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VOLUME 29, SUPP 1 2014 ABSTRACT BOOK ESHRE 2014 – MUNICH, GERMANY – 29 JUNE TO 2 JULY

human reproduction

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Abstracts of the 30th Annual Meeting of the European Society of Human Reproduction and Embryology

Munich Germany 29 June to 2 July 2014

Abstracts 30th Annual Meeting of the European Society of Human Reproduction and Embryology Munich, Germany 29 June to 2 July 2014 Print copies of the meeting abstracts are provided for Conference Delegates only. However, the abstracts are available on-line to all Human Reproduction/Update/Molecular Human Reproduction subscribers and are also freely available to all visitors to the following website www.humrep.oxfordjournals.org, and on the ESHRE website: www.eshre.eu

Copyright Notice: All abstracts together with the programme, for presentation during the 30th Annual Meeting of ESHRE are copyright of ESHRE. These abstracts [or parts thereof] may not be reproduced, stored, printed or transmitted in any form, or by any means, electronic, mechanical, photocopied, recording, or otherwise without written permission of ESHRE and the author of the abstract. Note to the media: all abstracts are strictly embargoed until the time and date of presentation at the conference. The opinions or views expressed in this abstracts supplement are those of the authors and do not necessarily reflect the opinions or recommendations of ESHRE. The abstracts have been reviewed by the Congress Scientific Committee and revised accordingly by the authors. The selection of abstracts is based on the scores given by an international panel of peer reviewers. Dosages, indications and methods of use for products that are referred to in the abstracts by the authors are not necessarily appropriate for clinical use and may reflect the clinical experience of the authors or may be derived from the professional literature of other clinical sources. Because of differences between in-vitro and in-vivo systems and between laboratory animal models and clinical data in humans, in-vitro and animal data may not necessarily correlate with clinical results. The investigators of these abstracts have stated in their submission letter that prospective studies where patients are involved have institutional Ethics Committee approval and informed patient consent, and that the studies using experimental animals have institutional approval. The Publishers have endeavoured to reproduce faithfully all of the abstracts as accepted by the Conference Organisers, but can accept no responsibility for inaccuracies or omissions caused by the late receipt of abstracts.

EUROPEAN SOCIETY OF HUMAN REPRODUCTION AND EMBRYOLOGY (ESHRE) COMMITTEES

Executive Committee (2013 – 2015) Chairman Juha Tapanainen (Finland) Chairman Elect Kersti Lundin (Sweden) Members Carlos Calhaz-Jorge (Portugal) Jacques De Mouzon (France) Petra De Sutter (Belgium) Roy Farquharson (United Kingdom) Anis Feki (Switzerland) Georg Griesinger (Germany) Grigoris Grimbizis (Greece) Cornelis Lambalk (The Netherlands) Cristina Magli (Italy) Tatjana Motrenko Simic (Montenegro) Andres Salumets (Estonia) Immediate Past Chairman Anna Veiga (Spain) Coordinator SIG’s Timur Gürgan (Turkey) Paramedical Board Chairman Helle Bendtsen (Denmark) Past-Chairman Jolieneke Schoonenberg-Pomper (the Netherlands) Members Eline Dancet (Belgium) Yves Guns (Belgium) Inge Rose Jorgensen (Denmark) Helen Kendrew (United Kingdom) Uschi Van den Broeck (Belgium) Leonie Van Den Hoven (The Netherlands) Cecilia Westin (Sweden) Central Office Christine Bauquis

