RESULTS: 7 normal weight (age:30.3 + 3.8 yrs, BMI: 21.8 + 1.4kg/m2) and 10 obese (age: 35.5 + 4.7 yrs, BMI: 35.5 + 4.7kg/m2) women provided complete daily urine samples for analysis. All women had confirmed ovulation. Compliance with dietary supplementation was verified by the significantly reduced (p < .01) ratios of omega-6 to omega-3 PUFA, in plasma and red blood cells, for both groups after treatment. After one month of omega-3 PUFA supplementation, urinary FSH levels were significantly decreased (p¼ .04, Table 1) in NW women in both follicular (-28.4%) and luteal phases (-12.6%). In contrast, obese women did not demonstrate any significant changes in gonadotropin levels in response to omega-3 PUFA treatment. CONCLUSIONS: We observed an almost 30% reduction in urinary FSH after dietary omega-3 supplementation in NW women. This effect in young women is intriguing and directionally consistent with reports of omega-3 treatment extending reproductive lifespan in mice. Our results imply that this nutritional intervention should be evaluated in women with diminished ovarian reserve in an attempt to delay ovarian aging and preserve fertility. References: 1. Khedr, NF. Fish oil and wheat-germ oil supplementation restores ovarian function in streptozotocin-diabetic rats. Reprod Fertil Dev. 2016. 2. Moriyama, R et al. Long-chain unsaturated fatty acids reduce the transcriptional activity of the rat follicle-stimulating hormone b-subunit gene. J Reprod Dev. 2016;62:195-9. 3. Al-Safi, ZA et al. Omega-3 Fatty Acid Supplementation Lowers Serum FSH in Normal Weight But Not Obese Women. J Clin Endocrinol Metab. 2016;101:324-33. Supported by: National Institute of Health R01 HD081162, Colorado Clinical Translational Sciences Institute NIH 1UL1 RR025780 P-395 Wednesday, November 1, 2017 DOES ALCOHOL INTAKE IMPACT OVARIAN RESERVE? A. Eskew,a K. Bligard,a D. E. Broughton,b M. Schulte,c C. E. Boots,d K. M. Cipolla,e E. Jungheim.f aWashington University School of Medicine, St. Louis, MO; bObstetrics and Gynecology, Infertility and Reproductive Medicine Center, Washington University in St. Louis, St Louis, MO; cWashington University in St Louis, St Louis, MO; dObstetrics & Gynecology, Northwestern University, Chicago, IL; eOB/Gyn Division of Clinical Research, Washington University in St. Louis, St. Louis, MO; fObstetrics and Gynecology, Washington University, St. Louis, MO. OBJECTIVE: The impact of lifestyle factors including dietary patterns and alcohol intake on ovarian reserve are conflicting. The objective of this study was to determine if alcohol intake is associated with ovarian reserve as determined by antral follicle count (AFC). DESIGN: Cross-sectional cohort study MATERIALS AND METHODS: Women ages 18-44 with regular menstrual cycles were included. Pregnant women and women with a history of infertility, ovarian surgery, or major chronic illness were excluded. Participants completed a detailed dietary questionnaire at the time of enrollment. AFC was obtained by transvaginal ultrasound. Participants provided the number of servings consumed per month of beer, red wine, white wine and liquor. Spearman’s correlation coefficient was used to assess for correlation between type of alcohol consumed and AFC, followed by regression analysis to control for potential confounders. Alcohol intake and AFC
Age (years) BMI (kg/m2) Red Wine <5 servings Red Wine >5 servings White Wine Beer Liquor
<0.001 0.47 0.86 0.06 0.88 0.49 0.37
0.82 0.97 1.09 14.92 1.03 1.03 1.09
0.74-0.91 0.91-1.04 0.38-3.18 0.88-251.3 0.74-1.42 0.94-1.13 0.91-1.31
