P–278 The embryo score provided by the KIDScoreD5 is correlated with implantation rate and clinical outcomes in fresh transfer

Study question

Can the algorithm used by EmbryoScopePlus software predict implantation and clinical pregnancy in women of different age groups on fresh transfer?

Summary answer

The embryo score generated by KIDScoreD5 is highly related to the rates of implantation and clinical pregnancy in fresh transfers in women of different age.

What is known already

Artificial Intelligence algorithms use statistics to find patterns in large amounts of data and describe a non-biased approach to multiparameter analysis. Several algorithms have been described, but none has been adopted for universal use. KIDScoreD5 is the algorithm included in the EmbryoScopePlus system and classifies embryos according to the cleavage times and morphology of the blastocyst. Version 3, more current, includes the annotations of the number of pronuclei, the time of division for 2, 3, 4 and 5 cells, time to start of blastulation, and morphology of the Internal Cell Mass and trophectoderm.

Study design, size, duration

Retrospective study evaluated 86 embryos from January to December 2019 at the Reproferty clinic, grown at EmbryoScopePlus and transferred fresh on the fifth day of embryo development. The morphological and morphokinetic parameters were automatically evaluated by the software and in case of any mistake, they were manually corrected. The embryos were evaluated by KIDScoreD5 v3 in different scores from 0.0 to 9.9 and divided into 4 groups (0.0–2.5; 2.6–5.0; 5.1–7.5; 7.6 –9.9).

Participants/materials, setting, methods

The inclusion criterion was transfer of a single embryo with 1 gestational sac and positive FHB and transfer of two embryos with 2 gestational sac and positive FHB. Patients with progesterone on the trigger day ≥ 1.5ng/mL and/or with endometrium ≤7mm were excluded. The implantation and clinical pregnancy rates were calculated according to age group, G1: ≤35 years; G2: between 36 and 39 years old; G3: ≥40 years, within the embryo classification.

Main results and the role of chance

For patients in group 1 (n = 31 embryos), 33.4% of the embryos were classified between 2.6–5.0; 69.20% of embryos with scores between 5.1–7.5 and 57.10% of embryos with scores between 7.6–9.9, with 100% of embryos that implanted, regardless of classification, resulting in clinical pregnancy . For group 2 (n = 35 embryos), they only showed an implantation rate for embryos where the scores were 5.1–7.5 (33.4%) and 7.6 - 9.9 (71.4%) , with 100% being the clinical pregnancy rate in these groups. For patients in group 3 (n = 24 embryos), we also observed implantation only in groups of embryos with a score of 5.1–7.5 (37.5%) and 7.6–9.9 (18.5%) , but the clinical pregnancy rate was lower when compared to the other age groups of the patients, with 33.5% for embryos having a score between 5.1–7.5 and 50% for the group 7.6–9.9. Regarding the average score given by the classification of KIDScore Day 5 v. 3 for embryos that implanted, for patients aged 35 years or less, the average was 6.92; for patients between 36 and 39 years old, the average was 8.06 and for patients aged 40 years or older, the average was 7.32.

Limitations, reasons for caution

This project is limited because it is a retrospective study and evaluated embryos from a single breeding center. Multicenter and prospective studies are necessary to validate the universal use of the KIDScoreD5 v3 algorithm in time-lapse incubators.

Wider implications of the findings: The study showed the ability of KIDScoreD5 v3 to assist the embryologist in deciding which embryo to transfer fresh, according to the patient’s age, in addition to the software being effective in automatic annotation of morphological and morphokinetic parameters. Validating an algorithm universally will improve embryonic selection.

Trial registration number

Not applicable

Health and epidemiological approaches of Trypanosoma evansi and equine infectious anemia virus in naturally infected horses at southern Pantanal

Equine infectious anemia virus (EIAV) and Trypanossoma evansi are endemic in Brazilian Pantanal Biome, an important area for livestock production. In this sense, we evaluated the epidemiological single and co-infection effects of T. evansi and EIAV in naturally infected horses in the southern Pantanal wetland by serological tests and hematological assays. Both higher seroprevalence and heath poor condition of the sampled animals were associated with differences in horse management between farms. We found that the negative animals for both infectious agents (NN) represented the major group in F1 (37%), and the smallest group in F2 (19%). Furthermore, we recorded higher EIAV seroprevalence (56%) in F2, compared to F1 (38%). We observed that T. evansi infection was mostly related to young horses, as seen by their higher seroprevalence, ranging from 70.7% in the beginning of the rainy season to 81% in the end of flood period, in comparison with the values of 42% and 68%, respectively, in working animals. on the other hand, working animals showed a higher seroprevalence for EIAV (48%) in both seasons than young horses. We observed that the management of working horses could be a risk factor of EIAV infection. On the other hand, as T. evansi is maintained in the study region by many species of wild mammals, the mechanical transmission through blood-sucking vectors ensures the infection to horses since early. Our results showed that single or co-infection by EIAV and T. evansi caused different degree of anemia in the infected animals. Moreover, the health of horses in Brazilian Pantanal is also influenced by differences in horse management and environmental circumstances.

