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Background: The Live Birth Rate (LBR) after day 5 (D5) blastocyst transfer is significantly higher than that with D6 embryos in both fresh and frozen-vitrified embryo transfer cycles, according to the most recently published meta-analyses. Therefore, for women obtaining only D6 blastocysts, the chances of pregnancy may be lower but nonetheless sufficient to warrant transferring such embryos. The best strategy for transfer (i.e., in fresh versus frozen cycles) remains unclear and there is a paucity of data on this subject., Methods: A total of 896 couples with D6 single blastocyst transfers were retrospectively analyzed: patients receiving a fresh D6 embryo transfer (Fresh D6 transfer group, n = 109) versus those receiving a frozen-thawed D6 embryo transfer (Frozen D6 transfer group, n = 787). A subgroup comprising a freeze-all cycle without any previous fresh or frozen D5 embryo transfers (Elective frozen D6, n = 77) was considered and also compared with the Fresh D6 transfer group. We compared LBR between these two groups. Correlation between D6 blastocyst morphology according to Gardner's classification and live birth occurrence was also evaluated. Statistical analysis was carried out using univariate and multivariate logistic regression models., Results: The LBR was significantly lower after a fresh D6 blastocyst transfer compared to the LBR with a frozen-thawed D6 blastocyst transfer [5.5% (6/109) vs. 12.5% (98/787), p = 0.034]. Comparison between LBR after Elective frozen D6 group to the Fresh D6 blastocyst transfers confirmed the superiority of frozen D6 blastocyst transfers. Statistical analysis of the blastocyst morphology parameters showed that both trophectoderm (TE) and inner cell mass (ICM) grades were significantly associated with the LBR after D6 embryo transfer (p < 0.001, p = 0.037). Multiple logistic regression revealed that frozen D6 thawed transfer was independently associated with a higher LBR compared with fresh D6 transfer (OR = 2.54; 95% CI: [1.05-6.17]; p = 0.038). Our results also show that transferring a good or top-quality D6 blastocyst increased the chances of a live birth by more than threefold., Conclusions: Our results indicate that transferring D6 blastocysts in frozen cycles improves the LBR, making it the best embryo transfer strategy for these slow-growing embryos., Clinical Trial Number: Not applicable., (© 2024. The Author(s).)

Study Question: Do severe endometriosis-related painful symptoms impact ART live birth rates?, Summary Answer: Severe pain symptoms are not associated with reduced ART live birth rates in endometriosis patients., What Is Known Already: ART is currently recognized as one of the main therapeutic options to manage endometriosis-related infertility. Presently, no data exist in the literature regarding the association between the core symptom of the disease, e.g. pain and ART reproductive outcomes., Study Design, Size, Duration: Observational cohort study of 354 endometriosis patients, who underwent ART at a tertiary care university hospital, between October 2014 and October 2021. Diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography and magnetic resonance imaging, and histologically confirmed in women who had a previous history of endometriosis surgery (n = 127, 35.9%)., Participants/materials, Setting, Methods: The intensity of painful symptoms related to dysmenorrhea (DM), dyspareunia (DP), noncyclic chronic pelvic pain, gastrointestinal (GI) pain, or lower urinary tract pain was evaluated using a 10-point visual analog scale (VAS), before ART. Severe pain was defined as having a VAS of 7 or higher for at least one symptom. The main outcome measure was the cumulative live birth rate (CLBR) per patient. We analyzed the impact of endometriosis-related painful symptoms on ART live births using univariable and multivariate analysis., Main Results and the Role of Chance: Three hundred and fifty-four endometriosis patients underwent 711 ART cycles. The mean age of the population was 33.8 ± 3.7 years, and the mean duration of infertility was 3.6 ± 2.1 years. The distribution of the endometriosis phenotypes was 3.1% superficial endometriosis, 8.2% ovarian endometrioma, and 88.7% deep infiltrating endometriosis. The mean VAS scores for DM, DP, and GI pain symptoms were 6.6 ± 2.7, 3.4 ± 3.1, and 3.1 ± 3.6, respectively. Two hundred and forty-two patients (68.4%) had severe pain symptoms. The CLBR per patient was 63.8% (226/354). Neither the mean VAS scores for the various painful symptoms nor the proportion of patients displaying severe pain differed significantly between patients who had a live birth and those who had not, based on univariate and multivariate analyses (P = 0.229). The only significant factors associated with negative ART live births were age >35 years (P < 0.001) and anti-Müllerian hormone levels <1.2 ng/ml (P < 0.001)., Limitations, Reasons for Caution: The diagnosis of endometriosis was based on imaging rather than surgery. This limitation is, however, inherent to the design of most studies on endometriosis patients reverting to ART first., Wider Implications of the Findings: Rather than considering a single argument such as pain, the decision-making process for choosing between ART and surgery in infertile endometriosis patients should be based on a multitude of aspects, including the patient's choice, the associated infertility factors, the endometriosis phenotypes, and the efficiency of medical therapies in regard to pain symptoms, through an individualized approach guided by a multidisciplinary team of experts., Study Funding/competing Interest(s): No funding; no conflict of interest., Trial Registration Number: N/A., (© The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The oocyte transcriptome follows a tightly controlled dynamic that leads the oocyte to grow and mature. This succession of distinct transcriptional states determines embryonic development prior to embryonic genome activation. However, these oocyte maternal mRNA regulatory events have yet to be decoded in humans. We reanalyzed human single-oocyte RNA-seq datasets previously published in the literature to decrypt the transcriptomic reshuffles ensuring that the oocyte is fully competent. We applied trajectory analysis (pseudotime) and a meta-analysis and uncovered the fundamental transcriptomic requirements of the oocyte at any moment of oogenesis until reaching the metaphase II stage (MII). We identified a bunch of genes showing significant variation in expression from primordial-to-antral follicle oocyte development and characterized their temporal regulation and their biological relevance. We also revealed the selective regulation of specific transcripts during the germinal vesicle-to-MII transition. Transcripts associated with energy production and mitochondrial functions were extensively downregulated, while those associated with cytoplasmic translation, histone modification, meiotic processes, and RNA processes were conserved. From the genes identified in this study, some appeared as sensitive to environmental factors such as maternal age, polycystic ovary syndrome, cryoconservation, and in vitro maturation. In the future, the atlas of transcriptomic changes described in this study will enable more precise identification of the transcripts responsible for follicular growth and oocyte maturation failures.

