Effect of paternal age on blastocysts aneuploidy rates

Table 1. Effect of density gradient centrifugation on ASA levels before and after sperm washing in patients with low (IBT<20%) and high (IBT >20%) ASA.

% Antisperm antibodies Pre-wash Post-wash Percent change p value

Group 1 (IBT <20%)

Group 2 (IBT >20%)

11.0 (7.0; 15.0) 6.5 (4.0; 11.0) -40.0 (-57.1; -16.6) <0.01

30.0 (24.0; 32.5) 19.5 (13.0; 27.5) -36.8 (-52.3; -3.9) 0.02

p value <0.001 <0.001 0.75

Data reported as median and 95% confidence interval. Percent change calculated as median of individual changes. Wilcoxon rank sum test used to compare pre- and post-wash ASA levels, as well as ASA levels between the groups. CONCLUSION: Sperm washing by density gradient centrifugation is an overall effective method to remove antibodies bound to sperm membranes, regardless of the levels of ASA in the neat semen. Due to an inter-individual variation in the effectiveness of the method, we recommend that each patient be tested before applying sperm washing by density gradient centrifugation in intrauterine insemination. P-650 Wednesday, October 22, 2014 EFFECT OF PATERNAL AGE ON BLASTOCYSTS ANEUPLOIDY RATES. D. Das, T. H. Taylor, J. Patrick, J. Crain, N. Teaff, R. Wing. Reproductive Endocrinology Associates of Charlotte, Charlotte, NC. OBJECTIVE: The correlation of maternal age and aneuploidy has been well studied but the effect of paternal age on aneuploidy is still not clear. With the current trend of couples starting a family at a later age this becomes an important emerging issue. Here we examined the effect of paternal age on aneuploidy when controlling for maternal age. DESIGN: Retrospective, single clinic study. MATERIALS AND METHODS: Patients undergoing IVF with comprehensive chromosome screening at the blastocyst stage were included in the study. Patients were divided into four groups based upon paternal and maternal age: maternal age <35 years and paternal age <40 years (group 1), maternal age <35 years and paternal age R40 years (group 2), maternal age R35 years and paternal age <40 years (group 3), and maternal age R35 years and paternal age R40 years (group 4). RESULTS: A total of 43, 16, 55, and 55 patients were included in groups 1, 2, 3, and 4, respectively. Average paternal age between group 1 and group 2 was significant, 34.0
2.7 years and 39.8
5.0 years, receptively (P<0.0001). Average maternal age between group 1 and group 2 was not significant, 31.6
2.1 years and 31.3
1.6 years, respectively (P¼0.5782). Blastocyst aneuploidy rates were not significantly higher in group 1 compared to group 2, 107/172 (62.2%) and 50/77 (64.9%), respectively (P¼0.7873). Average paternal age between group 3 and 4 was significant, 36.8
2.5 years and 45.3
5.9 years, respectively (P<0.0001). Average maternal age between group 3 and 4 was not significant, 38.2
2.2 years and 38.9
1.3 years, respectively (P¼0.0536). Blastocyst aneuploidy rates were significantly higher in group 3 compared to group 4, 93/196 (47.5%) and 70/202 (34.6%), respectively (P¼0.0127). CONCLUSION: Our results indicate that paternal age has little to no influence in a younger maternal population (<35 years). However, there is a significant increase in blastocyst aneuploidy rates in an older maternal population (>¼35 years) when the male is >¼40 years compared to younger men (<40 years old). This may indicate that oocytes from older women cannot compensate for the paternal contribution to aneuploidy at the same rate as oocytes from young women. Supported by: Reproductive Endocrinology Associates of Charlotte.

P-651 Wednesday, October 22, 2014 INVO & ICSI: A PIONEER IDEA AND A REAL ALTERNATIVE FOR ART. E. Lucena, H. Moreno, O. Lombana, A. Moran, L. Coral, C. Esteban. Reproductive Medicine, CECOLFES (Colombian Fertility and Sterility Center), Bogota, Colombia. OBJECTIVE: Intravaginal culture of oocytes (INVO) is an assisted reproductive technique (ART) that allows oocyte fertilization and early embryo development inside of air free, gas-permeable (CO2 and O2) plastic device