Protocol to cryopreserve and isolate nuclei from adipose tissue without dimethyl sulfoxide

Cryopreservation injuries involve nuclear DNA damage. A protocol for cryopreserving and isolating adipocyte nuclei is proposed. Adipose tissue samples were directly analyzed (NoCRYO-0h), or stored at -196°C for 7 days without 10% dimethyl sulfoxide (DMSO) (CRYO-WO-DMSO) or with DMSO (CRYO-W-DMSO). To determine the effect of DMSO on cryopreservation treatment, adipose tissue samples were stored at 4°C for 24 h with 10% DMSO (NoCRYO-W-DMSO-24h) and without (NoCRYO-WO-DMSO-24h). Samples were processed in isolation buffer, and nuclear integrity was measured by flow cytometry. The coefficient of variation, forward scatter, side scatter, and number of nuclei analyzed were evaluated. Pea (Pisum sativum) was used to measure the amount of DNA. All groups contained similar amounts of DNA to previously reported values and a satisfactory number of nuclei were analyzed. CRYO-W-DMSO presented a higher coefficient of variation (3.19 ± 0.09) compared to NoCRYO-0h (1.85 ± 0.09) and CRYO-WO-DMSO (2.02 ± 0.02). The coefficient of variation was increased in NoCRYO-W-DMSO-24h (3.80 ± 0.01) compared to NoCRYO-WO-DMSO-24h (2.46 ± 0.03). These results relate DMSO presence to DNA damage independently of the cryopreservation process. CRYO-W-DMSO showed increased side scatter (93.46 ± 5.03) compared to NoCRYO-0h (41.13 ± 3.19) and CRYO-WO-DMSO (48.01 ± 2.28), indicating that cryopreservation with DMSO caused chromatin condensation and/or nuclear fragmentation. CRYO-W-DMSO and CRYO-WO-DMSO presented lower forward scatter (186.33 ± 9.33 and 196.89 ± 26.86, respectively) compared to NoCRYO-0h (322.80 ± 3.36), indicating that cryopreservation reduced nuclei size. Thus, a simple method for cryopreservation and isolation of adipocyte nuclei causing less damage to DNA integrity was proposed.

IPSE/alpha-1 of Schistosoma mansoni egg induces enlargement of granuloma but does not alter Th2 balance after infection

Schistosomiasis is a parasitic disease with more than 200 million people infected worldwide. The formation of granulomas around eggs trapped in the liver is the main cause of disease morbidity. Therefore, the aim of this investigation was to characterize the immunopathological response induced by the recombinant (r) IPSE/alpha-1 egg protein in mice. Herein, we have shown that splenocytes from mice immunized with rIPSE/alpha-1 produced IFN-gamma, TNF-alpha, IL-4, IL-5 and IL-13 characterizing a mixed Th1/Th2 type of immune response. Pathological analysis of the liver revealed that there was no alteration in the number of eggs and granulomas; however, we observed an increase in granuloma area in immunized mice. Furthermore, eosinophil peroxidase assay showed that there was no alteration in the eosinophil infiltration in the liver; however, n-acetyl-beta-glucosaminidase measurement revealed an increase in macrophage activity. Despite the alteration in the profile of liver inflammatory cells in rIPSE immunized mice, the production of chemokines such as CCL2, CCL3, CCL5 and CCL11 was unaltered compared with the control group. In conclusion, IPSE/alpha-1 immunization induces a mixed Th1/Th2 type of immune response and enlargement of hepatic granuloma caused by an increased macrophage activity, but does not alter Th2 cytokines following infection.

Concentrations of CXCL8, CXCL9 and sTNFR1 in plasma of patients with pulmonary tuberculosis undergoing treatment

BACKGROUND

Chemokines are a class of cytokines with chemotactic properties shown to be induced by M. tuberculosis or its antigens in vitro and in experimental infection in vivo. A few studies have also demonstrated the expression of chemokines in clinical samples of patients with active tuberculosis (TB). In the present work, we measured the concentration of chemokines in plasma samples of HIV-negative patients with pulmonary tuberculosis at different stages of chemotherapy. For comparison, we also evaluated the levels of sTNFR1 and TNF-alpha.

METHODS

Cytokines and chemokines were measured by ELISA in healthy individuals and patients with active pulmonary TB at different stages of treatment.

RESULTS

The concentrations of CXCL8, CXCL9 and sTNFR1 were elevated in patients with active pulmonary TB but returned to background levels at 4-6 months of chemotherapy. The concentration of CCL11 was elevated in patients with active pulmonary tuberculosis when compared to control and remained elevated throughout the specific therapy. There was no difference in the plasma concentration of CCL2 and CXCL10 between pulmonary TB patients and control subjects.

CONCLUSION

Measurement of the CXCL8, CXCL9 and sTNFR1 may be useful to assess response to treatment in pulmonary TB patients.

[Epidemiological research on dementia in developing countries]

As the world population is ageing, dementia becomes an important public health problem, particularly in developing countries. Epidemiological research in these settings is scarce and present additional methodological difficulties, mainly regarding the socio-cultural adequacy of instruments used to identify cases of dementia. As a result of these concerns the 10/66 Dementia Research Group was founded to fill this gap. This is an international network of investigators, mostly from developing countries, and the group's name was based on the paradox that less than 10% of the population-based studies on dementia are directed to 2/3 or more cases of people with dementia living in developing countries. The aim of the paper is to update data in the literature regarding the differences in dementia prevalence and incidence seen in developed and developing countries.