Introduction: Nicotinamide nucleotide transhydrogenase (NNT) gene deficiency has recently been shown to be involved in Primary Adrenal Insufficiency (PAI). NNT encodes an inner mitochondrial membrane protein that produces large amounts of NADPH. NADPH is used in several biosynthesis pathways and the oxidoreduction of free radicals by the glutathione and thioredoxin systems in mitochondria. Patients with PAI due to NNT deficiency may also exhibit extra-adrenal manifestations, usually including gonadal impairment., Case Report: We present the case of a 35-year-old patient referred to our center for primary infertility with non-obstructive azoospermia, in a context of PAI and obesity. PAI genetic exploration carried out at the age of thirty revealed NNT deficiency due to the presence of two deleterious mutations (one on each allele) in the NNT gene. Scrotal ultrasound revealed a right Testicular Adrenal Rest Tumor (TART). Intensification of glucocorticoid therapy over the course of 8 months failed to reduce the TART volume or improve sperm production and endocrine function. No spermatozoa were found after surgical exploration of both testes, and subsequent histopathological analysis revealed bilateral Sertoli cell-only syndrome. A retrospective review of the hypothalamic-pituitary-gonadic axis hormonal assessment over 20 years showed progressive impairment of testicular function, accelerated during adulthood, leading to hypergonadotropic hypogonadism and non-obstructive azoospermia when the patient reached his thirties, while the PAI remained controlled over the same period., Conclusion: This case report provides, for the first time, direct evidence of complete germ line loss in an azoospermic man with NNT deficiency. Additional data further support the hypothesis of a determinant role of oxidative cellular damage due to reactive oxygen species (ROS) imbalance in the severe gonadal impairment observed in this NNT-deficient patient. Early and regular evaluation of gonadal function should be performed in patients with PAI, especially with NNT deficiency, as soon as the patients reach puberty. Fertility preservation options should then be provided in early adulthood for these patients., (© 2023. The Author(s).)

