P-112 Utilizing surgical sperm retrieval to improve clinical outcomes for men with high sperm chromatin fragmentation in their ejaculates

Study question

In men with elevated sperm chromatin fragmentation (SCF), can surgical sperm retrieval from the proximal area of the male genital tract improve clinical outcomes?

Summary answer

Spermatozoa retrieved from the epididymis or testes demonstrate higher genomic integrity and are associated with enhanced embryo implantation, clinical pregnancy, and delivery rates.

What is known already

Sperm genomic integrity is a key factor in achieving a successful pregnancy. During spermiogenesis, alteration of DNA topology involving nuclease and ligase mechanisms is required for supercoiling and DNA compaction. If a proper DNA repair mechanism fails during this intricate process, spermatozoa with DNA fragmentation should be picked up by the epididymis and phagocytized. When this mechanism fails, along with the presence of superimposed reactive oxygen species in the male genital tract, spermatozoa with DNA fragmentation may reach the ejaculates. We have previously demonstrated that retrieving spermatozoa directly from the epididymis and testes yields gametes with higher conserved genomic integrity.

Study design, size, duration

In a nine-year timespan, we identified over 1,000 men with high SCF in their ejaculates; 144 patients consented to undergo surgical retrieval of spermatozoa. In a preliminary assessment, their clinical outcomes were compared to those from men with normal SCF (n = 539). Of these men, 53 consented to undergo subsequent ICSI cycles with their female partners using surgically retrieved spermatozoa from the epididymis (n = 15) or testes (n = 38). Fertilization and clinical outcomes were compared.

Participants/materials, setting, methods

Ejaculated, epididymal, and testicular specimens were screened by terminal deoxynucleotidyl dUTP nick-end labeling (TUNEL) to assess SCF using a commercially available kit. A total of 500 spermatozoa/sample were screened with a normal threshold of 15%. Surgical samples from the epididymis and testes were cryopreserved in multiple vials for subsequent ICSI cycles.

Main results and the role of chance

In the preliminary assessment, ICSI outcomes utilizing ejaculated spermatozoa were compared between men with normal (n = 539, 9.3±3%) and abnormal (n = 144, 28.2±13%) SCF. Although fertilization did not differ, implantation (24.1% vs. 7.8%) and clinical pregnancy rates (CPR, 35.8% vs. 14.6%) were significantly impaired (P < 0.001) in men with elevated SCF.

SCF assessment on surgically retrieved spermatozoa revealed a decreasing trend from 28.2±13% in the ejaculate to 16.6±9.2% in the epididymis and 10.1±5.7% in the testes.

A total of 53 men underwent 79 subsequent ICSI cycles using surgically retrieved spermatozoa. Compared to their historical cycles using ejaculates (n = 65), ICSI with surgically retrieved sperm substantially improved implantation (18.8% vs. 2.1%; P < 0.001), CPR (36.5% vs. 5.3%; P < 0.0001), and ongoing/delivery rates (33.8% vs. 4.1%; P < 0.0001).

Among these couples, 15 underwent 21 ICSI cycles utilizing epididymal spermatozoa with a mean SCF of 16.6±9%. Implantation (26.5% vs. 3.7%; P < 0.05), CPR (68.4% vs. 4.2%; P < 0.0001), and ongoing/delivery rates (57.1% vs. 4.2%; P < 0.0001) were significantly improved compared to the historical cycles.

The remaining 38 patients underwent ICSI with testicular spermatozoa with an average SCF of 10.1±6%. Implantation (15.0% vs. 2.6%; P < 0.01), CPR (25.5% vs. 6.1%; P < 0.01), and ongoing/delivery rates (23.6% vs. 3.0%; P < 0.05) were higher when compared to historical cycles.

Limitations, reasons for caution

Although surgically retrieved spermatozoa can be used to enhance clinical outcomes in couples with high SCF, epididymal spermatozoa yielded higher pregnancy rates despite the higher level of SCF in these specimens compared to testicular spermatozoa. This can be explained by the corrective action of the ICSI procedure itself.

Wider implications of the findings

Our study demonstrated that sperm DNA integrity progressively increases through the journey of the male genital tract. In couples with a compromised sperm genome, surgically retrieved spermatozoa can be beneficial. Therefore, assessing SCF might be used a routine tool to evaluate the male gamete.

Trial registration number

N/A

P-270 Assisted gamete treatment to pinpoint acquired meiotic maturity and overcome oocyte activation deficiency contributed by both gametes

Study question

How can we treat couples with complete and persistent fertilization failure with ICSI linked to a combination of oocyte- and sperm-related oocyte activation deficiency (OAD)?

Summary answer

By targeting spindle presence, we optimized oocyte response to chemical activation and enhanced fertilization. Genomic assessment confirmed gamete contribution.

What is known already

Total fertilization failure occurs in 1-3% of all intracytoplasmic sperm injection (ICSI) cases. In sperm-factor OAD, the lack of phospholipase C zeta (PLCζ) prevents the spermatozoon from initiating downstream calcium oscillation in the oocyte. In these cases, assisted gamete treatment (AGT), which exposes gametes to calcium ionophore, has been adopted to artificially trigger the influx of calcium ions and has been shown to effectively improve fertilization. However, AGT is limited to triggering an intracytoplasmic calcium influx and still requires optimal ooplasmic maturity.

Study design, size, duration

Over the past 17 months, we identified couples with compromised PLCζ and reported persistent fertilization failure with ICSI despite AGT treatment. We then devised a treatment plan comprising an extended in vitro culture (IVC) to pinpoint meiotic oocyte maturity confirmed by the presence of a meiotic II spindle and followed by AGT post-ICSI. Genomic assessment was also carried out.

Participants/materials, setting, methods

Two couples with recurrent and total fertilization failure even after AGT were included. PLCζ expression was assessed using immunofluorescence on ≥ 200 cells/specimen with a 30% threshold. In the follow-up cycles, IVC was extended for at least 8 hours between retrieval and ICSI. Metaphase II spindles were visualized by Oosight®. AGT was performed by exposing both spermatozoa and oocytes to calcium ionophore. NGS was performed on spermatozoa to identify gene mutations involved in fertilization.

Main results and the role of chance

We identified 2 couples (couple A: 37-year-old female, 39-year-old male; couple B: 32-year-old female, 33-year-old male) with the following semen parameters: average volume of 2.6 ml, concentration of 82.0x106/ml, 44% motility, and normal morphology of 3%. The oocyte maturation rate was 76.3% (45/59) but resulted in zero fertilized out of a total of 45 MII oocytes injected. In-house PLCζ assessment revealed a deficiency of oocyte activation factor at 12.9%. AGT treatment alone failed to enhance fertilization on a subsequent cycle, resulting in 0% (0/8) and 5.6% (1/18) fertilization rates for couples A and B, respectively. Couple A then underwent 3 ICSI cycles with extended IVC and AGT; upon examination of nuclear maturity, 91.4% (32/35) of oocytes displayed normal metaphase II spindle and achieved an overall fertilization rate of 43.8% (14/32). To date, 12 blastocysts were cryopreserved. In couple B, 27 oocytes out of 34 retrieved presented normal metaphase II spindles after extended IVC; ICSI with AGT yielded a fertilization rate of 63.0% (17/27). All 17 zygotes were cryopreserved. Overall, our treatment improved fertilization to an overall rate of 52.5% (31/59, P  <0.00001). Genomic assessment of spermatozoa identified gene mutations involved in fertilization (ADAM15, ADAM30) and calcium channel activity (CATSPER1).

Limitations, reasons for caution

Assisted gamete treatment can enhance fertilization in cases of deficiency in PLCζ. However, chemical activation requires a responsive ooplasm that has reached meiotic maturity. These rare cases require precise diagnoses and tailored treatment techniques to address each aspect of sperm- and/or oocyte-factor OAD.

