Design: Case controlled study in a university affiliated IVF center.Materials/Methods: All donor oocyte cycles, including intracytoplamic

sperm injection (ICSI), using ganirelix or a long protocol with leuprolide forLH suppression from January 1, 2001 through December 31, 2001 per-formed in a university-affliliated IVF center were evaluated. Thirty-onewomen began 32 cycles utilizing leuprolide followed by recombinant FSH.Twelve women underwent oocyte preparation with recombinant FSH andganirelix began when follicular development reached 14 mm. All womenwere pretreated with oral contraceptives for 14–21 days. Cycle character-istics assessed included days and total dose of FSH, number of oocytesretrieved and fertilized. Implantation and clinical pregnancy rates werecompared using the Chi-square and Fisher Exact Test, repectively.

Results: Leuprolide was initiated in 32 cycles; 2 were cancelled due topoor stimulation. Twelve cycles were started and completed in the ganirelixgroup. No premature LH surges occurred. Mean duration of stimulation was9.2 (SD 1.455) days in the leuprolide group and 9.4 (SD 1.261) withganirelix. Median number of oocytes retrieved was 13.5 (SD 7.577) (range3–35) with leuprolide and 16.5 (SD 5.233) (range 6–24) in the ganirelixgroup. Median number of oocytes fertilized were 9.0 (SD 4.715) and 10.0(SD 3.576), respectively. The ganirelix group used on average 2400 IU FSH(SD 442.5) and 2100 IU FSH [SD 570.0 with leuprolide. Pregnancy oc-curred in 20/32 cycles (62.5%) in the leuprolide group and 6/12 (50%)ganirelix cycles [p � 0.48]. Within the agonist group, 78 embryos weretransferred with ultrasound indentification of 28 gestational sacs, and animplantation rate of 35.9% The ganirelix group had an implantation rate of38.0% [11 gestational sacs/ 29 embryos][p � 0.94].

Conclusions: Ganirelix is an effective method for LH suppression indonor cycles. When compared to cycles using the long protocol of leupro-lide, donor oocyte cycles using ganirelix are shorter and produce similarpregnancy and implantation rates.

Supported by: Partial support provided by Organon, Inc.

P-11

Relationship between serum LH and IVF outcome in cycles with aGnRH antagonist (Cetrorelix). Ernesto Bosch, Ivan Valencia, JuanaCrespo, Carlos Simon, Jose Remohi, Antonio Pellicer. Inst Valenciano deInfertilidad, Valencia, Spain.

Objective: To relate serum LH levels during ovarian stimulation to IVFoutcome in cycles where a GnRH antagonist was used to prevent the LHsurge.

Design: Prospective cohort study. Follow up of cycles according to serumLH levels the day of hCG.

Materials/Methods: Ninety eight cycles of ovarian stimulation for IVF-ICSI with at least one embryo transferred performed in our institutionbetween October 1st, 2001 and January 31st, 2002 were included. Allpatients received 0.25 mg daily of a GnRH antagonist (Cetrorelix) eitherfrom day 6 of stimulation or when a leading follicle was 14 mm in diameter,until the day that hCG was administered. FSH alone or with HMG wereused for ovarian stimulation. Serum LH was determined the day that hCGwas administered. To relate LH levels with IVF outcome, the distributionwas divided in three groups according to Tuckeys hinges (percentiles 25 and75). Age, number of oocytes collected, fertilization rate, number of trans-ferred embryos and implantation, and pregnancy rates were analyzed. Anal-ysis of variance was used.

Results: Serum LH the day of hCG was 1.28 � 0.21 (CI 95%: 0.86–1.70)mUI/ml. Tuckeys hinges were: percentile 25 � 0.50 mUI/ml; percentile75 � 1.32 mUI/ml. IVF outcome is shown in Table.