Study Question: Are ICSI outcomes impaired in cases of severe asthenozoospermia with multiple morphological abnormalities of the flagellum (MMAF phenotype)?, Summary Answer: Despite occasional technical difficulties, ICSI outcomes for couples with MMAF do not differ from those of other couples requiring ICSI, irrespective of the genetic defect., What Is Known Already: Severe asthenozoospermia, especially when associated with the MMAF phenotype, results in male infertility. Recent findings have confirmed that a genetic aetiology is frequently responsible for this phenotype. In such situations, pregnancies can be achieved using ICSI. However, few studies to date have provided detailed analyses regarding the flagellar ultrastructural defects underlying this phenotype, its genetic aetiologies, and the results of ICSI in such cases of male infertility., Study Design, Size, Duration: We performed a retrospective study of 25 infertile men exhibiting severe asthenozoospermia associated with the MMAF phenotype identified through standard semen analysis. They were recruited at an academic centre for assisted reproduction in Paris (France) between 2009 and 2017. Transmission electron microscopy (TEM) and whole exome sequencing (WES) were performed in order to determine the sperm ultrastructural phenotype and the causal mutations, respectively. Finally 20 couples with MMAF were treated by assisted reproductive technologies based on ICSI., Participants/materials, Setting, Methods: Patients with MMAF were recruited based on reduced sperm progressive motility and increased frequencies of absent, short, coiled or irregular flagella compared with those in sperm from fertile control men. A quantitative analysis of the several ultrastructural defects was performed for the MMAF patients and for fertile men. The ICSI results obtained for 20 couples with MMAF were compared to those of 378 men with oligoasthenoteratozoospermia but no MMAF as an ICSI control group., Main Results and the Role of Chance: TEM analysis and categorisation of the flagellar anomalies found in these patients provided important information regarding the structural defects underlying asthenozoospermia and sperm tail abnormalities. In particular, the absence of the central pair of axonemal microtubules was the predominant anomaly observed more frequently than in control sperm (P < 0.01). Exome sequencing, performed for 24 of the 25 patients, identified homozygous or compound heterozygous pathogenic mutations in CFAP43, CFAP44, CFAP69, DNAH1, DNAH8, AK7, TTC29 and MAATS1 in 13 patients (54.2%) (11 affecting MMAF genes and 2 affecting primary ciliary dyskinesia (PCD)-associated genes). A total of 40 ICSI cycles were undertaken for 20 MMAF couples, including 13 cycles (for 5 couples) where a hypo-osmotic swelling (HOS) test was required due to absolute asthenozoospermia. The fertilisation rate was not statistically different between the MMAF (65.7%) and the non-MMAF (66.0%) couples and it did not differ according to the genotype or the flagellar phenotype of the subjects or use of the HOS test. The clinical pregnancy rate per embryo transfer did not differ significantly between the MMAF (23.3%) and the non-MMAF (37.1%) groups. To date, 7 of the 20 MMAF couples have achieved a live birth from the ICSI attempts, with 11 babies born without any birth defects., Limitations, Reasons for Caution: The ICSI procedure outcomes were assessed retrospectively on a small number of affected subjects and should be confirmed on a larger cohort. Moreover, TEM analysis could not be performed for all patients due to low sperm concentrations, and WES results are not yet available for all of the included men., Wider Implications of the Findings: An early and extensive phenotypic and genetic investigation should be considered for all men requiring ICSI for severe asthenozoospermia. Although our study did not reveal any adverse ICSI outcomes associated with MMAF, we cannot rule out that some rare genetic causes could result in low fertilisation or pregnancy rates., Study Funding/competing Interest(s): No external funding was used for this study and there are no competing interests., Trial Registration Number: N/A., (© The Author(s) 2021. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Cilia and flagella are formed around an evolutionary conserved microtubule-based axoneme and are required for fluid and mucus clearance, tissue homeostasis, cell differentiation and movement. The formation and maintenance of cilia and flagella require bidirectional transit of proteins along the axonemal microtubules, a process called intraflagellar transport (IFT). In humans, IFT defects contribute to a large group of systemic diseases, called ciliopathies, which often display overlapping phenotypes. By performing exome sequencing of a cohort of 167 non-syndromic infertile men displaying multiple morphological abnormalities of the sperm flagellum (MMAF) we identified two unrelated patients carrying a homozygous missense variant adjacent to a splice donor consensus site of IFT74 (c.256G > A;p.Gly86Ser). IFT74 encodes for a core component of the IFT machinery that is essential for the anterograde transport of tubulin. We demonstrate that this missense variant affects IFT74 mRNA splicing and induces the production of at least two distinct mutant proteins with abnormal subcellular localization along the sperm flagellum. Importantly, while IFT74 deficiency was previously implicated in two cases of Bardet-Biedl syndrome, a pleiotropic ciliopathy with variable expressivity, our data indicate that this missense mutation only results in primary male infertility due to MMAF, with no other clinical features. Taken together, our data indicate that the nature of the mutation adds a level of complexity to the clinical manifestations of ciliary dysfunction, thus contributing to the expanding phenotypical spectrum of ciliopathies.

Objective: To investigate if there are any obvious clinical factors associated with delayed blastulation at day 6 (D6) compared with day 5 (D5)., Design: Monocentric observational cohort study from November 2012 to December 2018., Setting: Tertiary-care academic medical center., Patients: A total of 941 women with an entire cohort of exclusively D5 blastocysts compared with 162 patients with a cohort of exclusively D6 blastocysts., Interventions: None., Main Outcome Measures: Clinical characteristics and data related to the ovarian stimulation protocols., Results: After univariate analysis, a significantly higher proportion of women who were active smokers was found in the D6 group compared with the D5 group (n = 22/162 [13.6%] vs. n = 82/941 [8.7%]). In addition, the women in the D6 group had a higher rank number of assisted reproductive technology (ART; total no. of ART cycles performed: 2.1 ± 1.4 vs. 1.6 ± 1.1) and a lower antral follicle count (AFC; 18.7 ± 11.3 vs. 22.2 ± 12.8). Moreover, fertilization with the use of intracytoplasmic sperm injection was used more frequently in the D6 group compared with the D5 group. Logistic regression analysis adjusted for confounders highlighted several independent predictors for reaching blastocyst stage at D6 rather than D5: being an active smoker, previous ART cycles, and a lower AFC., Conclusions: Obtaining an exclusively D6 blastocyst cohort is independently associated with women who are active smokers, previous ART cycles, and a lower AFC. These findings provide evidence, to be confirmed by further studies, that women who are active smokers could greatly benefit from smoking cessation before undergoing ART., (© 2020 The Authors.)

