- Email: [email protected]
Application for cryopreservation of a small number of human spermatozoa in a closed system by using rapid-i™ VIA vitrification
semen quality; however, it is uncertain if various cancers impact post-thaw sperm survival differently. The objective of this study was to characterize sperm parameters from a thawed semen sample from men with different cancers who cryopreserved prior to onco-therapy. DESIGN: Retrospective review. MATERIALS AND METHODS: We retrospectively evaluated the raw and test thaw semen data from men with newly diagnosed cancer at the University of Washington Male Infertility Laboratory from 1994-2009. A total of 798 semen samples were analyzed from men with the 8 most common cancers of which 477 underwent test thaw. For each raw and test thawed sample sperm concentration and motility were determined and total motile sperm counts (TMC) were calculated. Mean TMCs and changes in TMC for each cancer were compared to normal samples. RESULTS: The most common cancers in this study were: testicular, Hodgkin’s lymphoma, myeloid and lymphoid leukemias, prostate, sarcoma, brain, and lymphocytic cancer NOS. Not surprisingly, healthy patients had the best pre-cryo and post thaw semen quality. Patients with prostate cancer had the best raw and post thaw semen quality (TMC of 155.1 and 53.2, respectively). Lymphoid leukemias demonstrated the worst raw TMC (26.8 M motile/mL), however, myeloid leukemias displayed the worst post thaw TMC (6.9 M motile/mL). All specimens showed severe reductions in TMC after cryopreservation. CONCLUSION: All cryopreserved specimens showed severe decline in the total motile sperm count post thaw. The most severe reduction was seen in myeloid leukemia group, suggesting that these patients should be counseled to provide increased numbers of specimens for fertility preservation.
P-367 Wednesday, October 19, 2011 HIGH IMPLANTATION RATES FOLLOWING SINGLE EMBRYO TRANSFER PROVIDE SIMILAR PREGNANCY RATES TO MULTIPLE EMBRYO TRANSFER USING VITRIFIED DONOR OOCYTES. Z. P. Nagy, C.-C. Chang, D. P. Bernal, A. A. Toledo, D. Mitchell-Leef, D. B. Shapiro. RBA, Reproductive Biology Associates, Sandy Springs, GA. OBJECTIVE: To evaluate the efficiency of single and multiple embryo transfers in a donor-recipient program using vitrified/warmed oocytes. DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 5014 MII oocytes were obtained and vitrified from 225 donors who were screened and tested according to FDA and ASRM guidelines. Eggs were vitrified 3-4 h after retrieval using minimal volume method. ICSI was performed 2-3 h after warming. Embryos were evaluated morphologically prior to transfer, and when high quality embryos were observed the recipient had the possibility of a single embryo transfer. Clinical and laboratory parameters were analyzed using the Oneway ANOVA and the Fisher’s exact test at the level of P<0.05. RESULTS: Donors mean age was 26.1 2.7 years.
No. of recipients Recipient age (mean SD) No. of oocytes warmed (mean SD) No. of oocytes survived (%) No. of oocytes fertilized (%) No. of good quality embryos on Day3 (mean SD) No. of blastocysts (mean SD)* No of embryos for ET (mean SD) No. of embryos re-vitrified (mean SD) No. clinical pregnancies (%) No. of implantations (%)
Single-ET
Multi-ET
P
126 42.2 4.2
351 40.7 4.4
<0.01
711 (5.6 1.8) 2238 (6.4 2.0) <0.01 643 (90.4) 1957 (87.4) 560 (78.8) 1707 (76.3) 380 (3.0 1.6) 1040 (3.0 1.4)
0.04 NS NS
396 (3.5 1.5)
976 (3.6 1.5)
NS
126
725
NA
265 (2.1 1.5) 77 (61.1) 78 (61.9)
356 (1.0 1.3) <0.05 211 (60.1) 317 (43.7)
NS <0.05
There were 105 (49.8%) pregnancies with multiple implantations in the MET group, while there was only one twin pregnancy (due to monozygotic twinning) in the SET group (P<0.001). * Only for Day-5 ET cases (113 for SET and 274 for MET).
