DESIGN: A retrospective analysis of couples utilizing ICSI in our IVFprogram.

MATERIALS AND METHODS: Records were analyzed for clients un-dergoing ICSI procedures from 1/1/04 to 1/31/07. Use of the male partner’ssperm and at least two semen analyses were required for inclusion in thestudy. WHO (World Health Organization) standards were used to determinemale infertility. Males were assigned to diagnosis groups: normal, astheno-zoospermia, azoospermia, hypospermia, oligospermia, and combinationsof these abnormalities. To receive a male factor (MF) diagnosis, more thanone semen analysis had to demonstrate the abnormality. Fetal heart beat, ec-topic implantation, spontaneous abortion (SAB), therapeutic abortion (TAB),and live birth or ongoing pregnancy were compared using c2 test, and differ-ences among groups were determined using t-test.

RESULTS: The study included 169 couples. A MF diagnosis was given to90 (53%) of the males. The most prevalent diagnosis was asthenozoospermiain 79 (88%) of the MF men, followed by oligospermia in 53 (59%), hyposper-mia in 39 (43%), and azoospermia in 5 (6%). The MF diagnoses were com-pared as population prevalence, as single diagnoses, and as combinations ofdiagnoses. No differences were seen among groups. Therefore, all men withMF diagnoses were combined into one group called Male Factor and werethen compared to the Normal group, as displayed in the table.

TABLE. Outcomes of Normal vs. Male Factor Diagnosis Groups

Outcome

FERTILITY & STERILIT

Normal n ¼ 79

Y�

Male Factor n ¼ 90

Not pregnant

39 (49%) 41 (46%) Ectopic 0 2 (2%) SAB 6 (8%) 1 (1%) TAB 2 (3%) 1 (1%) Live birth/ongoing

pregnancy

32 (42%) 45 (52%)

No statistically significant difference (P¼0.03) exists between experimentalgroups.

CONCLUSIONS: Although ICSI has become a well-established methodof assisted reproduction, the debate on its safety is ongoing. Many theoreticalsafety issues have been raised, but so far most concerns related to the ICSItechnique itself have not been translated into solid evidence. From this study,it may be concluded that performing ICSI on oocytes will avoid unnecessaryfertilization failure both in clients with abnormal semen parameters and inclients with normal semen parameters. Regardless of whether the spermused for ICSI were from semen having normal or abnormal parameters,once fertilized, oocytes seem capable of developing into embryos competentto establish a solid live birth rate.

Supported by: None.

P-810

EFFECT OF PATERNAL AGE ON FERTILIZATION AND SPONTA-NEOUS ABORTION RATES WITH IN VITRO FERTILIZATION.V. L. Baker, L. Palao, G. D. Adamson, M. Gvakharia. Fertility Physiciansof Northern California, Palo Alto and San Jose, CA.

OBJECTIVE: To determine if paternal age is associated with laboratory orclinical outcome in cycles of in vitro fertilization.

DESIGN: Retrospective analysis of an IVF database in a private practice.MATERIALS AND METHODS: All fresh IVF cycles using autologous

oocytes with retrieval from January 2005 through December 2006 (n ¼ 738)and all fresh cycles using donor oocytes with retrieval from January 2005 untilMarch 2007 (n¼85) were included. Cyclesusing donor sperm and cycleswhichdid not lead to retrieval were not included. Fertilization rates, mean cell numberfor the transferred embryos, mean embryo quality for the transferred embryos(Grade 1 ¼ 0–10% fragmentation, Grade 2 ¼ 10–25% fragmentation, Grade3 ¼ 26–50% fragmentation, Grade 4 > 50% fragmentation) were calculatedfor all cycles. Spontaneous abortion rate (pregnancy loss/positive quantitativehCG) was calculated for the cycles that resulted in a positive serum hCG (n¼ 377 and n ¼ 64 for autologous and donor cycles, respectively).

RESULTS: In cycles using autologous oocytes, fertilization rate was re-duced with conventional IVF, but not with ICSI for paternal age over 40 years(see Table). No statistically significant correlation between paternal age andfertilization rate was noted with the use of donor oocytes. There was also nostatistically significant difference in embryo quality related to paternal age.Although there was a suggestion of a higher spontaneous abortion rate related

to paternal age in cycles using autologous oocytes for women over 37 and withthe use of donor oocytes, this difference was not statistically significant.