Veerle De Rijbel Veerle Goossens Karen Maris Catherine Plas Erika Mar Rodriguez Raes Heidi Roijemans Bruno Van den Eede Titia Van Roy Ine Van Wassenhove Nathalie Vermeulen Committee of National ­Representatives (2011 – 2014) Vasco Almeida (Portugal) Birol Aydin (Macedonia) Basak Balaban (Turkey) Anette Bergh (Norway) Zeev Blumenfeld (Israel) Pierre Boyer (France) Giovanni Coticchio (Italy) Gabriel De Candolle (Switzerland) Alfonso L. De La Fuente (Spain) José Joaquim Domingues Nunes (Portugal) Jeremy Don (Israel) Bogdan Doroftei (Romania) Thomas Ebner (Austria) Geraldine Emerson (Ireland) Gregoris Grimbizis (Greece) Maurizio Guido (Italy) Bjorn Heindryckx (Belgium) Christina Hnida (Denmark) José Antonio Horcajadas Almansa (Spain) Julius Hreinsson (Sweden) Katalin Kanyo (Hungary) Borut Kovacic (Slovenia) Péter Kovács (Hungary) Markus S. Kupka (Germany) Rafal Kurzawa (Poland) Kalliopi Loutradi (Greece) Sirpa Makinen (Finland) Alice Malenovska (Czech Republic) Tania Milachich (Bulgaria) Laure C. Morin - Papunen (Finland) Milan Mrazek (Czech Republic)

Andreea Sandra Mustata (Romania) Lyubov Mykhaylyshyn (Ukraine) Nan Brigitte Oldereid (Norway) Julia Paget (United Kingdom) Michael Pelekanos (Cyprus) Manuel Pensis (Switzerland) Zoranco Petanovski (Macedonia) Ireneusz Polac (Poland) Nebojsa Radunovic (Serbia) Catherine Rongieres (France) Pia Saldeen (Sweden) Ertan Saridogan (United Kingdom) Kirsten Louise Tryde Schmidt (Denmark) Jesper M.J. Smeenk (The Netherlands) Anna Smirnova (Russia C.I.S.) Patrik Stanic (Croatia) Nada Tabs (Serbia) Tania Nikolova Timeva (Bulgaria) Krinos M. Trokoudes (Cyprus) Bulent Urman (Turkey) Aafke Van Montfoort (The Netherlands) Frank Vandekerckhove (Belgium) Peter H. Vogt (Germany) Hrvoje Vrcic (Croatia) Eda Vrtacnik-Bokal (Slovenia) Anthony Walsh (Ireland (Rep.)) Ludwig Wildt (Austria) Sergey Yakovenko (Russia C.I.S.) International Scientific Committee Chris Barratt (United Kingdom) Helle Bendtsen (Denmark) Maria Jose De Los Santos (Spain) Gerard A.J. Dunselman (The Netherlands) Ursula Eichenlaub-Ritter (Germany) Johannes Evers (The Netherlands) Luca Gianaroli (Italy) Mariette Goddijn (The Netherlands) Timur Gürgan (Turkey) Efstratios Kolibianakis (Greece) Markus S. Kupka (Germany) Tin-Chiu Li (United Kingdom) Kersti Lundin (Sweden) Edgar Vasile Mocanu (Ireland) Willianne Nelen (The Netherlands)

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Willem Ombelet (Belgium) Guido Pennings (Belgium) Felice Petraglia (Italy) Helen M. Picton (United Kingdom) Veerle Provoost (Belgium) Stefan Schlatt (Germany) Augusto Enrico Semprini (Italy) Johan E.J. Smitz (Belgium) Juha S. Tapanainen (Finland) Uschi Van den Broeck (Belgium) Bruno Van den Eede (Belgium) Rita Vassena (Spain) Anna Veiga (Spain) National Committee Monika Bals-Pratsch Hermann M. Behre Hennig Beier Verona Blumenauer Klaus Buehler Ralf Dittrich

Richardo Felberbaum Georg Griesinger Jörg Gromoll Thomas Haaf U. Hilland Jens Hirchenhain Bernhard Horsthemke Karin Hübner Evgenia Isachenko Heribert Kentenich Ludwig Kiesel Susanne Kliesch Frank M. Köhn Jan-S Krüssel Michael Ludwig Artur Mayerhofer Lilo Mettler Markus Montag Verena Nordhoff Thomas Rabe Hans Schöler Stefan Schlatt

