade examination. When children born to women requiring fertility assistance but without fertility treatment in the index pregnancy were used as a reference group, no differences in the adjusted overall mean marks and the likelihood of not passing the ninth grade with an examination were observed.

Conclusion: Our findings indicate that fertility treatment per se is not associated with lower school marks and the likelihood of not passing the ninth grade with an examination. Hence, we suggest that factors related to both fertility problems and cognitive development may more likely explain the slightly lower academic performance (i.e., modest lower mean marks) among children conceived after fertility treatment.

Biography:

Dr. Neha Singh completed her MBBS from SNMC, Agra. She has Obstetrician & Gynecologist at SRN Hospital in the year 2013-2016 and Nehru Hospital in the year 2016-2017. She has also Senior Consultant Gynecologist & Fertility Expert in Indira IVF Group. Also, she is ex- Mentee American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio. She had Masters in Obstetrics & Gynecology with more than 6 years’ experience in the field. Specialist in IVF and Assisted Reproductive Technologies. Committed to deliver results with full passion and spirit.

Abstract:

Since its inception in 1978, the rapidly progressive field of IVF has achieved many milestones. Technologies like ICSI, Blastocyst Transfer, Laser Assisted Hatching, Cryotechniques allowing freezing of gametes, reproductive tissues and embryos have exponentially grown to acquire a major share in the routine protocols of IVF Cycles world-wide. But still the reproductive success of an IVF cycle is limited creating an unmet need for consistent innovations and researches.  Therefore, this article reviews recent advances, newer techniques and future prospects in field of ART all targeting to reduce failures and complications like OHSS and multiple pregnancies.

Many researches are ongoing to improve the oocyte quality and maturity specially in older women and poor responder by novel stimulation protocols, donor and autologous mitochondrial transfer, ovarian rejuvenation PRP (platelet-rich plasma) therapy, IVM (in-vitro maturation), GV Nuclear transfer.

An increasing trend towards e-SET (euploid Single Embryo Transfer) is possible with pre-implantation genetic screening (PGS) for best embryo selection but limited by it’s invasive in nature and inaccuracy in case of genetic mosaicism. Newer noninvasive modalities like Time lapse imaging and EMBRACE (embryo analysis of culture environment) helps to prioritize transfer of embryo with maximum implantation potential increasing clinical pregnancy rate.

Recent meta-analyses demonstrate that Endometrial thickness alone has poor predictive value for pregnancy. Recent advancement like ultrasound measurement of sub endometrial wave frequency and microarray analysis of putative implantation-associated gene expression, the so-called endometrial receptivity array (ERA) improves the endometrial receptivity and thus the implantation rate. Multiple microfluidic devices have developed like SPARTAN(Simple Periodic ARray for Trapping and IsolatioN) to select healthiest and fasted  sperms.

The article concludes by discussing controversial topic of Crispr-Cas9 a gene editing splicing techniques and the use of Artificial Intelligence in customising and tailor-making babies which opens a plethora of possibilities but demanding clinical and ethical debates in long run.

Biography:

Christia Pelava is completed BSc Biological Sciences at University of Leicester where she graduated from in 2019. By September 2019 she has started master in medical sciences (MMedSci) in Assisted Reproduction Technology which she will complete in September 2020. With the completion of her MMedSci, her aim to pursue a career as a clinical embryologist, by starting training to become a clinical embryologist at a clinic that will offer her this opportunity.

Abstract:

Background: According to the DOHaD concept, parental environment, including the diet, affects the embryo development and offspring health.  Barker’s hypothesis supports that parental diet leads to increased risk of developing chronic diseases in the offspring.  Although the effect of maternal diet has been well established, the influence of paternal diet is still under research. 

Methods: Male C57BL/6 mice were allocated to one of the five diet groups: normal protein diet (NPD; 18% protein), isocaloric low protein diet (LPD, 9% protein), LPD supplemented with methyl donors (MDL), western diet (WD; 24% fat) or methyl donor Western Diet (MDWD) for at least 8-weeks before mating naturally to 8-week-old C57BL/6 females.  At embryonic day (E)1.5, oviducts of pregnant dams were flushed.  The embryos were cultured until blastocyst stage in KSOM, 5% CO2, 37°C and their development was monitored via Embryo Scope time-lapse system. The morpho kinetics and morphology of pre-implanted embryos were recorded.  AMPK-gene expression was examined on blastocyst-stage embryos by qPCR.  The stud males’ weight, foetal weight and litter size were measured.