TABLE

F

ConventionalIVF

ertilizationrate

F

ICSI

ertilizationrate

A

t

verage cellnumber inransferredembryos

AverageEmbryoQuality

Sl

AB(preg.oss/pos.beta)%

Autologous Eggs, Women %37,Male <40, n ¼ 368

73%*

66% 7.4 � 1.2 1 .26 � 0.47 18%

Autologous Eggs, Women %37,Male R40, n ¼ 84

68%*

70% 7.4 � 1.3 1 .25 � 0.45 16%

Autologous Eggs, Women >37,Male <40, n ¼ 120

71%**

68% 6.8 � 1.4 1 .45 � 0.6 15%

Autologous Eggs, Women >37,Male R40, n ¼ 166

64%**

72% 6.7 � 1.4 1 .47 � 0.6 21%

Donor eggs, Male <40,n ¼ 32

72%

68% 7.6 � 0.9 1 .07 � 0.18 0/16

Donor eggs, Male R40,n ¼ 53

70%

66% 7.7 � 0.7 1 .08 � 0.17 4/40

*P¼0.04, **P¼0.02.

CONCLUSIONS: Paternal age was associated with a lower fertilizationrate with conventional insemination of oocytes, but not with ICSI. No statis-tically significant difference in spontaneous abortion rate could be detected.

Supported by: None.

P-811

PREDICTING PARAMETERS FOR SUCCESSFUL SPERM RE-TRIEVAL IN AZOOSPERMIC MEN WITH KLINEFELTER SYN-DROME. R. Hauser, L. Yogev, A. Botchan, O. Lehavi, G. Paz, H. Yavetz.The Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Med-ical Center, Tel Aviv, Israel.

OBJECTIVE: To identify predicting parameters for successful spermretrieval in azoospermic men with Klinefelter syndrome.

DESIGN: Parameters of age, hormonal values, testicular size and consistencywere analyzed and correlated to successful sperm retrieval using Two-tail T Test.

MATERIALS AND METHODS: Eighteen azoospermic men were identi-fied as having 47 XXY karyotype. They underwent TESE procedures withmultiple biopsies.

RESULTS: Age ranged between 26 to 36. Sperm cells were found in 7cases (38.9%). FSH level was significantly lower in the group where spermcells were found compared to the group with no sperm cells (23.1 � 6.5vs. 36.7 � 8.5 mIU/ml, P<0.002, Two-tail T Test). No difference was foundin the age of patients (30.9� 3.2 vs. 31.8� 3.7), LH level (17.8� 6.9 vs. 22.6� 4.6 mIU/ml), Testosterone level (11.9 � 3.5 vs. 10.1 � 3.2 nmol/l), orProlactin (324.7 � 274.8 vs. 344.0 � 236.3 mIU/l).

CONCLUSIONS: Based on these results, FSH level can be used as a pre-dictive parameter for successful sperm retrieval in azoospermic patients with47 XXY karyotype. A cutoff value above 28 mIu/ml predicts cases wheresperm cells cannot be found.

Supported by: None.

P-812

EFFECTS OF INCUBATION TIME OF FROZEN-THAWED TESTIC-ULAR SPERM ON PREGNANCY AND IMPLANTATION RATES ININTRACYTOPLASMIC SPERM INJECTION PATIENTS. E. Ergin,Z. Oztel, Z. Zaman, T. Sohtorik, M. Atay, H. Ozornek. EUROFERTIL Repro-ductive Health Center, Istanbul, Turkey.

OBJECTIVE: Upon the improvement of Intracytoplasmic Sperm Injection(ICSI) techniques, successful pregnancy can be achieved by using spermwhich is obtained directly from the testicle of an azoospermic man. It is con-sidered that the duration of incubation of thawed testicular sperm may affectthe pregnancy and implantation rates. The aim of this study is to compare theeffects of short and long incubation periods on the outcome of frozen-thawedtesticular sperm patients.

DESIGN: Retrospective study.MATERIALS AND METHODS: Our selection criterias were women

%35 years of age and R 5 oocyte cumulus complex. Testicular sperm extrac-tion (TESE) was performed as an open biopsy before controlled ovarian

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