G. Pineda, N. T. Serafy. Women’s Research Institute, Wichita, KS; Amer-ican Assoc of Bioanalysts Proficiency Testing Service, Brownsville, TX.

Objective: Determine the level of standardization in the performance ofthe semen analysis among clinical laboratories in the United States.

Design: Anonymous mailed survey.Materials/Methods: A survey was mailed to clinical laboratories enrolled

in the American Association of Bioanalysts Andrology Proficiency TestingProgram requesting information about the laboratory and the performanceof the semen analysis. Responses were received from 536 laboratories.

Results: Sixty-one percent of respondents indicated that the laboratorywas a part of an assisted reproductive technology program. On average,each laboratory employed 3.4 individuals (range 1–25) to perform semenanalyses. The vast majority (94%) of the respondents indicated that theirlaboratories were accredited. The laboratories performed less than 50(53%), less than 10 (25%) or less than 5 (16%) andrology laboratoryprocedures per month. The laboratories routinely report sperm count (94%of laboratories), motility (95%), morphology (85%) and forward progres-sion (69%), and semen volume (96%) as part of the semen analysis. Only64% of laboratories routinely report abstinence, and 60% of laboratoriesindicate the criteria used for sperm morphology on the report form. Themost common lower limits of normality for sperm count and motility were.20 million sperm/ml (77% of laboratories) and.50% (59%), respec-tively, although a wide range of “normal values” were reported. Fewlaboratories performed quality control for sperm counts (29%), motility(28%) and sperm morphology (23%). Approximately one-third (34%) of thelaboratories indicated that they were either not familiar with the WHOLaboratory Manual, or did not possess a copy of this manual.

Conclusions: These data indicate a significant lack of standardization inthe performance and the reporting of semen analyses among laboratories inthe United States.

Supported by: Women’s Research Institute and the American Associationof Bioanalysts.

P-316

Intracytoplasmic sperm injection (ICSI) for everyone: comparison be-tween male factor vs. non-male factor cycles.V. M. Sopelak, S. B.McCulloch, R. S. Hines, B. D. Cowan. Univ of Mississippi Medical Ctr,Jackson, MS.

Objective: ICSI is now the gold standard for patients with male factor(MF) infertility. High levels of fertilization “guarantee” embryos for trans-fer and eliminate the need for second day rescue ICSI when routineinsemination leads to fertilization failure. However, the cost versus benefitsin patients with semen counts/ml of.20 3 106 sperm/ml is debatable. Thepresent retrospective study was done to compare and correlate pregnancyoutcome and cycle parameters, such as maternal age, oocytes recovered andfertilized and embryos transferred, between MF and non-male factor (non-MF) patients based on sperm count/ml.

Design: Retrospective analysis was done on cycles (n5 227) performedbetween 1997-2000 where all mature oocytes underwent ICSI (irrespectiveof diagnosis) and patients had at least 1 embryo transferred. Followinganalysis of the entire cohort, data were compared between cycles with#203 106 sperm/ml (MF; n5 67) versus cycles with.203 106 sperm/ml(non-MF; n5 160).

Materials/Methods: Maternal age, number of oocytes recovered and ma-ture oocytes injected, the number fertilized and embryos transferred andpregnancy outcome were analyzed in these cycles with all ICSI injections.Correlations were performed on the various mentioned parameters beforedata were regrouped and analyzed by MF versus non-MF.

Results: Analysis of the entire 227 cycles showed a significant correlationbetween maternal age vs number of oocytes recovered (r5 20.269, P,0.001), between the number of oocytes recovered and the number fertilized(r 5 0.762, P, 0.001) and number of embryos transferred with pregnancy(P , 0.001). The overall fertilization rate was 76.2%. When data weregrouped by MF vs non-MF (see table below), the number of oocytesfertilized, embryos transferred, and pregnancy rates were similar (NS).

Mean6 SEM in ICSI cycles with/without male factor.

MF Non-MF Significance

Number of cycles 67 160Age (years) 31.46 0.6 33.26 0.4 P, 0.01Oocytes recovered 11.66 0.9 8.66 0.4 P, 0.001Oocytes injected 9.16 0.7 6.66 0.3 P, 0.001Number fertilized 5.66 0.5 4.86 0.2 NSEmbryos transferred 2.86 0.1 2.86 0.1 NSPregnancy rate/cycle 31.36 5.7% 26.96 3.5% NS

Conclusions: In couples with MF infertility, the maternal age of thepatients is generally younger yielding more oocytes to inject compared tonon-MF patients. Since the number of embryos transferred is restricted to#3 in patients#35 years of age, pregnancy rates in both groups are similar.ICSI in non-MF cycles does not increase the pregnancy rate above thatfound in MF cycles.

Supported by: Department of Ob-Gyn.

P-317

Evaluation of silica-based sperm separation method on sperm motility,recovery, and morphology. S. Wang, J. Witmyer, R. Powers. BostonIVF, Waltham, MA.

Objective: To evaluate and optimize the efficiency of sperm separation byusing a silica-based medium (PureCeption, Sage-Biopharma).

Design: Prospective study.Materials/Methods: In previous studies, large variations of sperm param-

eters (total count, sperm motility, etc) between individuals, even fromnormozoospermic men, has often lead to large standard deviations (SD) ofthe parameters measured. The large SD due to individual variability inev-itably makes the accurate measurement of outcomes extremely difficult andthus confounds the evaluation of sperm separation methods. To reduce thiseffect, semen samples of 20 patients were pooled together and divided intoequal volume. The advantages of pooling samples are two-fold: To increasethe sample volume so more replicates can be performed to reach statisticalsignificance, and more importantly, the individual variability among sam-ples can be minimized. Each aliquot from the pooled sample was loadedinto gradients for comparison. Sperm motility, total recovery rate, motilesperm recovery rate, and percentage of normal sperm morphology weremeasured between (1) two-layer (90%-47%) and three-layer (85.5%-63%-45%) PureCeption gradients; (2) large (1.5 ml), medium (0.75 ml), andsmall (0.3 ml) sizes of three-layer gradients.

Results: There was no statistical difference between two-layer and three-layer gradients with respect to motility, total recovery rate, and motile spermrecovery rate. However, three-layer gradients resulted in recovery of asignificantly higher percentage of normal sperm morphology compared totwo-layer gradients (p, 0.05). The percentage of normal sperm morphol-ogy increased from 2.9% (two-layer gradients) to 5.4% (three-layer gradi-ents) according Tygerberg strict criteria. For different gradient sizes, similarresults were found between large, medium, and small gradients in terms ofmotility and percentage of normal sperm morphology. However, signifi-cantly higher sperm recovery rate was observed in the small gradients(14.4%) compared to medium (10.2%) and large (4.9%) columns (p,0.05).

Conclusions: Sperm samples prepared with three-layer gradients have ahigher percentage of normal sperm morphology than samples processedfrom two-layer gradients. For three-layer gradients, the small size gradientis a better choice since significantly higher sperm recovery rate was ob-tained, while other parameters like sperm motility and percentage of normalmorphology were not compromised.

REPRODUCTIVE SURGERY

P-318

Treatment of a unilateral hydrosalpinx by salpingectomy or proximaltubal occlusion may increase the potential for spontaneous pregnancy.A. W. Sagoskin, G. L. Mottla, S. J. Greenhouse, P. E. Browne, R. J.

S216 Abstracts Vol. 76, No. 3, Suppl. 1, September 2001