small follicles compared with those from large- and medium-sized folliclesin all age groups (L: 47.9%, M: 43.3%, S: 28.4% for group <37years, etc.)(p<0.05). Nevertheless, there were no differences in ongoing pregnancyrate per embryo transfer among each follicle sizes in all age groups (L:55.1%, M: 54.7%, S: 50.8% for group <37years, etc.).

CONCLUSION: The number of mature oocytes retrieved from collateralfollicles were equivalent to those retrieved from dominant follicles, and thesuccessful pregnancy rate achieved using collateral follicles was similar tothat achieved using dominant follicles; therefore, oocyte retrieval fromcollateral follicles may improve IVF outcome.

P-1107 Thursday, October 17, 2013

ANALYSIS OF TOTAL FERTILIZATION FAILURE IN INTRACY-TOPLASMIC SPERM INJECTION CYCLES. S. Shinar, Y. Hasson,I. Levin, B. Almog. Lis Maternity Hospital and the Sara Recine IVF Unit,Tel Aviv Sourasky Medical Center, Tel aviv, Israel.

OBJECTIVE: Total fertilization failure (TFF) after intracytoplasmicsperm injection (ICSI) is a rare and perplexing event. Limited data is avail-able regarding the proposed management of couples exhibiting sporadic orrepeated events of TFF. The aim in this study was to identify all ICSI casescomplicated by TFF in our unit, establish their frequency, cause and chanceof recurrence in order to optimize future treatment plans.

DESIGN: Retrospective.MATERIALSANDMETHODS: All ICSI cycles performed at our unit be-

tween 1/2006 and 7/2012 were reviewed and cases complicated by TFF wereretrieved. In an attempt to minimize TFF relating to statistical chance andreduced oocyte reserve, we isolated women younger than 40 with at least 5M2 oocytes available for ICSI for further study and analysis. Patient dataincluded demographics, obstetric history, sperm analysis, number of cyclesperformed, cycle protocol, progesterone and estradiol levels on day ofhCG administration, number of follicles>17 mm on day of hCG administra-tion, number of oocytes aspirated, number of M2 oocytes obtained andoocyte quality assessment.

RESULTS: Of the 3723 ICSI cycles performed at our unit the TFF rate forwomen under 40 with at least 5M2 oocytes was 0.7% (16 couples). Themeanage of the women was 32.3. The leading reasons for ICSI were severe malefactor or unexplained infertility. Of the 16 couples, 4 (25%) demonstrated asingle non-recurring episode of TFF, most likely due to faulty laboratory con-ditions. Ten (62.5%) demonstrated repeated failures and subsequent lowfertilization rates, hinting at a gamete defect not overcome by ICSI. Twocouples (12.5%) experienced a single episode of TFF of only one cycle per-formed at our unit.

CONCLUSION: Sporadic TFF events could imply a technical modifiablecondition and further treatments can produce encouraging results. Nonethe-less, cases with repeated TFF from the beginning of treatment, most likelyrepresent severe gamete defects for which only cross testing and donor gam-etes may prove successful.

P-1108 Thursday, October 17, 2013

DOES hCGTYPEFORFINALMATURATIONAFFECTSOUTCOMEOF ART TREATMENTS?. C. Harrity, V. Denis, E. Gerri, M. Edgar.Human Assisted Reproduction Ireland, Dublin, Ireland.

OBJECTIVE: Does the choice of urinary or recombinant hCG for triggerduring IVF or ICSI cycles affect oocyte numbers, fertilisation or pregnancyrates?

DESIGN: A retrospective cohort study was performed analyzing out-comes of ART therapy in relation to the type of hCG used for trigger. Alloocyte collections between 1.1.2011 and 1.12.2012 were identified and ana-lysed.

MATERIALS AND METHODS: A total of 1299 oocyte retrievals wereidentified between 1st January 2011 and 1st December 2012 in stimulatedIVF or ICSI cycles triggered using either Pregnyl (n¼825) or Ovitrelle(n¼474).

RESULTS: Statistical analysis demonstrated no significant difference indemographic details, ovarian reserve (day 3 FSH), stimulation protocol oraetiology of infertility between the two groups. There was no difference inthe average total dose of FSH needed for ovarian stimulation (Pregnyl,3275IU vs. Ovitrelle, 3374IU, p¼0.74). The average number of oocytes(9.7 vs. 10.0) per OR, and percentage of Metaphase II (76.9% vs. 75.9%)were the same. Fertilisation rates for ICSI were higher with rhCG (77.2%vs. 69.6%, p¼0.01) but significantly higher using uHCG for IVF (60.9%

S468 ASRM Abstracts

vs. 48.7%, p<0.001). The number of embryos obtained per collection(2.30 vs. 2.45) and clinical pregnancy rate per transfer (41.6 vs. 44.3%,p¼0.54) were no different.CONCLUSION: There appears to be little difference between uHCG and

rHCG in terms of outcomes after ART. The differences in fertilisation ratesbetween IVF and ICSI need to be further assessed, and a larger prospectivestudy to analyse this would be beneficial.

