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A relational database for successful storage and data analysis in a reproductive medicine program
FSH monitoring may thus represent a useful tool to standardize the approach to COH in letrozole-IVF cycles. Further studies are needed to determine the utility of FSH monitoring in cycle management with standard ovarian stimulation protocols. Supported by: None.
P-227 A RELATIONAL DATABASE FOR SUCCESSFUL STORAGE AND DATA ANALYSIS IN A REPRODUCTIVE MEDICINE PROGRAM. M. Cheng, S. Hong, T. Takeuchi, Q. V. Neri, Z. Rosenwaks, G. D. Palermo. The Center for Reproductive Med & Infertility, Cornell University, New York, NY. OBJECTIVE: To craft a database where a reproductive laboratory can store records concurrently and quickly provide precise information to each user. Here, we compared the efficiency and accuracy of such a customized database with that of a conventional hard copy and spreadsheet system. DESIGN: The Patient Demographics (PD) commences as the core and the main page of the database. From the PD a unique identifier branches out to 4 tables of andrological information as well as ICSI. From ICSI, another distinct identifier is used for 4 tables of IVF assessments. MATERIALS AND METHODS: A computer designated as the local area network acted as a server containing the database. All users participated in a 1 hr training class. Tests for both spreadsheet and study databases were run for all recurrent clinical and research scenarios. RESULTS: The user-friendly database included one main page PD and 5 tables: Semen Analysis (SA), IUI, Cryopreservation (Cryo), Cryostorage of Surgical Specimens (CSS), and ICSI. All tables can be accessed from PD in form of portals which allow unlimited storage of attempts per procedure, all viewable as a summary on one page. From Sept 2006 to May 2008, we entered 3470 PD, 2059 SA, 3509 IUI, 630 Cryo, 231 CSS, and 1878 ICSI cycles. The information for each table can be entered directly at the laboratory bench as soon as it becomes available. At the end of each procedure, the display print-out generated a hard copy for laboratory filing, and for patient charting. Regarding security, only specific personnel were granted privileges where a password had to be entered prior to gaining access or enter records into the database. The privileges for each password are tailored to the individual’s needs. The likelihood of unintentionally altering results or leakage of patients’ information is reduced. This database system drastically reduced the time required for technicians to transcribe, photocopy, classify, and enter a specific record. CONCLUSIONS: The conventional hard copy and spreadsheet is habitually vulnerable to inconsistencies. A customized database on the other hand, allows a single entry, provides data storage, and can be quickly modified according to the guidelines for standard operating procedures. The different levels of access grant a superior level of security. Lastly, because of the possibility to customize the screen similar to the original paper reports, it renders the use of a multi-relational database straightforward and pleasant for both medical and technical staff alike. Supported by: Insitutional.
P-228
ENVIRONMENT AND TOXICOLOGY
A SIGNIFICANT SEASONAL VARIABILITY IN PREGNANCY RATES IN WOMEN UNDERGOING IVF WAS DEMONSTRATED. S. Kim, K. H. Lee, S. Kim, S. G. Lee, B. Do. Infertility Lab., Mamapapa baby Obstetrics and Gynecology, Ulsan, Republic of Korea. OBJECTIVE: Several studies have investigated seasonal variations during IVF-ET. Their results are contradictory, especially concerning pregnancy rates. The study’s aim was to investigate the influence of seasonality in pregnancy rates following IVF-ET. DESIGN: Retrospective study. MATERIALS AND METHODS: We retrospectively studied 772 consecutive cycles of 732 women who underwent IVF-ET treatment over a 3-year period (2004-2006) at our institution. The seasons were defined before analyzing the data, according to the calendar definitions of the seasons in Korea, three months each, as follows: Winter: December-February, Spring: MarchMay, Summer: June-August, Autumn: September-November. We divided with four seasons according to the day when it picks the ovum, and we analyzed a pregnancy rate. Pregnancy rate are compared among different groups using t-test.
