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Contraception in America (CIA) national survey: segment of results focused on patient and physician attitudes about benefits of intrauterine devices (IUDs) as a contraceptive method
that they would still use condoms for STD protection compared to 35.4% of men. CONCLUSION: The idea of RMC and a non-hormonal oral RMC is generally accepted by both sexes. Men have stronger beliefs in their own compliance in use of such methods. Education of drug profiles will be crucial in achieving overall acceptance and use by the general public with the introduction of RMC. O-21 Monday, October 22, 2012 05:45 PM CELL CYCLE KINETICS, NUCLEAR RECEPTOR AND GENE EXPRESSION IN HUMAN ENDOMETRIAL CELLS: DIFFERENTIAL REGULATION BY PROGESTIN AND SELECTIVE PROGESTERONE RECEPTOR MODULATOR. P. L. Morris,a,b K. Hwang,a R. Hara,a C. Rapelje,a L. Mitchell.a aCenter for Biomedical Research, Population Council, New York, NY; bThe Rockefeller University, New York, NY. OBJECTIVE: Levonorgestrel (LNG) is a progestin used for emergency contraception (EC) within 72h of unprotected sexual intercourse. Selective progesterone receptor (PR) modulators (SPRMs) are PR ligands with agonist or antagonist effects on progesterone-responsive tissues. A dose of SPRM ulipristal acetate (UPA) is an effective EC alternative used up to 5-days after unprotected intercourse. In clinical studies, UPA inhibits follicle growth and ovulation. In other forms, both are effective for long-term contraception. The overall goal of this study is to characterize effects of these regulators on human endometrial genes and cell cycle. DESIGN: Test hypothesis that PR effectors are not only safe and efficacious for contraception but may provide additional benefits; human endometrial cell models used. MATERIALS AND METHODS: RNA and protein levels for steroid receptors, pathways and cycle-proteins evaluated by gene array, qPCR and Western analyses; cell cycle analysis by flow cytometry. E2 or P4 were used to determine responsiveness. RNA and protein extracts characterized. RESULTS: RNA analyses showed significant gene expression alterations by short-term exposure to either drug, with changes in ERa, AR and membrane PR and ER. E2 or P4 responses were differentially affected. After SPRM treatment, cells showed 1433 genes up- and 1464 down regulated; at 72h significant up (926) and 1183 (down) regulation noted. 27 genes were similarly up, 54 down regulated shared between conditions. 30 upand 52 down regulated genes were shared between E2-stimulated control and SPRM-treated. With time, subcellular receptor distributions changed. LNG altered patterns. UPA increased PR cytoplasm/nucleus ratio. E2 responses were significantly altered for cyclins A2, D1, B1 and AR, ERa, PR. UPA increased cells in G0G1, decreased those in S, G2/M. CONCLUSION: Data show changes in subcellular hormone receptors, responsiveness and cell cycle dynamics, suggesting that some PRMs could afford protection against abnormal growth as a health benefit. Supported by: NIH HD029990. O-22 Monday, October 22, 2012 06:00 PM CONTRACEPTION IN AMERICA (CIA) NATIONAL SURVEY: SEGMENT OF RESULTS FOCUSED ON PATIENT AND PHYSICIAN ATTITUDES ABOUT BENEFITS OF INTRAUTERINE DEVICES (IUDs) AS A CONTRACEPTIVE METHOD. M. Ziemana A. Patel.b a Emory University School of Medicine, Atlanta, GA; bFeinberg School of Medicine, Northwestern University, Chicago, IL. OBJECTIVE: The overall CIA survey was designed to describe contraceptive use/preferences from the perspective of US women (18-49 years of age) and physicians; this report specifically addresses how women’s attitudes differ from physicians about IUDs as a contraceptive method. DESIGN: National probability telephone survey of 1000 women of reproductive age and parallel survey of 100 Obstetrics-Gynecology (Ob-Gyn) and 101 Family Practice (FP) physicians. MATERIALS AND METHODS: Questions about IUDs were asked as part of the larger national CIA survey conducted from 12/12/11 to 1/19/12. Dual frame sampling (both landline [n¼800] and cell phone [n¼200]) ensured inclusion of women without landlines. The women’s sample was weighted by telephone status (landline or cell phone only) and age. Physicians were sampled from a list of American medical/osteopathic association members. Expected maximum sampling error (95% confidence) for women and physicians was 3.1% and 9.8, respectively.