Wider implications of the findings

Our study has demonstrated the usefulness of extended IVC by targeting spindle presence to enhance chemical responses to AGT. Our findings show that although calcium ionophore can trigger the release of intracellular calcium and allow fertilization, a fully mature ooplasm is required.

Trial registration number

N/A

Abstract LB503: Using JBrowse 2 plugins to visualize cancer genomic data

Genome browsers are essential tools for integrating, exploring, and visualizing data from large cancer genomics datasets. JBrowse 2 is a JavaScript genome browser with novel features for visualizing structural variants, syntenic alignments, and multiple types of genomic data. Although JBrowse 2 is available as a web-based or desktop application, the capabilities and features are not fixed and can be expanded through a comprehensive plugin system. To help address users' needs, we launched the new JBrowse 2 Plugin Store (https://jbrowse.org/jb2/plugin_store/). The overarching goals of the Plugin Store are to showcase the crucial features plugins add to JBrowse 2, to enable researchers to search for plugins they need, and for developers to highlight their plugins. The plugin system spans all aspects of the JBrowse 2 application and enables new track types (e.g. Manhattan plots, Hi-C data, ideograms), data adapters (e.g. API endpoint adapters for NCI Genomic Data Commons and the International Cancer Genome Consortium), and views (e.g. dot plots and multiple sequence alignments). Here, we present the capabilities of JBrowse 2 plugins and describe usage scenarios for cancer biologists and bioinformaticians, and software developers.

Citation Format: Robin Andrew Haw, Colin Diesh, Caroline Bridge, Rob Buels, Garrett Stevens, Peter Xie, Teresa Martinez, Elliot Hershberg, Junjun Zhang, Shihab Dider, Scott Cain, Lincoln Stein, Ian Holmes. Using JBrowse 2 plugins to visualize cancer genomic data [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB503.

Effect of Akt activation on apoptosis-related gene expression in the crop tissues of male and female pigeons (Columba livia)

The current study investigated whether the expression of apoptosis genes in the pigeon crops was affected by the Akt signaling pathway during crop milk formation. First, 78 pairs of adult White King pigeons were randomly assigned to 7 groups, and the expression of apoptosis-related genes and Akt signaling pathway-related proteins in the crop tissues during different breeding stages were examined. The results showed that the mRNA levels of Bak, caspase-3, caspase-6, and caspase-9 in female crops all increased and reached their highest levels at d 17 of incubation (I17). In male crops, the levels of caspase-3 and caspase-9 gene expression peaked at d 1 of chick rearing (R1). The lowest level of Bcl-2 gene expression in females was observed at I17. The expression ratios of p-Akt (Ser473)/Akt and p-Akt (Thr308)/Akt in male crops decreased to their minimum at R1, while it was observed at d 7 of chick rearing (R7) in females. Second, 36 pairs of adult pigeons were divided into 3 groups and were subjected to SC79 injections with dosages of 0, 0.02, or 0.04 mg/kg bodyweight. The SC79 injections resulted in a considerable decrease in growth performance of pigeon squabs. In male crops, the expression ratios of p-Akt (Ser473)/Akt and p-Akt (Thr308)/Akt were significantly elevated in the 0.02 mg/kg SC79 group, while in female crops, they were higher in the 0.04 mg/kg SC79 group (P < 0.05). The SC79 injection inhibited the gene expression of Bak in female crops, but enhanced the gene expression of Bcl-2 in both male and female crops. In the 0.04 mg/kg SC79 group, a 50.7 to 75.7% decrease was observed in the expression of caspase-3, caspase-6, and caspase-9 in male and female pigeon crops. Expression of the caspase-8 gene and total Akt protein in pigeon crops was not changed in different breeding stages or after SC79 injection. In conclusion, the expression of genes related to mitochondria-dependent apoptosis can be regulated by the Akt signaling pathway, which may play a potential role in pigeon milk formation.

O-206 Meiotic segregation analysis for reciprocal translocation carriers: Assessment of factors influencing meiotic segregation patterns

Study question

To analyze factors that could influence meiotic segregation patterns for reciprocal translocation carriers.

Summary answer

Involvement of an Acr-ch, female gender, and lower TAR1 (ratio of translocated segment 1 over the chromosome arm) were independent risk factors for alternate segregation.

What is known already

Reciprocal translocation is one of the more common structural rearrangements of chromosomes, which is associated with reproductive risks, such as infertility, spontaneous abortion and the delivery of babies with mental retardation or developmental delay. Extensive studies on meiotic segregation patterns of sperm, blastomere, and blastocysts have identified several factors that may influence the generation of unbalanced rearrangement of reciprocal translocations, including carrier’s gender and age, location of breakpoints, chromosome type, and the quadrivalent structure. However, some results are controversial.

Study design, size, duration

A retrospective study from October 2013 to December 2019, a total of 10846 blastocysts originating from 2871 oocyte retrieval cycles from 2253 couples with one of the partners carrying reciprocal were investigated. The mean maternal age was 29.97±4 years (20 –47years).

Participants/materials, setting, methods

Trophectoderm biopsy of blastocysts was performed on the 5th or 6th day of development. Whole genome amplification (WGA) was performed on all samples, and the WGA was analyzed with SNP array or NGS. Segregation patterns of quadrivalent in 10846 blastocysts were analyzed. Risk factors for segregation patterns were explored through analyzing carriers’ demographic and cytogenetic characteristics using multivariate generalized linear mixed models (GLMMs).

Main results and the role of chance

The percentage of normal/balanced blastocysts was 34.3%, and 2:2 segregation was observed in 90.0% of blastocysts. Increased TAR1 (the ratio of translocated segment 1 over the chromosome arm) was noted as an independent protective factor for the proportion of alternate segregation (P = 0.004). The female gender and involvement of an Acr-ch were found independent risk factors for alternate segregation (P &lt; 0.001). A higher TAR1 reduced the risk of adjacent-1 segregation; longer translocated segment and female gender increased the risk of adjacent-2 segregation (P = 0.009 and P &lt; 0.001, respectively). Female gender and involvement of an Acr-ch enhanced the risk of 3:1 segregation (P &lt; 0.001 and P = 0.012, respectively).

Limitations, reasons for caution

About 1400 blastocysts were not diagnosed in the 2871 cycles, which might cause bias in the results. Secondly, the interchromosomal effect of reciprocal translocations was not analyzed in this study.

Wider implications of the findings

In conclusion, a carrier’s gender, involvement of an Acr-ch, and location of breakpoints may influence the segregation patterns. Besides, involvement of an Acr-ch, female gender, and lower TAR1 are independent risk factors for alternate segregation. These results may provide more appropriate genetic counseling for couples with balanced translocation.

Trial registration number

no

P-805 Artificial oocytes: from somatic cells to fertile pups

Study question

We analyzed the efficacy of generating artificial oocytes using somatic cells (SCs) from two mouse strains (B6D2F1 and FVB) and followed their full pre-/post-implantation development.

Summary answer

While artificial oocytes generated from the new strain (FVB) had higher fertilization rates, those from the standard strain (B6D2F1) provided expanded blastocysts and fertile pups.

What is known already

B6D2F1 is a popular hybrid mouse strain for cloning and transgenic creation due to its geno-/pheno-typic uniformity and high oocyte yield and quality. Indeed, B6D2F1 oocytes have a distinct metaphase II (MII) spindle complex, making them an ideal candidate to generate ooplasts used in SC nuclear transfer (SCNT). However, because they lack genetic variance, they are less suitable for reciprocal SCNT studies. In contrast, FVB mice have single nucleotide polymorphisms and indels on each chromosome that can aid in tracing the pedigree of progeny.

Study design, size, duration

A total of 10 experiments were performed over the course of 3 months, using 30 stimulated mice. SCs were retrieved from cumulus oophorus harvested from FVB and B6D2F1 mice. SCs from both strains were injected into enucleated MII B6D2F1 oocytes. Unmanipulated B6D2F1 oocytes were piezo-ICSI inseminated, serving as controls. The occurrence of haploidization, fertilization, and full preimplantation development was compared. Some blastocysts were transferred into pseudo-pregnant CD-1 mice to obtain offspring.