Results:  Paternal diet and specifically WD and MDWD results in acceleration of pre-implantation embryo development at pre-compaction stages, the time of the start of the blastocyst and expanded blastocyst, combined with enlargement in their blastomere size.  WD and MDWD also promoted decreased gene expression.  Regarding the blastomeres shape, LPD embryos adapted a more spherical shape compared to the other groups.  WD and MDWD-derived foetuses showed heavier livers and decreased litter size. 

Conclusions: The data support that paternal diet affects the pre-implantation embryo development, in agreement with previous studies.  It is also linked with altered blastomeres shape in pre-implanted embryos which was not investigated previously.  Further investigation is required, specifically on methyl-donor supplementation which has not been investigated in many studies.  The effect of paternal diet on blastomeres shape also requires additional research. 

Biography:

Luis Arenaz is an expert in Big Data and AI applied to the field of Assisted Reproduction. Creator of an algorithm for donor selection based on phenotypic comparison. Scientific director at FENOMATCH, a world-leading company dedicated to big data solutions and AI for patient experience, embryo analysis, and digital management for fertility clinics.

Abstract:

How can we improve the donor selection to increase the resemblance between receptors and their offspring? It’s necessary to implement new algorithms including biometry distance measurements across family generations to improve donor selection according to the facial resemblance.

In order to improve this focus including facial biometric algorithms, several R and Phyton packages are available based on facial recognition and the probability of being the same person. Unfortunately, this approach is not valid as sorting images by biometric distances is needed to lead to a scientifically verified result. So, a new Data Scientist approach using specific and innovating methodologies with Big Data and Artificial Vision Technologies is required.

The Fenomatch algorithm, developed by Luis Arenaz, is capable of ranking potential donors by their facial resemblance to the patient (or the patient's partner). The algorithm focuses on features which are phenotypic, and was trained on photos of members of the same family.

The analysis is based on 12,208 data points and is designed to be used with other filters (ethnicity, eye colour, etc) in order to increase the likelihood of phenotypic resemblance between parents and donor-assisted children.

A scientific poster published at ESHRE in 2019 demonstrated that the results of the algorithm match human judgement in ~98% of cases. The algorithm is able to correctly identify family members in ~95% of cases.

Further testing of the algorithm has shown that it is able to correctly identify a pair of brothers when faced with a sample of 600 random human faces.

The Fenomatch donor selection platform, which combines the fenomatch facial matching algorithm with other industry-standard filters, including phenotypic traits (eye colour, hair colour, hair type, ethnicity, body type, height, etc) as well as carrier test results, hobbies and interests, etc. is used by the biggest clinics in Europe and around the world to improve the donor selection process and provide patients with peace-of-mind even in countries where legislation prohibits non-anonymous donation.

Biography:

An accomplished Embryologist, Geneticist and mentor, Joseph has spent the last 8 years mastering skills in the field of embryology driven by the need to deliver quality services. Having consistently attained professional distinction and proficiency in this field he is inclined to mentor and offer opportunities for growth and development to upcoming embryologist. He is specialized in Advance Micromanipulation, Embryo Biopsy, Cryopreservation and Thawing. Joseph studied at the prestigious University of Lagos, where he received his BSc. and MSc. Degrees in Cell Biology and Genetics. Other courses include Leadership and Management in Health, Project Management in Health both from University of Washington. Joseph is currently managing the Pre-implantation Genetic Testing (PGT) unit and Transport IVF unit in Bridge Clinic, Nigeria. He is; Member European Society of Human Reproduction and Embryology (ESHRE), Member Association for Fertility and Reproductive Health (AFRH) and Member Clinical Embryologist Association of Nigeria (CEAN).

Abstract:

Infertility is defined as a failure to conceive in a couple trying to reproduce for a period of two years without contraception (WHO, 2004). Approximately 15% of couples are infertile, and among these cases, male factor infertility accounts for approximately 50% of cases (Ombelet et al., 2008). Male infertility is a multifactorial syndrome with a wide variety of disorders. In more than half of infertile men, the cause of their infertility is unknown (idiopathic) and could be genetical or acquired (Poongothai et al., 2009).

Infertility is defined as a failure to conceive in a couple trying to reproduce for a period of two years without contraception (WHO, 2004). Approximately 15% of couples are infertile, and among these cases, male factor infertility accounts for approximately 50% of cases (Ombelet et al., 2008). Male infertility is a multifactorial syndrome with a wide variety of disorders. In more than half of infertile men, the cause of their infertility is unknown (idiopathic) and could be genetical or acquired (Poongothai et al., 2009).