FERTILITY & STERILITYÒ
CONCLUSION: The outcome of the current study shows that SET of vitrified/warmed donor oocytes provides both high implantation rates (and virtually no risks for multiples) and high pregnancy rates similar to multiple embryo transfers. Thus, SET should be recommended when high quality embryo(s) are available for qualifying patients to achieve safe pregnancy outcomes.
P-368 Wednesday, October 19, 2011 IS THERE ANY DIFFERENCE IN VITRIFICATION AND SLOW FREEZING PROTOCOL FOR OOCYTE CRYOPRESERVATION? L. Okada, R. Azambuja, V. Lazzari, L. Dorfman, M. Badalotti, A. Petracco. Fertilitat_ Centro de Medicina Reprodutiva, Porto Alegre, RS, Brazil. OBJECTIVE: This study was an observational retrospective cohort, with the objective to compare oocyte cryopreservation efficiency between slow freezing using choline chloride based medium, and vitrification protocol using cryotop. DESIGN: A total of 101 cycles (slow freezing and vitrification techniques) were performed for those patients that decided to thaw their oocytes from 2009 to 2011. MATERIALS AND METHODS: All patients with at least 10 oocytes and not willing to freeze embryos were offered the possibility to cryopreserve oocytes. The oocytes cryopreserved by slow freezing followed Stachecki’s (1998) protocol, while the oocytes vitrified followed Kuwayama’s. (2005) protocol. The endometrium was prepared using Estradiol Benzoate with an initial dose of 2mg/day, starting on the 3rd day of the cycle. The maximum dosage used was 6mg/day when the endometrium reached a thickness of 8mm by ultrasound. Two days before the replacement of the embryos, the oocytes were thawed. After thawing, the oocytes were kept in a incubator during 2 hours before inseminating by ICSI. The survival, fertilization, cleavage, average embryo transfer and pregnancy rates were compared through the chisquare test (P<0.05). RESULTS: The results are as follow: TABLE 1. Outcome results from slow freezing versus vitrification protocol.
Cycles Oocytes Thawed Oocytes Survived* Oocytes Fertilized Embryos Cleaved Embryos Transferred Average Embryo Transfer Implantation Pregnancies Clinical Pregnancies *
Slow freezing (%)
Vitrification (%)
56 523 289 (55.2) 200 (69.2) 185 (92.5) 121 (65.4) 2.2
45 399 255 (63.9) 177 (69.4) 156 (88.1) 100 (64.1) 2.2
15 (12.4) 16 (28.6) 14 (25.0)
16 (16.0) 15 (33.3) 13 (28.9)
P¼0.0085
CONCLUSION: Although the survival rate was statistically higher for the vitrification technique, this did not result in a statistically higher implantation and/or pregnancy rate. Therefore both techniques are reliable to cryopreserve oocytes.
P-369 Wednesday, October 19, 2011 APPLICATION FOR CRYOPRESERVATION OF A SMALL NUMBER OF HUMAN SPERMATOZOA IN A CLOSED SYSTEM BY USING RAPID-IÔ VIA VITRIFICATION. A. Egashira, M. Murakami, K. Tanaka, H. Otsubo, T. Matsuguma, T. Kuramoto. Kuramoto Women’s Clinic, Fukuoka, Japan. OBJECTIVE: In this study, we evaluated the usefulness of the Rapid-iÔ vitrification system for cryopreserving a small number of spermatozoa in a closed system.
