with their doctor included having a child at diagnosis (adjusted odds ratio

(OR), 95% confidence interval (CI): 1.7, 1.3-2.1), being younger at diagnosis
versus being aged 30-35 (aged 20-24: 1.5, 1.0-2.1; aged 25-29: 1.1, 0.8-1.4),
being African American versus being white (1.2, 0.9-1.6), and not being
treated with chemotherapy or radiation (3.1, 2.4-4.1). These ORs and 95%
CIs were similar in a model restricted to women treated with chemotherapy
or radiation. Among women who discussed fertility, 6% of those with a child
and 19% of those without were referred to a specialist.
CONCLUSION: Over half of reproductive-age women with cancer do not
discuss fertility with a doctor before treatment, and even fewer are referred to
a specialist. Some women, especially those aged 20-24, may not be getting
the information they need to make informed decisions about fertility preservation prior to cancer treatment.
Supported by: NICHD 5R01HD066059.
P-70 Tuesday, October 15, 2013
GnRH AGONISTS AND ANTAGONISTS IN CYCLOPHOSPHAMIDE-INDUCED OVARIAN DAMAGE: FRIEND OR FOE? H. A.
Parlakgumus,a E. B. Kilicdag,a F. Bolat,b B. Haydardedeoglu,a
A. Parlakgumus.c aObstetrics and Gynecology, Baskent University, Adana,
Turkey; bPathology, Baskent University, Adana, Turkey; cGeneral Surgery,
Baskent University, Adana, Turkey.
OBJECTIVE: To determine whether GnRH agonist(GnRHa) or antagonist(GnRHant) administration protects the ovarian follicles from cyclophosphamide(Cyc) induced damage and whether the processes were mediated by
AMH.
DESIGN: Experimental study.
MATERIALS AND METHODS: The control group had intraperitoneal(ip) saline injection. The GnRHa group had a single subcutaneous(sc) leuprolide acetate(LA, 1 mg/kg) 28 days prior to a ip saline. The GnRHant
group received a single ip cetrorelix acetate(CA, 0.1 mg/kg) 1 h prior to ip
saline. The Cyc group had an ip Cyc(75 mg/kg) at day 28. The GnRHa +
Cyc group had sc LA(1 mg/kg) 28 days prior to ip Cyc(75 mg/kg). The
GnRHant + Cyc group had an ip CA(0.1 mg/kg) 1 h prior to an ip Cyc(75
mg/kg). After oophorectomy on day 35,primordial follicles(PMFs) were
counted and AMH expression was assessed by H score. Kruscal Wallis
test, c2 test or Fisher Exact test were used in statistical analysis. p<0.05
was considered statistically significant.
RESULTS: The Cyc(p0.003) and GnRHant(p0.003) groups had fewer
PMFs than the control group. GnRHa+Cyc, GnRHant+Cyc and Cyc groups
had similar numbers of PMFs. The H score was lower in the GnRHa(p
<0.001), GnRHant(p0.003), and Cyc(p0.002) groups than in controls.
H scores of GnRHa+Cyc(p0.01) and GnRHant +Cyc(p0.002) groups
were lower than Cyc group.

Follicle counts and H score according to the study groups.

Control GnRHa GnRHant Cyc GnRHa+ GnRHant+

(n11) (n11) (n11) (n11) Cyc(n11) Cyc(n11)
Primordial 5.1 2.9 54.9 2.71.7a 32.4a 4.54
follicles
HScore
3.70.3 21.4a 3.20.6a 3 0.9a 1.41.4b

2.92.5a
11.4b

Data are given as mean  standard deviation.

a
p<0.05 when compared to control group.
b
p<0.05 when compared to cyc group.
CONCLUSION: Neither GnRHa nor GnRHant protect PMFs against
damage from Cyc exposure. GnRHant itself reduces the number of PMFs,
destroying rather than protecting PMFs. Changes in AMH expression suggest
that GnRHa, GnRHant, and Cyc may be AMH-dependent.
Supported by: This study was Supported by Baskent University research
fund.
P-71 Tuesday, October 15, 2013
SLEEP DISTUBANCES HIGH IN PATIENTS SEEKING FERTILITY
PRESERVATION. M. E. Pavone,a J. Hirshfeld-Cytron,b A. Lawson,a
K. Smith,a S. C. Klock.a aObstetrics and Gynecology, Northwestern University, Chicago, IL; bFertility Centers of Illinois, Orland Park, IL.

