Poster-Presentaion-Abstracts ASPIRE2017

POSTER PRESENTATION
ABSTRACTS
ART, Basic Research
ASPIR-0020
Posters: ART, Basic Research
HYDROGEN MOLECULE TREATMENT HAS NO EFFECT ON HUMAN SPERM DNA

FRAGMENTATION
K. Nakata1, K. Yoshida2, M. Yoshida3, N. Yamashita1
1
Yamashita Shonan Yume Clinic, Reproductive Medicine Research Center,
Kanagawa- Fujisawa, Japan
2
Toin University of Yokohama, Faculty of Biomedical Engineering, Kanagawa, Japan
3
the University of Tokyo, Misaki Marine Biological Station- Graduate School of Science,
Kanagawa, Japan
Background and Aims:
Previously we found that the hydrogen treatment increased the mitochondrial membrane
potential and ATP content of human sperm with low motility. We also found an increase
in motility by performing a second course of the treatment after the first treatment. In this
study, we evaluated the safety of the hydrogen treatment on the nuclei of human sperm.
Method
We used 80 samples of human sperm with a density of at least 2.0 × 106 /mL and motility
of at least 60%. After thawing, sperm samples were separated into 2 groups; a H2 group,
which was washed in a culture medium containing 75% saturated hydrogen, and a
control group. We used the TUNEL and EOSIN staining methods and the CASY cell
counting system to evaluate sperm nuclear fragmentation.
Results
The rate of positive TUNEL reactions was 1.4% ± 1.9% in the H2 group and 2.5% ± 3.6%
in the control group, revealing no significant difference between the two groups (n = 20, P
= 0.98). The rate of positive EOSIN reactions was 1.6% ± 4.3% in the H2 group and 2.3%
± 5.7% in the control group (n = 30, P = 0.069). The rate of dead spermatozoa as found
by CASY was 11.8% ± 2.6% in the H2 group and 11.5% ± 2.7% in the control group (n =
30, P = 0.69).
Conclusion
We can therefore conclude that the hydrogen treatment is a safe method of increasing
sperm motility and ATP content with minimal damage to cells and their nuclei.
ASPIR-0040
EXPRESSION OF HEY2 ON MICE UTERUS AND IMPLANTATION SITES DURING

DIFFERENT PREGNANCY DAYS
N. Acar1, H. Soylu1, S. Avci1, I. Ustunel1
1
Akdeniz University Faculty of Medicine, Histology and Embryology, Antalya, Turkey
Implantation is nidation of blastocyst into mother’ uterus. Physiologic, biochemical and

ultrastructurel changes occur during contact. Uterus is pre-receptive between days 1-3 of
pregnancy in mice. Implantation starts on day 4 night. Uterus become non-receptive on
day 5 afternoon. Notch signaling is involved in regulation proliferation, apoptosis,
differentiation,homeostasis. Hey2 gene encodes a member of the hairy and enhancer of
split-related (HESR) family of basic helix-loop-helix (bHLH)-type transcription factors.
Protein forms homo- or hetero-dimers localizing to nucleus and interact with histone
deacetylase complex to repress transcription. We aimed to investigate
immunolocalization and expression levels of Hey2 on mice uterus and implantation sites
through pregnancy days.
Method
Balb/C strain mice were used in our study. One male and two female mice were retained
together in the same cage overnight and next morning female mice with vaginal plug
were accepted on day 1 of pregnancy. Mice were sacrified on pregnancy days 1, 4, 5, 6
and 8. Non-pregnant mice on estrus phase of the cycle were included as control group.
Uteri and implantation sites were collected. Hey2 expressions were detected by
quantitative real time PCR (qRT-PCR), immunohistochemistry and western blotting.
Results
Hey2 expression was low on day 4 and 5; high on day 8 of pregnancy according to qRT-
PCR and western blotting results.
Conclusion
We think decreased expression of transcription repressor Hey2 on days 4 and 5 of

pregnancy may be due to increased expressions of transcription factors belonging to
different signal pathways. Further investigations should be performed to reveal the roles
of Hey2 in implantation.
ASPIR-0051
IMPROVEMENT OF LONG-TERM CULTURE SYSTEM FOR BOVINE

SPERMATOGONIAL STEM CELLS
. Suyatno1,2, Y. Kitamura1, N. Minami1, M. Yamada1, H. Imai1
1
Graduate School of Agriculture Kyoto University, Laboratory of Reproductive Biology,
Kyoto, Japan
2
Indonesian Agency for Agricultural Research and Development, -, Jakarta, Indonesia
There are limited studies for a long-term culture of spermatogonial stem cells (SSCs) in
mammalian species. Recently, we developed a culture system for bovine SSCs, in which
pluripotent-stem-cell-like colonies similar to mouse embryonic stem (ES) cells were
obtained. This experiment was conducted to establish a long-term culture for bovine
SSCs supporting pluripotent-stem-cell like colonies and to compare their cell
characteristics to ES cells.
Method
Bovine SSCs were isolated from 3 months old bulls by three step enzymatic digestion
and were enriched by Percoll gradient centrifugation. Collected SSCs were placed on
Poly-L-Lysine pre-coated dish and cultured in DMEM/F12 medium containing 20 % KSR
supplemented by growth factors GDNF and/or bLIF. RT-PCR and immunofluoresence
analysis against germ-cell-specific markers (UCHL-1, DBA) and pluripotent-stem-cell-
specific markers (OCT4, REX1, SOX2, NANOG) were performed to identify
characteristics of colonies from SSCs.
Results
We confirmed the expressions of SSCs specific markers (UCHL-1 and DBA) and
pluripotent marker (OCT4) even after 5 month culture (over 20 passages) of SSCs. This
was possible under serum-free and feeder-cell-free culture in the presence of GDNF and
bLIF. SSCs maintained their survival and self-renewal on LIF-signaling pathway similar to
ES cells. Moreover, SSCs cell lines were efficiently established in the culture system.
Conclusion
Bovine SSCs can be cultured for a long-term in serum-free and feeder-cell-free culture
system. GDNF and LIF supported colony formation, cell survival and proliferation of
SSCs in the absence of serum. Bovine SSCs shared pluripotent stem cell characteristics
with ES cells, but also had germ cell characteristics.
ASPIR-0060
IDENTIFICATION OF A NOVEL MARKER FOR SPERMATOGONIA STEM CELL IN

NEONATAL MICE
J. Huang1
1
Sun Yat-sen University, School of Life Sciences, Guangzhou, China
Mammalian spermatogenesis is maintained by a rare Spermatogonia Stem Cell (SSC).

Very few specific surface markers were found to define SSCs, which hindered the
research of the early spermatogenesis. Herein, we identified a newly protein termed
SPG1, as a specific surface marker of SSCs in Neonatal mice.
Method
RT-PCR；WB；IF；FACS；CRISRP\Cas9
Results
SPG1 was a testis specific protein. SPG1 labeled clusters mainly comprising GFRA1+
and PLZF+ SSCs in neonatal male mice. SPG1+ cells isolated by FACS exhibited an
enrichment of SSCs as an increase expression of SSC molecular markers and the
potential to form SSCs clones in vitro. Using CRISPR/Cas9 technique to produce SPG1
mouse model, we found that knockout SPG1 did not affect the number of SSCs or the
normal spermatogenesis progress in vivo. Thy1+ SSCs from Spg1-/- mice showed an
unaffected potential to form clones in vitro, indicating SPG1 was not necessary for self-
renewal and proliferation of SSCs.
Conclusion
Our data suggested that SPG1, as a novel marker of SSCs, can be successfully used to
enrich SSCs while knockout of this gene did not affect the development of SSCs.
ASPIR-0092
REDUCED TEMPERATURE FLUCTUATIONS RECORDED IN A MODIFIED EMBRYO

CULTURE DISH
S. Yagoub1
1
, Melbourne, Australia
Embryos in vitro have the task of balancing their energy resources requiring embryo
metabolism and growth while also needing energy to maintain homeostasis. Temperature
is one of the main concerning variables affecting homeostasis, particularly when dishes
are removed from the incubator for observation. Our aim was to design a culture dish
minimising temperature change.
Method
A modified culture dish, designed from a 35mm petri-dish raised slightly within a 60mm
petri-dish, with oil in both dishes, was compared with a single oil-filled 35mm dish for
temperature change of a 30µL culture-media drop under oil, using a data-logger
thermometer (CENTER 309). The dishes were removed from the incubator and placed on
a warm stage (set at 36.1oC ± 0.1oC). Temperature was recorded four consecutive times
(T1, T2, T3 and T4 for control and study group with 6 and 8 replicates, respectively). One
cell mouse embryos (N=200) were randomly divided between the 2 dish types (4
replicates) and blastocyst development recorded.
Results
In the first few minutes after dishes were taken out of the incubator, the temperature
reached 36.9oC (±0.1oC) in the modified dish, significantly warmer than the control dish,
(35.6oC (±0.1oC). Also, embryos cultured in the modified culture dish developed to the
blastocyst (89%) was not different to controls (86% developed to blastocyst).
Conclusion
The modified culture dish slows down the temperature drop and reduces temperature
fluctuations in culture media, implying a reduction in embryo stress, which in turn would
allow for enhanced embryo growth
ASPIR-0136
DYNAMIC CHANGES IN MITOCHONDRIAL DISTRIBUTION IN HUMAN OOCYTES

DURING MEIOTIC MATURATION
Y. Takahashi1
1
St.Marianna University, Obstetrics and Gynecology, kawasaki, Japan
Maturation of mammalian oocytes involves distinct events in the nucleus and the
cytoplasm. Although nuclear maturation has been studied extensively, cytoplasmic
maturation is less understood. The change of mitochondrial distribution in human
oocytes during meiotic maturation was assessed.
Method
Live cell images of fluorescence-labelled mitochondria in human oocytes were analyzed

to investigate dynamic changes in mitochondrial distribution during meiotic maturation
using a confocal microscope combined with an incubator in the presence or absence of
colchicine and cytochalasin B, inhibitors for tubulin and actin filament, respectively.
Subcellular distribution of mitochondria in human oocytes was also assessed at various
stages using a transmission electron microscope. This study was approved by the local
ethics IRB of IVF Namba clinic and JSOG. All donor patients provided the
signed informed consent.
Results
Live cell imaging analysis revealed that the mitochondria-occupied cytoplasmic area
decreased from 83 to 77% around 6h before germinal vesicle breakdown(GVBD) and that
mitochondria accumulated preferentially close to the perinuclear region. The
mitochondria-distributed area rapidly increased to 85% at the time of GVBD. In contrast,
there was no significant change in mitochondrial distribution before and after polar body
extrusion. Such changes in mitochondrial localization were affected by colchicine and
cytochalasin B. Most of mitochondria in the cytoplasm formed cluster-like
aggregates before GVBD while they distributed homogeneously after GVBD.
Conclusion
Most mitochondria localized predominantly in the non-cortical region of the cytoplasm of

GV stage-oocytes, while the mitochondria-occupied area decreased before GVBD and
increased to occupy the entire area of the cytoplasm at GVBD by some cytoskeleton-
dependent mechanism.
ASPIR-0139
TOXICITY TEST OF GLOVES USING HUMAN SPERM SURVIVAL TEST

J.Y. Lo1, M.Y.T. Tan1, M.F. Chew1, C.S. Heong1, S.T. Tee1
1
TROPICANA MEDICAL CENTRE, IVF Lab, Kota Damansara, Malaysia
This study is to evaluate the toxicity of medical grade gloves using human sperm survival
test.
Method
Sperm sample was processed using discontinuous density gradient method. Processed
sperm sample was tested on both rinse test and immersed test. In the rinse test, gloves
were contacted to sperm medium for 5 seconds. In the Immersed test, gloves were cut
into small pieces and mix with the sperm medium for 5 minutes. Four types of gloves
commonly used in medical set up, named Gammex PF latex gloves (Ansell), Nuzone X2
non-latex synthetic gloves (Adventa health), Yaan Device copolymer gloves (Yann
Device) and nitrile gloves (RS Safe) were assessed.Sperm motility was assessed at 0hrs,
24hrs, 48hrs, and 72hrs.The motility of each sample were compared with control. Sperm
survival index (SSI) >0.85 at 72hrs is considered as non-toxic.
Sperm survival index (SSI) = %motility of sample
%motility of control
Results
In the rinse test, Yann Device gloves showed the highest SSI (1.00), followed by Nuzone
X2 gloves (0.96), Gammex PF gloves (0.89) and Nitrile glove (0.29). Similarly, in the
immersed test, Yann Device gloves showed highest SSI (0.95), followed by Nuzone X2
gloves (0.33) and no motile sperm found in both Nitrile and Gammex PF gloves at 72hrs.
Conclusion
Out of 4 types of medical grade gloves tested, only Yaan Device gloves is non-toxic for
IVF usage.The study showed that the toxicity of some glove material may not be
prominent with short contact and may only be detected after prolong exposure as found
in the immersed test.
ASPIR-0146
A HOPE FOR PATIENT’S WITH FAILED ART CYCLES. A RETROSPECTIVE

ANALYSIS OF DAY 3 VS DAY 5 VS SEQUENTIAL EMBRYO TRANSFER.
C. Mohamad1, P. Gupta1, D.K. Malhotra1, D.N. Malhotra1, D.J. Malhotra1, D.N. Malhotra1
1
Rainbow IVF Centre, IVF, Agra, India
OBJECTIVE: The purpose of this study was to compare the overall outcomes in patients
undergoing sequential ET and those undergoing embryo transfers only on either
cleavage stage or Blastocyst stage.
Method
DESIGN: A Retrospective case control study was conducted, where 100 patients were
enrolled, after satisfying a strict inclusion criterion and then divided into 3 groups.
Group I – Patients with sequential ET.
Group II – Patients receiving ET only cleavage stage (D2/D3).
Group III – Patients receiving Blastocyst Transfer.
MATERIALS AND METHODS: The study was conducted at Rainbow IVF centre, Agra..
Patients with one or more previously failed IVF-ET in the past, who have undergone ET
on day 2 or Day 3 in the index cycle were included in this study. and divided into the
respective groups.
The outcome was analysed using paired T test.
Results
RESULT: The study suggests a significant rise in the Implantation Rate as well as the
Clinical Pregnancy Rate, after sequential ET on day 2 and day 5 as compared to the
other groups.
Conclusion
CONCLUSION: Sequential transfer increases the likelihood for synchronised

endometrial and embryonic development and endometrium receptivity, thereby increasing
the IR and CPR. Hence, with this study we can conclude that sequential ET on day 2 and
day 5, significantly improves the IR and CPR in patients with previous IVF-ET failures as
compared to the ET on either day 2, day 3 or day 5 alone.
ASPIR-0147
DOES OVERNIGHT CULTURE HAVE ANY EFFECT ON FET OUTCOMES -A

RETROSPECTIVE STUDY
S. gandhi1, K. Malhotra1, N. malhotra1, D.J. malhotra1, D.N. malhotra1
1
Rainbow hospital, IVF, Agra, India
The purpose of this study is to compare the pregnancy rates of frozen-thawed embryos
transfer on the same day and the second day .
Method
We have reviewed the data of 197 patients who were subjected to FET from September
2015 to September 2016 at our centre Rainbow IVF ,Agra. We collected all the baseline
data and pregnancy outcome and analysed it.
Out of 197 FET ,110 had a minimum of 2 hours incubation after thawing (Group 1) and 87
were cultured overnight (Group 2) before Embryo Transfer. The embryos were frozen and
thawed using Kitazato Vitrification and thawing Kit.The average no. of embryos
transferred were 2.27 and the mean age of women were 33.8 and 35.1 respectively.
Results
The pregnancy rate of Group 1 and Group 2 were 41.8% (46/110) and 42.5% (37/87)
respectively. When cultured to blastocyst (27/56 )48% clinical pregnancy rate was
achieved which was statistically significant when compared to the other groups.
Conclusion
Overnight culture does not have any significant effect on pregnancy outcomes in FET
cycles unless cultured till blastocyst.
ASPIR-0161
DETERMINATION OF ANTI-INFERTILITY AND TOXICITY EFFECTS OF CROTON

CAUDATUS GEISELER. (ROOTS) AQUEOUS EXTRACTS ON BISPHENOL A-
INDUCED MALE RATS MODEL
F. Sham1, H. Nina Keterina2, Z. Fatin Nadzirah2, B. Ebby Anuar2, A. Zulkhairi2, D. Razif3
1
Department of Nursing, Faculty of Health Sciences- Universiti Teknologi MARA,
Puncak Alam, Malaysia
2
Department of Basic Sciences, Faculty of Health Sciences- Universiti Teknologi MARA,
3
Maternofetal and Embryo MatE Research Group UiTM,
Faculty of Health Sciences- Universiti Teknologi MARA, Puncak Alam, Malaysia
Approximately 50 percent of infertility cases are due to male problems. The unexplained
tragedy of male infertility may be caused by environmental condition and pollution,
chronic stress, reactive oxygen species and genetics. Croton caudatus was
demonstrated to have potential anti-infertility effect and aqueous extract of various part of
this plant has revealed good antioxidant that believed to play the most important role in
protecting sperms against free radical. However, there is lack of scientific information
available regarding the effects of aqueous extract of C.caudatus roots on male fertility.
This study was performed to determine the anti-infertility potential and toxicity effects of
roots aqueous extraction at 60°C and 100°C on Bisphenol A (BPA)-induced rats.
Method
Thirty male Wistar rats were randomly divided into five groups (n=6). Negative control
group were received distilled water, positive control were received 200 mg/kg of BPA,
while the treatment groups were received 200 mg/kg BPA and 16, 32, and 64 mg/kg of
C.caudatus extracts orally for twenty one days. Blood was collected by retro orbital
techniques for biochemical and hormonal analysis. Sperm was collected from cauda
epididymis for sperm analysis using Hamilton Thorne Sperm Analyzer and testis were
harvested for histological assessments.
Results
Results from this study demonstrated that total sperm count, proliferation of
spermatogenic cells and motility were significantly increased in all treated groups without
any toxicity effects on the blood analysis.
Conclusion
This study clearly suggested that aqueous extract of C.caudatus roots possessed the anti
infertility potential and hepatoprotective effect in BPA-induced rats.
ASPIR-0167
RISK EVALUATION FOR PRONUCLEAR TRANSFER USING FOR PREVENTING THE

TRANSMISSON OF MITOCHONDRIAL DISEASE: A MOUSE MODEL
T. Li1, Y. Yu1, J. Qiao1
1
Peking University Third Hospital, Obstetrics and Gynecology, Beijing, China
Pronuclear transfer (PNT) is considered to be effective in preventing the transmission of

pathogenic mtDNA from mother to offspring. However, concerns remain regarding the
safety of this technique since it involves in destruction of half of embryos.Our study aims
at investigating the potential risk of mouse constructed by PNT from aspects of growth,
metabolism and reproductive function.
Method
Body weight, ratio of fat/weight, energy expenditure, blood pressure, glucose tolerance
test were measured. Estrous cycle, histogical analysis of ovary and testis, sperm
concentration and fertility was assessed. The expression profile of mRNAs in tissues
where mebabolism were more vigorous like heart, liver and muscle sample from PNT
mice was explored by mouse mRNA array.
Results
Compared to the controls, the body weight, ratio of fat/weight, energy expenditure, BP
and glucose tolerance showed no difference. Estrous cycle, histogical analysis of ovary
and testis, sperm concentration and fertility were normal in PNT mice. However, a
considerable of genes were differentially expressed in heart, liver and muscle.
Conclusion
Metabolism and fertility were not impaired by PNT procedure. However in tissues where
metabolism were more vigorous like heart, liver and muscle, an abundant of genes
showed the abnormal expression levels which were highly related in metabolism, fatty
metabolism which suggest a potential risk of PNT offspring. Our results facilitate a better
understand of the effects of PNT procedure on development of offspring and enhancing
the awareness of improving the outcome of PNT procedure.
ASPIR-0177
CORRELATION BETWEEN AGE WITH CONCENTRATION, MOTILITY, AND

VIABILITY OF SPERM ON MEN WITH NORMOSPERMIA SEMEN AT BANDUNG
CITY, INDONESIA
G.A. Hermawan1
1
Morula IVF Melinda Badung, Laboratory Andrology, Bandung, Indonesia
The testis is a functioning reproductive organ to produce sperm cell in a lifetime, the
ability to produce sperm may decline and reduced by many factors include aging. One of
the methods to the examine of testes function is a sperm analysis. This study aiming to
evaluate the contribution of aging to sperm concentration, motility, and viability at the
men with normospermia semen.
Method
The samples were analyzed for sperm concentration, motility, and viability according to
published guidelines by the WHO, samples grouped according to age group, A (25-30
years old), B (31-35 years old), C (36-40 years old) and D (> 40 years old). The
correlation of aging on concentration, motility, and viability was checked using SPSS 19.0
by Pearson Test.
Results
There is no correlation between the aging of the concentration, motility, and viability
Conclusion
The aging cannot direct causing a decrease of concentration, motility, and viability of
sperm. All parameter were observed can decline if occur damage of seminiferous
tubules, damage of Leydig cells, and damage to sertoli cells. Needed much research to
prove a correlation between aging and another factor which can cause a decrease of
sperm quality on normospermia semen.
ASPIR-0195
DEHYDROEPIANDROSTERONE IMPROVES MITOCHONDRIAL FUNCTION AND

REDUCES APOPTOSIS OF CUMULUS CELLS IN POOR OVARIAN RESPONDERS
L.T. Lin1, P.H. Wang2, Z.H. Wen3, C.J. Li4, E.M. Tsai5, J.T. Cheng1, K.H. Tsui6
1
National Sun Yat-sen University, Biological Science, Kaohsiung, Taiwan R.O.C.
2
Taipei Veterans General Hospital, Obstetrics and Gynecology, Taipei, Taiwan R.O.C.
3
National Sun Yat-sen University, Marine Biotechnology and Resources, Kaohsiung,
Taiwan R.O.C.
4
National Cheng Kung University, Clinical Medicine, Tainan, Taiwan R.O.C.
5
Kaohsiung Medical University Hospital, Obstetrics and Gynecology, Kaohsiung,
Taiwan R.O.C.
6
Kaohsiung Veterans General Hospital, Obstetrics and Gynecology, Kaohsiung,
Taiwan R.O.C.
Poor ovarian responders (PORs) pose a great challenge for in vitro fertilization (IVF).
Previous studies have suggested dehydroepiandrosterone (DHEA) may improve IVF
outcomes in PORs. The current study attempted to investigate the possible mechanism
of DHEA on cumulus cells (CCs).
Method
This was a prospective and a cell line study performed at one tertiary center from January
2015 to March 2016. One hundred and thirty-one women who underwent IVF treatment
participated, including 59 normal ovarian responders (NORs) and 72 PORs. PORs were
assigned to receive DHEA supplementation or not before the IVF cycle. CCs were
obtained from these patients. A HO23 granulosa cell line was used for further in vitro
study. In CCs, mRNA expression of apoptosis-related genes expression, TUNEL assay,
mitochondrial dehydrogenase activity and mitochondrial mass were measured. In HO23
cells, protein expression of pro-apoptotic relative genes, immunoassay, flow cytometry
analysis for mitochondrial membrane potential, reactive oxidative species and mass as
well as oxygen consumption rate (OCR) measurement were performed.
Results
DHEA supplementation in PORs decreased DNA damage and apoptosis in CCs while
enhancing the mitochondrial mass and function of CCs. In HO23 cells, treatment with
DHEA improved the mitochondrial capacity to defend against apoptosis by eliminating
mitochondrial ROS, increasing mitochondrial biogenesis, and enhancing mitochondrial
mass. Additionally, OCR significantly increased following DHEA supplementation.
Conclusion
In conclusion, the beneficial effects of DHEA on IVF outcomes may partially be mediated
by improving mitochondrial function and reducing apoptosis of CCs.
ASPIR-0208
KNOWLEDGE REGARDING FERTILITY AND AGE RELATED FERTILITY DECLINE

AMONG MEDICAL STUDENTS AT PENANG MEDICAL COLLEGE
S. sivasuntharam1, S. TAN1, Y. Ng1, R. WONG1, B. SIVAKUMAR1, K. RITCHIE1,
C. O'HERLIHY1
1
Penang Medical College, OBSTETRICS & GYNAECOLOGY, PENANG, Malaysia
There has been a general trend among women in many parts of the world to delay
childbearing until relatively late into their reproductive years. Objective: To assess overall
knowledge of fertility awareness and age related fertility decline in women among the
medical students.
Method
The study is designed as a prospective questionnaire on fertility awareness. The

questionnaires were distributed to all 4th year medical students in Penang Medical
College before their OBGYN rotation.
Results
There were 139 medical students involved in the study. It was noted that more than two
third of the students(69%) accurately estimated the age at which women are most
fertile(20-24years) but only 11% correctly stated that a woman's fertility begins to decline
between the ages of 35-39. About 20% of the male students thought that the age range
of 15-19 years old would be when fertility was at its peak. Only 31% of the students were
aware that the success rate of IVF is 30-39%. Female students were more aware that
ageing increases the time to conception compared to male students(70.9% vs 52.8%) (p-
value= 0.031) but more male students were aware that painful periods was not a risk
factor for infertility (83.0% vs 63.9%) (p-value=0.016). Interestingly, more males (83.2%)
thought women's ovaries continue to produce new oocytes throughout their reproductive
years.
Conclusion
Educating medical students regarding the effects of ageing on fertility and the
effectiveness of fertility treatment in the ageing population may decrease the delay in
childbearing and involuntary childlessness both personally and advice to the general
public.
ASPIR-0213
BCL2 AND BAX MRNA EXPRESSION PLAY AN IMPORTANT ROLE ON APOPTOSIS

IN HUMAN ENDOMETRIOSIS GRANULOSA CELLS
A. Bowolaksono1,2, N. Muna2, B. Wiweko1,3, D. Putri Gunarwati1, K. Mutia1,
P. Ameilia Iffanolida1, A. Hestiantoro1,3
1
Indonesian Reproductive Medicine Research and Training Center,
Obstetry and Ginecology, Jakarta, Indonesia
2
Universitas Indonesia, Department of Biology- Faculty of Mathematics and Science,
Depok, Indonesia
3
Universitas Indonesia, Obstetry and Gynecology, Jakarta, Indonesia
Endometriosis is a one syndrome in female reproductive system which marked by the

present of endometrium tissue outside the uterus cavity. Endometriosis affects the
reproductive system by decreasing oocyte quality as an impact of granulosa cells
apoptosis in the follicle. Apoptosis in granulosa cells has been known activated through
intrinsic pathway which is influenced by BCL2 family member including to the BAX as a
pro-apoptosis and BCL2 as an anti-apoptosis. This research was conducted to know the
mRNA expression of BAX and BCL2 in human endometriosis granulosa cells.
Method
Human endometriosis DNA (30 samples) and Normal DNA (30 samples) was analyzed
by real time PCR.
Results
The results show that ratio of BAX/BCL2 mRNA expression of human endometriosis was
higher than its control.
Conclusion
The results of this experiment suggest that BAX and BCL2 intrinsically play roles in
apoptosis of human endometriosis granulosa cells.
Keywords: apoptosis, BAX gene, BCL-2 gene, endometriosis, gene expression

ASPIR-0223
THE EVALUATION OF THE EFFECT OF HYDROXYPROPYL CELLULOSE

SUPPLEMENTED VITRIFICATION MEDIA ON HUMAN BLASTOCYSTS
C. Mori1, A. Yabuuchi1, K. Ezoe1, T. Okuno1, T. Kobayashi1, K. Kato1
1
Kato Ladies Clinic, Research and Development, Shinjyuku-ku, Japan
Our previous study demonstrated that the use of hydroxypropyl cellulose (HPC) as a
cryoprotectant in CryotopR vitrification media improved the survival rate of mouse and
human blastocysts. However, it is still unclear how HPC-supplemented media acts to
improve the survival rates. Therefore, we analyzed the characteristic of the HPC-
supplemented vitrification media along with the examination of the survival rate of human
blastocysts.
Method
Human vitrified blastocysts donated from patients were warmed and treated with acidic
tyrode's solution to remove zona pellucida (ZP). ZP free blastocysts were re-vitrified and
warmed using the media supplemented with 5% serum substitute supplement (SSS),
20% SSS or 5% HPC by CryotopR method, and then the survival rate was assessed. The
attachment time of blastocysts on the CryotopR during the warming step was compared
among the groups. The interface tension in the vitrification media used each group were
measured using Dynamic Surface Tensiometer.
Results
The survival rate was significantly higher in 5% HPC group compared with 5% and 20%
SSS groups. The mean attachment time was shorter in 5% HPC than 5% and 20% SSS
groups. The interface tension was notably lower in 5% HPC than 5% and 20% SSS-
supplemented media indicating that higher interface adsorption rate was observed in 5%
HPC.
Conclusion
Our findings suggest that increased interface adsorption rate in HPC-supplemented

vitrification media would facilitate embryos to detach from CryotopR during warming step.
Facilitation of embryo detachment reduces the physical damage of embryos which would
lead to improving the survival rate of ZP free human blastocyst.
ASPIR-0225
PICSI –A SELECTIVE TOOL FOR 0% MORPHOLOGY

S. gandhi1, C. Mohamad2, K. malhotra2, J. malhotra2, N. malhotra2, N. malhotra2
1
Rainbow hospital, IVF, Agra, India
2
Rainbow IVF Center Agra India, IVF, agra, India
Introduction: Teratozoospermia or abnormal morphology is associated with male factor

infertility with reduced rate of fertilization and pregnancy. This study was conducted to
determine the role of PICSI and pregnancy outcome for a sample with 0% sperm
morphology. PICSI is a technique that stimulates the natural selection of mature sperm.
The hypothesis behind this study is that selection of mature sperm even from an
abnormal morphological sample will result in delivering normal DNA component and
improve outcomes.
Method
Material and Method: The study involved 5 couples with male infertility with 0%
morphology with Strict Kruger’s criteria. All 5 patients had normal sperm count and
motility and the mean age of men and women were 33.8 and 35.1 respectively
Results
Results : Out of 5 patients ,3 patients achieved a pregnancy by PICSI, 1 patient had

preterm delivery at 32 weeks due to cervical incompetence.
Conclusion
Conclusion: In conclusion, PICSI might be a good technique to improve the clinical

outcomes of couples with 0% morphology. More Data is required to come to a statistically
significant conclusion.
ASPIR-0226
IS PROLONGED SPERM INCUBATION REQUIRED FOR TESA ICSI?

C. Mohamad1, D.K. Malhotra1, D.J. Malhotra1, D.N. Malhotra1, D.N. Malhotra1, S. Gandhi1
1
Rainbow IVF Centre, IVF, Agra, India
OBJECTIVE: - TESA ICSI is an option for Azoospermic men, there is a big

difference in opinion of when to time TESA for an ICSI cycle and usual practice is
to do it a day prior. At our centre we analysed our results with TESA ICSI who had
a maximum sperm Incubation period of 2 hours.
Method
Material & Methods:-A Retrospective analysis of patients who underwent Fresh TESA-
ICSI cycles. Cycles from October 2015 to October 2016 in Rainbow IVF Centre Agra
were analysed. Fresh Testicular epididymal sperm aspiration (Fresh TESA) was
performed on the same day of OPU with a maximum Incubation period of two hours.
Fertilization, Cleavage and Pregnancy outcomes were analysed.
Results
Results: - A fertilization rate of 76.8% (255/332) was observed, a cleavage rate of 96.8
%
(247/255). And 12/30, 40% achieved a clinical pregnancy in the same cycle and 3 more
achieved a pregnancy in a subsequent FET Cycle.
Conclusion
Conclusion: - Thus Fresh TESA with a 2 hour incubation seems to achieve acceptable
fertilization, cleavage and pregnancy outcomes and can be a good strategy to implement
in a clinic
ASPIR-0240
COMPARISON OF CELL-FREE DNA LEVELS IN SPENT CULTURE MEDIA FROM

EMBRYOS FERTILISED BY IN VITRO FERTILISATION AND INTRACYTOPLASMIC
SPERM INJECTION
B. McGillivray1, E. Hammond1, S. Wicker1, D. Morbeck2, P. Stone1, L. Chamley1,
L. Cree1,2
1
The University of Auckland, Obstetrics and Gynaecology, Auckland, New Zealand
2
Fertility Associates, IVF Clinic, Auckland, New Zealand
Evidence indicates that human embryos release cell-free nuclear and mitochondrial DNA
(cfDNA) into the surrounding culture medium, and that the extent of this process may be
reflective of embryo quality. Currently only spent culture media samples from embryos
fertilised by intracytoplasmic sperm injection (ICSI) have been characterised for cfDNA
content, in order to minimise the risk of maternal and paternal DNA contamination from
cumulus cells and sperm respectively. The aim of this study was to compare the quantity
of cfDNA in spent media from embryos fertilised by in vitro fertilisation (IVF) to those
fertilised by ICSI.
Method
Embryos were cultured in 20µL droplets of continuous single culture medium (Irvine
Scientific). Spent media was collected on day-6 from IVF (n=67) and ICSI (n= 52)
fertilised embryos that had successfully formed a blastocyst. The absolute number of cell-
free nuclear and mitochondrial DNA copies were quantified in the media using digital-
PCR.
Results
Spent media from embryos fertilised by IVF contained significantly lower levels of both
cell-free nuclear DNA (median 2.3 copies) and mitochondrial DNA (median 108.4 copies)
than media from embryos fertilised by ICSI (nuclear DNA: 3.3 copies, p=
0.007; mitochondrial DNA: 229.8 copies, p= 0.0004).
Conclusion
Unexpectedly, spent media from embryos fertilised by IVF contained significantly lower
levels of cfDNA than media from embryos fertilised by ICSI. This may indicate that the
assumed DNA contamination from cumulus cells and sperm is negligible. We
hypothesise that the ICSI process might facilitate the leakage of increased amounts of
cfDNA into the culture media through the injection site.
ASPIR-0262
GENE EXPRESSION OF GREM1 IN HUMAN CUMULUS CELLS COMPARED TO

OOCYTE MATURITY
T.T.H. Nguyen1, P.Q.M. Ma1, M.T.L. Nguyen1, A.B. Nguyen2, T.Q. Ha3, T.T.B. Truong3,
D.T. Vu4
1
Research Center for Genetic and Reproductive Health,
VNU - HCM Administrative Building, Ho Chi Minh, Vietnam
2
School of Medicine, VNU - HCM Administrative Building, Ho Chi Minh, Vietnam
3
IVF An Sinh, An Sinh Hospital, Ho Chi Minh, Vietnam
4
IVF Hung Vuong, Hung Vuong Hospital, Ho Chi Minh, Vietnam
In cumulus oocyte complex, cumulus cell provides microenvironment required and

express genes to support developing integrity oocyte. We study the relationship of
GREM1 expression with oocyte maturity and embryo quality, in patient undergoing ICSI.
Method
Total 42 cumulus cells were isolated from 42 oocytes (23 MII oocytes and 19 MI, GV
oocytes) from 10 women undergoing ICSI. Gene GREM1 expression was analyzed by
quantitative Real-time PCR follow ∆∆Ct method with housekeeping gene GAPDH.
Results
Cumulus cell GREM1 expression is 2.7-fold higher (3.5 versus 1.3, p = 0.005) in cumulus
cells from mature oocytes (MII) compared with immature oocytes (MI and GV). In 23
cumulus cells from mature oocytes, GREM1 expression is 4-fold higher (4.0 versus 1.0, p
= 0.07) in cumulus cell yielding good quality embryos (day 3 with ≥ 7 cells, low
fragmentation) compared with poor quality embryos.
Conclusion
GREM1 gene expression of cumulus cells correlate to oocyte maturation and embryo
quality.
ASPIR-0265
CHARACTERISING DNA CONTAMINATION IN DIFFERENT COMMERCIALLY

AVAILABLE EMBRYO CULTURE MEDIA SYSTEMS
B. McGillivray1, E. Hammond1, S. Wicker1, D. Morbeck2, P. Stone1, L. Chamley1,
L. Cree1,2
1
The University of Auckland, Obstetrics and Gynaecology, Auckland, New Zealand
2
Fertility Associates, IVF Clinic, Auckland, New Zealand
The ability to assess the genetics of an embryo in a non-invasive manner would

represent a major advancement in reproductive medicine. Studies show that spent
culture media from human embryos contains cell-free DNA; genetic material which may
be used for PGS/PGD. However, it is important to establish whether this cell-free DNA is
purely of embryonic origin. The aim of this study was to determine whether culture media
straight from the manufacturer contains detectable levels of nuclear DNA (nDNA) and
mitochondrial DNA (mtDNA) contamination.
Method
Previously unopened bottles from seven different culture media systems were screened
for the presence of contaminating DNA (CSCM, Irvine Scientific; G-TL, Vitrolife; SAGE 1-
step, Origio; Global, LifeGlobal; Sydney IVF Cleavage/Blastocyst, Cook Medical; Quinn’s
Advantage Cleavage/Blastocyst, Origio; G-1/G-2, Vitrolife). DNA was extracted and the
levels of contaminating DNA were quantified in triplicate using digital-PCR. Media
systems were tested both with and without human serum albumin (HSA) supplementation
where possible.
Results
Trace amounts of nDNA and mtDNA contamination were detected in all media systems
tested. Median nDNA contamination ranged from 0.0-0.025 copies/µL. Median mtDNA
contamination ranged from 0.034-0.133 copies/µL. There was no significant difference in
the levels of contaminating nDNA or mtDNA contamination across the different media
systems (p= 0.14 and 0.40 respectively).
Conclusion
Very low levels of DNA contamination were present in previously unopened bottles of
culture media. This contamination likely arises during manufacture, and does not seem to
originate from HSA supplementation. This has implications for the use of cell-free DNA in
non-invasive preimplantation genetic testing.
ASPIR-0290
IMPORTANCE OF USING TWO EMBRYO CULTURE MEDIA TO ENSURE CYCLE

SUCCESS
S.K. Idris1, N. Razali1, M. Hamdan1, S. Mahfudzah1, T. Hasnidar1, H. Syairah1, J. Ali1
1
UM Fertility Centre, Department of Obstetrics and Gynaecology, Kuala Lumpur,
Malaysia
Embryo culture media (CM) could be damaged due to: i detrimental effects of breakdown
in cold chain; ii. possible defects during manufacture; iii. deterioration of quality of media
due to handling by border security forces or by local agents/distributors or due to (iv)
batch variation. Dependence on a single culture media could therefore be
disadvantageous. Using two media is insurance that the cycle succeeds to the embryo
transfer stage.
Method
Standard procedures were employed.Embryos were graded: 4 = excellent, 3=good,

2=average, 1=poor) / Medium A (continuous culture system;USA) and Medium B
(sequential culture system, Europe).
Results
There is a significant different (p=0.0087) for fertilisation rate (67.0±6.7 vs 84.5±4.9)

between Medium A and Medium B but no difference (p=0.2776) for zygote arrest rate
(14.4±6.8 vs 3.7±3.7); day-2 mean blastomere number and embryo grade; 3.5±0.3 vs
3.8±0.3 (p=0.2509) and 3.1±0.2 vs 3.3±0.1 (p=0.1556), respectively. Day-3 mean
blastomere number and embryo grade for Medium A and Medium B were 9.8±0.7 vs
8.8±0.7 (p=0.3083) and 3.3±0.1 vs 3.2±0.1 (p=0.5200), respectively. Blastocyst formation
rate from day-2 and day-3 embryo for Medium A and Medium B were 16.7% vs 37.5%
and 32.0% vs 55.6%, respectively. Overall pregnancy rate is 27.8% (5/18).
Conclusion
The present study shows both media are equally efficacious (fertilization rate was better
in medium B) unlike our previous report (Ali et al., ASPIRE2014) which demonstrated
significant differences between the two media. This and our previous report (Ali et al.,
2014) suggest using two media is highly recommended to ensure cycle success.
Limitations:small sample size.
ASPIR-0294
COMBINED CONVENTIONAL IVF AND ICSI INSEMINATION OF HUMAN SIBLING

OOCYTES PREVENTS FERTILIZATION FAILURE AND ENSURES SUCCESS OF
ASSISTED REPRODUCTION TREATMENT PROCEDURES
S. Mahfudzah1, H. Tarmizi1, S. Hanafiah1, S.K. Idris1, N. Razali1, M. Hamdan1, J. Ali1
1
Malaysia
To determine whether combined conventional in vitro fertilization (cIVF) and

intracytoplasmic sperm injection (ICSI) insemination procedures will ensure fertilization in
sibling oocytes.
Method
Laboratory data were analyzed retrospectively to determine differences between

fertilization, embryo quality and pregnancy rate for both methods of insemination.
Results
Method cIVF ICSI P value

% Fertilization 80.9 % (229/283) 88 % (278/316) p = 0.0227
Mean day 2 emb cell no. 4.2(n=89) 4.2(n=112) p = 0.2190
Mean day 2 embryo grade 3.2(n=89) 3.3(n=112) p = 0.1115
Mean day 3 emb cell no. 6.5(n=125) 6.4(n=161) p = 0.4343
Mean day 3 embryo grade 3.1(n=125) 3.0(n=161) p = 0.3884
% Pregnancy / ET 40 % (6/15) 70 % (21/30) p = 0.1066
Three of 90 patients (3.3%) failed to fertilize during cIVF insemination but these cases
were positive for ICSI fertilizations. Two of 90 patients (2.2%) in ICSI group failed to
fertilize but were fertilized by cIVF insemination. Forty five patients received embryos
from both groups of which fifteen became pregnant (33.3%). Embryo quality was
comparable.
Conclusion
This study shows how critical it is to employ combined cIVF and ICSI to ensure
fertilization and the generation of embryos to prevent failure of treatment cycles even
though only small number of patients that would have otherwise failed to receive embryos
if only one type of insemination method was used. It is noteworthy ICSI insemination by
itself cannot ensure embryo generation because eggs of a limited number of patients are
not amenable to ICSI but fertilize and generate embryos after cIVF.
ASPIR-0296
IMPACT OF EMBRYO CULTURE MEDIA WITH AND WITHOUT ADDED PROTEINS

ON EMBRYOS GENERATED AND PREGNANCIES IN THE HUMAN
H. Tarmizi1, S.K. Idris1, S. Mahfudzah1, S. Hanafiah1, N. Razali1, H. Mukri1, J. Ali1
1
Malaysia
To determine the impact of absence of serum proteins in embryo culture medium (ECM)
on quality of cleavage stage embryos generated and on pregnancies. To determine
whether use of two culture media will help patients achieve better outcome.
Method
Laboratory data was analyzed retrospectively to determine differences between quality of

sibling embryos and pregnancies generated in the synthetic chemically defined protein-
free medium (PFM; Ali et al., 2000) from Cellcura, Norway and the control Sage®Medium
(SM) from Cooper Surgical, USA. The parameters investigated were: fertilization rate
(FR), zygote arrest rate (ZAR), mean blastomere number (MBN), mean embryo grade
(MEG). [Embryos graded 4 = excellent, 3=good, 2=average, 1=poor] and biochemical
and clinical pregnancies.
Results
Day 2 sibling embryo MBN and MEG for PFM and SM was 4.4 vs 3.9, p=0.4691; 3.2 vs
3.0, p=0.0405 respectively. On day 3 the mean blastomere numbers and embryo grades
for PFM and SM were 6.6 vs 6.1, p=0.2247; 3.2 vs 2.9, p=0.4318, respectively. Clinical
pregnancy rate (SAC& FHB) for the PFM was 43.3% (13/30) for all age (28 to 42yrs)
groups combined.
Conclusion
Sibling embryo development in PFM and SM suggest the efficacy of both media to be
similar in generating quality embryos but since the grade of embryos in PFM was better.
More embryos were selected from the PFM group for transfer that led to more
pregnancies with excellent CPR. The PFM is the only synthetic ECM available certified
Halal, eliminates risk of disease transmission, is safe, offering the most advanced lot to
lot functional consistency in ART.
ASPIR-0309
MINERALS AND SPERMATOZOA ACTIVITY:PRELIMINARY RESULTS

J. Ali1, F. Ismail1, O. Basri1, S. Naes1, N. Razali1, N.A. Mat Adenan1
1
Malaysia
To determine the role of individual mineral on spermatozoa activity and metabolism
Method
Standard methods such as Inductively coupled plasma mass spectrometry (ICP-MS) and
atomic absorption spectrophotometry,were employed to determine the mineral content of
human semen, Iron and copper tolerance and toxic levels were determines by
challenging mouse embryos and spermatozoa with grade amounts of these two metals.
Results
Mn, Co, Li and Cr were absent in all semen samples which included both normal and
abnormal specimen. It was noted Fe, Cu, P was significantly higher in normozoospermic
and severe oligospermic compared to oligozoospermic specimen; whereas Na and Cl
was significantly lower in normozoospermic and severe oligozoospermic compared
oligozoospermic specimen. The supplementation of iron in the form of ferric chloride
ranging from 2 to 50µM/L in present study is beneficial for embryo development but
higher levels were harmful.
Conclusion
The study is on-going. At this stage, we have demonstrated approximate levels of 15

minerals in human semen for the first time. In spite of the hazardous nature of iron it
appears carefully controlled amounts of iron supplementation will help embryo
development because of its role in cell proliferation. Initial findings show important roles
for the various minerals in spermatozoa activity and metabolism. This major investigation
is on-going
ASPIR-0310
EFFECT OF CURCUMIN ON SPERM ABNORMALITIES INDUCED BY MORPHINE IN

RATS
F. Jalili1, C. Jalili2, R. Salahshoor2
1
Kermanshah University of Medical Sciences, student research committee, Kermanshah,
Iran
2
Kermanshah University of Medical Sciences, Fertility and Infertility Research Center,
Kermanshah, Iran
Opioids are the most potent and effective analgesics available and have become
accepted as appropriate treatment for acute, cancer and non-cancer Morphine, which is
commonly used for the treatment of severe pain, gastrointestinal tract and kidneys
curcumin petals consist of, glycosides, flavonoids, and anthocyanins. curcumin effect
and morphine on sperm parameters, testis tissue and serum testosterone level in rat
Method
In this experimental study 48 male rats with 28 weeks of age and limited weight of 270 to
300 gerams were selected They were divided into eight groups of 6, untreated control
group; morphine –treated group (20 mg/kg/day); curcumin -treated groups (10, 30, 60
mg/kg./day); and morphine and curcumin treated group interperitoneal administration for
successive 28 days. After 24 hours animal were killed Sperm motility was measured
through WHO protocols The sperm parameter such as motility, sperm count, morphology,
and seminiferous tubules diameter, and weight testis, and serum testosterone level were
analyzed (one-way ANOVA) Then data were P<0.05 was considered significant
Results
curcumin (10, 30 and 60 mg/kg) significantly increased mean percentage of sperm

motility, count, testis weight, and serum testosterone level compared to control group
(p<0.05). Moreover testosterone level decreased significantly in rats treated with
morphine Co-administration of curcumin to morphine-treated rats improved the
histopathological alterations induced by morphine in testis and increased the sperm count
Conclusion
This study showed that curcumin has a very strong antioxidant effect at applied doses
and it can be probably used as an antioxidant and food supplement in reproductive
disorders
ASPIR-0317
DEVELOPMENT OF VITRIFICATION SOLUTIONS WITH SENARY (SIX)

