7/29/2019 00150282_S0015028213X00202_S0015028213023716_main.pdf

1/1

O-446 Wednesday, October 16, 2013 05:15 PM

THE VALUE OF CIRCULATING PROGESTERONE LEVELS ON

HCG DAY AND PREGNANCY OUTCOMES IN CONTROLLED

OVARIAN STIMULATION CYCLES FOR IN VITRO FERTILIZA-

TION USING FLEXIBLE ANTAGONIST PROTOCOL. H. S. Koo,M. H. Choi, I. O. Song, I. S. Kang, M. K. Koong, C. W. Park. Divisionof Reproductive Endocrinology and Infertility, Department OB/GYN, CheilGeneral Hospital, Kwandong University College of Medicine, Seoul, Repub-lic of Korea.

OBJECTIVE: To investigate the relationship between serum progesterone

levels on the hCG day and the pregnancy rate in the women undergoing COSfor IVF/ICSI-ET using flexible antagonist protocol.

DESIGN: The prospective study included a total 148 cycles of 148 IVFand/or ICSI ET patients using flexible antagonist protocol from May, 2012to June, 2012.

MATERIALS AND METHODS: The serum progesterone levels werechecked on the day of hCG administration. And we evaluated the IVFoutcomes (such as no. of retrieved oocytes, maturation rate, fertilizationrate, implantation rate, clinical pregnancy rate (CPR), miscarriage rate(MR)) were compared by progesterone level and the factor of correlationwith progesterone level (no. of retrieved oocytes, serum E 2 level on hCGday).

RESULTS: The 75 percentile serum progesterone level on hCG day was0.97ng/mL. The serum progesterone level on hCG day and serum E2 levelon hCG day, no. of retrieved oocytes were correlated positively by regres-sion analysis. The no. of retrieved oocytes was 16 and serum E2 level was

3400 pg/mL. So, we divided group by 3 factors. The serum E2 level and thenumber of oocytes retrieved were significantly higher in high P4 group thanlow P4 group (42632366 vs, 22701421, p0.000; 16.96.9 vs.10.26.3, p0.00). The CPR was higher in low P4 group (P4%0.97, 109cycles) than high P4 group (P4>0.97, 39 cycles) (39.4 vs. 20.5, %,p0.033). The CPR in the frozen thawed embryo transfer cycle afterhigh P4 on hCG day cycle was higher tendency (35.7 % vs. 20.5 %)than high P4 group.

CONCLUSION: Elevated serum progesterone levels on the day of hCGadministration is associated with reduced clinical pregnancy rates althoughmany oocytes retrieved. Measuring serum P4 values at the time of HCG isnecessaryin order to adjustthe strategy forembryotransfer. Thelarger scaledprospective study will be required.

O-447 Wednesday, October 16, 2013 05:30 PM

ANTI-MULLERIAN HORMONE (AMH) IN PERITONEAL FLUID

AND PLASMA IN PATIENTS WITH ENDOMETRIOSIS. H. Hipp,T. Loucks, K. Barrett, G. X. Yang, N. Sidell, D. Session. Department ofGynecology and Obstetrics, Emory University, Atlanta, GA.

OBJECTIVE: The aim of this study was to measure Anti-Mullerian hor-mone(AMH) in the peritoneal fluidand plasma in patientswith endometriosis.

DESIGN: AMH is made by antral follicles of the granulosa cells of theovary in reproductive aged women. It acts as a local endogenous aromataseinhibitor and may therefore have a physiologic role in the peritoneal environ-ment in patients with endometriosis. We hypothesized that there is a signif-icant correlation between plasma and peritoneal fluid AMH levels. Weanalyzed AMH in the plasma and peritoneal fluid in reproductive agedwomen with endometriosis.

MATERIALS AND METHODS: We recruited 61 reproductive agedwomen with surgical and pathologic confirmation of endometriosis. Their

peritoneal fluid and plasma were collected and then measured for AMHlevels using an ELISA (enzyme linked immunosorbent assay) kit. Sampleswere run in duplicate against known standards. Statistical analysis was per-formed with SPSS software v19. A Spearmans rank correlation coefficientwas used to determine a possible correlation of plasma and peritoneal fluidAMH. Analysis of variance (ANOVA) examined AMH levels by age in theplasma and peritoneal fluid.

RESULTS: Therewas a significant correlation of AMH levels between theplasma and peritoneal fluid in patients with endometriosis (r20.781 (p 0.001)). AMH levels declined with increasing age in both plasma and perito-neal fluid (ANOVA p value 0.001 for both).

CONCLUSION: We observed that there was a strong correlation in AMHlevels between plasma and peritoneal fluid in patients with endometriosis.Thecorrelation held as thelevels were examined by age. This strong relation-ship between plasma and peritoneal fluid may allow plasma AMH to be amarker for peritoneal AMH in studies evaluating local effects of AMH.