S168

ASRM Abstracts

OBJECTIVE: Sleep has been shown to have a key role in an increasing

number of medical diseases, yet the impact of sleep on infertile patients remains unknown. This is a pilot study to assess the frequency of disturbed
sleep in patients undergoing IVF for infertility compared to fertility preservation (FP) patients with a concurrent cancer diagnosis.
DESIGN: Prospective, multicenter survey.
MATERIALS AND METHODS: 57 IVF and 32 FP patients completed a
pre-treatment sleep questionnaire of which 50 IVF and 32 FP patients also
completed a post-treatment questionnaire. Demographic and IVF stimulation
information were also collected.
RESULTS: Pre-treatment, FP patients had a significantly higher sleep
disturbance score compared to IVF controls (P<.001). At the time of
retrieval we found that compared to pre-treatment scores, IVF patients reported significantly higher sleep problems (P.003). Sleep problem scores
in patients undergoing fertility preservation did not significantly change during treatment, however they continued to be significantly higher than patients
undergoing IVF for infertility.
CONCLUSION: FP patients report higher baseline problems with sleep
compared to IVF patients. However, in contrast to FP patients, IVF patients
reported an increase in sleep problems during treatment. Research is
warranted which examines the cause of sleep problems in both FP and IVF
patients. This work is on-going to determine the role sleep may have on
IVF outcomes and the impact of treatment directed to sleep dysfunction.
Supported by: K12HD050121 and U54HD076188 (MEP).
P-72 Tuesday, October 15, 2013
CLINICAL USE OF VITRIFIED OOCYTES AMONG AUTOLOGOUS IN VITRO FERTILIZATION (IVF) PATIENTS: A THREE
YEAR REVIEW. J. H. Lim,a,b M. A. Stout,a K. A. Milne,a
K. S. Richter,a E. E. Levens,a M. J. Tucker.a,c aShady Grove Reproductive
Science Center, Rockville, MD; bDonor Egg Bank USA, Rockville, MD;
c
Georgia Reproductive Specialists, Atlanta, GA.
OBJECTIVE: Successful cryostorage of vitrified oocytes has introduced a
therapeutic option giving young women pursuing higher education, beginning a career or facing life-threatening disease the opportunity to preserve
their fertility while postponing motherhood. Oocyte cryostorage also avoids
most of the ethical issues associated with creating embryos that may never be
used.
DESIGN: Retrospective review.
MATERIALS AND METHODS: Autologous oocyte cryopreservation cycles performed by a private IVF center from June 2009 to December 2012
were reviewed. A proven oocyte vitrification protocol (7.5% EG+DMSO,
followed by 15% EG+DMSO+sucrose) using commercially available media
in conjunction with an open vitrification carrier was employed. Warming
was performed using stepwise dilutions of sucrose. Surviving oocytes were
inseminated by intracytoplasmic sperm injection (ICSI). Average age of
women at the time of oocyte collection and vitrification was 34.9 yrs.
RESULTS: 542 oocytes from 63 patients were thawed, with 477 (88%)
surviving. Following ICSI, 356 oocytes displayed normally fertilization
(2PN, 75%). Embryo transfer (ET) was performed in 59 cycles with cancellation of 4 cycles due to inadequate embryo development. From 59 ETs (1.9
embryos/ET) there were 33 clinical pregnancies and implantation rates were
56% and 44% respectively. For comparison, among fresh oocyte cycles (<35
yrs) from January 2010 to December 2012 (n 2666) resulting clinical pregnancy and implantation rates were 56% and 49%.
CONCLUSION: This review provides clinical staff and patients with
valuable information as to the efficiency of oocyte cryopreservation allowing informed decisions to be made. While sample size is limited, clinical
pregnancy and implantation rates are comparable to fresh cycles. These
results are similar to published reports of donor oocyte banking, and suggest that vitrification of autologous oocytes provides similar outcomes and
may greatly reduce surplus embryos and ethical issues in some patient
populations.
P-73 Tuesday, October 15, 2013
EFFECT OF FETAL CALF SERUM AND BOVINE SERUM
ALBUMIN ON IN VITRO DEVELOPMENT OF BOVINE PREANTRAL FOLLICLES DURING THREE-DIMENSIONAL CULTURE. M. P. Bernuci, A. C. J. S. Rosa-e-Silva, L. Batista, C. Garcia,
J. O. Campos, M. F. S. S
a. Gynecology and Obstetrics, Faculty of
Medicine of Ribeir~ao Preto of S~ao Paulo University, Ribeir~ao Preto, S~ao
Paulo, Brazil.

Vol. 100, No. 3, Supplement, September 2013