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Assisted reproductive technology outcomes in Afro-Caribbean patients
P-33 Tuesday, October 31, 2017 THE POOR QUALITY OF WOMEN’S SLEEP NEGATIVELY INFLUENCES FERTILIZATION RATES IN ASSISTED REPRODUCTIVE TECHNOLOGY. S. Akamatsu,a J. Otsuki,a M. Fujii,a N. Enatsu,b Y. Tsuji,a T. Iwasaki,a M. Shiotani.a aHanabusa Women’s Clinic, Kobe, Hyogo, Japan; b Kobe City Medical Center West Hospital, Kobe, Hyogo, Japan. OBJECTIVE: The purpose of this study was to explore the association between the quality of women’s sleep and outcomes in assisted reproductive technology DESIGN: A questionnaire survey study MATERIALS AND METHODS: A survey questionnaire was conducted during June and July 2016, involving 208 patients, who had undergone Assisted Reproductive Technology (ART) treatment and consented to fill out a questionnaire. The Pittsburgh Sleep Quality Index (PSQI) ranging from level 0 to 21 was used to evaluate quality of sleep, by measuring subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and any related daytime dysfunction during the previous month. The questionnaire also included questions regarding their duration of infertility, sensitivity to cold (especially in the extremities, such as feet and hands), job classification such as full-time, part-time or shiftwork, and occasional and/or moderate alcohol consumption. The PSQI was divided into three categories: a total score of ‘‘5’’ or less indicated no sleep difficulties; ‘‘6-8’’ indicated mild difficulties; ‘‘9’’ or more indicated severe difficulties. Based on the collected responses to the above questions, a statistical comparison of ART outcomes, in three PSQI categories, was performed by Mann-Whitney U test and chi-square test. Logistic regression analysis was subsequently conducted to assess the association of the conditions in the questions with ART outcomes, as represented by fertilization rates per ovum pick-up and blastocyst development rates. RESULTS: The percentage of patients with a total score of ‘‘5’’ or less (Group A) was 65.1% (136/209), with a total score of ‘‘6-8’’ (Group B) was 26.8% (56/209), and a total score of ‘‘9’’ or more (Group C) was 8.1% (17/209). Fertilization rates among the retrieved oocytes in Groups A, B and C were 67.1%, 63.1% and 48.6% respectively and a statistically significant association between PSQI categories and fertilization rates was detected (p¼0.0018). Blastocyst development rates among the fertilized oocytes in Groups A, B and C were 62.9%, 57.1% and 48.4% respectively. The statistical difference of p¼0.087 narrowly missed a technical classification of statistically significant. Logistic regression analysis identified that a lifestyle PSQI score of ‘5’ or less and occasional and/or moderate alcohol consumption were significant predictors of successful fertilization. CONCLUSIONS: Our survey questionnaire found that a low quality of sleep has a negative impact on fertilization rates. Good sleep patterns can be one of the important daily habits for patients to improve their response to fertility treatments and increase their chances of pregnancy. Interestingly, occasional and/or moderate alcohol consumption had a positive impact on fertilization. This may be due to the beneficial effects of a moderate amount of alcohol, such as stress-relief and sleep-induction.