S215
DESIGN: Retrospective study. MATERIALS AND METHODS: Motile sperm obtained from the ejaculated sperm were collected from 2 azoospermic men and testicular sperm were obtained from 4 men with obstructive azoospermia. The cryoprotective solution consisted of a mixture of K-SISC and K-SISM buffers (Sydney IVF, Australia) in a 2:1 ratio. We aspirated 1–5 sperm into an ICSI pipette by using micromanipulation and deposited them into a 1.5-mL droplet of cryoprotective solution in the hole of a Rapid-iÔ at room temperature. The Rapid-iÔ was placed in liquid nitrogen vapour for 2 min and inserted into a pre-cooled RapidStrawÔ (Vitrolife). The RapidStrawÔ was sealed at the top and then submerged into liquid nitrogen. For thawing, Rapid-iÔ was removed from the RapidStrawÔ and directly submerged in a 2-mL droplet of pre-warmed cryoprotective solution covered with mineral oil. After thawing, the sperm in the droplets were recovered under an inverted microscope by using ICSI pipettes at 37 C. The recovered sperm were immediately transferred into a fresh 2-mL droplet of the holding medium. The immotile sperm were then transferred to water droplets to assess their viability by using the hypo-osmotic swelling test (HOST). Data were compared using c2 analysis. RESULTS: Out of 45 cryopreserved sperm, 41were successfully recovered an overall recovery rate of 91.1%. No significant differences were observed between the recovery rates for azoospermia and testis (90.0% [18/20] vs. 92.0% [23/25]). Overall, 38.1% (16/41) of the recovered sperm were motile; 66.7% (12/18) from were from azoospermia and 17.7% (4/23) were from testis. The HOST results revealed that 26.2% (11/42) of the immotile sperm recovered were HOSTpositive. CONCLUSION: Rapid-iÔ vitrification system-based method may be considered a simple effective option for cryopreserving a small number of spermatozoa in a closed system.
P-370 Wednesday, October 19, 2011 DELIVERY RATE AFTER FRESH EMBRYO TRANSFER (ET) IS DEPENDENT ON THE INCIDENCE OF EARLY CLEAVAGE (EC) AND THE AVAILABILITY OF EMBRYOS FOR CRYOPRESERVATION. K. E. Tucker, C. A. M. Jansen. IVF, Reinier de Graaf Group, Voorburg, ZH, Netherlands. OBJECTIVE: We attempted to determine the combined predictive value of the presence of early cleavage (EC) in the embryo cohort along with the incidence of cryopreservation on delivery rates following fresh IVF/ICSI cycles. DESIGN: Retrospective, non-randomised. MATERIALS AND METHODS: We analysed 1884 IVF/ICSI cycles from good prognosis patients (those with at least 1 additional embryo available for ET) from our center (from January, 2005 - June, 2009) for the presence/absence of EC on Day 1 as well as the incidence of cryopreservation. In all cases, the best quality embryos displaying the appropriate devlopment (with or without EC) were selected for ET on Day 2 or 3. The remaining good quality embryos were frozen on either Day 3, 4 or 5 (Slow Programmed Method). Pregnancy following fresh ET was determined 15 days after ET. Results were analysed and those with a P value < .05 were considered different. RESULTS: Three Groups were established: Group 1: Pregnant with Delivery (P+D: n ¼ 645), Group 2: Pregnant with Miscarriage (P+M: n ¼ 92) and Group 3: Not Pregnant (NP: n ¼ 1147). The number of IVF or ICSI cycles, single or double ET (SET/DET) and incidences of EC and cryopreservation were determined for each group. There were no differences in the number of IVF and ICSI cases or SET and DETs between groups. There were, however, significantly more cycles exhibiting EC in Group 1 (P+D) (53.4%) compared to Group 3 (NP: 41.4%; P<.0001). There was no difference in the incidence of EC between the pregnant groups (53.4 vs. 51.5%; Groups 1- P+D and 2; P+M; respectively). The percentage of cycles with embryos available for cryopreservation was different across all groups, but was highest in Group 1 (P+D: 83.5) vs 64.1 and 31.9% for Groups 2 (P+M) and 3 (NP), respectively (P<.001). CONCLUSION: EC, overall, is still a very reliable predictor of pregnancy outcome, but the incidence (or lack) of cryopreservation can provide additional critical information regarding delivery rate.