Participants/materials, setting, methods

Oocyte enucleation was performed under Oosight™ visualization and cytochalasin B exposure. An FVB or B6D2F1 SC was transferred into the perivitelline space of the ooplast with Sendai virus to promote fusion. Haploidization was monitored by pseudo-meiotic spindle formation followed by extrusion of a pseudo-polar body after insemination. Conceptuses were cultured in a time-lapse imaging system, with piezo-ICSI controls. Expanded blastocysts were transferred into uterine horns of pseudo-pregnant mice. Offspring were mated to test their fertility.

Main results and the role of chance

FVB (n = 278) and B6D2F1 (n = 905) SCs at G0 phase, with a diameter &lt;10 mm, were chosen for SCNT and transferred into enucleated B6D2F1 ooplasts. Enucleation of 1,212 oocytes yielded a survival rate of 97.6%. Both FVB and B6D2F1 SCNT resulted in similar survival rates of 100% and 98.5%, respectively. Successful haploidization, determined by the presence of a pseudo-meiotic spindle 2 hours after SCNT, was also comparable, with 59.9% of FVB and 63.7% of B6D2F1. Survival after piezo-ICSI was also comparable between FVB- and B6D2F1-reconstituted oocytes, with rates of 64.3% and 60.3%, respectively, albeit lower than the control (75.2%, P&lt;0.00001). FVB embryos fertilized at a rate of 88.7%, comparable to the control zygotes at 85.8%, while B6D2F1 conceptuses demonstrated a lower fertilization rate (70.8%, P &lt; 0.00001). Blastulation of FVB- and B6D2F1-derived embryos was 15.1% and 24.0%, respectively, while the control was 80.7% (P&lt;0.00001). Whole-genome karyotyping of 9 B6D2F1-derived blastocysts confirmed 5 of the samples to be euploid. FVB blastocysts (N = 8) and B6D2F1 blastocysts (N = 81) were transferred into pseudo-pregnant mice, resulting in 3 fertile offspring only from the B6D2F1 conceptuses.

Limitations, reasons for caution

This is still a limited number of observations, and pups were delivered only from the B6D2F1 strain. The utilization of a strain with higher genetic variance may help facilitate offspring fingerprinting.

Wider implications of the findings

This study demonstrates the ability to generate artificial genotyped conceptuses, yielding live offspring. The identification of a feasible donor cell, together with optimization of cell cycle stage and standardization of post-implantation development, will help promote this technique for human reproduction in couples with age-related infertility or poor ovarian reserve.

Trial registration number

N/A

P–119 The correlation between sperm chromatin fragmentation and intrauterine insemination outcome

Study question

Does sperm genomic integrity affect the intrauterine insemination (IUI) outcomes in couples with unexplained infertility and young maternal age?

Summary answer

Spermatozoa with higher genomic integrity are correlated with higher clinical pregnancy rates in couples with unexplained infertility undergoing IUI.

What is known already

It is known that elevated sperm chromatin fragmentation (SCF) on the male gamete affects embryo development and implantation. This is particularly relevant in IVF as well as programmed intercourse and IUI. By complementing the standard semen analysis with an SCF assay, we can assess the competence of the male gamete and its ability to generate euploid embryos and healthy offspring. Elevated SCF has been used as a way to identify subtle male factor infertility in couples undergoing IUI with poor pregnancy outcomes in order to plan for further treatments.

Study design, size, duration

This is a retrospective cohort study of IUI outcomes of couples with young maternal age and a negative infertility workup treated at our center from 2016–2020. Terminal deoxynucleotidyl dUTP transferase nick-end labeling (TUNEL) assay was used to assess sperm genomic integrity. Couples were grouped based on SCF level: normal (≤15%) or abnormal (&gt;15%). Rates of clinical pregnancy, defined as the presence of a fetal heartbeat, were compared between the groups following IUI.

Participants/materials, setting, methods

A total of 189 consenting couples, in which the female partner had a normal uterine cavity and patent fallopian tubes, underwent 454 IUI attempts. Only women ≤37 years old were included to control for age-related confounding factors. At least 500 spermatozoa were assessed per patient, and a threshold of ≤ 15% was considered normal. Women were either untreated for natural cycle IUI or stimulated with clomiphene citrate, gonadotropins, or Letrozole.

Main results and the role of chance

A total of 454 IUI cycles were reported at our center; 302 of these were carried out in 132 couples in which the male partner had normal SCF averaged at 9.29%. The average maternal age was 34.1±3 years, and the average paternal age was 37.1±5 years. These men had the following semen parameters: a concentration of 46.2±5x106/mL, 43.8±3% motility, and an average SCF of 9.3±3%. There were 45 documented clinical pregnancies (45/302, 14.9%) as confirmed by the presence of at least one fetal heartbeat detected by ultrasound; 26 delivered, 9 are ongoing, 5 were spontaneous abortions, and 5 were lost to follow-up. A total of 57 couples in which the male partner (37.2±5.9 years) had abnormal SCF underwent 152 IUI cycles (maternal age, 34.0±2.7 years). The men had the following semen parameters: an average SCF of 23.8±10 (p &lt; 0.0001), a concentration of 26.0±10 x106/ml, and 40.1±4% motility. These IUI attempts yielded a clinical pregnancy rate of only 4.6% (7/152; P &lt; 0.0001); 4 delivered and 3 were spontaneous abortions.

Limitations, reasons for caution

This study is a retrospective cohort analysis of a relatively small number of patients. Furthermore, most patients were screened for SCF due to at least one prior IUI failure. A prospective, randomized trial, in which men are concurrently screened for SCF levels at the first IUI attempt, would be ideal.

Wider implications of the findings: Assessment of SCF at the initial male infertility screening can be a useful tool to investigate the competence of the male gamete. Screening couples with idiopathic infertility for a subtle male factor would guide those with higher SCF toward alternative reproductive treatments to avoid unnecessary IUI treatments.

Trial registration number

Not applicable

P–804 Morphokinetic development by time-lapse imaging of conceptuses generated from artificial oocytes

Study question

What are the ideal culture conditions to enhance full preimplantation development of embryos generated by FVB somatic cell haploidization (SCH) in the mouse model?

Summary answer

The presence of a histone deacetylase inhibitor yielded the best morphokinetic development of expanded blastocysts generated by FVB SCH, comparable to control blastocysts.

What is known already

Various culture conditions and medium supplements have been proposed to promote preimplantation development of embryos generated by SCH, including supplementation with trichostatin A (TSA), fasudil, scriptaid, and RAD–51 stimulatory compound–1 (RS–1). TSA and scriptaid, both histone-deacetylase inhibitors, have been found to improve embryo development following nuclear transfer by enhancing histone acetylation and cellular reprogramming. Additionally, fasudil is a Rho-associated kinase inhibitor that has been shown to reduce apoptosis and promote cell proliferation. Finally, RS–1 stimulates RAD51 activity, which promotes the repair of DNA damage and increases the efficacy of somatic cell reprogramming.

Study design, size, duration

B6D2F1 mouse metaphase II (MII) oocytes underwent enucleation and nuclear transfer, or were ICSI inseminated serving as controls. Reconstituted oocytes showing development of a meiotic-like spindle demonstrated successful SCH, and were ICSI inseminated. SCH conceptuses were cultured in one of three groups: KSOM, KSOM supplemented with TSA (TSA), or KSOM supplemented with fasudil, scriptaid, and RS–1 (Cocktail). ICSI controls (ICSIC) were cultured in KSOM medium. Fertilization and full preimplantation development were compared among all groups.

Participants/materials, setting, methods

Ooplasts were generated from MII oocytes by removing spindle complexes under OosightÔ visualization and cytochalasin B exposure. A single FVB mouse cumulus cell was transferred into the perivitelline space and fused with the ooplast, facilitated by Sendai virus. Reconstructed oocytes with novel pseudo-meiotic spindles underwent piezo-ICSI and were cultured in different media conditions in a time-lapse imaging system up to 96h. TSA and Cocktail embryos had media changed to regular KSOM 10 hours after insemination.

