potential psychological risks that this situation may involve for the child a survey program was set up.
DESIGN: Two points were addressed: what kind of father can a transman be and, is the child psychological development normal? Since everybody in their family knows that the father was a female in his childhood, these cou-ples were advised to tell the children the truth in order to avoid any traumatic revelation.
MATERIALS AND METHODS: Thirty six children born from 26 couples were followed up for 12 years. At each stage in the follow-up, data were collected in the interviews of both parents with psychologists, then with a psychiatrist. A detailed observation of the interactions and behavior of the children was carried out by the two psychologists, initially while their parents were present, then without the parents. For the youngest children, the revised Brunet-Lezine infant psychomotor development test, which covers ages 2-72 months, was used. In addition, the children were asked to make drawings (of a person, of their family, of anything they wanted to draw). They also played interactive games with the psychologists.
RESULTS: Fathers of these children are quite proficient in their role as fa-thers. The children’s development is normal. There are no cases of Gender Identity Disorder or Variant or of any major psychological problem so far.
CONCLUSION: These children are well-loved; their development is good. New programs will be devised.
Supported by: Financial support came from Assistance Publique – H^opitaux de Paris.
O-487 Wednesday, October 16, 2013 05:30 PM
PRENATAL EXPOSURE TO DIETHYLSTILBESTROL AND RISK OF UTERINE LEIOMYOMATA IN THE NURSES’ HEALTH STUDY II: A PROSPECTIVE STUDY. S. Mahalingaiah,a
J. E. Hart,b,f L. A. Wise,c K. L. Terry,d R. Boynton-Jarrett,e S. A. Missmer.b,g,ha
De-partment of Obstetrics and Gynecology, Boston University School of Med-icine, Boston, MA;bChanning Division of Network Medicine, Brigham
and Women’s Hospital and Harvard Medical School, Department of Med-icine, Boston, MA;cSlone Epidemiology Center, Boston, MA;dObstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gy-necology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; eDivision of General Pediatrics, Boston University School
of Medicine, Boston, MA;fExposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA; gDepartment of Epidemiology, Harvard School of Public Health, Boston, MA;hDepartment of Obstetrics, Gynecology, and
Repro-ductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA.
OBJECTIVE: To determine the association of prenatal diethylstilbestrol (DES) exposure and incidence of uterine leiomyomata (UL) in the Nurses’ Health Study II (NHSII) from 1989 to 2009.
DESIGN: Prospective cohort study of female participants in the Nurses’ Health Study II (NHSII), with a one-time enrollment in 1989 and includes biennial follow-up surveys, through May 2009.
MATERIALS AND METHODS: The analytic sample included 102,164 premenopausal women with intact uteri, no prior history of UL or cancer, and complete data on prenatal DES exposure. Multivariable-adjusted time-varying Cox proportional hazard models were used to estimate the relation between DES exposure and UL risk. All models were adjusted for age, cal-endar time, race, current body mass index (BMI), smoking status, parity, oral contraceptive use, age at menarche, age at first and last birth, time since last birth, total months of exclusive breastfeeding, infertility, and antihyperten-sive medication use and blood pressure.
RESULTS: During 1,273,342 person-years of follow-up, there were 11,831 incident cases of UL. Women with prenatal exposure to DES had a higher incidence of UL compared to unexposed women, with a multivari-able-adjusted hazard ratio (HR) of 1.14 (95%CI: 1.00-1.29). Risk was stron-gest for women initially exposed to DES in the first trimester, adjusted HR¼ 1.23 (95%CI: 1.03-1.45).
CONCLUSION: These results suggest that prenatal DES exposure may be associated with an increased risk of UL. The association was highest for women exposed to DES in the first trimester, which corresponds to early stages of fetal mullerian development.
Supported by: Grant 5K12HD043444-10 from the National Institute of Child Health and Human Development, R01CA50385 from the National Cancer Institute, 5R01ES017017 from the National Institute for Environ-mental Health Sciences, and a research grant from the Boston University Department of Obstetrics and Gynecology.