COMBINATIONS OF CRYOPROTECTANTS FOR APPLICATION IN ASSISTED
REPRODUCTION TECHNOLOGY
O. Basri1, N. Razali1, N.A. Mat Adenan1, S. Naes2, F. Ismail1, J. Ali3
1
University of Malaya, Department of Obstetrics and Gynaecology, Kuala Lumpur,
Malaysia
2
University of Malaya, Department of Obstetrics and Gynaecology,
Department of Obstetrics and Gynaecology, Malaysia
3
Malaysia
Vitrification solutions (VSs) consist of at least 40% v/v (or ~ 6.0 M) cryprotectants but
such high solute concentrations are invariably toxic. Current commercial VSs appear to
be ternary or quaternary. Using higher combinations of cryoprotectants in VS
formulations is a strategy to reduce toxicity. The present investigation aims to develop
senary (six) combinations of VSs that can be applied for the cryopreservation of
spermatozoa, oocytes and embryos. The funding agency intends to patent the IP product
of this research hence the VSs are coded to safeguard IP proprietorship.
Method
A total 6 cryoprotectants were selected including water (soluteless). All VSs formulated
contained cryoprotectants coded as A,B,C,D,E made up in water. A total of 21 series of
senary solutions were systematically formulated ranging from 2.5M to 7M total solute
concetration consisting of all six cryoprotectants and were tested for vitrification property
using a 0.5ml straw.
Results
From these 21 senary VSs (a VS that contained 1.5 mol 1¯1of A, 1.0 mol 1¯1 of B, 1.0
mol 1¯1 of C, 1.0 mol 1¯1 of D, 1.0 mol 1¯1 of E and water –VS12S ) was chosen because
this VS vitrified on cooling at an easily achievable and repeatable rate, and it remained
vitreous on warming when using 0.5 ml plastic insemination straws. VS12S also vitrified
in 0.25 ml plastic insemination straws and several microvehicles (loops: 1µl, 5 µl and 10
µl).
Conclusion
A senary VS with potentially useful application in ART has been formulated. Further
studies will be undertaken to determine its usefulness.
ASPIR-0326
COMPARISON OF CUMULUS CELLS,THE EXPRESSION OF LH RECEPTOR,

CASPASE 3 AND P53 WITH THE SUCCESS IN OOCYTE MATURATION IN THE
PROCESS OF IVM AFTER VITRIFICATION
A. Amansyah1
1
The Medical School- University of Sumatera Utara- Medan- Indonesia, -, Medan,
Indonesia
to analyze the influence of number of cumulus cells and the expression of LH receptor,
caspase 3, p53 on the success in oocyte maturation in the process of ivm after
vitrification.
Method
The experimental study was conducted in the Gladiol Infertility Clinical Laboratory,
Magelang, Central Java. The research subjects were 60 oocyte of germinal vesicle
stadium of cows (Bos taurus), divided into two groups: control group consisted of non-
vitrified oocyte and exposure group consisted of vitrified oocyte.The examination of the
number of cumulus cells, using neubauwer calculating room and the expression of LH
receptor, caspase 3, and p53 with ihc method, was done. After that, ivm were performed
and their development were evaluated in 24 hours (first polar body)
Results
The average number of cumulus cells 1.577.777 in non-vitrified and 1.293.333 in vitrified,
statistically had no significant correlation with maturity (p>0.05).
The average of LH receptor expression 90,311% in non-vitrified and 78,550% in

vitrified , statistically had no significant correlation with maturity (p>0.05).
The average of p53 expression 1,387% in non-vitrified and 2,767% in vitrified, statistically
had significant correlation with maturity (p<0.05).
The average of caspase 3 expression 7,516% in non-vitrified 21,514% in vitrified,

statistically had significant correlation with maturity (p<0.05).
Conclusion
The expression of caspase 3 and p53 determined the success in oocyte maturation in the
process of ivm after the vitrification.
ASPIR-0338
LH RECEPTOR AND NUMBER OF MATURE OOCYTES AMONG ENDOMETRIOSIS

AND NORMAL WOMEN
R. Utami1, D. Gunarwati2, A. Bowolaksono3, P. Mounda3, O. Riayati1, S. Aulia1,
P. Iffanolida1, K. Mutia1, B. Wiweko4, A. Hestiantoro4
1
INA-REPROMED, Obsgyn, Jakarta, Indonesia
2
PT. Ingin Anak, Obsgyn, Jakarta, Indonesia
3
Faculty of Mathematics and Natural Sciences Universitas Indonesia, Biology, Jakarta,
Indonesia
4
RSCM, Obsgyn, Jakarta, Indonesia
Luteinizing Hormone is essential for follicle maturation and receptor for LH (LHR) have
been found in granulosa cells. Previous study showed strong correlation between LHR
expression and oocyte maturation. Endometriosis is associated with alterations in the
hypothalamus-hypophysis-ovary axis, and suggest abnormality in the function of
follicular, with altered LH concentration. The aim of this study is to compare the level
expression of granulosa cells LHR mRNA and number of mature oocytes among
endometriosis and normal women.
Method
This study was conducted on 20 endometriosis patients and 6 normal patients who
undergo IVF cycle in Yasmin IVF Clinic, Jakarta. The study was approved by the medical
ethics committee of Faculty of Medicine, Universitas Indonesia. Informed consent was
obtained. Granulosa cells were collected during oocyte retrieval. Levels of mRNA were
evaluated by real-time PCR. Mann-Whitney test was used to determine the differences
between two groups.
Results
Median level of LHR mRNA were lower in endometriosis patients than in normal patients
0.23(0.0034-11.5)x10-6 ng/µl vs. 1.01(0.2460-1.68) x10-6 ng/µl along with the number of
mature oocytes 8.00(2-21) vs. 9.50(2-37). However, Statistical analysis showed no
significant difference between granulosa cells LHR mRNA level and number of mature
oocytes in women with endometriosis compared to normal women (p value>0.05).
Conclusion
Level expressions of LHR mRNA and number of mature oocytes in endometriosis women
were lower than in normal women, but did not show significant difference. Further studies
with larger number of samples and different follicular size are needed to evaluate the
mean level expression of LHR mRNA among two groups
ASPIR-0350
HOW AGEING WOMEN INFLUENCES THE ABNORMALITIES OF EMBRYO'S

CHROMOSOME
A. Riyanti1, O. Riayati2, P.A. Iffanolida2, S. Narasati2, B. Wiweko3
1
, Bintaro, Indonesia
2
Indonesian Reproductive Medicine Research and Training Center- Faculty of Medicine U
niversitas Indonesia-, Obstetric and Gynaecology, jakarta, Indonesia
3
Research Manager Faculty of Medicine Universitas Indonesia Jakarta - Indonesia,
Obstetric and Gynaecology, jakarta, Indonesia
The increased rate of chromosomal abnormalities in women with advanced reproductive

age has been reported in many studies. The main cause of higher miscarriage risk in
older women increases the rates of chromosomal abnormalities in the eggs. Aneuploid
eggs and embryos are also responsible for most of the decline in fertility in ageing female
and for the low pregnancy success rates with IVF. Preimplantation genetic
screening(PGS) can be performed to check embryos for chromosomal abnormalities
before embryo transfer. This study was conducted to observe how ageing women’s ages
influences the abnormalities in embryo’s chromosomes
Method
The data of 20 embryos from 9 infertile women who underwent IVF treatment cycle in
Yasmin Clinic and IA-IVF clinic Daya Medika,Jakarta, Indonesia were collected
retrospectively. Embryos were biopsied followed by PGS. The association between
female age with embryos morphology and aneuploidy rates were then analysed
Results
Embryos with poor/low grades(grades 3 & 4) accounts for 29% in Group I(age < 35 years
old)and 100 % in group II(age >= 35 years old). The number of good/high grades
embryos in younger women(group I) is significantly higher compared to older women
(group II)with p<0,05. This is in line with lower aneuploidy rate in group I;78,6% compared
to group II;100%,even though it is not statistically significant(p>0,05). PGS showed the
incidence of aneuploidy(trisomy and monosomy)in poor embryos is higher(2 to 12) than
in good embryos(1 to 3).
Conclusion
This study showed the relationship between the older age women that joined the IVF
treatment with aneuploidy event and low gradings of embryos.
ASPIR-0352
EXPRESSION OF FSHR IN LUTEINIZED GRANULOSA CELLS OF ENDOMETRIOSIS

PATIENTS AND ITS CORRELATION WITH FERTILIZATION RATE
S.O.F. Jasirwan1, A. riyanti1, B. wiweko1
1
Faculty of Medicine University of Indonesia-Dr Cipto Mangunkusumo General Hospit,
Obstetric and Gynecology, Jakarta, Indonesia
Endometriosis affects 20-50% infertile women. The relationship between endometriosis

and infertility has been debated for many years. Some studies have demonstrated that
the quality of the oocytes is affected resulting in low fertilization rate. Low follicle
stimulating hormone receptor (FSHR) gene plays a role in the process, but no direct
evidence shows the correlation between expression of FSHR with fertilization rate. This
study aimed to investigate the expression of FSHR in endometriosis patients and its
correlation to fertilization rate
Method
This cross sectional study used 32 women undergoing ovarian stimulation with
recombinant follicle-stimulating hormone (rFSH). These women were divided into two
groups: endometriosis (n=22) and non endometriosis (n=10) group as a control. Both
study group and control group were matched according to anti-Müllerian hormone,
female age, previous treatment cycles, and method of fertilization. The FSHR expression
at mRNA was determined byreverse transcription-polymerase chain reaction in
granulosa cells obtained by follicular aspiration.
Results
Endometriosis patients had significantly lower expression of FSHR than control group
(0.30 +/- 0.05 vs 0.32+/- 0.02, P<0.05). Fertilization rate among endometriosis group was
non significantly lower than control group (51.2% vs 63.7%, P = 0.24). FSHR expression
had no correlation with fertilzation rate (r=0.08, P=0.66)
Conclusion
The FSHR in endometriosis patients was lower than other non specified factor of
infertility. It is evident from these data that FSHR expression is not a useful predictor of
fertilization rate. The fertilization rate could be dependent on several factors n a complex
multifactorial model.
ART, Clinical
ASPIR-0031
Posters: ART, Clinical
THE EFFICACY OF OOCYTE RETRIEVAL AT SMALL-SIZED FOLLICLES FOR POOR

RESPONDERS WITH A HIGH RISK OF CYCLE CANCELATION DUE TO PREMATURE
FOLLICLE RUPTURE
K. Mekaru1
1
University of the Ryukyus, Obsterics and Gynecology, Okinawa, Japan
To evaluate the efficacy of oocyte retrieval at small-sized follicles for poor responder patients
with a high risk of cycle cancelation due to premature follicle rupture.
Method
Patients included in the study fulfilled the Bologna criteria for the definition of poor ovarian
response performed in vitro fertilization-embryo transfer (IVF-ET) from January 2014 to
September 2015. Ovulation was induced using clomiphene citrate. Patients with a history of
previously failed IVF cycles due to premature follicle rupture during stimulation were selected
for oocyte retrieval at a maximal leading follicle size <16 mm (48cycles, 28 women;SF
group). Patients without a history of premature follicle rupture during stimulation were
selected for oocyte retrieval at a maximal leading follicle size >16 mm (128cycles, 60women;
NF group).
Results
No significant differences were observed between the SF and NF groups with age (40.1 ± 3
years vs 39.9 ± 3.1 years). Anti-Müllerian hormone tended to be low (0.52 ± 0.46 ng/ml vs.
0.66 ± 0.45; p = 0.054) and basal follicle-stimulating hormone tend to be high (19.9 ± 9.1
mIU/ml vs. 15.9 ± 6.7; p = 0.083) in the SF group. Mean dominant follicle diameter was 14.3
± 1.1 mm and 18.2 ± 1.7 mm in the SF and NF groups, respectively. No significant difference
was observed in the cancelation rates due to premature follicle rupture, the numbers of
oocytes retrieved (1.74±1.2 vs 1.97±1.3; p=0.28), fertilized oocytes and good quality
embryos.
Conclusion
Oocyte retrieval at small-sized follicles can avoid premature follicle rupture without decrease
of number of oocytes retrieved.
ASPIR-0034
THE UTILITY OF ENDOMETRIAL AND UTERINE VASCULARITY MEASUREMENT BY

TRANSVAGINAL ULTRASONOGRAPHY IN PREDICTING PREGNANCY OUTCOME
DURING FROZEN THAWED EMBRYO TRANSFER CYCLES
S. Kim1, K. Lee1, J. Joo1, B. Park1, M. Jo1
1
Pusan National University Hospital, Department of Obstetrics and Gynecology, Busan,
Republic of Korea
This study was performed to assess the role of endometrial and uterine vascularity status
measurement in predicting pregnancy outcome during frozen-thawed embryo transfer (FET)
cycles.
Method
Total 70 infertile women were recruited with controlled ovarian stimulation followed by
oocytes retrieval. Embryos were cultured to blastocysts with good quality were selected for
cryopreservation. After endometrial preparation, vitrified blastocysts were thawed and
assisted hatching was performed. On the day of embryo transfer, endometrial thickness
(EMT), resistance index (RI) and pulsatility index (PI) of sub-endometrial artery (SEA) and
uterine artery (UA) were obtained by transvaginal sonography (TVS). All women were
divided into pregnant or not groups, and these variables were compared between 2 groups.
Results
The implantation rate, clinical pregnancy rate, and ongoing pregnancy rate were 31.1%,
41.4% and 28.6%, respectively. 29 Patients who conceived had average EMT, RI of SEA, PI
of SEA, RI of UA, and PI of UA values of 9.15mm, 0.91, 2.42, 0.95, and 3.37, respectively.
41 Patients who didn’t conceive had average EMT, RI of SEA, PI of SEA, RI of UA, and PI of
UA values of 9.31mm, 1.01, 2.56, 0.94, and 3.00, respectively. In two groups, all variables
were not statistically different.
Conclusion
Measurement of endometrial thickness and blood flow index of uterus and endometrium
during FET cycles can’t seem to predict the pregnancy outcome. But endometrial receptivity
is thought to be still important factor in successful implantation of FET cycle and many
studies agree that high degrees of endometrial perfusion shown by Doppler suggests more
receptive endometrium.
ASPIR-0035
QUANTITATIVE ASSESSMENT OF ENDOMETRIAL VOLUME AND UTERINE

VASCULARITY AND PREGNANCY OUTCOME IN FROZEN THAWED EMBRYO
TRANSFER CYCLES
1
Republic of Korea
To investigate the usefulness of the endometrial volume and vascular indices in the
endometrial region as an effective predictor for pregnancy outcome in frozen-thawed embryo
transfer (FET).
Method
We evaluated 131 embryo transfer cycles in 73 infertile women. After controlled ovarian
stimulation all embryos were cultured to blastocyst stage, and the blastocysts with good
quality were vitrified for elective FET.On the day of FET, endometrial thickness, endometrial
volume, pulsatility index (PI), and resistance index of uterine artery and endometrial-
subendometrial vessels (ESVs) with zonal discrimination were evaluated by transvaginal
ultrasonography in each patient. These variables were compared between pregnant and
nonpregnant cycles.
Results
The endometrial volume was significantly higher in the pregnant group (2.32 +/- 0.86, 1.96
+/- 0.62 mL, p=0.007). Also, PI of ESVs was significantly higher in the pregnant cycle (2.58
+/- 1.32 and 2.05 +/- 1.08, p=0.016). The other variables were not different between the 2
groups.
Conclusion
This study suggested that endometrial volume and the vascular indices measured in
endometrial region are useful predictors of pregnancy outcome.
ASPIR-0041
TREATMENT OF POOR RESPONDERS WITH CORIFOLLITROPIN ALFA AND HIGHLY

PURIFIED MENOTROPIN (HPHMG) IN MICRODOSE FLARE-UP PROTOCOL
Y.T. Cheong1, M.T. Hatta2, I. Rahmatia2, M. Anjeline1, T.S.Y. Tan1
1
Sabah Care Specialist Clinic, Fertility Unit, Kota Kinabalu, Malaysia
2
Sabah Women's and Children's Hospital, Fertility Unit, Kota Kinabalu, Malaysia
OBJECTIVE: To examine the efficacy of treatment with 150µg corifollitropin alfa and highly
purified menotropin (hphMG) in microdose flare-up protocol for poor ovarian responders.
Method
DESIGN: Case reports on 5 patients who were poor ovarian responders from previous IVF
cycles.
MATERIALS AND METHODS: 5 patients who fulfilled the Bologna criteria for poor ovarian
response were treated with microdose flare-up protocol wIth GnRH agonist. Patients
received a single dose of 150µg corifollitropin alfa and 10 days of 150 IU hphMG. Ovarian
triggering was performed using 250µg of recombinant hCG, when at least 2 follicles reached
17mm in mean diameter. ICSI was performed and embryos were transferred on day 2.
Results
RESULTS: Out of the 5 patients, one did not proceed to oocyte retrieval due to no follicular
growth. The other 4 patients had between 2 to 7 oocytes retrieved. All 4 patients had day 2
embryo transfer and 3 achieved clinical pregnancy.
Conclusion
CONCLUSIONS: In women with previous cancelled/failed IVF cycles due to poor ovarian
response, treatment with corifollitropin alfa and highly purified menotropin (hphMG) in
microdose flare-up protocol can be considered. Further clinical studies with larger number of
subjects are required for us to draw conclusions on the rates of clinical pregnancy and live
birth using this treatment protocol.
ASPIR-0042
NUMBER OF MOVING SPERM IS THE BETTER PREDICTOR FOR INTRAUTERINE

INSEMINATION (IUI) PREGNANCY RATES
S. Bhairavi1, S. Dash2
1
, Pondicherry, India
2
Srishti Assisted Fertility Center, Embryology, Pondicherry, India
Intrauterine insemination is generally attempted before proceeding to more expensive and

invasive assisted-reproductive techniques such as intracytoplasmic sperm injection. Several
semen parameters have been shown to correlate with IUI outcome and may be useful when
counselling couples. Our aim was to determine the impact of processed total motile sperm
(PTMS) count on pregnancy after intrauterine insemination
Method
Hospital based retrospective study of patients who underwent IUI.The clinical and semen
parameters were recorded for each couple and each insemination. The parameters were
compared between those couples who achieved a pregnancy and those who did not
Results
Among 345 patients who underwent IUI,the total number of pregnancies was 29, resulting in
a pregnancy rate per cycle of 8.4%.Mean age of patients who conceived was 27.69 yrs,
Mean FSH was 4.765 and mean LH was 4.827.The pregnancy rate was significantly higher
in patients with post-wash total motile sperm count of >10×106 with P value of 0.057.The
number of follicles developed and endometrial thickness does not have any statistical
significance associated with pregnancy rates P-0.102 and P-0.890 respectively. On
multivariable logistic regression analysis, the PTMS count was independently associated
with fertility after IUI(P = 0.028). An average post-wash total motile sperm count of
10×106 may be a useful threshold value for IUI success
Conclusion
Our study demonstrated that post-wash total motile sperm count can provide valuable
decision making information to couples deciding between IUI and IVF treatment .In
conclusion, postwash semen quality was the most important factor for prediction of
successful pregnancy in this study
ASPIR-0067
ALTERNATIVE STRATEGY FOR POOR OVARIAN RESPONDERS: ACCUMULATION OF

EMBRYOS BASED ON NATURAL CYCLE
C.Y. Park1, M.K. Kim1, K. Park1, R.M. You2, S.Y. Moon2
1
M fertility Center, Laboratory of Reproductive Medicine, Seoul, Republic of Korea
2
M fertility Center, Reproductive Medicine, Seoul, Republic of Korea
Many studies reported that natural cycle-IVF is a valuable alternative to controlled ovarian
hyperstimulation (COH) in poor ovarian responders (PORs). This study was performed to
evaluate the pregnancy outcomes of frozen-thawed embryo transfer using accumulation of
vitrified embryos by consecutive natural cycle (ACCU-NAT) and fresh embryo transfer by
mild stimulation (MS) in PORs
Method
The cycles of PORs according to Bologna criteria were selected from 2014 to 2015. The
cycles were divided into two groups: ACCU-NAT and MS. In ACCU-NAT (n=13), Embryos
were frozen by the vitrification method on day 3. And then, the next natural cycle was
repeated for accumulation of vitrified embryos. In MS (n=38), patients were given with
letrozole and followed by administration of low amounts of gonadotropins.
Results
There was no significant difference in the female age, number of total retrieved/matured
oocytes and fertilization rates between ACCU-NAT and MS. Retrieved oocytes per natural
cycle (1.3 ± 0.5) in ACCU-NAT were significantly smaller than those in MS (3.1 ± 1.1) (Table
1). The number of transferred embryos in two groups did not differ. However, ACCU-NAT
group showed higher rates of β-hCG (+), implantation and live birth than MS group even
though there were no statistical significance (Table 2).
Conclusion
There was no statistically significant difference between ACCU-NAT and MS in live birth.
Nonetheless, this study shows that ACCU-NAT has potential advantage over MS in IVF
outcomes. For poor ovarian responders, the strategy of ACCU-NAT based on natural cycle
can strongly considered as the alternative protocol before depletion of ovarian reserves.
ASPIR-0086
ULTRALONG PROTOCOL IMPROVES PREGNANCY OUTCOMES OF IN VITRO

FERTILIZATION IN INFERTILE WOMEN WITH PERITONEAL FLUID
S.J. Tan1,2,3, C.H. Chen1, C.R. Tzeng1
1
Taipei Medical University Hospital,
Center for Reproductive Medicine- Department of Obstetrics and Gynecology, Taipei,
Taiwan R.O.C.
2
Taipei Medical University,
Department of Obstetrics and Gynecology- School of Medicine- College of Medicine, Taipei,
Taiwan R.O.C.
3
Taipei Medical University, Graduate Institute of Clinical Medicine- College of Medicine,
Taipei, Taiwan R.O.C.
Peritoneal fluid (PF) is the microenvironment of the pelvic organs and may play a role in regu
lating normal reproductive processes. Women with endometriosis may occasionally present
with PF, which containing activated macrophages and inflammatory factors affecting their
pregnancy outcomes. This study aims to investigate the pregnancy outcomes of in vitro
fertilization (IVF) with ultralong protocol in infertile women with PF.
Method
This is a retrospective cohort study. Infertile women under 40 years of age who underwent
AMH test at Taipei Medical University Hospital and controlled ovarian hyperstimulation
(COH) with ultralong protocol followed by fresh cleavage-stage embryo transfer between
January 2015 and April 2015 were recruited. Patient characteristics and pregnancy
outcomes in patients with and without PF showed by transvaginal ultrasound before COH
were analyzed and compared.
Results
The study included 333 patients, including 205 in the PF(+) group and 128 in the PF(-)
group. There was significantly higher prevalence of endometriosis-related infertility in the
PF(+) group (27.3% versus 15.6%; p = 0.002). The clinical pregnancy rate was significantly
higher in the PF(+) group than the PF(-) group (56.1% versus 38.3%; p = 0.016), and there
was no significant difference in the implantation rate (27.3% versus 17.4%; p = 0.093).
Conclusion
Ultralong protocol can improve the clinical pregnancy rate of IVF in infertile women with PF,
even those without endometriosis. PF may be considered as a noninvasive marker helpful to
decide the treatment protocol.
ASPIR-0109
COST EFFECTIVE ANALYSIS OF MINIMAL STIMULATION IN HARAPAN KITA

HOSPITAL, JAKARTA, INDONESIA
C.A. Susanto1, A. Supriyadi2
1
Faculty of Medicine- University of Indonesia, Obstetrics and Gynecology, Jakarta, Indonesia
2
Harapan Kita Mother and Children Hospital, Obstetrics and Gynecology, Jakarta, Indonesia
ART nowadays is the answer to infertile couple seeking pregnancy. In developing countries,
especially in Indonesia, this method still considered expensive and it is not covered by the
government medical insurance. Thus, making many infertile couple did not seek any help.
The introduction of minimal stimulation method, making this possible for couple who has
minimal funding. There are no known study especially of cost effective analysis of minimal
stimulation especially in Harapan Kita Hospital.
Aim: To analysed cost and effective of minimal stimulation technique
Method
This cohort retrospective study was conducted in Harapan Kita, Mother and Children
Hospital, Jakarta, Indonesia from January 2014 until August 2016. The subjects of this study
were infertile couple who underwent IVF cycles. The cycles were divided into two groups,
minimal stimulation using clomiphene citrate (n=24) and conventional hyperstimulation cycle
(long protocol, n=33; short protocol, n=140). Number of oocytes, number of embryos, and
clinical pregnancy were analyzed.
Results
There are significant difference among method of ovulation induction with number of oocyte
retrived (p<0,001),and embryos (p < 0,001). Minimal stimulation yields to lower oocyte
retrieved, number of fertilized oocytes and embryos compared to either long or short protocol
[{2 (0-11) vs 7 (0-32}, {1 (0-4) vs 3 (0-16)}, {1 (0-3) vs 2 (0-4)}]. However, in terms of clinical
pregnancy, there were no significant different with conventional ovulation induction
technique ( 21% vs 22%, p = 0,813), And the cost of minimal stimulation technique is lower.
Conclusion
Minimal stimulation is considered safer, lower cost, effective methods

ASPIR-0115
SERUM ANTI-MULLERIAN HORMONE (AMH) AND CLINICAL USES

K. Sawakwongpra1, S. Chanchamroen2, N. Siriprasertchok2, N. Duangprapat2,
N. Kulphaweesuwan2, T. Ruengkris2, W. Quangkananurug2
1
, Bangkok, Thailand
2
Safe Fertility and PGD Center, Laboratory, Bangkok, Thailand
AMH is a potential indicator of ovarian reserve and correlated with FSH, LH. Some studied
give the straight of the associated with oocytes yield but the correlation of AMH with
pregnancy after ART was inconcluded. Our study is to investigate the association between
AMH concentration and FSH, LH, pregnancy outcome.
Method
A retrospective study was included infertile patients in Safe Fertility and PGD Centre
between July 2015 to August 2016. A total 391 patients. All blood samples were collected for
testing of hormone. AMH measurement was used Beckman Coulter Gen II AMH assay. FSH
and LH hormone level were measure with Cobas e411 (Roche). Data was determined the
correlation between serum AMH, FSH, LH, Oocytes retrieved and pregnancy outcome. The
data was analyzed by regression analysis. p < 0.05 was considered to be statistically
significant.
Results
The relationship between AMH and FSH found negative correlation in age groups ≤ 40 years
(p < 0.05). AMH value decreased with increased LH in ≥ 35 years (p < 0.05). AMH value had
good relationship with oocyte retrieved (p < 0.0001) but no correlation with pregnancy rate (p
> 0.05).
Conclusion
Our data indicate that AMH has limited correlation with FSH in young patients (≤ 40 years)
and correlation with LH in maternal age groups (≥ 36 years). High serum AMH value are
significant correlation with oocyte retrieved but no correlation with pregnancy outcome.
According to this result, AMH serum could not be an independent predictor of clinical
outcomes.
ASPIR-0121
COMPARISON OF OUTCOMES OF ELECTIVE SINGLE EMBRYO TRANSFER

BETWEEN FROZEN AND FRESH CYCLES
S.Y. Lin1,2, T.S. Tan2, M.H. Lin2, Y.M. Hwu2, R.K.K. Lee2
1
Taipei Medical University Hospital- Taipei Medical University., Dept. Ob/Gyn, Taipei,
Taiwan R.O.C.
2
Mackay Memorial Hospital, Dept. Ob/Gyn, Taipei, Taiwan R.O.C.
The success rates of IVF associated technologies have been being improved and advanced
in Taiwan. However, multiple pregnancy rate is still high. To reduce multiple pregnancy
rates, especially twin pregnancy, the most efficient way is to transfer a single embryo.
Elective single embryo transfer (eSET) for good cases is a good start for this aim. We
already demonstrated that fresh eSET does not decrease the IVF success rates. In the
current study, we would like to know how frozen eSET influences the clinical outcomes.
Method
The main design is to compare the clinical outcomes between frozen eSET and fresh
eSET.The samples were prospectively recruited by a single physician (SYL) to exclude the
inter-observer confounding factors. The inclusion criteria: the blastocysts were obtained
when the patients’ age was less than 39 y/o; the morphological scores of blastocysts were
no worse than 3BB. The exclusion criteria: uterine pathological conditions; the blastocysts
from PGS. A total of 47 frozen eSET cycles and 45 fresh eSET cycles were recruited. All the
cases were the patients treated in the hospital from May 2012 ~ Apr 2016.
Results
The implantation rates of the frozen vs fresh eSET: 70.2% vs 62.2% (p = 0.5095). The
embryo development rate of the frozen vs fresh eSET: 66.0% vs 62.2% (p = 0.8284). The
ongoing pregnancy rates of the frozen vs fresh eSET: 66.0% vs 60.0% (p = 0.6665).
Conclusion
eSET can maintain a acceptable success rate. All the aspects of clinical outcomes between
frozen eSET and fresh eSET are comparable.
ASPIR-0122
THE EFFICACY OF FOLLITROPE PREPARATIONS COMPARED WITH GONAL F

PREPARATIONS FOR OVARIAN HYPERSTIMULATION IN PATIENTS UNDERGOING
IVF-ET.
E. Kwak1, H. Lee1,2, B. Choi2, S. Noh2, M. Son2
1
Cheongna Women's Hospital, Laboratory of Reproductive Medicine, Incheon,
Republic of Korea
2
Cheongna Women's Hospital, Obstetrics&Gynecology, Incheon, Republic of Korea
To compare the efficacy of two recombinant human FSH preparations, Follitrope(LG Life
Science, Seoul, Korea) and Gonal-F(Merck-Serono SA., US), for ovarian hyperstimulation in
patients undergoing IVF-ET.
Method
1,639 IVF-ET cycles were analysed. In 682 cycles folliculogenesis was induced with
Follitrope, and premature LH surges was prevented with GnRH agonist. In the control
group(957 cycles), premature LH surges was prevented with GnRH agonist and
folliculogenesis was induced with Gonal-F. Embryo transfer was performed on day3,4 or 5.
Pregnancy rates were determined by a serum β-hCG level ≥20mIU/mL.
Results
There was no significant difference in patients age and mean number of retrieved oocytes,
fertilized zygotes, transferred embryos. The overall pregnancy rate was significantly higher in
the control group(37.0 vs.42.3 p<.05). Also, the pregnancy rates according to
COH was higher in the control(GnRH Long; 36.1 vs.44.2 p<.05). However, two groups did
not show differences in pregnancy rates according to COH protocols(GnRH short; 39.5
vs.33.1), infertility causes(Female; 35.1 vs.41.3, Male; 43.9 vs.53.3, Idiopathic; 40.0 vs.30.3,
Combined; 12.5 vs.51.2), number of IVF-ET trial cycles(1st; 39.7 vs.45.9, 2nd; 30.9 vs.30.9,
3rd≤; 32.7 vs.36.6) and patients age(44.8 vs.56.2 in≤ 29 years, 38.7 vs.42.6 in 30~34 years,
and 29.4 vs.29.1 in 35~37 years group, Follitrope% vs. control%).
Conclusion
The efficacy of Follitrope preparation for ovarian hyperstimulation in IVF-ET was comparable
to the efficacy of Gonal F preparation compared to oocytes retrival number,fertilization rates,
embryonic developmental competence and pregnancy rates according to COH
protocols,infertility causes,number of IVF-ET trial cycles and patient's age.
ASPIR-0123
FRESH TRANSFER WITH INTENSIVE LUTEAL SUPPORT VERSUS FREEZE-ALL AND

SUBSEQUENT FROZEN TRANSFER IN GONADOTROPHIN RELEASING HORMONE
AGONIST (GNRHA) TRIGGERING CYCLES.
V.N.A. Ho1, T.D. Pham1, L.N. Vuong2
1
IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
2
Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy,
Ho Chi Minh City, Vietnam
GnRHa are highly effective in triggering final oocyte maturation in women at high risk of
OHSS. We evaluate the effectiveness and safety of the two strategies to overcome luteal
defect in GnRHa triggering cycles, fresh transfer with intensive luteal support (fresh transfer)
and freeze-all and subsequent frozen transfer (freeze-all).
Method
A retrospective cohort study was conducted at IVFMD, My Duc Hospital, HCMC, Viet Nam
from June 2014 to August 2016. Patients were eligible if they had GnRHa triggering, had
either fresh transfer with intensive luteal support or freeze-all and subsequent frozen
transfer. Intensive luteal support used a combination of intramuscular progesterone plus
vaginal progesterone gel, and oestradiol valerate administered from the day of oocyte
retrieval. Frozen transfer was performed in an HRT cycle. Embryo transfer was either on day
3 or day 5 in both groups.
Results
A total of 683 patients with GnRHa trigger (269 fresh and 414 freeze-all cycles) were
recruited to the study. Baseline characteristics were comparable between two groups. The
overall ongoing pregnancy rate (OPR) was significantly higher in the freeze-all group
compared with the fresh transfer group (37.9% versus 27.6% for day-3 transfer, and 63.5%
versus 27.3% for blastocyst transfer, all p<0.001). Ectopic pregnancy rate was significantly
lower in the freeze-all group (1.5% versus 5.0% for day-3 transfer, and 1.0% versus 5.7% for
blastocyst transfer, all p<0.001). Miscarriage rate was similar between groups. No OHSS
was recorded in any groups.
Conclusion
Freeze-all and subsequent frozen transfer is more effective and safer than fresh transfer in
GnRHa triggering cycles.
ASPIR-0126
HOW TO FACE ELEVATED SERUM PROGESTERONE BEFORE PROGESTERONE

ADMINISTRATION IN FROZEN BLASTOCYST TRANSFER? TRANSFER EARLIER
H.Y. Huang1, M.J. Lee1, C.L. Hsieh1, H.L. Wang1, H.H. Lai1
1
Stork fertility center, Department of medicine research, Hsinchu City, Taiwan R.O.C.
Elevated serum progesterone on the hCG administration (premature luteinization) in fresh

embryo transfer were associated with lower ongoing pregnancy rate. Patients with serum
progesterone levels ≦1.5ng/ml had significantly higher ongoing pregnancy rates than those
with progesterone levels >1.5ng/ml. We suppose there is the same phenomenon in frozen
embryo transfer cycle and we can transfer embryos earlier to coordinate the implantation
window. To demonstrate elevated serum progesterone level with earlier embryo transfer
don’t affect the clinical outcomes, we analyze the pregnancy rate, implantation rate, and
ongoing pregnancy rate.
Method
The clinical outcomes in patients categorized according to a serum progesterone cut-off

value of 1.5ng/ml on the day 12~15. The time interval of progesterone administration to
embryo transfer was listed in Table 1.
Table 1
P4 ng/ml 1.5-2 2-5 5-7.5 7.5-9 >9

progesterone administration(hr.) 110-126 95-110 86-95 63 42
Results
A total of 480 FBT cycles with serum progesterone levels ≦1.5ng/ml were performed. And a
total of 26 FBT cycles with serum progesterone levels >1.5ng/ml were performed. There was
no difference in pregnancy rate (52.2% and 53.8%), implantation rate(36.3% and 39.5%)
and ongoing pregnancy rate (46.9% and 50.0%) for patients with serum progesterone levels
≦1.5ng/ml and with progesterone levels >1.5ng/ml, respectively.
Conclusion
When Patients with progesterone levels >1.5ng/ml on the day 12~15 during frozen
blastocyte transfer (FBT) don’t give up. We found transfer embryo earlier, there was no
difference in clinical outcomes.
ASPIR-0130
CONVERSION OF HIGH RESPONSE IUI TO IVF IS AN EFFECTIVE ALTERNATIVE TO

CYCLE CANCELLATION
K. Shrimali1, H. Kalra2, R. Salve2
1
Nova IVI Fertility Clinic, IVF Consultant, indore, India
2
NOVA IVI Fertility Clinic, Embryology, Indore, India
To determine whether conversion of high response gonadotropin IUI cycles to IVF yields a
higher implantation and pregnancy rates as found in matched IVF controls
Method
Design : A retrospective Controlled Study

Setting : Nova IVI Fertility Clinic , India
Patient (s) : 170 patients switched from high response gonadotropin IUI cycle to IVF , out of
4225 IVF cycles from 2013-2016
Intervention(s)- High response Gonadotropin IUI cycles were converted to IVF to avoid cycle
cancellation and high order multiple pregnancies
Results
The pregnancy rate was similar to matched IVF controls. Implantation rates were also similar
to the matched IVF controls.
Conclusion
Our study demonstrates that conversion of gonadotropin IUI cycles in patients with
excessive follicles to IVF is a safe effective strategy.
ASPIR-0160
IMPACT OF DOMINANT FOLLICLE DIAMETER AT OOCYTE RETRIEVAL ON THE

TREATMENT OUTCOME
C. Heshiki1, K. Mekaru1, Y. Shimoji1, S. Oishi1, K. Akamine1, Y. Aoki1
1
University of the Ryukyus., Obstetrics and Gynecology, Nishihara-cho, Japan
In IVF-ET, performing oocyte retrieval when the dominant follicle diameter reaches 18mm
has generally been accepted prior to the introduction of GnRH analogue. This criterion
should be reevaluated because controlled ovarian stimulation protocols have remarkably
changed. We evaluated the impact of dominant follicle diameter at oocyte retrieval on the
treatment outcome.
Method
For both controlled ovarian stimulation (COH: GnRH antagonist, GnRHa short) and mild
ovarian stimulation (Mild: clomiphene citrate), dominant follicle diameter was classified as
three groups; <18mm (COH n=11; Mild n=54), 18–21mm (COH n=78; Mild n=42), and
≥22mm (COH n=6; Mild n=2). Treatment outcomes were analyzed retrospectively.
Results
In COH, the number of oocytes retrieved (12±9.9) and embryos produced (7±6.9) were
significantly higher in the 18–21mm group than either the <18mm (5±5.8 and 3±3.8,
respectively) or the ≥22mm groups (8.5±10.6 and 4±7.9, respectively) (p=0.006 and 0.021,
respectively). In Mild, there were no significant differences in the number of oocytes
retrieved, matured oocytes, or embryos in the three groups. In 167 cycles of completed
embryo transfer, clinical pregnancy rates for COH and Mild protocols were 25% vs. 13.9% in
the <18mm group, 26.2% vs. 16.7% in the 18–21mm, and 50% vs. 0% in the ≥22mm
groups. None of the differences were significant.
Conclusion
In COH, significantly more oocytes were retrieved and embryos produced in the 18–21mm
group, which was not the case in Mild protocol. Clinical pregnancy rates of three groups
were comparable in both protocols. Dominant follicle diameter at oocyte retrieval therefore
may not impact the treatment outcome.
ASPIR-0189
ELECTIVE SET - BOON FOR THE HIGH RISK- CASE REPORT OF LIVE BIRTH
FOLLOWING SET IN PATIENT WITH IDDM AND PANCREATIC FAILURE FOLLOWING
FREY’S PROCEDURE.
M. Kaur1, M. Banker2
1
NOVA IVI, Reproductive Medicine, Jalandhar, India
2
NOVA IVI, Reproductive Medicine, Ahmedabad, India
To understand the role of SET in patients with high risk conditions. Frey's procedure is used
in management of chronic pancreatitis. Diseased portion of pancreatic head is cored and
lateral pancreatico-jejunostomy is performed in which a loop of the jejunum is mobilized and
attached over exposed pancreatic duct. Pancreatic insufficiency occurs in 60% of such
patients. Multiple pregnancies and OHSS in such cases can add fuel to fire.
Method
27 year patient reported in OPD with unexplained infertility for 5 years. She had a history of
chronic pancreatitis and Frey’s procedure done 2 years back. She had 3 TI (timed
intercourse), and 3 IUI done already at some other centre. She was on pancreatic enzyme
supplements and recently diagnosed to have insulin dependent diabetes mellitus (IDDM)
due to pancreatic insufficiency. A small polyp was removed hysteroscopically and her
glycemic control was made stricter before stimulation. Her stimulation was uneventful and 16
oocytes were retrieved, 15 M2, 10 fertilized and 8 day 3 embryos were obtained. Single
embryo was transferred and 7 were frozen. She had multiple hospital admissions for pain
abdomen and was conservatively managed. An elective Caesarean section was carried out
at 36 weeks and an alive male baby was delivered.
Results
A good cryopreservation programme, selection of the best embryo, elective SET along with
combined efforts of endocrinologist and a high risk obstetrician can help achieve the target
of a single healthy baby.
Conclusion
Elective SET should be considered as a useful tool to prevent complications in high risk
medical conditions.
ASPIR-0194
PROTECTION OF CUMULUS CELLS FOLLOWING DEHYDROEPIANDROSTERONE

SUPPLEMENTATION
L.T. Lin1, P.H. Wang2, S.N. Chen1, C.J. Li3, Z.H. Wen4, J.T. Cheng5, K.H. Tsui1
1
Kaohsiung Veterans General Hospital, Obstetrics and Gynecology, Kaohsiung,
Taiwan R.O.C.
2
Taipei Veterans General Hospital, Obstetrics and Gynecology, Taipei, Taiwan R.O.C.
3
National Cheng Kung University, Institute of Clinical Medicine, Tainan, Taiwan R.O.C.
4
National Sun Yat-sen University, Marine Biotechnology and Resources, Kaohsiung,
Taiwan R.O.C.
5
National Sun Yat-sen University, Biological Science, Kaohsiung, Taiwan R.O.C.
Growing studies have demonstrated that dehydroepiandrosterone (DHEA) may improve

fertility outcomes in poor ovarian responders (PORs). The aim of this study was to compare
clinical outcomes and cumulus cell (CC) expression before and after DHEA treatment in
PORs undergoing in vitro fertilization (IVF) cycles.
Method
Six patients with poor ovarian response were enrolled in the study according to Bologna
criteria. DHEA was supplied at least 2 months before patients entered into the next IVF
cycle. Expression of apoptosis-related genes in CCs was determined by quantitative real-
time PCR. Mitochondrial dehydrogenase activity of CCs was assessed by cell counting kit-8
assay.
Results
Metaphase II oocytes, maturation rate, embryos at Day 3, and fertilization rate significantly
increased following DHEA treatment. Expression of cytochrome c, caspase 9, and caspase
3 genes in CCs were significantly reduced after DHEA therapy. Additionally, increased
mitochondrial activity of CCs was observed following DHEA supplementation.
Conclusion
DHEA supplementation may protect CCs via improved mitochondrial activity and decreased
apoptosis, leading to better clinical outcomes in PORs.
ASPIR-0198
EFFECT OF ESTRADIOL LEVEL BEFORE HCG ADMINISTRATION ON PREGNANCY

OUTCOMES IN FRESH IVF/ICSI CYCLES
S. Xuejiao1, Q. Kun1
1
Tongji Hospital- Tongji Medical College- Huazhong University of Science and Tech,
Reproductive Medicine Center, Wuhan, China
The impact of high estradiol before administration on IVF outcomes was controversial.The
objective of this retrospective study was to evaluate the effect of estradiol (E2) level before
HCG administration on pregnancy outcomes in fresh IVF/ICSI cycles with gonadotropin-
releasing hormone agonist protocols.
Method
Total 5233 infertile women aged≤35 years who underwent first IVF/ICSI cycle were assigned
to four groups according to estradiol level: group1 E2＜3000pg/ml; group2 3000≤E2＜
5000pg/ml; group3 5000≤E2＜7000pg/ml; group4 E2≥7000pg/ml. The primary outcome was
live birth rate.
Results
No significant differences were found in the live birth rate(45.6% vs 47.8% vs 48.4% vs
47.1%, P＞0.05 ), implantation rate(39.6% vs 41.3% vs 42.2% vs 42.6%, P＞0.05),
biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate and
miscarriage rate(P＞0.05). Logistic analysis also suggested estradiol was not an
independent prognostic factor for live birth rate (P=0.16).
Conclusion
In conclusion, high estradiol level didn’t have negative effect on the pregnancy outcomes in
women aged≤35 years who underwent first IVF/ICSI cycle.
ASPIR-0199
A 3 YEAR RETROSPECTIVE ANALYSIS OF OVULATION STIMULATION WITH

LETROZOLE IN WOMEN UNDERGOING ARTIFICIAL INSEMINATION BY DONOR
S. Xuejiao1, Q. Kun1
1
Tongji Hospital- Tongji Medical College- Huazhong University of Science and Tech,
Reproductive Medicine Center, Wuhan, China
The objective of this retrospective study was conducted to determine the clinical pregnancy
outcome in women with letrozole ovarian stimulation in artificial insemination by donor (AID).
Method
n this study, 939 letrozole cycles and 130 letrozole plus gonadotropin cycles were included
from 2012 to 2015. Letrozole cycles were divided into three groups by luteinizing hormone
before human chorionic gonadotropin administration: group 1, patients who had LH＜10
mIU/ml with follicle size≥18cm; group 2, patients with LH levels between 10 and less than 20
mIU/ml; group 3, patients with LH≥20 mIU/ml.
Results
The clinical pregancy rate (PR) were 17.3%, 22.4% and 26.8% in three groups respectively
(P=0.012). In LH≥10 mIU/ml group, logistic regression identified estradiol (OR=1.002,
95%CI, 1.000-1.004, P=0.026) and leading follicle size (OR=0.859, 95%CI, 0.770-0.958,
P=0.006) as significant predictive factors of PR; the higher the estradiol and the smaller the
follicles size, the better the PR. The PR was significantly higher in letrozole plus
Gonadotropin group than letrozole group (P=0.04).
Conclusion
In conclusion, better PR can be achieved if LH surge occurs before HCG administration,

especially with higher estradiol and lower follicle size; treatment with LE plus Gn was
significantly more effective than letrozole alone in AID.
ASPIR-0201
THE QUALITY OF OOCYTES IN POLYCYSTIC OVARIAN SYNDROME (PCOS) IS

SUPERIOR TO OTHER INDICATIONS IN TAIWANESE WOMEN UNDERGOING IN VITRO
FERTILIZATION (IVF)
C.W. Chen1, S.J. Tan1, C.H. Chen1, C.R. Tzeng1
1
Taipei Medical University Hospital, Center for Reproductive Medicine, Taipei,
Taiwan R.O.C.
Poor oocyte quality has been demonstrated in Caucasian PCOS patients. In this study, we
aim to investigate the oocyte quality in Taiwanese PCOS patients.
Method
A retrospective comparative study recruiting oocyte-retrieval cycles between January 2014

and December 2014 in center for reproductive medicine in a university hospital.
Results
A total of 95 patients were enrolled into the PCOS group according to the Rotterdam criteria.
Another 220 age-matched infertile patients with tubal factor were enrolled as the control
group. The level of Anti-müllerian hormone (AMH) and the number of oocytes retrieved in
the PCOS group were significantly higher (12.4±1.4 ng/ml vs. 4.1±0.4 ng/ml, p<0.001 and
17.3±0.9 vs. 10.5±0.5, p<0.0001, respectively), while the percentage of MII oocytes was
similar between the two groups (67.6±2.2% vs. 68.1±1.7%, P>0.05). The PCOS group also
yielded significantly higher number of embryos (11.5±0.7 vs. 7.0±0.3, P<0.001), while the
percentage of grade 1 blastomere was similar compared to controls (21.6±2.3% vs.
24.9±1.8%, P>0.05). In fresh embryo transfer, the PCOS group had a significantly higher
implantation rate (26.3% vs. 18.7%, P=0.026) and live birth rate (45.0% vs. 29.9%,
P=0.017). The implantation rate and live birth rate of frozen-thawed embryo transfer
remained identical between the two groups (16.3% vs. 14.5%, P>0.05 and 32.0% vs. 26.2%,
P>0.05, respectively). The accumulative live birth rate was significantly higher in the PCOS
group (46.3% vs. 31.4%, P=0.011).
Conclusion
Taiwanese PCOS patients had superior implantation rates and live birth rates compared to
patients with tubal factor. PCOS does not compromise the quality of oocytes in Taiwanese
population.
ASPIR-0203
HIGH FLEXIBILITY IN RANGES OF ENDOMETRIAL THICKNESS ACHIEVED AND

