LB groups (n¼3 studies).
Means of progesterone level were significantly U1203, CHU Montpellier, St-Eloi Hospital, Montpellier, France; 2American
lower in no OP and no LB groups than in OP and LB groups [difference
in means 68.8 (95% CI 45.6-92.0) and 272.4 (95% CI 10.8-533.9), ng/
ml, respectively].
CONCLUSIONS: Low luteal progesterone concentrations are related to
lower OP and LB rates in cycles with absence of CL or iatrogenically induced
luteal phase defect suggesting that standard luteal support might not be effec-
tive for optimizing outcomes in ART. These results support the requirement
of luteal serum progesterone level monitoring in order to individualize pro-
gesterone administration.
P-558 4:30 PM Monday, October 19, 2020
THE EFFECT OF GROWTH HORMONE ON CLINICAL
OUTCOMES OF POOR OVARIAN RESPONDER UN-
DERGOING IN VITRO FERTILIZATION/INTRACYTO-
PLASMIC SPERM INJECTION TREATMENT: A
RETROSPECTIVE STUDY BASED ON POSEIDON
CRITERIA. Xing Yang, Ph.D.,1 Mei-hong Cai Master,2 1The Sixth Affil-
iated Hospital of Sun Yat-sen University, Guangzhou, China; 2Guangzhou
First People’s Hospital, School of Medicine, South China University of Tech-
nology, Guangzhou, China.
OBJECTIVE: Poor ovarian responder (POR) had been dramatically
increased among patients require assisted reproductive technology. The ef-
fect of growth hormone (GH) adjuvant in POR had been widely discussed.
The novel POSEIDON criteria could better differentiate patients with minor
heterogeneity[1]. The aim of this retrospective analysis is to explore whether
GH treatment is beneficial for POR patients undertaken in vitro fertilization/
intracytoplasmic sperm injection (IVF/ICSI) treatment.
DESIGN: Retrospective cohort study.
MATERIALS AND METHODS: POR meet the POSEIDON criteria were
recruited and stratified into the 4 subgroups according to ovarian reserve and
patients age [1]. Patients in each subgroup were further divided into GH adju-
vant group (GH+ group) and the counterpart without GH pretreatment (GH-
group). One-to-one case-control matching was performed to adjust essential
confounding factors between GH+ group and GH- group in two layers,
normal ovarian reserve and poor oavarian reserve. Conventional ovarian
stimulation protocols were applied for IVF/ICSI treatment. The demographic
data, cycle characteristic and clinical outcomes between GH+ group and GH-
group in each subgroup were compared separately.
RESULTS: A total of 1104 patients were included in this study, among
which 428 with normal ovarian reserve and 676 with poor ovarian reserve.
GH adjuvant showed a beneficial effect on the ovarian response and live birth
rate in poor ovarian reserve subgroups (PG3 and PG4). The further stratifica-
tion revealed that in the PG4, the number of good-quality embryos were
significantly increased in the GH+ group than in the GH- group
(1.581.71 vs. 1.251.55, P ¼0.032), the miscarriage rate (6.7% vs.
13.8%, P¼0.173) and live birth rate (29.89% vs. 17.65%, P ¼0.028) were
also greatly improved, these effects failed to been detected in patients with
normal ovarian reserve(PG1,PG2) or in poor ovarian responder younger
than 35 (PG3).
CONCLUSIONS: In conclusion, GH pretreatment is beneficial for pro-
moting ovarian response and live birth rate, further decreasing miscarriage
rate in poor ovarian reserve patients older than 35 (PG4).
References: [1] Alviggi C M D P, Andersen C Y D M, Buehler K M D, et
al. A new more detailed stratification of low responders to ovarian stimula-
tion: from a poor ovarian response to a low prognosis concept[J]. Fertility
and Sterility,2016,105(6):1452-1453.
P-559 4:30 PM Monday, October 19, 2020
IMPROVEMENT OF PREGNANCY OUTCOME BY
TARGETING A CUSTOMIZED TIMING OF FROZEN
EMBRYO TRANSFER IN PATIENTS FOR DONOR
EGG RECIPIENTS. Delphine Haouzi, PhD,1
Frida Entezami, MD,2 Charlotte Mauries, MD,1 Alice Ferrieres-Hoa,
MD,1 Anna Gala, MD,3 Emmanuelle Vintejoux, MD,3 Cecile Brunet,
MD,3 Claire Vincens, MD,4 Sophie Bringer-Deutsch, MD,3
Sophie Brouillet, PharmD, PhD,3 Samir Hamamah, MD, PhD,3 1Inserm
FERTILITY & STERILITYÒ
Hospital of Paris, Neuilly sur Seine, France; 3Arnaud de Villeneuve Hospital,
CHU Montpellier, Montpellier, France; 4ART-PGD department, Arnaud de
Villeneuve Hospital, CHU Montpellier, Montpellier, France.