Main results and the role of chance

A total of 274 B6D2F1 MII oocytes were enucleated, resulting in a 95.9% survival rate. All ooplasts survived nuclear transfer and 62.1% successfully haploidized after 2 hours. ICSIC and reconstituted SCH oocytes survived piezo-ICSI at rates of 81.5% and 57.0%, respectively (P &lt; 0.01). SCH embryos were then allocated into KSOM, TSA supplied, and Cocktail media. Fertilization rates for ICSIC, KSOM, and TSA embryos were 92.4%, 90.7%, and 94.4%, respectively, while the rate for embryos cultured in Cocktail was only 71.9% (P &lt; 0.03). While embryos cultured in Cocktail had a comparable 2-cell timing to ICSIC, embryos in TSA reached developmental milestones with a closer timing to the ICSIC, having minor delays at the 3-, 4-, and 6-cell stages (P &lt; 0.05). KSOM- and Cocktail-cultured embryos were delayed at most of the stages (P &lt; 0.01), except for the two-pronuclei appearance. Although the TSA group displayed the best embryo developmental pattern, the final rate of blastocyst development was somewhat homogeneous with rates of 15.4%, 23.5%, and 13.0% for the KSOM, TSA, and Cocktail groups, respectively (P &lt; 0.001), and remarkably lower than the ICSIC (81.6%).

Limitations, reasons for caution

Although live pups have been obtained using BDF cumulus cells, embryos generated by FVB cumulus cells show a remarkably lower blastocyst development, but maintain morphokinetic characteristics similar to ICSIC in the presence of TSA.

Wider implications of the findings: While using different strains to enhance genetic variance, the morphokinetic analysis of preimplantation embryos in ideal culture conditions is paramount to the progress of neogametogenesis. The implementation of this technique may soon help create genotyped oocytes for women with compromised ovarian reserve.

Trial registration number

N/A

P-525 Analysis of segregation patterns of trivalent structure and the effect on genome stability in Robertsonian translocation carriers

Study question

What are the factors that affect the separation pattern of Robertsonian translocation trivalent, and whether the structure of the trivalent affected the chromosome stability?

Summary answer

The meiotic segregation modes can be affected by the carrier’s sex and special chromosome, and a trivalent structure can affect the stability of the genome.

What is known already

Robertson translocation occurs when two proximal acrocentric chromosomes fuse at the centromere, and forms a trivalent structure during meiosis. This structure will affect the fertility of Robertsonian translocation carriers, and may destroy the stability of the genome by affecting the separation of other chromosomes, which is called Inter-Chromosomal Effect (ICE). Previous research have confirmed that the use of PGT in Robertsonian translocation carriers can effectively reduce abortion and increase live birth. But some studies dispute this conclusion and the existence of ICE. However, there is no large data study to verify these controversies.

Study design, size, duration

PGT results of 928 oocyte retrieval cycles in 763 couples(one of the couples is a Robertsonian translocation carrier) were analysied from December 2012 to June 2020. A total of 1492 couples who received PGT-A were collected as control group, and matched according to age and testing time stage. The study was approved by the ethics committee(LL-SC-SG-2006-008 and LL-SC-SG-2014-016).

Participants/materials, setting, methods

Cytogenetic analysis was performed using GTG standard method (trypsin and GiemsaG banding) to analyze the chromosomes of peripheral blood lymphocytes. Blastocysts obtained by standard IVF procedure were biopsied on the 5th or 6th morning after fertilization, and the trophoblast cells were amplified by PicoPLEX whole genome amplification kit (Rubicon Genology) or Repli-g Single Cell Kit(Qiagen). PGT-SR was performed using SNP array or NGS as previously described.

Main results and the role of chance

In this study, a total of 3423 blastocysts from 763 couples were analysed using SNP-array or NGS. Among them, the rate of alternate segregation of male Robertsonian translocation carriers was significantly higher than that in female carriers (82.26% vs 59.96%, P &lt; 0.001), and meiotic segregation modes could be affected by the special chromosome such as 13 in female(P = 0.042) and 15 in male(P = 0.045) involved. A trivalent structure can affect the stability of the genome during mitosis, which is associated with an increase in the propotion of chromosome mosaic compared with the PGT-A control group(1.18% vs 0.53%, P &lt; 0.01). In addition, we found an interesting phenomenon: in the meiotic segregation of female Robertsonian translocation carriers associated with chromosomes 21 and 22, the chromosome 21 or 22 of the two chromosomes involved in translocation are more likely to be abnormal, and according to our results, the effect of chromosome 21 seems to be greater.

Limitations, reasons for caution

(1) Limitations of retrospective analysis; (2) The results are not fully representative of the general population; (3) PGT-A patients always had repeated implantation failure or recurrent aboration, which may cause deviation to the results.

Wider implications of the findings

This study analyzed the influencing factors of the separation patterns of trivalent, and verified the existence of ICE. This suggest that PGT-SR can have a better outcome in patients with Robertsonian translocation, especially in male carriers. These results will provide carrier couple with more appropriate genetic counseling.

Trial registration number

no

P–806 Neogametogenesis via oocyte replication

Study question

Can full preimplantation embryo development be achieved from artificial oocytes created through nuclear transfer of a haploid pseudo-blastomere (HpB) into a recipient ooplast?

Summary answer

It is feasible to replicate the female genome and generate novel sibling oocytes that can yield full preimplantation embryo development, albeit at a reduced rate.

What is known already

A limitation of assisted reproduction is the number of available oocytes for embryo creation. It is feasible to utilize a somatic cell nucleus to construct novel oocytes through a process known as haploidization, in which a reverse meiosis occurs after SCNT. Similarly, producing haploid parthenogenetic constructs can generate HpBs, useful for genetic testing at the pre-fertilization level or for reproduction. It is feasible to use a HpB as a nuclear donor since it has already completed homologue segregation.

Study design, size, duration

This is prospective translational animal model study. Over 6 months, 556 oocytes were manipulated for the experimental group, and 158 control oocytes were employed. B6D2F1 HpBs were used to establish the procedure and acquire expertise. FVB HpBs were subsequently introduced for genetic variance. Experimental and control embryos were cultured in a time-lapse incubator (up to 96h). Cleavage parameters were compared to control. Two-sample T-tests and one-way ANOVA with Bonferroni correction were employed for statistical analysis.

Participants/materials, setting, methods

A cohort of oocytes was harvested from B6D2F1 or FVB superovulated mice and artificially activated by 8% ethanol. At the 8-cell stage, HpBs were exposed to nocodazole. Another cohort of B6D2F1 oocytes was enucleated for recipient ooplasts. HpBs were individually transferred into the perivitelline space of the ooplasts alongside inactivated Sendai virus. After fusion, reconstructed oocytes with spindle development were fertilized by piezo-actuated ICSI using B6D2F1 spermatozoa. Unmanipulated and fertilized B6D2F1 oocytes served as control.

Main results and the role of chance

A total of 158 control oocytes underwent ICSI with a 67.7% survival rate; of these, 65.4% developed to the blastocyst stage. For artificial oocyte activation (AOA), up to 10 oocytes were activated for each experiment, yielding 8 HpBs per activated oocyte. For the experimental group, 556 oocytes underwent enucleation with a 96.4% survival rate. Nuclear transfer of HpBs resulted in a 93.2% survival rate, consistent for those derived from BDF and FVB. Reconstructed oocytes showed appropriate development of a novel pseudo-meoitic spindle at a rate of 63.7% for B6D2F1 HpBs and 75.5% for FVB HpBs, and ICSI yielded a 67.1% and 57.7% survival rate, respectively. The fertilization rate for the reconstructed oocytes was 64%. Control oocytes underwent ICSI with a 67.7% survival rate. When evaluating time-lapse parameters, reconstructed embryos created via blastomere nuclear transfer showed asynchrony compared to controls beginning as early as the stage of pronuclear fading. While the majority of reconstructed embryos arrested at the 4-cell stage, of those that progressed, 11.3% of those using BDF HpBs and 14.6% of those using FVB HpBs developed to the fully expanded blastocyst stage. This corresponds to a total of 23 reconstructed embryos that developed to the morula or blastocyst stage.

