degenerated oocytes (8.17 vs 7.25%, p50.28) was not different in both index were 34.6 years (SD 3.
were 34.6 years (SD 3.6) and 28.5 kg/m2 (SD 8.2). Analysis of
groups. The fresh cycle live-birth rate (# births/cycle) was not different
in PCOS women compared to NC (36.7 vs 31.7%, p50.19).
CONCLUSION: Oocyte morphology and live-birth rate during IVF
was not different between PCOS women and NC. This suggests that
oocyte quality in PCOS women is not reduced.
Financial Disclosure: The authors did not report any potential conflicts of
interest.
AMH Serum Level as a Predictor of In Vitro
Fertilization (IVF) Parameters [3B]
Stephanie R. Baum, MD
Lenox Hill Hospital, Northwell Health, New York, NY
Drorit Or, MD, Panagopoulos Georgia, PhD, Avner Hershlag, MD,
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Christine Mullin, MD, and Tomer Singer, MD
INTRODUCTION: Anti-müllerian hormone (AMH) serum level is
a component of the infertility workup to evaluate ovarian reserve.
Diminished ovarian reserve is one of the major causes of female infer-
tility. Our study examines the relationship between AMH serum level
and IVF success.
METHODS: We performed a retrospective cohort study at a single
academic institution, including 145 patients undergoing 185 IVF
cycles. The IVF outcomes were reviewed for completed cycles within
12 months of collected follicle stimulating hormone (FSH) and AMH
serum levels, under an exempt IRB in 2012. Data included number of
oocytes retrieved, number of mature oocytes, number of oocytes
fertilized, number of cleavage stage embryos, number of embryos
transferred, number of embryos frozen, and number of embryos
discarded. The Shapiro-Wilk test of normality and Spearman’s rank
correlation coefficient were used for statistical analysis with p,0.05.
RESULTS: There is a positive correlation between AMH serum level
and the number of oocytes retrieved, the number of mature oocytes,
the number of fertilized oocytes, and the number of cleavage stage
embryos. These findings are statistically significant. There is no
correlation between AMH serum level and embryo quality.
CONCLUSION: AMH serum level correlates with certain IVF
parameters, including oocytes retrieved and the number of cleavage
stage embryos. AMH serum level does not predict embryo quality.
However, an IVF cycle with an increased number of retrieved and
fertilized oocytes is likely to have a higher chance of resulting in
embryos preferable for transfer in a current or future cycle.
Financial Disclosure: The authors did not report any potential conflicts of
interest.
Successful Pregnancy Outcomes after Septum or no
Septum Resection in Patients with Recurrent
Pregnancy Loss [4B]
Anna Whelan, MD
University of Illinois at Chicago, Chicago, IL
Channing Burks, MD, and Mary Stephenson, MD, MS
INTRODUCTION: Acquired uterine malformations caused by
incomplete fusion or reabsorption of the Mullerian ducts can lead to
reproductive issues including infertility, recurrent pregnancy loss
(RPL), malpresentation and/or preterm birth. The septate uterus is
the result of partial or complete lack of reabsorption. It is the most
common acquired uterine malformation with a prevalence of ;2.3% in
the general reproductive population compared to ;6% in women with
RPL. Surgical management of the septate uterus is controversial and
subsequent pregnancy outcomes are based on retrospective studies to
date.
METHODS: Observational cohort study using prospectively col-
lected data from a well-defined RPL Database. Subsequent pregnancy
outcomes in subjects with a history of RPL and septate uterus were
analyzed, based on whether hysteroscopic metroplasty was performed
or not.
RESULTS: 36 subjects with RPL and septate uterus were identified,
with 82 subsequent pregnancies. Mean maternal age and body mass
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and Gynecologists. Published by Wolters Kluwer Health, Inc.
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subsequent pregnancy outcomes revealed no significant difference in
live birth rate $4 weeks of gestation, 36.8% (21/58) with surgery versus
45.3% (11/24) without surgery, OR 1.14 (P 5 0.74, 95% CI 0.43 -
3.25). No significant difference in rate of subsequent miscarriage, fetal
demise or preterm birth were noted, x2 5 1.67 (df53, P 50.65).
CONCLUSION: The outcomes of this study highlight the need for
a randomized controlled trial to evaluate the management of septate
uterus in RPL.
Financial Disclosure: The authors did not report any potential conflicts of
interest.
Increased Likelihood of Pregnancy from Sex on the
Two Days Before Ovulation [5B]
Sarah Johnson, PhD
SPD Development, Bedford, United Kingdom
Lorrae Marriott, MSc, and Michael Zinaman, MD
INTRODUCTION: Home ovulation tests are a convenient method
to maximize chances of becoming pregnant naturally. This study
examined intercourse patterns in women using tests and likelihood of
pregnancy in relation to timing.
METHODS: Women seeking to conceive used Clearblue Advanced
digital ovulation tests to time intercourse, kept an intercourse diary and
collected daily urine samples for 1 cycle. The home ovulation tests
detect estrogen rise to identify the onset of the fertile period
(approximately 4 days prior to ovulation) and Lutenising hormone
(LH) surge (24h prior to ovulation). LH was also measured using
AutoDELFIA to assign ovulation day. From the wider population of
1925 volunteers with sufficient data, comparative analysis was con-
ducted on all viable pregnancies (n5288), and a random selection of
ovular cycles from not pregnant volunteers (n5677).
RESULTS: One cycle conception rate was 15%. Women were able to
effectively target intercourse to their fertile period using home tests,
with .60% having sex on day of LH surge compared to ,30% in the
luteal phase. More women who became pregnant had sex on the day -1
(p5,0.0001) and -2 (p50.001) prior to ovulation; with an increased
likelihood of pregnancy of 18.5% for day-1 and 23.6% for day -2. The
day after the LH surge saw a marked decrease in pregnancy rates.
CONCLUSION: Women using home tests do target intercourse
effectively to the fertile window, and there is an increased likelihood
of pregnancy with successful timing. Sex on the day preceding the LH
surge, which identifiable only by home tests that measure estrogen,
significantly increases likelihood of pregnancy.
Financial Disclosure: Sarah Johnson disclosed the following—SPD Develop-
ment: Employment. SPD Development Company: Employment. Lorrae Mar-
riott disclosed the following—SPD Development Company: Employment. The
other author did not report any potential conflicts of interest.
Clomiphene Citrate and Intrauterine Insemination:
Analysis of 1,531 Cycles by Time Trying to Conceive
[6B]
Joshua Stewart, MD
The Ronald O. Perelman and Claudia Cohen Center for
Reproductive Medicine, Weill Cornell Medicine, New York, NY
Latha Panchap, BS, and Steven D. Spandorfer, MD
INTRODUCTION: Clomiphene citrate and intrauterine insemina-
tion (CC/IUI) is often a first-line treatment for infertile couples. While
it is well established that fecundity rates decrease with age, outcomes of
CC/IUI cycles have not been well stratified by time trying to conceive
(TTC).
METHODS: All CC/IUI cycles performed under a single physician
from January 1, 2010 to December 31, 2016 were included, totaling
1,531 cycles in 536 unique couples. The following data were collected
from an electronic medical record: age, obstetrical history, semen
parameters, time TTC at cycle start, and cycle outcome. Stata IC 15
was used to calculate pregnancy rates. Chi-squared test was used to
calculate p-values.
OBSTETRICS & GYNECOLOGY