- Email: [email protected]
The influence of working status and regular exercise on in vitro fertilization outcomes
increasing their average daily protein intake to > 25 % and lowering their CHO to < 40%.
P-411 Wednesday, October 24, 2012
whose assessments did not follow an IVF cycle failure. This difference was significant, X2 (1, N¼417)¼6.84, P<.01.
Rates of MDD in a Sample of Women Receiving Infertility Treatment
PROTEIN INTAKE AND EARLY IN-VITRO FERTILIZATION A. J. Gaskins,a D. Wright,b OUTCOMES. D. S. Colaci,a b a a a J. C. Petrozza, R. Hauser, J. E. Chavarro. Harvard School of Public Health, Boston, MA; bMassachusetts General Hospital, Boston, MA. OBJECTIVE: To evaluate the relation between protein intake and early in vitro fertilization (IVF) outcomes. DESIGN: Prospective cohort study. MATERIALS AND METHODS: Women presenting to the Massachusetts General Hospital Fertility Center were invited to participate this study. Participants completed a validated food frequency questionnaire. The analysis included 145 women who underwent a total of 205 cycles and fulfilled the eligibility criteria. Linear mixed models (for peak E2) and generalized estimating equation (GEE) models (Poisson for oocyte yield and M2 yield and logistic for all other outcomes) were used to examine the relation of protein intake with IVF outcomes while accounting for within-woman correlations in outcomes across cycles. Multivariate models included terms for age, fat intake, total energy intake, day 3 FSH, infertility diagnosis, stimulation protocol, body mass index and smoking. RESULTS: Peak E2 level was inversely related to protein intake from animal sources (P-trend¼0.03). Women in the lowest tertile of animal protein intake had an average (95% CI) peak E2 level of 2055 (1381-2730) whereas women in the highest tertile of animal protein intake had an average peak E2 level (95% CI) of 1723 (998-2448). However, protein intake was unrelated to total oocyte yield or the number of M2 oocytes. There was a suggestion of an association between higher vegetable protein consumption and higher fertilization rate among couples undergoing conventional IVF (P-trend¼0.05) but not among women undergoing ICSI cycles (P-trend¼0.22). We also found a suggestion of an association between higher animal protein intake and fewer poor quality embryos (Ptrend¼0.06). CONCLUSION: Protein intake was inversely associated with peak estradiol. There were suggestive associations of vegetable protein intake with fertilization rate and animal protein intake with embryo quality that require further study. Supported by: Grants ES009718 and ES00002 from NIEHS and training grant T32 DK07703 from NIDDK. MENTAL HEALTH
P-412 Wednesday, October 24, 2012 RATES OF MAJOR DEPRESSION FOLLOWING IVF FAILURE. S. R. Holley,a M. R. Passoni,a R. D. Nachtigall,b c c c a M. E. Bleil, N. E. Adler, L. A. Pasch. Psychology, San Francisco State University, San Francisco, CA; bObstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA; cPsychiatry, University of California, San Francisco, San Francisco, CA. OBJECTIVE: To evaluate the incidence of Major Depressive Disorder (MDD) following in vitro fertilization (IVF) failure in a sample of infertility patients in the United States. DESIGN: Prospective cohort of 417 women seeking infertility treatment in a four-wave study over an 18-month period. MATERIALS AND METHODS: At baseline, no participant had previously received IVF treatment. After 4, 10, and 18 months, participants completed interviews and questionnaires assessing fertility treatment outcomes and psychological symptoms. The presence of MDD was assessed for all participants at each time point using the Composite International Diagnostic Interview (CIDI) Major Depression module. This is a structured interview designed to assess if an individual has met the DSM-IV-TR criteria for MDD during a specified time period (i.e., between assessment points). RESULTS: Over the 18-month time frame, 127 women were assessed following at least one failed IVF cycle (i.e., cancelled cycle, negative pregnancy test, or pregnancy ending in miscarriage). Of those patients, 38.6% met the DSM-IV-TR criteria for MDD, as compared to 25.9% of all other participants
S234
ASRM Abstracts
Post-IVF Failure (N¼127)
No MDD Diagnosis MDD Diagnosis
All Other Patients (N¼290)
N
%
N
%
78 49
61.4% 38.6%
215 75
74.1% 25.9%
CONCLUSION: These are among the first data from the United States to address major depression following IVF failure. Rates of MDD are high for women undergoing infertility treatment, and even higher for women following the experience of an IVF cycle failure. Particular attention should be paid to the needs of these patients to effectively assess and treat depression. Supported by: Support provided by the NICHD/NIH Grant # PO1 HD37074.