S216
Abstracts
P-371 Wednesday, October 19, 2011 THE SAFETY OF OVARIAN AND TESTICULAR CRYOPRESERVATION IN CHILDREN. M. Karsy, E. Arslan, S. Kogan, K. Oktay. Department of Obstetrics & Gynecology, Institute for Fertility Preservation, Laboratory of Molecular Reproduction, New York Medical College, Valhalla, NY; Department of Pathology, New York Medical College, Valhalla, NY; Department of Urology, New York Medical College, Valhalla, NY; Department of Cell Biology & Anatomy, New York Medical College, Valhalla, NY. OBJECTIVE: While the use of chemotherapy and radiotherapy in pediatric patients has achieved widespread clinical success and increased lifespan, such gonadotoxic treatments may result in infertility and altered quality-of-life. Currently, ovarian and testicular tissue cryopreservation is the only option for fertility preservation (FP) in children. Because of the experimental nature of these procedures, it is important to determine their safety. DESIGN: Prospective MATERIALS AND METHODS: Female (n ¼ 26) and male (n ¼ 8) individuals <21 years of age who underwent ovarian or testicular cryopreservation for FP were evaluated for surgical outcomes. RESULTS: Females were older than males at the time of tissue harvesting (14.6 1.2 vs. 7.5 1.5 years, P<0.05). The indications for cryopreservation included cancer in 65% of females (leukemia, lymphoma, breast, cervical, ovarian, sarcoma, teratoma, brain) and 50% of males (leukemia, sarcoma). The non-cancer indications included Diamond-Blackfan, B-thalassemia, sickle cell, aplastic anemia, severe-combined immunodeficiency, SLE, myelodysplastic syndrome and myeloproliferative syndrome, familial hemophagocytic lymphohistiocytosis, Gorham-Stout syndrome, and triploidy in females, as well as sickle cell and B-thalassemia in boys. A similar number of females (12/26) and males (3/8) underwent prior chemotherapy. Under general anesthesia, a laparoscopic (25/26) or robotic (1/26) approach in females and incisional biopsy in all males (8/8) were used. The operative time was similar (1.6 0.1 vs. 0.9 0.3 hours) but the discharge time was significantly lower for females than males (14.9 4.5 vs. 224.3 176.3 hours, P<0.05) due to frequent bundling of medically-indicated procedures in males. All procedures were completed with no complications and blood loss of <10ml. CONCLUSION: Gonadal tissue cryopreservation is a safe outpatient procedure in the pediatric population. The procedure can be combined with other medically-induced procedures to reduce the inconvenience and cost. Supported by: R01HD053112-05.
P-372 Wednesday, October 19, 2011 COMPARATIVE STUDY OF RESULTS OBTAINED THROUGH FRESH OOCYTES CYCLES VS VITRIFIED OOCYTES CYCLES FOR AGE RANGE. J. Teruel, J. P. Jimenez, I. Vanrell, M. Riqueros, A. Ballesteros, G. Calderon. IVF Laboratory, IVI Barcelona, Barcelona, Spain; IVI Barcelona, Barcelona, Spain. OBJECTIVE: This study attemps to assess if there is any correlation of vitrified oocyte cycle outcomes based on patient’s age. DESIGN: Retrospective analysis of 130 fresh oocyte cycles vs. 65 vitrified oocyte cycles. Each group was divided according to patient’s age: Under 35 years old, between 36 and 39 years old and over 40 years old MATERIALS AND METHODS: Oocyte vitrification was done using the CryotopÒ method. RESULTS: Similar results were