Genetic male infertility is a situation where men are infertile as a result of gene defect or chromosomal abnormalities. While about 30% of men seeking help in fertility clinics are found to have oligozoospermia or azoospermia of unknown etiology, the causes of infertility in men are known in less than 50% of the cases, out of which genetic or inherited diseases are major factors (Poongothai et al., 2009).   

About 10-20% of males without sperm in their ejaculate carry a deletion of the Y chromosome (Y chrmosome micro-deletion). This deleted region includes the Azoospermia Factor (AZF) locus, located in the Yq11region, which is divided into three recurrently deleted non-overlapping sub regions-designated as AZFa, AZFb and AZFc (Chandley, 1998). About 30% of azoospermic men, 1–7% of severely oligozoospermia men, 5% of men with severe primary testicular failure and with a sperm density of less than 5 x106/ml showed Y chromosome micro-deletion (McLachlan et al., 1998). It is believed that these micro-deletions actually cause the azoospermia or oligospermia phenotypes observed, and they can be passed on to the sons of these infertile men if Intracytoplasmic sperm injection treatment is carried out (Chandley and Hargreave, 1996).

Biography:

Kelechi Andrew is attending the University of Port Harcourt in Nigeria where she hopes to obtain a Doctorate degree in Population and Reproductive Health. She has a master’s degree in Public Health and a bachelor’s in Human Anatomy. Passion to help young people make healthier life choices is her drive which has made her volunteer with several organizations and youth groups.

Abstract:

Introduction: Unplanned pregnancies and unsafe abortions among adolescents are major public health problems and seems to be on the rise with a declining age of sexual debut among adolescents. Most sexual activity among them are usually spontaneous without any form of protection against unwanted pregnancy and sexually transmitted infections.

Objective: The purpose of this study is to determine the prevalence of sexual activity and contraceptive use among the female secondary school students.

Methods: The study used a cross sectional descriptive design and a multistage random sampling method. A total of 315 secondary school students were sampled using a pre-tested semi-structured interviewer- assisted questionnaire, data collected was analyzed using Statistical Package of Social Science (SPSS) Version 20.0.

Results: The response rate of respondents was 96.83% vs 3.17% non-respondents. Participants were aged 13-18 years with mean age of 15.45 years, 95% Confidence interval, Standard Deviation of 1.33.

The results indicate prevalence of sexual activity of 32.79%, mean age of sexual debut as 14.07 years with a 95% confidence interval and standard deviation of 1.83. The rate of contraceptive ever used by the sexually active respondents was 35%, 34% had used at their last sexual intercourse, while 20% were consistent in their contraceptive use. The methods used include condom, post coital pills, and withdrawal method. Condom was the method mostly used. Most of the respondent’s reason for contraceptive use was to avoid pregnancy, only 1% of those who used had their reason to prevent sexually transmitted disease.  

Conclusion: The finding of this study showed that younger females are engaging in sexual activity without protection and thus the urgent need to introduce school based safe sexual and reproductive health education to increase adolescents’ access to it.

Biography:

Dr.Mariam Faruqui graduated from Dhaka Medical College in 1980. She obtained DGO from Dhaka University, MS (Gynae) from BIRDEM and MCPS and FCPS in Gyneacology and Obstetrics from Bangladesh College of Physicians and Surgeons. She served as Asstt. Registrar & Registrar at Dept. of Gynae & Obstetric, Dhaka Medical College Hospital. Subsequently, Dr. Mariam served as Sr. Consultant (Gynae), 250 Bed Hospital, Comilla, Registrar, Institute of Child & Maternal Health (ICMH) and later as Senior Consultant (Gynae) Sarkari Karmachari Hospital,Dhaka. In course of time,she served as Sr. Consultant (C.C), Family Planning Model Clinic,Dhaka Medical College Hospital and as  Consultant (C.C.) Gynae, Azimpur Maternity & Training Institute, Dhaka. She is currently serving as Senior Consultant, Gynaecology & Obstetrics & Infertility Specialist at Lab Aid Specialized Hospital.

Abstract:

Cumulative Pregnancy  Rates and Live Birth rates are indicators of success in IVF Programmes.They allow a better estimation of patient's chances of having a child and enable comparsions between centres and modalities of treatment.

Methods: A ten years cohort study was done with  patients undergoing their first assisted reproductive technique cycle.Patients were followed till delivering live births or discontinuation of treatment. All IVF and ICSI Cycles and Cycles with cryopreserved embryos and FET were included.