P-413 Wednesday, October 24, 2012 AN UNACKNOWLEDGED LOSS: THE EXPERIENCE OF PERMANENT, UNINTENTIONAL CHILDLESSNESS FOR WOMEN WHO DELAYED CHILDBEARING. E. Koert. Educational and Counselling Psychology, University of British Columbia, Vancouver, BC, Canada. OBJECTIVE: Recent census data reports that an increasing number of women are delaying childbearing. Unfortunately, for many women, medical intervention cannot overcome the realities of age-related fertility decline, resulting in an increasing number of women who are unable to realize their goal of becoming a mother. An exploration and understanding of the experience of unintentional childlessness for women who have delayed childbearing and are no longer fertile is the focus of this study. DESIGN: A qualitative, phenomenological approach was used to gain an in-depth understanding of the meanings and experience of permanent unintentional childlessness for women who have delayed childbearing. MATERIALS AND METHODS: In-depth, tape-recorded interviews were conducted with 15 women who identified themselves as being permanently and unintentionally childless after postponing childbearing. The interviews were transcribed, coded, and analyzed using an interpretive phenomenological method. Rich descriptions of the experience of unintentional childlessness were developed and common themes were identified. RESULTS: Common themes identified in the experiences of these 15 women included: a sense of profound grief and loss as they came to terms with their permanent childlessness after always expecting they would become mothers; a sense of powerlessness in being unable to create the right circumstances to become mothers earlier; feeling devastated when they realized that time had run out to become a mother; a sense of being judged by others for not making the time in their lives earlier to have children; and the sense of being an outsider in the world of other mothers. CONCLUSION: As more women continue to delay childbearing and find themselves facing permanent, unanticipated childlessness, this study’s findings can inform the development of clinical and mental health services and support for this growing group of women. Supported by: Grant from the Social Sciences and Humanities Research Council #752-2011-2149.
P-414 Wednesday, October 24, 2012 THE INFLUENCE OF WORKING STATUS AND REGULAR EXERCISE ON IN VITRO FERTILIZATION OUTCOMES. H.-G. Sun,a K. H. Lee,a I. H. Park,a S. G. Kim,a Y. Y. Kim,a G.-H. Jeon.b aMamapapa & Baby OB&GY, Ulsan, Republic of Korea; bOB/GY, Inje University, Haeundae Paik Hospital, Busan, Republic of Korea.
Vol. 98, No. 3, Supplement, September 2012
OBJECTIVE: It has been well documented that lifestyle behaviors can have a significant impact on quality of life. But there was limited research on the actual lifestyle of women treated by assisted reproductive technology (ART). Patients wanted to know impact of working status and exercise to maximize the probability of conception. The goal of this study was to evaluate influence on a variety of lifestyle behaviors in women who underwent an IVF cycle, especially working status and exercises. DESIGN: Prospective survey. MATERIALS AND METHODS: The study included 284 patients who underwent IVF cycles from September 2011 to February 2012. A survey was conducted by using questionnaire before starting ART treatment. The questionnaire included working status, working intensity (scale 0 to 10) and regular exercise (or not). RESULTS: Among total 284 patients, average age was 35.44.4, there were 117 working patients (41.2%) and 167 non-working patients (58.8%). Other demographics (age, infertility causes, IVF protocols, oocyte numbers, etc.) had no differences between groups. The pregnancy rate of the working group and non-working group were 54.7% (60/117) and 47.3% (76/167) respectively, which showed statistically significant difference (P<0.05). When analyzing working intensity and pregnancy rate, there was no correlation between them. Patients who exercise regularly and do not exercise were 101 (35.6%) and 183 (64.4%) respectively. The pregnancy rate of the exercising group was 49.5% (48/101) and that of the non-exercising group was 50.8% (88/183), which showed no difference. CONCLUSION: Working during ART treatment dose positively affect outcomes, but its intensity dose not affect. Regular exercise dose not affect IVF outcomes. In conclusion, to quit working is not recommended and to continue working is preferable. It is not necessary to start new exercise for archive good outcomes. It is clear that more research is needed to assess the advisable lifestyle and make specific recommendations to achieve the highest pregnancy rates.