DURATION OF ESTROGEN PRIMING BEFORE PROGESTERONE ADMINISTRATION
FOR ARTIFICIAL ENDOMETRIAL CYCLES PREPARED FOR FROZEN-THAW EMBRYO
TRANSFER
M.J. Chen1, H.F. Guu2, Y.F. Chen-2, Y.C. Yi2, H.F. Kung2, J.C.C. Jui-Chun Chang2,
L.Y. Chen2, M.M. Chou3
1
Taichung Veteran General hospital,
Division of Reproductive Endocrinology and Infertility- Department of Obstetrics and Gynecol
ogy and Womens’ Health, Taichung, Taiwan R.O.C.
2
Taichung Veterans General Hospital,
Division of Reproductive Endocrinology and Infertility- Department of Obstetrics and Gynecol
ogy and Womens’ Health, Taichung, Taiwan R.O.C.
3
Taichung Veterans General Hospital,
Department of Obstetrics and Gynecology and Womens’ Health, Taichung, Taiwan R.O.C.
Until recently, there is still uncertainty about how to best prepare for FET although various
methods appear to be equally successful. We are interested in the effect of the EM thickness
and the duration of EM priming by estrogen on the final pregnancy outcome in our
programmed FET cycles.
Method
A retrospective analysis of our ART database on FET cycles (n= 405) between Jan, 2015
and March, 2016. Of all the 405 FET cycles performed in Center for Reproductive Medicine,
Taichung Veterans General Hospital in this period, 211 D5 blastocyst thawed ET cycles
prepared by programmed estrogen-progesterone treatment comprised the study group. The
EM thickness achieved by the oral Estradiol and the total duration of this Estradiol priming
were analyzed and correlated with their respective pregnancy outcome. Statistical analysis
was carried out by SPSS-PC ver.18.0 with p<0.05 as statistical significance.
Results
Conclusion
Satisfactory clinical pregnancy and live birth/ on-going pregnancy rates could be achieved by
a wide range of endometrial thickness achieved and duration of estrogen priming for the
programmed hormonal treatment cycles prepared for frozen-thaw blastocyst transfer.
ASPIR-0216
FACTORS RELATED TO CUMULATIVE CLINICAL PREGNANCY OUTCOMES OF IN

VITRO FERTILIZATION-EMBRYO TRANSFER IN WOMEN MORE THAN 35YEARS OLD
X. La1, M. Zhang1
1
The First Affiliated Hospital Of Xinjiang Medical University, Reproductive Medicine Center,
Urumqi, China
We aimed to investigate the factors related to cumulative clinical pregnancy outcomes of

in vitro fertilization-embryo transfer (IVF-ET) in women more than 35 years old with normal
ovarian response, the factors are unclear and there is not enough research to study this
issue.
Method
The clinical, laboratory and follow-up data of 358 cycles undergoing IVF-ET between
January 2014 to March 2016 were retrospectively reviewed. The factors related to
pregnancy outcomes were analyzed by Cox regression methods. The relationship between
cumulative pregnancy probability per ovarian stimulation cycle and the number of embryos
required to reach clinical pregnancy were analyzed by survival curves and Kaplan-Meier
methods.
Results
Multivariate analysis showed that maternal age, number of oocytes retrieved and duration
of stimulation were the independent factors for cumulative clinical pregnancy outcomes of
IVF-ET. Compared with woman aged between 35-37 years, the woman aged more than 40
years old had lower cumulative clinical pregnancy rate(HR=0.407,95%CI:0.177-0.937,
P=0.035),while there was no significant difference in woman aged between 38-40 years old
(HR=0.976,95%CI:0.696-1.367, P=0.886). Compared with woman with 4-15 oocytes
retrieved, the woman with more than15 oocytes retrieved had higher cumulative clinical
pregnancy rate (HR=1.417,95%CI:1.001-2.006, P=0.049).
Conclusion
Maternal age ,number of oocytes retrieved and duration of stimulation were the
independent factors for cumulative clinical pregnancy outcomes of IVF-ET. There was no
differences in the cumulative probability of clinical pregnancy by using GnRH agonist long
protocol or GnRH antagonist protocol, with the increasing of the number of embryos
transferred, the cumulative probability of clinical pregnancy increased.
ASPIR-0218
PREGNANCY OUTCOME AFTER BLASTOCYST TRANSFER VERSUS CLEAVAGE

STAGE EMBRYO TRANSFER
X. Wang1, M. Du1, Q. Jia1, X. Chen1
1
The Third Affiliated Hospital of Zhengzhou University, Reproduction Center Department,
zhengzhou, China
The transfer of cleavage stage embryo transfer is more popular than the transfer of
blastocyst. So the present study aims to compare which one has a better pregnancy
outcome.
Method
In this cohort studies, a total of 13658 cycles performed with IVF/ICSI at a single center in
Zhengzhou, China. All patients accept the transfer of blastocysts (n=2116) or cleavage stage
embryos (n=11542) during the period January 2008 to August 2015. The most important
outcome is the live birth rate.
Results
The pregnancy after the transfer of blastocyst is associated with a better pregnancy outcome
compared with those resulting from the transfer of cleavage stage embryos. Blastocyst
transfer resulted in a higher frequency of clinical pregnancy rate than cleavage stage embryo
transfer (63.4% vs 44.5%; P<0.001). And they also have a high live birth rate (46.0% vs
34.8%; P<0.001).But patients who undergo blastocyst transfer have a high frequency of
abortion rate (10.2% vs 7.4%; P<0.001).
Conclusion
The patients who undergo blastocyst transfer have a higher rate of live birth rate and clinical
pregnancy rate. But they also have a higher risk of abortion.
ASPIR-0219
APPLICATION OF A QUANTITATIVE ASSAY FOR URINARY LUTEINIZING HORMONE

(LH) TEST IN OVULATION MONITORING
S. li1, L. Hu1
1
The Second Affiliated Hospital of Chongqing Medical University,
Reproductive Medicine Center- Department of Gynaecology and Obstetrics, Chongqing,
China
A study was performed to evaluate conditions in predictions of ovulation with quantitative

urinary luteinizing hormone (LH) tests and APP (a soft ware) by a quantitative
chromatography.
Method
a toIial of 169 cycles in 163 infertile patients were determined.The follicular development and
ovulation were monitored by B-mode ultrasonography. At the same time, urinary LH level
were determined dynamically by quantitative urinary LH test and APP.
Results
1) A well-defined LH peak was measured in the urine from 147 of total 169 circles. The
correct rate for the predictions of ovulation occur with qualitative urinary LH tests was up to
91.16% (134/147).
2) All the ovulation occurred within 24 hours of the peak.There were 61 circles with the
follicle diameter less than 18mm and 73 more than 18 mm before ovulation. However, there
is no significant difference (P<0.05) with the urinary LH peak between them.
3) In the anovulatory cycles, Luteinized Unruptured Follicle Syndrome (LUFS) cycles have
the urinary LH peak appearing with a slowly rising and declining parabola type,
and Polycystic Ovarian Syndrome (PCOS) cycles have no urinary LH peaks with the basal
of urinary LH level from 5 to17 mIU / ml.
Conclusion
The quantitative urinary LH test and APP have a good accuracy in the prediction of ovulation
and ovulation times. The dynamic changes of LH levels in urine are helpful for the diagnosis
for ovulation disorders. We concluded that this assay is a reliable, rapid and readily
acceptable method for measuring urinary LH and for the prediction of ovulation.
ASPIR-0224
ANTI-MULLERIAN HORMONE LEVELS AS A PREDICTOR OF PREGNANCY IN IN-

VITRO FETERLIZATION/INTRACYTOPLASMIC SPERM INJECTION-EMBRYO
TRANSFER CYCLES IN PATEINTS OF AGE 40-43
P. Lin1, C.R. Tzeng2
1
Yuan’s General Hospital- Kaohsiung, Department of Obstetrics and Gynecology,
Kaohsiung, Taiwan R.O.C.
2
Taipei Medical University Hospital, Center for Reproductive Medicine, Taipei,
Taiwan R.O.C.
In spite of the clear correlation between AMH and ovarian response to COS, the role of AMH
as a predictors of IVF result is still debated. The aim of this study was to determine the
predictive value of anti-mullerian hormone (AMH) levels for pregnancy outcome in patient of
age over 40s group who underwent in IVF/ICSI-ET cycles.
Method
We retrospectively analyzed the medical records of 1285 IVF/ICSI-fresh ET cycles in the

infertility center of TMUH during 2015.Patients were divided into group A, with AMH levels <
1.0 ng/ml (n=273); group B, with AMH level 1-1.9 ng/ml (n=297); group C, with AMH level 2-
3.9 ng/ml (n=395); group D, with AMH 4-7 ng/ml (n=215); group E, with AMH level≧7 ng/ml
(n=105). We compared the IVF results (retrieved oocytes, PR/ET, abortion rate) of each
groups. We also analyzed of the pregnancy outcome in women of age 40-43.
Results
Among those who reached ET, age significantly affected the success rate : despite
comparable AMH levels. In group A, patient below 35 years with AMH <1 ng/ml obtained
significantly more oocytes and a better pregnancy rate (PR/ET) than patients aged 35-39 or
40-43 ( 39.2 % vs. 32.0 % vs. 14.8 %, respectively; p<0.001).In age 40-43, women with
AMH≧1 had significantly higher pregnancy rate (25% vs. 14.8%).
Conclusion
Women with higher AMH level could predict better IVF outcome in age 40-43.Women with
AMH ≧1 could have around 2 times change to have pregnancy than women with AMH<1.
ASPIR-0245
GROWTH HORMONE SUPPLEMENTATION IMPROVES ENDOMETRIAL RECEPTIVITY

FOR POOR-PROGNOSIS PATIENTS UNDERTAKING IN VITRO FERTILIZATION
K.C. Lan1, P.Y. Lin1, Y.C. Chang1, H.Y. Kang1
1
Chang Gung Memorial Hospital- Kaohsiung Medical Center and College of Medicine-,
Obstetrics and Gynecology, Kaohsiung, Taiwan R.O.C.
Growth hormone (GH) supplements have been shown to improve pregnancy and live-birth
rates—thus speaking for an effect on oocyte quality, but the impacts of GH on the
implantation or endometrial effect remain unknown. The objective of this study was to
evaluate the efficacy of GH in assisted reproductive technology (ART) participants of ≥40
years of age, especially endometrial implantation effect.
Method
Cycles of IVF/ICSI-ET in women aged ≥ 40 years conducted between January 2009 and
December 2013 at a university-based reproductive center were reviewed retrospectively.
Infertile women were divided into two groups: with and without growth hormone co-
stimulation group. The effects of GH treatment on the expression levels of implantation
biomarkers in the endometrial stromal cell line T-HESC cells were determined by reverse-
transcription polymerase chain reaction RT-PCR). Mouse blastocysts were co-cultured with
GH-treated T-HESCs cells, the outgrowth of and total area of embryo spreading was
determined from vimentin-stainning were photographed and analyzed.
Results
In this study, we collected 161 and 148 cycles with and without GH supplementation,
respectively. There were significantly associated with favorable endometrial ultrasonographic
(a multilayered ‘triple-line’) pattern in GH stimulation group. Moreover, we found that the
growing doses of GH treatment increase a trend of leukemia inhibitory factor (LIF), and
colony-stimulating factor–1 (CSF-1), interleukin-1 receptor type I (IL-1RtI) and Integrin B3
expression. Besides, GH-treated T-HESCs promote mouse embryos implantation and
invasion potential.
Conclusion
GH supplements may improve embryos implantation

ASPIR-0248
DOES “FREEZE ALL” POLICY GET BETTER OUTCOME IN ASSISTED

REPRODUCTIVE TECHNIQUES THAN FRESH EMBRYO TRANSFERS?– A
RETROSPECTIVE STUDY ON CUMULATIVE LIVE BIRTH RATES
J.C. Chang1
1
Taichung Veterans General Hospital- Taiwan, Dept. of OBGY, Taichung City,
Taiwan R.O.C.
There are increasing concerns about the adverse effects associated with COH over the
endometrial and uterine environments. With the segmentation of ART, endometrial problems
may be obviated by embryo cryopreservation. However, it remains unclear if freeze-all policy
gets better outcome compared with fresh ET. To clarify this, here we compared the
cumulative live birth rates (CLBRs) between these two populations of patients.
Method
This is a retrospective study on 853 patients undergoing COH and ART (including IVF/ICSI)
during Jan 2012 to Jun 2014 in Taichung Veterans General Hospital, Taiwan, ROC. We
followed up these patients up to Jan 2016. Patients whose embryos were either not
completely transferred back were excluded. The study group ('freeze-all') had 84 patients
whose cycles were performed initially without fresh ET but were later given frozen-thawed
ET. The control group (fresh ET) had 625 patients whose cycles were performed with fresh
ET followed by frozen-thawed ET. Basic parameters and CLBRs were statistically compared
between these two groups.
Results
The CLBR in the study group was significantly higher than the control group (64.3% vs.
45.8%, p=0.001). Subgroup analysis revealed that when the number of OPU is 4 ~15, the
CLBR in the study group was significantly better (58.3% vs. 40.9%, p = 0.042). For those
OPU < 4 or OPU >15 the CLBRs were similar in these two groups. (OPU < 4: study vs.
control 23.1% vs. 18.8%, p=0.713; OPU>15: study vs. control 85.7% vs. 80.8%, p= 0.625)
Conclusion
Freeze-all policy did improve ART outcome in normal responders.

ASPIR-0250
ELONVA FLARE: A NEW APPROACH FOR POOR RESPONDERS

P. Atkinson1, P. Lutjen2, P. Sweeten1,3, H. Wand4, N. Khoo1, X. Wang1, W. Ledger1,3
1
University of New South Wales, Discipline of Obstetrics & Gynaecology, Randwick,
Australia
2
IVF Monash, Reproductive Medicine, Cheltenham, Australia
3
IVF Australia, Reproductive Medicine, Sydney, Australia
4
University Of New South Wales, The Kirby Institute, Randwick, Australia
We hypothesize that the unique pharmacodynamic properties of Elonva when used in a

short agonist flare cycle (Elonva Flare Protocol, EFP) will maximise FSH exposure during
antral follicle recruitment, increasing oocyte yield and possibly improving pregnancy rates in
poor responders to conventional FSH stimulation.
Method
This retrospective study included 56 poor responder patients, defined by the “Bologna
Criteria” and also who had previously yielded a poor ovarian response and no pregnancy
after conventional superovulation. Patients were treated with a short-acting GnRH agonist on
day 2 of natural menses followed by Elonva on day 3. Daily gonadotropin injections were
started on D7/8 after Elonva, with dosing decided by the managing physician. Cycle data
were compared with the response to the most recent previous IVF cycle and results were
divided by age: < 40 or 40 and over. Clinical pregnancy was defined as presence of a fetal
heartbeat at 6-8 weeks gestation. Outcome variables were analysed by paired t-test.
Results
Median age was 40 years (IQR : 37-40). 7 out 56 (13%) of the women had an ongoing
pregnancy with EFP. Compared with the immediate previous IVF cycle, EFP was associated
with a statistically significant increase in mean number of oocytes collected (0.73 more eggs,
p= 0.047) and median peak oestradiol concentration (2680pmol/L vs 2123pmol/L, p= 0.040).
75% (15/20) of those who had no oocytes in their previous cycle had at least 1 oocyte in the
EFP cycle. The differences were more pronounced in younger patients.
Conclusion
These results now require validation in a RCT.

ASPIR-0270
CLINICAL APPLICATION OF AUTOLOGOUS MENSCS COMBINED WITH PLATELET-

RICH PLASMA FOR ENDOMETRIAL REGENERATION
T. Jichun1
1
Shengjing Hospital Affiliated to China Medical Unversity,
Reproductive Center of Obstetrics and Gynecology Department, Shenyang, China
Previously, autologous menSCs was cultured from menstrual blood of 7 patients with severe
intrauterine adhesions (IUA), and transferred back to their worms. The endometrium
thickness (ET) of these women was significantly increased, and 3 of them had conceived
successfully. Besides, platelet-rich plasma (PRP) promoted MenSCs proliferation in vitro,
which implies the auxillary effect of PRP. These results indicate that autologous MenSCs
combined with PRP transplantation will be an effective remedy for refractory endometrial
damage. In this study, we aim to testify the efficacy of this therapy
Method
Infertile women, aged 20-40 years, with severe IUAs were recruited but subjects with acute
urogenital infection, combined with other genital disease including hysteromyoma,
adenomyosis, hydrosalpinx or body disease that could not bear pregnancy were excluded.
Patients were randomly assigned to MenSCs transplantation group or MenSCs+PRP
transplantation group. After transplantation, endometrium thickness (ET) was Intermittently
monitored, and frozen embryo transfer was conducted when ET>7 mm with pregnancy
followed up
Results
So far, 4 severe IUA patients accepted autologous MenSCs combined with PRP
transplantation, 1 ET significantly increased to 8 mm within 3 weeks. The growth speed of
ET in MenSCs+PRP group seems to be faster than the MenSCs group, which needs to be
validate in further study.
Conclusion
Combination of PRP may promote the function of MenSCs in regeneration endometrium of

IUA patients. The molecular mechanism should be explored in animal model for clinical
application of this therapy.
ASPIR-0271
THE DIFFERENCE OF SERUM AMH IN PATIENTS WITH SECONDARY

OLIGOAMENORRHEA
Z. Jingjing1
1
Henan, Zhengzhou, Zhengzhou, China
Antimullerian hormone (AMH) is a polypeptide of the transforming growth factor b family

secreted solely by granulosa cells of the preantral and small antral ovarian follicles up to 9
mm , and its level in serum shows little fluctuation through the menstrual cycle. The purpose
of the research is to compare the difference of serum antimullerian hormone (AMH) in
patients with common causes of secondary oligoamenorrhea.
Method
DESIGN: Retrospective analysis.
MATERIALS AND METHODS: A total of 538 patients with secondary oligoamenorrhea

(include 315 PCOS and 223 POI) and 142 women with normal ovulation (control group)from
Jun 2015 to May 2016 in Reproductive Endocrinology Clinic of The Women and Infants
Hospital of Zhengzhou. Serum samples from the subjects were analyzed for basal AMH.
Results
Serum AMH concentration was significantly raised in women with PCOS (8.40 ± 4.36ng / ml)
which was 2.8 times higher than that in the normal control group, and was significantly
decreased to low levels in POI (0.97 ± 1.63ng / ml) which was one-third of the control group.
Conclusion
In the diagnosis and treatment of patients with secondary oligoamenorrhea, serum AMH can
be used to evaluate ovarian reserve function.
ASPIR-0279
THE INFLUENCE OF ADMINISTERED LUTEINIZING HORMONE-TO-FOLLICLE-

STIMULATING HORMONE GONADOTROPIN RATIOS DURING OVARIAN
STIMULATION ON IVF OUTCOME
J.C. Chang1
1
Taichung Veterans General Hospital- Taiwan, Dept. of OBGY, Taichung City,
Taiwan R.O.C.
There are increasing evidences confirm that late follicular elevations in P during IVF
stimulation predict suboptimal outcomes after fresh ET. This study is to determine whether
different ratios of administered LH-to-FSH influence the risk of late follicular P elevations and
whether it influence pregnancy outcome in fresh ET cycles.
Method
This is a retrospective study on patients (n=970) undergoing COH and IVF/ICSI between
Jan, 2013 and April, 2015. Patients whose protocol used GnRH antagonist and stimulation
days more than five days were selected. Those cycles using microdose flare-up, GnRH
agonist, two-step protocols or using Elonva were excluded. There were total 554 cycles
stratified based on the total ratio of exogenous LH to exogenous FSH used, ratio ≤ 0.25,
ratio = 0.25~0.5 and ratio >0.5.
Results
The risk of premature rise in P (P>1.5 on trigger ovulation day) was significantly higher in
cycles with LH/FSH ration ≤0.25 (15%, 7.7% and 3.5% in LH/FSH ≤ 0.25, 0.25~0.5 and >0.5
(P=0.023)). The same results were noted in age >38 years-old patient (37.5%, 7.3% and
3.9% (P=0.004)). The pregnancy rate and live birth rate were not significantly different in
these three groups.
Conclusion
LH/FSH was not associated with pregnancy outcome, probably because we had chosen
those cycles with P>1.5 not to have fresh ET. But it does increase the risk of premature rise
of P. Therefore, if fresh ET will be performed, provide an appropriate amount of exogenous
LH in stimulation is needed to avoid the risk of PPR especially in patients older than 38
years-old.
ASPIR-0280
IN VITRO FERTILIZATION AND EMBRYO TRANSFER PRECEDED BY SOLE

ADMINISTRATION OF LONG TERM GNRHA FOR OVARIAN STIMULATION: 8 CASES
REPORT
C. Zhaoxia1, C. Ying1, Q. Wenyu1
1
Shenyang Women and Children‘s Hospital, Reproductive Center, Shenyang, China
The application of GnRHa is the milepost in the development process of ovulation

stimulation,desensitization of the hypothalamic pituitary that blocked the premature LH
surge,resulting in high synchrony of the maturing follicles to achieve the trigger ovulation.
Before to achieve complete downregulation, cause of the initial flare-up following GnRHa
some patients may develop ovarian cysts, the common approach with these “by-product”
were to suction the ovarian cysts then go on downregulation. The analysis on cases of 8
ovarian cysts and IVF–embryo transfer patients after using sole administration of long term
GnRHa and 4 of the patients conceived in our department is as follows.
Method
Retrospective analysis the clinical data which were developed ovarian cysts and IVF–
embryo transfer after using sole administration of long term GnRHa in
our department between June 2012 and December 2012.
Results
All of 8 patients obtained high-quality embryos,and 4 of the patients conceived.
Conclusion
Patients who were developed ovarian cysts and directly IVF–embryo transfer after using
sole administration of long term GnRHa may obtain good ending,which provide new ideas
for the individual ovulation stimulation.
ASPIR-0297
POSSIBILITY OF SPONTANEOUS NATURAL PREGNANCY OF 2.5% AFTER FAILED

ART TREATMENT
S. Hanafiah1, S. Mahfudzah1, H. Tarmizi1, S.K. idris1, N. Razali1, M. Hamdan1, J. Ali1
1
UM Fertility Centre, Department of Obstetrics and Gynaecology, Kuala Lumpur, Malaysia
To report 3 instances of spontaneous natural pregnancies post failed ART treatment in

patients that has been childless for many years.
Method
Three couples sought treatment for subfertility. All three patients had failed IUI and ART
treatments for childlessness of 2 to 11 years duration. It is interesting that all three patients
became spontaneously naturally pregnant after these failed IUI and ART treatments.
Results
Case 1:
A 32yrs old patient, been childless for 10yrs was treated by IUI (twice) and cIVF-ICSI (twice)
[1st cycle :3cell with apoptosis noted on day3, no transfer done. 2nd cycle: 4cell grade 2-3
and 6cell grade 2-3 on day2 transfered ] all failed. Her husband was oligospermic. She
became pregnant 3 months after the last ART treatment spontaneously. Pregnancy is on-
going.
The second patient (28yrs old) suffering from primary unexplained infertility was childless for
2yrs failed cIVF-ICSI twice although quality embryos were transferred [ 1st cycle:6cell grade
4-3 ,4cell grade 3; 2nd cycle : 5cell grade3-4, 4cell grade 3-4, 4cell grade 4-3 on day 2] but
conceived spontaneously 7 months after the last ART treatment.
Third, a 35yrs old patient with 11yrs history of infertility due to recurrent miscarriages was
treated once by combined cIVF-ICSI (5cell grade 4-3 and 6cell grade 3-4 on day2) but failed.
She conceived spontaneously 10 months after treatment. A baby girl was delivered in
November 2014.
Conclusion
This case series and previous reported and unreported elsewhere of similar instances of
pregnancies post failed ART treatments suggest that the opportunity for spontaneous
pregnancy is approximately 2.5%.
ASPIR-0298
CASE REPORT: CRITICAL OVARIAN HYPERSTIMULATION SYNDROME (OHSS) WITH

MASSIVE PLEURAL EFFUSION FOLLOWING GNRH AGONIST TRIGGER
D. Rahayu1, G. Pratama2
1
Indonesian Reproductive Medicine Research and Training Centre,
Department of Obstetrics and Gynecology- Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia
2
Division of Reproductive Endocrinology and Infertility,
Department of Obstetrics and Gynecology- Faculty of Medicine Universitas Indonesia- Dr. Ci
pto Mangunkusumo General Hospital, Jakarta, Indonesia
Ovarian hyperstimulation syndrome (OHSS) is a life threatening complication of ovarian

stimulation. Renal dysfunction, thrombosis, cerebral infarcts and adult respiratory distress
syndrome (ARDS) are the leading causes of morbidity and mortality in severe cases. Here,
we report a case of critical OHSS with massive pleural effusion causing ARDS.
Method
Case Presentation
A 31-year-old woman with 6 years of primary infertility and polycystic ovarian syndrome
(PCOS) underwent a short protocol IVF program in Yasmin Clinic, Dr. Cipto Mangunkusumo
Kencana Hospital, Jakarta, Indonesia. Agonist GnRH (buserelin acetate, 0.5 mg) was used
to trigger oocyte maturation. 30 oocytes were retrieved and 9 blastocysts were developed.
All embryos were cryopreserved to avoid OHSS. Dopamine agonist (cabergoline 0.25 mg)
was given for 7 days. 5 days after oocyte retrieval, the patient presented with abdominal
pain, dyspnea and ascites. Massive pleural effusion was diagnosed from chest X-ray.
Patient was treated in high care unit, water-sealed tube thoracostomy was performed to
drainage the pleural fluid. Patient was hospitalized for 2 weeks until the production of the
pleural effusion ceased.
Results
Conclusion
Discussion and Conclusion
GnRH agonist has been shown to effectively induce oocyte maturation and recommended
as a strategy for reducing the risk of severe OHSS in hyper-responder patients. In this case,
despite proper prevention, a critical OHSS was occurred. Early recognition of OHSS
symptoms should be performed to all patients at risk. Critical OHSS patient must be treated
in high care unit with multidisciplinary management. If left untreated, OHSS can result in
serious complications and even death.
ASPIR-0318
EMBRYO CRYOPRESERVATION BEFORE SURGERY (ECBS) FOR INFERTILE WOMEN

IN THEIR LATE REPRODUCTIVE AGE: A STRATEGY TO MINIMIZE THE EFFECT OF
OVARIAN AGING
A. Takayanagi1, M. Harada1, R. Tanabe1, G. Izumi1, N. Takahashi1, N. Oi1, M. Hirano1,
M. Kanatani1, N. Yamamoto1, R. Tsutsumi1, T. Hirata1, T. Fujii1, Y. Osuga1
1
The University of Tokyo, Obsterics and Gynecology, Tokyo, Japan
Enucleation of uterine fibroids (UF) causing deformity of uterine cavity is recommended for
women with infertility. Myomectomy prior to the infertility treatment causes approximately a
half year of delay of starting the treatment, given the periods of GnRH agonist treatment
before surgery and of contraception after surgery. The delay has an impact in decreasing
ovarian reserve of women in late reproductive age. To compensate the impact associated
with myomectomy, we propose a novel approach combined with ART and myomectomy,
Embryo Cryopreservation before Surgery (ECBS).
Method
ECBS consisted of cryopreservation of embryos, myomectomy, and ET in this order.

Inclusion criteria were as follows: a) over 33 years old at the first visit, b) presence of UF
causing deformity of uterine cavity, c) ovaries were accessible either trans-vaginally or -
abdominally, d) no history of ART.
Results
Twenty-seven patients underwent ECBS. The age at first OPU was 38.6 +/- 0.8 (mean +/-
S.D.) years old. The number of cryopreserved embryos was 4 .3 +/- 2.0 in 1.6 +/- 0.8 OPU
cycles. The duration of GnRH agonist treatment before surgery was 2 (0-4) (median, range)
months and postoperative contraception was 4 (3-6) months. Eight (1-34) UF were
enucleated with the whole weight, 105(8 – 660) g. Sixty-two ET were performed and 17
clinical pregnancies (27.4% / ET) in 13 patients were achieved.
Conclusion
ECBS assured a success rate comparable to that in women without UF in late reproductive
age. By preserving embryos as young as possible, ECBS would be a useful strategy for
infertile women with UF.
ASPIR-0321
EFFICACY OF LUTEAL PHASE (LP) -COS AND FOLLICULAR AND LUTEAL PHASE
OVARIAN STIMULATION DURING THE SAME MENSTRUAL CYCLE (DUOSTIM) IN
BREAST CANCER PATIENTS
K. Kawai1,2, M. Kawahara3, N. Kidera2, K. Teraoka1, A. Yamamoto2, K. Ohuchi1, Y. Iwahara2,
T. Ishikawa2, T. Harada3, N. Miyasaka2
1
Kameda Medical Center, Reproductive Medicine, Kamogawa City, Japan
2
Tokyo Medical and Dental University,
Department of Comprehensive Reproductive Medicine, Tokyo, Japan
3
Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba, Japan
Random-start Controlled Ovarian Stimulation (COS) is the protocol to start to stimulate

regardless of the menstrual cycle phase based on the concept that there are multiple waves
of follicle recruitment. Random-start COS can allow cancer patients to shorten treatment
periods to preserve fertility. In addition, follicular and luteal phase ovarian stimulation during
the same menstrual cycle (DuoStim) is proposed to be efficient in patients with reduced
ovarian response. So we aimed at the efficacy of luteal LP-COS and DuoStim in Breast
Cancer Patients.
Method
We have retrospectively analyzed 12 breast cancer patients requiring fertility preservation in

Random-start COS and DuoStim in Kameda Medical Center and Tokyo Medical and Dental
University. Oocyte banking was carried out in 8 patients, and 8 patients opted for embryo
banking. In the random-start COS, follicular phase (FP)-COS and LP-COS were performed
in 13 and 14 cycles, respectively. And DuoStim were performed in 9 cycles.We investigated
number of retrieved oocytes, ratio of oocyte maturation and normal fertilization rate in ICSI.
Results
The median patient age was 35.2 (26-41 years) and the median AMH level was 4.71 (0.62-
11.6 ng/ml). Interval between first visit and stimulation start (day) is 6.58 days (0-40
days).There was no significant difference in oocyte maturation and normal fertilization rate
between FP-COS and LP-COS. There was also no significant difference in those regardless
of presence or absence of ovarian stimulation during the same menstrual cycle (DuoStim).
Conclusion
Random-start LP-COS and DuoStim are as effective as FP-COS in fertility preservation.

ASPIR-0332
DOES OOCYTE MATURATION WITH DOUBLE TRIGGER GNRH AGONIST AND HCG
HAS BETTER OUTCOME COMPARE TO SINGLE TRIGGER USING HCG ALONE IN
INTRAUTERINE INSEMINATION CYCLE
Y. Sudewo1, B. Halim1, D. Novia2, E. Prasetiawan2
1
Faculty of Medicine- Universitas Sumatera Utara, Obstetrics and Gynecology, Medan,
Indonesia
2
Halim Fertility Center, Andrology, Medan, Indonesia
Intrauterine insemination (IUI) is the first method of treatment for many causes of infertility.
Despite its popularity, the effectiveness of IUI treatment is not consistent, and the role of IUI
treatment in practice protocols has not been clarified. Human chorionic gonadotropin (hCG)
at midcycle is usually used for triggering final oocyte maturation. Recently, a new treatment
modality has been clinically implemented in InVitro-Fertilization (IVF), with the co-
administration of gonadotropin-releasing hormone (GnRH)-agonist and hCG for final oocyte
maturation (double trigger). Some studies shows that this method improves oocyte maturity,
implantation, clinical pregnancy and live birth rates in IVF. The aim of this study was to
determine the efficacy of the dual trigger compare with the standard hCG trigger in IUI.
Method
A retrospective comparative analytical study of all patients who were underwent IUI program
in Halim Fertility Center that meets the inclusion and exclusion criteria was done.
Results
A total of 76 patients who underwent IUI cycle were enrolled (hCG trigger/control group: n =
38; dual trigger/study group: n = 38). The study group demonstrated higher pregnancy rates
(15.78% vs. 26.31%), although it is not statistically significantly different compared with the
control group. There was no statistically difference in terms of patient demographics, number
of follicle, or inseminated sperm-rate. In terms of complication rates of OHSS, we did not
encounter any case in both group.
Conclusion
Dual trigger of final oocyte maturation with GnRH-agonist and hCG shows higher pregnancy
rates although it is not statistically significantly different compared with the hCG trigger in IUI.
ASPIR-0342
A 5-YEAR RETROSPECTIVE REVIEW OF SEMINAL FLUID ANALYSIS OF COUPLES

WHO PRESENTED TO REPRODUCTIVE UNIT GENERAL HOSPITAL KUALA LUMPUR
(NMRR ID 32952)
S. Mubarak1, N.H. Yusoff2, S. Abd Samad1, N. Mohd Yunus1
1
Reproductive Unit IVF -General Hospital Kuala Lumpur, Obstetrics and Gynaecology,
kuala lumpur, Malaysia
2
Reproductive Unit IVF- General Hospital Kuala Lumpur, Obstetrics and Gynaecology,
Kuala Lumpur, Malaysia
Over the past two decades, there has been several papers published describing declining
numbers and quality of sperms.1 The overall trend in the literature is a slight and constant
decline in the sperm concentration.2The reasons remains unclear2.
Method
We evaluated the seminal fluid analysis done on male partners who were seen at our
reproductive unit at Maternity Hospital Kuala Lumpur from 1st January 2011 until 31st
December 2015. We analysed the age and race distribution. With regards to the seminal
fluid analysis, we analysed the appearance, liquefaction, consistency, volume, pH,
concentration, total sperm motility, sperm morphology, presence of round cells and presence
of WBC.
Results
We analysed a total of 3906 seminal fluid analysis reports. The average number of seminal
fluid analysis per year was 781.2.The distribution for race was majority 62.1% Malays, 7.4%
Chinese, 26.5% Indians and 4% other races.
For sperm concentration, comparing Years 2011 until 2015, the mean sperm concentration
remained the same throughout the years with the majority of patients in the category of
sperm concentration more than 100 million/ml.
The mean pH had a statistically significant decreasing trend throughout the 5 years analysed
(p=0.002). The mean total motility for the 5 years was 62.40%(SD 24.1) with an increasing
trend after 2012 (p<0.001). The mean morphology was 11.352% CASA (SD 8.44) with a
statistically significant reducing trend (p<0.001).
Conclusion
There was a constant decrease in the pH and morphology in the samples analysed. Possible
contributory factors can be change in diet and lifestyle among Malaysian men.
ASPIR-0343
DOES CONTROL OVARIAN STIMULATION USING CETROTIDE IMPROVED OUTCOME

IN IUI CYCLE
E. Prasetiawan1, N. Diana2, H. Binarwan3
1
Halim Fertility Center, Andrology, Medan, Indonesia
2
Halim Fertility Center, Embriology, Medan, Indonesia
3
Halim Fertility Center, Obstetrics and Gynecology, Medan, Indonesia
Intrauterine Insemination (IUI) had been approved as one of ART for infertility management.
Pregnancy rate could be increased by using GnRH antagonist protocol in IUI. However
some studies have reported a slight decrease in pregnancy and implantation rate in GnRH
antagonist cycle.
Method
This study is a comparative analytical study with retrospective approach which commenced
from April to June 2016 at Halim Fertility Center Medan. This subject of research is
secondary data (medical record) who underwent IUI procedure. The data were divided into 2
groups, 45 patients without cetrotide 0.25 mg (control group) and another 45 patients with
cetrotide administered. Data were analyzed using Student T-Test method and SPSS 16
program.
Results
Age characteristic of the subject between both groups was similar (29.87 ± 5.48 vs 32.62 ±
3.86). Number of follicle in both group was not significantly different (6.43 ± 3.30 vs 7.25 ±
4.25). Endometrium thickness in both group was similar (11.00 ± 1.82 vs 9.96 ± 2.10),
number of inseminated sperm in both group was not significantly different (9.10 ± 5.28 vs
9.48 ± 6.17). Pregnancy rate between both group was similar (25.00 ± 0.44 vs 18.75 ± 0.40).
Conclusion
Using GnRH antagonist in IUI was not improving the clinical pregnancy rate
ASPIR-0346
DOES DOUBLE TRIGGER OF FINAL OOCYTE MATURATION WITH GNRH-AGONIST

AND HCG IMPROVE THE NUMBER OF MATURE OOCYTE
B. Halim1, A. Hutasuhut2, D. Novia2, E. Prasetiawan2, M. Situmorang3
1
Medical Faculty Of Universities Sumatra Utara, Obstetric and Gynecology, Medan,
Indonesia
2
Halim Fertility Center, IVF, Medan, Indonesia
3
Medical Faculty Of Universitas Sumatera Utara, Obstetric and Gynecology, Medan,
Indonesia
Oocyte maturation for IVF cycles is commonly induced by hCG. Recently the use of double
trigger ( GnRHa and hCG) for final follicular maturation has been investigated with promising
result and shown reduce the occurrence of ovarian hyperstimulation syndrome compared
with hCG.To evaluate whether the double trigger oocyte maturation with GnRH and hCG
improves the number of mature oocytes retrieved in IVF cycles.
Method
This study is an comparative analytic study. We recruited 80 patient whose joined the IVF
program in Halim Ferility Center Medan Indonesia. Patients were devided into two groups.
Forty cases with single trigger injection hCG 10.000 unit ( control group ) and forty cases
with double trigger using GnRH ( Leuprolide acetate ) and hCG 10.000 unit (study group).
The characteristic that we analysis were the number of MII oocyte and percentage of MII
oocyte.
Results
Age characteristic in control group is 34,97 years old and in study group is 34,3 years old.
The number of oocyte retrieved in study group is 15,52 while in control group is 12 oocytes.
Percentage of MII in study group is 71 while in control groups is 83,64.
Conclusion
This study shows that the patients who received the double trigger had a significantly higher
number of oocyte retrieved. The number of MII oocyte seems no difference between two
groups. Percentage of MII oocyte was higher in control group.
ASPIR-0347
THE EFFECT OF ADDING DIFFERENT PREPARATIONS OF CONTAINING LUTEINIZING

HORMONE ACTIVITY IN PATIENTS WITH NORMAL OVARIAN RESERVE BUT
SUBOPTIMAL RESPONSE TO FSH UNDERGOING IVF.
T. Xiaoshi1, Y.l.c. Li1
1
Sun Yat-Sen Memorial Hospital - Sun Yat-Sen University, Gynaecology and Obstetrics,
Guangzhou, China
To investigate the effect of low-dose hCG, r-LH or hMG supplementation on the outcome of
patients with normal ovarian reserve but suboptimal response to FSH after long GnRH
agonist protocol
Method
It was a single-center retrospective analysis. 872 infertile patients with normal ovarian
reserve undergoing IVF/ICSI were enrolled in this study, who manifested with suboptimal
response to FSH only after long GnRH agonist protocol. According to the supplementation of
different preparations of containing LH activity, 872 patients were divided into low-dose hCG
group (n=28, 100IU/d), recombinant LH group (n=319, 75-150IU/d) and hMG group (n=525,
75-150IU/d). To compare the clinical and laboratory parameters and pregnancy outcome
among three groups.
Results
The total gonadotrophin dosage in low-dose hCG group was higher than other two groups
(3357.1±1645.5IU, 2581.3±817.5IU and 2746.5±837.5IU respectively, P<0.001). The
stimulation days in low-dose hCG group was more than the other two groups (15.6±5.4,
13.1±2.0 and 13.6±2.3 respectively, P<0.001). The numbers of oocyte retrieved in low-dose
hCG group were less than in other two groups (8.89 ± 3.61, 11.99 ± 6.11 and 12.06 ± 5.98
respectively, P<0.05). The clinical pregnancy rates were similar among three groups (69.2%,
59% and 65.5% respectively, P>0.05).There were no significant differences among three
groups in other laboratory and clinical parameters.
Conclusion
For patients with normal ovarian reserve but suboptimal response to FSH after long GnRH
agonist protocol, the supplementation of different preparations of containing LH activity
showed similar effect on pregnancy outcome. The addition of low-dose hCG could be related
to longer simulation days and less retrieved oocytes.
ASPIR-0353
THE OUTCOME OF IN VITRO FERTILIZATION IN HIV SERODISCORDANT COUPLES

H.P. Lubis1, B. Wiweko2,3, R. Muharam3,4, E. Mansyur3, G. Pratama2,3
1
Faculty of Medicine- University of Sumatera Utara- Adam Malik General Hospital,
Department of Obstetrics and Gynecology- Division of Reproductive- Endocrinology and Infe
rtility, Medan, Indonesia
2
Indonesia Reproductive Medicine Research and Training Center- Faculty of Medicine- Univ
ersitas Indonesia,
rtility,, Indonesia
3
Yasmin IVF Clinic- Cipto Mangunkusumo General Hospital,
rtility, Jakarta, Indonesia
4
Indonesia Reproductive Medicine Research and Training Center- Faculty of Medicine- Univ
ersitas Indonesia,
rtility, Jakarta, Indonesia
An increasing number of human immunodeficiency virus (HIV)-discordant couples in the

world have been seeking fertility help. Medical issues faced by HIV serodiscordant couples
include horizontal transmission risks between partners and vertical transmission between
mother and child, as well as the technologies and procedures available to reduce those
risks. Assisted reproductive technologies, including In vitro fertilization (IVF) with
intracytoplasmatic sperm injection (ICSI) in combination with semen washing have been
used to decrease the risk of HIV transmission in serodiscordant couples. The aim of this
study was to evaluate the outcome of in vitro fertilization in HIV serodiscordant couples.
Method
A cross sectional study was performed in HIV serodiscordant couples who have been
treated with in vitro fertilization (IVF) from 2012 until 2016 in Yasmin IVF Clinic.
Results
There were 16 cycles of in vitro fertilization from HIV serodiscordant couples. We found age
of woman was (33.63±3.75) years old, duration of infertility (5.75±1.88) years, retrieved
oocyte (12.29±9.74), 2PN oocyte (7.14±5.97). From the study, we also found the clinical
pregnancy rate per embryo transfer was 46.7% and the ongoing pregnancy rate was 33.3%.
Three out of four babies born in this study showed no seroconversion.
Conclusion
In Vitro Fertilization with intracytoplasmic sperm injection (ICSI) in HIV serodiscordant

couples appears to be safe and effective method to achieve pregnancy. It can reduce the
risk of HIV transmission to uninfected partner and newborn.
ART, Laboratory
ASPIR-0021
Posters: ART, Laboratory
PREGNANCY RATES AND IMPLANTATION RATES BEFORE AND AFTER MACS

PROCEDURE FOR INTRA CYTOPLASMIC SPERM INJECTION IN UNSELECTED
MALES
D. Patel1, H. Shukla2, P. George2, P. Shah1, S. Shah3, M. Banker4
1
Nova IVI fertility, IVF Laboratory, Ahmedabad, India
2
Nova IVI fertility, Androlgoy Laboratory, Ahmedabad, India
3
Nova IVI fertility, Consultant, Ahmedabad, India
4
Nova IVI fertility, Clinical Director, Ahmedabad, India
MACS has proved to be one of the promising technology in recent years for sperm
preparation. This is a retrospective analysis of patients undergoing consecutive pre and post
MACS ICSI cycles at Nova IVI fertility, Ahmedabad from April 2014 to June 2016.
Method
Total 47 patients undergoing 106 cycles with self oocytes and 15 Ovum Donation (OD)
patients with 35 cycles were analyzed for the differences in laboratory parameters and
pregnancy outcomes.
Results
In Pre MACS self patients, out of 34 fresh embryo transfers 7 (20.59%) pregnancies were
achieved, while Post MACS- 10 (38.46%) patients achieved success from 26 embryo
transfers. Miscarriage rate in Pre MACS group was 57.14% while it was only 20.00% in Post
MACS group. There was a significant difference (P<0.05) in Implantation rate (IR) of fresh
and frozen ET in both groups of self patients. In fresh ET of OD patients, pre MACS PR was
16.67% and Post MACS PR of 44.44% was achieved. While in frozen embryo transfers
(FET), 13.79% PR were achieved but all aborted (100%). While in Post MACS group,
47.62% PR was achieved and only 22.22% miscarriages were noted. In FET of OD patients,
no pregnancy was achieved after 5 embryo transfers, but post MACS 42.86% pregnancies
were achieved. Significant increase in cumulative ongoing PR per self patient was 6.38% in
pre MACS group and 29.79% in Post MACS group while it was non-significant in OD
patients.
Conclusion
MACS treatment has significant increase in cumulative PR and IR in patients with self and
donor oocytes.
ASPIR-0029
EFFECT OF SERUM FOLLICLE STIMULATING HORMONE LEVEL ON

SPERMATOGENESIS IN MALES WITH AZOOSPERMIA
M. Burhan1
1
Life Center, Art Lab, Lahore, Pakistan
Background: Azoospermia is diagnosed in clinics and labs in patients who walk in for a
semen analysis. Azoospermia is seen in many reports. Objective To evaluate if there is any
association between hormonal disturbance in regards to follicle stimulating hormone level
and Azoospermic semen analysis. The aims and objectives of the study are to investigate
the presence of spermatogenesis among azoospermic patients and smokers and to
investigate the high level of follicle stimulating hormone among azoospermic patients.
Method
Material and Method: The study design was observational. The study was conducted at
Lahore Institute of Fertility and Endocrinology (LIFE). This study was held at Hameed Latif
Hospital andrology Laboratory, New Garden Town Lahore. The sample size was 100
subjects coming for routine semen analysis.
Results
Result: The results indicated relationship between follicle stimulating hormone and
Azoospermia .They were 28.57% patients have altered follicle stimulating hormone level.
And 72.43% patients have normal follicle stimulating hormone level. There were 8.10% of
patients who had high follicle stimulating hormone level but showed evidence
spermatogenesis. Another group had normal follicle stimulating hormone 24.48% but did not
have any evidence of spermatogenesis.
Conclusion
Conclusion: It is concluded that follicle stimulating hormone is strongly associated with

spermatogenesis. Many other factors like smoking habit may not be associated with
spermatogenesis.
ASPIR-0030
EMBRYOS QUALITY OUTCOME BASED ON TIME-LAPSED MORPHOKINETICS

MONITORING USING DIFFERENT OVULATION TRIGGERING
R. Muharam1, M. Ikhsan1, H.E. Rizkinya1, G. Pratama1, B. Wiweko1, A. Hestiantoro1
1
Faculty of Medicine University of Indonesia-Dr Cipto Mangunkusumo General Hospit,
Department of Obstetrics and Gynecology, Jakarta, Indonesia
In vitro fertilization (IVF) success correlates with many factors including oocytes maturation.
Routine use of hCG as final trigger may increase the risk of ovarian hyperstimulation
syndrome that could be prevented by using GnRH agonist. Recent studies showed that both
of the protocols didn’t affect the embryos quality outcome morphologically. However, study
on morphokinetics monitoring using time-lapse toward embryos quality in different trigger is
still limited. Objective of the study is to assess embryos quality morphokinetically in patients
who underwent IVF with different ovulation triggering (hCG and GnRH agonist) using time-
lapsed monitoring.
Method
This cohort prospective study without randomization was conducted in Yasmin IVF Clinic,
Jakarta, Indonesia. 24 patients were included in this study with 17 patients in hCG group and
7 patients in GnRH agonist group. Embryos were monitored using time-lapse monitoring and
were assessed based on morphological events and morphokinetical (optimal cleavage time)
events.
Results
Among 136 embryos obtained, 82 embryos were in hCG group and 54 embryos in GnRH
agonist group. 110 (hCG=63, GnrH agonist=47) embryos exhibited abnormal morphological
events including direct cleavage from zygote to three blastomere embryo, uneven
blastomeres size, multinucleation at 4 cell stage, and reverse cleavage. There was no
difference on abnormal morphological events between hCG and GnRH agonist group
(p=0.139). The remaining 26 embryos (hCG=19, GnRH agonist=7) were assessed
morphokinetically using optimal cleavage time and showed no difference between groups
(p=0.210).
Conclusion
The use of different ovarian triggering did not affect the embryos quality morphokinetically
assessed using time-lapsed monitoring.
ASPIR-0033
EFFECT OF REGULAR EXERCISE ON REPRODUCTIVE FUNCTION OF AGED FEMALE