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ASRM Abstracts

called INVOcellTM. This study reports an application of INVO procedure for patients displaying male factor. After intracitoplasmatic sperm injection (ICSI) procedure, microinjected oocytes are placed into INVO device to be incubated inside of vaginal cavity. A total of 172 of cycles of couples showing male factor as cause of infertility were included in the INVO – ICSI protocol, from January to December 2012 in CECOLFES as a novel optional treatment in ART, showing similar results compared to classical ICSI procedures. DESIGN: Mild ovarian stimulation, ICSI procedure, INVO technique, embryo transfer (ET), and detection of b hCG hormone after fourteen days of ET. MATERIALS AND METHODS: In the present study, a total of 172 cycles were undergone to INVO-ICSI protocol after giving consent. Natural cycle or mild controlled ovarian stimulation with clomiphene citrate (OMIFINÒ) and hMG (MerionalÒ) were used. An average of 4.7 microinjected oocytes per patient were placed in the INVOcellTM containing G2 PLUSÒ of VitroLife stabilized at 37 grades centigrade. Seminal samples were collected one hour before oocyte retrieval and enabled using density gradients protocol for sperm capacitation. ICSI was performed on each oocyte and all microinjected oocytes were placed into the INVO device. INVO was then inserted in the vaginal cavity during 72 hours for incubation and at that time it was removed to recover the embryos for immediate uterine embryo transfer. Detection of serum b hCG was performed fourteen days later. RESULTS: A total of 172 cycles were performed. On average 6.5 oocytes per cycle were retrieved, a mean of 4.7 microinjected oocytes were placed into INVOcell device, and a mean number of transferred embryos per cycle was 2.0. The cleavage rate obtained after the INVO culture was 53.1%. A total number of 65 clinical pregnancies (59 single pregnancies and 6 multiple pregnancies) were achieved corresponding to 37.9 % of pregnancy rate per cycle and to 40.3% of pregnancy rate per transfer. CONCLUSION: This study shows for the first time that INVO-ICSI protocol can be an effective and viable alternative treatment option in ART to achieve pregnancy after ICSI since the severity of male factors is 68% with comparable results to those reported using classical ICSI. Supported by: Colombian fertility and sterilitiy center - CECOLFES.

P-652 Wednesday, October 22, 2014 IVF OUTCOME IN AZOOSPERMIC CANCER SURVIVORS. S. Dar,a J. Levron,a J. Haas,a R. Machtinger,a A. Kedem,a I. Gat,a I. Madgar,b R. Orvieto,a G. Raviv.b aIVF Unit, Chaim Sheba Medical Center, Ramat Gan, Israel; bUrology, Chaim Sheba Medical Center, Ramat Gan, Israel. OBJECTIVE: The number of cancer survivors is increasing constantly and an average of 15-30% of them remain sterile in the long term As such, concerns about fertility and family planning are more relevant than ever. Successful pregnancies have been reported with IVF/ICSI utilizing testicular sperm. We therefore aim to evaluate the IVF outcome in azoospermic cancer survivors, who underwent testicular sperm extraction (TESE) and IVF/ICSI in our tertiary university-affiliated IVF unit. DESIGN: A retrospective cohort study. MATERIALS AND METHODS: All consecutive azoospermic cancer survivors who underwent TESE consisting of multiple random biopsies and IVF/ICSI, between 1996 to 2011were evaluated. ICSI procedure was performed using sperm retrieved. Fertilization was confirmed by the presence of two pronuclei (PN) on the day after ICSI. Embryo transfer (ET) was done on day 2 or 3. Clinical pregnancy was defined as the presence of an intrauterine gestational sac with embryonic pole diagnosed by ultrasonography. Demographic information, pretreatment hormones levels and TESE and ICSI outcomes were analyzed. RESULTS: During the study period, 31 cancer survivors underwent 39 TESE combined with IVF/ICSI cycles. The mean patients’ age and serum FSH level were 34.0
7.0 years and 18.8
10.4 IU/L, respectively. The average left and right testicular volumes were 17.2
4.2 ml and 13.4
8.8 ml, respectively. The mean time from chemotherapy to TESE was 8.2
2.6 years. Sperm was retrieved on the day of oocyte retrieval (fresh cycle). Sperm was successfully retrieved in 11 out of 31 patients (35.5%) on initial TESE, with an overall sperm retrieval rate of 38.4% (15 of 39). The average number of retrieved oocytes was 14.0
4.0 per cycle, with clinical pregnancy and live birth rates per successful TESE of 60% (9 of 15) and 53.3% (8 of 15), respectively. Age, serum FSH, testicular volume and time from chemotherapy to TESE were not significantly different between patients with successful TESE to those without successful TESE. Non Hodgkin lymphoma 1 0f 3, leukemia 0 of 3, solid tumors 4 of 11, Hodgkin lymphoma 4 of 11 and Seminoma

Vol. 102, No. 3, Supplement, September 2014