depending on the number of oocytes retrieved. The enhanced cryopreser-vation with increasing oocyte number may improve efficiency of the donorcycle.

P-103

Transferring 2 or 3 embryos in women 35 to 37 years old: Influence ofembryo quality and number of previous cycles on pregnancy andmultiple pregnancy rates. David Schmidt, John Nulsen, ClaudioBenadiva, Linda Siano, Donald Maier. Univ of Connecticut Health Ctr,Farmington, CT.

Objective: Evaluate factors useful in determining whether to transfer 2 or3 embryos in women aged 35 to 37.

Design: Retrospective case review.Materials and Methods: Chart review of women aged 35 to 37 undergoing

IVF/ET with fresh embryos at the University of Connecticut Health Centerin 2002. Cycles were evaluated for the number of embryos transferred, thenumber of good embryos transferred (defined as 6 or more cells with grade1, 2 or 3), and the number of previous unsuccessful embryo transfers.Pregnancy was defined as the presence of a fetal heart beat. Chi squaretesting was used for analysis.

Results: The number of fresh embryos to transfer depends on the patient’sage. The goal is to achieve a high pregnancy rate and a low multiple birthrate. In our program in 2002, women aged 35 to 37 had either 2 or 3embryos transferred. We analysed our data to determine factors influencingpregnancy and multiple pregnancy rates. These rates depended on thenumber and quality of embryos transferred, and not on the number ofprevious failed cycles. Optimal pregnancy rates were achieved with thetransfer of two good embryos. Addition of a third good embryo resulted ina high rate of triplet pregnancies without increasing the overall pregnancyrate. Transfer of a third embryo that was not of good quality had no effecton pregnancy rates. When there were no good quality embryos, only transferof 3 embryos resulted in a pregnancy.

The number of previous failed cycles had no effect on the pregnancy rate.The majority of triplet pregnancies occurred in patients who had failed intwo or more previous attempts.

Conclusion: Embryo quality and number, but not number of previousfailed cycles, were important in determining outcome. Couples should nothave extra embryos transferred solely because of previous IVF failures.

P-104

Is that any value in treating women with elevated basal follicularstimulating hormone? Meen-Yau Thum, Hossam Abdalla, Marie Wren,Tunde Ogunyemi, Raef Faris, Amin Gafar. Lister Fertility Clin, London,United Kingdom.

Objective: To evaluate the value of treating women with high basalfollicular stimulating hormone.

Designs: Descriptive cohort study to evaluate 3,401 IVF/ICSI-ET cycles,in which gonadotrophin levels were known, from January 1997 to Decem-ber 2001. Data was collected prospectively and analysed retrospectively.

Materials and Methods: Blood samples were collected day 2 to day 4 ofthe menstrual cycle to measure basal FSH levels prior to treatment cycle.IVF/ICSI treatment was then commenced using a combination of a LHRHanalogue or Cetrotide and gonadotrophin injection. All cases were dividedinto four cohorts according to FSH levels. Group A: FSH less then 10IU/ml, group B: 10.1 to 15 IU/ml, group C: 15.1 to 20 IU/ml, group D: FSHabove 20 IU/ml.

Results:

a Values are mean � SD, not significant statisticallyb Significant statistical comparison using Chi-square Cross Tabulation

test with P�0.001c Mean no. of fertilised oocytes/Mean no. of oocytes collected x 100d Not significant statisticallye Significant statistical comparison using ANOVA test with P�0.001f Mean of average amount of gonadotrophin used for stimulation

Conclusion: Although there is a reduction in pregnancy and live birth rateassociated with higher levels of basal FSH, it is clear that in women stillhaving a cycling menstrual period, high basal FSH is not a contraindicationto IVF treatment. Even with markedly elevated basal FSH, greater than 10IU/L, in cycling women a respectable pregnancy and live birth rate can beachieved. Clinics refusing to treat women with basal FSH above 10 IU/L,are denying these women a reasonable chance of achieving a pregnancywith their own genetic child. Women with high basal FSH levels should becounselled according to their individual circumstances and allowed to makean informed choice about proceeding with treatment. Alternatives to fertilitytreatments (ovum donation, adoption or no treatment) should not be con-sidered as first choices and clinics should not be using basal FSH as ascreening tool to cherry pick patients for treatment to increase their clinicalsuccess rate. Women should not simply be refused treatment as a blanketpolicy.

P-105

The influence of body mass index on in vitro fertilization treatmentoutcome, risk of miscarriage, and pregnancy outcome. Meen-YauThum, Amin Gafar, Raef Faris, Marie Wren, Tunde Ogunyemi, HossamAbdalla. Lister Fertility Clin, London, United Kingdom.

Objective: To evaluate the effects of extreme body mass index on assistedreproductive treatment cycle outcome and pregnancy outcome.

Designs: Descriptive cohort study to evaluation of 6,123 consecutiveIVF/ICSI-ET cycles from August 1997 to December 2001 in a inner Londonmajor fertility clinic.

FERTILITY & STERILITY� S155