MICE
1
Republic of Korea
This study was aimed to examine whether regular exercise can improve the expression of
ovarian anigogenic factors, oocyte quality and fertility potential in aged female mice.
Method
Firstly, 40 C57BL female mice of 30-32 weeks were divided into the two groups. One group
(n=20) were regularly exercised (physical activity) by illuminating incandescent lights (60
Watts, 220V), placed on the top of the cage, for 30 minutes daily. The other group (n=20)
were served as control without exercise. After 4 weeks, the female mice were mated with the
same strained individual male mice of 12 weeks during 2 weeks maintaining the exercise
protocol. Then pregnancy was observed for subsequent 2 weeks (1st observation).
Results
The total number of pregnant mice was 15 (75%) in the exercise group, which was
significantly higher than 5 (25%) in the control group (P<.05). The mean number of offspring
was also significantly higher in the exercise group (9.2) than the control group (6.3) (P <.05).
The mean number of one-cell embryos retrieved and blastocyst formation rate were 12.6
and 43.8% in the exercise group and 10.8 and 8.1% in the control group with a significant
difference (P<.05). Ovarian VEGF and eNOS expression was increased, but ovarian
apoptosis was decreased in the exercise group.
Conclusion
This study demonstrates that regular exercise induced by illumination with incandescent
lights in aged mice improves their reproductive outcomes by improving ovarian function and
oocytes quality.
ASPIR-0048
TO ASSESS FREQUENCY AND DISTRIBUTION OF ABNORMAL SEMEN PARAMETERS

IN A GROUP OF PAKISTANI MEN IN LAHORE
M. Burhan1
1
Life Center, Art Lab, Lahore, Pakistan
In a quest to evaluate male’s fertility potential, different semen characteristics are analysed.
Spermatozoa are examined for (count), (morphology) and (motility) in order to assess their
quality. Non sperm cells analysis includes volume, fructose level, pH and liquefaction time.
To describe the pattern of semen parameters in subfertile males. To look into frequency and
distribution of abnormal semen parameters in a group of Pakistani males in Lahore.
Method
In this Retrospective, cross sectional, observational study all males undergoing for
evaluation and treatment for sub-fertility at a private Assisted Reproductive Technology clinic
in Lahore, Pakistan were included.Semen analysis was done by methods defined by the
WHO (World Health Organisation) criteria 2010.
Results
total patient (n=679)

Specimen produced:
92.2% (626) at clinic
(7.8%) 53 at home
(78.8%) 535 by masturbation
(11.9%) 81 by coitus
(9.3%) 63 not known
(14.1%) 96 found to be less than 2-6 ml
(5.3%) 36 found to be more than 2-6 ml
(2.9%) 20 count was found to be less than 15 million/ml
(5.9%) 40 count was less than 1 million/ml.
(9.1%) 62 counts was found to be abnormally low
(66.1%) 449 had normal sperm motility,
(21.8%) 148 had less than 40% motility
extremely low sperm motility was found in (12.1%) 82 males.
Conclusion
The results of the single semen analysis are of limited utility and no decision should be taken
on the basis of these results in term of diagnosis and treatment strategies.
ASPIR-0053
PIEZO-ICSI IMPROVES FERTTILIZATION RATE AND GOOD-QUALITY DAY 3 EMBRYO

AS COMPARED WITH CONVENTIONAL-ICSI
M. Nonaka1,2, T. Ishikawa1,2, S. Murakata1,2, K. Hiraoka2,3,4, N. Kidera1,2, A. Yamamoto1,2,
Y. Iwahara1,2, N. Miyasaka1
1
graduate school - Tokyo medical and dental university,
Comprehensive Reproductive Medicine, Tokyo, Japan
2
Japan Agency for Medical Research and Development, AMED, Tokyo, Japan
3
Kameda Medical Center, ART center, Kamogawa, Japan
4
Kameda IVF Clinic Makuhari, ART center, Chiba, Japan
Intracytoplasmic sperm injection (ICSI) is now widely used not only for the male infertility but
also for the patients in which conventional IVF is unsuccessful. Because the number of
oocytes retrieved at OPU decreases with advancing women’s age, more efficient and less
invasive ICSI method is required. Recently, piezo-ICSI (pICSI) has been reported to improve
survival and fertilization rates. The aim of our study was to compare the clinical outcomes of
the treatment with pICSI and conventional ICSI (cICSI) in order to clarify the efficiency of
pICSI.
Method
One hundred sixty seven oocytes treated with pICSI and 138 oocytes treated with cICSI
which were retrieved between Jan. 2014 and Aug. 2016 in our hospital were enrolled in this
study. The survival rate, fertilization rate, percentage of good-quality embryo at day3
(defined as cell numbers ≧7 with the same size) and clinical pregnancy rate were
retrospectively analyzed.
Results
The survival rate, normal fertilization rate and good-quality day3 embryo rate with pICSI and
cICSI were 91.6% vs. 89.9%, 81.4% vs. 63.8%, and 31.2% vs. 19.6%, respectively. Clinical
pregnancy rates per embryo transfer were 37.1% in pICSI and 23.3% in cICSI. The rates of
normal fertilization and good-quality day3 embryo were significantly higher in pICSI than
those in cICSI (p < 0.01).
Conclusion
pICSI improves fertilization rate and good-quality day3 embryo rate as compared with cICSI.
pICSI could be a useful method for obtaining better ART outcomes.
ASPIR-0057
OPTIMAL ICSI TIMING IN SELECTED VIETNAMESE POPULATION

D. Huu Nguyen1, H. Thu Thi Bui1
1
IVFMD - My Duc Hospital, My Duc Hospital, Ho Chi Minh City, Vietnam
The microinjection technique has been completely standardized but the results regarding the
timing of ICSI are still conflicting. The purpose of this study was to analyze retrospectively
the impact of oocyte denudation and microinjection timings on the ICSI outcome in a
selected population so as to carry out corrective measures to improve the results.
Method
We included 744 ICSI cycles with the following parameters: age < 38 years, at least four
aspirated oocytes, no more than two previous treatments, no reduced ovarian reserve, no
adenomyosis, use of freshly ejaculated sperm and fresh embryo transfer on day 2 or day 3,
GnRH antagonist suppression, OPU – hCG interval 36 hours. Several ICSI parameters were
analyzed: OPU – denudation interval more/less than 2 hours; denudation – ICSI interval
more/less than 1 hour.
Results
OPU – denudation timing > 2 hours significantly increased the rates of MII (80.91% vs
78.72%, p=0.036) and good quality embryo (39.76% vs 31.5%, p=0.01). Denudation - ICSI
interval > 1 hour helped improve good quality embryo rate (41.82% vs 32,07%, p=0.002) but
denudation - ICSI interval < 1 hour had higher clinical pregnancy rate (34.71% vs 27.17%,
p=0.027).
Conclusion
OPU – denudation timing > 2 hours and denudation - ICSI interval > 1 hour increased MII
rate and good quality embryo rate. Denudation - ICSI interval < 1 hour improved clinical
pregnancy rate.
ASPIR-0058
EUPLOIDY RATES OF BLASTOCYSTS DERIVED FROM MICROSORTED VERSUS

UNSORTED SPERM
Z.Q. Tee1, W.Y. Yap1, Y.X. Lim1, M.W. Lim1, C.S.S. Lee2
1
ALPHA INTERNATIONAL FERTILITY CENTRE, IVF LAB, PETALING JAYA, Malaysia
2
ALPHA INTERNATIONAL FERTILITY CENTRE, IVF CLINIC, PETALING JAYA, Malaysia
MicroSort® (MS) sperm sorting is a preconception method which separates X and Y sperm
and is used for family balancing and the prevention of sex-linked diseases in offspring. This
study compares the euploidy rates of blastocysts derived from microsorted and unsorted
sperm from January 2016 until August 2016.
Method
In this retrospective study, the chromosome copy number of blastocysts derived from
microsorted sperm (study group) and unsorted sperm (control group) were assessed. In the
study group, sperm was treated with fluorescence staining and were sorted into X or Y
enriched sperm samples using flow cytometry (MicroSort®, USA). Sperm was processed by
density gradient centrifugation with swim-up in the control group. Both groups had ICSI and
embryos were cultured to Day 5 or 6 and blastocysts with at least an average grade
(Gardner’s Grading) were biopsied and screened for aneuploidy.
Results
A total of 231 blastocysts from the study group and 566 blastocysts from the control group
were biopsied. The mean age of patients from the study group and control group were 34.3
and 32.9 respectively (p> 0.05). There was no significant difference in euploidy rates
between study group and control group (55.0% versus 58.7%; p= 0.3444) nor between both
groups for each age group: ≤30, 31-35, 36-37, 38-39 and ≥40.
Conclusion
This study suggests that blastocysts derived from microsorted sperm have similar euploidy
rates compared to blastocysts derived from non-sorted sperm.
ASPIR-0062
GNRH ANTAGONIST VS AGONIST PROTOCOL ON BLASTOCYST DEVELOPMENT

AND BLASTOCYST UTILISATION IN IVF CYCLES
M.W. Lim1, C.S.S. Lee2, J. Keith2
1
, PETALING JAYA, Malaysia
2
Alpha Fertility Centre, IVF lab, Kuala Lumpur, Malaysia
Although the clinical outcome of controlled ovarian stimulation between GnRH-agonist and
GnRH-antagonist protocols for IVF has been often analysed, the effect of these analogues
on blastocyst development and blastocyst utilisation rate has not been reported. This is a
retrospective study to determine the impact of both stimulation protocols on the blastulation
and utilisation rate in patients of different age groups in Alpha Fertility Centre (AFC).
Method
Oocyte donors were excluded from this study. Between June 2016 and September 2016, 71
patients and 91 patients were stimulated with GnRH agonist and GnRH antagonist
respectively. Both GnRH analogue groups were subdivided into 3 age groups: <35, 35-41
and >41. Patients across all age groups had OPU and IVF with or without ICSI. The
resultant embryos were cultured to blastocyst stage using Cook media and the blastocysts
were subsequently transferred, biopsied or cryopreserved.
Results
The blastocyst utilisation rate is significantly higher in patients under 35 years old stimulated
with GnRH-Antagonist (64.4%) compared to those stimulated with GnRH-Agonist (53.9%).
Conversely, there was a trend towards higher blastulation and utilisation rates in >40 year
old patients stimulated with GnRH-Agonist (71.7% and 67.6% respectively) compared to
GnRH-Antagonist (57.9% and 47.8%).
Conclusion
We suggest that patients under the age of 35 who are undergoing IVF should be stimulated
with a GnRH-Antagonist protocol to obtain higher blastulation and blastocyst utilisation rates.
Further study will test whether patients above 41 years old would benefit from higher
blastulation and utilisation rates when stimulated with a GnRH-agonist analogue rather than
the GnRH-Antagonist protocol.
ASPIR-0072
RESCUE IN-VITRO MATURATION (IVM) OF IMMATURE OOCYTES FROM STIMULATED

CYCLES
T. Nguyen Thi Lien1, A. Thi Kim Phan1, U. Thi Diem Ha1, T. Duong Pham1, B. Gia Huynh1,
T. Manh Ho1
1
IVFMD, MY DUC Hospital, Ho Chi Minh, Vietnam
Low maturation rate of oocytes in a controlled ovarian stimulation (COS) cycle with FSH and
hCG trigger has been recorded in a percentage of cycles. It has been speculated that the
mechanism of this phenomenon are either the unresponsiveness of the follicles to hCG
trigger or early trigger at immature size of follicles. We report a series of stimulated cycles
with low maturation at collection and had rescue-IVM and subsequent ICSI.
Method
A case-series study was performed at IVFMD, My Duc Hospital from May-2014 to August-
2016. Stimulated cycles with low maturation at collection were recruited to the study. IVM
was performed for 16-18 hours and subsequent ICSI was done for mature-oocytes. Embryos
derived from these oocytes were used for transfer on day-2. Primary outcome was ongoing
pregnancy rate. Secondary outcomes were maturation, fertilization and miscarriage rates.
Results
Forty cycles were recruited to the study, in which 13 cycles had fresh transfer and 27 cycles
had frozen transfer following freeze-all cycles. Mean patients’ age was 34.98±5.29. The
duration of stimulation was 9.28±2.11 days with mean total amount of FSH used was
3229.38±1098.0 IU. The maturation rate after rescue-IVM was 80%, fertilization rate was
91.5%. Mean number of embryos transferred was 2.4±0.6 and 1.5±0.9 for the fresh and the
frozen transfer groups, respectively. The ongoing pregnancy rate was 7.7% and 22.2% for
the fresh and the frozen transfer groups, respectively. The miscarriage rate was 0% for two
groups.
Conclusion
Rescue-IVM could be used as a back-up measures for stimulated cycles having low
maturation at collection.
ASPIR-0073
RESCUE ARTIFICIAL OOCYTE ACTIVATION (AOA) OF UNFERTILIZED OOCYTES

AFTER INTRA-CYTOPLASMIC SPERM INJECTION
A. Kim Thi Phan1, T. Thi Lien Nguyen1, T. Thi Minh Luu1, T. Duong Pham1, B. Gia Huynh1,
T. Manh Ho1
1
Artificial oocyte activation (AOA) has been proposed as a means to overcome the problem of
failed or impaired fertilization after intra-cytoplasmic sperm injection (ICSI). Mechanism of
AOA to rescue unfertilized oocytes at 16-18 hours after ICSI is unclear. We report a series of
cases that had low fertilization rate after ICSI in regard to fertilization rate, clinical and on-
going pregnancy rates.
Method
A case-series study was conducted at IVFMD, My Duc Hospital from April-2014 to July-
2016. Cycles that had low fertilization rate at 16-18 hours after ICSI had rescue-AOA. AOA
was performed by incubated in culture medium containing 10mM of ionomycin calcium I0634
for 10 minutes at 37oC, 5%CO2, 5%O2 within 2 hours after checking fertilization. Day-2
embryos derived from rescue-AOA were used for fresh transfer or freeze-all and frozen
transfer.
Results
A total of 41 cycles were recruited to the study, amongst them, 30 cycles had fresh transfer
and 11 cycles had freeze-all followed by frozen transfer. Mean age was 34.5±4.8 and mean
infertility duration was 5.2±3.9 years. Mean sperm count was 32.9±23.3 with the mean
motility rate of 26.7% and normal morphology rate of 0.1%. Mean number of utilization
embryos after rescue-AOA was 2.5±1.1 and number of embryos transferred was 2.3±0.9.
The fertilization, clinical pregnancy and on-going pregnancy rates were 89%, 2.4% and 0%,
respectively.
Conclusion
Rescue-AOA could achieve a good fertilization rate but does not result in ongoing
pregnancy. Further well-designed studies are needed to explore the efficiency of this method
in improving IVF treatment outcomes.
ASPIR-0082
IS FREEZE-ALL POLICY EFFECTIVE IN POOR RESPONDER PATIENTS?

C. TU TRAN1, B. GIA HUYNH1, T. DUONG PHAM1, H. THI MY LAM1,
T. THI QUYNH NGUYEN1, L. THI NGOC VUONG1
1
Recent studies have shown that frozen embryo transfer (FET) is superior to fresh embryo
transfer (ET). Poor response patients present a real dilemma since they have only a few
embryos available for transfer. We performed this study to compare the effectiveness of
fresh ET versus freeze-all followed by FET in poor response patients.
Method
A retrospective cohort study was conducted at IVFMD, My Duc Hospital from April 2014 to
July 2016. Patients were eligible if they were in between 18-45 years of age and diagnosed
as poor responder according to Bologna criteria. Patients received either fresh ET or freeze-
all followed by FET. Primary outcome was the ongoing pregnancy rate and secondary
outcomes were implantation and miscarriage rates.
Results
A total of 338 patients were recruited to the study, in which, 243 patients had fresh ET, 95
patients had freeze-all followed by FET. Baseline characteristics were comparable between
two groups. The mean number of embryos transferred was similar between fresh transfer
and FET groups (2.10 vs 2.24, p=0.15). The ongoing pregnancy rate was not significantly
different between fresh ET and FET (11.9% vs 10.5%, p=0.86). No different significance was
found between two groups in regard to implantation and miscarriage rates (9.4% vs 8.0%,
6.2% vs 5.3%, respectively, p>0.05).
Conclusion
Freeze-all followed by FET did not show a beneficial effect in poor response patients.
ASPIR-0085
SINGLE-STEP CULTURE MEDIA VERSUS SEQUENTIAL CULTURE MEDIA IN IVF/ICSI

Q. Ngoc Nguyen1, T. N Vo1, T. D Pham1, B. G Huynh1, V. Q Dang2, T. M Ho2
1
2
Research Center for Genetics and Reproductive Health CGRH – School of Medicine,
Vietnam National University VNU, Ho Chi Minh City, Vietnam
A growing body of evidence suggests that single-step culture media is as effective as

sequential media in blastocyst culture. In a laboratory with high number of cycles, the single-
step culture media could be more convenient and less expensive. This study is to compare
the blastulation rate between the single-step and the sequential culture media.
Method
This was a retrospective cohort study conducted at IVFMD, My Duc Hospital from July 2015
to April 2016. Patients who had their embryos cultured to blastocyst using either single-step
or sequential culture media were included in the study. Exclusion criteria were IVM, donor
cycles. Primary outcome was the blastulation rate. Secondary outcomes were the blastocyst
utilization rate, the on-going pregnancy rate and the implantation rate.
Results
A total of 200 patients were recruited to the study, amongst them, 92 used single-step and
108 used sequential culture media. There were no significant difference with age, BMI,
number of treatment cycles, infertility duration, IVF indication, endometrial thickness, the
average numbers of embryos transferred and top-quality embryos transferred between two
groups. Blastulation rate was not significantly different between single-step culture media
and sequential culture media (57% vs 60%, P>0.05). There were no differences in the
blastocyst utilization rate, the on-going pregnancy rate and the implantation rate between
two groups (49% vs 50%, 57% vs 62%, 45.8% vs 50.7%, respectively)
Conclusion
Single-step is as effective as sequential media for culturing the embryos to blastocyst and
achieving pregnancy outcomes in IVF/ICSI patients.
ASPIR-0088
IMPACT OF MOVING SPEED OF ICSI NEEDLE INSIDE THE OOCYTE ON SURVIVAL

AND FERTILIZATION IN HUMAN ICSI
K. Hiraoka1,2,3,4, M. Saito1, A. Kuga1, T. Kaji1, A. Ichihashi1, T. Suhara1, M. Ibayashi4,
T. Tamaki4, K. Miyata4, Y. Ohtsuka1, K. Ohuchi1, T. Ishikawa2,3, T. Harada4, K. Kawai1,2,3,4
1
Kameda Medical Center, Department of Reproductive Medicine, Kamogawa, Japan
2
AMED, Japan Agency for Medical Research and Development, Tokyo, Japan
3
Tokyo Medical and Dental University, Comprehensive Reproductive Medicine, Tokyo,
Japan
4
Kameda IVF Clinic Makuhari, Department of Reproductive Medicine, Chiba, Japan
Intracytoplasmic sperm injection (ICSI) has become an essential technique in human ART.
However, little information is available regarding the effect of moving speed of ICSI needle
inside the oocyte on human ICSI results. The objective of this study was to investigate the
effect of moving speed of ICSI needle inside the oocyte on survival and fertilization in human
ICSI.
Method
In total, 536 oocytes retrieved from 185 patients were microinjected by 3 embryologists with
Piezo-ICSI between January 2015 and August 2015. The average moving speed of ICSI
needle inside the oocyte of 3 embryologists were calculated respectively. Then, the survival
and fertilization rates of 3 embryologists were retrospectively compared.
Results
The average moving speed of ICSI needle of 3 embryologists A, B, C were 16.9, 13.8, 11.3
µm/s, respectively. The survival rates and fertilization rates of embryologist A, B, C were 95,
96, 94% and 79, 82, 84%, respectively. The average moving speed of ICSI needle of
embryologist A was significantly faster as compared to that of embryologist B. Also, the
average moving speed of ICSI needle of embryologist B was significantly faster as
compared to that of embryologist C. However, no significant difference was observed in the
survival rates and fertilization rates among the 3 embryologists.
Conclusion
Our results suggested that the moving speed of ICSI needle inside the oocyte does not have
an effect on survival and fertilization rates in human ICSI, so we need not to pay attention on
moving speed of ICSI needle inside the oocyte when performing ICSI.
ASPIR-0102
BENEFIT AND EFFECT OF ERYTHROCYTE LYSING BUFFER ON HUMAN SPERM

PREPARATION AFTER MICROSURGICAL TESTICULAR SPERM EXTRACTION
PROCEDURE
A. Vo Thien1, S. Dang Truong1, P. Nguyen Thi Kim1, T. Huynh Thi Thu1
1
Hanh Phuc International Hospital, Fertility Centre, Binh Duong, Vietnam
Compared with TESE, micro-TESE was reported to achieve higher success rates and had
significantly more effective results in patients with NOA. However, sperm preperation from
surgically-retrieved sperm is difficult. The main difficulty is the abundant presence of red
blood cells in a shredded testicular biopsy specimen. Erythrocyte-lysing Buffer (ELB) is
formulated for optimal lysis of erythrocytes in human peripheral blood.
Our aim was to compare sperm retrival rate, the fertilization rates, the usable embryos rates
and the cumulative pregnancy rates in ELB treatment group and non ELB treatment group.
Method
Male patients with NOA were retrieved spermatozoa by micro-TESE and performed ICSI at
Fertility Centre – Hanh Phuc International Hospital. The samples were divided into two
groups:
- Group 1: treated with ELB (35 cases).
- Group 2: not treated with ELB (87 cases).
Results
The sperm retrival rate is higher in group 1 compared with group 2 (47,8% versus 48,3%, P
= 0.75).
There was no difference between two groups in the fertilization rate (55,1% versus 64,5%, P
= 0.08), the usable embryos rate (85,1% versus 87,0%, P = 0.09) and the cumulative
pregnancy rate (73,1% versus 73,3%, P = 0.08).
The results of study also show that the time to find sperm in the samples halved compared
with not using ELB (15 minutes versus 31 minutes), resulting of ICSI time is also greatly
reduced when using ELB.
Conclusion
ELB treatment of micro TESE enhances the efficiency of sperm collection in those cycles in
which spermatozoa are present and does not affect fertilization and embryo development.
ASPIR-0107
MODIFICATION OF CLINIC POLICY: FROM EXCLUSION TO SUBSEQUENT INCLUSION

OF MULTINUCLEATED EMBRYOS AS A RESULT OF USE OF THE EMBRYOSCOPE
J. Mellon1
1
Pacific Centre for Reproductive Medicine, ART LABORATORY, Burnaby, Canada
Historically, we have removed multinucleated (MN) embryos from culture, as

previous literature had shown that they have a higher rate of chromosomal abnormalities,
and lower rate of implantation. Time lapse studies have since shown that MN occurs more
frequently than previously thought, and that if they develop into blastocysts , their euploidy
rate is the same as non-MN embryos. Our aim was to study:
1.The frequency of MN - single observation versus timelapse

2.The proportion of MN embryos progressing to blastocyst stage
3. How often blastocyst morphology would have led to MN embryos being considered for
transfer
From this we would decide whether to include or exclude MN embryos.
Method
Embryos from IVF/ICSI cycles were matched for age, treatment type and stimulation
protocol. Included were patients age <40 with ≥5 oocytes retrieved, and no severe male
factor. Embryos were cultured for six days with a single daily observation (n= 313) or in the
Embryoscope (Vitrolife) (n=291).
Results
1. A much higher frequency of multinucleated embryos was observed using time lapse
versus single observation (31% vs 5%).
2. 44% of MN embryos identified by time lapse made blastocysts.
3. Of this 44%, 64% had a day 5 grading which would have meant them being
considered for transfer.
Conclusion
Our observations led us to now include MN embryos in culture. If they form good quality
blastocysts they are vitrified. Non-MN embryos are transferred preferentially. We await birth
outcomes for transfers of MN embryos.
ASPIR-0108
APPLICATION OF MECHANICALLY ASSISTED HATCHING FOR BLASTOCYST

VITRIFICATION, CRYOPRESERVED WITH HOMEMADE GAMA SLEEVED CRYOLOOP
I.F. Hanoum1
1
Sardjito General Hospital/ Gajah Mada University School of Medicine,
Reprod. Endocrinology and Infertility, Yogyakarta, Indonesia
Background: Supernumerery good grade blastocysts generated in our institution

were preserved with a home-made vitrification device. Mechanically assisted hatching was
applied. Survival and pregnancy rate of blastocyst were assessed.
Method
Methods: IVF patients at RSUP Dr Sardjito January 2012-August 2015 were recruited in the
study, upon an informed consent. Excess good grade D5 blastocysts were vitrified.
Blastocysts were hold in handling media for 1 minute then VS1 (7.5% EG (v/v); 7.5% DMSO
(v/v)) for 2-3 minutes, VS2 (15% EG (v/v); 15% DMSO v/v; 10 mg/ml Ficoll; 0.65 M Sucrosa)
for 30 seconds at room temperature before inserted in to the loops, then directly plunged
into the liquid nitrogen. Prior to ET, blastocysts were warmed in sucrose 0.25M for 2 min and
0.125M for 3 min. Mechanically assisted hatching were applied for all transferred
blastocysts.
Results
Results: Total of 183 vitrified warmed human blastocyst (123 patients) were used where 170
(92.9%) transferred. Non-transferred blastocyst (7.1%) has more than 50% lyse. Clinical
pregnancy rate was 40.7%. Implantation rate was 32.6%. Currently, 25 deliveries of 37
babies born from vitrified blastocyst, and another 10 ongoing pregnancies. There were 3
early pregnancy loss, 2 miscarriages at 12 weeks pregnancy, and one infant died due to a
congenital anomaly.
Conclusion
Conclusion: Gama Sleeved cryoloop combined with mechanically assisted hatching

provides an excellent while cost effective alternative to existing vitrification devices. These
data and babies delivered from the program have been promising to a vitrification system in
our own ART program.
ASPIR-0111
SINGLE FROZEN-THAWED BLASTOCYST TRANSFER FOLLOWING

PREIMPLANTATION GENETIC SCREENING (PGS) RESULTS IN HIGH IMPLANTATION
RATE AND ELIMINATES THE RISK OF MULTIPLE BIRTH
C.S.S. Lee1, Y.X. Lim1
1
Alpha International Fertility Centre, IVF LABORATORY, Petaling Jaya, Malaysia
This retrospective study compares the clinical outcome between frozen-thawed single
blastocyst transfer (SBT) and frozen-thawed double blastocyst transfer (DBT) following PGS.
Method
Three-hundred and seventeen euploid-blastocysts from 245 patients were thawed between
November-2013 and July-2013. One euploid-blastocyst was transferred in 174 patients
(Group 1) and 2 euploid-blastocysts were transferred in 72 patients (Group 2). Age was
analysed as both a continuous and a categorical variable. The clinical pregnancy rate (CPR),
implantation rate (IR) and multiple gestation rate (MGR) were analysed.
Results
All 317 euploid-blastocysts survived post-thaw (100% post-thaw survival). The mean age of
patients undergoing SBT (33.1 years) was significantly higher than the mean age of patients
undergoing DBT (30.1 years)(P<0.000.1). The CPR in Group 2 was significantly higher than
in Group 1 (79.2% versus 61.8%;p=0.0109). However, there was no significant difference in
CPR between Group 1 and 2 within each age group: <30, 30-34, 35–37, and >40 (except
38-40;p=0.0197). There was no significant difference in IR between Group 1 and 2 (61.8%
versus 59.0%;p=0.6451) nor between Group 1 and 2 within each age group: <30, 30-34, 35–
37, 38–40, and >40. The risk of multiple gestations was greatly increased between Group 1
and 2 (0% versus 49.1%;p<0.0001), and this difference did not vary across age groups
(except >40;p=0.1111).
Conclusion
This study shows that frozen-thawed euploid SBT results in 100% singleton and a tendency
towards higher implantation rate. These data should encourage clinicians to evaluate their
embryo transfer policy and adopt SBT in euploid cryopreserved cycles as their routine
practice.
ASPIR-0112
CLINICAL OUTCOMES OF SINGLE EUPLOID- VERSUS DOUBLE UNTESTED-

BLASTOCYST TRANSFER IN VITRIFIED-WARMED CYCLES
Y.X. Lim1, C.S.S. Lee1
1
Alpha International Fertility Centre, IVF LABORATORY, Petaling Jaya, Malaysia
This is a retrospective study to examine whether transferring a single euploid-blastocyst

(SeBT) following preimplantation genetic screening (PGS) can result in clinical outcome that
is comparable to transferring 2 untested-blastocysts (DBT) while reducing the incidence of
multiple pregnancies.
Method
One-hundred and seventy-three euploid-blastocysts from 173 patients (Group 1) and 446
untested-blastocysts from 223 patients (Group 2) were thawed using the Cryotec Method
between November-2013 and July-2016. One euploid-blastocyst was transferred in Group 1,
and 2 untested-blastocysts were transferred in Group 2. Age was analysed as both a
continuous and a categorical variable. The clinical pregnancy rate (CPR), implantation rate
(IR) and multiple gestation rate (MGR) were analysed.
Results
All 619 blastocysts survived post-thaw (100% post-thaw survival), enabling transfer in all
cases. The mean age of patients undergoing SeBT (33.1 years) was significantly higher than
the mean age of patients undergoing DBT (31.9 years)(P=0.0415). The CPR in Group 1 and
Group 2 was similar (61.8% versus 62.3%;p=1.0000) and there was no significant difference
in CPR between Group 1 and 2 within each age group: <30, 30-34, 35–37, and 38-40
(except age group >40;p=0.0189). The IR in Group 1 was significantly higher than in Group
2 (61.8% versus 47.3%;p=0.0013) and within age group 35-37 (71.4% versus
44.3;p=0.0124) and >40 (72.7% versus 14.7%;p=0.0007). The incidence of multiple
pregnancies was greatly reduced in Group 1 (51.8% to 0%; p<0.0001).
Conclusion
The clinical pregnancy rate of SeBT and DBT were equivalent, but SeBT had a higher
implantation rate and a lower incidence of twins.
ASPIR-0125
THE CLINICAL OUTCOMES OF TRANSFERRING VITRIFIED BLASTOCYSTS DERIVED

FROM POOR QUALITY CLEAVAGE EMBRYOS (PQES)
H.T.T. Bui1, T.M.C. Mai1, L.N. Vuong2
1
2
Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy,
Ho Chi Minh City, Vietnam
Good quality cleavage embryos are usually chosen for embryo transfer or cryopreservation.
Reversely, PQEs are discarded due to their low developing competence to result in a
pregnancy. To maximize the embryo utilization, instead of discarding PQEs, another
approach could be to culture PQEs to blastocyst and transfer of those blastocysts, if any.
The aim of this study is to investigate the clinical outcomes of transferring blastocysts
derived from PQEs.
Method
This was a case series study conducted at IVFVH, Van Hanh Hospital from January 2014 to
March 2016. Cycles having at least one day-3 PQE were included. Poor quality day-3
embryo was defined as embryos having ≥7cells with ≥20% fragmentation or ≤6 cells with
≥15% fragmentation. All PQEs were cultured to blastocyst. Blastocysts with proper quality
were vitrified and frozen transfer was performed in subsequent cycle. We analyzed factors
that associated with the blastulation.
Results
143 cycles having at least one day-3 PQE was included to the study. Blastulation occurred in
82.52% cycles with the mean blastulation rate of 40.50%. 82 cycles had blastocyst vitrified
with a mean number of vitrified blastocysts of 1.74 ± 0.77. Thirty-four cycles had FET with a
mean number of blastocyst transfer of 1.71 ± 0.46. The CPR and ongoing pregnancy rates
were 29.41% and 23.52%, respectively. Number of embryonic-cells on day 3 is associated
with the capability of blastulation.
Conclusion
Transferring of vitrified blastocysts derived from PQEs is an approach to maximize the

utilization of embryos. PQEs with ≥ 7 cells have better chance to form blastocysts.
ASPIR-0133
CLINICAL PREGNANCY OF VITRIFIED-BLASTOCYSTS AT DIFFERENT SIZES OF RE-

EXPANDED BLASTOCOEL
L. Thi Do1, B. Ngoc Nguyen1, H. Thi Thu Bui1, T. Cong Minh Mai1, L. Ngoc Vuong1
1
IVFMD - My Duc Hospital, My Duc Hospital, Ho Chi Minh City, Vietnam
Vitrification is a commonly used method for blastocyst cryopreservation. The size of the re-
expanded blastocoel after warming has been speculated to correlate with the pregnancy
outcomes. This study is to evaluate the correlation between the size of re-expanded
blastocoel and the clinical pregnancy rate.
Method
This was a case series study conducted at IVF Van Hanh, Van Hanh Hospital from April
2016 to September 2016. Patients were eligible if they met the following criteria: age <37
years, ≤ 2 previous attempts, having vitrified-blastocyst replacement. The size of re-
expanded blastocoel was assessed at 3 points included thawing point (T0), 2 hours after
thawing (T2), and at transfer (Tcp). In addition, the size of re-expanded blastocoel was
categorized as grade A if <10%, B if 10 - ≤50%, and C if >50% blastocoel volume
expanded. In brief, primary outcome was clinical pregnancy.
Results
35 patients were enrolled for this study. The clinical pregnancy rate was significantly higher
in patients having grade B and C compared to grade A blastocoel expansion at Tcp ( 66.7%,
57.1% versus 25.0%, respectively, p = 0.33), whereas no difference was found between
different sizes of blastocoel at T2 and Tcp. No correlation was found between the grade of
vitrified blastocyst and the size of re-expanded blastocoel.
Conclusion
The size of re-expanded blastocoel at Tcp may predict the clinical pregnancy in cycles
having vitrified blastocyst transfer.
Keywords: vitrification, blastocyst, blastocoel, clinical pregnancy

ASPIR-0157
THE EFFECT OF CLINICAL FACTORS ON EMBRYO MORPHOKINETICS

B.T.T. Truong1, T.D. Pham2, T.N.T. Vo1, L.T.N. Vuong3
1
IVFAS, An Sinh Hospital, Ho Chi Minh, Vietnam
2
IVFMD, My Duc Hospital, Ho Chi Minh, Vietnam
3
Department of Obstetric and Gynaecology, University of Medicine and Pharmacy,
Ho Chi Minh, Vietnam
Over recent years, time-lapse monitoring (TLM) systems have been developed and given us
more knowlegde of embryo mophorkinetics. This study was to determine whether maternal
age, sperm cryopreservation, maternal body mass index (BMI) affect embryo
morphokinetics.
Method
This was a retrospective study conducted at IVFAS, An Sinh Hospital, from Sep 2013 to Aug
2016. Human embryos were monitored using TLM system. Morphokinetics of embryos were
compared between the following clinical factors (1) female age ≤ 35 versus >35 years), (2)
source of sperm (fresh versus frozen), (3) BMI (<19, 19-24.9, 25-29.9 and >30). Hours post
insemination (hpi) for embryos to reach the pronucleus (PN) breakdown, 2,3,4,5,8 – cell,
compacted, early, expanded, hatched blastocyst stage were recorded and compared
between the above clinical factors.
Results
A total of 2327 embryos were analyzed. Embryos from younger patients reached the PN
breakdown (24.5±4.8 vs 25.3±5.1hpi[n1] , p=0.006) and compacted (87.9±11.9 vs
90.6±11.1hpi, p=0.034) stages faster than older patients. Embryos derived from frozen
sperm were faster at reaching the 5-cell stage compared to fresh sperm (47.8±9.7 vs
49.2±8.8 hpi, p=0.031). Overweight patients had significantly delayed the PN breakdown
(27.1±4.3hpi, p=0.000), 2-cell (29.9±4.5hpi, p=0.000), 3-cell (39.3±5.5hpi, p=0.002), 4-cell
(41.8±5.5hpi, p=0.001), 5-cell (52.6±7.5hpi, p=0.007), 8-cell (63.7±10.5hpi, p=0.014),
compacted (96.9±9.6hpi, p=0.000) stages compared to other BMI groups. Multivariate
analysis showed that female age, source of sperm, BMI were the independent factors that
affect the embryo morphokinetics.
Conclusion
This study showed that maternal age, sperm cryopreservation and maternal BMI affect to
embryo morphokinetics in the early development stages.
ASPIR-0162
COMPARISON OF TWO COMMERCIALLY AVAILABLE CULTURE MEDIA: IRVINE

SCIENTIFIC AND VITROLIFE ON EMBRYONIC DEVELOPMENT AND BLASTOCYST
FORMATION
A. Vo Thien1, K. Tran Vy1, T. Huynh Thi Thu1
1
The aim of this study was to compare the efficacy of two commercially available media,
single step (Irvine Scientific – USA) and sequential (Vitrolife - Sweden) on blastocyst
formation.
Method
Retrospective data analysis was separated independently into two stages to compare the
effect of culture media on IVF/ICSI success rates. 150 cases were cultured with sequential
media from 07/2015 to 12/2015 and 145 cases were cultured with single step media from
05/2016 to 09/2016. Embryo development parameters were recorded for every embryo on
consecutive days of preimplantation embryo development, growing in each set of culture
media. Fertilization, embryo quality, pregnancy and implantation rate were analyzed to
compare separately.
Results
There was no statistically significant difference in the fertilization rate (77,4% versus 80,7%,
P = 0.084). The blastocysts formation rate is similar between two groups (58.7% versus
59.2%, P = 0.225). There was no difference in usable blastocysts rate (93% versus 92%, P =
5.112) but good blastocysts is higher in sequential media compared with single step media
(41.2% versus 30.3%, P = 0.012). No differences were found at the pregnancy and
implantation rate between two media when transferred embryos (53.4% versus 53.6%, P =
0.724; 33% versus 32%, P = 0.523; respectively).
Conclusion
Both two commercially media are equally effective for in-vitro cultivation of embryos. Based
on our results, both commercial media may be uses as valuable and efficient alternatives to
each other for sustaining blastocyst development in extended embryo culture programs.
ASPIR-0172
INFLUENCE OF DIFFERENT SINGLE STEP CULTURE MEDIA ON EARLY EMBRYO

DEVELOPMENT: A TIME LAPSE STUDY OF SIBLING OOCYTES
N. Yaacob1, E. Mocanu2, G. Emerson3
1
Hospital Sultanah Nur Zahirah, O&G, Kuala Terengganu, Malaysia
2
The Rotunda Hospital, O&G, Dublin, Ireland
3
Clane Fertility Clinic, Fertility, Kildare, Ireland
Studies have been done comparing between non-sequential to sequential media,

comparisons made between different patients. No study so far compares different single
step culture media, among sibling oocyes retrieved from the same cohort follicles. Are the
morphokinetics of growing embryos affected by the different types of single step culture
media used? What women do better in which media?
Prospective observational non-interventional study between May 2015 to Dcember 2015.
Method
Patients undergone IVF-ICSI in which embryos were cultured in two single step culture
media in a time-lapse system. Oocytes retrieved from the same cohort of follicles. Time
lapseEmbryo development was analyzed with time-lapse imaging for Irvine Scientific CSM
and Vitrolife GT-L were compared. Kinetics variables studied included the timing to two
cells(t2), four cells(t4), eight cells(t8), compaction, morula and blastulation.
Results
No statistically significant differences were observed between the two media for all the
variables analyzed. When analyzing the mean cleavage time for t2, t4, t8, tM, tB, ratio of
nuclear precursor bodies (NPB), the types of morula formed and the percentage of embryos
falling within the optimal ranges proposed, we did not find significant differences between the
two media. No significant correlation between diagnosis, stimulation protocol, NPB ratios
and cleavage time for t4, t8, tM across the two different media. 113 (16%) embryos were
transferred, out of which (59) 52.2% were cultured in CSMÂ©
Conclusion
The absence of significant differences in morphokinetics between sibling oocytes cultured in

two different media validates the use of algorithm for embryo selection in diverse culture
conditions.
ASPIR-0173
PERCENTAGE OF RECOVERY FOLLICLES AND MATURED OOCYTES USING NON

FLUSHING TECHNIQUE DURING OOCYTES RETRIEVAL IN ASSISTED
REPRODUCTIVE TECHNIQUES
S.P. Tee1, M.R. Varutha Rajoo1, S.H. Ng1, B. Ghani1, N.F. Hassan1, Y.Y. Chow1
1
METRO IVF FERTILITY CENTRE, IVF LAB, KLANG, Malaysia
Many studies have showed that there is no demonstrable benefit to follicle flushing over
aspiration alone (Gary et al, 2012). This study focuses and observes the outcome of
follicular non-flushing technique during oocytes retrieval in Metro IVF Fertility Centre from
July 2015 to September 2016.
Method
353 cases of oocytes retrieval done at Metro IVF Fertility Centre using single-lumen pick up
needle from July 2015 to September 2016 were reviewed. The patients were all given
human chorionic gonadotrophin (hCG) injection 34 to 38 hours before oocytes retrieval was
performed. Our record also showed that the procedure took an average duration of 20 to 30
minutes per case. After the oocytes were retrieved, they were viewed under the inverted
microscope with magnification of 200 times to observe the maturity of the oocytes. The
number and maturity of the oocytes collected were recorded. The compiled data were then
analyzed.
Results
4939 oocytes were retrieved from 6674 follicles in 353 treatment cycles. Our analysis
showed that the oocyte recovery rate was 74% which is comparable with others using non-
flush method (Gary et al, 2012). 29% of cases had 80% or more of oocytes retrieved and
only 4% had 40% or less of the eggs retrieved. Out of 4939 oocytes retrieved, 3507 oocytes
(73%) were matured. The result also showed that 81% of cases had 60% or more matured
eggs.
Conclusion
The result showed that performing non flushing technique with single-lumen pick up needle
during oocyte retrieval can retrieve optimal number of oocytes.
ASPIR-0206
COMPARISON OF OPEN VERSUS CLOSED SYSTEM FOR VITRIFICATION OF HUMAN

BLASTOCYSTS.
B.L. Ng1, H.L. Saw1, P.S. Wong1, E. Sinthamoney1
1
Sunfert International Fertility Centre, IVF Lab, Kuala Lumpur, Malaysia
High survival rates and clinical outcomes similar to those from fresh blastocysts have been
observed with vitrification system. Techniques are categorized as either ‘open’ or ‘closed’
according to occurrence of direct contact between medium and liquid nitrogen during
cryopreservation. There are concerns that open vitrification system has a higher risk of
microbiological transmission through liquid nitrogen while with closed system the lower
cooling rater would have an adverse effect on vitrification. The survival, clinical pregnancy
rate and implantation rate after warming of blastocysts using two devices was compared: the
Cryotop device (open vitrification) and Rapid-i device (closed vitrification).
Method
A total of ninety-five blastocysts vitrified warmed cycles have been performed between May
2016 to September 2016 and the outcome was analysed retrospectively. Twenty-two of the
blastocyst were vitrified with Cryotop and seventy-three with Rapid-i. Only single blastocyst
transfer was performed in all cycles.
Results
When comparing Cryotop and Rapid-i devices, no significant difference was found with
regards to blastocysts survival (95% versus 100%), clinical pregnancy rate (61.9% versus
52.1%) and implantation rate (61.9% versus 53.4%), although there is a trend towards a
better outcome in clinical pregnancy and implantation rates with Cryotop device.
Conclusion
This finding demonstrates that a lower cooling rate as a consequence of using a closed
vitrification device did not appear to affect the vitrification outcome. Although this is not
statistically significant possibly due to the small sample size, there is a trend towards a
higher implantation rate in open system. A larger study will help to elucidate this further.
ASPIR-0244
HYALURONAN BINDING ASSAY AS A POTENTIAL ALTERNATIVE TO THE TUNEL

ASSAY FOR ASSESSMENT OF DNA INTEGRITY IN ASTHENOZOOSPERMIC
SPERMATOZOA
P. Sarakarnkosol1, P. Laokirkkiat1, I. Thanaboonyawat1, S. Petyim1, J. Prechapanich1,
S. Phornwilardsiri1, R. Choavaratana1
1
Faculty of Medicine Siriraj Hospital Mahidol University, Obstetrics and Gynecology,
Bangkok, Thailand
This study was conducted to evaluate the appropriateness of the hyaluronan binding assay
(HBA) for assessment of DNA integrity indirectly in asthenozoospermic spermatozoa, by
studying its correlation with the terminal deoxynucleotidyl transferase-mediated dUTP nick
end labeling (TUNEL) assay.
Method
Thirty asthenozoospermic semen samples of the male partner of infertile couples were
recruited. Semen analysis was performed before being processed by HBA and the TUNEL
assay. All the semen parameters were recorded and analyzed. The correlation between the
results of the two assays was evaluated.
Results
The mean age of the patients was 38.1 ± 6.4 years. The average total and progressive
motility was 33.5 ± 11.0% and 21.9 ± 6.6%, respectively. The mean TUNEL-positive and
hyaluronan-bound sperm was 17.8 ± 6.4% and 57.2 ± 14.5%, respectively. Pearson
correlation coefficient showed a high negative correlation between HBA and the TUNEL
assay (r = -0.73, p < 0.001). The intraclass correlation coefficients revealed a high level of
agreement between two observers who evaluated the TUNEL-positive and hyaluronan-
bound sperm [0.81 (95% CI: 0.65–0.91) and 0.92 (95% CI: 0.84–0.96)], respectively.
Conclusion
The study results showed a high negative correlation between HBA and the TUNEL assay.
This suggests that HBA may be used as a viable intact DNA spermatozoa identification
method, as a potential alternative to the TUNEL assay, in asthenozoospermia sperm.
Nevertheless, its clinical value for fertility needs to be further evaluated.
ASPIR-0253
AN ATTEMPT TO RESCUE APPARENTLY UNHEALTHY OOCYTE BY IMMEDIATE

REMOVAL OF BLACK CUMULUS CELLS FOLLOWED BY CULTURE IN HEALTHY
CUMULUS OF SIBLING OOCYTE
S.K. Goswami1, R. Chattopadhyay1, S. Ghosh1, M. Goswami1, G. Bose1, B.N. Chakravarty1
1
Institute of Reproductive Medicine, ART, Kolkata, India
The aim was to observe whether quick removal of black cumulus cells followed by
immediate culture of denuded oocytes in healthy cumulus from sibling oocyte-corona-
cumulus complex (OCC complex), can restore oocyte competence for further development.
Study was performed between January2015 to July2016.
Method
1040 oocytes having black or unhealthy cumulus cells were identified from 2230 oocytes.
They were randomly divided into two groups Gr-A and Gr-B. In Gr-A, 604 oocytes with black
cumulus cells were denuded immediately after retrieval. Denuded oocytes were then
cultured in healthy cumulus cells, obtained by partial microsurgical resection from healthy
sibling oocyte-corona-cumulus complex, for 3 hours till ICSI. 427 OCC complex in Gr-B were
incubated for 3 hours after retrieval. Denudation and ICSI were done.
9 oocytes were discarded due to dysmorphism. All injected oocytes were cultured till
blastocyst stage. The rates of fertilization, ≥20% fragmentation, blastocyst formation and
implantation were compared.
Results
Fertilization rate was 57.23±13.01 in Gr-A and 48.00±11.3 in Gr-B (p<0.0001). fragmentation
in Gr-A was 29.31±10.3 compared to 35.15±10.55 in Gr-B (p<0.0001). Blastocyst formation
was 48.01±20.15 and 35.18±25.43 in Gr A and B respectively (p<0.0001). Implantation rate
in Gr-A was 27.12±10.16 and 17.60±10.13 in Gr-B (p<0.0001).
Conclusion
Black cumulus cells are indicator of apoptosis, and are associated with poor quality oocytes
tending towards apoptosis. Cumulus cells and oocytes are interdependent for their growth
and development. Early removal of unhealthy cumulus cells, followed by culture with healthy
cumulus cells from sibling oocytes, may rescue a few oocytes from apoptosis, leading to
better blastocyst formation and increased implantation.
ASPIR-0254
IMPACT OF REDUCTION OF VOLATILE ORGANIC COMPOUNDS (VOCS) IN THE IVF