P-34 Tuesday, October 31, 2017 ASSISTED REPRODUCTIVE TECHNOLOGY OUTCOMES IN AFRO-CARIBBEAN PATIENTS. C. Roman-Rodriguez,b L. Ghidei,c A. Wiltshire,a L. M. Brayboy.c aDepartment of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA; bDepartment of Obstetrics and Gynecology, Women & Infants Hospital, Providence, RI; cDepartment of Obstetrics and Gynecology, Women and Infants Hospital/Alpert Medical School, Providence, RI. OBJECTIVE: To assess the causes of infertility and ART outcomes in women of African descent living in the Caribbean and Bermuda. DESIGN: Cross-sectional study comprised of a questionnaire-based survey administered to providers who care for women undergoing ART in the Caribbean and Bermuda. MATERIALS AND METHODS: After an Internet search for infertility clinics in the Caribbean and Bermuda, a total of 8 clinics within 6 different
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islands were located. The primary physician at each site was contacted via email and invited to contribute to the study. A questionnaire from the Deerfield Institute (Audibert et al 2015) was adapted to meet the aims of our study with their permission. The invitation document included a detailed description of the study, a draft of the questionnaire for their review and documentation of IRB exemption status. Questionnaire responses are currently being collected and placed in a REDCap database. RESULTS: Our data indicate that Afro-Caribbean women presenting for infertility care most commonly present with secondary infertility. The most common etiologies of infertility reported were diminished ovarian reserve (40%), male factor (35%), ovulatory dysfunction (35%), endometriosis (20%), and uterine factor (20%). In Afro-Caribbean dominant nations, standard IVF is more commonly performed (50%). In Latino-Caribbean dominate nations IVF + ICSI is more dominantly performed (99%). All standard IVF and IVF +ICSI cycles consist mostly of fresh (90%) autologous (99%) embryos. Out of the total sample, the average number of embryos transferred per cycle for all age groups is 2. Preimplantation genetic screening is not commonly performed (average of once every 3 months). The average live birth rate for women ages %34 is 71%. The average live birth rate for those ages 35-42 is 28%. The most important factors reported that hinders patients from cycling is coping emotionally with poor ovarian response and cost. The biggest restraint to infertility care, in general, is cost and lack of local IVF centers in all islands. In describing the past 5 years, patient volume for infertility care was described to have increased. CONCLUSIONS: Understanding the effect of ethnicity on infertility care has become increasingly important as the nation’s multiracial and minority sub-populations continue to grow. Thus far, our study shows that Afro- Caribbean women receiving infertility care in the Caribbean have better ART outcomes compared to African-American women in the US. Data collection is still in progress. Reference: 1. Audibert C, Glass D. A global perspective on assisted reproductive technology fertility treatment: an 8-country fertility specialist survey. Reprod Biol and Endocrinol. 2015;13:133. Supported by: K12HD000849 Reproductive Scientist Development Program MENOPAUSE P-35 Tuesday, October 31, 2017 RISK FACTORS FOR PREMATURE OR EARLY MENOPAUSE: A COMPARATIVE STUDY BETWEEN UNITED STATES AND SOUTH KOREAN WOMEN. S. Choe,a Y. Kim,a I. Kang,a C. Sim,a J. Heo,a Y. Koh,a M. Koong,b T. K. Yoon,c D. Park,d Y. Lee,e J. Kim,f M. Kim.g aCHA University, College of Medicine, Seoul, Korea, Republic of; bCHA University School of Medicine, Seoul, Korea, Republic of; cFertility Center, CHA Gangnam Medical Center, College of Medicine, Seoul, Korea, Republic of; dGangnam CHA Infertility Center, Seoul, Korea, Republic of; eCHA Fertility Center, Seoul, Korea, Republic of; fCHA University, Seoul, Korea, Republic of; gCHA Fertility Center, Seoul Station, Seoul, Korea, Republic of. OBJECTIVE: To explore and compare the trends of premature or early menopause (PEM, menopause before age of 45)among different ethnic groups of the US and Korea using nationally representative population data collected by similar survey method. DESIGN: A retrospective study using population-based data. MATERIALS AND METHODS: We used data of the National Health and Nutrition Examination Survey (NHANES, 1999- 2014) and the Korean National Health and Nutrition Examination Survey (KNHANES, 2007-2012). Premature or early menopause (PEM) is generally defined as having final menstruation before age of 45. The information of age at menopause was obtained only in participants who reported to be ’naturally menopaused’. All the women who responded ’iatrogenic menopause’, history of hysterectomy (both in the NHANES and KNHANES) or bilateral oophorectomy (only in the NHANES) before age of 45 years were not included. Body mass index, level of education, relative household income, parity, early menarche (before age of 12) and smoking (started before 40) were included in the analyses with ethnic stratification. To compare the relative strength of various risk factors, odds risk per adjusted standard deviation (Hopper et al., 2015) for PEM of each variable was calculated.