The analysis assumed that couples who did not return for subsequent treatment cycles did not have the same chances of success as those who had continued treatment.

Results:A total of 650 women were treated between 2008 and 2015 .During the period 150 babies were born. Women already with a live birth re-enterd as a "new patient".in the analysis. For 650 patients under observation with 1950 cycles. the Cumulative Live Birth Rates (CLBR)  was 35% after 03 cycles,45% after 06 cycles and 55% after 12 cycles. The mean live birth rate from one fresh cycle and its subsequent cryocycle was 25%. Our analysis also shows ART can reach increased success rate if cycles were continued with the same patients.

Conclusions: Most couples with infertility problems can be treated successfully if they continue treatments. Thereby ART can reach natural fertility rate.

Biography:

Ahmad Alrahel has completed his PhD at 2017 from Tarbiat Modares University and MD studies from Tehran of Medical sciences University at 2012. He is the director of Arab Patients Department in Ibn sina IVF clinic. He has published an ISI article and participate in more than 10 congress related reproductive medicine like ESHRE 2016 in Helsinki, Finland. He is a Referee in Iranian Biomedicine Journal.

Abstract:

Objective: In fact, one of the most important improvements in the Germ cell transplantation process is the creation of sperm with frozen cells. Applications of this technique is clinically important specially in young patients with cancer, which should be subjected to severe chemotherapy, which is often used in long-term form and sometimes the irreversible, the amount of sperm production in them is reduced. In immature boys who have not yet started spermatogenesis, it is possible to maintain their spermatogonial activity against anticancer and radiotherapy drugs by frozen spermatogenic cells in liquid nitrogen and re-injected them into the testes. In this study, three-dimensional cultures of testicular tissue were studied in two control and experimental groups to evaluate the spermatogenesis process.

Methods and materials: In this survey, there was two groups as follow: Control group: The culture of frozen-thawed neonatal mouse testicular tissue fragments in the first day after thawing, and Test group: the culture of frozen-thawed neonatal mouse testicular tissue fragments on the agarose cube, in-vitro α -MEM culture and KSR %10 for 8 weeks.

Initially, the fragments of neonatal testicular tissues were dissected and transferred to laboratory. The testicular tissue fragments are placed in the special freezing culture, then by using the planner (KYRO 360-1.7 UK) programmable freeze device performs all freezing steps in a slow and stair manner automatically. Finally, the frozen tissue is ready to put in liquid nitrogen. At each stage of the study, the tissue was examined from the aspect of morphology using hematoxylin-Eosin staining. To evaluate the immunohistochemical feature, PLZF, SCP3, ACRBP antibodies were assessed to identify spermatogonia, spermatocyte and sperm-like cell respectively. In this study, three-dimensional culture of frozen-thawed testicular tissue components was studied to evaluate the progression of spermatogenesis process.

Results: The study of tissue sections prepared from the frozen-thawed testicular prepared from the tissue fragments at first day after thawing, and also eight weeks after the cultivation of the studied group revealed that the size and diameter of the seminiferous duct was increased compared to the control group and this increase in size showed the growth of testicular tissue. In two evaluated groups, fresh and frozen-thawed testicular, different categories of germ cells including spermatogonia stem cells and spermatocytes were observed.

Although, based on the quantitative results obtained from the software image J, the expression of PLZF proteins in the control group (50.06 ± 8.35), and experimental group (12.85% ± 5.21) was not statistically significant (P≥0.05), the expression level of ACRBP and SCP3 in the control group were (0% ±0) (1.21 ± 1.97) and in the experimental group were (7.85%±2.47)(4.54% ±3.08) , which were statistically significant (p≤0.05).

Conclusion: The slow programmed freeze of the testicular tissue and agarose testicular tissue culture appears to be a useful method to maintain long-term testicular tissue preservation, for children with cancer before initiating treatment with chemotherapy or radiotherapy.

Biography:

Tahereh Behrouzi-lak received her MD degree from Tabriz University of Medical Sciences, Tabriz, Iran, in 1997 and gynecology degree from Urmia University of Medical Sciences, Urmia, Iran in 2007 and postdoctoral studies in Infertility and IVF field from Tehran University of Medical Sciences, Tehran, Iran in 2013.She is currently Assistant Professor in Urmia University . She has published more than 15 papers in reputed journals.