S184
Abstracts
RESULTS: The mean SD age of the patients (winter: 33.74.3, spring: 33.83.7, summer: 34.04.0, and autumn: 34.04.1), fertilized oocytes (8.14.7, 7.24.5, 7.85.2, 8.56.0) and the embryos transferred (4.01.0, 3.91.2, 3.91.2, 4.01.3) were comparable in patients by season. The 772 embryo transfers performed during the study period resulted in 371 pregnancies (48.1%), of which 310 proved to be ongoing pregnancies (40.2%). An Implantation rate of 18.6% was recorded. Average seasonal variability in pregnancy rates was demonstrated. A one-way analysis of variance showed a significant seasonal variability in pregnancy rates: winter: 44.6 (62/ 139)%; spring: 53.5 (92/172)%; summer: 50.2 (130/259)%; and autumn: 43.1 (87/202)%(P <0.01). Note that the highest pregnancy rates were observed during the spring and the lowest in the autumn. CONCLUSIONS: This study demonstrates a significant seasonal variability in the pregnancy rates in IVF-ET. Comparing our analysis of the different seasons, the highest pregnancy rates were found in spring, despite a lower number of retrieved oocytes, fertilized oocytes and embryo transfers. Moreover, there were lower conception rates during autumn, the time period when both retrieved oocytes and fertilized oocytes are at their highest. However, the effectiveness of this study is drawn into question due to the fact that there were no proven correlations established between pregnancy rates and any of the seasonal parameters (including temperature, humidity and other environmental factors). Therefore, further studies are necessary to confirm this predictive parameter and to achieve more precise results in a larger population. Supported by: None. P-229 CIGARETTE SMOKING INCREASED SEMINAL PLASMA CHOLESTEROL LEVELS AND SIGNIFICANTLY REDUCED INTRACELLULAR SPERM CALCIUM IN SAMPLES FROM INFERTILE MALES. T. Viloria, N. Garrido, M. Calonge, J. Remohı, A. Pellicer, M. Meseguer. IVF Laboratory, Instituto Universitario IVI-Valencia, Valencia, Spain; Andrology Laboratory, Instituto Universitario IVI-Valencia, Valencia, Spain; IVF Laboratory, IVI-Chile, Santiago de Chile, Chile; Gynecologyst, Instituto Universitario IVI-Valencia, Valencia, Spain; Gynecologyst, Instituto Universitario IVI-Valencia, Valencia, Spain. OBJECTIVE: Cigarette smoking is one of the most common toxic habits that are able to induce deleterious effects on gametes and has been associated with an increase in oxidative stress within the ejaculates. We are previously demonstrated that smoking is negatively affecting intracellular antioxidant enzymes. Also, it could be interesting to study other molecular changes on sperm. Intracellular concentrations of calcium ([Caþ2]) and cholesterol ([CH]) in the sperm membrane has been demonstrated to be important markers of the sperm quality due to its direct relationship with sperm morphology and fertility potential; and mitochondrial activity (MA) is strongly related with sperm motility. Our aim with this study was to correlate levels of Caþ2, CH and MA with the cigarette consumption (CC). DESIGN: Prospective cohort study on 135 semen samples from infertile males. MATERIALS AND METHODS: Two groups were established according to CC: non-smoking (n¼73) and smoking males (n¼62). Patients with recent fever, exposure to gonadotoxins or heavy metals, and those with alcohol and/ or drug consumption in the previous 3 months were excluded. T test was employed to detect significant differences. Basic sperm parameters were analyzed; [Caþ2] and [CH] on seminal plasma were determined by enzymoimmunoanalysis. Intracellular [Caþ2] and [CH] in the sperm membrane and MA, were determined by fluorometry. RESULTS: There was no correlation between standard seminal parameters and CC; [CH] on seminal plasma in smokers was higher than in non smokers (p¼0.044). However, sperm plasma membrane [CH] between smokers and non smokers had not significant differences. Seminal plasma Caþ2 had not significant differences between groups, but intracellular Caþ2 in smokers resulted significantly diminished when where compared with non smokers (p¼0.030). The MA present in smokers and non smokers was not different. CONCLUSIONS: We have observed a significant increase of CH levels in seminal plasma from smokers (as described in smoker’s blood); but not on sperm membrane; probably preserving the capacitation function in which CH has been implicated. We have also demonstrated that smoking is negatively affecting intracellular sperm Caþ2, and this phenomenon should produce important changes in the cellular physiology of those sperm cells from infertile male smokers, although their mitochondrias were not altered. Further research is needed to study the potential negative effects of cigarette on gametes. Supported by: None.