obtained when fresh oocyte cycles were compared to vitrified oocyte cycles in patients under 35 years old. Mean number of metaphase II (MII) oocytes (10.84 7.73 vs. 11.96 7,75), fertilization rate (%F) (74.43 vs. 74.92), mean number of replaced embryos (RE)(1.86 0.85 vs. 2.05 0.92) and pregnancy rate (PR) (57.14 vs. 61.9). However, statically significant differences were observed in the mean number of frozen embryos (FE) (2.23 3.00 vs. 1.56 3.04,P¼0.03) and implantation rate (IR) (36.91 vs. 46.03, P¼0,021). In patients between 36-39 years old, no differences were observed in MII oocytes (7.94 4.49 vs. 9.35 5,27), %F (77.81 vs. 78.57), RE (1.83 0.91 vs. 1.77 0.86), PR (51.35 vs. 45.45) and IR (34.29 vs. 27.27). Significant differences were only observed in FE (1.51 2.41) vs. 0.73 1.50), P¼0.005). In patients over 40 years old, no differences were observed in RE (1.50 0.89 vs. 1.33 0.77), and FE (1.37 1.59 vs. 1.00 1.78). However, mean
Vol. 96., No. 3, Supplement, September 2011
P-367 Wednesday, October 19, 2011 HIGH IMPLANTATION RATES FOLLOWING SINGLE EMBRYO TRANSFER PROVIDE SIMILAR PREGNANCY RATES TO MULTIPLE EMBRYO TRANSFER USING VITRIFIED DONOR OOCYTES. Z. P. Nagy, C.-C. Chang, D. P. Bernal, A. A. Toledo, D. Mitchell-Leef, D. B. Shapiro. RBA, Reproductive Biology Associates, Sandy Springs, GA. OBJECTIVE: To evaluate the efficiency of single and multiple embryo transfers in a donor-recipient program using vitrified/warmed oocytes. DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 5014 MII oocytes were obtained and vitrified from 225 donors who were screened and tested according to FDA and ASRM guidelines. Eggs were vitrified 3-4 h after retrieval using minimal volume method. ICSI was performed 2-3 h after warming. Embryos were evaluated morphologically prior to transfer, and when high quality embryos were observed the recipient had the possibility of a single embryo transfer. Clinical and laboratory parameters were analyzed using the Oneway ANOVA and the Fisher’s exact test at the level of P<0.05. RESULTS: Donors mean age was 26.1 2.7 years.
No. of recipients Recipient age (mean SD) No. of oocytes warmed (mean SD) No. of oocytes survived (%) No. of oocytes fertilized (%) No. of good quality embryos on Day3 (mean SD) No. of blastocysts (mean SD)* No of embryos for ET (mean SD) No. of embryos re-vitrified (mean SD) No. clinical pregnancies (%) No. of implantations (%)
Single-ET
Multi-ET
P
126 42.2 4.2
351 40.7 4.4
<0.01
711 (5.6 1.8) 2238 (6.4 2.0) <0.01 643 (90.4) 1957 (87.4) 560 (78.8) 1707 (76.3) 380 (3.0 1.6) 1040 (3.0 1.4)
0.04 NS NS
396 (3.5 1.5)
976 (3.6 1.5)
NS
126
725
NA
265 (2.1 1.5) 77 (61.1) 78 (61.9)
356 (1.0 1.3) <0.05 211 (60.1) 317 (43.7)
NS <0.05
There were 105 (49.8%) pregnancies with multiple implantations in the MET group, while there was only one twin pregnancy (due to monozygotic twinning) in the SET group (P<0.001). * Only for Day-5 ET cases (113 for SET and 274 for MET).
FERTILITY & STERILITYÒ
CONCLUSION: The outcome of the current study shows that SET of vitrified/warmed donor oocytes provides both high implantation rates (and virtually no risks for multiples) and high pregnancy rates similar to multiple embryo transfers. Thus, SET should be recommended when high quality embryo(s) are available for qualifying patients to achieve safe pregnancy outcomes.
