SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 179A

Scientific Abstracts

T-209
Thyroid Stimulating Hormone (TSH) and Human Corpus Luteum: A
Possible Contribution to Reproductive Process. Elisa Scarinci†, Anna
Tropea*, Maria Chiara Marra†, Ornella Alesiani*, Calogero Messana†,
Giovanna Notaristefano†, Simone Michele Fabozzi†, Antonio Lanzone*,
Rosanna Apa*. Agostino Gemelli University Policlinic, Rome, Italy.
INTRODUCTION: The synthesis of thyroid hormones occurs in the
thyroid gland and depends on the binding of the thyroid stimulating
hormone (TSH) to its receptor (TSHr). Immunoistochemical and research
studies conducted on gene trascripts revealed the presence of THSr in
different mammalian extrathyroidal tissues. In particular, the findings of
TSH and thyroglobulin receptors in the bovine luteal cells and of free
fractions of thyroid hormones in bovine ovarian follicular fluid suggest
the intringuing hypothesis that an ovarian synthesis of thyroid hormones
may occur. The relationship between thyroid hormones and reproduction
has been also postulated after experimental findings indicating that
adequate circulating level of thyroid hormone is needed to support corpus
luteum formation and pregnancy. Indeed, hypothyroidism is significantly
associated with recurrent pregnancy loss in the first trimester in humans
and it interferes with the formation and function of corpus luteum. Other
data in literature demonstrated that TSH is able to influence porcine
luteal cell steroidogenesis. To further examine the potential regulatory
role of thyroid hormones in human luteal function, in the present study
we investigated whether TSH could affect progesterone (P4) release
by human luteal cells and the balance between luteotropic (Vascular
EndothelialGrowth Factor-VEGF-, prostaglandin (PG) E2) and luteolytic
factors (PGF2a). The presence of TSHr in human corpus luteum (CL) has
been also investigated.
METHODS: To this aim CL were obtained from normally menstruating
patients (aged 25-38 years) at the time of surgery for nonendocrine
gynecological diseases. Human luteal cellswere incubated for 24h with
medium alone (control) or in presence of increasing concentrations of
TSH (from physiological to suvraphysiological) or hCG (100 ng/ml) or
CoCl2 (10 mcM), chemical hypoxia. In the culture medium P4, PGs,
and VEGF release was assayed by ELISA. Immunoistochemistry was
performed in 4 corpora lutea.
RESULTS: Our preliminar results demonstrated the presence of TSH-R in
human corpora lutea. In addition physiological concentrations of TSH were
able to increase P4 and VEGF releases, meanwhile supraphysiological
concentrations to reduce them. No effect was observed on PGs secretion.
CONCLUSION: This suggests the ability of TSH in regulating luteal
function and its direct regulatory role in corpus luteum integrity. These
results straighten, in addition, the hypothesis that thyroid hormones
are important factors in supporting corpus luteum function and for the
initiation and maintenance of initial pregnancy.

T-210
Luteal Support in Obese Women Undergoing Fresh IVF. Jacqueline
Lee†, Christina Boots*. Northwestern University, Chicago, IL, United
States.
INTRODUCTION: To determine if live birth outcomes vary among
overweight and obese women undergoing fresh IVF cycles receiving
either vaginal or intramuscular progesterone supplementation.
METHODS: This is retrospective cohort study in an academic fertility
program. All fresh IVF cycles from 2012-2016 were analyzed. Women
with BMI ≥25kg/m2 and data describing luteal support dose and mode
of administration were included. Primary outcome was live birth.
Multinomial logistic regression analysis was performed using SPSS.
RESULTS: Of the 1,812 women analyzed, 31.2% were overweight or
obese. In the final analysis, 491 women were overweight or obese and
had complete data. There was no difference in live birth rate among

