Since the publication of the first edition of the WHO (World Health Organization) Laboratory Manual for the examination of Human Semen in 1980, the reference values of sperm parameters have been updated on four occasions. Currently and globally, most of the laboratories analyzing semen samples use the latest, 5th edition of the manual that recommends ejaculatory abstinence from two to seven days before producing the sample for examination. While this standardized interval of time facilitates the interpretation of the results and research, no solid evidence exists to support the WHO-recommended abstinence time for a semen analysis in order to optimize clinical outcomes after assisted reproduction. Most of the studies refer to different clinical outcomes, different groups of patients and different editions of the WHO Laboratory Manual, including heterogeneous intervals of abstinence or sperm parameters. The aim of the current systematic review was to evaluate available evidence correlating ejaculatory abstinence time with clinical outcomes and sperm parameters analyzed according to the last edition of the World Health Organization Laboratory Manual reference values in different male populations. The results from the included studies indicate that WHO abstinence recommendations may need revision, given that a shorter ejaculatory abstinence interval appears to be associated with improved sperm parameters, such as sperm DNA fragmentation, progressive motility or morphology, while evidence suggests a potential increase in embryo euploidy rates and pregnancy outcomes.

ObjectiveTo measure Irish opinion on a range of assisted human reproduction (AHR) treatments.MethodsA nationally representative sample of Irish adults (n=1,003) were anonymously sampled by telephone survey.ResultsMost participants (77%) agreed that any fertility services offered internationally should also be available in Ireland, although only a small minority of the general Irish population had personal familiarity with AHR or infertility. This sample finds substantial agreement (63%) that the Government of Ireland should introduce legislation covering AHR. The range of support for gamete donation in Ireland ranged from 53% to 83%, depending on how donor privacy and disclosure policies are presented. For example, donation where the donor agrees to be contacted by the child born following donation, and anonymous donation where donor privacy is completely protected by law were supported by 68% and 66%, respectively. The least popular (53%) donor gamete treatment type appeared to be donation where the donor consents to be involved in the future life of any child born as a result of donor fertility treatment. Respondents in social class ABC1 (58%), age 18 to 24 (62%), age 25 to 34 (60%), or without children (61%) were more likely to favour this donor treatment policy in our sample.ConclusionThis is the first nationwide assessment of Irish public opinion on the advanced reproductive technologies since 2005. Access to a wide range of AHR treatment was supported by all subgroups studied. Public opinion concerning specific types of AHR treatment varied, yet general support for the need for national AHR legislation was reported by 63% of this national sample. Contemporary views on AHR remain largely consistent with the Commission for Assisted Human Reproduction recommendations from 2005, although further research is needed to clarify exactly how popular opinion on these issues has changed. It appears that legislation allowing for the full range of donation options (and not mandating disclosure of donor identity at a stipulated age) would better align with current Irish public opinion.

Objective: Birth weight is an important predictive parameter for neonatal morbidity and mortality. Accurate estimation of fetal weight is therefore a valuable tool for determining further obstetric management. Commonly used weight formulae have a lack of accuracy. The aim of this study was to develop and to evaluate new formulae specifically designed for different ranges of fetal abdominal circumference (AC). Methods: This study included 5314 pregnancies. Inclusion criteria were singleton pregnancy, ultrasound examination with complete biometric parameters within 7 days before delivery, and absence of structural or chromosomal malformations. With regard to sonographic AC measurements, four subgroups were built (AC: ≤ 290 mm; AC: 291-330 mm; AC: 331-359 mm; AC: ≥ 360 mm). For each population, best-fit formulae were derived by forward regression analysis with standard biometric measurements as independent variables and birth weight and log(birth weight) as dependent variables, respectively. Finally, accuracy of the new formulae was compared with commonly used weight equations. Results: In all subgroups, except for AC measurements between 331-359 mm, the new weight formulae demonstrated significantly improved accuracy compared to commonly used formulae. Conclusion: Especially in the lower und upper ranges of AC measurements, specifically designed equations help to improve fetal weight estimation. OP27.05Customized versus population-based standards at a routine third-trimester ultrasound for prediction of SGA at birth Obstetrics, Hospital Clinic, Barcelona, SpainObjective: To compare customized versus population-based standards at routine third trimester US for the prediction of SGA at birth. Methods: A total of 455 consecutive routine US examinations at third trimester (30.0-35.6 weeks) were included. Estimated fetal weight (EFW) was calculated by Hadlock formula including biparietal diameter, head circumference, abdominal circumference and femur length. Both population-based and customised standards were applied to the EFW. Customised centiles were calculated by adjusting for maternal height, booking weight, parity, ethnic origin, gestational age at delivery and fetal sex. SGA was defined as a birthweight below the 10 th centile according local standards. Results: SGA was confirmed at birth in 55 cases. A total of 27 and 38 fetuses had an EFW below the 10 th centile according population-based and customized standards, respectively. Both standards showed a 4% false positive rate. However, sensitivity was 2-fold higher (47.8 vs. 23.9%) and positive likelihood ratio 1.9-fold higher (12 versus 6.1) for customized than for population-based standards. Conclusions: Application of customized standards to routine thirdtrimester ultrasound fetal weight estimation improves the prediction of SGA at birth. If the first ultrasound estimation was over 4000g, performed by a sonographist mid-wife, a second operator (Ob-Gyn), blinded to the first sonography, repeated the biometry within 24 hours. Two Hadlock formulas were used (F1:...