P-368 Wednesday, October 19, 2011 IS THERE ANY DIFFERENCE IN VITRIFICATION AND SLOW FREEZING PROTOCOL FOR OOCYTE CRYOPRESERVATION? L. Okada, R. Azambuja, V. Lazzari, L. Dorfman, M. Badalotti, A. Petracco. Fertilitat_ Centro de Medicina Reprodutiva, Porto Alegre, RS, Brazil. OBJECTIVE: This study was an observational retrospective cohort, with the objective to compare oocyte cryopreservation efficiency between slow freezing using choline chloride based medium, and vitrification protocol using cryotop. DESIGN: A total of 101 cycles (slow freezing and vitrification techniques) were performed for those patients that decided to thaw their oocytes from 2009 to 2011. MATERIALS AND METHODS: All patients with at least 10 oocytes and not willing to freeze embryos were offered the possibility to cryopreserve oocytes. The oocytes cryopreserved by slow freezing followed Stachecki’s (1998) protocol, while the oocytes vitrified followed Kuwayama’s. (2005) protocol. The endometrium was prepared using Estradiol Benzoate with an initial dose of 2mg/day, starting on the 3rd day of the cycle. The maximum dosage used was 6mg/day when the endometrium reached a thickness of 8mm by ultrasound. Two days before the replacement of the embryos, the oocytes were thawed. After thawing, the oocytes were kept in a incubator during 2 hours before inseminating by ICSI. The survival, fertilization, cleavage, average embryo transfer and pregnancy rates were compared through the chisquare test (P<0.05). RESULTS: The results are as follow: TABLE 1. Outcome results from slow freezing versus vitrification protocol.
Cycles Oocytes Thawed Oocytes Survived* Oocytes Fertilized Embryos Cleaved Embryos Transferred Average Embryo Transfer Implantation Pregnancies Clinical Pregnancies *
Slow freezing (%)
Vitrification (%)
56 523 289 (55.2) 200 (69.2) 185 (92.5) 121 (65.4) 2.2
45 399 255 (63.9) 177 (69.4) 156 (88.1) 100 (64.1) 2.2
15 (12.4) 16 (28.6) 14 (25.0)
16 (16.0) 15 (33.3) 13 (28.9)
P¼0.0085
CONCLUSION: Although the survival rate was statistically higher for the vitrification technique, this did not result in a statistically higher implantation and/or pregnancy rate. Therefore both techniques are reliable to cryopreserve oocytes.
P-369 Wednesday, October 19, 2011 APPLICATION FOR CRYOPRESERVATION OF A SMALL NUMBER OF HUMAN SPERMATOZOA IN A CLOSED SYSTEM BY USING RAPID-IÔ VIA VITRIFICATION. A. Egashira, M. Murakami, K. Tanaka, H. Otsubo, T. Matsuguma, T. Kuramoto. Kuramoto Women’s Clinic, Fukuoka, Japan. OBJECTIVE: In this study, we evaluated the usefulness of the Rapid-iÔ vitrification system for cryopreserving a small number of spermatozoa in a closed system.
S215
DESIGN: Retrospective study. MATERIALS AND METHODS: Motile sperm obtained from the ejaculated sperm were collected from 2 azoospermic men and testicular sperm were obtained from 4 men with obstructive azoospermia. The cryoprotective solution consisted of a mixture of K-SISC and K-SISM buffers (Sydney IVF, Australia) in a 2:1 ratio. We aspirated 1–5 sperm into an ICSI pipette by using micromanipulation and deposited them into a 1.5-mL droplet of cryoprotective solution in the hole of a Rapid-iÔ at room temperature. The Rapid-iÔ was placed in liquid nitrogen vapour for 2 min and inserted into a pre-cooled RapidStrawÔ (Vitrolife). The RapidStrawÔ was sealed at the top and then submerged into liquid nitrogen. For thawing, Rapid-iÔ was removed from the RapidStrawÔ and directly submerged in a 2-mL droplet of pre-warmed cryoprotective solution covered with mineral oil. After thawing, the sperm in the droplets were recovered under an inverted microscope by using ICSI pipettes at 37 C. The recovered sperm were immediately transferred into a fresh 2-mL droplet of the holding medium. The immotile sperm were then transferred to water droplets to assess their viability by using the hypo-osmotic swelling test (HOST). Data were compared using c2 analysis. RESULTS: Out of 45 cryopreserved sperm, 41were successfully recovered an overall recovery rate of 91.1%. No significant differences were observed between the recovery rates for azoospermia and testis (90.0% [18/20] vs. 92.0% [23/25]). Overall, 38.1% (16/41) of the recovered sperm were motile; 66.7% (12/18) from were from azoospermia and 17.7% (4/23) were from testis. The HOST results revealed that 26.2% (11/42) of the immotile sperm recovered were HOSTpositive. CONCLUSION: Rapid-iÔ vitrification system-based method may be considered a simple effective option for cryopreserving a small number of spermatozoa in a closed system.