Supported by: Atlanta Obstetrical and Gynecological Society, EmoryDepartment of Gynecology and Obstetrics, Dr. Michael Heard, and NationalInstitutes of Health grants RO1HD55379 and UO1HD66439.

O-448 Wednesday, October 16, 2013 05:45 PM

SOLUBLE RECEPTOR FOR ADVANCED GLYCATION END-PROD-

UCTS (SRAGE): A POTENTIAL INDICATOR OF OVARIAN

RESPONSE TO CONTROLLED OVARIAN HYPERSTIMUL-

ATION. J. D. Ambroggio, P. Casson, Z. Merhi. Obstetrics and Gynecol-ogy, Division of Reproductive Endocrinology and Infertility, University of

Vermont College of Medicine, Burlington, VT.

OBJECTIVE: The accumulation of advanced glycation end-products(AGE) is associated with pathologies such as diabetes, obesity, aging, oxida-tive stress, and inflammation. The soluble receptors for AGE (sRAGE) act asdecoys by binding the toxic AGE in the circulation thus preventing theiradverse intracellular events in all organs including the ovaries. The objectiveof this study was to test the hypothesis that follicular fluid (FF) sRAGE levelsin women undergoing IVF are indicator of ovarian response, as manifestedby oocyte quantity.

DESIGN: Prospective study.MATERIALS AND METHODS: 34 reproductive-aged women who un-

derwent controlled ovarian hyperstimulation (COH) followed by oocyteretrieval for IVF were enrolled. Cumulus GCs were collected then AMHand its receptor (AMH-R) mRNA levels were quantified using RT-PCR.FF sRAGE and AMH protein levels were measured by ELISA. Cycle de-terminants included age, BMI, maximum E2 level at day of hCG, total IUsof gonadotropin used/cycle, # of days of stimulation and # of oocytesretrieved.

RESULTS: A trend was observed for a negative correlation betweensRAGE and age (r-0.34, p0.09).The higher the FF sRAGE, the lowerthe number of IUs of gonadotropin needed per cycle independent of age(r-0.4, p0.04), and the higher the # of oocytes retrieved (r 0.57,p0.02). After adjusting for age and the dose of IUs, multivariate analysisshowed that sRAGE predicted the # of oocytes retrieved (R20.27,p0.045). Additionally, there was a positive correlation between FF sRAGEand FF AMH protein levels (r0.5, p0.0085). RT-PCR showed no correla-tion between FF sRAGE and AMH or AMH-R mRNA levels.

CONCLUSION: These data support a positive relationship betweensRAGE and ovarian response to COH, as manifested by oocyte quantity.The pathological significance of these harmful inflammatory molecules(AGEs) in follicular health clearly requires further investigation. TargetingAGE might offer potential therapeutic options for the treatment of dimin-ished ovarian response.

Supported by: Internal funds.

REPRODUCTIVE IMMUNOLOGY

O-449 Wednesday, October 16, 2013 04:00 PM

MARKED STIMULATION OF THE LIPOXIN A4 SYNTHESIS

PATHWAY DURING ENDOMETRIAL STROMAL DECIDUALIZA-

TION IN WOMEN WITH AND WITHOUT ENDOMETRIOSIS SUG-

GESTS A ROLE IN EARLY PREGNANCY. T. B. Mesen,a

B. A. Lessey,b G. O. Canny,c L. Yuan,a A. T. Fazleabas,d S. L. Young.aaOb/Gyn, University. of North Carolina, Chapel Hill, NC; bOb/Gyn, Univer-sity of South Carolina, Greenville, SC; cOb/Gyn, Lausanne University Hos-pital, Lausanne, Vaud, Switzerland; dCollege of Human Medicine, MichiganState University, Grand Rapids, MI.

OBJECTIVE: Lipoxin A4 (LXA4) is an anti-inflammatory and pro-reso-lution eiconsanoid, produced by sequential actions of the enzymesALOX15B and ALOX5. We have previously shown cycle-regulation of theseenzymes in the epithelial cells as well as increased expression in endometri-osis. We hypothesized that LXA4 could play an important anti-inflammatoryrole in early pregnancy and endometriosis might alter the expression of thebiosynthetic enzymes. Therefore, the objective of these studies was to deter-mine the effects of decidualization on ALOX15B and ALOX5 expression instromal cells from women with and without endometriosis.

DESIGN: In vitro assays of cultured tissue from human subjects.MATERIALS AND METHODS: Endometrial stromal cells obtained from

endometrial biopsy in women with or without endometriosis were isolatedby enzymatic digestion. Cells were decidualized for 7 days using estradiol

S136 ASRM Abstracts Vol. 100, No. 3, Supplement, September 2013

http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-http://-/?-