P-156

day of embryo transfer, the use of fresh or frozen embryos, and stimulation protocol. MATERIALS AND METHODS: Data were drawn from the Stanford IVF database for all IVF cycles resulting in pregnancy from January 1, 2002 to December 31, 2003. Out of 588 pregnancies, there were 358 live births, 93 miscarriages, 137 biochemical pregnancies and 15 ectopic pregnancies. Miscarriage was defined as pregnancy loss after ultrasound evidence of intrauterine gestation. Logistic regression analysis was performed using Stata version 8.2. Spontaneous abortion and biochemical pregnancy were the dependent variables and patient specific factors including diagnosis and treatment protocol were the independent variables. RESULTS: Maternal age is correlated with rate of miscarriage after IVF cycles with an odds ratio of 1.1 for each year increase in age (p⬍0.001). With an age cut-off of 37, the odds ratio of miscarriage is 1.82 (p⫽0.011). There was no significant correlation between FSH level and miscarriage rates after adjusting for age. However, only 47 patients had FSH levels over 12. The odds ratio for miscarriage for day 3 transfers compared to day 5 was 1.84 (p⫽0.015). The day of the transfer was significantly correlated with patient age, and after adjusting for age, the difference was no longer significant. Unadjusted odds ratios for endometriosis, PCOS, and the different types of stimulation protocols did not independently affect miscarriage rates. The initial ␤-HCG is highly correlated with rate of live birth, and strongly inversely correlated with the rates of miscarriage and biochemical pregnancy. Initial ␤-HCG ⬍25 has odds ratio of 13.16 for a non-viable pregnancy (p⬍0.001). CONCLUSION: Maternal age is independently correlated with miscarriage rates in IVF pregnancies. When adjusting for age, miscarriage rates are not independently associated with rising FSH levels. Endometriosis, PCOS and the different types of stimulation protocols do not appear to independently affect miscarriage rates. If these findings are validated by larger studies, patients can be reassured that the presence of these infertility factors and the particular stimulation protocol do not increase their risk of early pregnancy loss after IVF. Supported by: No financial support.

P-156 EVALUATION OF COMPLIANCE AND RANGE OF FEES BY ASRM LISTED EGG DONOR AND SURROGACY AGENCIES. J. Luk, J. Petrozza. Massachusetts General Hospital, Boston, MA.

although having signed an agreement with ASRM, do not follow their guidelines. Supported by: None

P-157 PERFORMANCE OF TUBAL EMBRYO TRANSFER MAY BE OF VALUE IN WOMEN UNDERGOING ASSISTED REPRODUCTION WITH HISTORY OF RECURRENT IVF-ET FAILURE OR LOW NUMBER OF ZYGOTES AVAILABLE FOR UTERINE TRANSFER. M. F. Mitwally, M. P. Diamond, H. Albuarki, M. H. Fakih, M. Ashraf, M. Abuzeid. Wayne State Univ, Detroit, MI; IVF-Michigan, Rochester Hills, MI. OBJECTIVE: To study the outcome of tubal embryo transfer (TET) in women undergoing IVF who have a history of recurrent failure of IVF with uterine embryo transfer (UET), or have three or fewer zygotes after in vitro fertilization DESIGN: Case control study. MATERIALS AND METHODS: Women with a history of recurrent IVF-UET failure or with three or fewer zygotes available for in vitro culture were counseled regarding their options: First option (study group) to receive TET (laparoscopically) on day 2 of in vitro culture. Second option, to continue in vitro embryo culture and receive UET on day 3 or day five (blastocyst transfer). A pre-requisite for TET was the absence of significant tubal pathology precluding embryo placement into the tubes (as evidenced by history, and prior hysterosalpingogram and/or laparoscopy). In women with a history of more than 4-failed IVF-UET transfers, both TET and UET were combined on day 2 and 3 respectively. The outcomes included clinical pregnancy rate and rate of live birth, as well as the rate of pregnancy loss (ectopic pregnancy, chemical pregnancy and miscarriage). RESULTS: Statistically significantly higher pregnancy rates (P ⬍ .05), with comparable rates of pregnancy loss, were associated with TET when compared to the corresponding UET groups. This was true after controlling for the woman’s age, infertility diagnosis and duration, and type of ovarian stimulation.

OBJECTIVE: To evaluate the compliance of donor and surrogancy agencies to ASRM guidelines and assess regional differences in agency, donor and surrogacy fees. DESIGN: A review of fees listed by each agency on its website. MATERIALS AND METHODS: The website for each agency that has signed an agreement with the Society for Reproductive Technology (SART) to abide by the American Society for Reproductive Medicine (ASRM) Ethics Committee Guidelines governing payment of egg donors was reviewed. If a fee range was given, the average fee was used. Each agency was divided into 8 national regions based on location, and mean operational fees and direct compensation to donor and gestational surrogates were calculated. RESULTS: A total of 61 agencies are listed. Ten agencies have either no website or their site was not operational. Of the remaining 51 sites, 24 managed both egg donation (ED) and gestational surrogacy (GS), 26 only egg donation, and 1 only gestational surrogacy. Six agencies referred to “premium” fees for selected donors that had certain preferred qualifications and 1 agency listed donor compensation greater than $10,000. The mean national agency fee for DE was $4,353 and for GS $10,892. The mean national compensation for DE was $5,204 and GS $20,000. Agency fees were higher in the west for both DE ($4,638) and GC ($8,000) as well as compensation for DE ($7,472) and GC ($20,875). The lowest agency fees for DE were in the midwest ($2,500) and northeast ($3,138) although only 1 of 8 agencies had any fees listed on their website. The lowest DE compensation was from the south ($4,250) and the lowest GC compensation from the southwest ($16,000). Many agencies added to their operational fees by charging a percentage of the DE or GC fee. CONCLUSION: The donor egg and gestational carrier industries are still unregulated with significant regional differences in operational fees and compensation to donors and surrogates. Many of these centers,

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Abstracts

Vol. 86, Suppl 2, September 2006