Limitations, reasons for caution

While we used single-well embryoscope culture for morphokinetic data collection, group culture is superior to single-embryo culture for mice. Thus, developmental rates may be underestimated by this protocol. Implantation and successful pregnancy are also needed to support the clinical utility of this method in generating gametes.

Wider implications of the findings: For women with diminished ovarian reserve, oocyte yield and age-related aneuploidy are limitations to achieving genotyped offspring. Nuclear transfer of HpB can generate sibling oocytes while maintaining genetic information. This model represents a promising path for expanding oocyte yield, allowing genetic assessment of sibling oocytes, and enhancing chances of procreation.

Trial registration number

none

P–800 Generation of artificial oocytes by two distinct mechanisms

Study question

Are haploid genome replication and somatic cell haploidization feasible mechanisms for generating parentally genotyped oocytes?

Summary answer

Artificial oocytes can be generated by haploid genome replication and somatic cell haploidization. The latter is more efficient and capable of generating live offspring.

What is known already

A low number of mature oocytes is one of the major limitations to treating infertile women who have impaired ovarian reserve. Although it has been proposed that competent oocytes can be created by a phenomenon known as somatic cell haploidization (SCH), its clinical value has yet to be examined due to its poorly understood mechanism. On the other hand, spindle transfer has been clinically applied for mitochondrial replacement therapy. Therefore, we propose to utilize G2-phase haploid pseudo-blastomere (HpB), generated by parthenogenesis, as a nuclear donor to create oocyte replica.

Study design, size, duration

In the past 7 months, individual G0 phase cumulus cells (CCs) were transferred into 1,066 ooplasts for SCH. HpBs obtained from the activation of 80 oocytes were transferred into 464 ooplasts. Both cohorts were ICSI-inseminated and placed in the time lapse for embryo development. Another 379 unmanipulated oocytes were ICSI-inseminated, serving as control. Pre-implantation development was monitored and compared for both neogametogenesis techniques. Fully expanded blastocysts were transferred to obtain live pups.

Participants/materials, setting, methods

CCs were isolated from the cumulus oophorus of B6D2F1 mice. HpBs were obtained via oocyte activation, cultured to the 8-cell stage, and subsequently treated by nocodazole to synchronize at the G2-phase. In two experimental groups, CCs or HpBs were individually transferred into the perivitelline space of the ooplasts with inactivated Sendai virus. Reconstructed oocytes presenting with a pseudo-meiotic spindle were fertilized by piezo-actuated ICSI. Blastocysts were transferred into a pseudo-pregnant CD–1 surrogate to obtain pups.

Main results and the role of chance

A total of 1,769 oocytes underwent enucleation to generate ooplasts, with a survival rate of 97%. Survived ooplasts were allocated to SCH (n = 1,034) and HpB-SCNT (n = 458). To generate HpBs, 80 unmanipulated oocytes were activated; 58 of them progressed to the 8-cell stage and generated 464 HpB for SCNT. For SCH, CCs were selected based on morphology with a diameter &lt;10 micron. Nuclear transfer of CCs and HpB yielded survival rates of 98.6% and 93.2%, respectively. Following SCH and HpB-SCNT, spindle development for SCH and HpB-SCNT was comparable at 63.5% for SCH and 66.7% for HpB-SCNT. The ICSI survival rates for SCH and HpB-SCNT were 58.9% and 64.9%, respectively, but lower than the control at 73.9% (P &lt; 0.001). Fertilization rates for SCH and HpB-SCNT were also comparable at 61.3% and 64.3%, respectively, but lower than the control at 89.6% (P &lt; 0.00001). Full pre-implantation development was achieved for both experimental groups. While the SCH group yielded a development rate of 24.6% (n = 94), the HpB-SCNT group yielded a lower rate at 12.4% (n = 23) (P &lt; 0.001), both lower than the control (71.7%, P &lt; 0.00001); however, the morphokinetics of the embryo development was retained. To date, only 3 live pups were obtained from SCH group.

Limitations, reasons for caution

While these techniques to manufacture oocytes are very new and highly experimental, our findings show a lower blastulation rate for oocytes generated by HpB. Both techniques require refinement and improvement of reliability and consistency before they can be considered a feasible technique for human reproduction.

Wider implications of the findings: The study confirms the potential to create artificial oocytes capable of supporting full pre-implantation development and, in some cases, live pups. If further streamlining of both procedures demonstrates their safety, they may both represent a viable option to generate de novo gametes

Trial registration number

N/A

O-124 Contact-free oocyte denudation in a chip-scale ultrasonic microfluidic device

Study question

To design and test an automated microfluidic device to revolutionize the cumulus-oocyte-complex (COC) denudation procedure for intracytoplasmic sperm injection (ICSI) using murine oocytes.

Summary answer

Oocyte exposure to temperature variation, mechanical stress, and prolonged chemical treatment during denudation was mitigated using our microfluidic device based on surface acoustic waves (SAWs).

What is known already

COC denudation is a prerequisite for many ART procedures such as ICSI. However, this procedure is based on manual pipetting (MP), which lacks standardization and requires experienced embryologists to perform. Inadequate MP may damage oocytes through prolonged enzymatic treatment or high fluidic stresses and may jeopardize gamete competence. The use of microfluidic devices based on porous membranes or microchannels has been adopted by many laboratories for sperm selection. Of these, microchannel devices may also be adapted for denudation with minimal mechanical stress in a controlled microenvironment. However, oocyte manipulation and extraction have proven difficult to achieve.

Study design, size, duration

We developed a novel ultrasonic microfluidic device based on a microwell design manufactured with Polydimethylsiloxane (PDMS). The SAWs were generated by 4 interdigitated transducers (IDTs) arranged in an orthogonally symmetric pattern. A non-toxic dosage of ultrasonic waves, similar to those used in gynecology and obstetrics, was applied. COCs were denuded by induced acoustic streaming and acoustic radiation force. Denudation rate, embryo development, and pregnancy outcomes were assessed and compared to control oocytes denuded by MP.

Participants/materials, setting, methods

For each run, up to 10 individual COCs from super-ovulated B6D2F1 mice were loaded into the microwell alongside diluted hyaluronidase (20 IU/ml) and denuded by 80 or 200 MHz SAWs. Denuded oocytes were fertilized by piezo-actuated ICSI using spermatozoa from the same strain. Pre-implantation embryo development was assessed in a time-lapse incubator for up to 96 h. High-quality blastocysts were transferred to 2.5-dpc pseudo-pregnant CD-1 surrogates. Pregnancy and offspring health were observed.

Main results and the role of chance

Using alternating frequency sweep in a pulse-repetition mode, we swirled the fluid inside the microwell consistently and tumbled COCs inside the microwell to expose them to acoustic steaming-induced drag forces and acoustic radiation force. Using a high-speed camera and particle-tracking technique, we observed that the drag force generated by the SAWs fulfilled the denudation mechanism. Additionally, due to the small attenuation coefficient in water, thermal absorption heating remains minuscule, preventing any thermal-induced damage.

Our device significantly reduced the time and labor of the denudation process. It also yielded proper denudation quality without oocyte loss. To ensure that SAWs do not damage oocytes, 40 oocytes denuded by 80 MHz SAWs, 25 oocytes denuded by 200 MHz SAWs, and 30 oocytes denuded by MP were inseminated by piezo-actuated ICSI. The 80-MHz, 200-MHz, and MP groups yielded comparable post-ICSI survival (82.5% vs. 84.0% vs. 83.3%, respectively), fertilization (80.0% vs. 80.0% vs. 83.3%,respectively), and blastulation rates (72.5% vs. 82.0% vs. 66.7%, respectively). Embryo morphokinetics were also not impacted. After transferring all blastocysts into recipient mice, 8 live births were achieved from the 80-MHz group, while 5 were achieved from the 200-MHz group.