Vol. 90, Suppl 1, September 2008
P-227 A RELATIONAL DATABASE FOR SUCCESSFUL STORAGE AND DATA ANALYSIS IN A REPRODUCTIVE MEDICINE PROGRAM. M. Cheng, S. Hong, T. Takeuchi, Q. V. Neri, Z. Rosenwaks, G. D. Palermo. The Center for Reproductive Med & Infertility, Cornell University, New York, NY. OBJECTIVE: To craft a database where a reproductive laboratory can store records concurrently and quickly provide precise information to each user. Here, we compared the efficiency and accuracy of such a customized database with that of a conventional hard copy and spreadsheet system. DESIGN: The Patient Demographics (PD) commences as the core and the main page of the database. From the PD a unique identifier branches out to 4 tables of andrological information as well as ICSI. From ICSI, another distinct identifier is used for 4 tables of IVF assessments. MATERIALS AND METHODS: A computer designated as the local area network acted as a server containing the database. All users participated in a 1 hr training class. Tests for both spreadsheet and study databases were run for all recurrent clinical and research scenarios. RESULTS: The user-friendly database included one main page PD and 5 tables: Semen Analysis (SA), IUI, Cryopreservation (Cryo), Cryostorage of Surgical Specimens (CSS), and ICSI. All tables can be accessed from PD in form of portals which allow unlimited storage of attempts per procedure, all viewable as a summary on one page. From Sept 2006 to May 2008, we entered 3470 PD, 2059 SA, 3509 IUI, 630 Cryo, 231 CSS, and 1878 ICSI cycles. The information for each table can be entered directly at the laboratory bench as soon as it becomes available. At the end of each procedure, the display print-out generated a hard copy for laboratory filing, and for patient charting. Regarding security, only specific personnel were granted privileges where a password had to be entered prior to gaining access or enter records into the database. The privileges for each password are tailored to the individual’s needs. The likelihood of unintentionally altering results or leakage of patients’ information is reduced. This database system drastically reduced the time required for technicians to transcribe, photocopy, classify, and enter a specific record. CONCLUSIONS: The conventional hard copy and spreadsheet is habitually vulnerable to inconsistencies. A customized database on the other hand, allows a single entry, provides data storage, and can be quickly modified according to the guidelines for standard operating procedures. The different levels of access grant a superior level of security. Lastly, because of the possibility to customize the screen similar to the original paper reports, it renders the use of a multi-relational database straightforward and pleasant for both medical and technical staff alike. Supported by: Insitutional.
P-228
ENVIRONMENT AND TOXICOLOGY
A SIGNIFICANT SEASONAL VARIABILITY IN PREGNANCY RATES IN WOMEN UNDERGOING IVF WAS DEMONSTRATED. S. Kim, K. H. Lee, S. Kim, S. G. Lee, B. Do. Infertility Lab., Mamapapa baby Obstetrics and Gynecology, Ulsan, Republic of Korea. OBJECTIVE: Several studies have investigated seasonal variations during IVF-ET. Their results are contradictory, especially concerning pregnancy rates. The study’s aim was to investigate the influence of seasonality in pregnancy rates following IVF-ET. DESIGN: Retrospective study. MATERIALS AND METHODS: We retrospectively studied 772 consecutive cycles of 732 women who underwent IVF-ET treatment over a 3-year period (2004-2006) at our institution. The seasons were defined before analyzing the data, according to the calendar definitions of the seasons in Korea, three months each, as follows: Winter: December-February, Spring: MarchMay, Summer: June-August, Autumn: September-November. We divided with four seasons according to the day when it picks the ovum, and we analyzed a pregnancy rate. Pregnancy rate are compared among different groups using t-test.