P-415 Wednesday, October 24, 2012 PSYCHOSOCIAL ISSUES IN FEMALE FERTILITY PRESERVATION PATIENTS. A. K. Lawson,a S. C. Klock,a M. E. Pavone,a J. Hirshfeld-Cytron,b K. N. Smith,a R. R. Kazer.a aObstetrics and Gynecology, Northwestern University, Chicago, ILbObstetrics and Gynecology, University of Illinois-Chicago, IL. OBJECTIVE: To describe the psychosocial factors and treatment choices of women who were offered fertility preservation services between 2005-2011. DESIGN: Retrospective chart review. MATERIALS AND METHODS: Between 2005 and 2011, 315 pre-menopausal patients (ages 18-45) with breast, gynecologic, hematologic, and other cancers underwent medical screening for fertility preservation. Patients also underwent pre-treatment psychological consultation. Demographic information, cancer diagnosis, choice of fertility preservation strategy, psychological status, pregnancy outcome, and embryo/gamete disposition decision were analyzed to assess psychosocial factors present in fertility preservation patients. RESULTS: 105/285 (37%) eligible patients chose to undergo oocyte or embryo cryopreservation; most patients were married/partnered and chose embryo cryopreservation. 34/96 (35%) women who participated in treatment, and for whom mental health information was available, met criteria for a depressive and/or anxiety disorder. Most patients chose to donate supernumerary embryos and oocytes to their partner in the event of their death; of the four patients who died, one partner attempted to return to use the patient’s frozen oocytes in the midst of bereavement. Thirteen women attempted to achieve pregnancy after treatment; four had live births, one is currently pregnant, 5/10 pregnancies resulted in miscarriage, and five women never achieved pregnancy. CONCLUSION: One third of eligible women chose to undergo oocyte or embryo cryopreservation. These patients frequently suffer from anxiety and/ or depression. Only a third (4/13) of patients achieved live birth. Decisions regarding oocyte and embryo disposition are emotionally difficult. Fertility preservation patients should be provided psychological counseling to address mood and anxiety symptoms as well as the potential emotional sequelae of not achieving pregnancy and of embryo and oocyte disposition decisions. Supported by: Support by K12HD050121 for Mary Ellen Pavone and NIH UL1DE019587 for Ralph R. Kazer.
FERTILITY & STERILITYÒ
P-416 Wednesday, October 24, 2012 DISCLOSURE PATTERNS OF FAMILIES CONFORMED BY OOCYTE DONATION IN ARGENTINA. A. Nabel, D. O. Fernandez, B. Riestra Marteleur, M. F. Ugozzoli Llugdar, S. D. Papier, C. E. Sueldo. CEGyR, Buenos Aires, Argentina. OBJECTIVE: To determine the percentage of couples that revealed the mode of conception to their children and relatives and the motivations for disclosing or not. Also to estimate the degree of satisfaction after going thru oocyte donation successfully. DESIGN: Descriptive, prospective, observational and transversal study completed by online survey. MATERIALS AND METHODS: Patients that had given birth by having oocyte donation at our Center between 2000 to 2008 were contacted. The study was approved by the Ethics Committee at our Institute. The survey inquired about disclosing the oocyte donation to children, close relatives and others. Also, the reasons behind disclosing or not. RESULTS: Of 166 women that were contacted, 115 (69,2%) fully completed the survey online. The percentage that already disclosed the information to the children was 8.7%, 37.4% planned to disclose in the future; 30.4% had not yet made a decision and 23.5% already decided not to disclose. Among those that decided to disclose the mode of conception, 69% would do it at the age of 8 or more. Among those that decided not to disclose, 52% felt they were the mothers so it was pointless to disclose,30% were afraid of causing a psychological trauma to the child, 22% were afraid that the child would not consider them ‘‘the true mother’’. Among those disclosing 77% did so because ‘‘ is not good to keep a secret with your child or it was his right to know how conception took place’’ and 46% disclosed to family members. Overall 100% were satisfied with having gone thru oocyte donation. CONCLUSION: Although the degree of satisfaction with oocyte donation was high,our results revealed that 50% of the children in our population will not be told the mode of conception, different from disclosing oocyte donation in other countries (Shehab 2008). During the psychological counselling of oocyte donation recipients as well as after birth, future disclosure should be thoroughly discussed as it may have significant consequences in the parents/children relationship.