O-488 Wednesday, October 16, 2013 05:45 PM
SORTING EMBRYOS ON DAY 2 PREDICTS EUPLOIDY AS VERI-FIED BY COMPREHENSIVE CHROMOSOME SCREENING (CCS). D. A. Kelk, E. L. Paganetti, J. Lo, K. Reyes, J. M. Hurwitz, M. P. Leondires. Reproductive Medicine Associates of Connecticut, Nor-walk, CT.
OBJECTIVE: Embryo sorting based on morphological assessment is uti-lized by virtually all IVF programs to optimize pregnancy rates. These morphological assessments may be utilized throughout the in vitro culture period or solely at the time of Day 3 or Day 5 embryo transfer. Studies uti-lizing TE biopsy and CCS are now reporting>50% of blastocysts from pa-tients>37 years are chromosomally abnormal, but this technology is not yet universally available. This study examines blastulation and euploidy rates be-tween embryos sorted based on Day 2 cell number.
DESIGN: Prospective observational analysis of 1852 embryos cultured in 234 CCS cycles.
MATERIALS AND METHODS: Embryos were group cultured until TE bi-opsy in 50ml drops of Global culture media in 5-well dishes in MINC incubators with a 6.5% CO2/5.0% O2gas mixture. On Day 2, embryos were sorted into the
following groups:<4-cell, 4-cell and >4-cell and group cultured until trophec-toderm biopsy. Laser zona breaching was performed on Day 3 and laser assisted TE biopsy was performed on Day 5 or 6 depending on blastocyst expansion. Individual groups were compared independently using Chi-squared.
RESULTS: Blastulation and euploidy rates are shown in Table 1. Average maternal age was 39 years.
CONCLUSION: Four-cell embryos on Day 2 had the highest blastulation and overall euploidy rates. Interestingly, embryos that were greater than 4-cells on Day 2 which formed blastocysts, showed a trend toward higher euploidy rates. This warrants further investigation. Laboratories should consider sorting embryos based on cell number on Day 2 to enhance the like-lihood of selecting a chromosomally normal blastocysts.
POSTER SESSION
MENOPAUSE
P-1 Tuesday, October 15, 2013 ABSTRACT WITHDRAWN
P-2 Tuesday, October 15, 2013
EFFECTS OF TRANSDERMAL AND ORAL HORMONE REPLACE-MENT THERAPIES ON MONOCYTECHEMOATTRACTANT PRO-TEIN-1 (MCP-1) LEVELS. M. S€onmezer,a
T. Tasc¸i,a Y. E. S€uk€ur,a C. S. Atabekoglu,aB. €Ozmen,aS. Dinc¸er Cengiz.baObstetrics and
Gynecol-ogy, Ankara University, Ankara, Turkey;bObstetrics and Gynecology, Ufuk University, Ankara, Turkey.
OBJECTIVE: To identify the effects of oral and transdermal hormone replacement therapies (HRT) on levels of a cardiovascular disease (CVD) marker, MCP-1.
DESIGN: Randomized controlled trial.
MATERIALS AND METHODS: Ninety nine healthy early postmeno-pausal women were enrolled in the study. Patients were randomly assigned to receive oral or transdermal HRT for 6 months. The first group received Table1: Blastulation and Euploidy Rates Based on Day 2 Cell Number
Day 2 Cell Number Blastulation Rate % Euploid from Blastocysts Biopsied % Euploid from Day 2 Embryos <4-cell (n¼427) 27.6%* 38.3%a 10.3%** 4-cell (n¼939) 70.3%* 47.7%b 32.7%** >4-cell (n¼486) 37.2%* 53.6%g 19.8%** Total (n¼1852) 51.8% 47.7% 24.1% * p<0.003; a:b¼NS; a:g¼p¼0.014; b:g¼NS; **p<0.001.
continuous combined oral HRT containing 1 mg 17b-estradiol and 0.5 mg norethisterone acetate (n¼39), whereas the second group received sequen-tial HRT containing estradiol alone (4 mg) given twice a week on days 1-14 and estradiol (10 mg) plus norethisterone acetate (30 mg) given twice a week on days 15-28 (n¼37). Twenty patients in the oral HRT group and 19 patients in the transdermal HRT group completed the study. Circulating levels of MCP-1 were assessed before and after the treatment in all patients.