P-370 Wednesday, October 19, 2011 DELIVERY RATE AFTER FRESH EMBRYO TRANSFER (ET) IS DEPENDENT ON THE INCIDENCE OF EARLY CLEAVAGE (EC) AND THE AVAILABILITY OF EMBRYOS FOR CRYOPRESERVATION. K. E. Tucker, C. A. M. Jansen. IVF, Reinier de Graaf Group, Voorburg, ZH, Netherlands. OBJECTIVE: We attempted to determine the combined predictive value of the presence of early cleavage (EC) in the embryo cohort along with the incidence of cryopreservation on delivery rates following fresh IVF/ICSI cycles. DESIGN: Retrospective, non-randomised. MATERIALS AND METHODS: We analysed 1884 IVF/ICSI cycles from good prognosis patients (those with at least 1 additional embryo available for ET) from our center (from January, 2005 - June, 2009) for the presence/absence of EC on Day 1 as well as the incidence of cryopreservation. In all cases, the best quality embryos displaying the appropriate devlopment (with or without EC) were selected for ET on Day 2 or 3. The remaining good quality embryos were frozen on either Day 3, 4 or 5 (Slow Programmed Method). Pregnancy following fresh ET was determined 15 days after ET. Results were analysed and those with a P value < .05 were considered different. RESULTS: Three Groups were established: Group 1: Pregnant with Delivery (P+D: n ¼ 645), Group 2: Pregnant with Miscarriage (P+M: n ¼ 92) and Group 3: Not Pregnant (NP: n ¼ 1147). The number of IVF or ICSI cycles, single or double ET (SET/DET) and incidences of EC and cryopreservation were determined for each group. There were no differences in the number of IVF and ICSI cases or SET and DETs between groups. There were, however, significantly more cycles exhibiting EC in Group 1 (P+D) (53.4%) compared to Group 3 (NP: 41.4%; P<.0001). There was no difference in the incidence of EC between the pregnant groups (53.4 vs. 51.5%; Groups 1- P+D and 2; P+M; respectively). The percentage of cycles with embryos available for cryopreservation was different across all groups, but was highest in Group 1 (P+D: 83.5) vs 64.1 and 31.9% for Groups 2 (P+M) and 3 (NP), respectively (P<.001). CONCLUSION: EC, overall, is still a very reliable predictor of pregnancy outcome, but the incidence (or lack) of cryopreservation can provide additional critical information regarding delivery rate.
