A closed vitrification system enables a safe and an aseptic vitrification without impairing the developmental competence of human embryos

the third such case and the first record of pregnancy following UTn in a rabbit model. Our single pregnancy did not result in the birth of a healthy term offspring. However the demonstration of pregnancy in this allogeneic model is a proof of concept of UTn and thereby an essential step in the research toward clinical application of UTn. This resorbed pregnancy may be explained by tacrolimus treatment and the surgical techniques employed during the grafting process. Advances in both as well as novel modalities to induce tolerance of a transplanted uterus may minimize these problems in the future. P-39 Tuesday, October 23, 2012 TRENDS IN ONCOFERTILITY SERVICES AND COSTS ACROSS THE NATION: HAVE WE OVERCOME THE FINANCIAL BARA. Crisci,a,b RIERS TO ACCESS? L. A. Kondapalli,a K. W. Timmerman,c C. Ahrendsen,a T. K. Woodruff.c aObstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO; b Fertile Action, Los Angeles, CA; cOncofertility Consortium, Northwestern University, Chicago, IL. OBJECTIVE: While fertility is important to cancer patients, limited data exists about the average costs of various fertility preservation (FP) options. Our aim was to assess the scope of FP options offered to cancer patients, the associated costs and utilization rates across the country. DESIGN: Cross-sectional study of oncofertility providers. MATERIALS AND METHODS: A 25-item survey instrument was developed to evaluate oncofertility practice patterns, utilization and costs. Participants, identified through professional membership lists were invited to complete the secure, web-based survey. Costs included consultation, egg retrieval, sperm freezing, long-term storage and ICSI, and excluded future transfer costs and PGD. RESULTS: Participants (n¼48) were in clinical practice for mean 13.9 years. Although>60% market their oncofertility services to patients and oncologists, only 30% offer FP consultations to male patients. Of note, only half of respondents were aware of ICD V codes used for FP. Two-thirds of providers acquired FP knowledge through self-study while 25% received formal academic training. While sperm and embryo cryopreservation were generally offered, only 10% performed in vitro maturation (IVM) of oocytes, primarily under an experimental protocol. The mean cost of oocyte cryopreservation was $6608, and embryo cryopreservation was $8285, with maximum cost of $12500. The mean cost of sperm cryopreservation was $244 and annual storage fees of $381. Providers report that financial constraints and patients feeling overwhelmed were the most common reasons that patients did not proceed with FP. CONCLUSION: FP is an expanding field with varying training, services and costs. Men appear underserved by current FP practices. On average, embryo cryopreservation has 20% greater costs than oocytes alone. Providers admit that cost remains a barrier to access these services, yet few are aware of ICD V codes. Further research into usage of stored gametes needs to be conducted. Supported by: NIH 5K12HD001271-12 (LAK), NIH 5UL1DE019587(KT and TKW). CRYOPRESERVATION

P-40 Tuesday, October 23, 2012 A CLOSED VITRIFICATION SYSTEM ENABLES A SAFE AND AN ASEPTIC VITRIFICATION WITHOUT IMPAIRING THE DEVELOPMENTAL COMPETENCE OF HUMAN EMBRYOS. A. Amo, S. Hashimoto, S. Hama, K. Oosumi, Y. Nakaoka, Y. Morimoto. IVF Namba Clinic, Osaka, Japan. OBJECTIVE: To avoid the risk of contamination by bacteria, virus and prions, we compared the developmental competence of human embryos vitrified using a closed vitrification system (CVS) with that using an open vitrification system (OVS). DESIGN: Prospective randomized human study. MATERIALS AND METHODS: This study was approved by a local IRB of IVF Namba Clinic. In experiment 1 and 2, vitrified embryos donated from patients who completed fertility treatment and gave informed consent were used. In experiment 1, 66 embryos at pronuclear stage were divided randomly into 2 groups after warming: CVS (Rapid-I, Vitrolife) and OVS (Cryotop, Kitazato medical) and were re-vitrified using CVS or OVS. After warming, embryos de-

