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Assisted reproductive registered dietician assessment: does prior alcohol intake affect a women's cycle outcome?
MATERIALS AND METHODS: 473 women undergoing laparoscopy or laparotomy for benign gynecologic indications enrolled in the ENDO (Endometriosis: Natural History, Diagnosis and Outcomes) study provided blood and morning urine samples, which were analyzed for trace metal content. Urine concentrations were adjusted for creatinine. Surgical findings were recorded by the surgeon. Mean trace metal concentrations were compared using the ANOVA statistic among 4 groups: endometriosis only, fibroids only, both, and neither. RESULTS: Both blood and urine showed increased lead and cadmium levels in women with fibroids (Table 1). Women with fibroids also had higher blood mercury and urine cesium, cobalt, manganese, and thallium. The four surgical groups did not significantly differ in urine antimony, arsenic, barium, beryllium, chromium, copper, molybdenum, nickel, tellurium, tin, tungsten, uranium, or zinc levels. CONCLUSION: Six trace metals were found elevated in urine, and lead and mercury were elevated in blood, from women with uterine fibroids and/or endometriosis. Trace metal exposures may contribute to the pathogenesis of these disorders. Fibroids may serve as a reservoir for deposition of these metals, leading to elevated blood and urine concentrations. Supported by: HHSN267200603427C.
P-953 Thursday, October 17, 2013 ASSISTED REPRODUCTIVE REGISTERED DIETICIAN ASSESSMENT: DOES PRIOR ALCOHOL INTAKE AFFECT A WOMEN’S CYCLE OUTCOME? D. Godfrey,a J. A. Lee,a V. Nedergger,a E. Cervantes,a B. Sandler,a,b A. B. Copperman.a,b aReproductive Medicine Associates of New York, New York, NY; bDepartment of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY. OBJECTIVE: Numerous researchers have observed the negative effects of alcohol intake on the fetus during gestation, although data regarding putative adverse effects of pre-conceptual alcohol consumption remains unclear. Our study examined whether alcohol consumption in women, prior to nutritional consultation with a registered dietician (RD), is associated variation in assisted reproduction treatment (ART) outcomes. DESIGN: Retrospective cohort analysis. MATERIALS AND METHODS: A history of diet, health, alcohol intake and lifestyle was collected from an interview during patient’s (n¼96) initial consultation with a specialized ART RD at an academic reproductive center (March 2010-January 2013). Alcohol intake frequencies were recorded for applied cohorts. Statistical analysis was conducted by t-test, chi-square and independent samples by Mann-Whitney U Test with significance a p<0.05. RESULTS: Alcohol consumption was observed in 42.7% (41/96) of patients, of whom 75.6% consumed <2 drinks/wk, 14.6% consumed 3-5 drinks/wk and 9.8% consumed >6 drinks/wk. A significantly higher pregnancy rate (PR) (70.7%) was observed in ART patients who self-reported no alcohol consumption, all of whom averaged 3.3 prior failed cycles prior to RD consultation.
Age BMI Weight(kg) Previous Alcohol No Previous Alcohol
Positive Pregnancy
Negative Pregnancy
p-value
35.25.1 241.2 643.1 29 (70.7%) 50 (90.9%)
36.84.9 231.4 63.52.9 12 (29.3%) 5 (9.1%)
0.3 0.7 0.9 0.01* 0.01*
CONCLUSION: We present descriptive data on alcohol consumption in an infertility population and encourage other programs to collect and analyze such information so that we can identify normative data and predictors of outcome. We demonstrated that patients who self-report previous alcohol consumption demonstrate comparable pregnancy rates (70.7%) to our study population. Our practice advises patients to limit their alcohol consumption, but reassures patients that prior alcohol consumption does not have carry-over effect and should not affect their future reproductive potential.