Limitations, reasons for caution

Although PDMS is a popular material due to its high optical transparency and biocompatibility, adverse effects due to gas permeability and small-molecule adsorption cannot be excluded. Large-scale mouse embryo assays should be performed to assess the teratogenicity of PDMS. Operation parameters must be optimized for human COCs in clinical application.

Wider implications of the findings

Adopting widely used ultrasound techniques with emerging SAW technology is a major step toward advancing and standardizing oocyte denudation—a laborious yet delicate procedure. We predict it will be further integrated with AI and miniaturized robotics, modules specialized in gamete assessment, ICSI, and embryo evaluation in the near future.

Trial registration number

‘not applicable’

P–805 Artificial oocytes: from somatic cells to fertile pups

Study question

We analyzed the efficacy of generating artificial oocytes using somatic cells (SCs) from two mouse strains (B6D2F1 and FVB) and followed their full pre-/post-implantation development.

Summary answer

While artificial oocytes generated from the new strain (FVB) had higher fertilization rates, those from the standard strain (B6D2F1) provided expanded blastocysts and fertile pups.

What is known already

B6D2F1 is a popular hybrid mouse strain for cloning and transgenic creation due to its geno-/pheno-typic uniformity and high oocyte yield and quality. Indeed, B6D2F1 oocytes have a distinct metaphase II (MII) spindle complex, making them an ideal candidate to generate ooplasts used in SC nuclear transfer (SCNT). However, because they lack genetic variance, they are less suitable for reciprocal SCNT studies. In contrast, FVB mice have single nucleotide polymorphisms and indels on each chromosome that can aid in tracing the pedigree of progeny.

Study design, size, duration

A total of 10 experiments were performed over the course of 3 months, using 30 stimulated mice. SCs were retrieved from cumulus oophorus harvested from FVB and B6D2F1 mice. SCs from both strains were injected into enucleated MII B6D2F1 oocytes. Unmanipulated B6D2F1 oocytes were piezo-ICSI inseminated, serving as controls. The occurrence of haploidization, fertilization, and full preimplantation development was compared. Some blastocysts were transferred into pseudo-pregnant CD–1 mice to obtain offspring.

Participants/materials, setting, methods

Oocyte enucleation was performed under Oosight™ visualization and cytochalasin B exposure. An FVB or B6D2F1 SC was transferred into the perivitelline space of the ooplast with Sendai virus to promote fusion. Haploidization was monitored by pseudo-meiotic spindle formation followed by extrusion of a pseudo-polar body after insemination. Conceptuses were cultured in a time-lapse imaging system, with piezo-ICSI controls. Expanded blastocysts were transferred into uterine horns of pseudo-pregnant mice. Offspring were mated to test their fertility.

Main results and the role of chance

FVB (n = 278) and B6D2F1 (n = 905) SCs at G0 phase, with a diameter &lt;10 mm, were chosen for SCNT and transferred into enucleated B6D2F1 ooplasts. Enucleation of 1,212 oocytes yielded a survival rate of 97.6%. Both FVB and B6D2F1 SCNT resulted in similar survival rates of 100% and 98.5%, respectively. Successful haploidization, determined by the presence of a pseudo-meiotic spindle 2 hours after SCNT, was also comparable, with 59.9% of FVB and 63.7% of B6D2F1. Survival after piezo-ICSI was also comparable between FVB- and B6D2F1-reconstituted oocytes, with rates of 64.3% and 60.3%, respectively, albeit lower than the control (75.2%, P &lt; 0.00001). FVB embryos fertilized at a rate of 88.7%, comparable to the control zygotes at 85.8%, while B6D2F1 conceptuses demonstrated a lower fertilization rate (70.8%, P &lt; 0.00001). Blastulation of FVB- and B6D2F1-derived embryos was 15.1% and 24.0%, respectively, while the control was 80.7% (P &lt; 0.00001). Whole-genome karyotyping of 9 B6D2F1-derived blastocysts confirmed 5 of the samples to be euploid. FVB blastocysts (N = 8) and B6D2F1 blastocysts (N = 81) were transferred into pseudo-pregnant mice, resulting in 3 fertile offspring only from the B6D2F1 conceptuses.

Limitations, reasons for caution

This is still a limited number of observations, and pups were delivered only from the B6D2F1 strain. The utilization of a strain with higher genetic variance may help facilitate offspring fingerprinting.

Wider implications of the findings: This study demonstrates the ability to generate artificial genotyped conceptuses, yielding live offspring. The identification of a feasible donor cell, together with optimization of cell cycle stage and standardization of post-implantation development, will help promote this technique for human reproduction in couples with age-related infertility or poor ovarian reserve.

Trial registration number

N/A

O-094 Utilization of ultrastructural analysis and genomics of spermatozoa to better characterize subtle forms of male factor infertility

Study question

Can sequencing the sperm genome provide insight into the various forms of male factor infertility caused by sperm organelle ultrastructural defects?

Summary answer

A comprehensive genomic assessment of spermatozoal DNA is able to identify genetic causes of ultrastructural defects visualized by transmission electron microscopy (TEM).

What is known already

To evaluate a man’s reproductive potential, a conventional semen analysis through the assessment of concentration, motility, and morphology can indicate the proficiency of male gametes. Among those, conventional morphology assay can only provide indirect information on the different components of the sperm cell. The assessment of nanoscopic details such as chromatin, centriolar, mitochondrial, and axonemal components can only be observed by TEM. Indeed, TEM has been used to identify defects in the acrosome, chromatin compaction, and axonemal/periaxonemal structures. Furthermore, exome sequencing of spermatozoal DNA may identify novel causes and candidate genes for these ultrastructural defects.

Study design, size, duration

In the past 2 years, 20 men with history of fertilization failure or severe astheno-/terato-zoospermia were selected for TEM analysis of their spermatozoa, while 3 fertile men served as controls. Sperm head characteristics, intactness of fibrous sheath, and axonemal/periaxonemal structure were examined by diagnostic TEM. For consenting patients, NGS assessment was concurrently performed to identify mutations responsible for the structural abnormalities identified by TEM.

Participants/materials, setting, methods

TEM was performed on the ejaculates of 20 infertile patients and 3 fertile controls. Post-centrifugation cell pellets were resuspended, fixed, and dehydrated to be infiltrated and embedded onto the resin. Fixed specimens were sliced by ultramicrotome to 100-nm sections, then viewed by JEOL-1400 electron microscope at 300,000X magnification. At least 100 spermatozoa were evaluated by TEM. For consenting patients, DNA was extracted and amplified from at least 500 spermatozoa for concurrent NGS analysis.

Main results and the role of chance

Four types of sperm ultrastructural defects were observed, including globozoospermia, dysplasia of fibrous sheath (DFS), proximal centriole defect, and primary ciliary dyskinesia (PCD). One combined case of globozoospermia and DFS was identified. In globozoospermic patients (n = 13), 97-100% of the spermatozoa displayed characteristic spherical heads with absence of acrosomes, dispersed chromatin, and perinuclear theca deformities. Centrosomal and axonemal structures were conserved. NGS identified gene deletions (DPY19L, PICK1, SPATA16) directly related to the globozoospermic phenotype. In patients with DFS (n = 4), complete absence of flagellum was observed in 90-100% of spermatozoa. These defective gametes also displayed mitochondria disorganization, microtubular deformities, and cytoplasmic residues containing coiled flagellum with deformed capitulum within the plasma membrane. Contrary to the globozoospermia, acrosomes and nuclei appeared normal, indicating incomplete late spermiogenesis. Indeed, NGS confirmed gene deletions involved in flagellar development/function (AKAP4, SPAG16, CATSPER1). For the patient with proximal centriole defect (n = 1), sperm nucleus, fibrous sheath, and flagellar structure were conserved. However, 90% of proximal centrioles assessed exhibited microtubular disorganization, confirmed by ODF2 mutation per NGS. In the PCD patient (n = 1), chaotic flagellar microtubule arrangement and absence of outer dynein arms were prevalent in 90% of axonemal cross-sections examined, which was explained by a DNAH5 gene deletion.