P-417 Wednesday, October 24, 2012 TICK TOCK: CAN THE CLOCK BE STOPPED? THE USE OF ELECTIVE OOCYTE CRYOPRESERVATION (EOC) AS A MEANS TO PRESERVE FERTILITY (PF). B. Hodes-Wertz, S. Druckenmiller, M. Smith, N. Noyes. NYU Fertility Center, New York, NY. OBJECTIVE: Worldwide, women are delaying childbearing. Our center’s OC birth rate/transfer is 50% and thus offers a potential bridge over the gap between reproductive prime and when a woman is realistically ready to bear children. From 2005-2011, 491 women undergoing EOC were queried about a societal shift to this new reproductive practice. DESIGN: Cross-sectional survey. MATERIALS AND METHODS: In 2012, an anonymous 30-question survey was sent to women who completed R1 EOC treatment cycle (mean age:38y). Queries included demographics/motivations/desires/fertility knowledge and outcomes following EOC. RESULTS: Survey response rate was 36% (n¼177). Of these women, R80% were 36-41y and Caucasian; had no partner at EOC; underwent EOC at a post-optimal age (reasons: technology, finance, personal); felt their post-EOC reproductive future improved and were empowered by the process; were aware of age-related infertility but sensed that popular media falsely portrayed the upper age limit to natural conception (NC); ranked NC, autologous ART and EOC above donor oocyte and adoption; and noted that lack of partner was the primary reason for not having children. A portion (19%) added that workplace inflexibility contributed. A perceived social stigma associated with EOC was reported by 33%. Half learned about EOC from a friend; others from a medical provider, the media and the internet. Most (93%) have not used their frozen oocytes; 12 stated they had and disclosed 8 outcomes. Overall, 22% reported a successful conception post-EOC (NC:16, ART:16 and EOC:3). CONCLUSION: Women electing EOC at our center know about age-related infertility yet continue to delay childbearing. EOC popularity is gaining and may serve as a means to PF. Furthermore, EOC may increase a woman’s security regarding her ability to bear her own genetic offspring, ranking it, above non-biologic procreative choices, a testament to genetics being a driving force behind mankind’s urge to reproduce.
S235
P-411 Wednesday, October 24, 2012
whose assessments did not follow an IVF cycle failure. This difference was significant, X2 (1, N¼417)¼6.84, P<.01.
Rates of MDD in a Sample of Women Receiving Infertility Treatment
PROTEIN INTAKE AND EARLY IN-VITRO FERTILIZATION A. J. Gaskins,a D. Wright,b OUTCOMES. D. S. Colaci,a b a a a J. C. Petrozza, R. Hauser, J. E. Chavarro. Harvard School of Public Health, Boston, MA; bMassachusetts General Hospital, Boston, MA. OBJECTIVE: To evaluate the relation between protein intake and early in vitro fertilization (IVF) outcomes. DESIGN: Prospective cohort study. MATERIALS AND METHODS: Women presenting to the Massachusetts General Hospital Fertility Center were invited to participate this study. Participants completed a validated food frequency questionnaire. The analysis included 145 women who underwent a total of 205 cycles and fulfilled the eligibility criteria. Linear mixed models (for peak E2) and generalized estimating equation (GEE) models (Poisson for oocyte yield and M2 yield and logistic for all other outcomes) were used to examine the relation of protein intake with IVF outcomes while accounting for within-woman correlations in outcomes across cycles. Multivariate models included terms for age, fat intake, total energy intake, day 3 FSH, infertility diagnosis, stimulation protocol, body mass index and smoking. RESULTS: Peak E2 level was inversely related to protein intake from animal sources (P-trend¼0.03). Women in the lowest tertile of animal protein intake had an average (95% CI) peak E2 level of 2055 (1381-2730) whereas women in the highest tertile of animal protein intake had an average peak E2 level (95% CI) of 1723 (998-2448). However, protein intake was unrelated to total oocyte yield or the number of M2 oocytes. There was a suggestion of an association between higher vegetable protein consumption and higher fertilization rate among couples undergoing conventional IVF (P-trend¼0.05) but not among women undergoing ICSI cycles (P-trend¼0.22). We also found a suggestion of an association between higher animal protein intake and fewer poor quality embryos (Ptrend¼0.06). CONCLUSION: Protein intake was inversely associated with peak estradiol. There were suggestive associations of vegetable protein intake with fertilization rate and animal protein intake with embryo quality that require further study. Supported by: Grants ES009718 and ES00002 from NIEHS and training grant T32 DK07703 from NIDDK. MENTAL HEALTH
