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STUDY QUESTION Is there a serum progesterone (P) threshold on the day of embryo transfer (ET) in artificial endometrium preparation cycles below which the chances of ongoing pregnancy are reduced? SUMMARY ANSWER Serum P levels <8.8 ng/ml on the day of ET lower ongoing pregnancy rate (OPR) in both own or donated oocyte cycles. WHAT IS KNOWN ALREADY We previously found that serum P levels <9.2 ng/ml on the day of ET significantly decrease OPR in a sample of 211 oocyte donation recipients. Here, we assessed whether these results are applicable to all infertile patients under an artificial endometrial preparation cycle, regardless of the oocyte origin. STUDY DESIGN, SIZE, DURATION This prospective cohort study was performed between September 2017 and November 2018 and enrolled 1205 patients scheduled for ET after an artificial endometrial preparation cycle with estradiol valerate and micronized vaginal P (MVP, 400 mg twice daily). PARTICIPANTS/MATERIALS, SETTING, METHODS Patients ≤50 years old with a triple-layer endometrium ≥6.5 mm underwent transfer of one or two blastocysts. A total of 1150 patients treated with own oocytes without preimplantation genetic testing for aneuploidies (PGT-A) (n = 184), own oocytes with PGT-A (n = 308) or donated oocytes (n = 658) were analyzed. The primary endpoint was the OPR beyond pregnancy week 12 based on serum P levels measured immediately before ET. MAIN RESULTS AND THE ROLE OF CHANCE Women with serum P levels <8.8 ng/ml (30th percentile) had a significantly lower OPR (36.6% vs 54.4%) and live birth rate (35.5% vs 52.0%) than the rest of the patients. Multivariate logistic regression showed that serum P < 8.8 ng/ml was an independent factor influencing OPR in the overall population and in the three treatment groups. A significant negative correlation was observed between serum P levels and BMI, weight and time between the last P dose and blood tests and a positive correlation was found with age, height and number of days on HRT. Multivariate logistic regression showed that only body weight was an independent factor for presenting serum P levels <8.8 ng/ml. Obstetrical and perinatal outcomes did not differ in patients with ongoing pregnancy regardless of serum P levels being above/below 8.8 ng/ml. LIMITATIONS, REASONS FOR CAUTION Only women with MVP were included. Extrapolation to other P administration forms needs to be validated. WIDER IMPLICATIONS OF THE FINDINGS This study identified the threshold of serum P as 8.8 ng/ml on the day of ET for artificial endometrial preparation cycles necessary to optimize outcomes, in cycles with own or donated oocytes. One-third of patients receiving MVP show inadequate levels of serum P that, in turn, impact the success of the ART cycle. Monitoring P levels in the mid-luteal phase is recommended when using MVP to adjust the doses according to the needs of the patient. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER NCT03272412.

The risk of fetal aneuploidies is usually estimated based on high resolution ultrasound combined with biochemical determination of criterion in maternal blood, with invasive procedures offered to the population at risk. The purpose of this study was to investigate the effectiveness of a new rapid aneuploidy screening test on amniotic fluid (AF) or chorionic villus (CV) samples based on BACs-on-Beads (BoBs) technology and to compare the results with classical karyotyping by Giemsa banding (G-banding) of cultured cells in metaphase as the gold standard technique. The prenatal-BoBs kit was used to study aneuploidies involving chromosomes 13, 18, 21, X, and Y as well as nine microdeletion syndromes in 321 AF and 43 CV samples. G-banding of metaphase cultured cells was performed concomitantly for all prenatal samples. A microarray-based comparative genomic hybridization (aCGH) was also carried out in a subset of samples. Prenatal-BoBs results were widely confirmed by classical karyotyping. Only six karyotype findings were not identified by Prenatal-BoBs, all of them due to the known limitations of the technique. In summary, the BACs-on-Beads technology was an accurate, robust, and efficient method for the rapid diagnosis of common aneuploidies and microdeletion syndromes in prenatal samples.

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Results: From the 3155 volume datasets included in this study, two-hundred and ninety-four cases presented with CUA. 95.21% volume datasets were declared by both operators as interpretable. The intraobserver agreement was 0.88 and the interobserver agreement was 0.89 (95% CI:, 0.72, 0.93), representing very good agreement. Conclusions:The subjective assessment of 3D transvaginal US findings (also called the pattern recognition) is an excellent method for discriminating between a normal and an abnormal shaped uterus. These results may support incorporating this tool in routine gynecological scanning. Objectives: To assess the diagnostic test accuracy of measurements suggested by ESHRE/ESGE and ASRM for distinguishing between normal/arcuate and septate uterus using experts' opinion as reference standard. Methods: We included 100 women evaluated between Jun-2016 and Jul-2016 with suspected uterine anomaly. The images of the coronal plane of these uteri were submitted to 15 experts for distinguishing between normal/arcuate (normal uterine morphology or degree of distortion caused by the internal indentation is not clinically relevant) and septate uterus (the degree of distortion caused by the internal indentation is clinically relevant). Two observers (>10y experience with 3D-ultrasound), blinded to each other results and to the opinion of the experts, measured the indentation depth, indentation angle, and indentation to wall thickness (I:WT) ratio. The average value was used to assess the area under ROC curve (AUROC) and the best cut-off values using Youden's index. EP27.07Results: There were 18 septate and 82 normal/arcuate uteri based on the experts' opinion. The diagnostic test accuracy of the three measurements was very good: AUROC=1.00/0.96/0.99, 95%CI=0.96-1.00/0.90-0.99/0.94-1.00; indentation depth, indentation angle and I:WT ratio respectively. The best cut-off values were: indentation depth ≥10mm, indentation angle ≤136 • , and I:WT ratio ≥110%. Conclusions: All the three measurements have good diagnostic test accuracy for distinguishing between normal/arcuate and septate uterus. However, the suggested cut-off values for indentation angle (<90 • by ASRM) and for I:WT ratio (>50% by ESHRE-ESGE) should be revised. EP27.08Feasibility study on the use of ultrasound scan for the insertion of postpartum contraceptive device (PPIUD) following vaginal delivery T. Padeniya District General Hospital, Nawalapitiya, Kandy, Sri LankaObjectives: Aim of this study was to evaluate the feasibility of new method of ultrasound guided insertion of intra uterine copper contraceptive (IUD) during post partum period. Methods: This study was conducted prospectively in one of the district general hospital in Sri Lanka. All consented woman without contraindications were positioned dorsally and strict sterile technique was gathered. Non dominant hand was used to stabilise the uterus at the posterior fornix. IUD was placed at the fundus of the uterus under ultrasound guidance using dominant hand while the other operator holding the u...