Limitations, reasons for caution

While TEM can overcome the limitations of conventional semen analysis by providing direct visualization of the inner organelle arrangement of spermatozoa to accurately diagnose rare sperm pathologies, it is not routinely applied in clinics due to its high cost and technical specifications. Therefore, confirmatory NGS can provide additional diagnostic value.

Wider implications of the findings

Ultrastructural analysis with a concurrent genomic assessment characterized phenotypes and genotypes of rare sperm pathologies in infertile men. The utilization of TEM, corroborated by genomic assay, is therefore crucial for clinical and translational reproductive medicine to better characterize male factor infertility.

Trial registration number

N/A

P–120 Selecting spermatozoa with the highest genomic integrity in order to enhance clinical outcomes in men with high DNA fragmentation levels

Study question

What are the best methods of selecting spermatozoa with the highest genomic integrity in order to improve embryo implantation and term pregnancy rates with ICSI?

Summary answer

Testicular or ejaculate spermatozoa isolated by microfluidic sperm selection (MFSS) were characterized by superior genomic integrity with improved clinical pregnancy and delivery rates.

What is known already

In couples with unexplained infertility, a subtle male factor can often be identified. Both single-strand (ss) and double-strand (ds) DNA nicks and breaks hinder the ability of the male gamete to support embryonic development. Surgical retrieval of spermatozoa from the proximal male genital tract can prevent their exposure to oxidative stress. Moreover, use of membrane-based microfluidics chips has been shown to allow for selection of the most progressively motile spermatozoa with higher genomic integrity.

Study design, size, duration

Over the course of 48 months, 86 consenting men presenting with high sperm chromatin fragmentation (SCF) in their ejaculate with prior ART failure underwent a subsequent cycle with specimens retrieved by testicular biopsy or ejaculate processed by MFSS. A concurrent TUNEL assay was performed on samples collected or selected by each method. Sperm specimens of both origins were utilized for ICSI cycles. Semen parameters, chromatin integrity, and pregnancy outcomes were compared between the two methods.

Participants/materials, setting, methods

Fresh ejaculates from consenting men were collected for standard semen analysis (WHO 2010). Testicular biopsy and MFSS were used to isolate spermatozoa with a higher genomic integrity after previous ART failure. SCF was assessed by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) on at least 500 spermatozoa under a fluorescent microscope with a threshold of ≥ 15%. MFSS was carried out by Zymot® chips. ICSI was performed in the standard fashion.

Main results and the role of chance

A total of 86 men (36.5±5 years) had the following semen parameters: volume of 2.6 ±1mL, concentration of 27.0±33 x 106/mL, 35.6±15% motility, and high SCF (24.1±10%). They underwent 146 ICSI cycles with their partners (maternal age, 33.7±3) resulting in a high incidence of pregnancy loss (100%; 13/13). Of those who failed to conceive, 22 couples used surgically retrieved spermatozoa (SRS) with a concentration of 1.8 ± 4 x 106/mL (P &lt; 0.01), 5.0±11% motility (P &lt; 0.01), and an SCF of 12.6 ± 6% (P &lt; 0.0001). SRS was used in 37 ICSI cycles, yielding a fertilization rate of 61.6% (204/331, P &lt; 0.01), an implantation rate of 10.6% (9/85, P &lt; 0.01), a CPR of 23.5% (8/34, P &lt; 0.01), and a delivery rate of 17.6% (6/34, P &lt; 0.01). Another 24 couples underwent ICSI cycles with ejaculated spermatozoa processed by MFSS with a concentration of 1.8±3 x 106/mL (P &lt; 0.01), but an increased motility of 99±1% (P &lt; 0.01) and an SCF of 1.2 ±1%, lower than both the raw and testicular specimens (P &lt; 0.0001). MFSS-processed specimens resulted in a fertilization rate of 76% (335/441, P &lt; 0.01), an implantation rate of 26.3% (15/57, P &lt; 0.05), and a CPR of 67.9% (19/28, P &lt; 0.01), of which 15 patients delivered and 2 pregnancies are ongoing (89.5%; P &lt; 0.01).

Limitations, reasons for caution

This is a preliminary study on a small number of subjects. A randomized prospective study conducted on a larger cohort would be required to confirm our findings.

Wider implications of the findings: SCF severely affects pregnancy by impairing embryonic development, consequently promoting implantation failure. While retrieving spermatozoa from the germinal epithelium is a viable option, MFSS provides an alternative. Although MFSS requires an adequate number of sperm with good kinetic characteristics, it provides a more palatable option, reducing surgical risk and costs.

Trial registration number

Not applicable

P–525 Analysis of segregation patterns of trivalent structure and the effect on genome stability in Robertsonian translocation carriers

Study question

What are the factors that affect the separation pattern of Robertsonian translocation trivalent, and whether the structure of the trivalent affected the chromosome stability?

Summary answer

The meiotic segregation modes can be affected by the carrier’s sex and special chromosome, and a trivalent structure can affect the stability of the genome.

What is known already

Robertson translocation occurs when two proximal acrocentric chromosomes fuse at the centromere, and forms a trivalent structure during meiosis. This structure will affect the fertility of Robertsonian translocation carriers, and may destroy the stability of the genome by affecting the separation of other chromosomes, which is called Inter-Chromosomal Effect (ICE). Previous research have confirmed that the use of PGT in Robertsonian translocation carriers can effectively reduce abortion and increase live birth. But some studies dispute this conclusion and the existence of ICE. However, there is no large data study to verify these controversies.

Study design, size, duration

PGT results of 928 oocyte retrieval cycles in 763 couples(one of the couples is a Robertsonian translocation carrier) were analysied from December 2012 to June 2020. A total of 1492 couples who received PGT-A were collected as control group, and matched according to age and testing time stage. The study was approved by the ethics committee(LL-SC-SG–2006–008 and LL-SC-SG–2014–016).

Participants/materials, setting, methods

Cytogenetic analysis was performed using GTG standard method (trypsin and GiemsaG banding) to analyze the chromosomes of peripheral blood lymphocytes. Blastocysts obtained by standard IVF procedure were biopsied on the 5th or 6th morning after fertilization, and the trophoblast cells were amplified by PicoPLEX whole genome amplification kit (Rubicon Genology) or Repli-g Single Cell Kit(Qiagen). PGT-SR was performed using SNP array or NGS as previously described.

Main results and the role of chance

In this study, a total of 3423 blastocysts from 763 couples were analysed using SNP-array or NGS. Among them, the rate of alternate segregation of male Robertsonian translocation carriers was significantly higher than that in female carriers (82.26% vs 59.96%, P &lt; 0.001), and meiotic segregation modes could be affected by the special chromosome such as 13 in female(P = 0.042) and 15 in male(P = 0.045) involved. A trivalent structure can affect the stability of the genome during mitosis, which is associated with an increase in the propotion of chromosome mosaic compared with the PGT-A control group(1.18% vs 0.53%, P &lt; 0.01). In addition, we found an interesting phenomenon: in the meiotic segregation of female Robertsonian translocation carriers associated with chromosomes 21 and 22, the chromosome 21 or 22 of the two chromosomes involved in translocation are more likely to be abnormal, and according to our results, the effect of chromosome 21 seems to be greater.

Limitations, reasons for caution

(1) Limitations of retrospective analysis; (2) The results are not fully representative of the general population; (3) PGT-A patients always had repeated implantation failure or recurrent aboration, which may cause deviation to the results.

Wider implications of the findings: This study analyzed the influencing factors of the separation patterns of trivalent, and verified the existence of ICE. This suggest that PGT-SR can have a better outcome in patients with Robertsonian translocation, especially in male carriers. These results will provide carrier couple with more appropriate genetic counseling.