P-412 Wednesday, October 24, 2012 RATES OF MAJOR DEPRESSION FOLLOWING IVF FAILURE. S. R. Holley,a M. R. Passoni,a R. D. Nachtigall,b c c c a M. E. Bleil, N. E. Adler, L. A. Pasch. Psychology, San Francisco State University, San Francisco, CA; bObstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA; cPsychiatry, University of California, San Francisco, San Francisco, CA. OBJECTIVE: To evaluate the incidence of Major Depressive Disorder (MDD) following in vitro fertilization (IVF) failure in a sample of infertility patients in the United States. DESIGN: Prospective cohort of 417 women seeking infertility treatment in a four-wave study over an 18-month period. MATERIALS AND METHODS: At baseline, no participant had previously received IVF treatment. After 4, 10, and 18 months, participants completed interviews and questionnaires assessing fertility treatment outcomes and psychological symptoms. The presence of MDD was assessed for all participants at each time point using the Composite International Diagnostic Interview (CIDI) Major Depression module. This is a structured interview designed to assess if an individual has met the DSM-IV-TR criteria for MDD during a specified time period (i.e., between assessment points). RESULTS: Over the 18-month time frame, 127 women were assessed following at least one failed IVF cycle (i.e., cancelled cycle, negative pregnancy test, or pregnancy ending in miscarriage). Of those patients, 38.6% met the DSM-IV-TR criteria for MDD, as compared to 25.9% of all other participants
S234
ASRM Abstracts
Post-IVF Failure (N¼127)
No MDD Diagnosis MDD Diagnosis
All Other Patients (N¼290)
N
%
N
%
78 49
61.4% 38.6%
215 75
74.1% 25.9%
CONCLUSION: These are among the first data from the United States to address major depression following IVF failure. Rates of MDD are high for women undergoing infertility treatment, and even higher for women following the experience of an IVF cycle failure. Particular attention should be paid to the needs of these patients to effectively assess and treat depression. Supported by: Support provided by the NICHD/NIH Grant # PO1 HD37074.
P-413 Wednesday, October 24, 2012 AN UNACKNOWLEDGED LOSS: THE EXPERIENCE OF PERMANENT, UNINTENTIONAL CHILDLESSNESS FOR WOMEN WHO DELAYED CHILDBEARING. E. Koert. Educational and Counselling Psychology, University of British Columbia, Vancouver, BC, Canada. OBJECTIVE: Recent census data reports that an increasing number of women are delaying childbearing. Unfortunately, for many women, medical intervention cannot overcome the realities of age-related fertility decline, resulting in an increasing number of women who are unable to realize their goal of becoming a mother. An exploration and understanding of the experience of unintentional childlessness for women who have delayed childbearing and are no longer fertile is the focus of this study. DESIGN: A qualitative, phenomenological approach was used to gain an in-depth understanding of the meanings and experience of permanent unintentional childlessness for women who have delayed childbearing. MATERIALS AND METHODS: In-depth, tape-recorded interviews were conducted with 15 women who identified themselves as being permanently and unintentionally childless after postponing childbearing. The interviews were transcribed, coded, and analyzed using an interpretive phenomenological method. Rich descriptions of the experience of unintentional childlessness were developed and common themes were identified. RESULTS: Common themes identified in the experiences of these 15 women included: a sense of profound grief and loss as they came to terms with their permanent childlessness after always expecting they would become mothers; a sense of powerlessness in being unable to create the right circumstances to become mothers earlier; feeling devastated when they realized that time had run out to become a mother; a sense of being judged by others for not making the time in their lives earlier to have children; and the sense of being an outsider in the world of other mothers. CONCLUSION: As more women continue to delay childbearing and find themselves facing permanent, unanticipated childlessness, this study’s findings can inform the development of clinical and mental health services and support for this growing group of women. Supported by: Grant from the Social Sciences and Humanities Research Council #752-2011-2149.