OBJECTIVE: The aim of this study was to optimize pregnancy outcome
using customized embryo transfer according to the evaluation of endometrial
receptivity of patients included in eggs donation program.
DESIGN: Endometrial biopsies are performed during the implantation
windows 5-9 days after progesterone administration under hormone replace-
ment therapy. Then, the transfer strategy consists in performing cET of blas-
tocysts according the endometrium receptivity day identified using the Win-
Test. Therefore, frozen day 2/3 embryos were transferred 72/48 hours before
this specific receptivity day, respectively. When the endometrial sample was
defined as non-receptive, a second evaluation was performed later, according
to transcriptomic result.
MATERIALS AND METHODS: 45 patients in eggs-donation program
due to an advanced age (n¼36) or premature ovarian failure (n¼9) were
included. RNAs from biopsies were extracted and the Win-Test gene expres-
sion was assessed by qRT-PCR. Positive pregnancy test was defined as at
least two consecutive positive b-hCG serum concentration. Clinical preg-
nancy, implantation rate and live birth rate were recorded after cET according
to the transcriptomic results.
RESULTS: Analyses of endometrial receptivity status (n¼108 biopsies) in
patients in oocyte donation program (age mean  SD: 41.2  3.8 years) re-
vealed a strong inter-patient variability of the moment of the opening of the
receptivity window within the implantation window. Majority of patients
(84%) present a delay of their receptivity window compared to the classical
timing for blastocyst transfer (16% at Pg+5/Pg+6). This delay was mainly be-
tween 1 (40%) to 2 days (33%), or more (11%). Then, a cET can to be
perform during a subsequent cycle according the endometrium receptivity
day and in the respect of the synchronization of the fœto-maternal dialogue.
Using this strategy, the positive b-hCG and clinical pregnancy rate per patient
were 73.3% and 60%, respectively. The implantation and live birth rates after
cET were 50% and 48.9%, respectively.
CONCLUSIONS: This finding demonstrated that customized embryo
transfer according to the specific cycle day where endometrium is receptive
improves both implantation rate and live birth rate in patients in oocyte dona-
tion program.
SUPPORT: This work was partially supported by a grant from the Gedeon
Richter Pharmaceutical Company.
P-560 4:30 PM Monday, October 19, 2020
ESTABLISHING THE FOLLITROPIN DELTA DOSE
PROVIDING COMPARABLE OVARIAN RESPONSE AS
150 IU/DAY FOLLITROPIN ALFA FOR CONTROLLED
OVARIAN STIMULATION. Joan-Carles Arce, MD, PhD,
Per Larsson, PhD, Ferring Pharmaceuticals, Copenhagen, Denmark.
OBJECTIVE: To determine the daily follitropin delta dose (mg) providing
similar ovarian response as 150 IU/day follitropin alfa.
DESIGN: Post-hoc analysis of ovarian response in 1,591 IVF/ICSI pa-
tients undergoing controlled ovarian stimulation in two randomized,
assessor-blind, controlled, multi-center trials in the development program
for follitropin delta (NCT01426386; NCT01956110). Ovarian response
was evaluated in terms of number of oocytes retrieved as well as number
of follicles by size and hormone response.
MATERIALS AND METHODS: The phase 2 dose-response trial included
265 IVF/ICSI patients who were randomized to receive a daily dose in the
range 5.2-12.1 mg of follitropin delta (Rekovelle, Ferring Pharmaceuticals)
or 150 IU (11 mg) of follitropin alfa (Gonal-F, Merck Serono) with no dose
adjustments of either follitropin during stimulation. The phase 3 efficacy trial
included 1,326 IVF/ICSI patients who were randomized to an individualized
follitropin delta dose (determined for each woman based on her serum AMH
level and body weight) that was fixed throughout stimulation or to a starting
dose of 150 IU (11 mg) follitropin alfa for the first five days followed by po-
tential dose adjustments as per the investigator’s judgement. Dose-response
relationships for follitropin delta dose and ovarian response parameters were
approximated by log-linear functions. For the phase 3 trial, follitropin delta
was compared to follitropin alfa by stratifying follitropin alfa patients
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