Vol. 108, No. 3, Supplement, September 2017
P-34 Tuesday, October 31, 2017 ASSISTED REPRODUCTIVE TECHNOLOGY OUTCOMES IN AFRO-CARIBBEAN PATIENTS. C. Roman-Rodriguez,b L. Ghidei,c A. Wiltshire,a L. M. Brayboy.c aDepartment of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA; bDepartment of Obstetrics and Gynecology, Women & Infants Hospital, Providence, RI; cDepartment of Obstetrics and Gynecology, Women and Infants Hospital/Alpert Medical School, Providence, RI. OBJECTIVE: To assess the causes of infertility and ART outcomes in women of African descent living in the Caribbean and Bermuda. DESIGN: Cross-sectional study comprised of a questionnaire-based survey administered to providers who care for women undergoing ART in the Caribbean and Bermuda. MATERIALS AND METHODS: After an Internet search for infertility clinics in the Caribbean and Bermuda, a total of 8 clinics within 6 different
e120
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islands were located. The primary physician at each site was contacted via email and invited to contribute to the study. A questionnaire from the Deerfield Institute (Audibert et al 2015) was adapted to meet the aims of our study with their permission. The invitation document included a detailed description of the study, a draft of the questionnaire for their review and documentation of IRB exemption status. Questionnaire responses are currently being collected and placed in a REDCap database. RESULTS: Our data indicate that Afro-Caribbean women presenting for infertility care most commonly present with secondary infertility. The most common etiologies of infertility reported were diminished ovarian reserve (40%), male factor (35%), ovulatory dysfunction (35%), endometriosis (20%), and uterine factor (20%). In Afro-Caribbean dominant nations, standard IVF is more commonly performed (50%). In Latino-Caribbean dominate nations IVF + ICSI is more dominantly performed (99%). All standard IVF and IVF +ICSI cycles consist mostly of fresh (90%) autologous (99%) embryos. Out of the total sample, the average number of embryos transferred per cycle for all age groups is 2. Preimplantation genetic screening is not commonly performed (average of once every 3 months). The average live birth rate for women ages %34 is 71%. The average live birth rate for those ages 35-42 is 28%. The most important factors reported that hinders patients from cycling is coping emotionally with poor ovarian response and cost. The biggest restraint to infertility care, in general, is cost and lack of local IVF centers in all islands. In describing the past 5 years, patient volume for infertility care was described to have increased. CONCLUSIONS: Understanding the effect of ethnicity on infertility care has become increasingly important as the nation’s multiracial and minority sub-populations continue to grow. Thus far, our study shows that Afro- Caribbean women receiving infertility care in the Caribbean have better ART outcomes compared to African-American women in the US. Data collection is still in progress. Reference: 1. Audibert C, Glass D. A global perspective on assisted reproductive technology fertility treatment: an 8-country fertility specialist survey. Reprod Biol and Endocrinol. 2015;13:133. Supported by: K12HD000849 Reproductive Scientist Development Program MENOPAUSE P-35 Tuesday, October 31, 2017 RISK FACTORS FOR PREMATURE OR EARLY MENOPAUSE: A COMPARATIVE STUDY BETWEEN UNITED STATES AND SOUTH KOREAN WOMEN. S. Choe,a Y. Kim,a I. Kang,a C. Sim,a J. Heo,a Y. Koh,a M. Koong,b T. K. Yoon,c D. Park,d Y. Lee,e J. Kim,f M. Kim.g aCHA University, College of Medicine, Seoul, Korea, Republic of; bCHA University School of Medicine, Seoul, Korea, Republic of; cFertility Center, CHA Gangnam Medical Center, College of Medicine, Seoul, Korea, Republic of; dGangnam CHA Infertility Center, Seoul, Korea, Republic of; eCHA Fertility Center, Seoul, Korea, Republic of; fCHA University, Seoul, Korea, Republic of; gCHA Fertility Center, Seoul Station, Seoul, Korea, Republic of. OBJECTIVE: To explore and compare the trends of premature or early menopause (PEM, menopause before age of 45)among different ethnic groups of the US and Korea using nationally representative population data collected by similar survey method. DESIGN: A retrospective study using population-based data. MATERIALS AND METHODS: We used data of the National Health and Nutrition Examination Survey (NHANES, 1999- 2014) and the Korean National Health and Nutrition Examination Survey (KNHANES, 2007-2012). Premature or early menopause (PEM) is generally defined as having final menstruation before age of 45. The information of age at menopause was obtained only in participants who reported to be ’naturally menopaused’. All the women who responded ’iatrogenic menopause’, history of hysterectomy (both in the NHANES and KNHANES) or bilateral oophorectomy (only in the NHANES) before age of 45 years were not included. Body mass index, level of education, relative household income, parity, early menarche (before age of 12) and smoking (started before 40) were included in the analyses with ethnic stratification. To compare the relative strength of various risk factors, odds risk per adjusted standard deviation (Hopper et al., 2015) for PEM of each variable was calculated.
Vol. 108, No. 3, Supplement, September 2017