RESULTS: There were no statistically significant differences between the baseline characteristics of the two groups. There were no statistically signif-icant differences between the mean serum MCP-1 levels in oral and trans-dermal HRT groups prior to the study (150.112.8 vs. 145.211.6 pg/ml; P¼.219). The mean MCP-1 levels did not change after 6 months of HRT use in both oral HRT group (150.112.8 vs. 153.612.5 pg/ml; P¼.192) and transdermal HRT group (145.211.6 vs. 146.115.1 pg/ml; P¼.419) when compared to baseline MCP-1 levels.
Effects of oral and transdermal HRT on MCP-1 levels, after 6 months of treatment
Baseline 6 months P value Oral HRT (pg/ml) (n¼20) 150.112.8 153.612.5 .192 Transdermal HRT (pg/ml) (n¼19) 145.211.6 146.115.1 .419 HRT; hormone replacement therapy, MCP-1; monocyte chemoattractant pro-tein-1.
Moreover there was no significant difference in MCP-1 serum levels after 6 months HRT use between the groups.
CONCLUSION: Both oral continuous and sequential transdermal HRTs do not affect MCP-1 levels significantly, which is a significant marker for endothelial damage, in young women at early postmenopausal period.
P-3 Tuesday, October 15, 2013
EFFECT OF LOW LEVEL GALLIUM ARSENID DIODE LASER ON BONE DENSITY. M. A. A. El-Nouri. Medical Laser, Cairo Univ, Cairo, Egypt.
OBJECTIVE: The aim of the study was to assess and evaluate the effect of low-level laser irradiation on the bone mineral density in postmenopausal women.
DESIGN: Prospective clinical study.
MATERIALS AND METHODS: Low level Gallium Arsenid Diode laser (wavelength at 904nm) at fluence of 30J/sq cm, pulsed wave was used 11 fe-male subjects (mean age standard deviation, 57 years 5). A semi station-ary treatment technique (treating point after point) was used over the ultra distal ends of the left radius and ulna. The course consisted of 9 sessions (3 per week), each sessions lasted for 30 minutes.
Outcome Measures: BMD (in grams per square centimeter) was measured with dual energy absorptiometry in the ultra-distal ulna and radius. Measurement of BMD was performed, using dual energy X-ray ab-sorptiometry (DEXA), in the as a marker of biostimulatory effect. Subjec-tive evaluation of therapy was observed using visual analogue scales for pain at rest and movements and assessment of muscle strength, range of motion and activities of daily living were documented before treatment and 1 and 3 months after.
RESULTS: Ultra-distal Ulna and Radius BMD increased with Low po-wer laser biostimulation for 3 weeks by (7.8, and 11.2%) from baseline vs 1.2, and 9.4% for the the contol group of the study. The ultradistal forearm (both radius and ulna) BMD increased in the study group by 8.7%. while the control group increased only by 3.3%. Differences in levels of the BMD were found to be significant comparing irradiated and non-irradiated groups. There was no significant difference in the pain score, strength of muscles, and range of wrist movement or daily activities between the study and control group, before and after treat-ment.
CONCLUSION: Low level Gallium Arsenid Diode laser bio-stimulation increases the BMD in postmenopausal women However It has no effect on the pain, range of movements, muscle strength or daily activities.
Supported by: Low level Laser irradiation, Osteoporosis.
P-4 Tuesday, October 15, 2013
FSHR POLYMORPHISMS ARE ASSOCIATED WITH
PREMA-TURE OVARIAN INSUFFICIENCY
DEVELO-PMENT. E. B. Cordts, M. C. Santos, A. A. Santos, F. A. Mafra, D. M. Christofolini. Genetics and Human Reproduction, FMABC, Santo Andre, Sao Paulo, Brazil.