S184
Abstracts
RESULTS: The mean SD age of the patients (winter: 33.74.3, spring: 33.83.7, summer: 34.04.0, and autumn: 34.04.1), fertilized oocytes (8.14.7, 7.24.5, 7.85.2, 8.56.0) and the embryos transferred (4.01.0, 3.91.2, 3.91.2, 4.01.3) were comparable in patients by season. The 772 embryo transfers performed during the study period resulted in 371 pregnancies (48.1%), of which 310 proved to be ongoing pregnancies (40.2%). An Implantation rate of 18.6% was recorded. Average seasonal variability in pregnancy rates was demonstrated. A one-way analysis of variance showed a significant seasonal variability in pregnancy rates: winter: 44.6 (62/ 139)%; spring: 53.5 (92/172)%; summer: 50.2 (130/259)%; and autumn: 43.1 (87/202)%(P <0.01). Note that the highest pregnancy rates were observed during the spring and the lowest in the autumn. CONCLUSIONS: This study demonstrates a significant seasonal variability in the pregnancy rates in IVF-ET. Comparing our analysis of the different seasons, the highest pregnancy rates were found in spring, despite a lower number of retrieved oocytes, fertilized oocytes and embryo transfers. Moreover, there were lower conception rates during autumn, the time period when both retrieved oocytes and fertilized oocytes are at their highest. However, the effectiveness of this study is drawn into question due to the fact that there were no proven correlations established between pregnancy rates and any of the seasonal parameters (including temperature, humidity and other environmental factors). Therefore, further studies are necessary to confirm this predictive parameter and to achieve more precise results in a larger population. Supported by: None. P-229 CIGARETTE SMOKING INCREASED SEMINAL PLASMA CHOLESTEROL LEVELS AND SIGNIFICANTLY REDUCED INTRACELLULAR SPERM CALCIUM IN SAMPLES FROM INFERTILE MALES. T. Viloria, N. Garrido, M. Calonge, J. Remohı, A. Pellicer, M. Meseguer. IVF Laboratory, Instituto Universitario IVI-Valencia, Valencia, Spain; Andrology Laboratory, Instituto Universitario IVI-Valencia, Valencia, Spain; IVF Laboratory, IVI-Chile, Santiago de Chile, Chile; Gynecologyst, Instituto Universitario IVI-Valencia, Valencia, Spain; Gynecologyst, Instituto Universitario IVI-Valencia, Valencia, Spain. OBJECTIVE: Cigarette smoking is one of the most common toxic habits that are able to induce deleterious effects on gametes and has been associated with an increase in oxidative stress within the ejaculates. We are previously demonstrated that smoking is negatively affecting intracellular antioxidant enzymes. Also, it could be interesting to study other molecular changes on sperm. Intracellular concentrations of calcium ([Caþ2]) and cholesterol ([CH]) in the sperm membrane has been demonstrated to be important markers of the sperm quality due to its direct relationship with sperm morphology and fertility potential; and mitochondrial activity (MA) is strongly related with sperm motility. Our aim with this study was to correlate levels of Caþ2, CH and MA with the cigarette consumption (CC). DESIGN: Prospective cohort study on 135 semen samples from infertile males. MATERIALS AND METHODS: Two groups were established according to CC: non-smoking (n¼73) and smoking males (n¼62). Patients with recent fever, exposure to gonadotoxins or heavy metals, and those with alcohol and/ or drug consumption in the previous 3 months were excluded. T test was employed to detect significant differences. Basic sperm parameters were analyzed; [Caþ2] and [CH] on seminal plasma were determined by enzymoimmunoanalysis. Intracellular [Caþ2] and [CH] in the sperm membrane and MA, were determined by fluorometry. RESULTS: There was no correlation between standard seminal parameters and CC; [CH] on seminal plasma in smokers was higher than in non smokers (p¼0.044). However, sperm plasma membrane [CH] between smokers and non smokers had not significant differences. Seminal plasma Caþ2 had not significant differences between groups, but intracellular Caþ2 in smokers resulted significantly diminished when where compared with non smokers (p¼0.030). The MA present in smokers and non smokers was not different. CONCLUSIONS: We have observed a significant increase of CH levels in seminal plasma from smokers (as described in smoker’s blood); but not on sperm membrane; probably preserving the capacitation function in which CH has been implicated. We have also demonstrated that smoking is negatively affecting intracellular sperm Caþ2, and this phenomenon should produce important changes in the cellular physiology of those sperm cells from infertile male smokers, although their mitochondrias were not altered. Further research is needed to study the potential negative effects of cigarette on gametes. Supported by: None.
Vol. 90, Suppl 1, September 2008