FERTILITY & STERILITYÒ
P-954 Thursday, October 17, 2013 COMPARISON OF THE EFFICIENCY OF THE 2 HUMAN SPERM BIOASSAY (HSB) METHODS IN THE EVALUATION OF THE QUALITY OF EMBRYO CULTURE MEDIA. A. Hossain, J. Phelps. Ob/Gyn, The University of Texas Medical Branch, Galveston, TX. OBJECTIVE: Fertility laboratories routinely use HSB as an in house quality control test and also in proficiency test (PT). In this study, we used 2 HSB methods for comparing their efficiency in evaluating the quality of embryo culture media. DESIGN: PT samples from American Association of Bioanalysts (AAB) were evaluated by 2 HSB methods. MATERIALS AND METHODS: Embryo culture media, culture 1 and culture 2, received from AAB, were used in the experiment. The quality of the media was assessed by 2 HSB methods, A and B that represented conventional and micro drop methods, respectively. In method A, 1 mL media covered with 1 mL oil was maintained in center-well dish (Falcon 3037). In method B, media was maintained in 5 mL size drop on 35 mm dish (Falcon 1008) covered with 3 mL oil. The sperm concentration was adjusted to 3x106/ ml in culture and the culture dishes were kept in the incubator (37o C and 6% CO2). Sperm motility (% motile) and quality of motility (motility grade) were determined sequentially at 0, 6, 12, 24 and 48 hours. Gradient column recovered sperm obtained from discarded semen collected for semen analysis (n¼10) were used. RESULTS: Both methods identified culture 1 as media of unacceptable quality (MUQ) and culture 2 as media of acceptable quality (MAQ). Time dependent deterioration of motility in MAQ and MUQ were manifested earlier in method B. In MUQ, the motility at 6 hrs was not different from initial motility at 0 hr (90% vs 85%) in method A but significantly different (90% vs 50%) in method B. Similarly, by 6 hours, no clear indication of change in motility grade was seen in method A as opposed to change documented in method B. Evidence of difference between MAQ and MUQ, reflecting changes in both motility and motility quality, emerged between 12 and 24 hours in method A and between 6 and 12 hours in method B. CONCLUSION: Both methods showed the same conclusion about the acceptability of the PT media. Micro drop method (method B) was user friendly and identified the adulterated media in less time.
P-955 Thursday, October 17, 2013 REDUCED PREIMPLANTATION EMBRYO DEVELOPMENT AFTER INTRACYTOPLASMIC SPERM INJECTION WITH SPERM EXPOSED TO ALKYLATING CHEMOTHERAPY IN A MOUSE MODEL. S. Malik, C.-C. Lin, K. E. Orwig. Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA. OBJECTIVE: To determine the effect of busulfan administration on epididymal sperm & subsequent embryo development. DESIGN: Prospective Laboratory Study. MATERIALS AND METHODS: Sperm was collected from the cauda epididymis of adult male C57BL/6 mice prior to chemotherapy. After recovery, the mice were administered intraperitoneal busulfan (55mg/kg) and sacrificed seven days later to obtain sperm from the contralateral cauda epididymis. All sperm samples were cryopreserved at the time of collection & thawed prior to use. Oocytes were collected from 25 individual C57BL/6 female mice after controlled ovarian stimulation & divided equally into two groups. Half of the oocytes from each female were fertilized with busulfanexposed sperm using intra-cytoplasmic sperm injection (ICSI) while the other half were fertilized with sperm collected from the same male prior to chemotherapy. Embryos were monitored for in-vitro development for four days. RESULTS: Twenty five cycles of in-vitro fertilization with ICSI were completed with 476 embryos monitored for preimplantation development. While 11.2% of the oocytes fertilized with untreated sperm progressed to blastocyst development, only 3.6% of the oocytes fertilized with busulfanexposed sperm reached the same level of embryo development. Embryo development was found to be significantly decreased in the busulfan-exposed group using Kaplan-Meier survival analysis and log-rank tests (p ¼ 0.0037; HR 1.631 [95% CI 1.172-2.270].
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P-953 Thursday, October 17, 2013 ASSISTED REPRODUCTIVE REGISTERED DIETICIAN ASSESSMENT: DOES PRIOR ALCOHOL INTAKE AFFECT A WOMEN’S CYCLE OUTCOME? D. Godfrey,a J. A. Lee,a V. Nedergger,a E. Cervantes,a B. Sandler,a,b A. B. Copperman.a,b aReproductive Medicine Associates of New York, New York, NY; bDepartment of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY. OBJECTIVE: Numerous researchers have observed the negative effects of alcohol intake on the fetus during gestation, although data regarding putative adverse effects of pre-conceptual alcohol consumption remains unclear. Our study examined whether alcohol consumption in women, prior to nutritional consultation with a registered dietician (RD), is associated variation in assisted reproduction treatment (ART) outcomes. DESIGN: Retrospective cohort analysis. MATERIALS AND METHODS: A history of diet, health, alcohol intake and lifestyle was collected from an interview during patient’s (n¼96) initial consultation with a specialized ART RD at an academic reproductive center (March 2010-January 2013). Alcohol intake frequencies were recorded for applied cohorts. Statistical analysis was conducted by t-test, chi-square and independent samples by Mann-Whitney U Test with significance a p<0.05. RESULTS: Alcohol consumption was observed in 42.7% (41/96) of patients, of whom 75.6% consumed <2 drinks/wk, 14.6% consumed 3-5 drinks/wk and 9.8% consumed >6 drinks/wk. A significantly higher pregnancy rate (PR) (70.7%) was observed in ART patients who self-reported no alcohol consumption, all of whom averaged 3.3 prior failed cycles prior to RD consultation.
