Prenatally, the cavum septi pellucidi (CSP) should be visible until close to term. Non-visualisation, particularly during the second trimester, is considered to be a marker of agenesis of the corpus callosum (CC). Failure to visualise the CSP during pregnancy may stem from agenesis of the septa or lack of formation or obliteration of the space between them. The cases with non-visualisation of CSP have been reported, presenting lipomas, cysts, hematoma, and other structures in CSP. Cases in which CSP is not confirmed, including the above cases, have very low incidence and are not frequently reported, so there are many limitations in predicting and consulting postnatal prognosis. The purpose of this study was to present our experience with a cohort of fetuses without callosal agenesis in which absence of fluid or increased echogenicity in the expected region of the CSP was observed and to evaluate the significance of this finding. 31 cases have reviewed and the mean value of maternal age at delivery was 32.54. The gestational age at diagnosis were reported as 20-24 weeks (17), 25-29 weeks (7), 30-34 weeks (5), less than 37 weeks (1) and 37 weeks or more (1). The ventricle was of normal size excepting 4 cases, and all the cisterna magna were within the normal range. Postnatal diagnoses were reported in 15 cases, including right hemimegalencephaly and left hemiparesis (1), normal (3), tiny subependymal cysts in bilateral caudothalamic grooves (1), absent septum pellucidum (2), small germinal matrix hemorrhage (1), bilateral subpendymal cyst (1), thin corpus callosum, but normal morphology (1), septo-optic dysplasia (1), and corpus callosum agenesis (4). In conclusion, although this study is a relatively small number of cases, multicentre review in Korea with non-visualisation CSP analysed prenatal and postpartum prognosis adding the reviews of international cases, which will be helpful for perinatal prognosis counselling.

To evaluate the usefulness of three-dimensional (3D) placental vascular index (VI) in uncomplicated pregnancies. This study is a prospective cohort study of singleton pregnancies between 20 40 weeks of gestation. Uncomplicated pregnant women without risk factors of placental insufficiency, such as maternal hypertension, diabetes, fetal growth restriction, were enrolled in the study. 3D placental volume vascular index (VI) were measured. An expert obstetrician achieved volume acquisition. Every measurement was done off-line after the scan by another obstetrician blinded to maternal information. To determine the intraobserver reproducibility of VI measurement, the intraclass correlation coefficient (ICC) was calculated. We also compared 3D VI values with previously studied 2D VI values in uncomplicated pregnancies, according to gestational age. The 3D VI was measured in 46 uncomplicated gravidas. The 3D VI showed high intraobserver correlation with values 0.893, indicating good reproducibility. There was no statistical difference in 3D VI values by gestational age, the average value of 3D VI was as followed: 52.4 ±12.2 for 20 weeks to 27 weeks 6 days, 45.3 ± 9.9 for 28 weeks to 33 weeks 6 days, 46.3 ± 12.8 for 34 weeks and later (p = 0.254). We compared the values of 3D VI and 2D VI of our previous study. The average value of the median 3D VI value was higher (47.4 ± 11.7 vs. 38.5 ± 14.7, p = 0.001) than that of 2D VI. 3D VI value was higher than 2D VI according to gestational age (52.4 ± 12.2 vs. 35.3 ± 14.9 for 20 weeks to 27 weeks 6 days, p = 0.003; 45.3 ± 9.9 vs. 37.3 ± 13.3 for 28 weeks to 33 weeks 6 days, p = 0.035), while at 34 weeks or more, there was no statistical significance (46.3 ± 12.8 vs. 41.4 ± 15.9 for 34 weeks and later, p = 0.285). In uncomplicated pregnancy, 3D VI shows good reproducibility. 3D VI value was not different among different gestational ages. The 3D VI value was higher than 2D VI. Larger studies may be necessary to utilise 3D VI value as a marker for placental insufficiency.