179A

women receiving vaginal progesterone only (33.5%, n=131) compared
to women receiving intramuscular progesterone only (35.1%, n=27) or
compared to women receiving both modes of luteal support (38.9%, n=7).
There were also no differences among miscarriage rates. A sub-analysis
of obese women only (BMI ≥ 30kg/m2) produced similar results. Using
multinomial logistic regression, only age at start of the cycle and number
of oocytes retrieved predicted live birth (p< 0.05).
CONCLUSION: Obese and overweight women have worse reproductive
outcomes, however, a clear etiology explaining this disparity has yet to
be elucidated. Impairments in hypothalamic-pituitary pulsatility and
dysfunctional steroidogenesis in the corpus luteum have both been
demonstrated in the obese population. In addition, hormonal contraceptive
dose and mode of administration have been shown to impact effectiveness
in obese women. Therefore, one could hypothesize that self-administration
of intramuscular injections in women with increased body fat could yield
lower bioavailability of progesterone. Unfortunately, no studies have
compared the efficacy of the different formulations for progesterone
supplementation in the obese population.
Our data suggests that there is no difference in live birth rates among
overweight and obese women taking either progesterone intramuscularly
or vaginally. Although retrospective data of a limited sample size should
be interpreted with caution, this study is the first and largest of its kind
and should encourage larger randomized trials to further investigate the
effects of BMI on effectiveness of luteal support. Until these studies are
published, providers may continue to use their supplementation of choice.

T-211
Correlation between Morphologic Grading and Euploidy Rate of
Preimplantation Genetic Screening, and Comparison of Pregnancy
Rates in Young and Old Ages by PGS in Blastocyst Stages. Hee Jun
Lee,1 Woo-ho Kim,2 Woo Sik Lee.1 1Fertility Center of CHA Gangnam
Medical Center, CHA University, Seoul, Korea, Republic of; 2Fertility
Center of Seoul Women's Hospital, Daejeon, Korea, Republic of.
INTRODUCTION: To investigate the correlation between morphologic
grading and euploidy rate of preimpantation genetic screening and
compare the pregnancy rates in young and old ages by PGS in blastocyst
stages during IVF treatments.
METHODS: This study is a retrospective study and was performed using
the medical records of patients who underwent IVF procedures with PGS
between January, 2016 and February, 2017 in Fertility Center of CHA
Gangnam Medical Center. The embryo grades were categorized into 4
groups: Excellent (E; Expanded AA, Hatching AA, Hatched AA), Good
(G; Early AA, Mid AA, Expanded AB, BA, Hatching AB, BA, Hatched
AB, BA), Average (A; Early AB, BA, Mid AB, AC, BA, BB, Expanded
AC, BB, CA, Hatching AC, BB, CA, Hatched AC, BB, CA), and Poor
(P; Early AC, BB, BC, CA, CB, CC, Mid BC, CA, CB, CC, Expanded B
C, CB, CC, Hatching BC, CB, CC, Hatched BC, CB, CC).
RESULTS: Total of 138 IVF cycles which contain 446 blastocysts were
included: ET after PGS were done in 84 cycles, and others, 54 cycles
after PGS were not transferred because of all-freezing state in Table 1.
Among the total 446 blastocysts, there were 154 euploid blastocysts that
were analyzed by PGS (34.53%) in Table 1. The euploidy rates were as
follows: E (47.82%), G (41.55%), A (30.26%), and P (29.46%) in Fig 1.
There was significant difference between E and P group (P<0.01). When
the four groups were recategorized into two groups (E & G vs. A & P),
they also showed significant difference in euploidy rates (P<0.01) in Fig
1. The clinical pregnancy (CP) rate among the 84 cycles that had embryos
transferred was 46.43% in Table 1. When the 84 cycles were divided
into two groups by age 35, the CP rate for those under 35 was 44.74%
and 47.83% for those over 35 years old, which showed no significant
difference in Table 2
CONCLUSION: The significant differences among the euploidy rates
of different morphologic embryo grades, such as E, G, A and P groups
demonstrated the positive correlations between the morphologic grading
of the embryo and the euploidy rate of PGS; the greater the morphologic
embryo grade, the greater the euploidy rates are. Additionally, there was

Thursday Posters

retrievals for IVF, but it does not include embryo freezing or storage
fees. Whether or not these policies are deterring women from freezing
their excess embryos and from returning for additional IVF treatment
warrants further investigation. This is an important consideration for
insurance policy as modern protocols for embryo freezing and frozen
embryo transfer offer excellent pregnancy rates.

Reproductive Sciences Vol. 25, Supplement 1, March 2018
Table of Contents for the Digital Edition of SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018
