Contrary to prior published studies, the current data suggest that blastocyst morphologic grading and particularly inner cell mass grade is a useful predictor of OPR per euploid embryo. Morphologic grading should be used to help in the selection among euploid blastocysts.

The 8-item HSS Pedi-FABS can be used to reliably and accurately evaluate activity level as a prognostic variable for clinical research studies. It is a simple, reliable, and valid metric to assess activity in children and adolescents 10 to 18 years of age. This instrument will lead to better evaluation of posttreatment outcomes and patient-reported activity for child and adolescent athletes.

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Level I, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Objective: To survey fertility patients' agreement with ASRM recommendations during the pandemic and the emotional impact on them.Design: An online survey was sent to current fertility patients Setting: New York City academic fertility practice at the epicenter of the COVID-19 pandemic Patient(s): Fertility patients seen within the last year Intervention(s): None Main Outcome Measures(s): Patient agreement with the ASRM recommendations during the COVID-19 pandemic and the emotional impact rated on a Likert scale.Result(s): A total of 518 patients completed the survey for a response rate of 17%. Fifty percent of respondents had a cycle canceled due to the COVID-19 pandemic. Of those who had a cycle cancelled, 85% of respondents found it to be moderately to extremely upsetting with 22% rating it to be equivalent to the loss of a child. There was no difference on the emotional impact based on the type of cycle cancelled. Fifty-five percent of patients agreed that diagnostic procedures such as hysterosalpingograms should be cancelled while 36% of patients agreed all fertility cycles should be cancelled. Patients were slightly more likely to agree with the ASRM guidelines if they have an upcoming cycle cancelled (p = 0.041). Of all respondents 82% would have preferred to have the option to start a treatment cycle in consultation with their doctor.

p¼0.011). Lower STAI scores were noted at the pre-retrieval survey compared to baseline (p¼0.039). The results were unchanged when controlling for a history of anxiety or history of prior IVF treatment.CONCLUSIONS: The use of a web-based application to support medication management during IVF did not appear to have much impact on quality of life scores and anxiety measures during IVF. However, when examining the CART score in particular, there was a significant difference in CART scores in the application arm compared to the control arm, which suggests the application may have a positive impact in allaying patient concerns during the IVF process. Medication management during IVF is particularly anxiety-provoking for patients. Patient tools that can improve this component of the IVF experience warrant further study.

BackgroundThere is no consensus on the exact parameters that define the LH surge for natural cycle frozen-thawed embryo transfers (NC-FET). Accurately determining the LH surge would affect the timing, and subsequently the success rates, of embryo transfer. Therefore, the aim of this study was to delineate the optimal levels and relationship for luteinizing hormone (LH) and estradiol in an effort to optimally identify the LH surge in NC-FET.MethodsIt is a retrospective study that was performed in an academic medical center. Patients who underwent blastocyst NC-FET who either had preimplantation genetic screening (PGS) or were <35 years old but did not undergo PGS (non-PGS) were included in separate analyses. They were divided into two groups: Group A included patients whose LH surge was defined as the first attainment of LH ≥ 17 IU/L during the follicular phase with a ≥30% drop in estradiol levels the following day; group B encompassed patients whose LH level continued to rise and the surge was defined as the highest serum LH level occurring a day after LH ≥ 17 IU/L despite a ≥ 30% drop in estradiol levels. The main outcomes measures were implantation and live birth rates.ResultsFour hundred-seven non-PGS and 284 PGS NC-FET were included. Among non-PGS cycles, group A was associated with significantly higher implantation rates (48.7% vs. 38.1%) and live birth rates (52.9% vs. 40.1%) compared to group B. In contrast, group A and B had comparable live birth rates among PGS cycles.ConclusionsAmong non-PGS cycles, measuring LH and estradiol levels the day after an LH ≥ 17 IU/L and defining the surge as the first day of LH ≥ 17 IU/L in the context of a ≥ 30% drop in estradiol the following day was associated with better NC-FET outcomes than defining the surge as the day representing the highest serum LH level despite a ≥30% drop in estradiol levels.