To evaluate whether the right modified myocardial performance index (Mod-RMPI) can predict adverse perinatal outcomes in pregnancies complicated with fetal growth restriction (FGR). We conducted a multicentre prospective study including 57 singleton pregnant women at 24-38 weeks of gestation complicated with FGR [estimated fetal weight (EFW) < 10th centile and 59 controls. We measured the Mod-RMPI by using MPI+ on HERA W10 (Samsung Medison Co. Ltd., Seoul, Republic of Korea) three times at every 191 examinations. We defined adverse perinatal outcomes as iatrogenic preterm delivery before 37 weeks, a birthweight < 2000g, 5-min Apgar < 7 or umbilical arterial pH < 7.200. We compared Mod-RMPI between FGR and control groups as well as evaluated whether there was a difference in Mod-RMPI according to the occurrence of perinatal outcomes in the FGR group. Although Mod-RMPI results were similar at initial examination [0.527 (0.368-0.677) vs. 0.555 (0.367-0.771), p = 0.066], there was a significant difference in the whole of Mod-RMPI results between two groups [0.520 (0.368-0.710) vs. 0.555 (0.367-0.781), p = 0.009]. There were 27 adverse perinatal outcomes among 93 deliveries. Interestingly, when we evaluated total tests, the median Mod-RMPI was higher in the adverse perinatal outcome group [0.527 (0.367-0.750) vs. 0.555 (0.377-0.781), p = 0.039]. Also, there were nine cases of adverse perinatal outcomes with normal umbilical artery Doppler (10/69,12.7%). Notably, we found that the Mod-RMPI result of these pregnancies were higher compared to normal perinatal outcomes [0.533 (0.367-0750) vs. 0.607 (0.437-0.781), p = 0.001]. Our data suggest the changes of Mod-RMPI could be preceded to umbilical artery Doppler deterioration. It could be used an ancillary tool to conventional fetal surveillance in the management of FGR pregnancies.

To assess the modified myocardial performance index (Mod-MPI) of fetal left and right heart in pregnant women with diabetes mellitus and compare it with the Mod-MPI in the control group. This was a multicentre prospective cross-sectional study to assess the Mod-MPI of the fetal heart for singleton pregnant women with diabetes mellitus in the third trimester. Mod-MPI was measured using an automated measurement system for the left heart and a semi-automated system for the right fetal heart (MPI+, Samsung Medison, Seoul, Republic of Korea). Singleton pregnant women with pregestational diabetes or gestational diabetes beyond 28 weeks of gestation were included in the diabetes group, and uncomplicated pregnant women were included in the control group. A total of 120 measurements (67 diabetes, 53 controls) were included in this study. The mean gestational age of measurement was 32.7 ± 2.4 weeks in the control group and 34.1 ± 3.4 weeks in the diabetes group. There was no significant difference for Mod-MPI of the left fetal heart between the diabetes and the control group (0.52 [0.47-0.57] vs. 0.50 [0.45-0.53], p = 0.067). Mod-MPI of the right heart was significantly higher in the diabetes group (0.57 [0.50-0.62]) compared to the control group (0.52 [0.47-0.57], p = 0.0070). However, there was no significant difference in Mod-MPI of the fetal right or left heart between pregestational diabetes and gestational diabetes group. Mod-MPI of the right fetal heart is significantly higher in the diabetes group and might have a predictive value of fetal cardiac function associated with the adverse perinatal outcome of diabetic pregnancy.

To provide reference ranges for fetal cardiac parameters by using HeartAssist™, an automated system for measuring such parameters, in 17 large referral centres in South Korea. This prospective study included normal singleton fetuses between 16.0 and 36.6 weeks of gestational age (GA) from October 2022 to February 2023. Video clips of the fetal hearts were collected, and a total of 34 parameters were measured in six cardiac views. In the four chamber view, we measured cardiac axis; thoracic area and circumference; heart area and circumference; atrial widths and areas; ventricular widths, lengths, and areas; and annular diameters of the tricuspid and mitral valves. In the outflow tract view, annular diameters of the aortic and pulmonary valves when open and closed and the diameter of the ascending aorta were measured. In the three vessel view, diameters of the pulmonary artery, aorta, superior vena cava, and thymus were measured. In the three-vessel tracheal view, diameters of the aortic isthmus and ductus arteriosus were measured. In the aortic arch view, the diameters of the ascending aorta, proximal and distal transverse aortic arches, aortic isthmus, and descending aorta were measured. The HeartAssist™ (Samsung Medison Co. Ltd., Seoul, Republic of Korea) was used for all measurements, which were further modified manually by two experts in fetal echocardiography. We analysed video clips from 350 fetuses and designed scatterplots for each parameter according to GA. The cardiac axis was constant throughout gestation, with a mean value of 37.2°. All other parameters increased gradually with advancing GA. The mean ratios of the left ventricular width and length to the right ventricular width and length were 0.96 and 1.09, respectively. Annular diameters of the aortic valve and pulmonary valve were larger when the valves were closed than when open. We established comprehensive reference ranges for fetal cardiac parameters by using HeartAssist™.