Age BMI Weight(kg) Previous Alcohol No Previous Alcohol
Positive Pregnancy
Negative Pregnancy
p-value
35.25.1 241.2 643.1 29 (70.7%) 50 (90.9%)
36.84.9 231.4 63.52.9 12 (29.3%) 5 (9.1%)
0.3 0.7 0.9 0.01* 0.01*
CONCLUSION: We present descriptive data on alcohol consumption in an infertility population and encourage other programs to collect and analyze such information so that we can identify normative data and predictors of outcome. We demonstrated that patients who self-report previous alcohol consumption demonstrate comparable pregnancy rates (70.7%) to our study population. Our practice advises patients to limit their alcohol consumption, but reassures patients that prior alcohol consumption does not have carry-over effect and should not affect their future reproductive potential.
FERTILITY & STERILITYÒ
P-954 Thursday, October 17, 2013 COMPARISON OF THE EFFICIENCY OF THE 2 HUMAN SPERM BIOASSAY (HSB) METHODS IN THE EVALUATION OF THE QUALITY OF EMBRYO CULTURE MEDIA. A. Hossain, J. Phelps. Ob/Gyn, The University of Texas Medical Branch, Galveston, TX. OBJECTIVE: Fertility laboratories routinely use HSB as an in house quality control test and also in proficiency test (PT). In this study, we used 2 HSB methods for comparing their efficiency in evaluating the quality of embryo culture media. DESIGN: PT samples from American Association of Bioanalysts (AAB) were evaluated by 2 HSB methods. MATERIALS AND METHODS: Embryo culture media, culture 1 and culture 2, received from AAB, were used in the experiment. The quality of the media was assessed by 2 HSB methods, A and B that represented conventional and micro drop methods, respectively. In method A, 1 mL media covered with 1 mL oil was maintained in center-well dish (Falcon 3037). In method B, media was maintained in 5 mL size drop on 35 mm dish (Falcon 1008) covered with 3 mL oil. The sperm concentration was adjusted to 3x106/ ml in culture and the culture dishes were kept in the incubator (37o C and 6% CO2). Sperm motility (% motile) and quality of motility (motility grade) were determined sequentially at 0, 6, 12, 24 and 48 hours. Gradient column recovered sperm obtained from discarded semen collected for semen analysis (n¼10) were used. RESULTS: Both methods identified culture 1 as media of unacceptable quality (MUQ) and culture 2 as media of acceptable quality (MAQ). Time dependent deterioration of motility in MAQ and MUQ were manifested earlier in method B. In MUQ, the motility at 6 hrs was not different from initial motility at 0 hr (90% vs 85%) in method A but significantly different (90% vs 50%) in method B. Similarly, by 6 hours, no clear indication of change in motility grade was seen in method A as opposed to change documented in method B. Evidence of difference between MAQ and MUQ, reflecting changes in both motility and motility quality, emerged between 12 and 24 hours in method A and between 6 and 12 hours in method B. CONCLUSION: Both methods showed the same conclusion about the acceptability of the PT media. Micro drop method (method B) was user friendly and identified the adulterated media in less time.
P-955 Thursday, October 17, 2013 REDUCED PREIMPLANTATION EMBRYO DEVELOPMENT AFTER INTRACYTOPLASMIC SPERM INJECTION WITH SPERM EXPOSED TO ALKYLATING CHEMOTHERAPY IN A MOUSE MODEL. S. Malik, C.-C. Lin, K. E. Orwig. Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA. OBJECTIVE: To determine the effect of busulfan administration on epididymal sperm & subsequent embryo development. DESIGN: Prospective Laboratory Study. MATERIALS AND METHODS: Sperm was collected from the cauda epididymis of adult male C57BL/6 mice prior to chemotherapy. After recovery, the mice were administered intraperitoneal busulfan (55mg/kg) and sacrificed seven days later to obtain sperm from the contralateral cauda epididymis. All sperm samples were cryopreserved at the time of collection & thawed prior to use. Oocytes were collected from 25 individual C57BL/6 female mice after controlled ovarian stimulation & divided equally into two groups. Half of the oocytes from each female were fertilized with busulfanexposed sperm using intra-cytoplasmic sperm injection (ICSI) while the other half were fertilized with sperm collected from the same male prior to chemotherapy. Embryos were monitored for in-vitro development for four days. RESULTS: Twenty five cycles of in-vitro fertilization with ICSI were completed with 476 embryos monitored for preimplantation development. While 11.2% of the oocytes fertilized with untreated sperm progressed to blastocyst development, only 3.6% of the oocytes fertilized with busulfanexposed sperm reached the same level of embryo development. Embryo development was found to be significantly decreased in the busulfan-exposed group using Kaplan-Meier survival analysis and log-rank tests (p ¼ 0.0037; HR 1.631 [95% CI 1.172-2.270].
S423