Spectral unmixing was investigated for fast spectroscopic identification in γ-emitter mixtures at low-statistics in the case of measurements performed to prevent illegal nuclear material trafficking or for in situ environmental analysis following a radiological or nuclear accident. For that purpose, a multiplicative update algorithm based on full-spectrum analysis was tested in the case of a 3″x3″ NaI(Tl) detector. Automatic decision-making was addressed using Monte Carlo calculations of decision thresholds and detection limits. The first results obtained with a portable instrument equipped with a 3″x3″ NaI(Tl) detector designed for the control of food samples by non-expert users following a radiological or nuclear accident, are also presented., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

An internal consistency test of the calculation of coincidence-summing correction factors F C for volume sources is presented. The test is based on exact equations relating the values of F C calculated for three ideal measurement configurations. The test is applied to a number of 33 sets of F C values sent by 21 teams. Most sets passed the test, but not the results obtained using the quasi-point source approximation; in the latter case the test qualitatively indicated the magnitude of the bias of F C ., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

In humans, structural or functional defects of the sperm flagellum induce asthenozoospermia, which accounts for the main sperm defect encountered in infertile men. Herein we focused on morphological abnormalities of the sperm flagellum (MMAF), a phenotype also termed "short tails," which constitutes one of the most severe sperm morphological defects resulting in asthenozoospermia. In previous work based on whole-exome sequencing of a cohort of 167 MMAF-affected individuals, we identified bi-allelic loss-of-function mutations in more than 30% of the tested subjects. In this study, we further analyzed this cohort and identified five individuals with homozygous truncating variants in TTC29, a gene preferentially and highly expressed in the testis, and encoding a tetratricopeptide repeat-containing protein related to the intraflagellar transport (IFT). One individual carried a frameshift variant, another one carried a homozygous stop-gain variant, and three carried the same splicing variant affecting a consensus donor site. The deleterious effect of this last variant was confirmed on the corresponding transcript and protein product. In addition, we produced and analyzed TTC29 loss-of-function models in the flagellated protist T. brucei and in M. musculus. Both models confirmed the importance of TTC29 for flagellar beating. We showed that in T. brucei the TPR structural motifs, highly conserved between the studied orthologs, are critical for TTC29 axonemal localization and flagellar beating. Overall our work demonstrates that TTC29 is a conserved axonemal protein required for flagellar structure and beating and that TTC29 mutations are a cause of male sterility due to MMAF., (Copyright © 2019 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.)