Objectives:We aimed to compare the maternal characteristics and neonatal outcomes according to the severity of pre-eclampsia, and to find out the changes in heart function of severe pre-eclampsia through maternal 2D-echocardiography.Methods: This is a retrospective study including 209 singleton pregnant women who performed echocardiography and delivered at 24 +1 -40 +2 weeks of gestation between March 2014 and December 2022 at our institution.Of those, 186 were diagnosed with pre-eclampsia.The subjects were divided into non-severe pre-eclampsia (Group 1) (N = 100) and severe pre-eclampsia (Group 2) (N = 86).We compared the maternal characteristics, pregnancy related complications, neonatal outcomes and echocardiographic findings between two groups.Results: Group 2 had a higher amount of urine protein excretion for 24 hours than Group 1 and laboratory results such as platelet, albumin, LDH, fibrinogen and antithrombin III also showed statistically significant differences.Group 2 also tended to have early delivery (32.8 ± 3.6 vs. 35.6 ± 2.7, weeks, p < 0.001), and emergency delivery was often performed for iatrogenic reasons caused by maternal condition.The 1-and 5-minute Apgar score below 7, neonatal intensive care unit admission, neonatal mortality and composite morbidity showed significant differences, too.In echocardiographic findings, there was no significant statistically difference in the ejection fraction (58.7 ± 4.7 vs. 59.34 ± 5.6, %, p = 0.379) or left ventricle systolic dysfunction (7.0% vs. 3.0%, p = 0.359) between the two groups, but Group 2 had a higher frequency of left ventricle wall hypertrophy (16.3% vs. 5.0%, p = 0.22) than group 1.Compared to Group 1, Group 2 had a higher left ventricle end diastolic volume (85.4 ± 22.5 vs.79.4 ± 18.2, p = 0.049) and the frequency of diastolic dysfunction (40.7% vs. 24.0%,p = 0.023) was higher.Conclusions: In severe pre-eclampsia, there is no significant difference in systolic function of heart compared to non-severe pre-eclampsia, but the frequency of diastolic dysfunction is high.EP18.15

32 weeks of gestation (aOR 0.70; 95% CI 0.56-0.89)remained significantly lower after the implementation of universal TVU-CL.There was a trend toward lower risk of sPTB < 37 weeks (aOR 0.89; 95% CI 0.79-1.00)after implementation of universal TVU-CL, however, the risk of sPTB < 34 weeks became non-significant.Conclusions: This meta-analysis showed a significantly lower rate of sPTB after the implementation of a universal TVU-CL screening that correctly identifies pregnant individuals at high risk of sPTB who may benefit from intervention and should therefore be advocated.

We aimed to determine whether cervical elastography (CE) could predict cervical ripening. We prospectively enrolled 83 singleton pregnancies between 37 and 40 weeks of gestation at our institution from July 2018 to March 2020. The strain ratio of the cervix was evaluated using the E cervix (WS80A, Samsung Medison, Seoul, Republic of Korea) after digital examination. We divided our subjects into 2 groups according to the digital examination Results: group 1 consisted of gravidas who had an unripened cervix; group 2 consisted of gravidas who had a ripened cervix. A ripened cervix was defined as a cervix that was dilated more than 1cm and more than 50% effaced. CE parameters such as the internal os (IOS), external os (EOS), IOS/EOS ratio, elasticity contrast index (ECI), hardness ratio (the percentage of upper 30% of the hardness area divided within the region of interest), and cervical length (CL) were compared between these groups. Group 1 had 48 (57.8%) subjects and group 2 had 35 (42.2%). There were 59 nulliparous and 24 multiparous women (70.7% vs. 71.4%, p = 0.953). We noted significant differences in CL (3.34 [2.23-4.84] vs. 1.98 [0.79-3.34] p < 0.001] and ECI [2.45 (1.24-6.76) vs. 3.03 (1.61-5.48), p = 0.033) between the 2 groups. While there was a significant difference in CL between the 2 groups, with both nulliparous and multiparous women (p < 0.001), there were no notable dissimilarities in ECI in multiparous women (2.60 [1.24-4.63] vs. 2.25 [1.61-4.79], p = 0.709) in the subgroup analysis. However, the difference in ECI between the 2 groups was strengthened in nulliparous women (2.41 [1.35-6.76] vs. 3.19 [2.19-5.48], p = 0.005). ECI could be used in the prediction of a ripened cervix in full-term pregnancies, especially in nulliparous women. This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1696).