FERTILITY & STERILITYÒ
RESULTS: Of 1000 women, 712 familiar with IUDs answered IUD-related questions during the survey and all 201 physicians responded to questions about IUDs. In response to ‘‘What do you think are the benefits of IUDs as a contraceptive method?’’ women were less likely than Ob-Gyns and FPs to view IUDs as convenient (58% vs 79% and 84%), easily reversible (5% vs 20% and 14%), highly-effective (18% vs 47% and 35%), or cost-effective (1% vs 14% and 7%). Although Ob-Gyns and FPs generally shared similar perceptions about the benefits of IUDs, some differences were noted between them that may influence the dialog with women during contraception counseling. CONCLUSION: While IUDs have increased in popularity, misconceptions and gaps in perception about this method of birth control exist among women and physicians. Education is needed to close these gaps and improve physician communication with reproductive-age women about IUDs, with emphasis that IUDs can provide an effective, convenient, and safe contraceptive choice. Supported by: Teva Global Branded Products R&D. FERTILITY PRESERVATION O-23 Monday, October 22, 2012 04:15 PM SIMILAR IN VITRO MATURATION (IVM) AND FERTILIZATION RATES OF OOCYTES RETRIEVED EITHER AT THE FOLLICULAR OR THE LUTEAL PHASE OF THE CYCLE OFFERS FLEXIBLE OPTIONS FOR URGENT FERTILITY PRESERVATION (FP). M. Grynberg,a M. Even,a L. Hesters,b R. Treves,a R. Fanchin,a N. Frydman.b aDivision of Reproductive Medicine, H^opital Antoine Beclere, Clamart, France; bDepartment of Reproductive Biology, H^opital Antoine Beclere, Clamart, France. OBJECTIVE: To compare IVM and fertilization rates of immature oocytes retrieved during the follicular or the luteal phase of the cycle in an urgent FP program. DESIGN: Prospective study. MATERIALS AND METHODS: 94 candidates for urgent FP were studied. Serum AMH levels and antral follicle count (AFC) were measured prior to oocyte retrieval, irrespective of the cycle day. Patients were sorted into 2 groups according to the phase of the cycle in which eggs were harvested (Follicular Group, n¼52 and Luteal Group, n¼42). Oocyte retrieval was performed 36 hours after hCG administration. Number of immature oocytes recovered, maturation rates after 24 hours and 48 hours of culture, fertilization rates and total number of oocytes and embryos cryopreserved were assessed. Moreover, the oocyte output rate (OORT) was calculated by AFCx100/number of immature oocytes recovered. RESULTS: In both groups, women were comparable in terms of age (30(18-39) vs. 30(19-39) years, respectively), BMI (22.20.2 vs. 21.70.4 Kg/m2) and markers of the follicular ovarian status (serum AMH levels (3.1(1.1-8.2) vs. 3.3(0.7-11.7) ng/mL, respectively) and AFC (16(5-44) vs. 16(4-38) follicles, respectively)). In addition, there were no significant difference in the number of oocyte recovered, and in the OORT (8(0-21) vs. 8(0-28) follicles and 48.7%4.8 vs. 47.3%5.0, respectively). Moreover, maturation rates after 24h and 48h of culture (68.4%4.2 vs. 67.4%4.9, and 9.5%1.5 vs. 9.2%2.1, respectively), as well as fertilization rates (87.5%2.1 vs. 88.5%1.9) were comparable in the Follicular and Luteal groups. Finally, the total number of oocytes (6.50.6 vs. 6.20.9) and embryos (5.60.7 vs. 5.40.8) cryopreserved were similar in both groups. CONCLUSION: That no major difference in the IVM and fertilization rates of immature oocytes retrieved during the follicular or the luteal phase of the cycle was noticed suggests that this technique can be offered to patients seeking for urgent FP. O-24 Monday, October 22, 2012 04:30 PM BABY BUDGETING: A COST-EFFECTIVENESS ANALYSIS (CEA) OF ELECTIVE OOCYTE CRYOPRESERVATION (EOC) AS A MEANS TO INCREASE LIVE BIRTH RATES (LBR) IN WOMEN DELAYING REPRODUCTION. K. Devine,a S. Mumford,b B. HodesWertz,c S. Druckenmiller,c A. Propst,d N. N. Noyes.c aProgram in Adult and Reproductive Endocrinology, NICHD, National Institutes of Health, Bethesda, MD; bEpidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, NICHD, National Institutes of Health, Bethesda, MD; cNYU Fertility Center, NYU School of Medicine, New York, NY; d Uniformed Services University of Health Sciences, Bethesda, MD.