Study Question: Did the revised Alpha/ESHRE consensus (Vienna, 2017) bring a real answer on managing oocytes with aggregates of smooth endoplasmic reticulum (SERa)?, Summary Answer: According to the currently available literature, a case by case approach on the time of injecting/inseminating SERa+ oocytes may be not helpful for embryologists making a decision, so we suggest fertilizing both SERa+ and SERa- oocytes and prioritizing embryos derived from SERa- oocytes., What Is Known Already?: In 2011, the Istanbul consensus recommended not to inject/inseminate SER+ oocytes due to adverse foetal outcomes reported in literature. At the end of 2017, a panel of experts reconsidered this recommendation and advised a case by case approach. Hence, with a lack of clear recommendations, in-vitro fertilization practitioners still have heterogeneous attitudes when managing SERa+ oocytes. In this context of controversy, an updated review could be helpful in (i) forming a common language for managing cases of SERa+ oocytes and (ii) offering the most ethical practice and best care for patients seeking infertility treatment or fertility preservation., Study Design, Size, Duration: This review (with a last literature search on 1 June 2018) evaluated the effect of the SER dysmorphism on embryological and neonatal outcomes., Participants/materials, Setting, Methods: Studies were considered for inclusion if they were prospective or retrospective cohort or case-control studies. Electronic searches of the Pubmed and Embase databases were done using the keyword combination: smooth endoplasmic reticulum, SER, oocyte and zygote. Abstracts and articles written in English and limited to humans were included., Main Results and the Role of Chance: The search returned a total of 726 studies among which 21 met the inclusion criteria. The literature does not unanimously support a negative association between SERa and embryogenesis, implantation or assisted reproductive therapy outcomes. The reviewed studies reported 112 neonatal outcomes after transfers where at least one embryo originated from oocyte affected by SERa. They included 101 healthy babies, three live births with malformations, three neonatal deaths, one stillbirth and four medical interruptions of pregnancy. After transfer of embryos exclusively derived from SERa+ oocytes, a total of 48 healthy newborns were reported along with four babies with perinatal complications (including one ventricular septal defect), one stillbirth, one neonatal death and one pregnancy termination for multiple malformations., Limitations, Reasons for Caution: As with any review, this review was limited by the quality of the included studies especially in terms of possible methodological limitations, the limited sample size and the retrospective aspect of the studies. Among the 21 selected studies, seven were abstracts and two were case reports. Of the remaining 14 studies, only three were prospective. The tools used in identifying SERa+ oocytes may have varied from one study to another and a consequent misclassification cannot be excluded. Considering the poor resolution of light microscopy in detecting SER aggregates, we are not sure that apparently SERa- oocytes do not really exhibit such a dysmorphism if they were analysed under electronic microscopy or a time lapse system., Wider Implications of the Findings: In the light of the existing data and the lack of a real link between fertilizing SERa+ oocytes and the occurrence of embryo aneuploidy/malformations, we think that discarding SERa+ oocytes may be not the most ethical approach even in patients with large cohorts on the day of oocyte retrieval. Avoiding the wastage of oocytes and embryos with respect to medical ethics remains a constant concern in daily IVF practice. Thus, we recommend that all mature oocytes could be fertilized and embryos originating from SERa- oocytes would be preferably transferred, even if they come from a cohort with SERa+ oocytes. The remaining embryos derived from SERa+ oocytes could be considered with a lower priority for transfer after obtaining consent from the couple if a strict follow-up of the pregnancy and the baby is performed., Study Funding/competing Interest(s): We have no conflict of interest to declare and no funding was received., Registration Number: N/A., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Purpose: This study was designed to evaluate patient management and quality of information given by French oncologists to cancer women concerning fertility issues and possibilities of fertility preservation., Methods: An online survey was sent to 1161 physicians in all major cancer centers throughout France between May 2012 and January 2013., Results: A total of 102 responses were received and analyzed. Only 46% of all physicians surveyed reported discussing infertility risks with patients of reproductive age and 22% referred them to a fertility center before beginning treatments. Only 14% of practitioners considered themselves knowledgeable in FP techniques and ovarian transposition was the most frequently mentioned technique in consultation., Conclusion: This study is at the best of our knowledge the first nationwide survey to assess the state of the art in oncofertility management. It highlights inadequate management of fertility preservation for female patients in France. Physicians reported lacking knowledge and tools that would allow them to provide patients with appropriate information. A better collaboration between cancer and fertility centers needs to be organized in France as already organized in other countries.

Two main non-destructive techniques can be used to measure standard 222 Rn gas ampoules: well-type ionization chambers and gamma-ray spectrometry, the former being used in the Système International de Référence (SIR) for international comparison purposes. The reliability of these techniques requires that the variability of the flame-sealed gas glass ampoules used have a negligible influence on the detector response. This variability is studied in this work by considering three parameters: the volume of the ampoule, the position of the sealing point and the thickness of the glass. Results showed that variability of the gas ampoules induced measurement bias larger than the uncertainty of the standard sources., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Study Question: The aim of this study was to evaluate the live birth rate (LBR) after frozen-thawed Day 5 (D5) and Day 6 (D6) blastocyst transfers., Summary Answer: LBR following frozen-thawed blastocyst transfer is significantly lower with D6 than with D5 blastocyst regardless of embryo quality., What Is Known Already: During fresh embryo transfer cycles, pregnancy rates (PR) are significantly higher when transferring blastocysts expanded on D5 compared with slow developing blastocysts (D6). In programmed thawed blastocyst transfer (TBT) cycles, the same clinical outcomes should be expected when transferring D5 or D6 blastocysts because of endometrial/embryonic synchronization due to hormonal priming of endometrial receptivity. However, the impact of delayed blastocyst expansion at D6 on clinical outcomes remains unclear. Some reports have shown higher PRs after D5 TBT compared with those of D6, while others have shown equivalent TBT outcomes after D5 and D6 cryopreserved blastocysts transfers., Study, Design, Size, Duration: This retrospective cohort follow-up study included 1347 single autologous frozen-thawed blastocyst transfers performed between January 2012 and December 2015 at a tertiary care university hospital., Participants/materials, Setting, Methods: All of the patients scheduled for TBT were allocated to two groups according to the day of blastocyst expansion: on D5 (n = 994) or on D6 (n = 353). The primary outcome was LBR per embryo transfer in the first blastocyst thawing cycle. Secondary outcomes were clinical pregnancy rate (cPR), early miscarriage rate and neonatal outcomes following TBT for the two groups. Statistical analyses were conducted using univariate and multivariate logistic regression model., Main Results and the Role of Chance: The LBR was significantly increased in the D5 group compared to the D6 group [294/994 (29.6%) versus 60/353 (17.0%); P < 0.001]. The cPR was also higher when blastocysts were vitrified on D5 compared with those vitrified on D6 [429/994 (43.2%) versus 95/353 (26.9%); P < 0.001]. No significant differences were found between groups in terms of early miscarriage rate (P = 0.862). More good-quality embryos (defined as an B3-B4 or B5 embryo ≥BB according to the grading scale proposed by Gardner) were transferred in the D5 group than in the D6 group [807 (81.2%) versus 214 (60.6%); P < 0.001]. However, a comparison of TBT cycles with equal embryo quality (good versus low) also supported the superiority of D5 blastocysts. Concerning neonatal outcomes, the D5 group infants had a lower mean birth weight compared to those of the D6 group (P = 0.001). In addition, a significantly shorter gestational age at birth is reported in the D5 blastocyst group as compared to the D6 group (P = 0.004). After multivariate logistic regression taking into account potential confounders such as the women's age, number of previous IVF/ICSI procedures, the day of the blastocyst vitrification (D5 or D6) and embryo quality, blastocyst expansion at D6 was independently associated with a significant decrease in LBR compared to D5 expanded-blastocysts (OR 0.52; 95% CI 0.38-0.72; P < 0.001)., Limitations, Reasons for Caution: The poor predictive value of the morphological approach in embryo selection could constitute a limitation in this study. However, blastocyst quality was evaluated similarly in both groups., Wider Implications of the Findings: The LBR following frozen-thawed blastocyst transfer was significantly lower with D6 than with D5 blastocysts, regardless of their quality. These results could affect cryopreservation procedures as they suggest that the use of D5-expanded blastocysts for TBT may be preferred in order to shorten the time of conceiving., Study Funding/competing Interest(s): No specific funding was obtained for this study. None of the authors have any competing interests to declare., Trial Registration Number: Not applicable.