The transabdominal probe (TP) is recommended to be positioned usually vertical to floor and parallel to maternal sagittal plane when measuring amniotic fluid index (AFI). However, many examiners report AFI measured in different ways. This study was performed to investigate the difference of AFI according to the positioning of TP. AFI was measured in 105 gravidas without fetal abnormalities from 20 to 40 weeks of gestation by four experienced examiners according to the technique proposed by Phelan et al. Maternal abdomen was divided into four quadrants using the umbilicus and linea nigra as landmarks. AFI was generated by the sum of these four values without umbilical cord or fetal parts. In each patient, AFI was measured by four different ways. Group 1: TP kept vertical to floor and parallel to maternal sagittal plane, Group 2: TP kept vertical to abdominal contour and parallel to maternal sagittal plane, Group 3: TP kept vertical to floor and parallel to maternal transverse plane, Group 4: TP kept vertical to abdominal contour and parallel to maternal transverse plane. Repeated Measures Analysis of Variance (RMANOVA) was used for statistical analysis. Mean gestational age at measure of AFI was 30.1 ± 5.7 weeks. AFI was different among four groups (15.24 ± 3.74 versus 16.93 ± 4.75 versus 14.75 ± 3.77 versus 15.98 ± 4.62, p<0.001). Post hoc analysis showed the difference in AFI existed between group 1 and 2 (p<0.001), group 2 and 4 (p=0.003) and group 3 and 4 (p<0.001). There was no difference in AFI between group 1 and 3 (p=0.385). AFI was overestimated when TP was positioned vertical to abdominal contour compared to which acquired by positioning TP vertical to floor. We need to use different reference values according to the positioning of TP. When we kept TP vertical to abdominal contour to measure AFI, the direction of TP also influenced on determination of AFI. This was not the case in TP kept vertical to floor. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

To compare clinical outcomes after fresh embryo transfer on laser-assisted zona pellucida opening (LAO) versus thinning (LAT) according to maternal age in patients with repeated implantation failure (RIF). A retrospective study of 509 (n = 458 patients) in vitro fertilization/intracytoplasmic sperm injection cycles was investigated from January 2013 to July 2017. We compared whether LAT and LAO affect the clinical outcomes in young maternal age (YMA, <38 years) and old maternal age (OMA, ≥38 years) patient groups with ≥2 of RIF. The cycles with an oocyte donation, oocyte activation, genetic diagnosis, and that used surrogate mothers were excluded. Participants were divided into 4 groups according to maternal age and the two types of laser-assisted hatching (YMA: LAT, n = 119 vs. LAO, n = 179 and OMA: LAT, n = 72 vs. LAO, n = 139). LAO was opened using 3-4 laser shot in the zona pellucida. The laser thinning was performed by making 3-4 holes without reaching the inner membrane at a depth of 60%-80% of the zona pellucida thickness. Laser-assisted hatching was performed 2 hours before the embryo transfer. The characteristics of patients did not differ significantly among the groups (p > 0.05), with the exception of mixed factor infertility, which was more common in the LAT group than in the LAO group among patients <38 years of age (10.1% vs. 2.8%, p = 0.008). We also observed similar rates of clinical pregnancy (27.7% vs. 24.6%, p = 0.543; 16.7% vs. 18.7, p = 0.715), ongoing pregnancy (22.7% vs. 21.8%, p = 0.854; 8.3% vs. 15.1, p = 0.163), abortion (18.2% vs. 11.4%, p = 0.397; 50.0% vs. 19.2, p = 0.052), implantation (17.2% vs. 16.5%, p = 0.811; 11.1% vs. 11.2, p = 0.990), and twin pregnancy (5.0% vs. 5.6%, p = 0.498; 0.0% vs. 2.2, p = 0.553) between LAT and LAO in the YMA or the OMA group. Clinical outcomes were similar between LAT and LAO in the YMA or the OMA group. However, the OMA group who underwent LAO tended to have a lower abortion rate. Further study is necessary to confirm these results in a larger population.