Andreas Schmutzler Ulrich Schneider Katarina Spanel-Borowski Thomas Strowitski Hans Tinneberg Bettina Toth Hans van der Ven Peter H. Vogt Victoria Von Schönfeld Lisa Wiesmüller Peter Wieacker Elke Winterhager Ulrich Zechner Local Committee Tina Bucholz Klaus Diedrich Ursula Eichenlaub-Ritter Karl Friese (Chair) Markus Kupka Christian Thaler

Every effort has been made to faithfully reproduce the abstracts as submitted. However, no responsibility is assumed by the organisers for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Because of the rapid advances in the medical sciences, we recommend that independent verification of diagnoses and drug dosages should be made.

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human human human human reproducti on human reproducti on reproduction reproduction reproduction Editor-in-Chief J. L. H. Evers Editor-in-Chief Deputy Editors A. Van Steirteghem

E. Somigliana Editor-in-Chief Editor-in-Chief Deputy Editors Editor-in-Chief R. Sharpe A.Van Steirteghem A.Van Steirteghem E. Somigliana A.Van Steirteghem Associate Editors J. L. H. Evers DeputyDeputy Editors Editors Deputy Editors R. Sharpe A Ferlin, Italy P.G.Crosignani L Pal, USA P.G.Crosignani P.G.Crosignani J Fuglsang, Denmark S Palomba, Italy J.L.H.Evers Associate Editors J.L.H.Evers S Gameiro, UK A Palumbo, Spain J.L.H.Evers R.Sharpe M Gauster, Austria C Petry, UK A. Palumbo, Spain R.Sharpe G. Harton, USA R.Sharpe