LABORATORY ON SUCCESS RATE OF IVF-ET CYCLES
S. Ghosh1, R. Chattopadhyay1, N. Agarwal1, S.K. Goswami1, M. Chakravarty1,
B.N. Chakravarty1
1
Institute of Reproductive Medicine, ART, Kolkata, India
To evaluate the detrimental effect of volatile organic compounds (VOCs) in the laboratory
with respect to implantation rate and clinical pregnancy in women undergoing in-vitro
fertilization (IVF). Prospective study with VOC assessment before (Gr-A: June2014 to
April2015) and after (Gr-B: June2015 to April2016) remodeling of IVF laboratory.
Method
In May2015, particle board and other wood-based panels, PVC flooring were replaced with
epoxy paints on the floor and double-shield glass on the windows. Use of aerosol or
ammonia-based cleaning agents in the IVF laboratory was avoided. Fumigation was
performed yearly. ‘Perfume-free’ zone was strictly adhered to. VOC sources were
investigated with a VOC specific probe (Saswel-AQC910-China) by photo-ionization
detection. Rates of blastocyst formation, implantation and clinical pregnancy were the
outcome measures in 514 cycles(Gr-A) and 522 cycles(Gr-B).
Results
Demographic profile and basal hormonal level of both groups were comparable. A significant
(p<0.02) decreased trend (16.6±7.0 vs. 5.2±3.0) in the level of VOC(ppm) of indoor air was
observed before and after remodeling of the laboratory. Blastocyst formation rate increased
significantly (p<0.0001) in Gr-B(62.83%) compared to Gr-A(44.94%) with a concomitant rise
(p<0.008) in implantation rate (Gr-A vs Gr-B: 31.60% vs. 42.98%). The clinical pregnancy
rate varied significantly (p<0.004) before and after VOC elimination (27.27% vs. 37.80%).
Live birth rate was higher in Gr-B than Gr-A (30.79% vs 22.94%) (p<0.043).
Conclusion
Following remodeling of the laboratory and strictly avoiding VOC generation, significant
decrease in embryo-toxic VOCs is observed. This may reduce apoptosis and help embryos
to proceed to blastocyst stage, leading to significant improvement in IVF success.
ASPIR-0258
TROPHECTODERM SCORE OR ICM SCORE: WHICH ONE HAS BETTER PREDICTION

OF IMPLANTATION AND LIVE BIRTH RATE IN SINGLE BLASTOCYST TRANSFERS?
A. Vo Thien1, T. Huynh Thi Thu1
1
To evaluate the effect of embryo stage, trophoectoderm grade and inner cell mass (ICM)
grade on live birth in single blastocysts transfers.
Method
This retrospective cohort study analysed all patients who were transferred with single
blastocyst (including fresh embryo transfer and frozen-thawed embryo transfer).
Results
Our results showed that trophoectoderm grade was correlated with implantation and live
birth rates. Live birth rates were 51%, 38% and 25% for trophectoderm grade A, B and C,
respectively. However, there was no significant association ICM grade A or B and live birth
rates, 48% and 45% for inner cell mass quality A and B respectively. Live birth rate was 0%
for ICM grade C.
Conclusion
Trophectoderm grade significantly correlated with implantation and live birth rates in single
blastocyst transfers.
ASPIR-0284
PREDICTIVE FACTORS FOR CLINICAL SUCCESS AFTER INTRAUTERINE

INSEMINATION (IUI)
N. T Do1, T. D Pham2, N. L Dinh1, K. A Bui1, K. T Le1, T. M Ho3
1
IVFAS, An Sinh Hospital, Ho Chi Minh City, Vietnam
2
3
CGRH, School of Medicine - Vietnam National University, Ho Chi Minh City, Vietnam
IUI is a popular treatment for infertile couples. So far, many studies investigated factors
affecting pregnancy rates after IUI. However, various investigators have not agreed on the
ranking of these criteria. The aim of the study is to determine the factors for pregnancy after
controlled ovarian hyperstimulation (COH)/IUI.
Method
A retrospective cohort study was conducted at IVFAS, An Sinh Hospital and IVFMD, My Duc
Hospital from April 2014 to July 2016. All women in the study underwent ovarian stimulation
using gonadotropin and IUI was performed 36 - 40h after triggering ovulation. The primary
outcome was ongoing pregnancy.
Results
Overall, 1670 couples who underwent 1757 cycles were included in the study. There were
306 (17.4%) pregnancies, of which 257(14.6%) pregnancies were ongoing. There were
significant difference with age of wife, AMH level, number of follicles ³14mm and endometrial
thickness on day IUI between cycles with ongoing pregnancy and non-ongoing pregnancy
(29.6 ± 4.4 vs 30.8 ± 4.5, p<0.001; 7.9 ± 4.4 vs 6.4 ± 4.5, p<0.001; 1.5 ± 0.7 vs 1.4 ± 0.7,
p=0.006, 11.0 ± 1.9 vs 10.6 ± 1.8, p=0.001, respectively). Multivariable logistic regression
analysis revealed two predictive variables as regards ongoing pregnancy: the maternal age
(OR: 0.96, CI: 0.93 – 0.99, p=0.048) and AMH level (OR: 1.05, CI: 1.01 – 1.08, p=0.005).
Conclusion
These results suggest that the maternal age and AMH level are prognostic factors for
pregnancy after IUI.
ASPIR-0292
OUTCOME OF NORMAL OOCYTE AND OVAL OOCYTE MORPHOLOGY IN IN VITRO

FERTILISATION
M. Situmorang1
1
School of Medicine University of Sumatera Utara, obstetric and gynaecology, Medan,
Indonesia
The success rate of in vitro fertilization and intracytoplasmic sperm injection (ICSI) is
strongly influenced by the quality of the oocyte. Oocyte quality is an important prognostic
factor for the maturity of the oocyte nucleus and cytoplasm associated with a success rate of
intracytoplasmic sperm injection. To determine the difference in fertilization outcome in
invitro fertilisation between normal oocyte and oval oocyte morphology.
Method
This study is a comparative analytical study with retrospective approach which commenced
from September 2015 until November 2015 at Halim Infertility Clinic at Stella Maris Hospital
Medan. The subject of research is secondary data (medical records) who underwent in vitro
fertilization procedure in Halim Infertility Clinic at Stella Maris Hospital Medan. Data were
analyzed with computer applications in accordance with comparative analytical data
presentation.
Results
Total sample of 120 oocytes was enrolled in this study. It was found in normal oocyte group
with 68.3% positive fertilization, while in oval oocyte group with 61.7% positive fertilization.
Based on statistical test of Chi-square p value> 0.05. In normal oocytes, there was 36.7%
embryo grade 1-2 from embryos that can’t be transfered , while in oval oocytes there was
53.3% embryo grade 1-2 from embryos that can’t be transferred (p value> 0.05). In normal
oocytes group, there was more embryos with medium quality (84.2%), while in oval oocyte
group there was more embryo with medium quality (75%).
Conclusion
There was no significant difference in fertilization between normal oocytes and oval oocyte.
There is no significant difference in embryo quality in both groups.
ASPIR-0301
EFFECT OF SPERM DNA FRAGMENTATION ON THE OUTCOMES OF

INTRACYTOPLASMIC SPERM INJECTION
N.T.Q. Tien1, M. Ma Pham Que2
1
2
Research Center for Genetics and Reproductive Health, GENETIC, Ho Chi Minh, Vietnam
Poor seminal parameters such as reduced count and motility or abnormal morphology often
correlate with high level of sperm DNA damage. The aim of the present study was to
evaluate correlation between sperm DNA Fragmentation Index (DFI) and Intra-cytoplasmic
Sperm Injection (ICSI) outcomes.
Method
A prospective cohort study was conducted at IVFMD, My Duc Hospital from July 2016 to
September 2016. DFI was measured by sperm chromatin dispersion test (SCD) assay.
Primary outcome was fertilization rate and secondary outcomes were cleavage rate and
good quality embryo rate.
Results
A total of 30 cycles were recruited to the study. Mean sperm concentration and sperm
progressive motility were 55.8 ± 37.8 (106/ml) and 33.8%. The mean DFI was 23.5%. Mean
patients’ age was 31.3 ± 4.0. Overall, there was no correlation between DFI and fertilization
rate, day 3 embryo cleavage rate, good quality embryo rate (r=0.21, p=0.188; r=0.3,
p=0.148; r=0.32, p=0.24, respectively).
Conclusion
In this study, we found no correlation between DFI and fertilization, cleavage rate, and good
quality embryo in infertile couples undergoing ICSI procedure. Study with larger sample size
is needed to verify this issue.
ASPIR-0328
DOES THE NUMBER OF PEOPLE PRESENT DURING AN EMBRYO TRANSFER

PROCEDURE ALTER VOLATILE ORGANIC COMPOUND LEVELS?
T.A. Isa1, N.H. Wan Fatul1, M.N.A. Ishak1, K. Kanniah1, S.N. Wagiman1, S. Sarmidi1,
S.D. Valiapan1, N.H. Yussoff1, N. Mohd Nordin1
1
Kuala Lumpur General Hospital, Obstetric & Gynaecology, Kuala Lumpur, Malaysia
High Volatile Organic Compounds (VOC) are detrimental to embryos. High VOC in an
Assisted Reproductive Technology (ART) laboratory might be due to medical staff who do
not fulfill the hygiene recommendations for procedure rooms and laboratories. Perfumes and
aftershaves are a source of high VOC. This study was aimed at evaluating the effect of
having non-essential people (observers) present during embryo transfer procedure on VOC
levels.
Method
This retrospective study on 145 embryo transfer procedures was done at the Reproductive
Medicine Unit, Kuala Lumpur General Hospital in 2016. The VOC reading and the numbers
of people present during each procedure were recorded. VOC levels were captured with a
Research Instrument (R.I) VOC meter. Data was analysed using SPSS 20.0 and Chi-square
was used to test for statistical significance.
Results
The VOC was recorded at 0.1±0.1 when 3 people were in the procedure room, (n=2),
0.10±0.01 for 4 people (n=53), 0.10±0.01 for 5 people (n=62), 0.12±0.02 (n=25), 0.1 for 7
people (n=1), and 0.15±0.05 for 8 people (n=2). There was no significance difference
(p>0.05) between the total number of people present during procedures and VOC levels.
Conclusion
The number of people in the embryo transfer room does not adversely affect VOC levels.
This might be due to a well-maintained air quality environment, using air filters. Staff
adherence to avoidance of fragrances and clean procedure room attire and footwear might
also help in controlling the VOC level. This study shows that the number of people present
during a transfer procedure need not be limited.
ASPIR-0334
SEMINAL FLUID PARAMETERS POST SPERM WASH WITH GRADIENT

CENTRIFUGATION METHOD
K. Krishnan1
1
Reproductive Medicine Unit, Obstetric &Gynaecology, Kuala Lumpur, Malaysia
The objective of this study was to review the outcome of sperm preparation for intrauterine
insemination (IUI) using gradient centrifugation method.
Method
Semen analysis was performed for 1386 men, whose partners underwent IUI at the
Reproductive Medicine Unit, Kuala Lumpur Hospital from 2011 to 2015. Samples were
collected after an abstinence period of 2-5 days and analyzed within one hour of receipt at
the laboratory. Semen volume was measured by aspirating the whole liquefied sample into a
5 ml or 10 ml graded syringe without needle. Makler counting chambers and compound
microscopy were used to measure sperm concentration, total motile sperms and
morphology. Post-wash sperm parameters were calculated as a percentage of pre-wash
levels.
Results
The pre-wash mean sperm concentration was 122.6 ± 2.8 million/ml and the post-wash
concentration was much lower, 43.4 ± 1.2 million/ml; a reduction of 65%. We also found a
71% reduction in the total motile sperm count after sperm preparation with gradient
centrifugation. The pre-wash mean for total motile sperm was 103.3 ± 2.6 million, whereas
the post-wash mean was 29.5 ± 0.7 million. However, the post-wash sperm morphology
showed a 3% improvement. The mean pre-wash and post-wash morphology was 7.7 ± 0.1%
and 10.6 ± 0.2% respectively. Paired t-test analysis showed that the differences between the
pre-wash and post-wash characteristics studied in this review were statistically significant
(p≤0.05).
Conclusion
This study highlights the importance of having adequate pre-wash concentrations of motile
sperms, due to the significant loss after gradient centrifugation, which can negatively impact
intrauterine insemination outcomes.
ASPIR-0341
BLASTOCYST CULTURE AT PERMATA HATI CLINIC, THE DR.SARDJITO GENERAL

HOSPITAL, YOGYAKARTA
D. Suryaningtyas1
1
Sardjito General Hospital/ Gajah Mada University School of Medicine, Permata Hati Clinic,
Yogyakarta, Indonesia
Introduction: The development of Assisted Reproductive Technology in the field of embryo

culture is moving forward. It encourages the increasing of the quantity and quality of the
resulting embryos at each stage of culture. Embryo culture up to the blastocyst stage is
necessary for the selection of embryo transferand frozen embryo. Permata Hati Clinic, the
Dr. Sardjito General Hospital of Yogyakarta developsthe embryo culture up to the blastocyst
stage mainly to improve the embryo selection.
Method
Methods: Patients of fresh IVF cycles that have the blastocyst in Permata Hati Clinic from
January 2015 to October 2016 were divided into three groups based on age: A (less than 35
years old), B (35-40 years),C (more than 40 years). Total blastocysts were categorized into
two: 1-2 blastocysts and more than 2 blastocysts.
Results
Results: In 2015, the patients who obtained blastocyst were 21.9% while in 2016 (January
to October) were 17.4%.In 2015 they were: Group A: 28, B: 8, C: 1, whereas in 2016: Group
A: 18, B: 7 C: 1. In 2015, the number of blastocyst obtained by Group A was 43.2% in the
group of more than 2 blastocysts, In Group B, the number of blastocyst in the group of more
than 2 blastocysts was 13.5%. In 2016, the number of blastocyst in Group A was high
showing 57.7% in the group of more than 2 blastocysts,Group B showed 15.4% of the same
group.
Conclusion
Conclusion: Patients with embryo culture reaching the blastocyst stage and the number of
blastocyst obtained increase every year.
ASPIR-0344
SIMULTANEOUS PREIMPLANTATION GENETIC DIAGNOSIS (PGD) FOR ALPHA-

THALASSEMIA AND PREIMPLANTATION GENETIC SCREENING (PGS) FOR
ANEUPLOIDY ON SINGLE BIOPSY USING ION-TORRENT NEXT GENERATION
SEQUENCING (NGS)
C.S.S. Lee1, Y. Wei Yuan1, M.W. Lim1, J.M.S. Chooi1
1
Alpha International Fertility Centre, IVF Lab, Petaling Jaya, Malaysia
This report reviews the clinical outcome of embryo transfer following simultaneous PGD and
PGS from a single biopsy using a single-NGS platform in Alpha Fertility Centre (AFC),
Malaysia.
Method
There were 7 patients who underwent frozen embryo transfer (FET) following alpha-
thalassemia PGD and PGS from the time AFC deployed the Ion-Torrent NGS platform from
September 2015 till November 2016. Twenty-nine blastocysts with at least fair grade
(Gardner, 1999) were biopsied and amplified using multiple displacement amplification. The
amplification product from each blastocyst was separated into 2 aliquots: one for library
construction using a customised thalassemia-Ampliseq panel; and another to construct PGS
library. All libraries were pooled and sequenced simultaneously using a single-NGS platform
according to the manufacturer’s specification (Ion Torrent, USA).
Results
All 29 blastocysts were successfully amplified and analysed; 9 were unaffected, 12 were
carriers and 8 were alpha-thalassemia major. Five out of the 9 unaffected blastocysts were
euploid whereas 11 out of 12 carrier blastocysts were euploid. Two patients with unaffected-
euploid blastocysts and five patients with carrier-euploid blastocysts underwent single
blastocyst frozen embryo transfer. The clinical outcome of these patients are summarised in
Figure 1.
Conclusion
The Ion-Torrent NGS platform in AFC enabled both PGD for genetic disease diagnosis and
PGS to be performed concurrently on a single platform. This eliminates the need of biopsy
twice on the same blastocyst as required for tests performed on separate platforms, and
prevents potential damage from a second biopsy. We believe this contributes to our high
implantation rate of 71.4%.
ASPIR-0360
ABERRANT CELL DIVISION IN EARLY-STAGE HUMAN EMBRYOS OBSERVED BY

TIME-LAPSE MONITORING AND ITS NEGATIVE IMPACTS ON SUBSEQUENT
EMBRYONIC DEVELOPMENT
K. Iwata1, Y. Keitaro2, Y. Mio2
1
Mio Fertility Clinic, Yonago, Japan
2
Mio Fertility Clinic, Reproductive Centre, Yonago, Japan
Using time-lapse monitoring systems, we often observe embryos showing aberrant cell
division in which a single zygote divides into more than three blastomere-like cells in the first
cleavage and a single blastomere into three or more blastomere-like cells in the second
cleavage. It seems to be an abnormal behavior of embryos; however, the developmental
potential and negative impacts on embryonic quality of embryos showing aberrant cell
division have not been elucidated.
Method
In this study, 2,297 normally fertilized zygotes after ICSI were then cultured for three days in
time-lapse incubator. We analyzed the occurrence of aberrant division in normally fertilized
zygotes and we also compared the developmental time-course of the first and the second
cleavage of blastomeres.
Results
Of 2,297 zygotes, 239 (10.5%) showed aberrant division, and among embryos in the
aberrant group, 75.7% (181/239) and 17.6% (42/239) of embryos showed aberrant division
in the first cleavage (aberrant1st) and in the second cleavage (aberrant2nd), respectively. Of
239 embryos, 16 embryos (6.7%) showed aberrant division in both first and second
cleavages (aberrant1st/2nd). The time required from syngamy to the first cleavage in
aberrant1st embryos (aberrant1st vs. normal; 6.1±4.9 v.s. 2.9±1.9 hours, P<0.05) was
significantly longer than in the normal group. Additionally, in case of transferring aberrantly
divided embryos, the pregnancy rate was 7.7% (1/13).
Conclusion
Our study suggested that aberrant cell division was associated with retardation of embryonic
development, especially a delay in syngamy to the first cleavage.
Contraception
ASPIR-0302
Posters: Contraception
SEARCHING FOR A NOVEL CONTRACEPTIVE: DOES KISSPEPTIN ANTAGONIST

SHADE LIGHT?
M.R.I. Bhuiyan1, A.H. Shaikat2, S.M. Alif3, S. Khaliduzzaman1, K.N. Priti4
1
Apollo Hospital Dhaka, Apollo Fertility Center, Dhaka, Bangladesh
2
Chittagong Veterinary and Animal Sciences University,
Department of Physiology- Biochemistry and Pharmacology, Chittagong, Bangladesh
3
The University of Melbourne, Centre for Epidemiology and Biostatistics CEB, Melbourne,
Australia
4
Shere E Bangla Medical college, Obstetrics and Gynaecology, Dhaka, Bangladesh
Though, a wide range of contraceptive method is available, many of them have been found
as inconvenient for most of the couples. The physical barrier method is reported as less
attractive for many couples due to latex allergy and diminish of sexual pleasure during
intercourse. Furthermore, the usage of hormonal contraceptive preparation raised many
questions due to having some drawbacks such as increased risk of venous
thromboembolism and cancer in the reproductive organ. For this, to ameliorate the side
effects of hormonal contraceptive and to develop new contraceptive is an urged issue.
Immunofluroscence studies and westernblot analysis established the co-localization of
kisspeptin and its receptor( KISSR) in equatorial region, neck and mid-piece of mature
human spermatozoa. Kisspeptin antagonist can regulate sperm motility by reducing sperm
cytoplasmic ca2+ level via G protein-phospholipase C (PLC) signaling pathway. The
previous studies in Kisspeptin and its receptor (KISS1R) and its relationship in sperm motility
fueled our mind to think that the Kisspeptin antagonist could be a possible choice as a
contraceptive
Method
To test this hypothesis, we will use invitro culture model of fertilization by blocking the sperm
motility using commercially available Kisspeptin antagonist peptide (P234)to calculate the
oocyte fertilization rate along with free Ca2+ measurement of sperm from a cohort group of
consented persons in Apollo Hospital, Dhaka..
Results
Kisspeptin antagonist (P234) is expected to reduce sperm motility and inhibit fertilization in
in-vitro sperm oocyte complex
Conclusion
The outcome of this study will create an opportunity to use Kisspeptin antagonist to develop
a novel contraceptive gel.
Counselling, Ethics and
Psychosocial
ASPIR-0015
Posters: Counselling, Ethics and Psychosocial
ACCEPTANCE OF DONOR EGGS, DONOR SPERMS OR DONOR EMBRYOS IN INDIAN

INFERTILE COUPLES
K. 1, B. Singla2
1
, Reproduction unit,, India
2
Advanced fertility & Gynaecology Centre, Reproduction unit, New Delhi, India
To assess the attitude toward egg, sperm and embryo donation among the Indian infertile
couples.
Method
From 1st October 2015 till 31st December 2015, total 594 infertile couples were assessed. A
well-structured questionnaire was given to each infertile couple at first visit. Both female and
male partners had filled the questionnaire separately. The acceptance rate of couple towards
the egg, sperm and embryo donation was assessed.
Results
Out of 594 female partners, 118 females agreed for donor eggs (19.9%), 116 females
agreed for donor sperms (19.5%) and 93 females agreed for donor embryos (15.7%). Out of
594 male partners, 262 males agreed for donor eggs (44.1%), 90 males agreed for donor
sperms (15.2%) and 141 males agreed for donor embryos (23.7%).
Conclusion
The overall acceptance of donor eggs, sperms or embryos in Indian infertile couples is low.
The acceptance rate of females for donor eggs or donor sperms is same but males are more
amenable to accept donor eggs than donor sperms. This is the first study to assess the
acceptability of donor gametes or embryos in Indian population.
ASPIR-0071
THE FIRST PSYCHOLOGICAL STUDY IN VIETNAM TO IDENTIFY INFERTILE

PATIENTS AT HIGH RISK OF FERTILITY QUALITY OF LIFE
T. Vu1
1
Tu Du Hospital, Infertility Department, HCM, Vietnam
Psychological distress and dissatisfaction of infertile couples are major determinants of

treatment discontinuation. Viet Nam has a specific environmental, socio-cultural context and
rising numbers of infertile patients. However, little is known about psychological distress
amongst patients, also they are likely to experience a lower quality of life and reduced
satisfaction levels with infertility treatment services. To date, this is the first study to explore
patient satisfaction with infertility care service in the country.
The aims of this study are to validate the Fertility Quality of Life (FertiQoL) instrument in the
Vietnamese population and to identify significant correlations between satisfaction and
psychological distress level among infertile couples.
Method
This cross-sectional survey is self-completion of the FertiQoL questionnaire, which has been
validated in European infertile patients. Participants (N=323) will be couples, having multiple
contacts the service, preparing for embryo transfer in the Infertility Department of Tu Du
hospital within the period from 1st Nov to 31st Dec 2016. Each male/female participant
returns the completed questionnaire at a subsequent visit or by mail. Baseline demographic
information is collected on all those given a blank questionnaire to provide information on
non-responders.
Results
Findings from this study should be useful in validating the FertiQol questionnaires, in
identifying the patterns and the determinants of patient’s distress associated with satisfaction
of the major infertility services in Viet Nam.
Conclusion
The study should have an impact on public health by providing a validated tool and an
acceptable procedure for measuring infertility quality of life routinely in other infertility
services throughout the country.
ASPIR-0340
A CROSS SECTIONAL SURVEY ON LIFESTYLE BEHAVIOURS IN WOMEN

UNDERGOING IN VITRO FERTILISATION IN SINGAPORE
S.Q. Tan1, E. Huang2, M. Lau3
1
, Singapore, Singapore
2
KK Women's and Children's Hospital, O&G, Singapore, Singapore
3
KK Women's and Children's Hospital, Reproductive Medicine, Singapore, Singapore
Research has drawn light on many lifestyle habits associated with reduced IVF success
rates, many of which are modifiable. Detailed lifestyle questioning should be better
integrated into IVF counselling to correct generalised public misconceptions. Our study aims
to look at modifiable lifestyle behaviours of women prior to an IVF cycle to critically evaluate
our current counseling.
Method
A cross sectional survey was distributed to all women scheduled to undergo an IVF cycle
between August to September 2012. Our target sample size was 100. The invitation was
offered until our target sample size was achieved. There was no exclusion criterion. The
survey questions included modifiable lifestyle habits in the past month, as well as that 5
years ago.
Results
A total of 126 women were approached. Of which, 106 survey forms were returned. 99
survey forms are analysed. Prior to their IVF cycle, 35% exercised, 2% smoked, 14% drank
alcohol, 73% drank caffeinated drinks, 26% consumed herbs and 10% underwent
acupuncture. Compared to habits 5 years ago, 74% exercised, 5% smoked, 24% drank
alcohol, 80% drank caffeinated drinks, 27% consumed herbs and 12% underwent
acupuncture. There were statistical changes in lifestyle habits in the areas of exercise,
alcohol and caffeine intake (p<0.05). There was no difference in the areas of vegetable and
fruit consumption, as well as use of herbs and traditional chinese medicine.
Conclusion
Our study, though small, highlights areas of modifiable lifestyle habits which can be
improved in our patient IVF counselling to maximize success rates via simple changes in
habits.
Embryology
ASPIR-0012
Posters: Embryology
EVALUATION OF THE PROTECTIVE EFFECT OF ETHYL PYRUVATE ON IN VITRO

FERTILIZATION (IVF) IN CYCLOPHOSPHAMIDE TREATED ADULT MALE MICE
Z. Bakhtiary1, R. Shahrooz1, S. Amani1
1
Urmia university, basic science, Urmia, Iran
This study was aimed to evaluate the role of ethyl pyruvate (EP) in the amelioration of
fertility in animals that received CP.
Method
24 adult male mice (6-8 weeks) were randomly divided into 3 groups: Control group received
normal saline (0. 2ml/day, IP), CP group received CP (15 mg/kg/week, IP),the CP+EP group
received EP (40mg/kg/day, IP) along with CP, were treated for 35 days. After 8 mice from
each group were arranged for evaluation in vitro fertilization (IVF). Afterward, the separated
oocytes from 72 ovulation stimulated mice were collected in HTF medium that contained
BSA, and in-vitro fertilization (IVF) has been done with capacitated sperms. The trend of
Fertilization and primitive embryonic growth evaluated for 120 hours.
Results
The results revealed that CP caused notable decrease in percentage of fertilization in CP

group, but administration of EP along with CP caused an increase in the percentage of
fertilization in comparison to CP group. The percentage of the two cell zygotes in CP+EP
group, and the percentage of blastocysts in control and CP+EP groups were higher than that
in CP group (P<0.05). Results showed that the total number of arrested embryos in control
and CP+EP groups was decreased in comparison to CP group (P<0.05). The percentage of
arrested embryos type I, II, and III in CP+EP group was decreased in comparison to CP
group, but that decrease was significant only in types I and II (P<0.05).
Conclusion
The results of this study showed the role of EP in amelioration of rate of embryo
development.
ASPIR-0027
Posters: Embryology
USE OF TESTICULAR SPERMS TO IMPROVE EMBRYOLOGICAL PARAMETERS IN

FAILED IVF CYCLES
K.C. Mantravadi1, D.R. Gedela1
1
OASIS center for Reproductive Medicine, IVF, HYDERABAD, India
Objective:
To investigate the effectiveness of testicular sperm in improving embryological parameters in

failed IVF cycles
Method
Design:
Retrospective study
Setting:
Private fertility clinic
Patient(s):
Couples who underwent 1st IVF-ICSI cycle with Ejaculate sperm and had a negative
outcome (n=43).
Intervention(s):All male partners who had a failed IVF cycle with us were subjected to
Sperm DNA Fragmentation Index (DFI) assessment through Sperm Chromatin integrity
assay (SCIA) (n=43). Sperm DNA fragmentation Index of 25% and above was considered
high. Use of surgically retrieved testicular sperms was considered during the 2nd IVF cycle
for couples with raised sperm DFI (n=14). All cycles were subjected to extended embryo
culture till Blastocyst stage. Embryological parameters were compared in both the cycles
Results: Various embryological parameters of first cycle with ejaculate sperm versus 2nd
cycle with testicular sperms were compared. No difference with respect to number of
oocytes retrieved (11 Vs 12.57), fertilization rate (71.02 Vs 63.11), number and percentage
of Grade 1 embryos on Day 3 (74.01 Vs 85.67). No difference in number of embryos
available for freezing (1.42 Vs 3.57). Interestingly, statistically significant increase is noted in
the percentage of blastocysts on Day 5 (13.65 Vs 45.43), (P<0.05).
Conclusion:
There seems to be a role for active intervention through testicular sperms aspiration for
couples with failed IVF cycles with raised sperm DFI
ASPIR-0052
Posters: Embryology
BLASTULATION AND BLASTOCYST UTILISATION RATES AT ALPHA FERTILITY

CENTRE
S.Y. Low1, Y.X. Lim1, C.S.S. Lee2
1
Alpha Fertility Centre, IVF Lab, Petaling Jaya, Malaysia
2
Alpha Fertility Centre, IVF Clinic, Petaling Jaya, Malaysia
We had selectively cultured embryos to blastocysts from year 2011 to April 2013. In that
period of time, only 13.2% of the IVF cases were selected for blastocyst culture. We had
then reported a blastulation rate of 72.5% and blastocyst utilisation rate of 62.8% (Lee et. al.,
2014). Since then we increased the proportion of cases for blastocyst culture progressively.
This study measures the blastulation and blastocyst utilization rates for all age groups in
Alpha International Fertility Centre from June 2016 till now, during which time 95.7% of
cases had blastocyst culture.
Method
Since June 2016 till now, we adopted a policy of having all patients going for blastocyst
culture with occasionally exception (95.7% of cases had blastocyst culture). In this study,
blastulation rate was defined as total number of blastocysts formed per total number of 2PN
zygotes. Blastocyst utilisation rate was defined as total number of blastocysts (2PN) utilised
(transferred, cryopreserved or biopsied) per total number of blastocysts formed (2PN).
Results
As shown in Table 1, nearly all of the IVF cycles (95.7%) had blastocyst culture. The
blastulation and blastocyst utilisation rates for patients aged <35 were 75.9% and 62.5%
respectively. Similar rates were also achieved for age group: 35-37, 38-39, 40-41 and >41
(p>0.05). Overall, the blastulation rate and blastocyst utilisation rate for all age groups were
73.2% and 58.0% respectively.
Conclusion
Our study shows high blastulation and blastocyst utilisation rates among all age groups at
Alpha Fertility Centre.
ASPIR-0116
Posters: Embryology
EFFECT OF A CERTAIN WAVELENGTH OF LIGHT ON EMBRYO DEVELOPMENT

A. Saini1, J. Thompson1, H. Brown1, P. Reineck2, A. Orth2
1
Robinson Research Institute, Obstetrics & Gynaecology, Adelaide, Australia
2
Centre for Nano Scale BioPhotonics, Science, Melbourne, Australia
Embryo observation is an integral step in an everyday ART setup. Allowing scientists to

study the morphology and select the best embryo for day 5/6 transfer. During this process
embryos are exposed to light, which is harmful for it’s development as there is no light
present in vivo. Various sources of light ranging from halogen lamps to fluorescent lamps are
used. It has been thought that embryo observation at various time points is not harmful for
embryos, however light has the potential to change the temperature of the culture medium,
which effects the pH. Ultimately leading to decreased embryo development rate. Our aim
was to test the effect of red light on embryo development rates
Method
Light emitting diodes (LED) of 616nm wavelength was selected at 0.97 mW/cm2. Day one
CBAF1 mouse zygotes were collected and cultured to day 5 blastocysts in 6% CO2.
Embryos were exposed to red light for a total of 5 min from day1-5. Cleavage and blastocyst
rates were recorded and statistical analysis was performed.
Results
Cleavage rate in the control group was lower in comparison to treatment, 80.7% vs 85.36%
(p = 0.67). Whereas, Blastocyst rate in the control group was higher in comparison to
treatment, 79.63% vs 77.42% (p = 0.81) & no statistical significance was achieved.
Conclusion
Pilot studies prove that, light is toxic to embryos and only certain wavelengths are safe for
embryo observation invitro. Our data suggests otherwise as the blastocyst rates were
unaffected, but more studies are to be conducted with powerful LED’s.
ASPIR-0119
Posters: Embryology
DAY 6 BLASTOCYSTS ARE ASSOCIATED WITH HIGHER ANEUPLOIDY RATES

COMPARED TO DAY 5 BLASTOCYSTS
S.Y. Chen1, S.T. Tee1
1
TMC Fertility Centre, IVF LAB, Petaling Jaya, Malaysia
The relationship between chromosomal abnormalities and developmental rate of blastocysts

on day 5 and 6 was evaluated in this study.
Method
752 fresh blastocysts with trophectoderm biopsy on day 5 (n=643) and day 6 (n=109)
between January 2014 and Sep 2016 were included in this retrospective study. Assisted
hatching was done on day 3. Embryos were assessed at 114-118 hours (day 5) and 138-142
hours (day 6) post-injection. Blastocysts were graded using the grading system as described
by Gardner and Schoolcraft. Only blastocysts which scored A or B for both trophectoderm
cells (TE) and inner cell mass (ICM) with protruding TE at the time of checking were selected
for biopsy. The biopsy criteria were the same for both day 5 and day 6 blastocysts. If the
embryos did not met the biopsy criteria on day 5, they were evaluated again on day 6.
Embryos were categorized into two groups (day 5 vs day 6) based on the day they met the
biopsy criteria. The biopsied cells were screened for aneuploidy using array comparative
genomic hybridization (aCGH). The aneuploidy rates were compared between these two
groups.
Results
Out of 643 blastocysts on day 5, 303 of the blastocysts (47.1%) were aneuploid. 65 out of
109 blastocysts (59.6%) on day 6 were aneuploid. Blastocysts formed on day 6 had a 12.5%
increase in aneuploidy rates compared with day 5 blastocysts (p < 0.01).
Conclusion
Blastocyst which take longer duration to develop to appropriate stage for biopsy has higher
risk of being aneuploid.
ASPIR-0131
Posters: Embryology
INCREASED ACTIN COMPONENT IN EARLY-CLEAVING EMBRYOS IMPROVE

VITRIFICATION TOLERANCE
M.N.K. Nor-Ashikin1, W.J. Wan-Hafizah2,3, M.H. Rajikin1, A.S. Nuraliza4, A.R. Nor-Shahida2,
O. Salina2, D. Razif1,5, J. Norhazlin6, M. Mohd-Fazirul2
1
Maternofetal and Embryo Research Group- Faculty of Medicine UiTM,
Universiti Teknologi MARA, Sg Buloh, Malaysia
2
Institute of Medical Molecular Biotechnology IMMB- Faculty of Medicine,
Universiti Teknologi MARA, Sg Buloh, Malaysia
3
Faculty of Pharmacy and Health Sciences,
Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Malaysia
4
Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh, Malaysia
5
Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
6
Faculty of Applied Sciences, Universiti Teknologi MARA, Tapah, Malaysia
Timing of the first zygotic cleavage is a predictor of early embryonic viability. Previous
studies have shown that early-cleaving (EC) embryos have higher cryotolerance than late-
cleaving (LC) embryos. We hypothesize that the difference is attributed to differences in their
actin and tubulin components. This study was thus conducted to investigate actin and tubulin
components in vitrified embryos, based on their first zygotic cleavage status.
Method
Embryos were retrieved from superovulated ICR mice, 28 hours after hCG injection. Two-
cell stage embryos were categorized as EC, while zygotes with two pronuclei as LC
embryos. Embryos were cultured overnight in M16 medium supplemented with 3% Bovine
Serum Albumin in a humidified carbon dioxide incubator. The following day, embryos were
vitrified for 1 hour, and warmed. The embryos were then fixed and immunostained for actin
and tubulin. Finally, the embryos were mounted on slides and examined under a Confocal
Laser Scanning Microscope. Actin and tubulin intensities were analysed using the LAS-AF-
Lite Software.
Results
Vitrified EC embryos showed significantly higher actin intensities compared to vitrified LC

embryos (11.43 + 5.44 versus 5.23 + 2.20 pixels (<0.001). No significant difference were
found in tubulin intensities between vitrified EC (29.77 + 7.66) and vitrified LC embryos
(23.09 + 8.38 pixel).
Conclusion
These findings suggest that the higher cryotolerance of vitrified EC embryos is attributed to
higher densities of actin which led to better maintenance of cellular structural integrity and
cell division functions.
ASPIR-0140
Posters: Embryology
COMPARISON OF ICSI FERTILIZATION RATE FOR DIRECT SWIM-UP VS SWIM-UP

AFTER CENTRIFUGATION
G.P.U. Khoo1, S.S. Lim1, O.N. Atikah1, S.K. Sim1, M. Devindran1
1
Loh Guan Lye Specialists Centre, Fertility Unit, Georgetown, Malaysia
Sperm preparation techniques involved centrifugal pelleting of unselected spermatozoa for

ICSI have been considered to result in sperm DNA fragmentation. It was therefore of interest
to compare swim-up technique involving centrifugation, as used in our ICSI, with the one that
does not use a centrifugation step (Direct swim-up).
Method
The retrospective non-randomized controlled trial was based on 108 of semen samples that
are of suboptimal quality in 2015, according to latest WHO standards. The samples are
allocated into Group A (Swim-up after centrifugation) and Group B (Direct Swim-up), prior to
subsequent allocation for ICSI. In Group A, semen was diluted with culture media,
centrifuged at 331g for 10mins. After removal of supernatant, pellet was layered under 1ml
of culture medium, subsequently incubated in a trigas incubator. In Group B, 1ml of semen
was layered under 1ml of culture media and then incubated in a trigas incubator. Both were
harvested before the injection time. The average age and number of embryo(s) transferred
for Group A and B were 34.6, 34.1 & 2.0, 1.8 respectively. There were no statistically
significant difference in both parameters (P>0.05).
Results
ICSI fertilization rate from group B (66.0%; 338/512) was significantly higher compared to
group A (55.6%; 150/270) respectively (P<0.05). However, there were no significant
differences in live birth and implantation rates among the two groups (A: 30.3% (10/33),
25.8% (17/66) (P>0.05); B: 34.4% (21/61), 31.8% (35/110).
Conclusion
The results of this study shows that direct swim-up method lead to higher ICSI fertilization
rate as compared with swim-up after centrifugation.
ASPIR-0155
Posters: Embryology
MITOCHONDRIAL ASSESSMENT OF 8-CELL EMBRYOS FROM C57BL/6 FEMALE

MICE SUPPLEMENTED WITH PALM TOCOTRIENOL RICH FRACTION (TRF)
M. Sophia-Sarbandi1, A.A. Abu-Thalhah1, A.R. Nor-Shahida1, Z. Eshak2, M.H. Rajikin1,
N. Hashim3, M.N.K. Nor-Ashikin1
1
Maternofetal and Embryo Research Group - Faculty of Medicine,
Universiti Teknologi MARA, Sungai Buloh, Malaysia
2
Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Malaysia
3
Reproductive Biotechnology - Faculty of Applied Sciences, Universiti Teknologi MARA,
Shah Alam, Malaysia
Mitochondrial damage in the embryo can lead to developmental arrest during

preimplantation stages. Palm TRF contains tocopherol and tocotrienol isomers of vitamin E.
It has been shown to improve preimplantation development of murine embryos. We
hypothesized that this is due to improved mitochondrial function. Therefore, the aim of this
study is to examine the effects of palm TRF on mitochondria using Transmission Electron
Microscopy (TEM).
Method
Female C57Bl/6 in each group were given oral gavage of 60 mg/kg body weight per day of
corn oil (control), palm TRF and alpha-tocopherol, respectively for 7 days. They were
superovulated, mated and euthanized. Two-cell embryos were harvested and
morphologically categorized as either normal or abnormal. Normal 2-cell stage embryos
were cultured to the 8-cell stage for mitochondrial assessment. For TEM, the embryos were
fixed with glutaraldehyde and osmium tetroxide before serial dehydration with acetone and
resin infiltration. They were stained with uranyl acetate and subjected to ultramicrotomy
before TEM.
Results
The production of abnormal 2-cell embryos was significantly lower in TRF (10.6 ± 7.3)
compared to other groups. Although less abnormality was found in TRF embryos, TEM
micrographs indicated mitochondrial degradation. Intramitochondrial vacuoles and loss of
mitochondrial cristae were also observed at the 8-cell stage.
Conclusion
Although palm TRF maternal supplementation improves the production of normal 2-cell
embryos, its effect on mitochondria at 8-cell stage appears to be adverse.
ASPIR-0169
Posters: Embryology
THE OOCYTE AND EMBRYO QUALITY ARE POORER IN WOMEN WITH

ENDOMETRIOSIS COMPARED TO THOSE WITHOUT ENDOMETRIOSIS
M. Hamdan1, S. Ingamells2, P. Anthony2, Y. Cheong3
1
University of Malaya, Obstetrics and Gynaecology, Kuala Lumpur, Malaysia
2
Wessex Fertility, Reproductive Medicine, Southampton, United Kingdom
3
University of Southampton, Human Development and Health, Southampton,
United Kingdom
Endometriosis is known to be detrimental to fertility in many ways including poorer

oocyte/embryo quality. Evidence drawn from studies on oocyte recipient cycles that showed
poorer reproductive outcome in those who received oocytes from women with
endometriosis, suggest that the oocyte quality of women with endometriosis is
compromised. We speculated endometriosis affects embryo quality.
Method
We performed a multi-centre retrospective evaluation of women with endometriosis

undergoing IVF. We reviewed treatment cycle and embryology records via IDEASTM
database from January 2011 to December 2014.
Results
678 women who had IVF treatment were analysed (EN, n=89; TF, n=214; UE, n=375). The
mean age for each group was EN, 34.4±3.3; TF, 33.5±3.7 and 34.6±3.2. Number of mature
follicles (>14mm) on the day of trigger injection was similar (P=0.746) and percentage of
oocytes collected per mature follicle was lower in endometriosis (P=0.008; EN, 65±23; TF,
76±20; UE, 71±24). Higher percentages of embryos fail to achieve 8-cell stage in EN
compared to TF groups [P=0.02, MD 2.77, 95%CI (0.33, 5.21)] and UE [P=0.03, MD 2.51,
95%CI (0.22, 4.79)]. Percentages of embryos at all grades (Grade1-4) per women were
similar between the comparison groups (P>0.05). Endometriosis did not impair (P>0.05)
blastocyst development or the development of Fully Expanded Hatching Blastocysts (FEHB).
Conclusion
Women with endometriosis have a lower number of oocyte collected per mature follicle. The
presence of endometriosis is associated with a higher rate of early embryo arrest, which
implicates poor oocyte quality. However endometriosis has no effect on the embryo quality
beyond the 8-cell-stage of embryo development.
ASPIR-0178
Posters: Embryology
IMPACT OF BODY MASS INDEX (BMI) ON IN VITRO FERTILISATION- INTRA

CYTOPLASMIC SPERM INJECTION (IVF-ICSI) TREATMENT OUTCOMES IN WOMEN
OF EAST COAST OF MALAYSIA.
N. Yaacob1, S.N. Ab Rahman1, A. Mohd Zizi1, M.Z. Mohd Kasim1
1
Hospital Sultanah Nur Zahirah, O&G, Kuala Terengganu, Malaysia
Obesity has become a major health issue worldwide. It is associated with anovulation,
infertility, increased risk of fetal loss, maternal and perinatal morbidity. However, there is
conflicting evidence on the influence of increased BMI on the assisted reproductive
treatment outcomes. The aim of this study was to look at effects of BMI on the treatment
outcomes, among patients from around east coast region of Peninsular Malaysia.
Method
A retrospective analysis of 172 IVF-ICSI cycles between January 2013 to December 2015.
All cases included were fresh cycle, antagonist protocols and own gametes. The cycles were
clustered into subgroups of A=BMI ≤19(Underweight), B=BMI 19.1-25(Normal), C=BMI 25.1-
30(Overweight) and D=BMI ≥ 30.1(Obese). Outcomes measured were duration of
stimulation, total dosage of gonadotrophins used, number of oocytes collected, fertilization
rate and the number of top quality embryos available.
Results
Nearly half of study population was in the group B. There was no difference in the duration of
stimulation. However, there was a significant difference in the mean total dose of
gonadotrophins used, whereby there was a positive correlation between BMI and amount of
gonadotrophins needed. There was no significant difference in fertilisation rate. The mean
number of oocytes was least in the obese group (Mean=5.7), but no difference in the
number of good grades embryos formed.
Conclusion
Obese women used more gonadotrophins, obtained less oocytes but they have similar
number of top quality transferrable embryos. In public funded programme, this translated into
increased burden of cost to healthcare providers. Therefore, effective weight management
prior to treatment is essential.
ASPIR-0179
Posters: Embryology
PATTERN OF MITOCHONDRIAL DISTRIBUTION AND FLUORESCENCE INTENSITIES

OF MURINE EMBRYOS BASED ON TIMING OF THE FIRST ZYGOTIC CLEAVAGE
W.H. Wan Jusof1,2, N.A. Mohamed Noor Khan3, M.H. Rajikin4, N. Abdul Satar4,
N.S. Abdul Rahman1, S. Othman1, R. Dasiman5, N. Jusoh1,6
1
Universiti Teknologi MARA,
Institute of Medical Molecular Biotechnology- Faculty of Medicine, Sungai Buloh, Malaysia
2
Universiti Kuala Lumpur Royal College of Medicine Perak,
Faculty of Pharmacy and Health Sciences, Ipoh, Malaysia
3
Universiti Teknologi MARA,
Maternofetal and Embryo Research Group- Faculty of Medicine, Sungai Buloh, Malaysia
4
Universiti Teknologi MARA, Faculty of Medicine, Sungai Buloh, Malaysia
5
Universiti Teknologi MARA, Faculty of Health Sciences, Puncak Alam, Malaysia
6
Universiti Teknologi MARA, Faculty of Applied Sciences, Tapah, Malaysia
Timing of the first zygotic cleavage has now become a common selection parameter in many
in vitro fertilization (IVF) laboratories. Embryos that cleaved early will be selected for embryo
transfer. However, the factors contributing to the superiority of early cleavers are still not
clear. It is hypothesized that it may be related to energy production from mitochondria of the
embryos. This study was therefore conducted to investigate mitochondrial distribution and
fluorescence intensities of embryos based on timing of the first zygotic cleavage.
Method
Embryos were retrieved from superovulated ICR mice, 28 hours after hCG injection. At this
point of time, 2-cell stage embryos were categorized as early-cleaving (EC), while zygotes
with two pronuclei as late-cleaving (LC) embryos. Embryos were cultured overnight in M16
medium supplemented with 3% Bovine Serum Albumin in a humidified carbon dioxide
incubator. The embryos were then fixed and immunostained to visualize distribution and
intensity of their mitochondria. Finally, the embryos were mounted on slides and examined
under a Confocal Laser Scanning Microscope. Mitochondria intensities were analyzed by
LAS-AF-Lite Software.
Results
The EC and LC embryos were distributed homogenously in the cytoplasmic region of

blastomeres. Quantification analysis showed significantly higher mitochondrial fluorescence
intensities in EC embryos (40.45 + 11.16 pixel) compared to LC embryos (25.71 + 9.55
pixel) (p<0.001).
Conclusion
These findings suggest that early cleavage is highly dependent upon the organization of
mitochondria. Higher densities of mitochondria in EC embryos suggest improved
functionality of these structures, which appear to result in more efficient cell division and
greater developmental competence.
ASPIR-0303
Posters: Embryology
THREE PRONUCLEAR ZYGOTES (3PN) POTENTIAL FACTORS AND ITS IMPACT ON

