immersed into the water at 37
C after 5min at RT. 1.0M, 0.5M, and 0.

25M,
0.125M sucrose or trehalose in sequentially according to our lab protocol. Group
1 and 3 was used sucrose as cryoprotectant, instead group 2 and 4 was used trehalose. We observed histology, viability, growing and apoptosis of follicle, using
H&E, PCNA, VEGF, and Caspase-3 within 30 minutes.
RESULTS: No difference was found between sucrose and trehalose as cryoprotectant among groups. But the group 1 and 2 which has the more soaking time
(30 min.) showed the better histological intactness and viability of follicle than
group 3, 4. The expression of caspase-3 has no difference in each group.
CONCLUSION: Enough exposure time to freeze will give better condition
after thawing in vitrification of ovary tissue. Therefore, vitrification method
is more reliable way to freeze compared to the previous freezing methods for
ovary tissue.
Supported by: The grant of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare abd Family Affairs.

P-12 Tuesday, October 23, 2012

ANTI-MULLERIAN
HORMONE (AMH): A RELIABLE BIOMARKER OF OOCYTES QUALITY IN STIMULATED IN VITRO
FERTILIZATION (IVF). P. Lehmann, M. Del P. Velez, J. Saumet,
L. Lapensee, F. Bissonnette, J. Kadoch. Obstetric and Gynecology, Clinic
OVO and University of Montreal, Montreal, QC, Canada.
OBJECTIVE: To evaluate the impact of serum AMH levels on stimulated
IVF implantation and pregnancy rates.
DESIGN: Retrospective cohort study.
MATERIALS AND METHODS: 637 patients undergoing stimulated IVF
protocols between January 2009 and December 2011 were included. Only
non-polycystic ovary first IVF attempt patients were considered for the analysis. Cycle outcomes were analysed according to AMH percentiles per patients age category (<35, 35-39 and 40-43 years old) based on the AMH
normogram of our infertile population. Univariate and multivariate analysis
adjusted for patients age, total exogenous FSH dosage and number of eggs
retrieved were performed.
RESULTS: The multivariate analysis demonstrated that women under 35
years old with AMH levels<25th percentile (<1 ng/ml) had a significant lower
implantation rate (0.26 vs. 0.45 P 0.04), compared to the reference population
(R25th percentile - AMH%75th percentile). Similar results were obtained
with the ongoing pregnancy rate per cycle (OR 0.46 95% CI 0.22-0.96). Additionally, in all age categories, patients with AMH levels<25th percentile, had
a lower embryo freezing rate (OR 0.41 95% CI 0.21-0.80, OR 0.45 95% CI
0.23-0.86, OR 0.18 95% CI 0.04-0.82) and a lower number of mature oocytes
per cycle (6(SD 3.5) Vs 8.5(SD 4.2), 4.2 (SD 2.7) Vs 7 (SD 4.1), 3.6 (SD 1.8)
Vs 5.8 (SD 3.9)), respectively (P<0,001). For all ages combined, the multivariate analyses showed that patients with AMH levels<25th perc (<0.47 ng/ml)
were two time less likely to obtain an ongoing pregnancy per cycle started
(OR 0.56 95% CI 0.31-0.99), compared to the reference population.
CONCLUSION: AMH plays a major role in assisted reproductive technology (ART). It allows not only the quantification of the ovarian reserve, but
also the prediction to an eventual ovarian response to the stimulation. Our results suggest that AMH is a reliable biomarker of oocyte quality. Furthermore, it could enable a better patient protocol allocation along with a more
comprehensive embryo transfer policy.

P-13 Tuesday, October 23, 2012

CYCLOPHOSPHAMIDE (CYC) EXPOSURE IN PEDIATRIC PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (pSLE) IS
ASSOCIATED WITH REDUCED SERUM ANTI-MULLERIAN HORMONE (AMH) LEVELS. L. C. Grossman,a J. Isgro,b S. K. Nurudeen,a
M. V. Sauer,a R. Lobo,a N. C. Douglas.a aObstetrics and Gynecology, Columbia University College of Physicians & Surgeons, New York, NY; bPediatric Rheumatology, Columbia University College of Physicians & Surgeons,
New York, NY.
OBJECTIVE: The reproductive risk of young girls and women suffering
from pSLE of varying disease severity and medication exposure is not well
established. This pilot study aimed to compare serum AMH levels between
pSLE patients and healthy controls.
DESIGN: Retrospective cohort study
MATERIALS AND METHODS: pSLE patients (n20, median age 19.0
years) and controls (n20, median age 18.5 years), all>3 months after menarche, were studied. Demographic data, menstrual history, and serum levels of