Abstract:

Asymptomatic pelvic fistulas maybe a silent cause of infertility, and association can only be stated as all other factors of infertility could not be convincingly ruled out. The case of a 27 years old woman with a diagnosis of primary infertility and booked for hysterosalpingogram (HSG) as part of the routine work-up is presented. There was a positive history of pelvic surgery for bilateral adnexal cysts 3 years ago. In this case previous pelvic surgery without any medical problems was strongest risk factor for tubointestinal fistula. Cystectomy was done for left adnexal cyst and only drainage was done for the right one. Pathologic report for left ovarian cyst was endometriosis. HSG result showed evidence of bilateral fallopian tube opacification with contrast outlining from the fallopian tubes. Outlining of contrast take placed to adjacent small intestine in right side and to peritoneal cavity in the left side. Few cases with fistulous communication between the GI system and female adnexal structure have been reported in the literature, but bilateral salpingeal fistulae have been reported only in one case and this case is second one in all over the world that reported. 

Biography:

Miss Mehwish David has completed her Masters and Mphil degree from Quaid-i-azam University and is currently doing PhD from from Quaid-i-azam University, Department of animal Sciences. She is teaching as a visiting lecturer of Zoology at Taxilla Institute of asian Civilization, Quaid-i-azam University for the last two years. She has been working to achieve sustainable development goal (SDG) number 3 which states “Ensure healthy lives and promote well-being for all at all ages” with focus on different persistent and emerging reproductive health issues. Se has been the member of Endocrine society since 2017. She has published many research articles in reputed journals and has been serving as an editorial board member of reputed journals such as Toxicology and Inductrial health, Acta Scientific Pediatrics.

Abstract:

The present study was designed to determine the possible effects of brick kiln emissions on the body mass index (BMI), biochemical and stress profile, genotoxicity and hormone levels of children working at brick kiln industries. A survey was conducted, questionnaires were filled out, and demographic data were collected from Punjab, Pakistan. BMI was calculated, and heavy metals analysis, hematological and enzyme analysis, comet assay and hormonal ELISA for cortisol were performed. The results showed decreased BMI, RBC count, hematocrit, MCH and MCHC in the exposed group. Nickel, cadmium, zinc and chromium concentrations in whole blood were significantly higher among industry children. Antioxidant enzymes catalase, sodium dismutase and guaiacol peroxidase levels were decreased, while reactive oxygen species increased in the exposed group. Plasma cortisol level increased, while growth hormone concentrations decreased in the exposed group when compared with controls. In the comet assay, a decrease in percentage DNA in the head and an increase in percentage DNA in the tail were observed in the exposed group. It was concluded that children living at brick kiln sites and exposed to experienced decreased BMI, antioxidant enzymes status, altered hormone levels and cellular DNA damage.

Biography:

Received her B.Sc in Physics & Computer Science in 2000 from Bar-Ilan University, Israel. received her M.Sc at the Biophysical Schottenstein Center, Bar-Ilan University Physics Department. M.Sc research title: About the evaluation dependency of the of energy transfer efficiency on the emission wave length of the donor. currently studying for her Ph.D. degree. Ph.D Sc research title : Cryopreservation of Individual Cells in Volumes Less than Nano Liter.

Abstract:

About a million cases of low-sperm-count-related diseases are treated every year at IVF labs using unsuitable procedures and means for cryopreservation of individual spermatozoa. Initial attempts to cryopreserve and thaw spermatozoa in nanoliter containers under oil yielded exceptionally high cell-mortality rates when compared to that obtained within the common microliter containers. The miniaturized volume was found not to be the direct cause of cell death, since spermatozoa have shown satisfactory survival after incubation in such containers. This volume-dependency of the successful sperm cell freezing-thawing cycle leads to the assumption that surface-to-volume ratio may be a significant parameter in the diffusion of essential ingredients from the freezing medium into surrounding oil. Considering the solubility of these ingredients in oil, it appears, surprisingly, that the oil enables absorption of water molecules. This phenomenon was overcome by mixing the oil with pure water prior to use, a procedure that pronouncedly improved survival of cells after thawing. This research is tracked by software developed to trace the cells and provide accurate statistics of their mobility scores. In addition, research and development of nanoliter-volume doughnut-like arrayed micro-chambers for cryopreservation of rare sperm cells at individual-cell resolution has been accomplished. Micro-arrayed donut-shaped chambers (DSCs) are miniature vessels which were developed in the frame of this work. Each chamber is designed to act as an individual isolated reaction compartment, which creates an in-vitro assay, mimicking biology environments. Such a device enables individual live cell treatment and analysis, with the assistance of a designated image processing algorithm.