Purpose: The aims of this study were to investigate the possible benefits of extending the culture of poor-quality day-2 embryos (PQE) versus good-quality embryos (GQE) and to identify factors associated with pregnancy and live birth when transferring frozen-thawed blastocysts originating from GQE and PQE., Methods: This is a retrospective cohort follow-up study performed between November 2012 and February 2015 at the IVF Laboratory Unit of Cochin University Hospital (Paris, France) including 3108 day-2 supernumerary embryos resulting from 1237 IVF/ICSI cycles., Results: Total blastulation rate was 67.2% from GQE and 48.7% from PQE. Percentage of good-quality blastocysts was 60.7 and 47.9% respectively including 14.7 and 7.3% top-quality blastocysts. A total of 150 blastocysts originating from GQE and 729 from PQE were frozen, and then, 37 and 164 were thawed and transferred respectively resulting in 19 (51.4%) and 61 (37.9%) clinical pregnancies with 13 (35.1%) deliveries from GQE and 32 (19.9%) from PQE (p = 0.046) without any difference in neonatal outcomes. Quality of blastocysts that resulted in live birth was similar in the two groups. Women < 35 years old and day-5 blastocyst expansion were predictive of pregnancy and live birth., Conclusions: (i) PQE are able to reach the blastocyst stage, to implant, and to give healthy babies and (ii) women age and day of blastocyst expansion are predictive of pregnancy and live birth.

Two series of activity standards of (60)Co in cast steel matrix, developed for the calibration of gamma-ray spectrometry systems in the metallurgical sector, were characterised using a European interlaboratory comparison among twelve National Metrology Institutes and one international organisation. The first standard, consisting of 14 disc shaped samples, was cast from steel contaminated during production ("originally"), and the second, consisting of 15 similar discs, from artificially-contaminated ("spiked") steel. The reference activity concentrations of (60)Co in the cast steel standards were (1.077±0.019) Bqg(-1) on 1 January 2013 12h00 UT and (1.483±0.022) Bqg(-1) on 1 June 2013 12h00 UT, respectively., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The present paper addresses the calibration of well-type ionization chambers (ICs) used at LNE-LNHB as standard transfer instruments to calibrate hospitals in the case of SIR-Spheres(®)(90)Y resin microspheres (Sirtex, Australia). Developed for interventional oncology, this radiopharmaceutical is directly injected in the liver for cancer treatment via a selective internal radiation therapy. The present work was carried out in the framework of the European project "Metrology for molecular radiotherapy" (MetroMRT). As commonly performed in radionuclide metrology for radiopharmaceuticals, the objective is to ensure the metrological traceability of SIR-Spheres(®) to hospitals. Preceding studies were focused on primary measurements of SIR-Spheres(®) based on the TDCR (Triple to Double Coincidence Ratio) method, applied after the dissolution of the (90)Y-labeled resin microspheres. As (90)Y is a high-energy β(-)-emitter, the IC response strongly depends on the transport of electrons in the radioactive solution and surroundings (vial, chamber liners and materials). The variability of the IC-response due to the geometry dependence is investigated by means of measurements and Monte Carlo simulations in the case of a Vinten IC. The aim of the present study was also to propose a reliable uncertainty for ICs calibrations for the standard transfer of SIR-Spheres(®) to hospitals., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