OBJECTIVE: To evaluate the incidence of polymorphisms Asn680Ser (rs6166) and Ala307Thr (rs6165) of the FSHR gene and the occurrence of chromosomal abnormalities in woman with Premature Ovarian Insufficiency (POI) and in a control group and correlate the genetic and clinical findings.
DESIGN: Case control study.
MATERIALS AND METHODS: A group of 103 infertile and patients with POI was selected trough clinical history and serum levels of the hor-mone FSH.The control group included 101 women with no familial history of POI and normal age of menopause.The genotyping of polymorphisms Asn680Ser (rs6166) and Ala307Thr (rs6165) of the FSHR gene was per-formed in both groups using TaqMan by PCR real time. Cytogenetic analysis was performed only in the group of patients with POI. 40 methaphases were evaluated through G banding technique.
RESULTS: The karyotype analysis performed in patients POI showed that 98.05% (101/103) presented normal karyotype 46,XX, 1.95% (2/103) showed and increased heterochromatin region in the 9 and 16 chromosomes (46,XX,9qh+;46,XX,16qh+) both considered normal variations in the popula-tion.The genotyping for polymorphisms Ala307Thr demonstrated a statisti-cally significant difference between the allele Ala of the polymorphism Ala307Thr, and a p value of 0.035, comparing the POI group with the control group. The analysis of Asn680Ser polymorphism incidence in patients and con-trol group showed a non significant difference between them (p¼0.094). The average levels of FSH hormone in POI patients in this study was 57.8mUI/mL. CONCLUSION: We concluded that most patients with POI and no other phenotypical alteration have normal karyotype, and they do not suspect of POI untill testing fertility. Also, we observed that the polymorphic allele Ala from Ala307Thr polymorphism showed statistically significant differ-ence between patients with POI and control group, being more present in pa-tients with POI, suggesting an important rule of FSHr in the regulation of folliculogenesis.
Supported by: CNPq for Monise de Castro Santos Scholarship.
P-5 Tuesday, October 15, 2013 ABSTRACT WITHDRAWN
P-6 Tuesday, October 15, 2013
EFFECTS OF TIBOLONE ON SERUM CALCIUM AND 25-HY-DROXY VITAMIN D3 LEVELS AND HEALTH RELATED QUALITY OF LIFE (HRQOL) IN POSTMENOPAUSAL (SURGICAL) WOMEN. S. M. Bhattacharya,a,b M. Ghosh.caObstetrics & Gynecology,
S.C.DAS Memorial Medical & Research Center, Kolkata, West Bengal, India;bObstetrics & Gynecology, KPC Medical College, Kolkata, West
Ben-gal, India; cPharmacology, Murshidabad Medical College, Murshidabad, West Bengal, India.
OBJECTIVE: There are growing evidences that vitamin D3 sufficiency is required for optimal health. Objective is to study the effects of 6 months of treatment with Tibolone, as hormone replacement therapy (HRT) on BMI (body mass index), serum calcium and 25-hydroxy vitamin D3 levels, Health related quality of life (HRQOL) in postmenopausal (surgically) women and the relationship between different studied parameters.
DESIGN: Prospective interventional study.
MATERIALS AND METHODS: Study was done in Kolkata, India be-tween July, 2012 and March, 2013. Informed written consent and Ethical approval were obtained. A sample size of 37 patients was found to have 80% power at 5% level of significance to detect a difference of 2.5ng/ml in vitamin D3 level with SD (standard deviation) 6 and a difference of 2 points in MRS score (SD 5). 40 patients after surgical menopause with dis-tressing menopausal symptoms were treated with Tab. Tibolone (2.5mg daily) for 6 months. Parameters studied in each case at baseline and after 6 months were- BMI (kg/M2), serum calcium (mg %) and 25 hydroxy vitamin D3 (ng/ml) levels.Each woman scored herself the Menopause Rating Scale (MRS) at the two points of study to assess HRQOL.
