Should minority women have only frozen-thawed embryos transfers?

to patients with both BMI > 25 (overweight) and BMI > 30 (obese) by t-test and among groups with ANOVA. RESULTS: The average age of the cohort was 33.2 +/- 3.0 years, mean BMI was 25.5 +/- 5.5 kg/m2, and the average number of mature oocytes collected was 11.6 +/- 3.9. When stratified into three groups of BMI < 25, 25-29 and > 30 kg/m2, there was no difference in age, number of mature oocytes expected or retrieved between groups. The delta value in BMI < 25 patient cohort (n ¼ 69) was 2.3 +/- 4.8 oocytes, delta value in the BMI 25-30 cohort (n ¼ 32) was 3.3 +/- 4.3 oocytes, and delta value in the BMI > 30 (n ¼ 20) was 2.0 +/- 4.8 oocytes, with no difference among groups (p ¼ 0.51). There was no statistically significant difference between the delta values in the BMI < 25 and BMI > 25 groups (2.3 +/- 4.8 vs. 2.8 +/- 4.5; p ¼ 0.55), and no difference was found between the delta values in the BMI < 25 and BMI > 30 groups (2.3 +/- 4.8 vs. 2.0 +/- 4.8 oocytes; p ¼ 0.80). CONCLUSIONS: Although technically more challenging, there may be no difference in oocyte retrieval rate in patients with higher BMI. Further studies are needed with larger sample sizes in the future. P-600 Wednesday, October 19, 2016 UTILIZATION AND EFFECTS OF EMBRYO BANKING ON ART OUTCOME REPORTING IN THE U.S. V. A. Kushnir,a,b D. H. Barad,a,c S. Darmon,a D. Albertini,a,d N. Gleicher.a,e aCenter for Human Reproduction, New York, NY; bWake Forest School of Medicine, Winston-Salem, NC; cAlbert Einstein College of Medicine, Bronx, NY; d University of Kansas Medical Center, Kansas City, KS; eRockefeller University, Bronx, NY. OBJECTIVE: Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) exclude embryo banking cycles from outcome calculations. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: We examined 2013 CDC data for impact of cycle exclusions from reporting on national ART outcomes due to embryo banking by recalculating live birth rates for autologous oocyte cycles. Inflation of reported live birth rates was assessed for all age groups of infertile women as the difference between fresh cycle live births in reference to number of initiated fresh cycles (excluding embryo banking cycles), as typically reported by the CDC and, again, with refernce fresh ART cycles (i.e., ‘‘intent to treat’’), including embryo banking cycles. RESULTS: Out of 121,351 fresh non-donor ART cycles 27,564 (22.7%) involved in 2013 embryo banking. The proportion of banking cycles increased with female age from 15.5% in women <35 years to 56.5% in women >44 years. Concomitantly, the proportion of thawed cycles decreased with advancing female age (P <0.0001). Exclusion of embryo banking cycles led to inflation of live birth rates in fresh ART cycles, increasing in parallel to advancing female age, with utilization of embryo banking reaching 56.3% in women age >44. Inflation of live birth rates in thawed cycles could not be reliably calculated from publically available CDC data but appears even larger. CONCLUSIONS: Utilization of embryo banking increased during 2013 with advancing female age, suggesting a potential age selection bias. Exclusion of embryo banking cycles from national ART outcome reports significantly inflated national ART success rates, especially among older women. Supported by: Intramural funds from The Center for Human Reproduction and grants from The Foundation for Reproductive Medicine.