Trial registration number

no

JBrowseR: An R Interface to the JBrowse 2 Genome Browser

MOTIVATION

Genome browsers are an essential tool in genome analysis. Modern genome browsers enable complex and interactive visualization of a wide variety of genomic data modalities. While such browsers are very powerful, they can be challenging to configure and program for bioinformaticians lacking expertise in web development.

RESULTS

We have developed an R package that provides an interface to the JBrowse 2 genome browser. The package can be used to configure and customize the browser entirely with R code. The browser can be deployed from the R console, or embedded in Shiny applications or R Markdown documents.

AVAILABILITY

JBrowseR is available for download from CRAN, and the source code is openly available from the Github repository at https://github.com/GMOD/JBrowseR/.

SUPPLEMENTARY INFORMATION

Supplementary data are available at Bioinformatics Online.

Disparities in Utilization of Autologous Stem Cell Transplantation as Consolidative Therapy for Multiple Myeloma: A Single Institution Retrospective Review

BACKGROUND

Most guidelines recommend induction therapy followed by autologous hematopoietic cell transplantation. A Surveillance, Epidemiology, and End Results-Medicare database analysis from 2000 to 2011 noted a lower use of HCT and bortezomib among Black patients, despite adjusting for care barriers, and this practice was associated with a poorer outcome. The goal of this study was to evaluate patterns of acceptance of HCT as consolidative therapy for MM.

METHODS

Cox proportional hazards model was used to investigate the association between the survival time of the patients (overall survival) and age of the diagnosis, race, socioeconomic status, disease cytogenetic, and initial induction regimens. A total of 194 patients with a confirmed diagnosis of MM who were referred for HCT between January 1, 2009, and June 30, 2019, were included in this study. Patients who received autologous stem cell transplant for relapsed MM were excluded.

RESULTS

We found that income category was not significantly associated with overall survival, time to transplant or transplant-/relapse-related mortality. High-risk cytogenetic was significantly associated with shorter overall survival, higher transplant-related mortality and relapse-related mortality (P < .002). The use of aggressive induction choices was associated with poorer transplant outcomes (P = .02). Time to transplant tended to be shorter in African American compared with other ethnic groups (P = .07).

CONCLUSION

There was no significant difference in the use rate of the HCT between Caucasians and AA patients with MM. Further comparative studies of MM induction therapy and access to clinical trials in African Americans and other racial minorities are warranted.

Heterotrimeric G protein signalling in plant biotic and abiotic stress response

Heterotrimeric G proteins act as molecular switches to participate in transmitting various stimuli signals from outside of cells. G proteins have three subunits, Gα, Gβ and Gγ, which function mutually to modulate many biological processes in plants, including plant growth and development, as well as biotic and abiotic stress responses. In plants, the number of Gγ subunits is larger than that of the α and β subunits. Based on recent breakthroughs in studies of plant G protein signal perception, transduction and downstream effectors, this review summarizes and analyses the connections between different subunits and the interactions of G proteins with other signalling pathways, especially in plant biotic and abiotic stress responses. Based on current progress and unresolved questions in the field, we also suggest future research directions on G proteins in plants.

Transient Anti-Phospholipid Antibodies in Two Patients With COVID-19

We report two cases of coronavirus disease 2019 (COVID-19) in patients who developed pulmonary embolism and transient anti-phospholipid antibodies. At the time of presentation with acute pulmonary embolism, both patients had leukocytosis and increased levels of anti-cardiolipin antibodies, which resolved at testing 12 weeks after initial presentation. Studying cases of pulmonary embolism and increased anti-phospholipid antibodies in the context of COVID-19 could be one of the factors for elucidating the possible connection between severe acute respiratory syndrome coronavirus 2 infection, anti-phospholipid antibodies, and thrombosis.

Disparities in utilization of autologous stem cell transplantation as consolidative therapy for multiple myeloma: A single-institution retrospective review

e20504

Background: Multiple Myeloma (MM) accounts for about 17% of hematologic malignancies in the United States. It is a disease of older adults, with a median age at diagnosis of 66 years. The incidence in African Americans is 2 to 3 times more that in Whites, and this disparity has been found to be greater among patients less than 50 years. Most guidelines recommend induction therapy with a triplet regimen followed by autologous hematopoietic cell transplantation (HCT). Unfortunately, racial and ethnic minorities have been found to be less likely to receive ASCT. A SEER-Medicare database analysis from 2000 to 2011 noted a lower utilization of ASCT and Bortezomib among black patients. The goal of this study was to evaluate patterns of acceptance of ASCT as consolidative therapy of MM. Because the receipt of upfront ASCT is dependent on response to induction therapy, our study also investigated disparity in transplant outcomes and time to transplant, which are areas that previous studies had not looked at. Methods: In this retrospective review we used Cox PH model to investigate the association between the survival time of the patients (OS) and age of the diagnosis, race, socioeconomic status, disease cytogenetic, and initial induction regimens. 194 patients with a confirmed diagnosis of MM who were referred for autologous hematopoietic stem cell transplantation (ASCT) between January 1st 2009 and June 30st 2019 were included in this study. Patients who received ASCT for relapsed MM were excluded. Results: Using Cox PH model, we found that high risk cytogenetic were significantly associated with shorter overall survival, higher transplant related mortality and relapse related mortality (P < 0.002). Use of aggressive induction choices was associated with poorer transplant outcomes (P 0.02). Time to transplant tended to be shorter in African American compared to other ethnic groups (P 0.07). Income category was not significantly associated with overall survival, time to transplant or transplant / relapse related mortality. Conclusions: Cytogenetic continues to be a significant factor in transplant outcomes affecting overall survival. Time to transplant tended to be shorter in African American comparing to others, potentially reflecting the differences in disease course. Our study provides a more real life data on ASCT outcome patterns. It is hoped that the results of this study will better guide interventions to improve utilization of ASCT as consolidative therapy for MM.

Effects of incubation and chick rearing on intestinal morphology, digestive enzyme activities, and mRNA expression of nutrient transporter genes in the pigeon (Columba livia) under artificial farming conditions

The present study investigated the changes in morphology, enzyme activities in the pancreas and mucosa, and nutrient transporter gene expression in the duodenum and jejunum in male and female pigeons during the incubation and chick-rearing periods. Forty-two pairs of White King pigeons with 2 fertile eggs per pair were randomly divided into 7 groups by different breeding stages. The crypt depth of the duodenum and jejunum reached the peak at day 1 (R1) and day 7 (R7) of chick rearing, respectively. The jejunum surface area increased to a maximum value at R1. Amylase activity in the pancreas decreased to the lowest value at R1, whereas trypsin and lipase activities peaked at 17 D of incubation (I17) and R7, respectively. In male pigeons, mucosal Na⁺-K⁺-ATPase activity in the duodenum and jejunum was the highest at R15 and it was at I17 in female pigeons. Jejunum sucrose activity in female pigeons was higher at I4 than that at I17 (P < 0.05). The gene expression of FAT/CD36 and I-FABP in the duodenum gradually increased and then declined in the late chick-rearing period. SGLT1 in the jejunum decreased to a lower level at I17 and R25 in male pigeons (P < 0.05). GLUT2 expression in female duodenum and male jejunum decreased to a lower value at I17 compared with that at R15 (P < 0.05). In the late of incubation (from I10 to I17), expression of duodenum CAT1, B⁰AT1, and PepT1 and jejunum CAT1, ASCT1, and PepT1 in female pigeons was significantly reduced (P < 0.05), whereas opposite results were found in male jejunum CAT1 and duodenum ASCT1. In conclusion, variations of intestinal morphology, activities of pancreatic and mucosal enzymes, and gene expression of nutrient transporters during incubation and chick-rearing periods, underlying potential changes of digestive and absorptive function and intestinal adaptation with sexual effects, may represent a complicated response to stimuli of different breeding stages.