S116

ASRM Abstracts

AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were obtained. For pSLE patients, SLE Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics (SLICC) damage
index scores, and medications were also recorded. The median disease duration
was 4.8 years. Current medication use by pSLE patients included hydroxychloroquine (90%) and prednisone (70%); 30% had prior exposure to CYC.
RESULTS: There was no significant difference in BMI, age since menarche, reported irregular menses, or median levels of FSH, LH, E2 between
pSLE patients and controls. Although median AMH levels in pSLE patients
and controls were similar (1.7 (IQR 0.1-2.4) and 1.9 (IQR 1.1-2.8) ng/ml),
AMH levels in pSLE patients with a history of CYC exposure (pSLE+CYC)
were significantly lower than in pSLE patients who had never received CYC
(pSLE-CYC) (0.8 (IQR 0.2-1.7) and 1.9 (IQR 1.5-2.5) ng/ml) with P0.03.
SLEDAI scores were similar, however SLICC damage scores were significantly higher in pSLE+CYC with P0.04. There was no correlation between
AMH level and SLEDAI or SLICC damage scores.
CONCLUSION: The disease severity of pSLE does not appear to be correlated with serum AMH levels. However, exposure to CYC is associated
with a significant reduction in AMH levels, which implies a risk of diminished ovarian reserve and impaired future fertility in these patients. Following pSLE patients prospectively is necessary to observe further changes in
AMH levels over time and determine the meaning of this relationship.

P-14 Tuesday, October 23, 2012

WOMEN WITH POLYCYSTIC OVARY SYNDROME EXPERIENCE
MORE RAPID DECLINE IN ANTI-MULLERIAN HORMONE
LEVELS. F. J. Roca,a A. K. Schutt,b E. C. Mazur,a W. E. Gibbons,a
E. Kovanci.a aOb&Gyn, Baylor College of Medicine, Houston, TX; bOb&Gyn, University of Virginia, Charlottesville, VA.
OBJECTIVE: It is not clear how higher antimullerian hormone (AMH)
levels in women with polycystic ovary syndrome (PCOS) change with age
compared to normal cycling women. Our objective was to investigate the
change in AMH levels with age in women with PCOS and to determine
the predictive value of AMH in these women if they undergo IVF.
DESIGN: Retrospective case-control.
MATERIALS AND METHODS: Our study included 366 women with an
AMH level from March 2009 to April 2012. Patient charts were reviewed for
peak estradiol, number of total eggs retrieved, fertilization rate and pregnancy rate. The Rotterdam Criteria were used to confirm the diagnosis of
PCOS. Pregnancy was defined as a positive serum beta HCG. The data
were analyzed using Wilcoxon rank sum test and Fisher exact test. The ANCOVA was used to compare regression lines.
RESULTS: Women with PCOS were younger than women without PCOS
(33.4 vs 35.7 P<0.01). The average AMH level was higher in women with
PCOS (6.1 vs 1.8 ng/mL, P<0.01). The rate of decline in AMH was more rapid
among women with PCOS than in women without PCOS (P<0.05). Of 84
women who underwent IVF, 25 had PCOS and 59 did not. Overall IVF pregnancy rate was not different between women with PCOS vs. without PCOS
(40% in both). Women with PCOS had a higher average peak estradiol, higher
average number of total oocytes retrieved, but similar average fertilization rate.
When the AMH level was%5, women with PCOS had a higher likelihood of
pregnancy compared to women without PCOS (53% vs. 38% P>0.05). Women
with PCOS had a lower likelihood of pregnancy when the AMH levels were>5
(13% and 67%, P>0.05). Women with PCOS and AMH>5 had lower BMI and
higher peak E2 than women with PCOS and AMH%5.
CONCLUSION: Our data suggests that AMH declines more rapidly in
women with PCOS. AMH levels>5 may have a negative impact on IVF success in women with PCOS. A normal or high AMH level in women with
PCOS should be cautiously interpreted as it may decline rapidly, and very
high levels may be detrimental for IVF success.

P-15 Tuesday, October 23, 2012

THE EFFECT OF OOCYTE RESERVE ON PREGNANCY RATES (PRs)
PER OOCYTE HARVEST IN WOMEN AGED%35. J. H. Check,a,b
A. Whetstone,c C. Wilson,a J. K. Choe.a aDept. OB/GYN, Division of Repro.
Endo. & Infertility, UMDNJ, Robert Wood Johnson Med. School at Camden,
Camden, NJ; bDept. OB/GYN, Division of Repro. Endo. & Infertility, Cooper
Medical School of Rowan University, Camden, NJ; cDept. OB/GYN, UMDNJSchool of Osteopathic Medicine, Stratford, NJ.

Vol. 98, No. 3, Supplement, September 2012