yield for age was defined as %6 oocytes retrieved for women %35 years pected from a healthy female

ealthy female population. High BMI, Asian and/or black eth-

(n¼184) and %3 oocytes for women 36-39 years (n¼107). Patient demo-
graphics as well as IVF cycle outcomes, including clinical pregnancy rate,
live birth rate, and miscarriage rate were compared within each age group.
Statistical analysis was performed with Student’s t-test and and Chi-squared
test.
RESULT(S): See Table 1 for results. Among women %35 years of age
with low age-adjusted oocyte yield, there was a statistically significant de-
crease in clinical pregnancy and live birth rate and a trend towards higher
miscarriage rate which did not reach significance. Additional analyses with
logistic regression including age and oocyte yield as continuous variables
will be presented. There was a statistically significant decrease in clinical
pregnancy and live birth rate in women 36-39 years with low oocyte yield,
but no difference in miscarriage within this older group.
CONCLUSION(S): Poor response to gonadotropins is associated with
a lower live birth rate in both young and older women.
SUPPORT: NICHD PO1 HD065647-01A1.
nicity are identified as risk factors for VD deficiency, with Asian women
being at the highest risk. Lastly, VD levels did not appear to be associated
with baseline ovarian reserve.
SUPPORT: None.
P-49
The Predictive Value of Antral Follicle Count (AFC) At Down Regulation
Prior to IVF Stimulation is Better Than A Diagnostic AFC. R.P. Gada,
P. Leonard, A. Grzenda, A. Asante, Z.M. Tabbaa, C.C. Coddington,
G.S. Daftary. Dept. of Ob/Gyn, Mayo Clinic. Rochester, MN.
BACKGROUND: Antral follicles represent the cohort of oocytes sur-
rounded by granulosa cells that may potentially develop into a lead follicle
during an ovulatory cycle. During an IVF cycle, this cohort of follicles is

TABLE 1. Patient Demographics and IVF Cycle Outcomes

Age%35 years Age 36-39 years

Oocyte Yield % 6 Oocyte Yield >6 Oocyte Yield %3 Oocyte Yield >3

Demographics/Cycle Outcomes (n¼184) (n¼921) P value (n¼107) (n¼931) P value

Mean Age 33.1 32.1 <0.001 37.7 37.6 0.14

Prior Live Birth 19.0% 15.6% 0.25 20.6% 25.6% 0.25
Prior ART cycles 8.2% 11.8% 0.15 12.2% 11.9% 0.91
Serum FSH>12 28.0% 4.5% <0.001 33.3% 10.8% <0.001
Mean Gonadotropin Dose (IU) 5204.3 3442.9 <0.001 5910.1 4740.3 <0.001
Mean Number of Oocytes Retrieved 4.2 15.1 <0.001 2.2 11.7 <0.001
Mean Number of Embryos Transferred 2.0 2.2 0.01 1.4 2.7 <0.001
Clinical Pregnancy Rate 25.0% 43.7% <0.001 15.0% 29.4% <0.001
Miscarriage Rate 23.9% 14.4% 0.09 31.0% 24.8% 0.56
Live Birth Rate 19.0% 36.7% <0.001 9.4% 21.8% 0.002