IVF OUTCOME
D.P. Gunarwati1, E. Mansyur2, T. Yuningsih2, S. Mariyam2, E. Purdiningsih2, O. Riayati1,
B. Wiweko1, N.A. Ulfah3, D. Miati3, P. Ameilia1, K. Mutia1, R. Nasution1
1
Indonesian Reproductive Medicine Research and Training Center, RSCM KENCANA,
Salemba, Indonesia
2
Yasmin IVF, RSCM, Jakarta, Indonesia
3
PT. Ingin Anak, PT. Ingin Anak, Jakarta, Indonesia
3PN zygotes is an abnormality which characterized by three copies of each chromosome per
cell. Its prevalence has been estimated about 1% to 3% of all pregnancies. The
understanding of 3PN potential factors and its impact on IVF outcome are needed to IVF
advancement. The aim of this study was to explore 3PN potential factors such as maternal
age, number of oocyte retrieved, sperm concentration and motility. We also evaluated 3PN
impact on IVF outcome including percentage of normal fertilization and clinical pregnancy
rate
Method
This study included 298 fresh-nondonor ICSI cycles of patients who underwent IVF from
February 2013 to September 2016 in Yasmin-Kencana Clinic. There were 2 groups: group
A consist of patients with no 3PN zygotes and group B consist of patients with one or more
3PN zygotes. Maternal age, number of oocyte retrieved, sperm concentration and motility,
as well as fertilization rate between groups were analyzed by Mann-Whitney test, SPSS 22.
Chi-Square test was used to evaluate clinical pregnancy rate.
Results
There were no significant differences between group A and B (P>0.05) in sperm

concentration (30.106 and 25.106 per ml, P=0.683) and motility (51% and 50%, P=0.889).
Age (34 and 35.5, P=0.0005) and number of oocyte retrieved (8 and 10, P=0.021) were
significantly different (P<0.05). Normal fertilization (77.27% and 73.03%, P=0.287) and
clinical pregnancy rate (P=0.409) between two groups were not significantly different.
Conclusion
Maternal age and oocyte number might become potential factors of 3PN occurrence, but the
occurrence of 3PN probably doesn’t affect fertilization and clinical pregnancy rate.
ASPIR-0327
Posters: Embryology
COMPARISON OF BLASTULATION RATES BETWEEN NORMAL, RAPIDLY CLEAVING

AND MULTINUCLEATED EMBRYOS
M. Nurmuhaimin Adli1
1
Reproductive Medicine Unit, Obstetric &Gynaecology, Kuala Lumpur, Malaysia
The aim of this study was to observe blastulation rates of rapidly growing embryos and
multinucleated embryos in comparison to embryos growing at normal rates.
Method
This retrospective study on 454 embryos from 143 patients was done at the Reproductive
Medicine Unit, Kuala Lumpur Hospital, from 2014-2016, and excluded women more than 40
years old. Patients were on an antagonist protocol. Intracytoplasmic sperm injection (ICSI)
was performed and embryos were single cultured in 10µl droplets covered with oil. Oocytes
with normal fertilization (presence of 2 pronuclei and 2 polar bodies) were evaluated.
Embryos were grouped according to multinucleation and blastomere numbers; normal
cleavage (3-4 cells on day 2, 7-8 cells on day 3) and rapid cleavage (≥5 cells on day 2, ≥9
cells on day 3). Subgroups assigned were: normal cleavage day 2 + normal cleavage day 3
(NN); rapid cleavage day 2 + normal cleavage day 3 (RN); normal cleavage day 2 + rapid
cleavage day 3 (NR); and rapid cleavage days 2 and 3 (RR). Blastocysts were assessed at
116±4 hour’s post-ICSI.
Results
Chi-square analysis showed significant difference of blastulation rates between the groups;
73% (NN), 66% (NR), 60% (RN), 43% (RR) and 22% for multinucleated embryos (p=0.00).
Blastulation rates for rapidly growing embryos on both day 2 and day 3 were significantly
lower compared with other subgroups.
Conclusion
Cleavage rates can be used as a selection tool in choosing embryos for further culture to
blastocyst. Rapidly cleaving embryos have a higher risk of cancellation of blastocyst stage
embryo transfer.
ASPIR-0406
Posters: Embryology
COMPARISON OF THE CLINICAL OUTCOME OF DAY 3 AND DAY 5 EMBRYO

TRANSFER-A SINGLE CENTRE EXPERIENCE
R. Shah1, V. Shukla1, P. Doshi1, M. Doshi1
1
Blossom Fertility and IVF Centre
Blastocyst transfer has been suggested to improve clinical outcome in comparison to Day 3
embryo transfer. The aim of this study was to compare the clinical pregnancy rate and
pregnancy outcome of day 3 and 5 transfers in a cross sectional study. Day 3 and Day 5
embryo culture was done by using Cook SIVF sequential culture media.All the patients
(200),who underwent IVF treatment followed by embryo transfer from January 2016 to
march 2016 were selected, by convenient sampling technique to study primary outcomes
like clinical pregnancy rate and live birth rate and secondary outcomes like incidences of
multiple pregnancies ,miscarriages ,ectopic pregnancies and comparison of fresh v/s vitrified
Day 3 & Day 5 ETs as far as clinical pregnancy rates and miscarriage rates are concerned.
Clinical pregnancy rate was significantly high in Day 5 embryo ET group(68%) than Day 3
ET group(49%) { By chi square test , P0.0063, CI 95%},But there is no statistical difference
in live birth rate(Day 3-65% and Day 5-67%) and miscarriage rates between Day 3 and Day
5 embryos.(Day 3 -32% and Day 5-27%){ By chi square test P0.640, CI95%}.Similarly there
was no significant difference in incidence of multiple pregnancy rates(Day 3-30% and day 5-
28%){ By chi square test P0.863, CI95%}.As a secondary outcome ,we did not find any
statistical difference in clinical pregnancy rates of fresh and frozen cycles of both the groups.
Our conclusion of this study is that day 5 transfer is better than day 3 transfer in terms of
clinical pregnancy. However there is no significant difference when embryos are fresh or
frozen.
Endocrinology, Clinical
ASPIR-0202
Posters: Endocrinology, Clinical
AN UNUSUAL CASE OF THYROID AUTOIMMUNITY (TAI) AND RECURRENT

PREGNANCY LOSS (RPL)
M. Kaur1, M. Banker2
1
NOVA IVI, Reproductive Medicine, Jalandhar, India
2
NOVA IVI, Reproductive Medicine, Ahmedabad, India
To understand the importance of TAI in the management of unexplained infertility and RPL
and need for frequent monitoring of TFT (thyroid function tests) in these cases especially in
early pregnancy probably due to lower capacity of thyroid to adequately adapt to demands of
pregnancy.
Method
32 yr old dentist reported in OPD with a history of 4 spontaneous abortions at 5-6 weeks of
gestation, secondary infertility for almost a 1 year. Extended profiles of both genetic and
acquired thrombophilia and karyotyping were done already and were normal. Very high
levels (>1300) of Anti thyroid per-oxidase antibodies (TPO) were noted, with sub-clinical
hypothyroidism (TSH- 4.0 mIU/L) which was treated with prophylactic doses (1µg/kg) of
thyroxin. There was a very typical history of severe constipation and malaise in early
pregnancy during previous miscarriages. Diagnostic hysteroscopy was done to rule out
anatomic causes and she conceived naturally in the subsequent cycle. As soon as UPT was
found positive she had similar symptoms of constipation and malaise, repeat TSH was 20
mIU/L. She was immediately supplemented with therapeutic dosage of thyroxin (2µg/kg) and
she continued her pregnancy well.
Results
Diagnosis of TAI and appropriate thyroxine supplementation could effectively treat this
atypical case of RPL where almost all other investigations were found to be normal.
Conclusion
TAI is the commonest auto-immunity in reproductive age group (5-15%). Detection of TAI
should form an important part of investigations in un-explained infertility and RPL. The ones
diagnosed to have high titers need stringent monitoring of TSH due to fluctuating levels.
ASPIR-0204
Posters: Endocrinology, Clinical
CIPTO MANGUNKUSUMO GENERAL HOSPITAL AUDIT IN CURRENT PRACTICE OF

REPRODUCTIVE ENDOCRINOLOGY, AND INFERTILITY
C.A. Susanto1, A. Hestiantoro1
1
Faculty of Medicine University of Indonesia- Cipto Mangunkusumo General Hospital,
Obstetrics and Gynecology, Jakarta, Indonesia
Reproductive Endocrinology and Infertility in Cipto Mangunkusumo General Hospital is a

main referral hospital in Indonesia. There are seven most cases such as primary
amenorrhea, adenomyosis, endometriosis, infertility, PCOS, menopause, and recurrent
pregnancy loss. In order to evaluate each services, clinicial audit needs to be done
periodically in order to improved quality of management.
Method
Based on big seven cases presenting in policlinic, Venn diagram was used in order to
prioritized case of audit. Prioritizing was made by evaluating number of cases, risk and
complications, cost of management, necessity to improve clinical practice guidelines (CPG),
and whether there is a potency for quality improvement,
Cases will be evaluated from the medical record between June 2014 until June 2015. Then
components such as structure (the use of CPG), process of making diagnosis, also outcome
of pain after therapy will be conducted in every single case. Evaluation of each of the criteria
in compared to standard, while standard has been set to 85%.
Results
Using diagram Venn, Adenomyosis found to be the top rank of problem in RSCM. There
were 48 cases of Adenomyosis identified within one year, and 30% (14 cases) of
Adenomiosis were being randomly evaluated. Process of making diagnosis ranging from
78.6% until 100 %, and outcome of therapy especially pain is 71.4 %. Among six criteria,
clinicians asking about infertility problems and performing transvaginal ultrasound already
concordance to standard.
Conclusion
There is a need to established CPG especially in adenomyosis case in order to improve

management.
Female Infertility
ASPIR-0025
Posters: Female Infertility
CLINICAL PREGNANCY RATE IN WOMEN WITH UNEXPLAINED INFERTILITY AFTER

REMOVAL OF UNSUSPECTED INTRAUTERINE POLYPS
R. Izhar1, S. Hussain1, S. Tahir2
1
Karachi Medical and Dental College, Gynaecology And Obstetrics, Karachi, Pakistan
2
Dow Medical College, Medical Student, Karachi, Pakistan
Unexplained infertility is said to exist if the cause of infertility remains unknown after
complete infertility workup. Around 30% of couples have unexplained infertility. Evidence is
accumulating that in patients with unexplained infertility removal of endometrial polyps
suspected on ultrasound may increase clinical pregnancy rates. Cochrane database review
concluded that benefit with the hysteroscopic removal of submucous fibroids for improving
the chance of clinical pregnancy in women with otherwise unexplained subfertility cannot be
excluded.
Method
A prospective case control study was conducted from 1ST January 2013 to 31ST December
2015 at Aziz Medical Centre. Women with a diagnosis of unexplained infertility having
unsuspected polyps on saline sonography were included as cases (Group A). They were
offered removal under ultrasound guidance and general anesthesia. Those with
unsuspected polyps on saline sonography but who refused to undergo intervention,were
used as controls (Group B). Both groups were matched for age and followed for one year.
Results
In group A, 92 were included, 37 who underwent polypectomy conceived and 55 failed to

conceive during the follow up, giving a pregnancy rate of 40.21%.
In group B, 92 age matched controls were included, 10 conceived and 82 failed to conceive
during the follow up, giving a pregnancy rate of 10.86%.
Our study shows a pregnancy rate of 40.21 % in women after removal of unsuspected
polyps. This is four fold higher than the age matched controls who did not undergo the
intervention.
Conclusion
Our study shows the beneficial effect of removal of polyps in consensus with the Cochrane
review.
ASPIR-0196
PROXIMAL TUBAL OCCLUSION AS A MAJOR CAUSE FOR INTERTILITY WITH

ENDOMETRIOMA
P.H. Chen1
1
Shuang Ho Hospital, Obstetrics and Gynecology, Taipei, Taiwan R.O.C.
It is known that women with endometrioma combined with hydrosalpinx have poorer
pregnancy outcome than women with other forms of tubal infertility. At present, it is unclear
whether a proximal tubal occlusion leads to infertility compared with hydrosalpinx with distal
fimbriae swelling.The study was designed to check the tubal condition by chromopertubation
prior to laparoscopic cystectomy.
Method
A retrospective, non-controlled study. A total of 65 infertile women aged 21–41 years, with
unilateral or bilateral endometriomas were scheduled for laparoscopic cystectomy between
January 2014 and May 2016.Patients were subgrouped with bilateral tubal obstruction
(n=30) and unilateral tubal obstruction (n=35) by chromopertubation with methyl blue dye .
Results
The median duration of subfertility was significantly longer for women with bilateral tubal
obstruction [28.4 months (75th percentiles 15.6–54.6)] compared with women with unilateral
tubal obstruction [16.8 months (13.1–21.2)] (P=0.009).Furthermore, women with bilateral
tubal obstruction had higher primary infertility rate of 24/30 (80%) compared with 24/35
(68.5%) in women with unilateral tubal obstruction (P=0.035) (Table I ).The size of
endometrioma more than 4 cm showed a significant difference between bilateral tubal
obstruction 20/30 (66.6%) and unilateral tubal obstruction 12/35(34.2%) (absolute
difference:22.4%; 95% CI:5.2-28.6, RR:0.35; 95% CI : 0.27-0.98, p=0.021).The proximal
tubal occlusion is 22/30 (73.3%) compared with 8/30 (26.6%) distal fimbriae swelling, which
is a significant difference in bilateral tubal obstruction. (absolute difference: 27.4%, 95%
CI:7.3-48.1,RR:0.41; 95% CI:0.31-0.79 ; P=0.042) (Table II).
Conclusion
This study found the significance of proximal tubal occlusion related with endometrioma.
Detailed chromopertubation before laparoscopic cystectomy should be performed in case of
infertility.
ASPIR-0275
CURCUMIN AS FERTILITY REGULATOR THE STUDY ON LH, ESTRADIOL,

PROGESTERONE LEVELS
T.Y. iqbal1, R. Rajuddin1, S.K. Sri Kadarsih2, M.H. Mohammad Hakimi3,
S.P. Suwijiyo Pramono4, I.A. Indwiani Astuti5
1
Syiah Kuala University- Zainoel Abidin Hospital, Department Obstetric and Gynecology,
Banda Aceh, Indonesia
2
Gajah Mada Unversity, medical faculty, Yogyakarta, Indonesia
3
Gajah Mada University, Department Obstetric and Gynecology, Yogyakarta, Indonesia
4
Gajah Mada University, Farmacological faculty, Yogyakarta, Indonesia
5
Gajah Mada University, Medical Faculty, yogyakarta, Indonesia
Curcumin (Diferuloylmethane) is a substance that isolated from turmeric extract. In an in

vitro and in vivo studies demonstrated its efficacy to inhibits steroidogenesis of luteal cell by
inhibiting the production of progesterone. Curcumin inhibits the production of progesterone,
17β-estradiol.
Method
This research was design “Randomized double-blind placebo-controlled trial”. The sample
were all fertile woman with regular menstrual cycles, aged between 20-30 years, married
and had children. Subject were divided into groups of curcumin and control groups with
conceal randomised. The curcumin dose converted from rat dose of 100mg/kg (20mg) to
human dose. The curcumin encapsulated with a dose of 800mg. The capsule were given
orally once a day for 10 days starting from the third day of the first period. Examination of
LH hormone and estradiol serum serially on the third day of the first period, in the mid-
menstrual cycle and on the 21th day of the first period. Examination of progresterone levels
conducted at mid-menstrual cycle and on the 21th day of the first period.
Results
The result of this study stated that the hormone levels of LH, estradiol and progesterone in
the middle of menstrual cycle and on the 21th day of the first period of the curcumin group
was lower (p<0,05) and significantly different (p>0,05) than the control group.
Conclusion
Based on the results of this study, it’s concluded that the ovarian steroidogenesis of
curcumin causes the LH serum levels did not represent an LH surge.Curcumin decrease
estradiol and progesterone levels.Curcumin decrease estradiol and progesterone levels.
ASPIR-0276
GOSERELINE PRIMED LAPAROTOMIC RESECTION AS A NEW APPROACH IN

MANAGEMENT OF ADENOMYOSIS IN INFERTILE WOMEN (EXPERIENCE IN 32
CASES)
R. Rajuddin1, T.Z.J. Teuku Zulkifli Jacoeb2, T.Y. iqbal1
1
Syiah Kuala University- Zainoel Abidin Hospital, Department of Obstetrics and Gynecology,
Banda Aceh, Indonesia
2
University of Indonesia- Cipto Mangunkusumo General Hospital,
Division of Reproductive Immunoendocrinology- Department of Obstetrics and Gynecology,
Jakarta, Indonesia
Adenomyosis is an internal endometriosis growing in the myometrium.
Method
Cases of ademyosis in infertile women were collected for three years (January 1999 to
December 2001) and the diagnoses were confirmed using transvaginal USG. Cases were
grouped into two groups, i.e. group 1 (undergoing laparotomic resection) and group 2
(receiving treatment with aromatase inhibitor of anastrozole). Both groups were evaluated
for changes in clinical symptoms, rate of successful pregnancy, and postoperative
recurrency rate.
Results
32 cases of surgical resection, the histopathological results showed 30 (93.75%) cases of

adenomyosis and 2 (6.25%) cases of uterus myoma. In the group undergoing
resection three cases (9.4%) were successfully pregnant, i.e., two cases had live birth, one
case ended up with 6-week abortion. Moreover, 25 (78.1%) cases were not pregnant and 4
(12.5%) cases had recurrency, 24 (75.35%) cases experienced disappearance of symptoms
yet not pregnant. 23 cases in the group receiving aromatase inhibitor 2 (8.6%) cases were
able to be pregnant, one case had live birth and another case ended up with abortion, while
14 (59.1%) cases had disappearance of symptoms yet not pregnant. During three months of
treatment with aromatase inhibitor, a reduction in the lesion size between 7.31 mm3 and
25.90 mm3 were observed with CI 95% (p < 0.001).
Conclusion
Treatment with aromatase inihibitor did not heal lesions, but only reduced the size of
adenomyosis lesions. On the other hand, resection could heal lesions, yet recurrency of
disease may occur (12.5%) after one postoperative year.
ASPIR-0305
THE EFFECT OF PREDNISOLONE, INTRAVENOUS IMMUNOGLOBULIN AND

INTRALIPID ON NK CYTOTOXICITY IN WOMEN WITH RECURRENT FAILED IVF
R. Bansal1, S. Bhaskaran1, B. Ford1, A. Bansal1, M.Y. Thum2
1
St Helier Hospital, Immunology, Carshalton, United Kingdom
2
The Lister Fertility Clinic, Lister Hospital, London, United Kingdom
Several treatments aimed at immune modulation are used in women with recurrent failed in
vitro fertilisation. Foremost amongst these involve the use of steroids, intravenous
immunoglobulin therapy and intralipid. We therefore examined the ability of these therapies
in vitro to alter peripheral blood NK cytotoxicity.
Method
We assessed 1,967 women with recurrent failed IVF who presented for fertility treatment at
the Lister Hospital in Chelsea. Blood samples were taken mid-cycle and analysed within 6
hours. NK cytotoxicity was assessed using a flow cytometric method, and suppression of
K562 target cell killing by the three agents used at 2 different concentrations and 3
Effector:Target ratios (50:1, 25:1 and 12.5:1).
Results
Suppression of NK cytotoxicity was greatest with IVIG, followed by Prednisolone and then
Intralipid (the mean [SD] reduction in NK killing of IVIG, Prednisolone and Intralipid were 64
[17]%, 47 [19]% and 34 [20]% respectively). Paired t-testing confirmed significant differences
in suppression of K562 killing between IVIG vs. Prednisolone, Prednisolone vs. Intralipid and
IVIG vs. Intralipid, with p values of < 0.0001.
Conclusion
IVIG appears superior to prednisolone and intralipid in suppressing NK cytotoxicity in women

with recurrent failed IVF. We are presently assessing how this translates into clinical
outcomes. Further work is required to examine robust protocols regarding these treatments
and the associated side effects. However, immune modulatory therapy is best reserved for
women with demonstrable immune dysfunction and should not be given empirically for
women with infertility.
ASPIR-0315
UTERINE TRANSPLANTATION IN SINGAPORE FOR ABSOLUTE UTERINE FACTOR

INFERTILITY : PREPARATIONS AND PROGRESS
H.K. Tan1, L.K. Tan1, S.L. Yu1, B.K. Tan2, J. Olofsson3, M. Brännström4, P. Dahm Kahler3
1
SINGAPORE GENERAL HOSPITAL, Obstetrics and Gynaecology, SINGAPORE,
Singapore
2
Singapore General Hospital, Plastics- Reconstructive and Aesthetic Surgery,
Singapore General Hospital, Singapore
3
Karolinska University Hospital, Division of Reproductive Medicine, Stockholm, Sweden
4
Sahlgrenska Academy at University of Gothenburg, Obstetrics and Gynaecology,
Gothenburg, Sweden
Uterine transplantation (UTx) is an ephemeral transplant which has achieved successful

pregnancies for women with Absolute Uterine Factor Infertility (AUFI). UTx provides an
additional option besides adoption in Singapore and SE Asia, where surrogacy is illegal.
The aim is to chronicle our preparations and progress in establishing a UTx service.
Method
In 2012 a multidisciplinary team involving Gynaecology, Plastic reconstructive surgery,

Transplant Medicine,Pathology, Psychiatry, Anesthesiology, Social
services, Bioethics, with Prof Mats Brännström and A/Prof Jan Olofsson as advisors was
formed. The team was further divided into: donor surgical harvesting, transplant surgical,
immunosuppression support, IVF and Obstetric support.
Results
During the first animal workshop with macaque monkeys in 2015, one auto-
transplantation and one allo-transplantation of macaque uteri were successfully performed,
allowing better understanding of vascular anastomosis and perfusion of the transplanted
uterus. There was no evidence of hyperacute or acute rejection post-operatively with
immunosuppression. Next, a successful Human cadaveric uterine dissection workshop took
place in November 2015. The Singapore team is one of the founding members of the
International Society of Uterine Transplantation (ISUTx) inaugurated in January 2016. They
successfully carried out a sheep uterine transplant under direct supervision of
Prof Brännström in Aug 2016 in Gothenberg. Future plans include an initial observational
study of 5 patients with congenital absence of uterus or post hysterectomy chosen from an
ongoing search for suitable patients and donors.
Conclusion
The multidisciplinary translational clinical research and international academic collaboration
augur well for UTx to respond to the hitherto unmet demand for effective treatment for AUFI
in this region.
ASPIR-0336
MUC1, LIF AND INTEGRIN Β3 AS EARLY IMPLANTATION MARKERS IN THE PERI-

IMPLANTATION ENDOMETRIUM OF WOMEN WITH RECURRENT IMPLANTATION
FAILURE AND UNEXPLAINED RECURRENT MISCARRIAGE
F. Wu1
1
The Chinese university of Hong Kong,
Obstetrics and Gynaecology of Prince of Wales Hospital, Hong Kong, Hong Kong S.A.R.
Abnormal endometrial function may contribute to implantation failure or miscarriage. Many

receptivity markers have been proposed, but only a few of them expressed in luminal
epithelium which is the first structure to be encountered by the blastocyst. The receptivity
markers expressed in the luminal epithelium may therefore be considered as markers of the
very early stages of implantation i.e. attachment to and migration across the luminal
epithelium, before the next stage i.e. stromal invasion. The early markers include Mucin-1
(MUC1), leukemia inhibitor factor (LIF) and integrin β3.
The expression of MUC1, LIF and integrin β3 in women with recurrent miscarriage (RM),
women with recurrent implantation failure (RIF) and fertile controls have been examined.
Method
Precisely dated endometrial biopsy was obtained 7 days after LH surge from 34 RM women,
22 RIF women and 22 control subjects. The expression of MUC1, LIF and integrin β3 were
examined by semi-quantitative immunohistochemistry.
Results
The luminal epithelium of MUC1 expression in women with RIF was significantly lower than
that of women with RM and fertile controls. There were no significant differences in LIF and
integrin β3 expression in both luminal and glandular epithelium among three groups. MUC1
and integrin β3 expression showed a positive and weak correlation with LIF.
Conclusion
Women with RIF had reduced expression of MUC1 in luminal epithelium which may
contribute to the impairment of implantation in this group. In contrast, MUC1 expression is
not deranged in women with RM which suggest that implantation process in this group is
disrupted at a later stage.
ASPIR-0026
Posters: Fertility Preservation
FERTILITY-PRESERVING STRATEGIES FOR EARLY-STAGE SMALL CELL CERVICAL

CARCINOMA (SCCC): A CASE REPORT
Y.F. Huang1, G.H. New1
1
National Cheng Kung University Hospital- College of Medicine- NCKU,
Obstetrics & Gynecology, Tainan, Taiwan R.O.C.
Small cell cervical carcinoma (SCCC) is reported as highly aggressive, early propensity for
hematogenous spread and frequently fatal, even in early stage disease. Fertility-preserving
treatment for SCCC is more challenging than other histological types because most are at
the risk of poorer oncologic prognosis.
Method
To our knowledge, we describe the first case of stage IB1 SCCC who had a spontaneous,
uneventful pregnancy and cesarean delivery 7 years after fertility-preserving treatment.
Results
This 25-year-old nulligravida girl presented with large amount of malodorous vaginal
discharge. She had no history of smoking, medical diseases and family history of
malignancy. On pelvic examination, a 3.0-cm exophytic, fragile cervical tumor was seen. No
parametrial or vaginal involvement was found. Microscopic examination after a cervical
biopsy showed a poorly-differentiated carcinoma composed of small cells with scant
cytoplasm, oval nuclei with a pepper-salt appearance, and distinct nucleoli.
Immunohistochemical stains revealed that this tumor was positive for synaptophysin and
chromogranin A, which are the markers of neuroendocrine tumor. Chest X-ray, abdominal
sonography and whole body bone scintigraphy were all negative for cancer metastasis.
Pelvic magnetic resonance image scan showed a cervical lesion. She had a spontaneous,
uneventful pregnancy 6 years after peri-operative chemotherapy plus radical abdominal
trachelectomy, and then successfully delivered a singleton term baby via cesarean section.
No disease recurrence was encountered.
Conclusion
The oncologic, reproductive and obstetric outcomes were favorable after offering a fertility-
preserving multimodality strategy in our case. Individualized multimodality therapy may be
utilized in specific early-stage cervical cancer patients to preserve their fertility function.
ASPIR-0050
CURRENT STATUS OF FERTILITY PRESERVATION THERAPY FOR YOUNG CANCER

PATIENTS AT OUR CLINIC
D. Kadogami1
1
IVF Namba Clinic, a medical office, Osaka, Japan
Our clinic has been making concerted efforts to preserve the fertility of young cancer
patients. Here, we report the current status of fertility preservation therapy at our clinic.
Method
Subjects were 68 female cancer patients, mean age 34.1 years, who consulted to our clinic
for fertility preservation between April 2013 and July 2016. The patients included 44 patients
with breast cancer, 19 with hematopoietic malignancies, and 5 with other cancers. Of the 68
patients, 64 patients who had provided consent were enrolled in this study, and their cases
were examined retrospectively.
Results
At initial examination, 5 of 10 patients who had already completed chemotherapy were

diagnosed with chemotherapy-related amenorrhea (CRA), resulting in their exclusion. The
remaining 59 patients underwent fertility preservation therapy, and oocytes were collected
1.37 times per patient. Ovarian stimulation was performed for 6.68 days on average. The
mean number of frozen oocytes and frozen embryos was 3.7 and 2.4 respectively. Mean
peak estradiol level was 337.56 pg/ml but was 156.06 pg/ml in patients with breast cancer.
Embryo transfer was performed a total of 10 cycles in 4 patients. Two of the patients
became pregnant, but one of them miscarriage occurred in the 9th week.
Conclusion
All the patients underwent assisted reproductive technology with no delay in cancer therapy.
However, some patients hoping to become pregnant were unable to undergo fertility
preservation therapy because of CRA. Thus, it is necessary to undertake collaborative
efforts with other clinical departments and to educate the public about fertility preservation
therapy.
ASPIR-0065
THE BEST STRATEGY FOR FERTILITY PRESERVATION USING OVARIAN TISSUE IN

JAPAN IS SAFER SLOW FREEZING AND USE OF THE TRANSPORTATION NETWORK
K. Kyono1,2, M. Mori2, Y. Nakamura1, R. Obata2, N. Okuyama2, N. Aono1,2, T. Hashimoto2,
H. Igarashi1
1
Kyono ART Clinic, Department of Obstetrics and Gynecology, Sendai- Miyagi, Japan
2
Kyono ART Clinic Takanawa, Department of Obstetrics and Gynecology, Minatoku- Tokyo,
Japan
More than 60 healthy babies have been born after transplantation of frozen-thawed ovarian
tissue. Fifty-eight babies were derived from slow freezing and two babies were from the
vitrification method. The concentration of cryoprotectants is 3-4 times higher and thawing
time is shorter in vitrification, so we are concerned about toxicity for mothers and babies.
Transplantation is useful in Denmark (one center) and Germany (two centers). In Japan, we
examined fertility preservation methods for cancer patients.
Method
We compared Germany with Japan: area, population, cryopreservation centers, operation

centers (removal and transplantation of ovarian tissue), start dates, cryopreservation
patients, number of transplantation patients, number of pregnancies, and number of births.
We measured the residual EG and DMSO amount in ovarian tissue after warming following
the vitrification protocol.
Results
Area and population of Germany vs. Japan are 35.8 x104 km2 vs. 37.9 x104 km2 and 8,150
x104 vs. 12,650 x104. Germany has two cryopreservation centers and 101 operation centers,
whereas Japan has 30 cryopreservation centers and 23 operation centers. Germany and
Japan have had around 2,000 and 150 cryopreservation cases respectively. Start dates are
2006 (FertiPROTEKT) in Germany and 2006 (first center) in Japan. Transplantation patients
were 95 in Germany and 2 in Japan. Pregnancies and births were 21 and 16 in Germany vs.
0 and 0 in Japan. For cryoprotectants, we confirmed around 10mg/g in ovarian tissue just
before transplantation after complete warming.
Conclusion
In Japan, we should adopt safer slow freezing in cryopreservation for ovarian tissue and a
transportation network like Germany and Denmark.
ASPIR-0214
LUTEAL PHASE OVARIAN STIMULATION CYCLE FOR FERTILITY PRESERVATION

FOLLOWED IMMEDIATELY BY A FOLLICULAR PHASE STIMULATION CYCLE IN A
PATIENT WITH RECTAL ADENOCARCINOMA, A CASE REPORT
S.D. Valiapan1, N.H. Yussoff1
1
Kuala Lumpur Hospital, Obstetrics & Gynaecology, Kuala Lumpur, Malaysia
Due to the advances in cancer treatment and improved life-span, more patients are
presenting for fertility preservation. The limiting factor is the short interval to the initiation of
cancer treatment. Conventional stimulation regimes start in the early follicular phase or after
gonadotrophin releasing hormone agonist (GnRHa) pretreatment and this can cause delays.
In most cases, these regimes only offer the possibility of a single stimulation cycle before
cancer treatment is commenced.
Method
CASE REPORT
This is a 33 year old nulliparous woman, diagnosed with rectal adenocarcinoma. She was
planned for colorectal surgery and adjuvant chemoradiation. She presented in the luteal
phase of her cycle and was commenced on gonadotrophin stimulation in an antagonist
cycle. She had 8 days of stimulation, 9 oocytes, 5 of which fertilized and 3 good quality
embryos frozen. One week later, she had her menstruation. Ovarian stimulation was
commenced again, using the same regime. In this cycle, she had 9 days of stimulation, 8
oocytes, 5 of which fertilised and 4 good quality embryos cryopreserved.
Results
DISCUSSION
Ovarian stimulation for fertility preservation can be started in the luteal phase and followed
directly by stimulation in the follicular phase. Two consecutive ovarian stimulation cycles can
be completed without causing delays to the commencement of cancer treatment. This is an
advantage as a greater number of embryos can be cryopreserved.
Conclusion
Oocytes can be obtained regardless of the phase of the menstrual cycle. Initiating ovarian
stimulation in the luteal phase should be considered for patients who present in this phase of
their cycle.
ASPIR-0234
FERTILITY PRESERVATION VIA SPERM BANKING: A TERTIARY CENTRE

EXPERIENCE
X. Li1, R. Santhanam2, W.Y.Y. Wong1, S.N. Lee2, S.L. Yu1, H. Rajesh1
1
SINGAPORE GENERAL HOSPITAL, Obstetrics and Gynecology, SINGAPORE, Singapore
2
SINGAPORE GENERAL HOSPITAL, Centre of Assisted Reproduction CARE,
SINGAPORE, Singapore
There has been a rise in malignancies with the Singapore Cancer Registry reporting 29,779
newly diagnosed cancers amongst male residents between 2010-2014. It is known that
cancer itself and cancer therapy affects men’s fertility. Fortunately, sperm banking is
available for fertility preservation. Our study aims to understand the patient demographics,
assess semen parameters and explore the eventual outcomes of these cryopreserved
sperms.
Method
This is a retrospective study of 121 cases of sperm banking from August 2007 to May 2015
before initiation of therapy in Singapore General Hospital. Patient demographics, semen
parameters and outcomes of cryopreserved sperm were analysed.
Results
Our patients range from 15 to 54 years old, with the most between 25-34 years old (56,
45.9%). Of 121 patients, 116 cases (95.9%) had malignancies. A further breakdown showed
26 (21.5%) leukemia cases, 21 (17.4%) non-Hodgkin’s lymphoma, 18 (14.9%) Hodgkin’s
lymphoma, 17 (14%) germ-cell tumours, 12 (9.92%) testicular cancers, 8 (6.61%) GIT
related cancers and 19 (15.7%) other conditions. 82.6% had 2 to 3 semen samples
collected. The semen analysis showed that 41 (33.9%) patients had a density <20 million
sperm per ml and 63 (52.1%) patients had <50% sperm motility. Out of the 121 patients, 97
(80.2%) continued with storage, 19 (15.7%) samples were disposed and 5 (4.13%) opted for
assisted reproductive techniques (4 ICSI, 1 IVF).
Conclusion
Sperm banking is currently the most effective method for fertility preservation. This is
particularly significant in the younger age group with increasing survival rates and the pursuit
for improved quality of life.
ASPIR-0255
KNOWLEDGE AND ATTITUDE OF INDONESIAN FEMALE CANCER PATIENTS

REGARDING FERTILITY PRESERVATION
M. Silvia1, A.K. Harzif1, K. Iswaranti1, M. Maidarti1, B. Wiweko1
1
Universitas Indonesia, Department of Obstetric and Gynecology-
Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Fertility has received significant attention in improving the quality of life for cancer patients of
childbearing age.Long-term effects of cancer and its treatments may cause loss of
fertility.Therefore,efforts were made to maintain the reproductive function in cancer patients
through fertility preservation(FP).This study aimed to explore knowledge and attitude among
Indonesian female cancer patients regarding FP
Method
Data was collected using questionnaire from 50 female cancer patients in reproductive age
(18–40 years) in Indonesia. The questionnaire measures knowledge and attitude of FP
Results
Only 12% of cancer patients knew about FP and the only FP method that most of them felt
knowledgeable about was ovarian tissue cryopreservation (8%). Eighty-six percent of
participant stated they needed more knowledge about FP. About 72% agreed that
reproductive function is one of important things to consider in cancer treatment and 66%
agreed that FP is high priority to discuss with newly diagnosed cancer patients. However,
82% also agreed that treating primary cancer was more important than FP and 62%
disagreed with statement that they would be willing to be given a less effective cancer
treatment in order to save their reproductive function. Most of them would like to have or add
more child and they agreed to consider having FP. Factors that influence their decision to
have FP were knowledge (96%), cost for FP (88%), and social environment (42%)
Conclusion
This study discover lack of knowledge about FP in Indonesian female cancer patients and
highlights that the provision of information to them about FP may be not optimal
ASPIR-0337
KNOWLEDGE AND ATTITUDE OF INDONESIAN OBSTETRICIAN AND

GYNECOLOGISTS REGARDING FERTILITY PRESERVATION IN CANCER PATIENTS
A.K. Harzif1, M. Maidarti1, K. Iswaranti2, M. Silvia2, G. Pratama1, B. Wiweko1
1
Universitas Indonesia,
Subfertility and Immunoendocrinology Division- Department of Obstetric and Gynecology,
Jakarta, Indonesia
2
Universitas Indonesia, Department of Obstetric and Gynecology, Jakarta, Indonesia
Long-term effects of cancer and its treatments may cause loss of fertility.Fertility has
received significant attention in improving the quality of life for cancer patients of
childbearing age.Therefore, efforts were made to maintain the reproductive function in
cancer patients through fertility preservation(FP).This study aimed to explore knowledge and
attitudes among obstetrician and gynecologists in Indonesia regarding FP in cancer patients
Method
Data was collected using validated questionnaires from 80 obstetrician and gynecologists in
Indonesia.The questionnaire measures knowledge and attitudes of FP
Results
Most of participants knew about FP (86.3%) but only felt knowledgeable about pre-treatment
with GnRH Agonists,not other methods of FP.95% expressed a need for more
information.About 92.5% agreed that FP is high priority to discuss with newly diagnosed
cancer patients and 45% agreed that treating the primary cancer was more important than
FP.Most reported checking how important future fertility was for the cancer patients,80%
suggested FP to their patients and 35% reported having referred patients to a fertility
specialist,but only 15.1% providing patients with written information.Most of them had never
consulted any FP guidelines (26.3%), but consulted local hospital guidelines only (30%).The
main barriers to initiating discussions about FP were poor success rates of fertility
preservation options (97.5%),patients could not afford FP treatment (93.8%),poor patient
prognosis (92.6%), lack of obstetrician and gynecologists’ knowledge (91.3%),and lack of
fertility services in their area (81.3%)
Conclusion
This study discover lack of knowledge about FP options in Indonesian obstetrician and
gynecologists and highlights that the provision of information to patients about FP may be
sub-optimal
Gynaecology and
Surgery
ASPIR-0180
Posters: Gynaecology and Surgery
PRENATAL DIAGNOSIS OF VASA PRAEVIA AND MANAGEMENT TO REDUCE

PERINATAL MORTALITY
P. Karine1
1
Westmead Hospital, Obstetrics and Gynaecology, Westmead, Australia
Introduction:Vasa praevia is a rare condition whereby fetal vessels course through the
membranes over the internal cervical os and below the fetal presenting part. The incidence
is 1 in 2000 to 6000 pregnancies . The unsupported fetal vessels within the membranes are
prone to tear when the membranes rupture, resulting in fetal exsanguination. The classic
presentation is rupture of membranes followed by painless, dark vaginal bleeding associated
with profound fetal distress or fetal demise
Risk factors for vasa praevia include placental anomalies, low lying placenta, multiple
pregnancy and assisted reproductive technique. The neonatal mortality rate is reported to be
around 60% .
Ultrasound imaging using colour Doppler and pulse wave Doppler technology, enable the
antenatal diagnosis of vasa praevia. Due to the risk of fetal haemorrhage with rupture of
membranes, caesarean section close to term is recommended .
Method
Background:
27 year old G3P1, with low risk antenatal screening, was diagnosed with Vasa praevia at the
time of the morphology scan which showed fetal vessels crossing the cervix and a marginal
cord insertion. She was admitted electively from 34 weeks gestation for monitoring. There
were no episodes of vaginal bleeding or fetal distress throughout admission and had an
elective caesarean section at 36+6/40 and delivered a live female baby.
Results
N/A
Conclusion:
Vasa praevia is a rare condition which has a high neonatal mortality rate. Admission to a
tertiary centre with appropriate neonatal facilities is recommended. An elective caesarean
section between 35 – 37 weeks of gestation has the potential to reduce neonatal mortality.
ASPIR-0237
Posters: Gynaecology and Surgery
REPRODUCTIVE OUTCOMES FOLLOWING FLUROSCOPICALLY GUIDED

HYSTEROSCOPIC SYNECHIOLYSIS FOR ASHERMAN SYNDROME
R. Deans1, J. Abbott1, W. Ledger1, T. Vancaille2, J. Liu1
1
University of New South Wales, Women and Children, Sydney, Australia
2
Royal Hospital for Women, Gynaecology, Sydney, Australia
o evaluate the menstrual, pain and fertility outcomes of fluroscopically guided synechiolysis
in women before and after treatment for Asherman Syndrome
Method
Retrospective cohort study in a tertiary referral University Hospital, between January 2000
and June 2014
Results
There were no differences in the rate of regular periods prior to and following
surgery p=0.246. Regular periods were lower in women with Grade 4 following
surgery p=0.001. Significantly fewer women reported pain after, compared to before
surgery, P=0.0001. Of the 124 women trying to conceive 98 (79%) were successful. These
women had 157 pregnancies subsequent to surgery. There were 93 livebirths in 79 women
79/124 (63.7%). Sixty three women had 1livebirth, 13 women had 2 livebirths and 1 woman
had 3 livebirths. There 47 1st trimester miscarriages in 29 women, 3 ectopics, 2 terminations,
and 9 had ongoing pregnancies. The rate of placenta previa was 7/85 (8%),13 women
required manual removal of placenta (15%). Placenta accreta affected 7 (8%). Thirteen
women (15%) suffered post partum haemorrhage. The post-partum hysterectomy rate was 4
(5%). There was a high rate of prematurity, with 25 of the 86 live births delivering poor to 37
weeks (29%).
Conclusion
Fluoroscopic guided synechiolysis is an effective technique for anatomical restoration of the

uterine cavity in women with Asherman syndrome, with significant reductions in menstrual
and pain symptoms. Pregnancy rates are excellent, however these pregnancies are
complicated by premature delivery, and the sequlae of abnormal placentation. They must be
treated a high risk with adequate antenatal and intrapartum surveillance.
Male Fertility
ASPIR-0008
Posters: Male Fertility
EFFECT OF CHEMICAL SYMPATHECTOMY ON UNILATERAL VASECTOMY-INDUCED

SPERMATOGENESIS DISTURBANCE IN CONTRALATERAL TESTICULAR TISSUE OF
MICE
A. Najafi1, A. Shalizar Jalali1, G. Najafi1, M. Behfar2
1
Urmia university, Veterinary Basic Sciences, Urmia, Iran
2
Urmia university, Veterinary Surgery and Diagnostic Imaging, Urmia, Iran
It has been proposed that a vasospasm through a sympathetic reflex arc and hypoxia are
main reasons of contralateral testicular deterioration following unilateral injuries of vas
deferens. The aim of the present study was to determine whether chemical sympathectomy
(CS) affects spermatogenesis impairment in contralateral testicular tissue following
experimental unilateral vasectomy in mice.
453Method
454Neonatal male mice were randomly divided into four groups of six mice each. Within 24
hours of birth, control mice were received 0.1 ml/day normal saline for 7 days
intraperitoneally and sham operated at 42 days of age. The CS group received
intraperitoneal injections of 6-Hydroxydopamine at a dose of 0.075 mg/gr/day for 7 days
after 24 hours of birth. In the left vasectomy (LV) group, the mice were unilaterally
vasectomized at 42 days of age and in the CS + LV group, the animals were treated by CS
plus unilateral vasectomy. At 11 weeks of age all the mice were euthanized and
histopathological analyses were determined to monitor the spermatogenesis in contralateral
testicular tissue.
Results
Left vasectomy significantly reduced spermiation, tubule differentiation and repopulation

indices as well as germinal epithelium height and seminiferous tubules diameter. Moreover,
significant increases in interstitial tissue and testicular capsule thicknesses and number of
mononuclear immune cells were observed in vasectomized mice. Significant differences
were not observed between LV and CS + LV groups regarding above-noted parameters.455
Conclusion
These findings suggest that contralateral testicular damages following unilateral vasectomy
do not mainly result from the involvement of the sympathetic system.456
ASPIR-0018
SUCCESSFUL DELIVERY OF PATIENT WITH IDIOPATHIC

OLIGOASTHENOTERATOZOOSPERMIA BY ICSI USING SPERM SELECTED BY
HYDROGEN TREATMENT: FIRST CASE REPORT.
K. Nakata1, H. Kawano2, M. Yoshida3, N. Yamashita4
1
Yamashita Shonan Yume Clinic, Reproductive Medicine Research Center,
Kanagawa- Fujisawa, Japan
2
Yamashita Shonan Yume Clinic, Lab., Kanagawa- Fujisawa, Japan
3
Yamashita Shonan Yume Clinic, Doctor, Kanagawa- Fujisawa, Japan
4
Yamashita Shonan Yume Clinic, Director, Kanagawa- Fujisawa, Japan
Various types of treatments have been used for idiopathic OAT in order to obtain and select
good sperm for ICSI. However, empirical treatments such as the use of pentoxifylline have
met with limited success, and their effectiveness and safety have not been established.
Many clinical trials to reduce elevated reactive oxygen species levels, which have been
recognized in male factor infertility, have demonstrated beneficial effects of antioxidants,
whereas others have failed to achieve similar results. Hence, we aimed to develop a new
sperm enhancer in order to achieve a better and safer treatment for OAT. We have reported
that hydrogen treatment elevates the mitochondrial membrane potential, increases the ATP
production and improves the motility of OAT sperm. We confirmed that no injury of sperm
DNA occurs by hydrogen treatment. We obtained healthy offspring of mice using hydrogen-
treated sperm.
Method
The husband was 35 years old. The semen volume was 1.7 ml, total sperm was 7.2 ×
106/ml, motility sperm rate was 13 %, and normal morphological sperm rate was 5%. The
wife was 30 years old and had endometriosis. They have tried to conceive for 2 years;
however, 3 cycles of ICSI failed. After obtaining informed consent from the couple, we
performed ICSI using sperm selected by hydrogen treatment and then transferred the
egg.
Results
The wife conceived and delivered a healthy baby. We report this case as the first successful
case of hydrogen treatment in a patient with OAT.
Conclusion
More trials should be conducted to confirm the efficacy of hydrogen treatment.

