Ehy Ng

A double‐blind randomised controlled trial on the effect of dehydroepiandrosterone on ovarian reserve markers, ovarian response and number of oocytes in anticipated normal ovarian responders

To assess the effect of dehydroepiandrosterone (DHEA) on antral follicle count (AFC), ovarian response to a standard low dose of gonadotrophin stimulation and number of oocytes in anticipated normal responders undergoing in vitro fertilisation (IVF).

Endometrial vascularity is lower in pregnancies with pregnancy‐induced hypertension or small‐for‐gestational‐age fetus in live birth after in‐vitro fertilization

To assess the relationship between endometrial/subendometrial vascularity and the risk of pregnancy‐induced hypertension (PIH) or small‐for‐gestational‐age (SGA) fetuses in women who had a live birth following in‐vitro fertilization (IVF).

Hyperglycemia impedes definitive endoderm differentiation of human embryonic stem cells by modulating histone methylation patterns

Exposure to maternal diabetes during fetal growth is a risk factor for the development of type II diabetes (T2D) in later life. Discovery of the mechanisms involved in this association should provide valuable background for therapeutic treatments. Early embryogenesis involves epigenetic changes including histone modifications. The bivalent histone methylation marks H3K4me3 and H3K27me3 are important for regulating key developmental genes during early fetal pancreas specification. We hypothesized that maternal hyperglycemia disrupted early pancreas development through changes in histone bivalency. A human embryonic stem cell line (VAL3) was used as the cell model for studying the effects of hyperglycemia upon differentiation into definitive endoderm (DE), an early stage of the pancreatic lineage. Hyperglycemic conditions significantly down-regulated the expression levels of DE markers SOX17, FOXA2, CXCR4 and EOMES during differentiation. This was associated with retention of the repressive histone methylation mark H3K27me3 on their promoters under hyperglycemic conditions. The disruption of histone methylation patterns was observed as early as the mesendoderm stage, with Wnt/β-catenin signaling being suppressed during hyperglycemia. Treatment with Wnt/β-catenin signaling activator CHIR-99021 restored the expression levels and chromatin methylation status of DE markers, even in a hyperglycemic environment. The disruption of DE development was also found in mouse embryos at day 7.5 post coitum from diabetic mothers. Furthermore, disruption of DE differentiation in VAL3 cells led to subsequent impairment in pancreatic progenitor formation. Thus, early exposure to hyperglycemic conditions hinders DE development with a possible relationship to the later impairment of pancreas specification.

Human varicella zoster virus is not present in the semen of a man affected by chickenpox during the in vitro fertilisation of his wife

Human varicella zoster virus (VZV) is a member of the herpes virus family and affects humans only. Information about the presence of the virus in the semen samples of men affected by chickenpox is rather limited in the literature. Here, we reported a husband was affected by VZV during in vitro fertilisation treatment of his wife treated in our centre. The semen sample was checked for the presence of VZV by the PCR technique. The PCR result found no detectable viral DNA in the semen sample. The semen sample was then used for conventional IVF insemination and subsequently a healthy baby boy was born. This single case report suggests that the semen sample of men affected by chickenpox may be safe to use for assisted reproduction methods during the VZV infective period.

Ulipristal acetate may contribute to contraceptive action by its effects on tubal function