P-414 Wednesday, October 24, 2012 THE INFLUENCE OF WORKING STATUS AND REGULAR EXERCISE ON IN VITRO FERTILIZATION OUTCOMES. H.-G. Sun,a K. H. Lee,a I. H. Park,a S. G. Kim,a Y. Y. Kim,a G.-H. Jeon.b aMamapapa & Baby OB&GY, Ulsan, Republic of Korea; bOB/GY, Inje University, Haeundae Paik Hospital, Busan, Republic of Korea.
Vol. 98, No. 3, Supplement, September 2012
OBJECTIVE: It has been well documented that lifestyle behaviors can have a significant impact on quality of life. But there was limited research on the actual lifestyle of women treated by assisted reproductive technology (ART). Patients wanted to know impact of working status and exercise to maximize the probability of conception. The goal of this study was to evaluate influence on a variety of lifestyle behaviors in women who underwent an IVF cycle, especially working status and exercises. DESIGN: Prospective survey. MATERIALS AND METHODS: The study included 284 patients who underwent IVF cycles from September 2011 to February 2012. A survey was conducted by using questionnaire before starting ART treatment. The questionnaire included working status, working intensity (scale 0 to 10) and regular exercise (or not). RESULTS: Among total 284 patients, average age was 35.44.4, there were 117 working patients (41.2%) and 167 non-working patients (58.8%). Other demographics (age, infertility causes, IVF protocols, oocyte numbers, etc.) had no differences between groups. The pregnancy rate of the working group and non-working group were 54.7% (60/117) and 47.3% (76/167) respectively, which showed statistically significant difference (P<0.05). When analyzing working intensity and pregnancy rate, there was no correlation between them. Patients who exercise regularly and do not exercise were 101 (35.6%) and 183 (64.4%) respectively. The pregnancy rate of the exercising group was 49.5% (48/101) and that of the non-exercising group was 50.8% (88/183), which showed no difference. CONCLUSION: Working during ART treatment dose positively affect outcomes, but its intensity dose not affect. Regular exercise dose not affect IVF outcomes. In conclusion, to quit working is not recommended and to continue working is preferable. It is not necessary to start new exercise for archive good outcomes. It is clear that more research is needed to assess the advisable lifestyle and make specific recommendations to achieve the highest pregnancy rates.
P-415 Wednesday, October 24, 2012 PSYCHOSOCIAL ISSUES IN FEMALE FERTILITY PRESERVATION PATIENTS. A. K. Lawson,a S. C. Klock,a M. E. Pavone,a J. Hirshfeld-Cytron,b K. N. Smith,a R. R. Kazer.a aObstetrics and Gynecology, Northwestern University, Chicago, ILbObstetrics and Gynecology, University of Illinois-Chicago, IL. OBJECTIVE: To describe the psychosocial factors and treatment choices of women who were offered fertility preservation services between 2005-2011. DESIGN: Retrospective chart review. MATERIALS AND METHODS: Between 2005 and 2011, 315 pre-menopausal patients (ages 18-45) with breast, gynecologic, hematologic, and other cancers underwent medical screening for fertility preservation. Patients also underwent pre-treatment psychological consultation. Demographic information, cancer diagnosis, choice of fertility preservation strategy, psychological status, pregnancy outcome, and embryo/gamete disposition decision were analyzed to assess psychosocial factors present in fertility preservation patients. RESULTS: 105/285 (37%) eligible patients chose to undergo oocyte or embryo cryopreservation; most patients were married/partnered and chose embryo cryopreservation. 34/96 (35%) women who participated in treatment, and for whom mental health information was available, met criteria for a depressive and/or anxiety disorder. Most patients chose to donate supernumerary embryos and oocytes to their partner in the event of their death; of the four patients who died, one partner attempted to return to use the patient’s frozen oocytes in the midst of bereavement. Thirteen women attempted to achieve pregnancy after treatment; four had live births, one is currently pregnant, 5/10 pregnancies resulted in miscarriage, and five women never achieved pregnancy. CONCLUSION: One third of eligible women chose to undergo oocyte or embryo cryopreservation. These patients frequently suffer from anxiety and/ or depression. Only a third (4/13) of patients achieved live birth. Decisions regarding oocyte and embryo disposition are emotionally difficult. Fertility preservation patients should be provided psychological counseling to address mood and anxiety symptoms as well as the potential emotional sequelae of not achieving pregnancy and of embryo and oocyte disposition decisions. Supported by: Support by K12HD050121 for Mary Ellen Pavone and NIH UL1DE019587 for Ralph R. Kazer.