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FERTILITY & STERILITYÒ
RESULTS: Of 1000 women, 712 familiar with IUDs answered IUD-related questions during the survey and all 201 physicians responded to questions about IUDs. In response to ‘‘What do you think are the benefits of IUDs as a contraceptive method?’’ women were less likely than Ob-Gyns and FPs to view IUDs as convenient (58% vs 79% and 84%), easily reversible (5% vs 20% and 14%), highly-effective (18% vs 47% and 35%), or cost-effective (1% vs 14% and 7%). Although Ob-Gyns and FPs generally shared similar perceptions about the benefits of IUDs, some differences were noted between them that may influence the dialog with women during contraception counseling. CONCLUSION: While IUDs have increased in popularity, misconceptions and gaps in perception about this method of birth control exist among women and physicians. Education is needed to close these gaps and improve physician communication with reproductive-age women about IUDs, with emphasis that IUDs can provide an effective, convenient, and safe contraceptive choice. Supported by: Teva Global Branded Products R&D. FERTILITY PRESERVATION O-23 Monday, October 22, 2012 04:15 PM SIMILAR IN VITRO MATURATION (IVM) AND FERTILIZATION RATES OF OOCYTES RETRIEVED EITHER AT THE FOLLICULAR OR THE LUTEAL PHASE OF THE CYCLE OFFERS FLEXIBLE OPTIONS FOR URGENT FERTILITY PRESERVATION (FP). M. Grynberg,a M. Even,a L. Hesters,b R. Treves,a R. Fanchin,a N. Frydman.b aDivision of Reproductive Medicine, H^opital Antoine Beclere, Clamart, France; bDepartment of Reproductive Biology, H^opital Antoine Beclere, Clamart, France. OBJECTIVE: To compare IVM and fertilization rates of immature oocytes retrieved during the follicular or the luteal phase of the cycle in an urgent FP program. DESIGN: Prospective study. MATERIALS AND METHODS: 94 candidates for urgent FP were studied. Serum AMH levels and antral follicle count (AFC) were measured prior to oocyte retrieval, irrespective of the cycle day. Patients were sorted into 2 groups according to the phase of the cycle in which eggs were harvested (Follicular Group, n¼52 and Luteal Group, n¼42). Oocyte retrieval was performed 36 hours after hCG administration. Number of immature oocytes recovered, maturation rates after 24 hours and 48 hours of culture, fertilization rates and total number of oocytes and embryos cryopreserved were assessed. Moreover, the oocyte output rate (OORT) was calculated by AFCx100/number of immature oocytes recovered. RESULTS: In both groups, women were comparable in terms of age (30(18-39) vs. 30(19-39) years, respectively), BMI (22.20.2 vs. 21.70.4 Kg/m2) and markers of the follicular ovarian status (serum AMH levels (3.1(1.1-8.2) vs. 3.3(0.7-11.7) ng/mL, respectively) and AFC (16(5-44) vs. 16(4-38) follicles, respectively)). In addition, there were no significant difference in the number of oocyte recovered, and in the OORT (8(0-21) vs. 8(0-28) follicles and 48.7%4.8 vs. 47.3%5.0, respectively). Moreover, maturation rates after 24h and 48h of culture (68.4%4.2 vs. 67.4%4.9, and 9.5%1.5 vs. 9.2%2.1, respectively), as well as fertilization rates (87.5%2.1 vs. 88.5%1.9) were comparable in the Follicular and Luteal groups. Finally, the total number of oocytes (6.50.6 vs. 6.20.9) and embryos (5.60.7 vs. 5.40.8) cryopreserved were similar in both groups. CONCLUSION: That no major difference in the IVM and fertilization rates of immature oocytes retrieved during the follicular or the luteal phase of the cycle was noticed suggests that this technique can be offered to patients seeking for urgent FP. O-24 Monday, October 22, 2012 04:30 PM BABY BUDGETING: A COST-EFFECTIVENESS ANALYSIS (CEA) OF ELECTIVE OOCYTE CRYOPRESERVATION (EOC) AS A MEANS TO INCREASE LIVE BIRTH RATES (LBR) IN WOMEN DELAYING REPRODUCTION. K. Devine,a S. Mumford,b B. HodesWertz,c S. Druckenmiller,c A. Propst,d N. N. Noyes.c aProgram in Adult and Reproductive Endocrinology, NICHD, National Institutes of Health, Bethesda, MD; bEpidemiology Branch, Division of Epidemiology, Statistics, and Prevention Research, NICHD, National Institutes of Health, Bethesda, MD; cNYU Fertility Center, NYU School of Medicine, New York, NY; d Uniformed Services University of Health Sciences, Bethesda, MD.
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