This journal suppl. entitled: Book of Abstracts of the First Global Conference on Contraception, Reproductive and Sexual HealthObjectives: Since the 1994 Cairo conference on Population and Development, the liberty of women and couples to decide freely on the number and timing of their children is widely recognised as a human right. One of the consequences of this consensus, the necessity to provide universal access to modern family planning methods, has however proven difficult to realise. Despite the obvious beneficial impacts of generalised access to family planning services on maternal and child health, as well as on the economic, social and psychological well-being of individuals and communities, the number of women who dont have access to FP today is still estimated at 222,000. In some countries, the percentage of women who are willing to delay or avoid pregnancy but have no access to modern methods reaches 40%. Advocates for providing universal access to family planning are traditionally to be found in circles of health care and womens rights, and their efforts to raise funding and political support for their cause is often hampered by competition with other causes, many of them undoubtedly being of comparable importance. One of these is the preservation of the environment and the fight against climate change. In a world of scarce resources, competition is unavoidable, but identifying synergies between causes and joining forces across sectors may lead to broader support and more successful policies and programmes. n nMethods: In this presentation, we explore the interrelatedness between meeting the unmet need for family planning on the one hand, and fighting climate change and environmental deterioration on the other. n nResults: Population size is – together with lifestyle and use of technology – one of the main drivers of climate change. Reducing fertility and slowing down population growth have significant impacts on emission of greenhouse gasses, and one would expect that this is reflected in considerable attention and support from political and societal actors in the field of environment, for policies that are aimed at improving access to contraception. In practice however, the issues of family planning and demography are largely absent in the climate change debates. Similarly, population is an important stress factor on many natural resources and vulnerable ecosystems, but conservation activities rarely include family planning initiatives. n nConclusions: We conclude by pointing at opportunities for synergies and mutual reinforcement of environmental and demographic research, policy and action, and we plead for an integrated policy approach to tackle environmental and family planning issues.

P13.03: First‐trimester growth in fetuses from assisted reproduction and spontaneous pregnancies

1. Dating pregnancies using ultrasound alone changed the EDD on an average by +2.5 days. 2. In May 2002, overall 40.8% of women had their labors induced as compared to 27.2% in May 2005 (p = 0.003). In 13.1% of women (54 of 411) the indication for IOL was prolonged pregnancy (< 41 weeks) in May 2002 as compared to 8.0% (35 of 439) in May 2005 (p = 0.03). Conclusions: Introduction of policy to date pregnancies using ultrasound alone resulted in a change of the EDD by an average of +2.5 days and a significant reduction in the rate of IOL for prolonged pregnancy.

P10.17: Intrauterine growth velocity in assisted reproduction and spontaneous pregnancies

Objectives: To construct new reference charts and equations for fetal biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) using a large sample of fetuses examined at 15–40 weeks in France. To compare this new reference with previous ones. Materials and methods: The study data were obtained from a population of pregnancies undergoing ultrasound examination over a continuous one-year period. Exclusion criteria were: known abnormal karyotype or congenital malformation, multiple pregnancies, no first trimester dating based on crown-rump length No exclusion was made on the basis of abnormal biometry or birth weight. For each measurement, separate regression models were fitted to estimate both the mean and standard deviation at each gestational age. Results: Complete biometric measurements were obtained in 19 647 fetuses. New charts and reference equations are presented for BPD, HC, AC and FL. Prediction intervals for the new reference were comparable to those of previous references, whereas there were some difference in the predicted centiles among references. Conclusion: We have presented new French reference charts and equations for fetal biometry. They can be easily used to compute centiles and Z-scores, to control quality of biometric assessment as well as to evaluate their performance as compared to other references.

OC148: Reduced ovarian stromal blood flow and elevated serum FSH level after abdominal hysterectomy for benign conditions

and relate the results to studies on ultrasound diagnosis in view of necessity of surgical intervention. Material and Methods: Two-hundred and thirty-four ovaries of postmenopausal women, who had died from non-gynaecological diseases, were examined prospectively and consecutively, by the pathologist (G.P. Blom), for cystic structures. The results were compared to recent ultrasound studies of adnexal cysts. Results: Ovarian cysts were found in 15.4% of the women. Paraovarian cysts were found in 4.7% of the women. All cysts were benign, except for one woman, who had bilateral serous cystadenoma of borderline type. Macroscopically the borderline cysts were multilocular with mean diameters of 60 mm and 15 mm, respectively. Conclusions: The results were in agreement with diagnostic ultrasound studies. The fact that we found benign ovarian and paraovarian cysts in 21.1% of the women should in our opinion make the gynecologists reconsider the need for surgical intervention in favor of follow-up.