ogy, The Brooklyn Hospital Center, Brooklyn, NY; bGenetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY; cReproductive Specialists of New York, Brooklyn, NY; dReproductive Specialists of New York, Mineola, NY; eSUNY Stony Brook School of Medicine, Stony Brook, NY. OBJECTIVE: To determine if the type of IVF cycle (fresh versus frozen) influences IVF live birth rates (LBR) in different ethnic groups. DESIGN: A retrospective cohort study of 2511 patients of known ethnicity at a single site who underwent fresh (IVF) or frozen (FET) single and double embryo transfers. We compared ethnicity, age, BMI, FSH, AMH, gravidity, parity, infertility diagnoses, previous fresh cycles, oocytes retrieved, LBR and number of embryos transferred. MATERIALS AND METHODS: Women under age 40 who underwent fresh IVF or FET, day 5 blastocyst transfer of fewer than 3 embryos from 2010 to 2015, with fewer than two prior IVF retrievals, were included in the study. We included four ethnic groups: Caucasian, African American, Asian and Hispanic, which were dichotomized into two main groups: Caucasian (n¼1918, 76.4%) and non-Caucasian(n¼593, 23.6%). Primary outcome was live birth rate. Variables were analyzed using Chi-square, ANOVA, Student’s t-test and logistic regression. A p-value < 0.05 was considered statistically significant. RESULTS: Age, BMI, day 3 FSH, AMH, number of previous fresh cycles, number of oocytes retrieved and number of blastocysts were similar in both ethnic groups. Peak estradiol levels, gravidity and parity were higher in nonCaucasians (p<0.01). Infertility diagnoses were similar in both groups with the exception of more tubal factor and uterine factor in non-Caucasian women (p<0.01) and more cases of unexplained infertility in Caucasian women (p<0.01). Non-Caucasian women had a significantly higher LBR (48.8%) in FET compared to the fresh IVF (27%) (p < 0.001) in double (DET) but not in single embryo transfers (SET). Caucasian women had significantly higher LBR in fresh IVF vs FET in SET but not in DET. Differences in LBR between cycle groups persisted after accounting for differences in infertility diagnoses. CONCLUSIONS: Minority women have a significantly higher LBR in FET cycles compared to fresh IVF cycles, regardless of age. Caucasian women have higher LBR in fresh vs FET cycles in SET but not in DET. Further research is needed to identify confounding factors and to determine if minority women would benefit from double FET in selected cases. References: 1. Shah MS In vitro fertilization outcomes after fresh and frozen blastocyst transfer in South Asian compared with Caucasian women. Fertil Steril 2016, in press. 2. Csokmay JM, Are there ethnic differences in pregnancy rates in African-American versus white women undergoing frozen blastocyst transfers? Fertil Steril 2011;95:89-93.

P-602 Wednesday, October 19, 2016

P-601 Wednesday, October 19, 2016

OUTCOMES FOR IN VITRO FERTILIZATION IN UTERINE ADENOMYOSIS: A RETROSPECTIVE COHORT STUDY. D. O’Connor,a M. A. Bedaiwy,b C. Dunne,c B. Taylor,c J. Havelock,d C. Lawrence,e B. Kuzeljevic.f aResident, University of British Columbia, Vancouver, BC, Canada; bDepartment of Obstetrics and Gynecology, BC Women’s Hospital, Vancouver, BC, Canada; cUniversity of British Columbia, Vancouver, BC, Canada; dPacific Centre for Reproductive Medicine, Vancouver, BC, Canada; ePacific Centre for Reproductive Medicine, Burnaby, BC, Canada; fBritish Columbia Women’s Hospital, Vancouver, BC, Canada.

SHOULD MINORITY WOMEN HAVE ONLY FROZEN-THAWED EMBRYOS TRANSFERS? C. Chatzicharalampous,a,b M. Bray,c,a J. Jackman,a M. Saketos,d L. Sung,d J. Stelling.e aObstetrics and Gynecol-

OBJECTIVE: Uterine adenomyosis is an abnormal condition of the uterus defined by endometrial glands and stroma within the myometrium. The impact of adenomyosis on infertility and IVF outcomes demonstrates

Live BIrth Rate by ET count, ethnic group and cycle type (fresh vs frozen)

Single Embryo Transfer Caucasian Fresh LBR (%)

Double Embryo Transfer Non-Caucasian

Frozen LBR(%)

Fresh LBR(%)

Frozen LBR(%)

Caucasian Fresh LBR(%)

Frozen LBR(%)

162(30.6)* 30(20.3)* 32(23.5) 12(24.5) 276(28.4) 87(32.6) Twin Rate: Caucasian: FR: 19.6%, FET: 14.5%, Non-Caucasian: FR: 16.8%, FET: 24.1%. *p¼0.01**p< 0.001

FERTILITY & STERILITYÒ

Non-Caucasian Fresh LBR(%)

Frozen LBR(%)

87(27.0)**

42(48.8)**

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