ASPIR-0070
CLOMIPHENE CITRATE THERAPY IN AZOOSPERMIA OCCURING POST TREATMENT

FOR HODGKIN’S LYMPHOMA YIELDS SUFFICIENT EJACULATED SPERMATOZOA
FOR INTRACYTOPLASMIC SPERM INJECTION, A CASE REPORT
S.D. VALIAPAN1, N.H. YUSSOFF1
1
KUALA LUMPUR HOSPITAL, OBSTETRICS & GYNAECOLOGY, KUALA LUMPUR,
Malaysia
BACKGROUND
Hodgkin’s lymphoma frequently affects reproductive aged men who have good survival
rates. Hypogonadism and azoospermia are documented complications. This case report is
on a patient who had undergone chemotherapy and autologous bone marrow transplant for
Hodgkin’s lymphoma. After 21 months of completing chemotherapy, he remained
azoospermic.
Method
CASE REPORT
This 31 year old man completed chemotherapy in June 2014 for Hodgkin’s lymphoma and
had autologous bone marrow transplant in August 2014. His initial hormonal profile in June
2016 revealed hypogonadism, with FSH 21.3IU/L, LH 11.8IU/L and testosterone 6.1nmol/L.
Two semen analyses in March and June 2016 showed azoospermia. He commenced
clomiphene citrate (CC) in July 2016. Serial hormonal profiles and semen analysis were
done. The CC dose was titrated based on the hormonal profile trend. A repeat test in
September 2016 showed an FSH of 29.8IU/L, LH 17.2IU/L and testosterone 22.4nmol/L. His
semen analysis in September 2016 showed a significant improvement with a sperm count of
0.3x106/ml, progressive motility 67% and morphology 2%. Sperm freezing was done.
Results
DISCUSSION
The finding of spermatozoa in this patient’s seminal fluid will avoid the need for a testicular
biopsy which is an invasive procedure. Clomiphene citrate treatment is simple, safe and cost
effective, and was used in this patient who developed azoospermia post therapy for
Hodgkin’s lymphoma, and which has now resulted in sufficient spermatozoa production for
use in assisted reproduction. Sperm has also been frozen for future use.
Conclusion
CONCLUSION
Clomiphene citrate offers a viable option for men with persistent azoospermia post treatment
for Hodgkin’s lymphoma.
ASPIR-0083
HEALTHY LIVE BIRTH RESULTING FROM SPERM OBTAINED VIA SUPRAPUBIC

CATHETER: A CASE REPORT
T. huynhvan1, T. Laivan1, C. Lethiminh1
1
Tu Du Hospital, Infertility Department, Ho Chi Minh, Vietnam
Introduction
We report a rare case of healthy live birth resulting from intracytoplasmic sperm injection
(ICSI) of frozen-thawed sperm obtained from post-ejaculatory urine by the Hotchkiss
technique using suprapubic catheter.
Case report
A 26 year-old man presented with diagnosis of primary infertility. He had the medical history
of tethered spinal cord syndrome, three tethered spinal cord release procedures, and
suprapubic cystostomy for long term drainage at the age of 21. He recognized dry
ejaculation when he got married at the age of 25.
He was diagnosed with retrograde ejaculation because of the presence of many sperms in
post-ejaculatory urine collected via suprapubic catheter. Before starting ICSI treatment,
sperm obtained from post-ejaculatory urine by the Hotchkiss technique using suprapubic
catheter was cryopreserved, the initial total number of sperms retrieved in bladder was
39x106 with percentage progressive motility 6%.
Result was a healthy live birth following one cycle of ICSI using frozen-thawed sperm
retrieved from post-ejaculatory urine.
Conclusion
The use of suprapubic catheter may be useful in diagnosis and treatment of infertility due to
retrograde ejaculation in men with cystostomy.
ASPIR-0105
CORRELATION OF BODY MASS INDEX WITH SEMEN QUALITY AMONG MALE

PARTNERS OF INFERTILE COUPLES IN BANGLADESH
T. Chowdhury1
1
, Dhaka, Bangladesh
This study aims to find out the correlation of body mass index with semen quality among
male partners of Bangladeshi infertile couples.
Method
This prospective, observational study was done on male partners of 100 infertile couples
who attended at the Infertility Management Center; a tertiary care setup from August 2016 to
October 2016. Only those who were unable to conceive after one year of unprotected sexual
intercourse and agreed to take part were included in this study. Those with history of any
testicular surgery or on drugs that can affect the semen quality were excluded from the study
Results
The mean age was 36.63 (±5.27) years, minimum age was 25 years and maximum age was
57 years, majority 69% cases were service holders. In this study showed no significant
relation between BMI with total sperm count (p>0.05). In this series negative correlation was
showed BMI with active motility, there was 23% possibility if BMI was decreased then active
motility was increased (p 0.02) Also in this series there was negative correlation between
BMI with normal morphology, there was 25% possibility if BMI was decreased then normal
morphology was increased (p 0.01).
Conclusion
This study shows no definite correlation between BMI and sperm concentration among
Bangladeshi men but BMI can affect the progressive sperm motility and morphology. So life
style modification with proper diet and exercise can be an integral part of management of
infertile men with high BMI.
ASPIR-0113
MAJOR FACTORS DETERMINING PREGNANCY OUTCOME IN IVF TREATMENT WITH

AZOOSPERMIA
L. Hinting1, E. Setijowati1, R. Witjaksono1, H. Lunardhi1,2, A. Hinting1,2
1
FERINA, Andrology, Surabaya, Indonesia
2
Airlangga University, Andrology, Surabaya, Indonesia
Background : Three major factors (FSH level, type of sperm recovered from PESA or TESA
and the women's age) are involved in increasing the pregnancy rate in IVF treatment with
azoospermia
Aim : To evaluate the major factors increasing the pregnancy outcome in IVF treatment with
azoospermia
Method
A total of 270 couples requiring PESA or TESA with ICSI from January 2015- August 2016
were reviewed. The womens’ ages were divided into 5 groups < 35, 35-37, 38-42, and >42
year old. FSH level criteria ranged between 1.9 and 23.4 mIU/mL. The type of sperm
recovered is classified into spermatozoa and spermatid. All variables were analyzed for
linear regression and chi-square analysis using SPSS v23 (IBM).
Results
There were 178 female patients aged <35 (65, 93%), 61 female patients aged 35-38
(22,59%), 27 female patients aged 39-42 (10%) and 4 female patients aged >42 (4%). In
chi-square analysis, we found no correlation between pregnancy rate and women’s age (p=
0.102, r= 0.153 and CI = 95%). A strong correlation is demonstrated between FSH level (p=
0.03, r= 0.2, and CI= 95%) and type of sperm recovered (p= 0.00, r= 0.4, and CI=95%) with
pregnancy rate. Linear regression analysis demonstrated a weak correlation between
women’s age, FSH level and the type of sperm recovered with pregnancy rate (p= 0.000,
r=0.4, and CI=95%).
Conclusion
Our study showed that FSH level and the type of sperm recovered affected the pregnancy
outcome. The women’s age did not correlate with the pregnancy outcome .
ASPIR-0134
RELATIONSHIP BETWEEN DURATION OF WORK WITH SPERM CONCENTRATION

AND SPERM DNA FRAGMENTATION IN AUTOMOBILE PAINTERS IN MALANG
D.F. Irnandi1, A. Hinting2, R. Yudiwati2
1
, Malang, Indonesia
2
Airlangga University, Medical Biology, Surabaya, Indonesia
Intoduction: Automobile painters are exposed to complex chemical mixture including

benzene, toluene, and xylene which may induce male reproductive dysfunction, especially
sperm concentration and sperm DNA fragmentation. The aim of this study was to determine
whether the work duration of automobile painters has correlation with their sperm
concentration and sperm DNA fragmentation
Method
Material & method: Ejaculate of fifteen married-and-have-children automobile painters were

collected. Sperm concentration were counted according to the World Health Organization
(WHO) protocol. Sperm DNA fragmentation of these ejaculates were tested by TUNEL
Assay in combination with Propidium Iodide (PI) and analyzed by flowcytometry. Sperm
concentration and TUNEL assay results are then correlated with the various work duration of
automobile painters.
Results
Result: The results showed that automobile painters have an average value of 47.66% and
52.77% of sperm DNA fragmentation and sperm concentration, respectively. Correlation test
between work duration and sperm concentration showed a statistically not significant, p =
0.798 (p <0.05, CI 95%). For the sperm DNA fragmentation, it showed correlation with
statistically not significant, p = 0.813 (p <0.05, CI 95%).
Conclusion
Conclusion: Work duration, related to the chemical exposure of automobile painters, may
interfere sperm production and sperm DNA fragmentation. But this study showed that they
were not correlate statistically significant. This result indicate that may be some lifestyle
factors like chemical exposure in previous jobs and or smoking as confounding factors for
the responses.
Keywords: sperm concentration, fragmentation, DNA, spermatozoa, TUNEL, propidium

iodide, flowcytometry
ASPIR-0148
DOES BODY WEIGHT HAVE AN IMPACT ON SPERM DNA FRAGMENTATION IN MALE

INFERTILITY?
H.P. Lubis1,2, B. Halim1,2, D. Novia2
1
Faculty of Medicine- University of Sumatera Utara- Adam Malik General Hospital,
2
HFC IVF Center,
A high percentage of body fat, most commonly approximated by the body mass index (BMI),
has been associated with hormonal alterations in men, and high BMI in both male and
female partners have been suggested to reduce couple fertility. Sperm DNA fragmentation is
another factor that may be affected in obese male, possibly resulting from increased damage
due to oxidative stress. Sperm DNA fragmentation as one of sperm test for male infertility
can be measured and expressed by a DNA Fragmentation Index (DFI). The aim of the study
is to analyze relationship between BMI and sperm DNA fragmentation in subfertile men .
Method
A retrospective analytic study was done by recruiting 100 male partners of subfertile couples
undergoing IVF-ICSI cycle from January 2015 to January 2016 and by using secondary
data from medical records in Halim Fertility Center. Sperm DNA fragmentation was detected
by halosperm kit.
Results
From 100 subfertile men, we found 30 patients with normoweight (30%), 48 patients with
overweight (48%) and 22 patients with obese (22%). We also found 95 patients with DFI ≤
30% (14,58 ± 7,50) and 5 patients with DFI > 30% (32,33 ± 2,69). The Statistical analysis
showed that there was no significant relationship between BMI and DFI (p>0,05). Statistical
analysis also showed that there was no significant relationship between BMI and sperm
concentrations and motility (p>0,05).
Conclusion
There is no significant relationship between body mass index (BMI) and sperm DNA
fragmentation in subfertile men.
ASPIR-0149
EFFECT OF 6-WEEK MICRONUTRIENT SUPPLEMENTATION ON SPERM

PARAMETERS AND PREGNANCY OURCOMES IN MALES WITH IDIOPATHIC
INFERTILITY UNDERGOING FERTILITY INTERVENTIONS: A PILOT STUDY
G.S. Choo1, L.D. Aw2, M. Prakash2, B.S. Ooi2, Y. Zamri2, K. Balanathan3, H.K. Chan4,
M.Z. Murizah2
1
Penang General Hospital, O&G Department, Penang, Malaysia
2
Sultanah Bahiyah Hospital, O&G Department, Alor Setar, Malaysia
3
Seberang Jaya Hospital, O&G Department, Seberang Jaya, Malaysia
4
Sultanah Bahiyah Hospital, Clinical Research Centre, Alor Setar, Kedah, Malaysia
Background and Aim: Approximately 50% of male infertility cases are idiopathic, while the
usefulness of treatment still remains uncertain. This study evaluated the effectiveness of the
consumption of Profortil®, a combination of eight micronutrients, on sperm count, sperm
motility, and pregnancy outcome following a fertility intervention.
Methods: An observational, pilot study was undertaken at the Seberang Jaya Hospital and
the Sultanah Bahiyah Hospital, Malaysia. A total of 90 infertile males were enrolled, 52 of
which decided to take two capsules of Profortil® daily for a six-week period during the 1st
September and 30th November 2016. Infertile men who decided not to consume Profortil®
served as the control group (n=38). Semen analysis and an observation of pregnancy
outcomes following the fertility interventions were conducted after 6 weeks.
Results: Despite the consumption of Profortil®, both groups showed a significant increase in
sperm count (p<0.001), but no change in sperm motility after 6 weeks. Although the
difference in increment of sperm count between two groups was not significant, more
participants who took Profortil® achieved a sperm count above 15 million/mL
(25% versus18.4%) and sperm motility above 40% (57.7% vs 60.5%). The Profortil® group
also demonstrated a higher pregnancy rate following the fertility interventions (26.9% versus
18.4%).
Conclusion: Profortil® was not shown to significantly increase sperm count and sperm
motility. However, there is a trend of more patients having sperm count and motility above
the WHO-recommended lower limit values for semen analysis, which could had a positive
impact on the pregnancy outcomes. However, a double-blind, randomized, placebo-
controlled study would be able to support and verify these findings.
ASPIR-0152
IMPACT OF CROTON CAUDATUS GEISELER DIETARY SUPPLEMENTATION ON

SPERMATOGENIC ACTIVITY IN THE SEXUAL DYSFUNCTION-INDUCED RATS: A
HISTOLOGICAL STUDY
D. Razif1, S. Fatimah2, Z. Fatin Nadzirah3, H. Nina Keterina3, B. Ebby Anuar3, A. Zulkhairi3
1
Maternofetal and Embryo MatE Research Group- Universiti Teknologi MARA,
Faculty of Health Sciences, Puncak Alam, Malaysia
2
Department of Nursing- Faculty of Health Sciences, Universiti Teknologi MARA,
3
Department of Basic Sciences- Faculty of Health Sciences, Universiti Teknologi MARA,
Infertility is a biological inability of an individual to conceive and half of the cases are related
to male factors such as premature ejaculation, azoospermia and impotence. To date, no
precise treatment has been established to treat male infertility whereas consumption of
medicinally claimed phytomedicine without proper scientific evident exposes various
unwanted side effects. Croton caudatus Geiseler has been reported to have antimutagenic,
antiinflammatory, and antioxidant properties. However, to date, least information is available
on the anti-infertility properties of C.caudatus Geiseler. Furthermore, no scientific data about
the histological study on spermatogenic activity of this herb have been reported.
Method
Thirty male Wistar rats (9 weeks old) were randomly divided into five groups, namely; the
negative control (distilled water); the positive control (200 mg/kg BPA), and the treatment
groups which received 16, 32, and 64 mg/kg doses of C.caudatus root extracts + 200 mg/kg
BPA, orally for twenty one days. After twenty one days of treatment, sperm parameters were
examined using Hamilton Thorne Sperm Analyzer and testis were harvested for histological
assessments using Haematoxylin Eosin technique.
Results
Overall, C.caudatus at 64 mg/kg significantly (p < 0.001) increased the total sperm count
and progressive cells motility; as well as decreased abnormal sperm morphology. The
histological results revealed that normal morphology of germ cells organized in concentric
layers of seminiferous tubules.
Conclusion
Abundant and compact spermatogenic cells were found on the lumen of seminiferous
tubules which indicate the influence of spermatogenesis process that facilitated by this herb.
ASPIR-0158
THE EFFECT OF SELENIUM AND VITAMIN E ON SPERM QUALITY, EXPERIMENTAL

STUDY ON WISTAR RATS (RATTUS NORVEGICUS) INDUCED WITH MONOSODIUM
GLUTAMAT
M. Milla1
1
Faculty og Medicine- Sultan Agung Islamic University, Anatomy, Semarang, Indonesia
Monosodium Glutamate has been shown to have a correlation with quality of spermatozoa.
The administration of selenium and vitamin E has been shown to scavenge the free radicals
contained in MSG. Antioxidant usage such as selenium and Vitamin E have a role in
eliminating free radical caused by MSG. This study was aimed at evaluating effect of
selenium and vitamin E on the quality of ROS (Reactive Oxygen Species) induced sperm
damage in rat.
Method
This post test only control group design experiment divided into four groups. Group I
received MSG (0,8 gr/200gr BW). Group II received MSG and selenium (0,8 gr/200gr BW;
1,67 mg/150 gr BW). Group III received MSG and vitamin E (0,8 gr/200gr BW; 150
mg/150gr BW). Group IV received MSG, selenium and vitamin E (0,8 gr/200gr BW; 1,67
mg/150 gr BW; 150 mg/150gr BW). The experiment was conducted for 15 days. Result of
concentration and motility were analyzed by Kruskal Wallis followed by Mann-Whitney test.
Result of morphology and viability were analyzed by One way Anova followed by Post Hoc
test.
Results
Mean of concentration spermatozoa in group I, II, III, and IV were 12,5x107/ml; 50,5x107/ml;
75,4 x107/ml dan 90,1x107/ml, morphology were 21%; 81,20%; 86,8% dan 80,2%. motility
were 0,4%; 5,6%; 27,8% dan 36,13%, and viability were 17,2%; 52,2%; 67,2% dan 72,6%.
Result of quality spermatozoa were significantly different between control group and
experimental group.
Conclusion
There was the effect of vitamin E and selenium on rat sperm quality induced by MSG.
ASPIR-0171
CORRELATION BETWEEN BMI AND THE SPERM CHARACTERISTICS

S.P. Tee1, M.R. Varutha Rajoo1, N.F. Hassan1, Y.Y. Chow1, S.H. Ng1, B. Ghani1
1
METRO IVF FERTILITY CENTRE, IVF LAB, KLANG, Malaysia
Several past studies have shown that body mass index (BMI) is correlated to the sperm
characteristics. This observational study is to observe the correlation of BMI and man’s
sperm characteristics in Metro IVF Fertility Centre.
Method
The sperm characteristics of the men that had their semen analysis done in Metro IVF
Fertility Centre were identified by inspecting the concentration, motility and morphology of
the sperms according to the World Health Organization (WHO, 2010) standard reference
values of semen variables. Patients’ height and weight were recorded by staff nurse of Metro
IVF Fertility Centre in order to calculate their BMI corresponding to the WHO standard. The
data collected consisted of 183 men with ages ranging from 25 to 54 years. The compiled
data were then analyzed and had excluded data of those with history of varicocele.
Results
47% of normal weight men had normozoospermia, 36% in overweight and 18% in obese
suggesting the normozoospermia decreases with increasing BMI. The percentages of all the
three WHO lower limit sperm parameters; sperm concentration, motility and morphology are
higher in the overweight and obese men compared to the normal weight.
Conclusion
It is recorded that a higher percentage of overweight and obese men have lower
percentages of sperm concentration, sperm motility and sperm morphology. One man’s BMI
is observed to be correlated to his sperm characteristics in this study.
ASPIR-0192
STUDY ON THE RELATIONSHIP BETWEEN THE LEVEL OF SERUM FSH,LH,T AND

SEMEN QUALITY REPRODUCTIVE MEDICINE CENTER，RENMIN HOSPITAL OF
WUHAN UNIVERSITY,WUHAN CHINA XIANGLI PANG JING YANG
X. Pang1
1
Renmin Hospital of Wuhan University, Reproductive center, Wuhan, China
To explore the relationship between the level of serum FSH,LH,T and semen quality.
Method
semen samples of 1020 male patiens were collected and analysed according to the World
Health Organization Laboratory Manual for the Examination and Processing of Human
Semen (5th edition,2010). They are divided into four groups on the semen quality: Normal
spermatozoa (Group A), Oligospermia (Group B ), Asthenospermia (Group C)，
Azoospermia(Group D). Meanwhile, the level of serum sex hormones (FSH,LH ,T) were
tested by chemiluminescence immunoassay(CLIA), The correlation between the level of
serum FSH,LH,T and semen quality was analyzed.
Results
There is significant difference in the level of serum FSH and LH between groups(P＜0.05).
The level of serum T is different significantly between group C , group D and group B, the
same result was found in group C ,group D and group A(P＜0.05), but there is no significant
difference in the level of serum T between group A and group B(P＞0.05). The level of
serum FSH in group C ,group D and group B were significant higher than that in group
A. The level of serum T in group C was significant lower than that in group A.
Conclusion
The semen quality is close relate to the level of serum sex hormones, particularly FSH. It is
of importance to analysis sperm parameters combined with serum sex hormones , which
may provide us an reasonable way to evaluate the male reproductive ability.
ASPIR-0193
STUDY ON THE RELATIONSHIP BETWEEN AGE AND SPERM DNA FRAGMENTATION

INDEX , SEMEN PARAMETERS
X. Pang1
1
Renmin Hospital of Wuhan University, Reproductive center, Wuhan, China
To explore the relationship between age and sperm DNA fragmentation index (DFI), semen
parameters.
Method
semen specimens were collected from 912 male patients in our center , these
patients are divided by age into three groups : age 20-29(Group A),age 30-39(Group
B),age≥40(Group C), Sperm chromatin structure assay (SCSA) was used to detect sperm
DNA fragmentation index in three groups. Routine semen analysis also was performed
according to the fifth edition of WHO criteria. The relationship between age and DFI, normal
sperm morphology rate, sperm motility, sperm concentration was analyzed.
Results
Sperm concentration and normal sperm morphology rate have no significant correlation with
the age;The DFI has a positive correlation with the age, meanwhile progressive motility
sperm rate (PR%) has a negative correlation with the age .
Conclusion
Age has an impact on sperm DNA fragmentation index ,and progressive motility sperm rate .
ASPIR-0207
MALE INFERTILITY TREATMENT FOR CANCER SURVIVORS

H. HIBI1, T. Ohori1, Y. Asada2
1
Kyoritsu General Hospital, Urology, Nagoya, Japan
2
Asada Ladies Clinic, Obstetrics & Gynecology, Nagoya, Japan
Owing to the increasing number of cancer survivors because of the advances in cancer
treatment, fertility preservation has become a serious problem. This study was conducted to
evaluate the outcomes of male infertility treatment for cancer survivors at our hospital.
Method
Of 1165 men who visited our male infertility clinic during a recent 10-year period, 36 cancer
survivors who desired to have their offspring were evaluated. The patients’ ages ranged from
27 to 54 years (median 35.5 years). The cancer types along with their corresponding number
of cases as follows: testicular cancer (n=13), blood cancer (n=9), colorectal cancer (n=4),
extragonadal germ cell cancer (n=2), osteosarcoma (n=2), renal cancer (n=2), malignant
thymoma, rhabomyosarcoma, Ewing sarcoma, and lung cancer (n=1 each). Treatment
status was past chemotherapy in 23 patients and surgical removal alone in 9. The median
duration from the late chemotherapy session was 14 years. Semen analysis revealed
azoospermia in 25 patients and oligoasthenozoospermia in 5. Three subjects showed
anejaculation.
Results
Sperm banking before cancer treatment was performed in only 3 patients. Sperm retrieval
surgery was performed in 18 patients. In 11 cases, motile sperm was retrieved successfully
and reserved for intracytoplasmic sperm injection (ICSI). As a result, 10 healthy babies were
born. One subject who did not achieve sperm recovery produced an offspring through donor
insemination.
Conclusion
Male infertility in cancer survivors is rare. However, cancer survivors even those with
azoospermia, can have their own genetic offspring through sperm retrieval surgery after
ART. Providing more information to cancer survivors should be emphasized.
ASPIR-0231
EFFECT OF SEMINAL TESTOSTERONE SUPPLEMENT ON SPERM MOTILITY IN

ASTHENOSPERMIA
I. Thanaboonyawat1, P. Chantrapanichkul1, S. Petyim1, R. Choavaratana1, C. Kaewjunun1
1
Faculty of Medicine Siriraj Hospital Mahidol University, Obstetrics and Gynecology,
Bangkok, Thailand
Significantly lower seminal testosterone is found in asthenospermia. Androgen receptors are

present on sperms. Testosterone might exert its function through these receptors via either
classical or non-classical pathway, to affect the motility of the post-ejaculated sperms. This
study was conducted to evaluate the testosterone effects on motility of asthenospermic
sperms, at specific durations after adding various concentrated testosterone solutions.
Method
Semen was collected by masturbation from 41 infertile men with asthenospermia. After
liquefactions, each semen sample was divided into six portions, the control, the vehicle
control, and the 3rd-5th portion that mixed with 4.75, 7.75 and 17.75 nmol/L testosterone
solutions, respectively. The supernatant of the rest was sent for testosterone assay. The
sperm motility was evaluated at 5th, 15th, 30th, and 45th min after mixing.
Results
There was no difference in the number of samples in each portion that had 20% sperm
motility improvement. However, the portion that mixed with 4.75 nmol/L testosterone solution
had significantly retardation in motility reduction compared with the one having 17.75 nmol/L
solution addition (p-value <0.05). The group that had a final testosterone concentration of
4.51-10 nmol/L, had significant sperm motility improvement at the 5th minute. In contrast, the
group that had testosterone level rise over 10 nmol/L displayed a reduction in both sperm
motility and sperm viability.
Conclusion
Testosterone addition affected the sperm motility. The final testosterone concentration of
4.5-10 nmol/L may be the optimal range for the best sperm motility. Yet, excessively high
testosterone concentration could conversely effect on sperm motility and viability.
ASPIR-0259
SERIOUS SEMINIFEROUS TUBULE HYALINIZATION INDICATED A HIGHER SPERM

RETRIEVAL RATE WHEN MICRO-TESE WAS PERFORMED ON NON-OBSTRUCTIVE
AZOOSPERMIA PATIENTS
J. Zhang1, G.H. Liu1, X.Y. Liang1, Z.Y. Wang2
1
the Sixth Affiliated Hospital of Sun Yat-Sen University, Reproductive Center, GuangZhou,
China
2
the Sixth Affiliated Hospital of Sun Yat-Sen University, Urology, GuangZhou, China
To evaluate the predict value of seminiferous tubule hyalinization for sperm retrieval rate of
microdissection testicular sperm extraction(micro-TESE) in non-obstructive
azoospermia(NOA) patients.
Method
85 NOA patients who diagnosed as SCO and suffered micro-TESE from Jan.2015 to
Jun.2016. These SCO patients were divided into three groups according to the pathology
(Group A, 28 patients without seminiferous tubule hyalinization, Group B, 21 patients with
hyalinization, Group C, 36 patients with serious hyalinization and Sertoli cells are rare).The
three groups were compared in age,testicular volumes,FSH,LH,inhibin B,testosterone,SRR
and microscopic findings of testicular tubules during operation.
Results
No significant difference was observed in FSH, LH, inhibin B and testosterone levels
between the three groups(All P>0.05). However, testicular volume in group C was lower than
other two groups (P<0.05, respectively)(TableⅠ). Spermatozoa were successfully retrieved
from 27 patients (31.8%). Sperm retrieval rate was higher in group C (55.6%) than that in
group A or group B (10.7% and 19.0%, P<0.05, respectively). Patients in group C had more
opportunity to show heterogeneous tubule than other two groups during micro-TESE
procedure (P<0.05, respectively)(TableⅡ). Sperm could be found in 75% (24/32) cases if
heterogeneous tubules presented.
Conclusion
Micro-TESE should be recommended to NOA patients who diagnosed as SCO with serious
seminiferous tubule hyalinization.Considering micro-TESE would not provide an advantage if
seminiferous tubules show homogeneous thickness,needle biopsy should be performed
previously to minimized testicular damage.
ASPIR-0266
АNEUPLOIDY SPERM IN INFERTILE MEN

S. Bogolyubov1, V. Magomedova2, A. Artamonov1, B. Dmitriev3, A. Astahova1
1
Tver State Medical University, Dr. Fomin's reproductive clinic, Tver, Russia
2
Private clinic, "JUSU ARSTI", Riga, Latvia
3
Tver State Medical University, Urology, Tver, Russia
Elevated levels of sperm aneuploidy can cause miscarriages, IVF failures. The purpose of
the study to evaluate the impact of clinical parameters and sperm parameters in infertile men
to the level of sperm aneuploidy.
Method
The study included 48 men with infertility, mean age 32 ± 5,3 years .Clinical parameters
were evaluated - level of LH, testosterone, TSH, T4 free in the blood serum. Semen
parameters were assessed - concentration, motility, morphology, sperm DNA fragmentation.
Sperm aneuploidy was detected by FISH, labeled 13, 18, 21, X, Y chromosome. The data
were processed using statistical software SPSS v.12.
Results
We have identified a strong direct correlation between smoking and aneuploidy sperm on
chromosome 21 (r = 0.65; p = 0.012), and the total sex chromosomes (r = 0.59; p = 0.02),
DNA fragmentation and aneuploidy 13 chromosome (r = 0.49; p = 0.023), average direct
correlation between varicocele and sperm aneuploidy on chromosome 18 and 21 (r = 0.39; p
= 0.048, r = 0.45; p = 0.023). We found a strong relationship between the LH and aneuploidy
13, 21 and the total sex chromosomes (p = 0.56; p = 0.046, r = 0.64; p = 0.024, r = 0.85; p =
0.001), and between the TSH and aneuploidy 13, 21 and total autosomes (r = 0.69; p =
0.003, r = 0.59; p = 0.013, r = 0.72; p = 0.002), respectively.
Conclusion
Smoking and varicocele linked with sperm aneuploidy.The role of LH and TSH in sperm
aneuploidy requires further research.
ASPIR-0300
EFFECT OF PHOSPHODIESTERASE 10A INHIBITOR ON SPERM MOTILITY

S.N. Wagiman1, C.L. Barratt2
1
Hospital Sultanah Nur Zahirah, Obstetric&Gynecology, Kuala Terengganu, Malaysia
2
University of Dundee, Medicine, Dundee, United Kingdom
Sperm development and motility is important to allow the unique paternal properties to reach
the immotile oocyte and deliver its information after fusion with the oocyte membrane. Cyclic
nucleotides (cyclic adenosine monophosphate (cAMP) and cyclic guanosine
monophosphate (cGMP)) have reported to play roles in sperm motility that leads to
capacitation and the ability of sperm in fertilizing an oocyte. Phosphodiesterases (PDEs) are
enzymes that control the intracellular levels of cyclic nucleotides. PDE 10A, is a dual-
substrate gene in PDE family that hydrolase both cyclic nucleotide (cAMP and cGMP) that is
found expressed in brain, thyroid and testis.
Method
We examine the effect of PDE 10A inhibitor (PQ-10) towards sperm motility from 40% and
80% sperm fraction in non-capacitating condition (NCM) and capacitating condition (CM) in
phase 1. In addition, the motility effect from 40% fraction in NCM from 30 sample (25 donor
and 5 patient sample) and sperm penetration ability through Kremer test in phase 2
Results
The 40% fraction have shown higher motility in NCM and CM after treated with 10nM of PQ-
10 compared to 80% fraction. Significant difference observed in total and progressive motility
in PQ-10 compared to control sample (p<0.0001) in donor samples (n=25) and higher total
motility in patient’s treated sample in PQ-10, p<0.05, n=5. Although some samples have
shown non-significant effect towards the penetration ability after treated with PQ-10.
Conclusion
Sperm cells with low motility count is possible to be treated with PQ-10 in recommending a
safe and established ‘drug’ to improve sperm function in infertility treatment.
ASPIR-0316
SPERM CRYOPRESERVATION BEFORE TESTICULAR CANCER TREATMENT AND

LIVE BIRTH AFTER INFERTILITY TREATMENT: A CASE REPORT
T. Lai Van1, T. Hua Thanh2, N.T. Ha2
1
Tu Du Hospital, Infertility Department, Ho Chi Minh, Vietnam
2
Tu Du Hospital, Infertility Department, Ho Chi Minh City, Vietnam
Aim: To evaluate the ability of sperm cryopreservation in male fertility preservation. In this
study, the result of sperm cryopreservation in infertility treatment in which testicular cancer
patient after a year of cancer treatment is reported.
Method
Methods: A case study. The testicular cancer patient was consulted about sperm
cryopreservation in about March 2008 to March 2010 prior to removing malignant tumor and
treating cancer.
Results
Results: After a year of cancer treatment, in May 2012 we conducted ICSI cycle with the
cryopreserved sample and the outcome was health live birth.
Conclusion
conclusion: The testicular cancer survivors have good opportunity of fathering their child by
using cryopreserved sperm prior to onclology treatment by many of assisted reproduction
methods
ASPIR-0361
THE CORRELATION STUDY OF SPERM NUCLEAR DNA DAMAGE AND

LEUKOCYTOSPERMIC SAMPLES IN JAKARTA, INDONESIA
R. Margiana1
1
universitas indonesia, Anatomy, jakarta, Indonesia
Sperm Chromatin Dispersion (SCD) Test with Sperm DNA Fragmentation Index (DFI) as its
result is one of examination that is important to assess the pathologic condition in sperm
nuclear DNA. Other study has reported that lucocytospermia can cause nuclear damage
though its mechanism in increasing the superoxide dismutase and catalase. This correlation
study of sperm nuclear DNA damage and leukocytospermic samples has not been done by
other andrology lab in Indonesia, espescially in Jakarta.
Method
We used secondary data from 169 data in Yasmin Infertility Clinic in Cipto Mangunkusumo
Hospital in Jakarta from August to November 2016. Semen analysis was done to determine
is there any lecocytospermic condition. In addition, we used HALO kit to assess sperm
nuclear DNA damage.
Results
Leucocytospermia was detected in 53 (31.36%) patients. As the classification of DFI, we

found leucicytspermia as follow: (1) good category was 13.21%, whereas in (2) moderate
category was 52.83% and in (3) severe category was 33.96% from 53 patients that are
categorized as leucocytospermic case. The data was analize further using SpSS, and we
found there is a positive correlation between leucocytospermia and the DFI.
Conclusion
The leucocytospermic patients prone to have higher level of DFI but not enough to the worst
category than those who did not have any leucocytospermia.
ASPIR-0362
THE PROFILE OF SPERM QUALITY IN TRIPRONUCLEUS HUMAN ZYGOTES

OBTAINED FROM INTRACYTOPLASMIC SPERM INJECTION
R. Margiana1
1
universitas indonesia, Anatomy, jakarta, Indonesia
There are numerous studies documenting the role of sperm factors that contribute to this
3PN zygote issue. However, data on sperm quality has largely been absent. In making a
comprehensive management of embryo development disorder, it's important to consider the
contribution of sperm quality. The aim of this study, therefore, was to avail the profile of
sperm quality in 3PN zygotes obtained from ICSI of Yasmin Infertility Clinic in Cipto
Mangunkusumo Hospital in Jakarta from January to October 2016.
Method
Forty four semen analysis report based on WHO, 2010 and sperm DNA fragmentation index
(DFI) report based on Mathwig et al, 2010 were compiled.
Results
All of the conventional semen analysis was within normal reference value. The sperm
concentration was 39.58 million/ml, whereas progressive motile sperm was 79.27% and
normal sperm morphology was 19%. In contrast to conventional semen analysis, the DFI as
another parameter of sperm quality showed results in categories as follow: (1) good category
was 12.44%, whereas in (2) moderate category was 21.0% and in (3) severe category was
36.72%. In addition, the most prevalent DFI category in the 3PN zygote formation was the
moderate category (DFI >15-<30%).
Conclusion
Since the all sperm quality is in normal reference value, it may be concluded that the all
sperm quality parameter i.e. sperm concentration, sperm motility, sperm morphology and
DFI was not involved to the 3PN zygote formation.
Menopause
ASPIR-0087
Posters: Menopause
CORRELATION BETWEEN BODY MASS INDEX AND AGE TOWARD MENOPAUSAL

SYMPTOMS IN POST-MENOPAUSAL WOMEN
B. Budiman1, R. Muharam2, R. Nirmalasari2, H. Rizkinya2, M. Ikhsan2
1
Faculty of Medicine Universitas Indonesia- Persahabatan Hospital,
Obstetrics and Gynecology, Jakarta Timur, Indonesia
2
Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital,
Obstetrics and Gynecology, Jakarta Pusat, Indonesia
Age of life expectancy has increased thus population of women in menopausal state also
developed. Nowadays, transformation of lifestyle became major influence in many aspects.
This research aimed to understand correlation between age and BMI toward post-
menopausal women.
Method
This was a cross sectional study conducted in Persahabatan General Hospital. Menopausal
symptoms were measured using Menopause-spesific Quality of Life questionnaire. Data was
analyzed statistically to determine mean of age and BMI, data distribution, and to discover
correlation between dependent and independent variables.
Results
Seventy-nine post-menopausal women were involved in this study with average age 54.10
(±4.3) years old and mean of BMI 26.1841(±4.2). Data was normally distributed. There was
a weak significant correlation between BMI and physical domain in MenQOL (p=0.04;
r=0.231). Analysis to correlate BMI toward vasomotor, psychosocial, sexual, and mean of all
domains revealed no significant difference with p value 0.11, 0.18, 0.23, and 0.51 (p>0.05)
consecutively. Analysis of age toward menopausal symptom domains did not show any
statistical difference (p>0.05).
Conclusion
Body mass index weakly correlated to physical domain symptoms but did not influence other
menopausal symptom domains. Age did not affect occurrence of menopausal symptoms.
ASPIR-0233
Posters: Menopause
EFFECT OF FLAVONOL GLYCOSIDES ON ENDOTHELIAL CELL MIGRATION IN

HUVECS
B.S. Ko1, B. Kim1, D. Jung1
1
Korea Institute of Oriental Medicine, KM-Based Herbal Drug Development Group, Daejeon,
Republic of Korea
Menopause is associated with endothelial dysfunction as a result of sex steroids reduction.

Endothelial dysfunction can result from contribute to cardiovascular disease (CVD), such
as hypertension, hypercholesterolaemia, coronary artery diseases. CVD is a leading cause
of morbidity and mortality in postmenopausal women. The purpose of this study was to
investigate the effect on endothelial cell migration in HUVECs of the biological activities
compounds from Tetragonia tetragonioides.
Method
To develop for the novel phytochemical compounds, we were isolated two flavonol
glycosides from the 70% EtOH extract of the aerial parts of T. tetragonoides. The structures
were identified by the interpretation of their spectroscopic data including 1D, 2D-NMR as
well as by comparison with reported values. The chemotactic motility of HUVECs were
assayed using Transwell plates (8 µm pore size). The lower surface of the filter was coated
with gelatine (10 mg/mL). HUVECs were trypsinized and suspended at a final concentration
of 1ｘ106 cells/mL. 250 µL of the cell suspension with 70% EtOH of T. tetragonioides
compounds were loaded into each of the upper wells for 6 hour. Cells were fixed and stained
with hematoxylin and eosin.
Results
In HUVECs, the treatment of two flavonol glycoside compound significantly increased cell
migration activity in a dose dependent manner. These results reveal a novel role of
flavonol glycoside compounds that could result in the development of the endothelium
dysfunction by menopause.
Conclusion
The present study demonstrates that two flavonol glycosides from T. tetragonioides were
proper to phytoestrogen. Selected candidates will be required to examine for further
study.
Nursing
ASPIR-0016
Posters: Nursing
THE ASSOCIATIONS OF POSTPARTUM SEXUAL FUNCTIONING, FATIGUE, AND

DEPRESSION AMONG TAIWANESE WOMAN
F.J. Lee1, Y.Y. Lu2, S.M. Chen1
1
Taiwan Adventist Hospital, Obstetrics and Gynecology, Taipei, Taiwan R.O.C.
2
National Taipei University of Nursing and Health Sciences, Nursing, Taipei, Taiwan R.O.C.
Postpartum sexual problems are highly prevalent; however, research in this subject is under-
explored. This study aimed to determine the status of postpartum sexual function and its
relationship with fatigue and depression among Taiwanese woman.
Method
This study was carried out with a cross-sectional research design. In total, 135 postpartum
women were recruited into this study from one teaching hospital in north Taiwan and asked
to answer three surveys regarding their perceived postpartum fatigue (Visual Analogue
Fatigue Scale), depression (Edinburgh Postnatal Depression Scale), and sexual function
(Female Sexual Function Index). SPSS 20.0 software was used for statistical analysis.
Results
The mean total score of sexual function was 22.04 (SD ± 5.41) of the achievable score
range of 0-36. In the seven domains of sexual function, ‘Sexual Satisfaction’ domain
reported the highest satisfaction level, following by ‘Lubrication’ domain, and finally ‘Desire’
reported the lowest satisfaction level. A significant negative correlation was observed
between total sexual function score, postpartum depression and fatigue score (p<0.05, r= -
0.18-0.26). The variables of education, delivery mode, episiotomy, breastfeeding, delivery
complications, postpartum depression, and fatigue were predictors of sexual function and
were able to explain 6% of the variance in the sexual function score.
Conclusion
Sexual dysfunction is highly prevalent among postpartum women. Therefore, health care
providers should detect and treat fatigue, and depression in postpartum women in a timely
manner to prevent the decline in their sexual function.
ASPIR-0229
Posters: Nursing
DOES INFORMATION CHANGE PATIENTS DESIRE FOR DOUBLE EMBRYO

TRANSFER?
S.N.A. Syed Tahir1, P. Nadkarni2, T. Dey3
1
Kl Fertility & Gynaecology Centre, Nursing, Kuala Lumpur, Malaysia
2
Kl Fertility &Gynaecology Centre, Clinical, Kuala Lumpur, Malaysia
3
Royal Lancaster Irfirmary, Obstetric & Gynaecology, Lancaster, United Kingdom
Increased multiple birth following in vitro fertilisation (IVF) has been a rising concern. The
world has started moving towards single embryo transfer in an effort to reduce the risks of
multiple pregnancy and many countries have restricted the transfer of more than 1 embryo.
In Asia where patients pay for their treatment, they have the choice of deciding the number
of embryos to be transferred. The aim of this study was to explore the preference of KL
Fertility & Gynaecology Centre(KLFGC) patients for the number of embryos to be transferred
( single or double ) after being well informed of the risks of multiple pregnancy.
Method
This was an online self administered questionnaire survey. Patients were randomly chosen
during a 3 months survey period. They were asked to fill out the questionnaire before
counselling, and again after counselling, about the risks of a twin pregnancy.
Results
From the survey, 89.1% of 151 patients were aware of the higher risks of multiple pregnancy
and 67.4% agreed that the ideal outcome of IVF was to have a single baby. Despite
understanding these risks, 85.7% still preferred to have double embryo transfer.
Conclusion
The study shows that patients are inclined to have double embryo transfer to achieve higher
pregnancy rate despite knowing the risks. It may be due to the desire to complete family all
at once, history of failed IVF, family pressure and the financial cost of repeated IVF where
patients are self funded.
Ovary and Ovarian
Biology
ASPIR-0084
Posters: Ovary and Ovarian Biology
UNIQUE PROTEIN PROFILES IN OVARIAN TISSUES ANALYZED BY MALDI-TOF MS

C.C. Hsu1, C.T. Hsu2
1
TUBE Fertility Clinic, Obstetrics & Gynecology, Tainan, Taiwan R.O.C.
2
E-Da Hospital- I-Shou University, Pathology, Kao hsiung, Taiwan R.O.C.
Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) is a

powerful tool for investigating the distribution of proteins and small molecules within
biological systems through the in situ analysis of tissue sections. We analyzed ovarian tissue
proteins in a case with persisted ovarian follicles employing IMS.
Method
A 31 y/o woman with spontaneous persisted bilateral multiple ovarian follicular growth was
investigated. Laparoscopic examination was performed and ovarian tissue obtained. Another
ovarian tissue taken from a normal reproductive age woman receiving myomectomy as
control tissue. Frozen sections of 10 mm ovarian tissues were performed on a cryostat and
onto a ITO coated slides. Samples were applied with matrix solution and allowing to dry on
the MALDI sample plate. Protein calibration standard were also included in the matrix
solution as internal calibrators. MALDI images were obtained on an Ultraflex III MALDI-TOF-
TOF-MS instrument (Bruker Daltonics) using fleximageing2.0 and ClinProt tools 2.1 software
package for acquisition and evaluation.
Results
Without any ovarian stimulation of the investigated subject, 6-10 cysts/follicles persisted up
to 18-30 mm at bilateral ovaries were detected over the period of sixteen months. The
hormone profiles showed AMH 0.94 ng/mL, FSH 15-20 IU/L; LH 0.3-0.9 IU/L; E2 400-1600
pg/mL during observation period. MALDI-TOF MS on her ovarian tissue showed multiple
different protein images including relative abundance, and spatial distribution of a large
number of proteins compared to the control woman’s ovarian tissue.
Conclusion
The in situ proteome profiles of ovarian tissues may help in further understanding of ovarian
folliculogenesis and controlled ovarian hyperstimulation.
ASPIR-0135
IS DHEA THE MAGIC DRUG?