S216
Abstracts
P-371 Wednesday, October 19, 2011 THE SAFETY OF OVARIAN AND TESTICULAR CRYOPRESERVATION IN CHILDREN. M. Karsy, E. Arslan, S. Kogan, K. Oktay. Department of Obstetrics & Gynecology, Institute for Fertility Preservation, Laboratory of Molecular Reproduction, New York Medical College, Valhalla, NY; Department of Pathology, New York Medical College, Valhalla, NY; Department of Urology, New York Medical College, Valhalla, NY; Department of Cell Biology & Anatomy, New York Medical College, Valhalla, NY. OBJECTIVE: While the use of chemotherapy and radiotherapy in pediatric patients has achieved widespread clinical success and increased lifespan, such gonadotoxic treatments may result in infertility and altered quality-of-life. Currently, ovarian and testicular tissue cryopreservation is the only option for fertility preservation (FP) in children. Because of the experimental nature of these procedures, it is important to determine their safety. DESIGN: Prospective MATERIALS AND METHODS: Female (n ¼ 26) and male (n ¼ 8) individuals <21 years of age who underwent ovarian or testicular cryopreservation for FP were evaluated for surgical outcomes. RESULTS: Females were older than males at the time of tissue harvesting (14.6 1.2 vs. 7.5 1.5 years, P<0.05). The indications for cryopreservation included cancer in 65% of females (leukemia, lymphoma, breast, cervical, ovarian, sarcoma, teratoma, brain) and 50% of males (leukemia, sarcoma). The non-cancer indications included Diamond-Blackfan, B-thalassemia, sickle cell, aplastic anemia, severe-combined immunodeficiency, SLE, myelodysplastic syndrome and myeloproliferative syndrome, familial hemophagocytic lymphohistiocytosis, Gorham-Stout syndrome, and triploidy in females, as well as sickle cell and B-thalassemia in boys. A similar number of females (12/26) and males (3/8) underwent prior chemotherapy. Under general anesthesia, a laparoscopic (25/26) or robotic (1/26) approach in females and incisional biopsy in all males (8/8) were used. The operative time was similar (1.6 0.1 vs. 0.9 0.3 hours) but the discharge time was significantly lower for females than males (14.9 4.5 vs. 224.3 176.3 hours, P<0.05) due to frequent bundling of medically-indicated procedures in males. All procedures were completed with no complications and blood loss of <10ml. CONCLUSION: Gonadal tissue cryopreservation is a safe outpatient procedure in the pediatric population. The procedure can be combined with other medically-induced procedures to reduce the inconvenience and cost. Supported by: R01HD053112-05.
P-372 Wednesday, October 19, 2011 COMPARATIVE STUDY OF RESULTS OBTAINED THROUGH FRESH OOCYTES CYCLES VS VITRIFIED OOCYTES CYCLES FOR AGE RANGE. J. Teruel, J. P. Jimenez, I. Vanrell, M. Riqueros, A. Ballesteros, G. Calderon. IVF Laboratory, IVI Barcelona, Barcelona, Spain; IVI Barcelona, Barcelona, Spain. OBJECTIVE: This study attemps to assess if there is any correlation of vitrified oocyte cycle outcomes based on patient’s age. DESIGN: Retrospective analysis of 130 fresh oocyte cycles vs. 65 vitrified oocyte cycles. Each group was divided according to patient’s age: Under 35 years old, between 36 and 39 years old and over 40 years old MATERIALS AND METHODS: Oocyte vitrification was done using the CryotopÒ method. RESULTS: Similar results were obtained when fresh oocyte cycles were compared to vitrified oocyte cycles in patients under 35 years old. Mean number of metaphase II (MII) oocytes (10.84 7.73 vs. 11.96 7,75), fertilization rate (%F) (74.43 vs. 74.92), mean number of replaced embryos (RE)(1.86 0.85 vs. 2.05 0.92) and pregnancy rate (PR) (57.14 vs. 61.9). However, statically significant differences were observed in the mean number of frozen embryos (FE) (2.23 3.00 vs. 1.56 3.04,P¼0.03) and implantation rate (IR) (36.91 vs. 46.03, P¼0,021). In patients between 36-39 years old, no differences were observed in MII oocytes (7.94 4.49 vs. 9.35 5,27), %F (77.81 vs. 78.57), RE (1.83 0.91 vs. 1.77 0.86), PR (51.35 vs. 45.45) and IR (34.29 vs. 27.27). Significant differences were only observed in FE (1.51 2.41) vs. 0.73 1.50), P¼0.005). In patients over 40 years old, no differences were observed in RE (1.50 0.89 vs. 1.33 0.77), and FE (1.37 1.59 vs. 1.00 1.78). However, mean
Vol. 96., No. 3, Supplement, September 2011