significantly in terms of age, attempt number, estradiol level, number offollicles, number of days stimulated, ampules of gonadotropins adminis-tered, number of eggs, number of embryos, or quality of embryos (Table).

Cycle characteristics and pregnancy outcomes betweentransmyometrial oocyte retrievals (cases) and controls

Cases, n � 81 Controls, n � 83 p value

Age [mean � SEM] 35.8 � 0.5 35.8 � 0.5 0.97Attempt number

[mean � SEM]2.0 � 0.2 2.0 � 0.2 0.95

Estradiol level onday of hcg (pg/mL) [mean �SEM]

1977 � 109 1778 � 90 0.16

Number of follicleson day of hcg[mean � SEM]

13.1 � 0.8 13.4 � 0.7 0.81

Total amps ofgonadotropins[mean � SEM]

52.5 � 2.6 53.9 � 2.9 0.72

Total number of eggs[mean � SEM]

14.1 � 0.9 14.7 � 0.9 0.64

Number of embryostransferred [mean� SEM]

3.4 � 0.2 3.5 � 0.2 0.76

Clinical pregnancies[n(%)]

23 (28.4) 33 (39.8) 0.12

Miscarriages* [n(%)] 9 (11) 3 (3.6) 0.18Chemical

pregnancies*[n(%)]

1 (1.3) 3 (3.6)

* Miscarriages and chemical pregnancies combined for statistical analysis.

Conclusions: Transmyometrial oocyte retrieval is an uncommon eventthat does not seem to be associated with poor IVF outcome. Moreover,oocyte yield is not reduced when transmyometrial oocyte retrieval is per-formed. The clinician and patient may be reassured that transmyometrialoocyte retrieval does not appear to decrease IVF success rates.

Supported by: N/A.

P-398

Prognosis for live birth with IVF after elevated day 3 FSH. JessicaRosenberg Brown, Lewis Krey. New York Univ Sch of Medicine, NewYork, NY.

Objective: To assess the prognosis for live birth using IVF with awoman’s own oocytes after an FSH level has been determined to beelevated on cycle day 3.

Design: A retrospective review of IVF cycle outcome and all day 3 FSHlevels done at a large University-based IVF program was performed for allpatients with a history of an elevated FSH level on day 3.

Materials/Methods: For each woman with a history of elevated day 3 FSHwho had an oocyte retrieval between 1995 and 2001 the following infor-mation was compiled: age, number of IVF cycles with egg retrieval, cycleoutcome, and day 3 FSH levels. All FSH levels were determined at ouron-site endocrine laboratory using ImmuliteR. FSH levels 12 IU/L or greaterwere determined to be elevated.

Results: Women (n�118) with a history of elevated day 3 FSH under-went a total of 181 oocyte retrieval procedures; 45 of these cycles ended inthe delivery of a live born infant or an ongoing pregnancy (25%). Of the 118women, 43 (36%) delivered at least one live born infant or are having anongoing pregnancy as a result of IVF with her own oocytes and 2 womenhad 2 deliveries. Seventy-three women had a single retrieval, 32 women had2 retrievals, 9 had 3 retrievals, 3 had 4 retrievals, and 1 had 5 retrievals.When we evaluated the outcomes of the initial IVF cycle performed at ourprogram, 32/118 (27%) retrievals ended in live birth or an ongoing preg-nancy. For the repeat IVF cycles at our program, 13/63 (21%) retrievalsended in live birth or ongoing pregnancy; this included two women whodelivered after their third retrieval, and one woman who delivered after herfourth. Of the 118 women studied, 33 had elevated day 3 FSH levelsdocumented in our laboratory; of these, 8 (24%) had an ongoing or delivered

pregnancy by IVF. Forty-nine women had elevated FSH levels measuredelsewhere but only normal day 3 FSH levels monitored in our laboratory; ofthese, 23 (47%) had an ongoing or delivered pregnancy. Of the 36 womenwith no record of a day 3 FSH determination in our lab, 12 (33%) had anongoing or delivered pregnancy. When outcomes were analyzed as a func-tion of patient age (�35, 35–37, 38–40, and �40 years), the rates ofongoing and delivered pregnancy per retrieval were 40%, 32%, 22%, and8%, respectively.

