J.K. Choe

P-13: The Effect of Endometriosis on Pregnancy Outcome Following In Vitro Fertilization-Embryo Transfer (IVF-ET) in Women With Decreased EGG Reserve

PURPOSE To determine the effect of the presence of endometriosis on the delivered pregnancy rate following in vitro fertilization-embryo transfer. METHODS A retrospective cohort analysis of fresh or frozen embryo transfer in women with diminished egg reserve having IVF-ET and who also had had a laparoscopy. The data was analyzed as to whether endometriosis was present or not. RESULTS The data demonstrated that women with diminished egg reserve can achieve pregnancies following IVF-ET. The presence of endometriosis did not have any negative effects on pregnancy rates. CONCLUSIONS At least in women with diminished egg reserve the presence of endometriosis did not impair outcome following IVF-ET.

P-9: Pregnancy Outcome Following In Vitro Fertilization-Embryo Transfer (IVF-ET) in Women of More Advanced Reproductive Age With Elevated Serum Follicle Stimulating Hormone (FSH) Levels

PURPOSE To present data on the chances of pregnancy following in vitro fertilization embryo transfer, according to day 3 serum FSH and age groups in women > or = age 36. MATERIALS AND METHODS Data were analyzed according to three age groups (36-39, 40-42, > or = 43) and five serum FSH ranges (< or = 10, 11-12, 13-14, 15-16, > or = 17). RESULTS No live pregnancies were found in women aged > or = 40 with serum FSH > or = 15 mlU/ml but they were seen in women aged 36-39. Live deliveries were seen in women even > or = 43 with serum FSH 13-14 mlU/ml. CONCLUSIONS The higher the serum FSH and the greater the age, the lower the chances of successful conception. However, reasonable pregnancy rates are found in women aged > or = 36 with serum FSH > or = 15 mlU/ml and a live delivered pregnancy rate of about 10% can occur even in women aged > or = 43 with mild FSH elevations.

AbstractPoster presentationP-14: Relationship of Serum Progesterone (P) Level the Day After Human Chorionic Gonadotropin (hCG) Injection on Outcome Following In Vitro Fertilization-Embryo Transfer (IVF-ET)

PURPOSE To determine if either too little or too much of a rise in serum progesterone (P) on the day after human chorionic gonadotropin (hCG) injection has any negative impact on pregnancy outcome following in vitro fertilization-embryo transfer (IVF-ET). METHODS Retrospective review. Three progesterone groups established--low, normal and high. RESULTS There was a significantly higher clinical pregnancy rate in the normal P group vs low or high. There were no significant differences in ongoing delivered pregnancy rates but a trend for higher implantation rates in the normal P group. CONCLUSIONS These data are consistent with the hypothesis that either too little or too much P can adversely effect implantation. However, the differences are not of sufficient magnitude to warrant a clinical intervention, e.g., deferring fresh transfer and freezing the embryos for future transfer.

Prognosis following in vitro fertilization-embryo transfer (ivf-et) in patients with elevated day 2 or 3 serum-follicle stimulating hormone (fsh) is better in younger vs. older patients

PURPOSE To determine if younger women with increased day 2 or 3 serum follicle stimulating hormone (FSH) levels have a better prognosis than older women with similar FSH elevations. METHODS Retrospective comparison of in vitro fertilization (IVF) outcome from cycles from 1/1/97 to 9/30/99 according to serum FSH < or = 12 vs > 12 and age < or = 38 or > 38. Only cycles where follicular phase leuprolide acetate was used were included. RESULTS Age group < or = 38 - clinical pregnancy rate (PR)/transfer was 32% with lower FSH vs 28.6% with higher FSH. The respective PRs for the older group were 30.3% and 5.5%. CONCLUSIONS Oocyte quality as evidenced by PRs following IVF-ET seems to be better in younger vs older patients despite increased basal serum FSH levels.