IVF outcome according to Serum LH the day of hCG

Serm LH(mUI/ml) Age # oocytes

%fertilization

# embryostransferred

%pregnancy

%implantation

�0.5(n � 32)

33.4 � 3.6 18.9 � 9.5 61.9 2.3 � 1.1 31 16.4

0.5–1.32(n � 40)

32.7 � 4.5 14.1 � 7.6 70.5 2.9 � 0.9 50 24.5

1.32(n � 26)

36.6 � 3.4 (*) 9.9 � 7.9 (*) 62.4 2.1 � 1.5 (*) 19 (*) 12.1 (*)

p 0.001 0.008 N.S. 0.027 0.032 0.044

(*)Statistically significant when compared to the group with LH � 0.5–1.32mUI/ml

Conclusions: In ovarian stimulation with GnRH antagonists for IVF,patients whose serum LH at the end of stimulation was in the interquartilerange (between percentile 25 and 75, �0.5 mUI/ml and �1.32 mUI/ml)showed a better IVF outcome with higher implantation and pregnancy rates.The highest levels of serum LH were present in older patients, with lowerresponse, and poorer outcome. Analysis with longer series to confirm thesefindings is needed. If confirmed, developing more flexible antagonist regi-mens with modulation of LH levels during ovarian stimulation and takinginto account individual patient characteristics, could improve the clinicaloutcome in cycles where a GnRH antagonist is used.

Supported by: None provided.

P-12

Sperm capacitation index (SCI) predicts pregnancy outcome with con-trolled ovarian hyperstimulation (COH) � intrauterine insemination(IUI). Deborah C. Merryman, Sara E. Stringfellow, Katie E. Dalton,Virginia L. Houserman, Cecil A. Long, Kathryn L. Honea. ART Programof Alabama, Birmingham, AL.

Objective: The Sperm Penetration Assay (SPA) evaluates aspects of theability of human sperm to complete certain processes necessary to achievefertilization using zona-free hamster oocytes. There is controversy regard-ing the correlation between the SPA and fertilization of human oocytes orpregnancy outcome. An abnormal SPA is a good predictor of IVF � ICSIpregnancy outcome, but does not affect fertilization rates (Merryman, et al,ASRM abstract #P313, Orlando, FL, 2001). The SCI is the quantitativemeasurement of the SPA (average number of sperm penetrations per oo-cyte). Our objective was to determine the SCI score predictive of COH �IUI outcome. Clinical pregnancy per treatment cycle used as the outcomemeasurement.

Design: A retrospective study comparing the outcome of cycles withCOH � IUI for the year 2001 in which patients had an SPA performed.SPAs were performed by Baylor College of Medicine, Houston, TX.

Materials/Methods: The data consisted of 214 COH � IUI cycles inwhich patients had an SPA performed. Eighty-eight cycles had an SCI �5(“possibly impaired by” Baylor standards) while 126 cycles had a normalSCI (�5). Patients with an SCI �5 initially may have had a repeat SPA withchymotrypsin preparation (CTP). The highest SCI obtained was used for theanalysis. COH � IUI was carried out by conventional methods. If CTPimproved SCI, sperm prep for IUI included CTP. Fisher exact test was usedto test for differences between SCI groups.

Table 1. Fertilization rates for different groups of patients based uponthe cut-off values

Sperm Capacitation Index (SCI) 0–5 5 TotalCOH/IUH Cycles 88 126 214Clinical Pregnancies 8 25 33Clinical Pregnancy per Cycle 9%* 20%* 15%

* P � .05

Results: Patients were grouped according to SCI: �5 and �5. Theclinical pregnancy rate (CPR) per cycle was 9% (8/88) when SCI was �5and 20% (25/126) when SCI was �5 (p �.05). There were no clinicalpregnancies in cycles with an SCI �1 (0/17). A trend towards a decrease inCPR was seen when SCI was 1–5 (8/71, 11%) vs. �5. A trend towards adecrease in CPR was noted for patients age �35 as compared to patients age�35.

Conclusions: (1) Patients with an impaired SCI of �5 have a significantlydecreased clinical pregnancy rate per COH � IUI cycle as compared topatients with SCI �5. (2) Routine screening of SCI is indicated for preg-nancy rate prediction for patients undergoing COH � IUI.

Supported by: Not applicable.

P-13

Assessment of endometrial leukemia inhibitory factor (LIF) levels byuterine flushing at the time of egg retrieval in IVF-ET. Francois J.Olivennes, Nathalie Ledee-Bataille, Marise Samama, Jean-Luc Taupin,Gerard Chaouat, Rene Frydman. Hosp Antoine Beclere, Clamart, France;

FERTILITY & STERILITY� S119