In this new approach, the active shielding of a low level spectrometer is monitored by an extendable dead time used as an "extendable GATE" signal. This concept is directly inspired from the live-timed anti-coincidence system implemented at LNE-LNHB (MTR2 modules). This allows a significant reduction in the cost and complexity of the system since several electronic modules are replaced by only one module dedicated specifically to this type of experiment. Settings of this new approach are detailed and results are discussed., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The project "Metrology for molecular radiotherapy" is a collaborative European project initiated to bring together expertize in ionizing radiation metrology and nuclear medicine research. This project deals with the development of personalized dosimetry to individual patients who are undergoing molecular radiotherapy (also known as targeted radionuclide therapy). The general aim is to provide a metrological traceability to primary standards for individual dosimetry in the case of molecular radiotherapy. In particular, one objective is the standardization of (90)Y-labeled resin microspheres SIR-Spheres (Sirtex, Sydney, Australia) used for the treatment of liver cancer by radioembolization. The present paper describes the primary measurements carried out using the Triple to Double Coincidence Ratio (TDCR) method applied after the complete dissolution of the SIR-Spheres in the Sirtex vial. A method for the dissolution was developed to optimize the homogeneity of the solution to enable the primary measurements based on Cherenkov and liquid scintillation counting. A comprehensive description of the protocol implemented for the microsphere dissolution is reported. First calibration factors obtained with the reference ionization chambers at LNE-LNHB are also given., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

In the framework of the organization of proficiency testing, filters with deposits of 137 Cs and 90 Sr+ 90 Y radioactive aerosols have been submitted to laboratories for radionuclide measurement. Procedures for the special preparation and characterization of filters have been developed. The different steps of filter preparation, determination of the deposited radionuclide activity and characterization of the homogeneity of these deposits are presented. This method of filter preparation can also be used in the production of secondary standards, whose properties are more adapted to the needs of laboratories measuring radioactivity in filters than are the solid sources that they typically use., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Measurement of radionuclides from environmental samples includes a wide variety of matrix compositions and densities. To improve the traceability of environmental monitoring, LNE-LNHB intends to produce mixed γ-ray reference materials with a known mass activity and a composition as representative as possible of real environmental samples. This paper describes the preparation and characterization of a low density treated grass matrix spiked with mixed γ-emitters. This material was used in a proficiency test exercise whose results are presented., (© 2013 Published by Elsevier Ltd.)

This study focuses on two radioisotopes of silver, (108m)Ag and (110m)Ag, characterized by a complex decay scheme. Each isotope has two disintegration modes, the isomeric transition leading to the daughter isotope ((108)Ag and (110)Ag, respectively) with a short half-life. The radioactive solution was obtained by neutron activation on silver powder enriched in (109)Ag. Gamma-spectrometry was carried out using a calibrated high purity germanium detector. The main relative photon emission intensities for both radionuclides were obtained and compared with previously published values., (© 2013 Published by Elsevier Ltd.)

In this study, different aspects of the Compton scattering inside volume sources are illustrated using experimental approach and Monte Carlo simulation. For the low-energy range (below 100 keV) scattered events represents around 30% of the whole spectrum. Influence of the source-detector geometry is discussed. The scattering effects induce strong differences in spectrum shape for different geometrical conditions. This should influence efficiency transfer factors. A new approach is proposed, including the scattered events, to avoid complex peak area determination., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In this work, PENELOPE2008 and MCNP5 software packages were used to investigate the effect of simulation parameters such as cut-off energy of photons and electrons on the detector response function and peak escape intensity to assess their influence on the efficiency determination. The results showed a general agreement between the two codes, however both the intensity of escape peaks and total efficiency computed with PENELOPE2008 are higher than those obtained with MCNP5. Moreover, the calculated efficiencies are typically 8% higher than what is experimentally found in the low energy range. Further investigation was required to obtain better agreement and lead to better estimate of the real germanium crystal dimensions and dead layer., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In the framework of environmental measurements by gamma-ray spectrometry, some laboratories need to characterize samples in geometries for which a calibration is not directly available. A possibility is to use an efficiency transfer code, e.g., ETNA. However, validation for large volume sources, such as Marinelli geometries, is needed. With this aim in mind, ETNA is compared, initially to a Monte Carlo simulation (PENELOPE) and subsequently to experimental data obtained with a high-purity germanium detector (HPGe)., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Radioactivity found in wild food products has assumed greater importance when assessing the total exposure of the population. For this reason, IRMM has been developing a reference material for the activity concentration of three radionuclides in bilberry samples. In order to characterise this new material, a CCRI(II) supplementary comparison was organised. The difficulties encountered in this comparison are discussed, in particular the efficiency calibration for volume sources of gamma-ray emitters, and comparison reference values for (137)Cs and (40)K are calculated., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The numerical calculation of coincidence summing corrections requires both the total and full-energy peak efficiencies to be included in the corrective factors. Moreover, in the case of volume sources, the coincidence probability depends on the position of the photon emission inside the radioactive sample, thus it is necessary to calculate the coincidence summing corrective factors by integrating the elemental contributions for the entire volume. The software ETNA calculates coincidence summing corrective factors according to a deterministic method, for volume sources, two approaches are included in the software: the "simplified" calculation uses directly the efficiency of the volume source like in the case of point source, and the "complete" calculation performs the volume integration. To assess the difference between these, different geometrical cases are tested for several radionuclides using both methods., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The second part of an intercomparison of the coincidence summing correction methods is presented. This exercise concerned three volume sources, filled with liquid radioactive solution. The same experimental spectra, decay scheme and photon emission intensities were used by all the participants. The results were expressed as coincidence summing corrective factors for several energies of (152)Eu and (134)Cs, and different source-to-detector distances. They are presented and discussed., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