P-48
Prevalence and Risk Factors of Vitamin D Deficiency in Women With
Infertility. L. Li,a E. Schriock,a K. Dougall,a C. Givens.a a Pacific Fertility
Center, San Francisco, CA.
BACKGROUND: Low vitamin D (VD) levels have been linked to preg-
nancy complications, congenital rickets and fractures in the newborn, as
well as poor outcomes in assisted reproduction. Traditionally, serum levels
<20 ng/ml have been considered deficient, though experts argue that even
levels <32 ng/ml are inadequate. Insufficient VD levels are found in 40-
50% of healthy pregnant women, despite supplementation with prenatal vi-
tamins. Identifiable risk factors are black race, diminished sun exposure, and
residing in the northern United States. Currently, there is little data on the
prevalence of VD deficiency in women with infertility.
OBJECTIVE(S): We aimed to evaluate the prevalence of VD deficiency in
patients presenting for infertility treatment at a large private ART practice in
Northern California, and to identify risk factors that predispose low VD
levels. We also aimed to assess if any associations existed between serum
VD and ovarian reserve.
MATERIALS AND METHOD(S): We retrospectively reviewed the re-
sults of serum 25-hydroxy (25-OH) VD, a component of routine workup,
for 1192 women presenting for fertility evaluation since January 1, 2009.
Baseline patient characteristics including age, ethnicity (self reported), and
BMI were recorded. Initial ovarian reserve was assessed by cycle day 3
FSH for all patients and by AMH for a subset of patients (n¼303). Statistical
analysis was performed using IBM SPSS Statistics 20.0.0.
RESULT(S): The median (interquartile range) VD levels for 1192 patients
were 27.00 (20.92 – 33.68) ng/ml with 68.6% (n¼818) being VD insufficient
(<32 ng/ml) and 22.2% VD deficient (<20 ng/ml). BMI [22.46 (20.37 –
25.50) kg/m2] negatively correlated with VD (Spearman r ¼ –0.201,
p<0.001). Asian women were most likely to be VD deficient (131/306,
42.8%) with a relative risk (RR) of 4.03 (95% CI 3.08 – 5.28) followed by
black women (13/47, 27.7%) with a RR of 2.61 (1.55 – 4.38) compared to
Caucasians (62/584, 10.6%). VD levels did not correlate with D3 FSH or
AMH when adjusted for age.
CONCLUSION(S): The majority of women presenting with infertility had
insufficient serum VD levels. The prevalence is higher than would be ex-
stimulated using gonadotropins. AFC is used as a clinical marker for ovarian
reserve and predictor of IVF cycle response.
OBJECTIVE(S): The present study aimed to determine if AFC at IVF down
regulation is more predictive of stimulation outcomes than a diagnostic AFC.
MATERIALS AND METHOD(S): Eighty-three patients undergoing IVF
from 2010 to 2011 were prospectively studied. All had a diagnostic AFC,
FSH and estradiol as part of their evaluation. The patients’ IVF protocol
was selected from their diagnostic evaluation. At IVF, all patients underwent
an ultrasound at down regulation and an AFC (pre-IVF AFC) was determined
prior to stimulation. Analysis of correlation coefficients (R) was calculated
using Spearman’s rho.
RESULT(S): Average patient-age was 33.2  5.2 years. Mean diagnostic
AFC and pre-IVF AFC were 24.9  14 and 23.2  15 respectively. Mean fol-
licles aspirated and oocytes retrieved were 25  15 and 16.4  9.6 respec-
tively. Pre-IVF AFC was more predictive that diagnostic IVF for both
follicles aspirated (R¼0.74 vs 0.68, p< .05) and oocytes retrieved (R¼0.58
vs 0.51, p<0.05). In cases where there was greater than 15% discordance be-
tween AFC values, pre-IVF AFC had a stronger correlation of stimulation
outcomes compared to diagnostic AFC (Table).
Correlation Coefficient when Discordance >15%
Diagnostic AFC Pre-IVF AFC
Follicles Aspirated 0.561 0.621
Oocytes Retrieved 0.341 0.481
1
p<0.05, N¼45.
CONCLUSION(S): Pre-IVF AFC is a better predictor of IVF stimulation,
than a routine diagnostic AFC. This is likely because the pre-IVF AFC rep-
resents the follicles that will be stimulated during the index cycle. If a patient
has discordant AFC values particular attention should be paid to the pre-IVF
AFC, as this value will more likely to correlate with IVF outcomes and clin-
ical decisions may need to be modified accordingly.
SUPPORT: None.

S26 Abstracts Vol. 97, No. 3, Supplement, March 2012