RESULTS: Opiorphin treatment resulted in a 1.2 fold change in motility inmen with asthenozoospermia (p¼0.01) bringing 40% of cases into thenormal motility range. Conversely, opiorphin did not affect sperm motilityin the control group.

CONCLUSION: Overall, these exciting preliminary data suggest that theendogenous NEP inhibitor, opiorphin, may offer potential benefit for thetreatment of idiopathic male infertility characterized by asthenozoospermia.

Supported by: This work was partly Supported by NIH/NIDDK (Grant#DK087872) awarded to KPD.

P-634 Wednesday, October 22, 2014

1H NMR BASED METABOLOMIC PROFILING IN SEMINALPLASMA OF ASTHENOZOOSPERMIC MEN: A PILOTSTUDY. S. Singh,a E. Subramani,b R. Chattopadhyay,a S. Yasmin,a

K. Chowdhury,b B. Chakravarty.a aReproductive Medicine, Institute ofReproductive Medicine, Kolkata, West Bengal, India; bSchool of MedicalScience and Technology, Indian Institute of Technology, Kharagpur, WestBengal, India.

OBJECTIVE: Sperm motility is usually evaluated in research and infer-tility clinics for assessing the male fertility. However, there is a need to iden-tify metabolite markers for the improved diagnosis and treatment of maleinfertility.[1] The present pilot study, therefore, aims to identify differentiallyexpressed metabolites in seminal plasma of asthenozoospermic men usingproton NMR based metabolomics.

DESIGN: Asthenozoospermic semen samples (n¼19) were randomlycollected from subjects (28–40 years) reporting at the Institute of Reproduc-tive Medicine, Salt Lake City, Kolkata for male factor infertility treatment.Proven fertile men (n¼19) whose partners had delivered healthy babies dur-ing the last six months without assisted reproductive technologywere consid-ered as controls.

MATERIALS AND METHODS: Proton NMR spectra of seminal plasmawere recorded using 700MHz Bruker AvanceAV III spectrometer. Followingphased and baseline correction of all NMR[2] spectra using Mest ReNova,spectral binning of the data was performed. The acquired data were analyzedusing multivariate principal component analysis, partial least-squares-discriminant analysis, and orthogonal projection to latent structure withdiscriminant analysis and metabolites were identified.

RESULTS: A significant alteration in metabolites including lactate,alanine, choline, glycerophosphocholine, tyrosine, histidine, phenylalanineand isoleucine was observed in seminal plasma of asthenozoospermic menas compared with controls.

CONCLUSION: Themetabolic changes in seminal plasma of asthenozoo-spermic men produced a distinct pattern which helps in differentiating asthe-nozoospermia from controls. The altered endogenous metabolites in theseminal plasma of patients showed glycolysis intermediates, amino acids,andmolecules related to lipid catabolism. These findings suggest that theme-tabolomic profiling may contribute for the diagnosis and treatment of infer-tility. However, this study warrants further investigation with large samplesize.

P-635 Wednesday, October 22, 2014

SEMEN VARIATION IN A POPULATION OF FERTILE CANDI-DATES FOR SPERM BANK. C. Borghi, A. Nabel, F. Aguirre,S. Papier, M. A. Barros, C. Alvarez Sedo. CEGYR - Genetics and Reproduc-tive Medicine, Capital Federal, Buenos Aires, Argentina.

OBJECTIVE: The seminal parameters related to male fertility have beenstudied for many years by the World Health Organization (WHO), in theirlast manual (2010) many of the values suffered some important changes inrelation to the 1999 version. The aim of this study was to compare the sem-inal parameters of fertile candidates for sperm bankingwith the currentWHOvalues.