RESULTS: 135 women participated. Participants were a mean age of 31.1 6.7 years, had a mean BMI of 28.1 7.3 kg/m2 and mean AFC of 26.7 14.1. Beer, liquor and white wine intake were not associated with AFC (Table 1). Red wine intake was positively correlated with AFC (r¼ .176, p¼0.045). Red wine intake ranged from 0 to 15 drinks (6oz) per month. 37.8% (n¼51) of the total cohort drank at least 1 serving of red wine per month. After controlling for age and BMI, consuming >5 servings of red wine per month was positively associated with AFC with a trend toward significance (p¼0.06, OR¼14.91 95% CI 0.885-251.3). CONCLUSIONS: Red wine intake is associated with ovarian reserve as measured by AFC. Resveratrol is a naturally occurring polyphenol found in higher concentrations in red wine, and it is known to have anti-inflammatory effects. Resveratrol may act to decrease reactive oxygen species at the level of the ovary, with moderate consumption of red wine, and is one proposed mechanism of higher AFC in our cohort. Supported by: UL1TR000448 REPRODUCTIVE IMMUNOLOGY P-396 Wednesday, November 1, 2017 ONE DOSE OF IBUPROFEN DECREASES LEVELS OF INTERLEUKINS INVOLVED IN OVULATION IN THE FOLLICULAR FLUID OF WOMEN UNDERGOING MINIMAL STIMULATION IN-VITRO FERTILIZATION. L. Bou Nemer, A. Word, B. Carr, O. Bukulmez. University of Texas Southwestern Medical Center, Dallas, TX. OBJECTIVE: Reported rates of premature ovulation in natural, modifiednatural and minimal or mild stimulation regimens range from 6 to 27%1-4. Although various methods have been used, recent studies suggest posttrigger administration of non-steroidal anti-inflammatories (NSAIDS) to prevent premature ovulation. NSAIDS inhibit LH-induced cyclooxygenase-2 (COX-2) that catalyzes the synthesis of PGE2, the key prostaglandin effecting follicle rupture and ovulation. We sought to evaluate the effect of one dose of oral Ibuprofen on follicular fluid levels of inflammatory markers involved in ovulation. DESIGN: Prospective within-subjects study. MATERIALS AND METHODS: 9 patients undergoing minimal stimulation In-Vitro Fertilization (IVF) with freeze-all protocol were recruited in our IVF center. The first cycle of IVF using our minimal stimulation protocol was followed by the same stimulation protocol, except one dose of ibuprofen 800mg was administered orally 15-18 hours after trigger injection. Follicular fluid was obtained during oocyte retrieval in both cycles and analyzed for levels of selected inflammation markers. RESULTS: Of 27 cytokines and 10 matrix metalloproteinases (MMPs), levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) were decreased significantly in follicular fluid from cycles receiving Ibuprofen (IL-6, 10.3 1.07 vs. 7.2 0.62 pg/mL, p¼0.016; IL-8, 85.8 13.03 vs. 57.2 6.43 pg/mL, p¼0.028). Other cytokine levels, however, were similar with or without ibuprofen, including IL-1 and VEGF. Interestingly, levels of MMP-2 and MMP-9, both described to be involved in ovulation, were either nondetectable or unchanged by ibuprofen, respectively. The number of oocytes retrieved, number of mature oocytes, and number of embryos cryopreserved were similar in both cycles. None of the cycles experienced premature ovulation. CONCLUSIONS: One dose of Ibuprofen 800mg taken orally on the day after trigger injection lead to significant decreases in follicular fluid levels of two major interleukins involved in ovulation, IL-6 and IL-8. More data is needed to correlate these findings to clinical outcomes of premature ovulation, oocyte quality, and pregnancy outcomes. Our data support the use of single-dose ibuprofen post-trigger in patients at higher risk of premature ovulation undergoing freeze-all cycles, without any harmful effects on oocyte and embryo yield. References: 1. Reprod Biomed Online 2012 Mar; 24(3): 308-13. 2. Reprod Biomed Online 2013 Sep; 27(3): 297-304. 3. Reprod Biomed Online 2008 Feb; 16(2): 245-9. 4. Reprod Biomed Online 2014 Aug; 29(2): 209-15.
Vol. 108, No. 3, Supplement, September 2017