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velopment and blastocysts cell number were assessed. In experiment 2, 60 vitrified-warmed blastocysts were divided randomly into 3 groups (CVS, OVS, and non-revitrified) and were assessed the proportion of dead cell by staining with Hoechst and Propidium iodide. In experiment 3, 27 high grade blastocysts were randomly divided into two groups and were vitrified using CVS (14) and OVS (13). After warming, single blastocyst transfer was performed. RESULTS: There were no differences between CVS and OVS in the survival rates (100% vs. 100%, respectively), the blastulation rates (Day 5: 50% vs. 50%; Day 6: 68% vs. 56%, respectively), the rate of good blastocyst (Day 5: 32% vs. 22%, Day 6: 47% vs. 41%, respectively), and the mean cell numbers (137 vs. 138) in experiment 1. In experiment 2, the proportion of dead cells in re-vitrified blastocysts were similar at 31%, 38% and 32% in the groups CVS, OVS and non-revitrified respectively. In experiment 3, the implantation rate of blastocysts vitrified using CVS (73%) was comparable to that for the OVS group (54%). CONCLUSION: The closed vitrification system overcomes the concerns associated with direct liquid nitrogen contact in the open system without impairing the developmental competence of human embryos. P-41 Tuesday, October 23, 2012 THE VITRIFICATION METHOD IS SIGNIFICANTLY BETTER FOR THAWING OF SLOW-FREEZING EMBRYOS. E. Kojima,a,b N. Fukunaga,a,b,c R. Nagai,a,b H. Kitasaka,a,b H. Ohno,a,b Y. Asada.a,b,c a Asada Ladies Nagoya Clinic, Nagoya, Aichi, Japan; bAsada Ladies Kachigawa Clinic, Kasugai, Aichi, Japan; cThe Asada Institute for Reproductive Medicine, Kasugai, Aichi, Japan. OBJECTIVE: In Japan, the method used for human embryo cryopreservation in assisted reproductive technology has recently changed from a slowfreezing to a vitrification method with good embryonic development and a high rate of survival after thawing. Although we changed the standard cryopreservation procedure in 2008, we have many slow-freezing embryos and have to continuously prepare media for thawing these embryos. We therefore assessed the effect of using vitrification-thawing media for slow-freezing embryos. DESIGN: Prospective study. MATERIALS AND METHODS: All pronuclear embryos intended for research were used after obtaining informed consent from patients. We evaluated the survival rate and development of the embryos. Slow-freezing pronuclear embryos were thawed using vitrification-thawing media (group A, 43 embryos, 10 cycles and 10 women) or slow-thawing media (group B, 316 embryos, 47 cycles and 42 women). RESULTS: The survival rate of embryos in groups A and B was 100% (43/ 43) and 92.4% (292/316), respectively. The rate of cleavage on day 3 was 100% (43/43) and 96.9% (283/292), respectively. These were not significant differences. The rate of blastocyst formation (RB1) on day 5 was 41.9% (18/ 43) and 36.6% (94/257), respectively, showing no significant difference. The rate of blastocyst formation on day 5 (RB3) was 7.0% and 11.7% (30/257), respectively, and showed no significant differences. The rate of blastocyst formation (RB1) on day 5–6 was 65.1% (28/43) and 48.6% (125/257), respectively, with group A showing a significantly higher rate than group B. The rate of good-quality blastocyst formation on day 5–6 (RB3) was 30.2% (13/43) and 23.3% (60/257), respectively, and showed no significant differences. CONCLUSION: There was a significant difference in the rate of blastocyst formation (RB1) on day 5–6 between the two cryopreservation methods. Therefore, we recommend thawing a slow-frozen embryo using vitrification-thawing media.

P-42 Tuesday, October 23, 2012 PREGNANCY POTENTIAL AND PERINATAL OUTCOMES OF WARMED BLASTOCYSTS: THE INFLUENCE OF DELAYED BLASTULATION PRIOR TO VITRIFICATION. F-c. Hung. City Fertility Centre, Brisbane, QLD, Australia. OBJECTIVE: This study investigated whether embryos that reach blastocysts and cryopreserved at day 5 were more likely to result in a successful pregnancy than where blastulation is delayed until day 6. DESIGN: A retrospective clinical study examined the pregnancy and perinatal outcomes of vitrified blastocysts formed by day 5 compared to day 6. MATERIALS AND METHODS: 309 cycles of vitrified-warmed blastocysts transferred in 2009-10 were investigated. 211 cycles had day 5 blastocysts transferred and 98 cycles had day 6 blastocysts. Blastocysts were

Vol. 98, No. 3, Supplement, September 2012