In this work, the activities of radionuclides in a marine sediment sample have been determined. The gamma spectrometer comprises an N type coaxial HPGe detector with active shielding to reduce cosmic background. The mass activities of radionuclides have been derived and found to be around a few Bq kg(-1) to several hundreds Bq kg(-1) with relative uncertainties in this paper quoted corresponding to the combined standard uncertainties (k=1)., (Copyright 2010 Elsevier Ltd. All rights reserved.)

To study the decay scheme of (126)Sn, two samples of a purified solution were measured by gamma-ray spectrometry and the relative photon emission intensities were determined. The (126)Sb(m) isomeric branching ratio was derived to be 18.6 (6) %. The maximum beta energy of the (126)Sn decay was checked by liquid scintillation. The Kbeta/Kalpha intensity ratio of Sb was determined being 0.226 (11). These new experimental results were used to re-examine the whole decay scheme of (126)Sn and its daughters., (Copyright 2010. Published by Elsevier Ltd.)

A comparison of the coincidence summing correction methods is presented. Since there are several ways for computing these corrections, each method has advantages and drawbacks that could be compared. This part of the comparison was restricted to point sources. The same experimental spectra, decay scheme and photon emission intensities were used by all the participants. The results were expressed as coincidence summing correction factors for several energies of (152)Eu and (134)Cs, and three source-to-detector distances. They are presented and discussed., (Copyright 2010 Elsevier Ltd. All rights reserved.)

The activity measurement of beta-plus emitters by gamma-ray spectrometry is studied. Experimental measurements are performed with (22)Na, (65)Zn and (64)Cu with sources included in a lead container. For these nuclides, the activity can be derived both from one photon emission peak and from the 511 keV annihilation peak, including annihilation in-flight correction and geometry correction computed by Monte Carlo simulation. The activity values obtained using the two types of peaks show satisfying agreement. The extension of the method to volume sources is discussed., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Gamma-ray spectrometry measurements have been carried out to determine the activity of natural radionuclides in a phosphogypsum sample included in a specific tight container. The gamma spectrometer includes an N-type coaxial high-purity germanium (HPGe) detector equipped with an anti-cosmic system. This measurement required the determination of linear attenuation coefficients of phosphogypsum to calculate self-absorption correction between efficiency calibration conditions and measurement ones. The results are given for the three natural chains and for (40)K, in term of specific activity/g of dry material, ranging from a few Bq kg(-1) to a few hundreds Bq kg(-1). The equilibrium within the different families and the (235)U/(238)U ratio are discussed.

Measurements of (241)Am L X-ray emission probabilities were conducted using both HPGe and Si(Li) detectors. The efficiency calibrations of these detectors were performed by means of a tunable, monochromatic photon beam and the determination of the thickness of absorbing materials inside the detector. These efficiency calibrations were obtained without any reference to radionuclide decay data, and with 0.8% relative standard uncertainty. The complex L X-ray region was processed using Voigt functions and by taking account of the detector response function established with the monochromatic beam. Twenty-two components of the L X-ray group were identified and quantified. The present results are compared with previously published data.

A tunable monochromatic X-ray source operating in the 1-20 keV energy range is described. An X-ray tube provides initial photons. A dispersive crystal performs the energy selection, according to Bragg's law. An X-ray detector is connected to the monochromator fixed exit. This setup can be used for metrological studies. A first application consists in measuring attenuation coefficients in the 4-10 keV energy range. Results for aluminum and copper are given, with average relative uncertainties (1sigma) of 1% and 3% respectively.

The Moyer model, based on a semi-empirical method validated in the 7.4 to 350 GeV energy range, is generally used to calculate lateral shielding for high energy proton accelerators. Measurements made for the Saclay Synchrocyclotron, Saturne, have enabled the parameters corresponding to a 2.7 GeV model to be studied for different target thicknesses and angles of observation. These studies show how new data have been used to modify the equations of the model.