To evaluate the influence of overcome semen viscosity (SV) on clinical outcomes according to two types of insemination method (i.e., conventional in vitro fertilization or intracytoplasmic sperm injection) in fresh embryo transfer cycles. Retrospective cohort study of 681 IVF/ICSI cycles from January 2013 to October 2017. Cycles were divided into 4 groups according to the presence of SV and the types of insemination method (IVF: SV, n = 51 vs. no SV, n = 77 and ICSI: SV, n = 255 vs. no SV, n = 298). Cycles with poor responder, advanced maternal age (≥38 years), frozen sperm, and surgically retrieved sperm were excluded. Semen parameters were evaluated according to the WHO 2010. SV (length of ≥2 cm) was checked by gentle aspiration of liquefied semen into a 5-mL serological pipette and then allowing the semen to drop by gravity and observing the length of any thread. To overcome semen viscosity, a sterile 5-mL syringe fitted with a sterile 18G needle was used. The semen was gently drawn into the syringe and expelled slowly back into the tube and repeated. Semen was treated by swim-up method. Patients' characteristics between SV and no SV in the IVF or the ICSI group were not statistically significant difference (p > 0.05). We observed similar rates of fertilization and good-quality embryos on day 3 between SV and no SV in IVF or the ICSI group, respectively. Moreover, the rates of biochemical pregnancy, clinical pregnancy, ongoing pregnancy, miscarriage, and implantation per cycle also did not significantly differ between SV and no SV in the IVF or the ICSI group (p > 0.05).Tabled 1Table 1. Clinical outcomes in SV versus no SV according to insemination methodIVF-SVIVF-no SVp-valueICSI-SVICSI-no SVp-valueCycles (n)5177255298Oocytes fertilized rate (%)84.7 (533/629)83.1 (726/874)0.38673.7 (2238/3037)73.6 (2503/3401)0.931Good quality embryos rate (%)18.6 (99/533)21.8 (158/726)0.16514.3 (319/2238)15.8 (396/2503)0.132Biochemical pregnancy rate (%)60.8 (31/51)50.6 (39/77)0.25949.8 (127/255)48.3 (144/298)0.728Clinical pregnancy (%)51.0 (26/51)36.4 (28/77)0.10139.6 (101/255)37.2 (111/298)0.569Ongoing pregnancy (%)41.2 (21/51)33.8 (26/77)0.39532.9 (84/255)34.2 (102/298)0.749Abortion (%)19.2 (5/26)7.1 (2/28)0.24316.8 (17/101)8.1 (9/102)0.053Implantation (%)36.2 (38/105)25.5 (41/161)0.06123.7 (129/544)21.3 (132/621)0.316 Open table in a new tab When SV was overcome, it did not affect the clinical outcomes of fresh embryo transfer cycles regardless of insemination methods.