DESIGN: Prospective blind study.MATERIALSANDMETHODS: Since one year, our institution is recruit-

ing men for creating a sperm bank. After passing the medical and psy-chological evaluation, a total of 80 candidates were considered for theevaluation of a semen sample. The evaluation was conducted using theguidelines of the WHO (2010) and blinded to the personal history of eachcandidate. Mainly, we proceeded to measure: volume, concentration / mL,progressive motility, vitality and sperm morphology. DNA fragmentation(TUNEL), is not considered as an essential parameter by the WHO, but itwas also evaluated. Subsequently, we proceeded to check out the medical

FERTILITY & STERILITY�

history each candidate, stating that 28 were fertile, but only 20 were fertilein a period not exceeding two years, so it was decided to take this group ofmen for the analysis.RESULTS: Considering the average value of each seminal parameter,

all of them were over the threshold established by WHO (table 1). How-ever, some candidates showed values under the cut-off for specificparameters. In that sense, 25% of fertile men had abnormal volumevalues, 35% for concentration, 20% for progressive motility and 10%for vitality. Sperm morphology was the only parameter that didn’t hadan abnormal value. There were not candidates who had two or morealtered parameters.The average of DNA fragmention levels was 8.4�3.9.

Candidates WHO (2010)

Volume

2.2�1.6 1.5 Concentration 49.1�27.2 39 Progressive motility 36.5�11.0 32 Vitality 71.1�12.1 58 Morphology 8.5�3.4 4 DNA fragmentation 8.4�3.9

CONCLUSION: In our experience, the seminal parameters of fertile menhad normal average values according to WHO, but some individual casesmay be below the cutoff values. The sperm concentration, is the seminalparameter that suffered more variation between the candidates, andmorphology seems to be the most stable parameter.Supported by: CEGYR Foundation.

P-636 Wednesday, October 22, 2014

OUTCOMEOF INTRACYTOPLASMIC SPERM INJECTIONUSINGFRESH AND CRYOPRESERVED-THAWED TESTICULAR SPER-MATOZOA IN 83 AZOOSPERMIC MEN WITH KLINEFELTERSYNDROME. K. Vicdan,a C. Akarsu,a E. S€ozen,a B. Buluc,a

A. Vicdan,b K. Biberoglu.c aPrivate Ankara IVF Center, Ankara, Turkey;bDepartment of Genetics, Ankara University Medical School, Ankara,Turkey; cDepartment of Obcstetric and Gynecology, Gazi University Medi-cal School, Ankara, Turkey.

OBJECTIVE: To report the outcome of intracytoplasmic sperm injection(ICSI) using fresh or cryopreserved-thawed testicular spermatozoa in pa-tients with Klinefelter syndrome.DESIGN: Retrospective clinical study.MATERIALS ANDMETHODS: Medical records of 83 azoospermic men

with Klinefelter syndrome who underwent 88 TESE procedures between2003-2013 were reviewed. The clinical parameters for predicting sperm re-covery, the sperm retreival, pregnancy and live birth rates of ICSI cycleswere evaluated.RESULTS: Seventy seven out of 83 azoospermic men had classic and

the remaining 6 had mosaic Klinefelter syndrome. A total of 88 TESEprocedures were performed of which conventional method consisting ofmultiple tissue biopsies and microsurgery were applied in 48 and 40 ofthe cases, respectively. Spermatozoa were found in 35 men with aretrieval rate of 39.7 %. The age, volume of testes, serum FSH and testos-terone levels, presence of mosaicism, the method of sperm retreival andsmoking were not found to be predictive in obtaining testicular spermato-zoa. A total of 41 embryo transfer cycles were carried out using freshtesticular spermatozoa in 30, cryopreserved-thawed spermatozoa in 10and frozen thawed embryo replacement in one. Twenty two clinical preg-nancies were established, including 14 singleton, 5 twin, 2 triplet and 1quadriplet gestation (53.6 %). Fifteen women delivered singleton and 7women twin fetuses. In total, while 21 of the newborns (15 female and6 male) were healthy, 5 newborns died following delivery due to variousreasons. The outcome of three fetuses was unknown because the motherswere lost to follow-up. Karyotype analysis were available in 12 of thehealthy newborns and all were normal.CONCLUSION: Testicular sperm extraction (TESE) and ICSI provide

high sperm recovery and pregnancy rates in infertile couples with azoo-spermia due to Klinefelter syndrome. There is no clinical, epidemiolog-ical or laboratory finding that predicts sperm retrieval in TESEprocedures.

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