Desde la introducción de los tratamientos de reproducción asistida, hace ya más de 40 años, ha habido un creciente interés por conocer la función de la P, tanto en los ciclos naturales como en los de FIV y de transferencia de embriones criopreservados. Su impacto directo en los resultados clínicos en varios niveles activó varias líneas de investigación, con algunas de ellas aún abiertas hoy en día. En este capítulo describimos la evidencia disponible actualmente para valorar la implicación de la P en TRA y revisamos los factores que pueden modificar los niveles de P sérica, así como los que pueden interferir en su lectura correcta a la hora de analizar el resultado obtenido del laboratorio.

Study question Is ejaculatory abstinence period (EAP) associated with semen parameters in males undergoing preliminary fertility investigation? Summary answer Short EAP is associated with increased progressive motility (%), vitality but with reduced volume, concentration, total sperm count. No association was indentified with morphology, DNA fragmentation. What is known already It is known that semen parameters may present important intra-individual variations. At present, the last edition of the WHO Manual recommends ejaculatory abstinence from two to seven days for semen analysis. Nonetheless, this period is not supported by some relevant bodies in the reproductive field guidelines that limit abstinence period to three or four days. Recently published reviews on this matter support that the relationship between the abstinence time and sperm quality is not straightforward. Therefore the aim of this study is to analyze correlation between the ejaculatory abstinence time and sperm parameters in patients having initial work-up in our clinic. Study design, size, duration We conducted a retrospective cross-sectional study on the diagnostic semen samples from individuals having their initial fertility investigation in the Fertility Department of a University Affiliated Hospital between the beginning of 1997 and the end of 2022. Basic semen parameters and sperm deoxyribonucleic acid (DNA) fragmentation were registered in 14067 and 784 samples respectively. Sperm morphology was analysed in 4812 samples. Participants/materials, setting, methods We included exclusively results from the first diagnostic semen sample from males of any age undergoing preliminary infertility work-up. All samples were produced on-site and analysed “ad hoc” for basic semen parameters (according to 6th Edition of WHO Manual) or/and sperm DNA fragmentation (Sperm Chromatin Dispersion test). Samples were divided according to EAP: ≤2(A-group); 2-7(B-group); >7 days (C-group) and compared with ANOVA. Additionally, Spearman Correlation was used to confirm correlation between EAP and sperm parameters. Main results and the role of chance Semen analysis was performed either completely manually (23.4%) or with the use of Computer Assisted Semen Analysis (CASA) system (76.6%) with the exception of morphology which was always assessed manually. Overall, 661 samples were produced after ≤2 days of abstinence, 12734 after 2 to maximum 7 days and 690 after >7 days of which ones 330(50%), 6798(53%) and 336(49%) were normozoospermic, respectively. Mean male age was 39 years (SD 6.5) and EAP 4.5 days (SD 1.9). We found the following parameters positively correlated with EAP in both normozoospermic and abnormal samples: volume (A-2.6ml; B-3.6ml; C-4ml, p < 0.05), concentration (A-72M/ml; B-93M/ml; C-127M/ml, p < 0.05), total sperm count (A-161M; B-285M; C-472M, p < 0.05), total motile count (A-111M; B-186M; C-270M, p < 0.05), straightness coefficient (STR) (A-73.1; B-75.7; C-77.8%, p < 0.05) and Zinc concentration (A-14277; B-17375; C-22538µg/dl, p < 0.05). The following parameters were negatively correlated with EAP in both normozoospermic and abnormal samples: progressive motility (A-46; B-43.6; C-36.6%, p < 0.05), vitality (A-60.5; B-60.3; C-53.7%, p < 0.05). We did not find any correlation with leucocytes, fructose, morphology or DNA fragmentation in unselected patients. However, in the group of abnormal samples there was a negative correlation between EAP and morphology (A-3.7; B-3.1; C-2.8%, p < 0.05) and DNA fragmentation, in generalized additive model (Spearman-Correlation, R2 0.01, p < 0.05). Limitations, reasons for caution This is a cross-sectional study which demonstrates only association and does not allow establishment of a cause-effect relationship between EAP and sperm parameters. Additionally, despite significant correlation between EAP and some sperm parameters, its clinical usefulness remains unclear. Wider implications of the findings To our knowledge this is first study correlating EAP with semen parameters only from diagnostic semen samples produced on-site, which confirms that the abstinence time should be seriously considered when analysing ejaculates, especially when borderline results are obtained. Additionally, different clinical strategies may be considered for normo and non-normozoospermic patients. Trial registration number not applicable