ObjectiveIt is recommended that thyroid-stimulating hormone (TSH) level of early pregnant women is maintained below than 2.5 mIU/L. However, the reference value of the preconception TSH has not been established. The purpose of this study is to determine whether the preconception TSH level is affecting the pregnancy outcome in women undergoing in vitro fertilization (IVF).DesignRetrospective study.Materials and MethodsSix hundred sixty-three infertile patients with normal range TSH level who underwent IVF for the first time were studied from June 2012 to December 2014. The study subjects were categorized in two groups according to their preconception TSH level; one with TSH < 2.5 mIU/L and the other with TSH ≥ 2.5 mIU/L. We compared the clinical pregnancy rates, live birth rates, chemical abortion rates and miscarriage rates in two group.ResultsFour hundred sixty patients of the study subjects had serum TSH level < 2.5 mIU/L and 203 patients ≥ 2.5 mIU/L. There were no statistically significant differences in age, periods of infertility, BMI, the number of metaphase II (MII) oocytes at ovum pick-up day, the number of transferred embryos and anti-müllerian hormone (AMH) level of patients between the study groups. The clinical pregnancy rate in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 40.90% and 42.90% respectively (p value= 0.632). The live birth rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 33.5% and 35% respectively (p value= 0.707). The chemical abortion rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 11.1% and 8.4% respectively (p value= 0.289). The miscarriage rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 18.1% and 18.4 % respectively (p value= 0.951).ConclusionsThere was no significant difference between the IVF outcomes of the normal-TSH-level groups of <2.5 mIU/L and ≥ 2.5 mIU/L. ObjectiveIt is recommended that thyroid-stimulating hormone (TSH) level of early pregnant women is maintained below than 2.5 mIU/L. However, the reference value of the preconception TSH has not been established. The purpose of this study is to determine whether the preconception TSH level is affecting the pregnancy outcome in women undergoing in vitro fertilization (IVF). It is recommended that thyroid-stimulating hormone (TSH) level of early pregnant women is maintained below than 2.5 mIU/L. However, the reference value of the preconception TSH has not been established. The purpose of this study is to determine whether the preconception TSH level is affecting the pregnancy outcome in women undergoing in vitro fertilization (IVF). DesignRetrospective study. Retrospective study. Materials and MethodsSix hundred sixty-three infertile patients with normal range TSH level who underwent IVF for the first time were studied from June 2012 to December 2014. The study subjects were categorized in two groups according to their preconception TSH level; one with TSH < 2.5 mIU/L and the other with TSH ≥ 2.5 mIU/L. We compared the clinical pregnancy rates, live birth rates, chemical abortion rates and miscarriage rates in two group. Six hundred sixty-three infertile patients with normal range TSH level who underwent IVF for the first time were studied from June 2012 to December 2014. The study subjects were categorized in two groups according to their preconception TSH level; one with TSH < 2.5 mIU/L and the other with TSH ≥ 2.5 mIU/L. We compared the clinical pregnancy rates, live birth rates, chemical abortion rates and miscarriage rates in two group. ResultsFour hundred sixty patients of the study subjects had serum TSH level < 2.5 mIU/L and 203 patients ≥ 2.5 mIU/L. There were no statistically significant differences in age, periods of infertility, BMI, the number of metaphase II (MII) oocytes at ovum pick-up day, the number of transferred embryos and anti-müllerian hormone (AMH) level of patients between the study groups. The clinical pregnancy rate in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 40.90% and 42.90% respectively (p value= 0.632). The live birth rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 33.5% and 35% respectively (p value= 0.707). The chemical abortion rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 11.1% and 8.4% respectively (p value= 0.289). The miscarriage rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 18.1% and 18.4 % respectively (p value= 0.951). Four hundred sixty patients of the study subjects had serum TSH level < 2.5 mIU/L and 203 patients ≥ 2.5 mIU/L. There were no statistically significant differences in age, periods of infertility, BMI, the number of metaphase II (MII) oocytes at ovum pick-up day, the number of transferred embryos and anti-müllerian hormone (AMH) level of patients between the study groups. The clinical pregnancy rate in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 40.90% and 42.90% respectively (p value= 0.632). The live birth rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 33.5% and 35% respectively (p value= 0.707). The chemical abortion rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 11.1% and 8.4% respectively (p value= 0.289). The miscarriage rates in the group of patients with TSH < 2.5 mIU/L and those with ≥ 2.5 mIU/L were 18.1% and 18.4 % respectively (p value= 0.951). ConclusionsThere was no significant difference between the IVF outcomes of the normal-TSH-level groups of <2.5 mIU/L and ≥ 2.5 mIU/L. There was no significant difference between the IVF outcomes of the normal-TSH-level groups of <2.5 mIU/L and ≥ 2.5 mIU/L.

