Does Prior Success Predict Future Performance in FET Cycles?
Post on 31-Dec-2016
estradiol (E2) and sex hormone-binding globulin (SHBG). Free E2 was cal-culated using SHBG and the E2/ E1S ratio calculated. A students T test,Mann-Whitney test, and Wilcoxon rank sum test were used to determinestatistical differences.
RESULT(S): 22 women with BC were included in this analysis. 12/22 re-ceived Tamoxifen daily throughout stimulation (Ant + Tam) and 10/22 un-derwent standard antagonist protocols (Ant only). The mean age (35.93.9vs. 393.0) and BMI (22.72.5 vs. 24.62.1) in the Ant + Tam and Antonly groups were not significantly different. Baseline E2, E1S, and E2/ E1Swere similar in both groups. There was a progressive increase in all estrogensfrom baseline to the peri-ovulatory phase in all patients. The total peri-ovu-latory E2 was significantly higher in the Ant + Tam group compared with theAnt only group (3218 vs. 1910 pg/mL, p0.47), likely due to the greaternumber of follicles (21.56.6 vs. 13.77.8) and oocytes retrieved(17.67.3 vs. 11.88.9). However, there was no significant difference infree E2 levels (53.1 vs. 29.9 pg/mL, p>.05), and E1S levels (60.1 vs. 42.9ng/mL, p .03) were significantly higher in the Ant + Tam groupcompared with the Ant only group. There was a trend toward lower E2/E1S ratio (0.06 vs. 0.09, p0.078) in the Ant + Tam group.
CONCLUSION(S): This is the first study to our knowledge to describe Emetabolism at supraphysiologic levels in BC patients receiving Tamoxifen asan adjunct to COH. Greater conversion of active E2 to inactive E1S in the Ta-moxifen group may confer a protective effect in E metabolism. These find-ings support the theory that concurrent use of Tamoxifen reduces the riskof COH in BC patients, not only by direct receptor blockade, but also by po-tentially altering E metabolism.
Does Prior Success Predict Future Performance in FET Cycles? LouisN. Weckstein, M.D., Ariana Weckstein, Bethany Layport, Kristen Ivani,Ph.D., Nancy Huen, M.S., E.L.D., Mary D. Hinckley, M.D. ReproductiveScience Center of the San Francisco Bay Area, San Ramon, CA.
BACKGROUND: With the advent of improved cryopreservation successcoupledwith increasing utilization of elective single embryo transfers, frozenembryo transfers (FET) are increasingly being performed. Understanding thelikelihood of success based upon prior outcomewill help physicians in coun-seling patients on the ideal number of embryos to transfer.
OBJECTIVE(S): We hypothesized that patients with successful IVF cy-cles would have higher pregnancy rates in subsequent FET cycles comparedwith patients not achieving pregnancy in their fresh IVF cycle.
METHOD(S): Retrospective review of 352 FET cycles (first FET cycleonly following fresh IVF cycle) when only one or two embryos were trans-ferred, from January 2011 June 2012. Chi-Squared analysis was performedusing OpenEpi.1
ClinicalFERTILITY# FETs& STPreg from FETERILITYeSET FETs All ETs 1 Emb ETs 2 EmbPos Fresh IVF 143Own Eggs 119 53/119 (44.5%) 12/29 (41.3%) 26/66 (39.4%) 34/53 (64.2%)Donor Eggs 24 10/24 (41.6%) 5/10 (50%) 5/11 (45.5%) 5/13 (38.5%)Neg Fresh IVF 209Own Eggs 176 96/176 (54.5%) 7/24 (29.2%) 12/47 (25.5%) 84/149 (56.4%)Donor Eggs 33 12/33 (36.4%) 4/9 (44.4%) 6/13 (46.2%) 6/20 (30%)Patients using their own eggs who had a negative fresh IVF cycle hada higher clinical pregnancy rate in their subsequent FET cycle (96/176,54.5%) compared with patients with a successful fresh IVF cycle (53/119,44.5%, p