FERTILITY & STERILITYÒ
P-416 Wednesday, October 24, 2012 DISCLOSURE PATTERNS OF FAMILIES CONFORMED BY OOCYTE DONATION IN ARGENTINA. A. Nabel, D. O. Fernandez, B. Riestra Marteleur, M. F. Ugozzoli Llugdar, S. D. Papier, C. E. Sueldo. CEGyR, Buenos Aires, Argentina. OBJECTIVE: To determine the percentage of couples that revealed the mode of conception to their children and relatives and the motivations for disclosing or not. Also to estimate the degree of satisfaction after going thru oocyte donation successfully. DESIGN: Descriptive, prospective, observational and transversal study completed by online survey. MATERIALS AND METHODS: Patients that had given birth by having oocyte donation at our Center between 2000 to 2008 were contacted. The study was approved by the Ethics Committee at our Institute. The survey inquired about disclosing the oocyte donation to children, close relatives and others. Also, the reasons behind disclosing or not. RESULTS: Of 166 women that were contacted, 115 (69,2%) fully completed the survey online. The percentage that already disclosed the information to the children was 8.7%, 37.4% planned to disclose in the future; 30.4% had not yet made a decision and 23.5% already decided not to disclose. Among those that decided to disclose the mode of conception, 69% would do it at the age of 8 or more. Among those that decided not to disclose, 52% felt they were the mothers so it was pointless to disclose,30% were afraid of causing a psychological trauma to the child, 22% were afraid that the child would not consider them ‘‘the true mother’’. Among those disclosing 77% did so because ‘‘ is not good to keep a secret with your child or it was his right to know how conception took place’’ and 46% disclosed to family members. Overall 100% were satisfied with having gone thru oocyte donation. CONCLUSION: Although the degree of satisfaction with oocyte donation was high,our results revealed that 50% of the children in our population will not be told the mode of conception, different from disclosing oocyte donation in other countries (Shehab 2008). During the psychological counselling of oocyte donation recipients as well as after birth, future disclosure should be thoroughly discussed as it may have significant consequences in the parents/children relationship.
P-417 Wednesday, October 24, 2012 TICK TOCK: CAN THE CLOCK BE STOPPED? THE USE OF ELECTIVE OOCYTE CRYOPRESERVATION (EOC) AS A MEANS TO PRESERVE FERTILITY (PF). B. Hodes-Wertz, S. Druckenmiller, M. Smith, N. Noyes. NYU Fertility Center, New York, NY. OBJECTIVE: Worldwide, women are delaying childbearing. Our center’s OC birth rate/transfer is 50% and thus offers a potential bridge over the gap between reproductive prime and when a woman is realistically ready to bear children. From 2005-2011, 491 women undergoing EOC were queried about a societal shift to this new reproductive practice. DESIGN: Cross-sectional survey. MATERIALS AND METHODS: In 2012, an anonymous 30-question survey was sent to women who completed R1 EOC treatment cycle (mean age:38y). Queries included demographics/motivations/desires/fertility knowledge and outcomes following EOC. RESULTS: Survey response rate was 36% (n¼177). Of these women, R80% were 36-41y and Caucasian; had no partner at EOC; underwent EOC at a post-optimal age (reasons: technology, finance, personal); felt their post-EOC reproductive future improved and were empowered by the process; were aware of age-related infertility but sensed that popular media falsely portrayed the upper age limit to natural conception (NC); ranked NC, autologous ART and EOC above donor oocyte and adoption; and noted that lack of partner was the primary reason for not having children. A portion (19%) added that workplace inflexibility contributed. A perceived social stigma associated with EOC was reported by 33%. Half learned about EOC from a friend; others from a medical provider, the media and the internet. Most (93%) have not used their frozen oocytes; 12 stated they had and disclosed 8 outcomes. Overall, 22% reported a successful conception post-EOC (NC:16, ART:16 and EOC:3). CONCLUSION: Women electing EOC at our center know about age-related infertility yet continue to delay childbearing. EOC popularity is gaining and may serve as a means to PF. Furthermore, EOC may increase a woman’s security regarding her ability to bear her own genetic offspring, ranking it, above non-biologic procreative choices, a testament to genetics being a driving force behind mankind’s urge to reproduce.
S235