N. Malhotra1, K. Malhotra2
1
, agra, India
2
Rainbow IVF, IVF, agra, India
: Dehydroepiandrosterone (DHEA) is being presented as a miracle-drug for the treatment of

women responding poorly to gonadotrophin stimulation, while the debate on its actual
effectiveness is still ongoing.
Method
This is a prospective, self-controlled study of poor responders to IVF treatment, comparing

day 3 biochemical (anti-Mullerian hormone (AMH)) and ultrasound (antral follicle count
(AFC)) ovarian reserve markers and IVF treatment outcome before and after DHEA
supplementation of at least 3 months duration.
Study done at Rainbow hospitals Agra duration from jan 2016 and ongoing We have studied
around 30 women till now. Evaluation done were- Serum – cycle day 3 AMH Ultrasound –
AFC, endometrial thickness. Outcome – peak E2 levels, number of >15mm follicles on the
day of hCG administration, number of oocytes retrieved, MII oocytes, oocytes/total FSH
dose, number and grade of embryos, pregnancy rate.
We have done a IVF/ICSI cycle once before and then gave them a 3 months treatment with
DHEA and then stimulated them with the same drug again and compared them with previous
cycle.
Results
42 women were suitable for analysis. Following DHEA supplementation, there was a
significant increase in AFC. No significant rise in AMH seen.
Conclusion
DHEA improves IVF treatment outcome in women with poor response to IVF treatment. It
seems that the mechanism does not include recruitment of more pre-antral or very small
antral follicles (no change in AMH ) but rather rescue from atresia of small antral follicles
(increased AFC).
ASPIR-0313
EFFECT OF MATERNAL HIGH-FAT DIET AND POST-WEANING HIGH-FAT DIET ON

THE REPRODUCTIVE FUNCTION IN THE ADULT FEMALE OFFSPRING RAT: ROLE OF
INSULIN-LIKE GROWTH FACTOR 2
Y.J. Lin1, L.T. Huang2, Y.L. Tain3
1
Kaohsiung Chang Gung Memorial Hospital, Obstetrics and Gynecology, Kaohsiung City,
Taiwan R.O.C.
2
Kaohsiung Chang Gung Memorial Hospital, Pediatrics, Kaohsiung City, Taiwan R.O.C.
3
Kaohsiung Chang Gung Memorial Hospital,
Pediatrics and Institute for Translational Research in Biomedicine, Kaohsiung City,
Taiwan R.O.C.
Consumption of high-energy foods is linked to a global burden of metabolic syndrome and

reproductive dysfunction. However, only a handful of studies have examined the impact of
maternal and postnatal high-fat (HF) diet on offspring reproductive function. The aim of the
present study is to elucidate whether a maternal and postnatal HF diet confers similar risks,
and to explore the impact of HF diet on ovarian follicular population, steroidogenesis and
gene expression with a focus on the insulin-like growth factor 2 (Igf2) in adult offspring
ovaries.
Method
Virgin Sprague-Dawley (SD) rats were fed with normal chow (C) diet or HF diet for 5 weeks
before mating, during gestation and lactation. Female offspring were fed with the C or HF
diet from weaning to 6 months of age, resulting in four study groups (n=6 per group): C/C,
C/HF, HF/C, and HF/HF.
Results
Ovaries from offspring exposed to post-weaning HF diet (i.e. the C/HF and HF/HF groups)
had a decrease in small follicle numbers, but with similar numbers of antral follicles and
corpora lutea. Offspring from HF-fed dams had increased plasma estradiol concentrations
and decreased luteinizing hormone levels at 6 months of age. Maternal and post-weaning
HF synergistically caused a highest estradiol level in HF/HF group. In addition, a maternal
HF diet increased ovarian expression level of Igf2.
Conclusion
Post-weaning HF intake resulted in the reduction of small follicles in adulthood, whereas

maternal HF diet had long-term deleterious consequences on female offspring
steroidogenesis and coincided with alteration of the upregulation of the imprinted gene Igf2.
PCOS
ASPIR-0117
Posters: PCOS
TAILORED FIRST-LINE OVULATION INDUCTION FOR WOMEN WITH POLYCYSTIC

OVARY SYNDROME - AN INDIVIDUAL PARTICIPANT DATA NETWORK META-
ANALYSIS
R. Wang1, B. Kim1, H. Zhang2, M. van Wely3, R. Homburg4, C. Lambalk5, N. Weiss6, E. Moll3,
N. Johnson7, S. Kar8, S. Palomba9, A. Falbo9, W. Vegetti10, V. Leanza11, Ü. Özmen12,
Y. Şahin13, R. Legro14, B. Mol1
1
The University of Adelaide, Robinson Research Institute and School of Medicine,
North Adelaide, Australia
2
Yale University, Department of Biostatistics, New Haven, USA
3
University of Amsterdam, Centre for Reproductive Medicine, Amsterdam, The Netherlands
4
Homerton University Hospital, Homerton Fertility Centre, London, United Kingdom
5
VU University Medical Center, Department of Obstetrics and Gynaecology-, Amsterdam,
The Netherlands
6
Free Medical University, Center for Reproductive Medicine, Amsterdam, The Netherlands
7
University of Auckland, Department of Obstetrics & Gynaecology, Auckland, New Zealand
8
Kar Clinic and Hospital Pvt. Ltd, Department of Obstetrics and Gynecology, Orissa, India
9
ASMN-IRCCS of Reggio Emilia, Unit of Reproductive Medicine and Surgery, Reggio Emilia,
Italy
10
Ospedale Maggiore Policlinico, Infertility Unit, Milan, Italy
11
Catania University, Department of Surgery, Catania, Italy
12
Bülent Ecevit University, Department of Obstetrics and Gynecology-, Zonguldak, Turkey
13
Erciyes University Medical School, Department of Obstetrics and Gynecology, Kayseri,
Turkey
14
Pennsylvania State University, Department of Obstetrics and Gynecology, Hershey, USA
Clomiphene has been considered as the first-line ovulation induction treatment in women
with anovulatory PCOS for decades. However, there is a lack of high quality evidence to
support the tailoring of ovulation induction according to an individual's characteristics. We
aimed to evaluate the comparative effectiveness of different pharmacological ovulation
induction interventions in different subgroups of women with PCOS.
Method
We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials

databases without language restrictions and conducted an individual participant data (IPD)
network meta-analysis. We included on relevant randomised controlled trials (RCTs)
comparing the following interventions in women with PCOS: clomiphene, metformin,
combined clomiphene-metformin, letrozole, tamoxifen and gonadotropins. Studies were
excluded if they studied clomiphene resistant PCOS. The primary outcome was clinical
pregnancy. We performed pairwise meta-analyses as well as network meta-analyses using
IPD.
Results
IPD of 11 RCTs including 2,477 women with PCOS were shared by the original
investigators. Overall, letrozole (OR 1.9, 95%CI 0.7-4.8) and combined clomiphene-
metformin (OR 1.8, 95%CI 0.9-3.8) showed trends with higher pregnancy rates compared to
clomiphene alone. In subgroup analyses, letrozole resulted in higher pregnancy rates in
women with BMI > 34.5 (OR 2.6, 95%CI 1.6-4.3), ovarian volume > 12ml (OR 2.5, 95%CI
1.5-4.1), Ferriman–Gallwey score >15 (OR 2.1, 95%CI 1.4-3.3), and free androgen index >
7.6 (OR 3.3, 95%CI 1.4-7.5), compared to clomiphene.
Conclusion
In conclusion, in women with high BMI, large ovarian volume or severe

hyperandrogenaemia/ hyperandrogenism, letrozole led to higher pregnancy rates than
clomiphene.
ASPIR-0186
Posters: PCOS
MUTATIONS IN MITOCHONDRIAL TRNA GENES MAY BE RELATED TO INSULIN

RESISTANCE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME
Y. Ding1, Z. Caijuan2, Z. Guang-chao1
1
First People's Hospital of Hangzhou, Central laboratory, Hangzhou, China
2
First People's Hospital of Hangzhou, Gynecology and Obstetrics, Hangzhou, China
Polycystic ovary syndrome (PCOS) is a complex disorder affecting women of reproductive

age, insulin resistance (IR), a central component of this disease, occurs in 30-40% women
with PCOS. Recently, increasing evidence showed that mitochondrial dysfunction played
important roles in the pathogenesis of PCOS-IR. In this study, we aimed to evaulate the
contribution of mitochondrial tRNA (mt-tRNA) mutations to PCOS-IR.
Method
130 women with PCOS-IR and 80 healthy subjects were recruited. We screened the mt-
tRNA mutations in PCOS-IR patients and healthy subjects. In addition, oxidative stress and
mitochondrial function were determined by using the trans-mitochondrial cybrid cells.
Results
Using PCR-Sanger sequencing, we identified 10 potential mt-tRNA mutations associated

with PCOS-IR: mt-tRNALeu(UUR) A3302G and C3275T mutations, mt-tRNAGln T4363C
and T4395C mutations, mt-tRNACys G5821A mutation, mt-tRNASer(UCN) C7492T
mutation, mt-tRNAAsp A7543G mutation, mt-tRNALys A8343G mutation, mt-tRNAArg
T10454C mutation and mt-tRNAGlu A14693G mutation. These mutations were localized at
the highly conserved nucleotide of the corresponding mt-tRNAs, altered the secondary
structure of mt-tRNAs and consequently resulted the failure in mt-tRNAs metabolism.
Moreover, molecular and biochemical analysis revealed the increased levels of 8-hydroxy-2'-
deoxyguanosine (8-OHdG), malondialdehyde (MDA) and reactive oxygen species (ROS),
whereas a significant reduction of Superoxide Dismutase (SOD), mitochondrial copy
number, mitochondrial membrane potential and ATP were observed in women with PCOS-
IR carrying these mt-tRNA mutations.
Conclusion
Our data indicated that mt-tRNAs were the hot spots for pathogenic mutations associated
with PCOS-IR. Mitochondrial dysfunction caused by mt-tRNA mutations may play important
roles in PCOS-IR. Thus, our findings provided the novel insight into the pathophysiology of
PCOS-IR.
ASPIR-0232
Posters: PCOS
THE IMPACT OF ADVANCED AGE ON ART OUTCOME IN WOMEN WITH POLYCYSTIC

OVARY SYNDROME
P. Pan1, Y. Duan1, D. Yang1, Y. Li1, X. Chen1, Q. Zhang1
1
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Obstetrics and Gynecology,
Guangzhou, China
Although PCOS patients had higher indexes of ovarian reserve, whether their fertile window
extended or not were uncertain. A retrospective clinical study was performed to assess
whether pregnancy outcomes among women with PCOS undergoing IVF were influenced by
advanced age.
Method
A total of 135 cycles in women with PCOS over age 35 undergoing IVF/ICSI were identified.
Controls were 353 cycles of the age-matched infertile patients with AMH≥3.0ng/ml. Ovarian
stimulation included only gonadotropin-releasing hormone agonist and antagonist protocols.
The clinical features, ovarian response and pregnancy outcomes were compared.
Results
In comparison to controls, women with PCOS presented more available embryos, higher
clinical pregnancy rate and higher cycle cancellation rate (P<0.05). In the control group,
women ≥40 years old demonstrated significant lower clinical pregnancy rate and higher
miscarriage rate than the 35- to 39-year-old cohort (P<0.05). Unlike the controls, PCOS
women showed stable clinical pregnancy rate and a trend of increased miscarriage rate with
increasing age (P>0.05).
Conclusion
PCOS patients' fertility declined slowly until at the age of 40, but at or after 40, fertility had a
similar descending tendency as general population.
ASPIR-0304
Posters: PCOS
OBSTETRIC OUTCOMES OF POLYCYSTIC OVARY SYNDROME (PCOS) PATIENTS

HAVING OVULATION INDUCTION USING HUMAN MENOPAUSAL GONADOTROPHIN
(HMG)
L. K Nguyen1, N. HH Du2, N. TM Mac2, L. TN Vuong3
1
My Duc Hospital, IVFMD, Ho Chi Minh, Vietnam
2
Phuong Chau Hospital, IVFMK, Can Tho, Vietnam
3
University of Medicine and Pharmacy at Ho Chi Minh City, O&G, Ho Chi Minh, Vietnam
It has been reported that PCOS patients have higher obstetric complications such as
miscarriage, gestational diabetes mellitus, and hypertension. However, most studies were
conducted on PCOS patients undergoing ART. There was little knowlegde on their obstetric
outcomes after ovulation induction (OI) with gonadotropin, especially hMG. This study is to
report the obstetric outcomes of PCOS patients having OI using hMG.
Method
This is a multi-center case-series retrospective study conducted at IVFMD, My Duc Hospital

and IVFMK, Phuong Chau Hospital between Jan 2011 and Dec 2015. Patients were eligible
if they had (1) age < 40 yrs, (2) PCOS diagnosed following Rotterdam criteria, (3) OI using
hMG. Outcome measures were live birth rate, pregnancy complications and neonatal
outcomes.
Results
There were 123 (25.95%) biochemical pregnancies out of 474 eligible PCOS patients,
amongst them, 5 were lost to follow-up. The ectopic pregnancy and miscarriage rates were
1.90% and 7.38%, respectively. Live birth rate was 15.61%. Deliveries before 28 and 37
weeks of gestation were 0.63% and 3.59%, respectively. Gestational diabetes mellitus and
pregnancy-induced hypertension occurred in 1.48% and 0.42% of patients, respectively.
Regarding neonatal outcomes, the mean birth weight was 3033 ± 604g, high and low birth
weight rates were 3.85% and 7.04%, respectively. Nine (1 full term and 8 preterm) were
admitted to NICU for pnemonia and respiratory distress.
Conclusion
The follow-up of pregnancy in PCOS women undergoing OI using hMG has revealed a high
pregnancy loss due to miscarriage. Larger data are required to obtain more knowledge
about obstetric outcomes in PCOS women.
ASPIR-0329
Posters: PCOS
FOLLICULAR HYPERANDROGENISM UPREGULATES AMH VIA JAK2/STAT3

SIGNALING IN THE GRANULOSA CELLS IN POLYCYSTIC OVARY SYNDROME
WOMEN
H. Huang1, D. Yang1
1
Sun Yat-sen University, Reproductive Endocrinology & Infertility, Guangzhou, China
The abnormally elevated serum level of AMH was not only related with increased antral
follicles in PCOS, but also caused by the overproduction of individual follicle. The aim of this
study was to investigate the regulation of AMH in PCOS granulose cells(GCs) by androgen
and related molecular signaling pathways.
Method
Follicular fluid and mural GCs of 50 PCOS patients and 55 controls were collected during
oocyte retrieval and gene expression was analyzed. The human KGN cells and mural GCs
from 30 control subjects (4-5 samples were pooled together for each experiment) were
cultured in vitro. The regulation of AMH was confirmed by qPCR, western blotting and dual-
luciferase reporter assay after androgen stimulation. Relevant signaling pathways were
identified using specific inhibitors.
Results
Follicular fluid collected from PCOS women showed high levels of testosterone and AMH.
The gene expression of androgen receptor(AR) and AMH was found significantly
upregulated and positively correlated in luteinized granulosa cells from PCOS women. In
cultured luteinized granulosa cells isolated from non-PCOS women and KGN cell lines, their
exposure to testosterone increased AMH expression and upregulated p-STAT3 protein level
in a concentration dependent manner. Both flutamide(AR antagonist) and S3I-201 (STAT3
phosphorylation inhibitor) inhibited hyperandrogenism-induced AMH expression.
Conclusion
These results suggest that the increased follicular androgen, acting through AR, stimulates
the AMH production via JAK2/STAT3 signaling pathway in granulosa cells in PCOS,
indicating a novel regulatory system for AMH overproduction in PCOS.
Preimplantation
Screening and Diagnosis
ASPIR-0046
Posters: Preimplantation Screening and Diagnosis
COMPARISON OF EMBRYO ANUEPLOIDY WITH EJACULATED & TESTICULAR

SPERMS IN PGS CYCLES
K.C. Mantravadi1, D.G. RAO2
1
OASIS center for Reproductive Medicine, HYDERABAD, India
2
To compare the mean anueploidy rates in embryos produced from ejaculated sperm ICSI
versus Testicular sperm ICSI in PGS cycles.
Method
Design:
Retrospective study
Patient(s):
Couples undergoing PGS cycles at our center for Recurrent Implantation Failures (RIF)
either with ejaculated sperm (n=16) or TESA / TESE sperms (n=10) was compared for mean
embryo anueploidy rates.
Intervention(s):
All oocytes were subjected to ICSI as PGS was planned. ICSI was done with either
Ejaculated sperm (n=16) or Surgical retrieved sperms through TESA / TESE (n=10).
TESA/TESE was done either for azoopsermia or raised sperm DNA fragmentation Index. All
embryos were cultured till blastocyst stage and subjected to trophectoderm biopsy. PGS was
done with Next Generation Sequencing. Mean embryo anueploidy was compared between
the Ejaculated sperm group and Testicular sperm group.
Results
Results:
Mean embryo anueploidy rates with Ejaculate sperm group was 58% with atleast one
euploid embryo in every case available for transfer. The ongoing pregnancy rate in this
ejaculate sperm group was 71.4%.
Mean embryo anueploidy rates with Testicular sperm group was 63%, of which two cases
(20%) had 100% anueploid embryos and cycle cancellation and the rest had atleast one
euploid embryo for transfer. The ongoing pregnancy rate in this testicular sperm group was
75%.
Conclusion
The mean embryo anueploidy rates in Ejaculate sperm group and testicular sperm group
seem to have no difference with a good ongoing pregnancy rates.
ASPIR-0047
IS THERE A DIFFERENCE IN ANUEPLOIDY RATES IN RECURRENT PREGNANCY

LOSS (RPL) & RECURRENT IMPLANTATION FAILURE (RIF) CASES
K.C. Mantravadi1, D.G. RAO2
1
OASIS center for Reproductive Medicine, HYDERABAD, India
2
To compare and see if the percentage of embryo anueploidy is any different in RPL and RIF
cases
Method
Design:
Retrospective
Setting:
Private fertility clinic
Patient(s):
Couples undergoing PGS at our clinic for either RPL (n=10) or RIF (n=17). Women under
the age of 35years and couples with normal karyotypes were only included in this study.
Couples who had two or more first trimester miscarriages were considered as RPL. Couples
who had two cycles with 2-4 blastocyst transfers in total and no implantations were
considered as RIF.
Intervention(s):
All oocytes were subjected to ICSI. All embryos were cultured till Blastocyst stage and were
subjected to trophectoderm biopsy. PGS was done through Next Generation Sequencing
(NGS). Mean percentage of Anueploidy per case was calculated and compared between
RPL and RIF.
Results
Mean embryo anueploidy rate in RPL group (n=10) was 78% with mean ongoing pregnancy
rate of 71.4%. Mean embryo anueploidy rate in RIF group (n=17) was 58.7% with mean
ongoing pregnancy rate of 71.2%. P value was 0.0671, statistically not significant. All the
case had atleast one euploid embryo for transfer.
Conclusion
There doesn’t seem to be a difference in incidence of percentage of embryo anueploidy in

RPL and RIF cases. However, higher incidence of embryo anueploidy in RPL and RIF
supports the role for PGS in this group of patients as evidenced by higher implantation rates
and higher ongoing pregnancy rates.
ASPIR-0129
CASE REPORT: LIVE BIRTH FOLLOWING TRANSFER OF A CELL LINE MOSAIC

BLASTOCYST
A. Chen1, M. Lim2, E. Sinthamoney2, L. Lei Jun2, W. Pak Seng2
1
Sunfert International Fertility Centre, Pre-Implantation Genetic Testing Lab, Kuala Lumpur,
Malaysia
2
Sunfert International Fertility Centre, Medical, Kuala Lumpur, Malaysia
Next-generation sequencing (NGS) enhances sensitivity and identifies low-level mosaicism

that would be undetectable by conventional testing. Mosaic blastocysts (IVF) may have a
lower implantation potential and increase the risk birth defects and are not usually
transferred. We report a successful live birth following transfer of a mosaic blastocyst.
Method
The patient is a 35 year old who presented with secondary subfertility and a history of two
previous miscarriages. She underwent IVF with preimplantation genetic screening (PGS) for
aneuploidy screening. Five blastocysts were biopsied and cryopreserved. The biopsies were
amplified and sequenced with Illumina-based NGS.
Results
The NGS sequence data were analysed for copy number variations. 2 blastocysts were not
suitable for transfer due to aneuploidy or segmental aneusomy. Chromosomal mosaicism
was identified in the rest (40% segmental gain at chromosome 22, 25% segmental loss at
chromosome 9 and 70% loss at chromosome 10 respectively). After extensive genetic
counselling, the blastocyst with 40% segmental gain at chromosome 22 was transferred as it
was better in quality (3BB). The treatment was successful and she delivered a healthy baby
with a normal karyotype as confirmed by amniocentesis at 16 weeks.
Conclusion
Cell division error produce abnormal cell lines which may be excluded to the placenta,
allowing the embryo to self-correct. PGS allows the selection of the embryos with the highest
implantation potential for transfer, leading to a reduction in time to pregnancy. While waiting
for more data to emerge, after extensive genetic counselling we may transfer mosaic
embryos if a patient has no normal embryos available.
ASPIR-0164
A COMPARISON STUDY OF NEXT-GENERATION SEQUENCING BASED PRE-

IMPLANTATION GENETIC SCREENED BLASTOCYSTS BETWEEN DONOR AND NON-
DONOR CYCLES
E. Sinthamoney1, A. Chen2, M. Lim2, L.J. Lim1, P.S. Wong1
1
Sunfert International Fertility Centre, Fertility, Kuala lumpur, Malaysia
2
Sunfert International Fertility Centre, Genetics, Kuala Lumpur, Malaysia
Objective
To compare the clinical pregnancy rates (CPR) and implantation rates (IR) between donor
and non-donor blastocysts transferred after VeriSeq PGS using the Next-Generation
Sequencing (NGS) platform.
Method
All patients undergoing a frozen blastocyst transfer after PGS over a 12 month period ending
April 2016 were included. ICSI was performed in all cases. In both groups, Comprehensive
Chromosomal Screening was carried out using NGS. All blastocysts were frozen and
transferred later. Only normal embryos or with <40% mosaicism were transferred. The CPR
and IR in the donor group were compared to the control group (non-donors).
Results
In total, 55 patients had transfers after PGS-NGS. 26 patients were from the donor group
while 29 utilized their own embryos. The CPR and IR in the donor group was 69.2% and
66.7% while the rates were 58.6% and 50.0% respectively in the non-donor group (P> 0.05
for both respectively). The mean age was 26.7 in the donor group and 37.9 years in the non-
donor group (P< 0.0001), while the mean number of embryos transferred were 1.5 and 1.2
respectively (P<0.05).
Conclusion
PGS-NGS in donor cycles result in higher CPR and IR compared to non-donor patients. This
trend towards better CPR and IR rates in donor cycles may be related to the younger age of
donors. Since all embryos were euploid in both arms, it would appear that embryos in
younger women are healthier and have a greater reproductive potential. This would suggest
that more complex factors are at play in determining the implantation potential of euploid
embryos.
Regenerative Medicine
and Stem Cells
ASPIR-0209
Posters: Regenerative Medicine and Stem Cells
INDUCTION OF DIFFERENTIATION OF BOVINE MALE GERM CELLS IN CULTURE

Y. Kitamura1, . Suyatno1,2, N. Minami1, M. Yamada1, H. Imai1
1
Graduate School of Agriculture - Kyoto University, Laboratory of Reproductive Biology,
Kyoto, Japan
2
Indonesian Agency for Agricultural Research and Development,
Indonesian Agency for Agricultural Research and Development, Jakarta, Indonesia
We have been developed in vitro long-term culture systems of bovine germ cells from
neonatal and adult testes. However, it has been difficult to induce cell differentiation of germ
cells towards meiosis and spermatogenesis in vitro. Here this study was investigated specific
markers for detecting cell differentiation on bovine germ cells cultured in vitro.
Method
Bovine testes were collected from bull aged 3 to 7 months old. Germ cells were isolated from
testicular cell suspension by Percoll gradient centrifugation and allowed to differentiate in
DMEM/F12 medium containing retinoic acid. To identify cell differentiation of germ cells,
testicular tissues and cultured germ cells were morphologically and immunocytochemically
examined using pre-meiosis marker STRA8 antibody.
Results
In the testicular tissues, differentiated germ cells were present in the testis over 5 months of
age and STRA8+ cells were weakly appeared during the same period. Over 6 months of age,
both weak and strong STRA8+ cells were detected in the testis. STRA8 was also expressed
in retinoic acid treated germ cells in culture. In the testicular sections, differentiated
spermatocytes were morphologically distinguished from undifferentiated germ cells by the
state of chromatin condensation.
Conclusion
STRA8 known as a pre-meiosis marker in mouse differentiated germ cells was also detected
bovine differentiated germ cells from testicular tissues aged 5 months of bull testes. Isolated
germ cells cultured in vitro could be induced their cell differentiation in the medium
containing retinoic acid. STRA8 might be useful for a marker detecting cell differentiation of
bovine germ cells in vivo and in vitro.
ASPIR-0221
Posters: Regenerative Medicine and Stem Cells
INDUCTION OF PATIENT-SPECIFIC INDUCED PLURIPOTENT STEM CELLS TO

ADIPOCYTE LINEAGE AS A DISEASE MODEL TO STUDY ADIPOCYTE
DEVELOPMENT IN POLYCYSTIC OVARY SYNDROME
H.F. Chen1
1
, Taipei, Taiwan R.O.C.
Polycystic ovary syndrome (PCOS) is the common female endocrinopathy and associated
with metabolic disorders. Previous evidences suggested that adipose tissue plays important
roles in the pathophysiology of PCOS. For example, dysregulated expressions of adipokines
have been observed in PCOS patients. Induced pluripotent stem cells (iPSCs) are stem
cells, derived by reprogramming somatic cells to embryonic stem cell-like cells, that have the
potential to differentiate into specialized cells like adipocytes. Patient-specific iPSCs provide
a promise for establishing useful disease models for exploring disease mechanisms and
screening drug. We designed to derive PCOS patient-specific iPSCs, differentiate iPSCs to
adipocyte and compare the adipocyte developmental potential between iPSCs from non-
PCOS and PCOS patients.
Method
We collected luteinized granulosa cells from non-PCOS and PCOS patients involved in in-
vitro fertilization. Yamanaka factors were transduced into the granulosa cells by Sendai virus
reprogramming system. Subsequently, we differentiated the iPSCs into adipocyte lineage
through mesenchymal progenitor cells. Finally, we will compare adipogenesis ability of the
adipocytes derived from these iPSCs by gene expression profiling.
Results
We have successfully established 3 non-PCOS and 3 PCOS patients iPSCs. These iPSCs
expressed pluripotency markers and differentiated to three germ layer cells. We also
differentiated these iPSCs into adipocyte lineage and they expressed adipocyte markers,
including DLK1, PPARd and PPARg. In comparison analysis, we found low expression level
of PPARg in patients, which likely will affect adipogenesis.
Conclusion
Furthermore, we will compare gene expression profiles of these adipocytes by microarray.

Following these studies, we hope to identify the dysregulation in adipocyte development of
PCOS.
Reproductive Genetics
ASPIR-0187
Posters: Reproductive Genetics
WOMEN 28 YEARS OLD COME WITH TURNER ‘S SYNDROME IN DR. ZAINOEL ABIDIN
HOSPITAL, BANDA ACEH, WHAT WE SHOULD DO FOR MANAGEMENT?
I. Kosman1, M. Munizar1, R. Rajuddin1
1
Syiah Kuala University, Obstetric and Gynecology, Banda Aceh, Indonesia
Objectives: Turner’s syndrome, or monosomy X, is defined as the total or partial loss of the
second sex chromosome. Turner’s syndrome occurs in approximately 1 of 2500 or 1 of 3000
of born baby female. This report will present one rare case of turner’s syndrome in
Acehnese’s woman who complain have never had a menstrual period.
Method
Methodology: Case Report
Results
Results: A 28 years old Acehnese woman, Senior high school graduated, came to our
outpatient clinic due to primary amenorrhea. On physical examination was found short
stature (height 125 cm) and shield like chest breasts, armpit hair and pubic hair were not
developed (Tanner stage 1). Results of estradiol was low (10.1 pg/mL), whereas FSH and
LH hormones were high (FSH: 73,74 mIU/mL, LH: 23,02 mIU/mL, Anti-Mullerian Hormone :
< 0,13 ng/mL). The impression was a premature ovarian failure. Other investigations that
were done, karyotyping examination (45,X). which was in accordance with turner syndrome.
The epiphyseal line was probably closed already. From MRI we obtained uterine hypoplasia
and adnexa difficult to evaluate. The goal of therapy in this patient is to develop secondary
sex signs and prevent osteoporosis. Patient came to our outpatient clinic due to primary
amenorhea until she was 28 years old due to finansial reason.
Conclusion
Conclusion: This patient came to our hospital too late and the therapy for patient with turner
syndrome should be start at age 2-5 years old to increase the positive outcomes.
Uterine Disorders and
Endometriosis
ASPIR-0006
Posters: Uterine Disorders and Endometriosis
FAMILIAL MULLERIAN & WOLFFIAN DUCT AGENSIS - A RARE CASE REPORT FROM
RAJASTHAN , INDIA
M. Shandilya1
1
, Jaipur, India
Mullerian agenesis is characterised by the absence of the Fallopian tubes, uterus and
internal portion of the vagina. Patients have normal female phenotype and genotype, with
normal secondary sex characteristics but with amenorrhoea. We report a family in which
mullerian agenesis was diagnosed in three siblings and their one parental aunt and one of
the brother's with wolffian duct agenesis. This family was ascertained when the proband was
evaluated for primary amenorrhoea. She had normal secondary sexual development. Her
karyotype was 46 XX. Ultrasound examination and Magnetic resonance imaging of the
pelvis revealed absence of the uterus and vagina. The proband had two sisters and two of
them showed similar physical and radiological findings. One of the proband’s paternal aunt
had no uterus. After going through the literature thoroughly, the proband’s family was re-
evaluated and thorough history was taken again and was found that proband’s sister-in-law
had conceived through ICSI as her brother was diagnosed to be azoospermic. Although the
pathogenesis of mullerian agenesis is well understood, the aetiology and genetics are still
unknown.
Conclusion
In conclusion, it would appear that mullerian and wolffian agenesis is influenced by

multifactorial inheritance and polygenic and familial factors and needs to be further studied
well.
ASPIR-0055
DOWNREGULATION OF E-CADHERIN, CD34, AND SUPEROXIDE DISMUTASE 1

EXPRESSION AND UPREGULATION OF GSTM4 EXPRESSION BY GONADOTROPIN-
RELEASING HORMONE AGONIST (GNRHA) IN WOMEN WITH ENDOMETRIOSIS
Y.W. Chen1, Y.A. Chen2, C.R. Tzeng2
1
Center for Reproductive Medicine and Sciences,
Department of Obstetrics and Gynecology- College of Medicine- Taipei Medical University,
Taipei City, Taiwan R.O.C.
2
Center for Reproductive Medicine, Taipei Medical University Hospital, Taipei City,
Taiwan R.O.C.
The purpose of this study was to identify the potential markers which were up-regulated in
endometriotic tissues and down-regulated following long acting GnRHa treatment.
Method
Sera and tissues were collected from endometriosis and non-endometriosis patients during
laparoscopic surgery. Western Blot, IHC and ELISA were carried out the protein levels of
candidate genes before and after GnRHa therapy. t-test and ROC were used for statistical
analysis.
Results
After GnRHa treatment, Western blot of endometriotic tissue showed the CD34 expression
levels was 2.7 fold decreased (p=0.036), the E-cadherin was 7.8 fold decreased (p=0.016)
and the GSTM4 expression levels was 1.5 fold (p=0.041) upregulated. Serum SOD1 levels
were lower in patient with endometriosis following GnRHa treatment (p < 0.001). By contrast,
serum GSTM4 levels were lower in patient without treatment (p < 0.05). ROC curve revealed
serum SOD1 can be a valuable biomarker for distinguishing between GnRHa treatment and
without, AUC = 0.70, p =0.0375. In women with endometriosis compared with non-
endometriosis women both SOD1 and CD34 levels were significantly increased (P<0.05).
ROC curve demonstrated five serum proteins, namely SOD1, sE-cadherin, CD34, sVCAM1
and sVE-cadherin can be useful biomarkers for distinguishing between patients with and
without endometriosis (AUC = 0.90, 0.82, 0.73, 0.81, and 0.70; all p < 0.05).
Conclusion
For infertility treatment, we observed that GnRHa could decrease serum antioxidant enzyme
(SOD1), increase detoxification enzyme (GSTM4) levels suppress both adhesion (E-
cadherin) and angiogenesis (CD34) activities in women with endometriosis. The mechanism
may provide a conducive microenvironment for restore the fertility potential in women with
endometriosis.
ASPIR-0056
EVALUATION OF A PANEL OF SERUM CYTOKINES AND CHEMOKINES AS

POTENTIAL MARKERS OF ENDOMETRIOSIS
Y.C. Chou1, C.R. Tzeng1
1
Department of Obstetrics & Gynecology- Center for Reproductive Medicine- Taipei Medical
University Hospital, Taipei City, Taiwan R.O.C.
Endometriosis is a frequent benign gynecological disorder that affects 6%–10% of fertile

women and causes severe pelvic pain, suffering, infertility, and hysterectomy. Because lack
of suitable diagnostic marker, we systematically detected the 40 chemokines and cytokines
to evaluate potential markers of endometriosis.
Method
We enrolled 13 non-endometriosis and 48 endometriosis patients who were diagnosed by

laparoscopy. Serum and peritoneal fluids of patients were measured using the Bio-Plex Pro
Human Chemokine Panel 40-Plex. A total of 4 endometriosis patients were enrolled and
collected the serum before and after GnRH agonist treatment for 1 month.
Results
We systematically detected the 40 chemokines and cytokines and uncovered five genes
were increased in serum of endometriosis patients, including, CXCL10 (IP-10) [3.28-fold], IL-
1b [2.15-fold], CCL25 (TECK) [2.08-fold], CCL17 (TARC) [1.78-fold], and CXCL9 (MIG)
[1.63-fold]. Among differentially expressed genes, CXCL10 expression levels had the
highest area under the ROC curve (AUC). In peritoneal fluids, CXCL10 and CCL17
expression levels in endometriosis patients were higher than non-endometriosis patients.
Follow up studies showed that GnRH agonist treatment decreased serum CCL17 levels in
the same endometriosis patient.
Conclusion
These upregulated- chemokines and -cytokine are novelly detected in both locally and
systematically in women with endometriosis. GnRH agonist treatment decreased CCL17
expression and it may be a marker for therapeutic efficiency.
ASPIR-0097
DOWNREGULATION OF NEURITIN 1 FOLLOWING GONADOTROPIN-RELEASING

HORMONE AGONIST TREATMENT IN WOMEN WITH ENDOMETRIOSIS
E. Rahmawati1,2, W.C.V. Yang3, M. Pawan Kumar4, Y.P. Lei5, H.W. Chen6, C.R. Tzeng7
1
Taipei Medical University, Graduate Institute of Clinical Medicine- College of Medicine,
Taipei city, Taiwan R.O.C.
2
Universitas Gadjah Mada, Department of Obstetrics and Gynecology- School of Medicine,
Yogyakarta, Indonesia
3
The PhD Program for Translational Medicine- College of Medical Science and Technology,
Taipei city, Taiwan R.O.C.
4
Amity University, Amity Institute of Biotechnology, Noida, India
5
National Yang-Ming University School of Nursing, Department of Nursing, Taipei,
Taiwan R.O.C.
6
National Taiwan University, Graduate Institute of Toxicology- College of Medicine, Taipei,
Taiwan R.O.C.
7
Taipei Medical University, Department of Obstetrics and Gynecology- College of Medicine,
Taipei, Taiwan R.O.C.
The mechanisms by which endometriosis leads to pain have been widely discussed but
remain unclear. A cDNA microarray study by our group revealed that neuritin 1, a
neurotrophic factor, is upregulated in the ectopic endometrium of women with endometriosis.
For that reason, we investigated the expression of neuritin 1 in endometriosis patients
following GnRHa treatment and how this varied with the menstrual cycle and disease stage.
Method: A case–control study with total 98 women with endometriosis treated with (n = 56)
or without (n = 42) GnRHa before laparoscopy. We measured the main outcomes, including:
analysis of neuritin 1 mRNA and protein in endometriosis tissues using qPCR, western blot
and immunohistochemistry and its serum level using ELISA, following GnRHa treatment.
Results: Neuritin 1 mRNA and protein expression were downregulated in endometriosis
tissues with GnRHa treatment. Immunolocalization data showed high expression of neuritin
1 in endometrial gland epithelium and in the stroma. Follow-up studies in the same patients
demonstrated significantly decreased serum levels of neuritin 1 after GnRHa treatment.
Patients with stage III–IV endometriosis exhibited higher serum concentrations of neuritin 1
compared with stage I–II endometriosis patients (354.6 vs. 136.6 pg/ml). There was no
difference in neuritin 1 expression in the proliferative and secretory phases of the menstrual
cycle.
Conclusion: Neuritin 1 is downregulated following GnRHa treatment in women with
endometriosis. The expression level of neuritin 1 is disease stage dependent and relatively
consistent throughout the menstrual cycle. Neuritin 1 may be a sensitive marker indicating
response to GnRHa treatment for endometriosis-related pain.
ASPIR-0165
A NATIONAL-WIDE RETROSPECTIVE COHORT STUDY FOR UNRAVELLING THE

ASSOCIATION BETWEEN ENDOMETRIOSIS AND CANCER
G.L. Lai1, C.R. Tzeng2
1
Taipei Medical University, School of Public Health, Taipei City, Taiwan R.O.C.
2
Taipei Medical University, Department of Obstetrics & Gynecology, Taipei City,
Taiwan R.O.C.
The relationship between cancer and endometriosis was still unclear. Many reports
suggested that endometriosis associated with increased risk of gynecological cancers,
especially ovarian cancer but the conclusion was still inconsistent.This study aimed to
unravel the association between endometriosis and cancers.
Method
A retrospective population-based cohort study was performed by linking to National Health

Insurance Research Database (NHIRD) in Taiwan. A total of 19,378 women with newly
identified endometriosis from 2000 to 2008 and 96,890 multivariable-matched controls (1:5)
were selected. Sociodemographic and other potential confounding factors were selected as
adjusted variables from database. They were compared between the endometriosis and
control cohort using a Chi-square test. The Cox regression model adjusted for potential
confounders was used to assess the risk of cancers due to endometriosis.
Results
After adjusted potential confounders, the adjusted hazard ratio associated with
endometriosis was 1.64 (95% confidence interval (CI) 1.49-1.81) for overall cancers, 4.77
(95% CI 3.40-6.70) for ovarian cancer, 4.19 (95% CI 2.91-6.04) for endometrial cancer, 2.67
(95% CI 1.93-3.70) for cervical cancers, and 1.64 (95% CI 1.15-2.35) for thyroid cancers.
Conclusion
Endometriosis is associated with increasing risk of overall cancers especially with ovarian,
endometrial, cervical, and thyroid cancer. Estrogen stimulation and chronic inflammation
might be as putative mechanisms to endometrial cancer. Besides, estrogen receptors
participate in cellular processes contributing to enhanced mitogenic, migratory, and invasive
properties of thyroid cells. The investigation of association between endometriosis and
cancers would advance the exploration of endometriosis etiology.
ASPIR-0184
ANDROGEN RECEPTOR GENE CAG TRINUCLEOTIDE REPEAT POLYMORPHISM IN

PATIENTS WITH ENDOMETRIOSIS
Y.M. Choi1, J.J. Shin2, H.Y. Choi1, S.J. Chae3, K. Hwang4, J.J. Kim5, G.H. Lee6, T.J. Kim7
1
Seoul National University College of Medicine, Department of Obstetrics and Gynecology,
Seoul, Republic of Korea
2
Seoul National University Bundang Hospital, Department of Obstetrics and Gynecology,
Seoul, Republic of Korea
3
Maria Fertility Hospital, Department of Obstetrics and Gynecology, Seoul,
Republic of Korea
4
Seoul Municipal Boramae Hospital, Department of Obstetrics and Gynecology, Seoul,
Republic of Korea
5
Seoul National University Hospital, Healthcare System Gangnam Centre, Seoul,
Republic of Korea
6
Seoul Women’s Hospital, I-one Center, Seoul, Republic of Korea
7
Hosan Women's Hospital, Department of Obstetrics and Gynecology, Seoul,
Republic of Korea
To investigate the association between the androgen receptor (AR) CAG repeat
polymorphisms and endometriosis.
Method
Four hundred twenty-one women diagnosed with endometriosis and 349 controls were
included in this case-control study. The AR CAG repeat polymorphism was genotyped using
the fluorescent polymerase chain reaction.
Results
There was no difference in the allele frequency of CAG repeats between patients with
endometriosis and the controls. When the endometriosis group was divided by the ASRM
stage, allele frequency of 24 CAG repeats was significantly higher in mild endometriosis
(stage I-II) group compared to the controls (19.8% vs 13.3%, p=0.032). And patients with
mild endometriosis showed higher frequency of genotypes with both alleles of 24 or higher
CAG repeats compared to the controls (25.6% vs 15.2%, p=0.022).
Conclusion
The androgen receptor gene CAG trinucleotide repeat polymorphism is associated with an
increased risk of developing mild endometriosis, but not with advanced stage endometriosis.
ASPIR-0185
EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH FACTOR A (VEGF A) AND

PROTEIN GENE PRODUCT 9.5 (PGP 9.5) OF EUTOPIC ENDOMETRIUM IN PATIENTS
WITH ENDOMETRIOSIS
R. Anwar1, D. Hendry1, T.H. Madjid1, W. Permadi1, T. Djuwantono1, A. Rachmawati1
1
Faculty of Medicine - Universitas Padjadjaran,
Department Obstetrics and Gynecology/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
There are some changes in the molecular phenotype of eutopic endometrium of

endometriosis include increased activity of angiogenesis and neurogenesis. Establishment
of neovascular always followed by the formation of new nerve fibers. Small sensory nerve
fibers nonmyelin are found only in the functional layer of the endometrial eutopic
endometriosis. This study aims to analyze the expression of VEGF A (markers of
angiogenesis) and PGP 9.5 (markers of nerve fibers) in menstrual blood and the correlations
of both factor for complement existing aetiopathogenesis.
Method
This cross sectional study was performed on 20 patient endometriosis group and 20 non
endometriosis group that went to the fertility clinic Hospital, from February to May 2016.
Patients already diagnosed clinically and ultrasound as endometriotic cyst, histopathological
proved for endometriosis after surgery, menstrual blood sampling is done on second day of
subsequent menstruation, treat with preservative solution and sent for immunocytochemistry
examination.
Results
There were significant differences between the expression of nerve fibers in endometriosis
group compare with non endometriosis (p <0.05). Spearman correlation test between VEGF
and PGP 9.5 factors in menstrual blood of endometriosis group showed a positive
correlation with the strength of a weak correlation (r ₌ 0.384).
Conclusion
There is a positive correlation between the expression of VEGF and PGP 9.5 of eutopic
endometrium in patients with endometriosis
ASPIR-0235
PLASMACYTOID DENDRITIC CELL-SECRETED IL-10 PROMOTES THE ANGIOGENIC

ACTIVITY DURING THE DEVELOPMENT OF ENDOMETRIOSIS
E. Tsai1, Y. Chang2, S. Jau-Ling3, H. Tzyh-Chyuan3
1
Kaohsiung Medical University Hospital-Kaohsiung Medical University,
Obstetrics and gynaecology, Kaohsiung City, Taiwan R.O.C.
2
EDa Hospital, Department of Obstetrics and Gynecology, Kaohsiung, Taiwan R.O.C.
3
Kaohsiung Medical University, Graduate Institute of Medicine, Kaohsiung, Taiwan R.O.C.
Endometriosis is a common, benign, and estrogen-dependent gynecological disease that is

characterized by the growth of eutopic endometrial cells outside the uterine cavity.
Accumulating evidence suggest that angiogenesis and immune dysregulation may play
crucial roles in the pathgenesis and development of endometriosis. Our previous study has
shown that anti-inflammatory cytokine IL-10 over-expression may enhance the growth of
endometrial tissue through suppressing the anti-endometrial immunity. Thus we propose that
altered IL-10 expression may contribute to the immune suppression as well as angiogenesis
in the development of endometriosis.
Method
HUVEC cells and ectopic endometrial cells were used to determine the angiogenic activity of
IL-10 using tube formation assay and transwell migratory assay.
Results
We found that IL-10 promote the tube formation and migratory activity of HUVEC cells, while
anti-IL-10R blocking antibody significantly suppress these two angiogenic activities of
HUVEC cells. Furthermore, the soluble factor(s) released by IL-10-treated ectopic stromal
cells also enhanced the tube formation and migratory activity of HUVEC cells using transwell
assay. We showed that the angiogenic activity of IL-10, at least in part, was mediated by
VEGF in vitro.
Conclusion
The final goal of this research is to ultimately define the mechanistic link between immune
suppression and angiogenesis, and to provide a rational basis for the development of novel
therapeutic approaches that will have direct and significant impact on endometriosis and
endometriosis-associated cancers.
ASPIR-0239
BENIGN ENDOMETRIOSIS MASQUERADING AS INTRA-ABDOMINAL MALIGNANCY –

ONE OF THE MOST EXTREME CASES REPORTED AND A REVIEW OF THE
LITERATURE
P. Walker1, A. Budden2, N. Johnston3
1
Auckalnd City Hospital, Obstetrics and Gynaecology, Auckland, New Zealand
2
Auckland City Hospital, Obstetrics and Gynaecology, Auckland, New Zealand
3
Robinson Research Institute, Fertility, Adelaide, Australia
To elicit key clinical lessons from an extreme case of endometriosis associated with massive
ascites and a review of the literature
Method
We report one of the most extreme cases of massive ascites with right sided pleural effusion
caused by endometriosis for literature review MEDLINE via OVID (from 1946 to 2016)
database was searched. As a result, all the publications based on the keywords relating to
the review topic were acquired.
Results
A 32 year-old nulliparous woman, with stage 4 endometriosis and primary infertility,

presented with massive ascites, complex pelvic mass, pleural effusion, weight loss, anaemia
and elevated CA-125 suggesting ovarian malignancy. Six litres of ascites was drained. After
extensive investigations to exclude malignancy, endometriosis-related ascites was
diagnosed. Red-cell transfusion, nasogastric-tube-feeding and gonadotrophin-releasing-
hormone analogue (GnRH) were initiated and long-term follow-up is planned .
Ablation of ovarian function either by surgical oophorectomy or ovarian irradiation appears to

cure the condition without recurrence. Endocrine therapy, in the form of GnRH analogue or
progestins, is useful if surgery is undesirable, as most women with this condition are young
and wish to preserve fertility. Endocrine therapy alone resolves the problem in the majority,
but ascites reappears after stopping treatment.
Conclusion
Endometriosis associated with massive ascites and pleural effusion is rare. In women of
reproductive age who present with clinical and imaging features to suggest ovarian
malignancy, a diagnosis of endometriosis should be considered. Although permanent cure
is by oophorectomy, endocrine therapy is useful if surgery is undesirable.
ASPIR-0307
NON-INVASIVE TESTS FOR THE DIAGNOSIS OF ENDOMETRIOSIS

N. Johnson2, V. Nisenblat1
1
Fertility SA, Reproductive Endocrinology and Infertility, Adelaide, Australia
2
New Zealand
Laparoscopy is a gold standard for diagnosis of endometriosis, but is costly and carries
surgical risks.
Aims: To determine the diagnostic accuracy of non-invasive tests for endometriosis, using a
surgical diagnosis as the reference standard.
Method
Five sister DTA reviews were conducted for each testing modality by utilising similar
methodology. No limits were imposed on study design, language, publication dates or
sample size. We included cross-sectional studies on prospectively collected samples from
reproductive-aged women with suspected ovarian, peritoneal or deep infiltrating
endometriosis (DIE). Bivariate model was used to obtain pooled diagnostic estimates.
Results
We assessed the blood (137 studies, 14,930 participants, 122 biomarkers), endometrial ( 53
studies, 2639 participants, 94 biomarkers), urinary (8 studies, 646 participants, 7
biomarkers) and imaging tests (49 studies, 4807 participants) and combination of several
testing methods (11 studies, 1339 participants, 30 tests). Small number of tests had
sufficient data for meta-analysis, but most did not reach the criteria for a diagnostic test.
Endometrial PGP 9.5 qualified as a replacement test for endometriosis. Transvaginal
ultrasound met the criteria for a triage test and MRI – for a replacement test for
endometrioma. Given low quality of the included studies, the findings of each sister review
should be interpreted with caution.
Conclusion
Although several non-invasive tests showed diagnostic potential, there was insufficient or
poor quality evidence for any clinical recommendations and using any non-invasive tests
should only be undertaken in a research setting. We also identified the biomarkers that
demonstrated no diagnostic value for endometriosis, and are not worth pursuing.
ASPIR-0312
DIFFERENCES IN ENDOMETRIAL CURRETAGE HISTOPATHOLOGY OF ABNORMAL

UTERINE BLEEDING WITH AND WITHOUT UTERINE FIBROID
M. Rusda1
1
School of Medicine University of Sumatera Utara, Obstetrics and Gynecology, Medan,
Indonesia
Abnormal uterine bleeding (AUB) is a health problem that often occurs in the community,
especially in women of reproductive age. One in 20 women came to consult a doctor
because of AUB. 30% of women will experience much menstrual bleeding at some time
during their reproductive time.
AIMS: To investigate the results of endometrial curettage histopathology in AUB patients

with and without uterine fibroid.
Method
The study design is a unpaired categorical comparative analytic to determine differences in

the results of endometrial curettage from women with AUB with and without uterine fibroid in
Adam Malik Hospital from July 2014 until July 2015.
Results
AUB with uterine fibroid were 51 people and without uterine fibroid were 32 people. The
following data was obtained: AUB with and without uterine fibroid were more at age > 40
years (72.5%) and (81.3%); more with high school education (39.2) and (37.5%); had BMI ≥
25 kg/m2 (54,9%) and (53.1%); in general had menarche age ≥ 12 years (96.1%) and
(96.9%); was multiparous (47.1%) and (50%). Most of the research group of AUB with
uterine fibroid shows histopathological results of normal endometrium (84.3%) while those
without uterine fibroid most results was endometrial cancer (50%). Statistically, with Fisher
exact test, a p value < 0.05 was obtained, hence there is a significant difference between the
results of histopathology of endometrial curettage in AUB with and without uterine fibroid.
Conclusion
There is a significant difference between the results of histopathology of endometrial

curettage AUB patients with uterine fibroid and without uterine fibroid.

Poster-Presentaion-Abstracts ASPIRE2017

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POSTER PRESENTATION

HYDROGEN MOLECULE TREATMENT HAS NO EFFECT ON HUMAN SPERM DNA

Background and Aims:

EXPRESSION OF HEY2 ON MICE UTERUS AND IMPLANTATION SITES DURING

Background and Aims:

Implantation is nidation of blastocyst into mother’ uterus. Physiologic, biochemical and

We think decreased expression of transcription repressor Hey2 on days 4 and 5 of

IMPROVEMENT OF LONG-TERM CULTURE SYSTEM FOR BOVINE

Background and Aims:

IDENTIFICATION OF A NOVEL MARKER FOR SPERMATOGONIA STEM CELL IN

Background and Aims:

Mammalian spermatogenesis is maintained by a rare Spermatogonia Stem Cell (SSC).

REDUCED TEMPERATURE FLUCTUATIONS RECORDED IN A MODIFIED EMBRYO

Background and Aims:

DYNAMIC CHANGES IN MITOCHONDRIAL DISTRIBUTION IN HUMAN OOCYTES

Background and Aims:

Live cell images of fluorescence-labelled mitochondria in human oocytes were analyzed

Most mitochondria localized predominantly in the non-cortical region of the cytoplasm of

TOXICITY TEST OF GLOVES USING HUMAN SPERM SURVIVAL TEST

Background and Aims:

Sperm survival index (SSI) = %motility of sample

A HOPE FOR PATIENT’S WITH FAILED ART CYCLES. A RETROSPECTIVE

Background and Aims:

Group I – Patients with sequential ET.

Group II – Patients receiving ET only cleavage stage (D2/D3).

Group III – Patients receiving Blastocyst Transfer.

The outcome was analysed using paired T test.

CONCLUSION: Sequential transfer increases the likelihood for synchronised

DOES OVERNIGHT CULTURE HAVE ANY EFFECT ON FET OUTCOMES -A

Background and Aims:

DETERMINATION OF ANTI-INFERTILITY AND TOXICITY EFFECTS OF CROTON

Background and Aims:

RISK EVALUATION FOR PRONUCLEAR TRANSFER USING FOR PREVENTING THE

Background and Aims:

Pronuclear transfer (PNT) is considered to be effective in preventing the transmission of

CORRELATION BETWEEN AGE WITH CONCENTRATION, MOTILITY, AND

Background and Aims:

DEHYDROEPIANDROSTERONE IMPROVES MITOCHONDRIAL FUNCTION AND

Background and Aims:

KNOWLEDGE REGARDING FERTILITY AND AGE RELATED FERTILITY DECLINE

Background and Aims:

The study is designed as a prospective questionnaire on fertility awareness. The

BCL2 AND BAX MRNA EXPRESSION PLAY AN IMPORTANT ROLE ON APOPTOSIS

Background and Aims:

Endometriosis is a one syndrome in female reproductive system which marked by the

Keywords: apoptosis, BAX gene, BCL-2 gene, endometriosis, gene expression

THE EVALUATION OF THE EFFECT OF HYDROXYPROPYL CELLULOSE

Background and Aims:

Our findings suggest that increased interface adsorption rate in HPC-supplemented

PICSI –A SELECTIVE TOOL FOR 0% MORPHOLOGY

Background and Aims:

Introduction: Teratozoospermia or abnormal morphology is associated with male factor

Results : Out of 5 patients ,3 patients achieved a pregnancy by PICSI, 1 patient had

Conclusion: In conclusion, PICSI might be a good technique to improve the clinical

IS PROLONGED SPERM INCUBATION REQUIRED FOR TESA ICSI?

Background and Aims:

OBJECTIVE: - TESA ICSI is an option for Azoospermic men, there is a big

COMPARISON OF CELL-FREE DNA LEVELS IN SPENT CULTURE MEDIA FROM

Background and Aims:

GENE EXPRESSION OF GREM1 IN HUMAN CUMULUS CELLS COMPARED TO

Background and Aims:

In cumulus oocyte complex, cumulus cell provides microenvironment required and

CHARACTERISING DNA CONTAMINATION IN DIFFERENT COMMERCIALLY

Background and Aims: