RESULTS: See Table.

Tuesday, October 16, 2007

CONCLUSIONS: Cb2 administration in different doses to experimentally 11:15 am
induced endometriosis mice is associated with a significant descrease in new
vessel formation and neoangiogenesis expression markers, providing the O-106
rationale to test dopamine agonists as a novel therapeutic approach in human
peritoneal endometriosis. ACUPUNCTURE LOWERS PREGNANCY RATES WHEN PER-
FORMED BEFORE AND AFTER EMBRYO TRANSFER.
TABLE L. B. Craig, A. R. Criniti, K. R. Hansen, L. A. Marshall, M. R. Soules.
Reproductive Endocrinology & Infertility, University of Oklahoma Health
Vehicle* Cb2 0.05* Cb2 0.1* P value Sciences Center, Oklahoma City, OK; Seattle Reproductive Medicine, Seat-
tle, WA; Pacific Northwest Fertility & IVF Specialists, Seattle, WA.
Immature vessels 75.5  1.7% 13.5  1.0% 10.7  3.2% <0.001
Mature vessels 24.5  1.7% 86.5  1.0% 89.3  3.2% <0.001 OBJECTIVE: Acupuncture performed onsite before and after embryo
MVD 9.1  3.2 5.1  0.9 4.7  1.4 ¼0.328 transfer has been reported to improve in vitro fertilization (IVF) outcome
VEGF 1.2  0.5 0.5  0.4 0.4  0.1 <0.05 in patients with good quality embryos. The purpose of this investigation
VEGFR2 1.0  0.3 0.4  0.2 0.3  0.2 <0.05 was to evaluate whether acupuncture before and after embryo transfer would
Notch4 1.0  0.1 0.5  0.1 0.4  0.1 <0.001 alter pregnancy rates in patients undergoing IVF regardless of embryo quality
Ang1 1.1  0.5 3.2  1.1 3.7  1.2 <0.001 if the treatment was performed offsite.
DESIGN: Multi-center, prospective, randomized study.
MATERIALS AND METHODS: 107 patients undergoing IVF were
* Data expressed as Mean  SD. randomized to acupuncture vs. control group. The treatment group received
Supported by: None. acupuncture by one of two licensed acupuncturists at an offsite location for
25 minutes before and after embryo transfer using a modified Paulus protocol
(protocol described by Paulus et. al. 2002 with the addition of Cv6 before and
K3 after transfer). The control group underwent embryo transfer without any
Tuesday, October 16, 2007 other intervention. The IVF protocol was determined by the treating physi-
11:00 am cian who was blinded to assigned group. The main outcome measures
were a positive quantitative hCG, clinical pregnancy as manifested by fetal
O-105 cardiac activity, and live birth (data pending). Chi-squared analysis and
Student’s t-test were used for statistical analyses. Of the 107 patients
THIAZOLIDINEDIONES DECREASE VASCULAR ENDOTHELIAL randomized, 94 completed the study (10 IVF cycles canceled, 3 patients
GROWTH FACTOR (VEGF) PRODUCTION BY HUMAN LUTEI- withdrew).
NIZED GRANULOSA CELLS IN VITRO. D. K. Shah, K. M. J. Menon, RESULTS: The proportion of patients with a positive pregnancy test was
S. K. Kavoussi, D. I. Lebovic. Department of Obstetrics & Gynecology, Uni- higher in the control group (36/46) than the acupuncture group (25/48)
versity of Michigan, Ann Arbor, MI; Department of Biological Chemistry, (78.3% vs. 52.1%, respectively; P%0.01). More importantly, the clinical
University of Michigan, Ann Arbor, MI; Division of Reproductive Endocri- pregnancy rate was higher in the control group than in the acupuncture group
nology and Infertility, Department of Obstetrics & Gynecology, University of (69.6% vs. 43.8%, respectively; P%0.03). The groups were statistically sim-
Michigan, Ann Arbor, MI. ilar with respect to age, peak estradiol, number of oocytes retrieved, fertiliza-
tion method, fertilization rate, number of embryos transferred, and the
OBJECTIVE: Overproduction of VEGF by granulosa cells of the corpus proportion with blastocyst transfer (P¼NS).
luteum is implicated in the development of ovarian hyperstimulation syn- CONCLUSIONS: In contrast to previous reports, acupuncture before and
drome (OHSS). Thiazolidinedione derivatives are synthetic ligands of per- after embryo transfer was associated with lower biochemical and clinical
oxisome proliferator activated receptor-gamma (PPAR-g) that have been pregnancy rates when compared to the control group. The value of acupunc-
shown to decrease VEGF production in a variety of human cell types. We ture in pateints undergoing IVF needs to be further examined before recom-
sought to assess the in vitro effect of a commercially available thiazolidine- mending it to patients.
dione agonist, ciglitazone (CIG), on VEGF production by human luteinized Supported by: Internal departmental funding from the University of Wash-
granulosa cells. ington College of Medicine.
DESIGN: Prospective, experimental in vitro study.
MATERIALS AND METHODS: Ovarian follicular aspirates were ob-
tained from ten women undergoing oocyte retrieval as part of an in vitro fer-
tilization program. Granulosa cells were isolated and plated in duplicate in
24-well plates at a density of 50,000 viable cells per mL. On day 2 of culture, Tuesday, October 16, 2007
the cells were treated with a DMSO control, 10 mM, 20 mM, and 40 mM CIG,
both in the presence and absence of a 2.7 mM hCG stimulus. Media was har-
11:30 am
vested 24 and 48 hours post-treatment. VEGF concentrations were measured
O-107
using specific ELISA kits. Comparisons of VEGF concentrations between
treatment groups were made using a one-way ANOVA with post hoc Bonfer- DECREASED IMPLANTATION RATE AFTER CERVICOVAGINAL
roni test. EXPOSURE TO LIPOPOLYSACCHARIDE, A POTENTIAL PATH-
RESULTS: All three doses of CIG decreased VEGF production in a statis- WAY OF DECREASED UTERINE RECEPTIVITY BY TOLL-LIKE
tically significant fashion 48 hours after treatment in those cells not exposed RECEPTOR ACTIVATION. R. A. Meter, M. Horton. Reproductive Endo-
to hCG (P<0.01), but only the 40 mM concentration achieved statistical sig- crinology, Johns Hopkins Medical University, Baltimore, MD; Pulmonology,
nificance at the 24 hour time interval (896 pg/mL vs. 335 pg/mL, P<0.01). Johns Hopkins Medical University, Baltimore, MD.
Following an hCG stimulus, treatment with 10 mM, 20 mM or 40 mM CIG
decreased VEGF production in a statistically significant manner at both the OBJECTIVE: To determine whether cervicovaginal exposure to lipopoly-
24 and 48 hour time intervals. The effect appeared dose related, with sacharride influences implantation efficiency in the mouse and, if so, to
a 45% diminution in VEGF production when cells were treated with determine whether a potential mechanism includes activation of the innate
10 mM CIG (1987 pg/ml vs. 1091 pg/ml, P<0.001) as compared to a 70% immune system via ligation of a Toll-Like receptor, TLR-4.
decrease noted 48 hours after treatment with 40 mM CIG (1987 pg/ml vs. DESIGN: Comparison of number and size of embryos in both wild type
598 pg/ml, P<0.001). (WT) and TLR-4 knockout mice (TLR4 KO) after cervico-vaginal exposure
CONCLUSIONS: CIG significantly decreased VEGF production by hu- to lipopolysacharride (LPS), a specific ligand of TLR-4.
man granulosa cells in an in vitro model. The effect appeared dose related, MATERIALS AND METHODS: Female wild-type (WT), n ¼ 8, and
with the greatest inhibitory response observed when using a 40 mM dose. TLR-4 knockout mice (TLR4 KO) n ¼ 4, were treated daily with ultra-
Given VEGF’s pivotal role in the pathogenesis of OHSS, these findings pure lipopolysacharride (LPS), 1 mg per day in PBS carrier, or an equal volume
prompt further investigation of thiazolidinedione drugs such as FDA- of PBS carrier for controls. Exposure to LPS was via atraumatic placement in
approved pioglitazone as a novel prophylaxis or therapy for this condition. the vagina. All animals were housed in a pathogen-free environment and
Supported by: Milton Goldrath Resident Research Support Award (DKS), treated for 3 to 4 days prior to pairing with males of the same respective back-
NIH HD06656 (KMJM) and NIH 5K23HD043952–02 (DIL). ground (WT or TLR4 KO). Treatment continued until six days post vaginal

S40 Abstracts Vol. 88, Suppl 1, September 2007