Conclusions: It is reasonable to give an infertile woman with a history ofelevated day 3 FSH an opportunity to attempt IVF with her own eggs,especially if she is younger than 41. These women do not need to becounseled aggressively to proceed directly to oocyte donation.

Supported by: None.

P-399

Success of TESE-ICSI in men with non-mosaic Klinefelter syndrome.Jonathan D. Schiff, Gianpiero D. Palermo, Takumi Takeuchi, D. Liotta, ZevRosenwaks, Peter N. Schlegel. New York Presbyterian Hosp-Weill CornellMedical Ctr, New York, NY.

Objective: To determine the success rate of sperm retrieval using testic-ular sperm extraction (TESE) in men with non-mosaic Klinefelter syndrome(47,XXY). Further, fertilization and pregnancy rates after intra-cytoplasmicsperm injection (ICSI) in this cohort of patients and their partners wereevaluated.

Design: Retrospective review of prospectively gathered data of a singleinstitution experience with TESE and ICSI in patients with Klinefeltersyndrome.

Materials/Methods: The records of 322 consecutive patients who under-went TESE by a single surgeon (PNS) were reviewed. We found 20 menwho underwent a total of 27 TESE procedures with Klinefelter syndrome.Success rate of sperm retrieval, ICSI, fertilization and clinical pregnancywere then reviewed along with other demographic data.

Results: The average age of the men comprising the study population was34.4 years. Their average pre-treatment FSH and testosterone levels were 34IU/L and 190 ng/dL. After aromatase inhibitor therapy the mean testoster-one level rose to 332 ng/dL (p �0.05). Motile sperm were found duringmicrodissection TESE for 16 patients, and three more had non-motilesperm. Overall, 19 of 27 (70.4%) TESE procedures retrieved testicularspermatozoa adequate for ICSI. Fourteen of the 20 (70%) different men hadsufficient genetic material for ICSI. There were 17 cycles that yieldedembryos for transfer in the 19 cycles with sperm retrieved and 11 clinicalpregnancies (11/19; 58%) resulting in 14 live births.

Conclusions: The combination of TESE and ICSI is very successful intreating the infertility associated with non-mosaic Klinefelter syndrome.Couples presenting with infertility with a male partner diagnosed withnon-mosaic Klinefelter’s have sperm retrieval and fertilization/pregnancyrates comparable to other men with non-obstructive azoospermia at ourinstitution.

Supported by: James Buchanan Brady Foundation Department of Urol-ogy and Department of Reproductive Medicine, New York PresbyterianHospital, Weill-Cornell Medical Center.

P-400

Heterotopic pregnancies after IVF: A case-control study. SonyaKashyap, Isaac Kligman, Pak Chung, Zev Rosenwaks. Ctr for Reproduc-tive Medicine, Weill Medical Coll, Cornell Univ, New York, NY.

Objective: To compare heterotopic pregnancies (HP) with ectopic preg-nancies (EP) following IVF with respect to incidence, tubal risk factors andoutcome.

Design: Retrospective case-control study.Materials/Methods: All heterotopic pregnancies identified over a 5 year

period (1997 to 2002) were reviewed. They were compared to a controlgroup of ectopic pregnancies (1995 to 2002) for the following information:pregnancy outcome, maternal age, number of embryos transferred, gesta-tional age at diagnosis, endometrial thickness before transfer, day 28 hCG,infertility diagnosis, history of tubal disease, fresh versus frozen embryotransfer, day 3 versus blastocyst transfer, presence of rupture, and medicalversus surgical therapy of ectopic pregnancy. Statistical analysis was doneusing a Mann Whitney U test for continuous variables between groups.

S248 Abstracts Vol. 78, No. 3, Suppl. 1, September 2002