To identify the most viable embryo is the main goal for embryo selection. However, it still remains a challenge despite the numerous scoring methods currently in use. This study was performed to determine whether the sequential embryo assessment on day 2 and day 3 could be a simple and non-invasive method for embryo selection. A retrospective cohort study was conducted between June 2012 and May 2015. A total of 416 cycles (younger than 36 years) which underwent GnRH agonist or antagonist protocol with fresh embryo transfer were analyzed. Cycles with oocyte/sperm donation, surrogacy, preimplantation genetic screening, severe male factor, surgically retrieved sperm, or frozen sperm were excluded. The sequential embryo assessment (SEA, n=202) was performed on day 2 and day 3, four-cell stage embryos were selected and cultured separately from non-4-cell stage at 40-42 hours after insemination and then 8-cell stage embryos with good morphology derived from pre-selected 4-cell stage were sequentially selected at 64-66 hours after insemination. The morphological assessment only (MAO, n=214) was performed on day 3, eight-cell stage embryos with good morphology were selected at 64-66 hours after insemination without pre-selection. There were no differences between SEA and MAO regarding female age (32.7 ± 2.3 vs. 32.4 ± 2.3, p=0.128), number of previous IVF failure (0.5 ± 0.8 vs. 0.6 ± 1.0, p=0.060), number of retrieved oocytes (13.1 ± 5.8 vs. 12.4 ± 6.1, p=0.259), maturation rate (93.2% vs. 93.6%, p=0.332), fertilization rate (76.8% vs. 80.1%, p=0.952), 4-cell stage embryo formation rate (42.2% vs. 40.9%, p=0.559), and number of transferred embryos (2.0 ± 0.2 vs. 1.9 ± 0.2, p=0.765). However, SEA achieved significantly higher rates of biochemical pregnancy (71.3% vs. 55.1%, p=0.001), clinical pregnancy (60.9% vs. 46.3%, p=0.003), ongoing pregnancy (54.5% vs. 41.6%, p=0.009), and implantation (43.4% vs. 32.0%, p=0.001) than those of MAO. Although the rate of 4-cell stage embryo formation was similar in the two groups, transfer of sequentially assessed embryos results in significantly higher rates of biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and implantation. Therefore the sequential embryo assessment on day 2 and day 3 could be a simple and non-invasive method for embryo selection in human IVF.

To investigate an influence of abstinence period on clinical outcomes in fresh embryo transfer after intracytoplasmic sperm injection (ICSI). A retrospective cohort study of 122 women who underwent 131 ICSI cycles from January 2013 to February 2015. All women who underwent long or antagonist protocol with fresh embryo transfer after ICSI were analyzed. Cycles were divided into two groups; 2-4 days of abstinence (Group 1, n=67) and 5-7 days of abstinence (Group 2, n=64). Cycles with poor responder, advanced maternal age (≥38 years), frozen sperm, and surgically retrieved sperm were excluded. Day3 top-quality embryos were defined as those having even blastomeres and no fragments. We compared the rates of day3 top-quality embryos, implantation, chemical pregnancy, clinical pregnancy, and ongoing pregnancy between group 1 and group 2. There were no significant differences between group 1 and group 2 regarding mean maternal age (32.6 ± 2.9 vs. 32.8 ± 2.6, p=0.590), mean paternal age (35.2 ± 3.5 vs. 34.7 ± 4.0, p=0.509), mean number of previous IVF cycles (0.3 ± 0.5 vs. 0.2 ± 0.4, p=0.105), mean number of retrieved oocytes (13.1 ± 4.2 vs.14.4 ± 6.5, p=0.170), maturation rate (90.4% vs. 88.1%, p=0.084), fertilization rate (77.5% vs. 72.9%, p=0.102), and mean number of transferred embryos (2.2 ± 0.5 vs. 2.3 ± 0.6, p=0.223). We also observed similar rates of day3 top-quality embryos (11.4% vs. 7.3%, p=0.121), implantation (28.3% vs. 22.6%, p=0.266), chemical pregnancy (49.3% vs. 48.4%, p=0.926), clinical pregnancy (44.8% vs. 43.8%, p=0.906), and ongoing pregnancy (41.8% vs. 35.9%, p=0.492) in group 1 and group 2. Our data showed that 2-7 days of abstinence recommended by the WHO did not influence on the rates of day3 top-quality embryos, and clinical outcomes in fresh embryo transfer after ICSI.

This study investigates the effects of strain ratio and strain rate on microstructure and magnetic properties of Nd-Fe-B nanocrystalline magnets during hot-deformation process. The consolidated Nd-Fe-Ga-Co-B isotropic magnet is prepared by hot-pressing under 100 MPa in a vacuum. Field emission scanning electron microscopy, transmission electron microscopy, and vibrating sample magnetometry are used for characterization. Observations show that the remanence and coercivity tended to increase and decrease with increasing strain ratio, respectively. Moreover, remanence increases while coercivity decreases as strain rate decreases. These results indicate that slow strain rate is favorable for improvement of remanence with well-aligned grains. However, a change in grain boundary phase as thinned Nd-rich phase is a major drawback, caused by increasing strain ratio including extended deformation time in slow strain-rate hot-deformation process.