P-1109 Thursday, October 17, 2013

SINGLETON BUT NOT TWIN INFANTS CONCEIVED THROUGHASSISTED REPRODUCTIVE TECHNOLOGIES (ART) HAVE AGREATER LENGTH OF STAY IN THE NEONATAL INTENSIVECARE UNIT (NICU). G. Bhasin,a E. T. Wang,a,b K. Gregory,a,b

S. Forbis,c C. Simmons,c M. D. Pisarska.a,b aOB/GYN, Cedars-Sinai Med-ical Center, Los Angeles, CA; bOB/GYN, David Geffen School of Medicine@ UCLA, Los Angeles, CA; cPediatrics, Cedars-Sinai Medical Center, LosAngeles, CA.

OBJECTIVE: To determine if there are differences in NICU admissionsbetween infants conceived spontaneously and those conceived through ART.DESIGN: Cross-sectional study.MATERIALS AND METHODS: 513 infants who were in the NICU

from 1/1/12 -12/31/12 were evaluated. There were 404 singletons [391 in-fants were spontaneously conceived (spontaneous group) and 13 wereconceived through ART (ART group)]. There were 101 infants that deliv-ered as twins [spontaneous (n¼53) and ART (n¼43)] in the NICU duringthat period. Gestational age, birth weight and length of stay were comparedbetween the spontaneous and ART groups using Student’s t-test and theKruskal-Wallis test. Mode of conception and length of NICU stay (log-transformed) was further evaluated using linear regression adjusted forgestational age.RESULTS: There was a significant difference in the gestational age at

delivery for the spontaneous singleton group compared to the ART group[36 2/7 weeks vs. 33 4/7 weeks (p¼0.03)] and a significant difference inthe birth weight between the 2 groups [2757 vs. 1923 gms (p¼0.003)]. Therewas also a significant increase in the length of stay for the ART infants [15.5vs. 30.4 days (p¼0.05)]. This was no longer significant after adjusting forgestational age. In twin gestations, there was no significant difference inthe gestational age (33 4/7 vs. 33 weeks), birth weight (1841 vs. 1803gms) or length of stay (23.4 vs. 29.2 days) among those that conceived spon-taneously compared with those that conceived through ART.CONCLUSION: Among singletons admitted to the NICU, ART pregnan-

cies were delivered earlier than spontaneous pregnancies, accounting for thelower birth weight and longer length of stay in the NICU. When looking atinfants from a twin gestation, there was no difference in the gestationalage, birth weight or length of stay among the spontaneous group comparedto the ART group. Further studies are necessary to determine the etiologyfor the earlier deliveries seen in the singleton group.Supported by: Helping Hand of Los Angeles, Inc.

P-1110 Thursday, October 17, 2013

IMPACT OF EARLY GnRH ANTAGONIST ADMINISTRATION ONOVARIAN RESPONSE AND PREGNANCY OUTCOME INIVF. Y. I. Hwang, K. M. Yang, I. O. Song, M. K. Koong, E. G. Min,C. W. Park. Division of Reproductive Endocrinology and Infertility, Depart-ment of Obstetrics and Gynecology, Cheil General Hospital and Women’sHealthcare Center, Kwandong University College of Medicine, Seoul,Republic of Korea.

OBJECTIVE: Recently, it has been suggested to initiate the GnRH antag-onist use earlier than the established fixed GnRH antagonist regimen toachieve a more synchronized follicular growth and lower exposures toFSH, LH, estradiol and progesterone. The objective of this study was toassess the impact of IVF cycle using early initiation of GnRH antagoniston follicular synchronization and pregnancy outcome comparing with thoseof GnRH antagonist flexible multi-dose protocol.DESIGN: This study was designed prospectively from February 2011 to

September 2012.MATERIALS AND METHODS: For early GnRH antagonist initiation

cycles (n¼ 34 cycles, 34patients), GnRH antagonist (Cetrorelix 0.25mg)was administered form the 2nd day of menstruation. As a control GnRHantagonist flexible multi-dose protocol cycles, GnRH antagonist adminis-tration from the day of leading follicle sized 12�14mm, were included

Vol. 100, No. 3, Supplemnt, September 2013