T Adriaenssens, Belgium S Sunkara, UK Chrisi Amorim, Belgium J G Thompson, Australia C Y Andersen, Denmark A Tiitinen, Finland A-M Andersson,R.Denmark G Toft, Denmark Abir, Israel B Ata, Turkey C. Y. Andersen, Denmark K Gemzell-Danielsson, Portugal K Toulis, Greece E. Harville, USA J Ramalho-Santos, C. Petry, UK Associate EditorsEditors Associate Associate Editors M Bedaiwy, Canada Sweden P Ray, FranceC. Plancha, Portugal K Tremellen, Australia A.-M. Andersson, Denmark E. Hauzman, Hungary C.Petry, UK E.Hauzman, Hungary C.Y.Andersen, A. Balen,C.Y.Andersen, UK Denmark E. Hughes, Canada S. Publicover, UK C.Petry, UK B Urman, Turkey E.Hauzman, Hungary R Behr, Germany M Denmark Goddijn, Netherlands A Romano, Netherlands C.Petry, UK C.Plancha, Portugal E.Hauzman, Hungary C.Y.Andersen, A.Balen, Denmark UK E.Hughes, Canada C.Plancha, E.Hughes, Canada A.Balen, UKM Götte, Germany F. Belva, Belgium L. Hull, Australia C. Racowsky, USA Portugal Z Van der Spuy, Republic of F Belva, Belgium L Rombauts, Australia C.Plancha, Portugal E.Hughes, Canada A.Balen, UK O.Basso, USA S.Publicover, UK L.Hull, Australia S.Publicover, UK L.Hull,France Australia O.Basso, USA Sweden P. Jouannet, P. Ray, France South Africa D O.Basso, Bodri, Hungary R Gruemmer, Germany G Sacks, Australia S.Publicover, UK L.Hull, Australia USA L.Bjorndahl, C.Racowsky, USA B.Huppertz, Austria F.Belva, Belgium C.Racowsky, USA B.Huppertz, Austria F.Belva, Belgium C.Racowsky, USA Austria D. Bodri, Hungary L. Kumar, Sweden P. Scriven, UK Belgium G F.Belva, Buck Louis, USA DSweden Hapangama, UK H Schatten, USA L.Rienzi, Italy P.M.W.Janssens, Netherlands L.Bjorndahl, SwedenB.Huppertz, L.Rienzi, ItalyL Van Landuyt, Belgium P.M.W.Janssens, Netherlands L.Bjorndahl, L.Rienzi, Italy P.M.W.Janssens, Netherlands Sweden O. B Christiansen, Denmark S.Netherlands Laird, UK K. Sermon, Belgium K.Sermon, J.Johnson, USA O.B.Christiansen, Denmark Belgium C Verhaak, Netherlands O L.Bjorndahl, Bukulmez, USA F Helmerhorst, P Scriven, UK K.Sermon, J.Johnson, USA O.B.Christiansen, Denmark Belgium K.Sermon, Belgium J.Johnson, USAP.Jouannet, O.B.Christiansen, Denmark C. De Geyter, Switzerland S. Langlois, Canada A. N. Shelling, Zealand France P.De Boer, Netherlands A.Shelling, New New Zealand P.Jouannet, France P.De Boer, Netherlands A.Shelling, New W Zealand Verpoest, Belgium G P.De Coticchio, Italy A Kamischke, Germany J Shaw, Australia P.Jouannet, France Boer, Netherlands A.Shelling, New Zealand L.Kumar, Sweden C.De Geyter, Switzerland Y.Shu, L.Kumar, Sweden C.De Geyter,ASwitzerland Y.Shu, USA J Visser, Netherlands L. Dessolle, France J. Laven, Netherlands Y. Shu,USA USA J den Hartog, Ludwig, Germany W-Y Son, Canada L.Kumar, Sweden C.De Geyter,Netherlands Switzerland Y.Shu, USA S.Laird, UK A.De Belgium J-P.Siffroi, France S.Laird, UK A.De Vos, Belgium J-P.Siffroi, A. DeVos, Vos, Belgium R.S. Legro, USA E. Somigliana, ItalyFrance S.Laird, UK Belgium A.De Vos,France Belgium France TItaly Wischmann, Germany L Dessolle, ENetherlands Marbaix, B Sonntag, Germany S.Langlois, Canada J-P.Siffroi, W.Dondorp, Netherlands E.Somigliana, Italy S.Langlois, Canada W.Dondorp, E.Somigliana, P. Devroey, Belgium G.B. Louis, USA C. Spits, Belgium S.Langlois, Canada W.Dondorp, Netherlands E.Somigliana, Italy Wise, USA C Diaz-Garcia, Sweden S UK Matsuzaki,J.Laven, France Netherlands C Spits, Belgium M.El Toukhy, M.Stephenson, USA LUSA J.Laven, Netherlands M.El UK Toukhy, M.Stephenson, J.Laven, Netherlands M.El Toukhy, UK M.Stephenson, A.Strandell, USA W. Dondorp, Netherlands M.Ludwig, M. Stephenson, USASweden R.S.Legro, USAGermany H.F.Escobar-Morreale, Sweden R.S.Legro, USA H.F.Escobar-Morreale, Spain A.Strandell, F Dominguez, Spain BSpain McKinnon, Switzerland E Stener-Victorin, Sweden R.S.Legro, USA H.F.Escobar-Morreale, Spain A.Strandell, Sweden J.E.Fragouli, Ehmcke, Germany F. MacCallum, UKGermany A. Strandell, Sweden M.Ludwig, Germany UK Japan M.Ludwig, E.Fragouli, UK Japan J Drevet, France A Meinhardt, Germany H Stern, Japan USAN.Sugino,N.Sugino, M.Ludwig, Germany E.Fragouli, UKM. N.Sugino, F.MacCallum, UK M.Fritz, USA R.Sullivan, Canada El Toukhy, UKUSA E. Marbaix, Belgium N. Sugino, Japan Canada F.MacCallum, UK M.Fritz, R.Sullivan, J Ehmcke, Germany H Mertes, Belgium I Sundstrom-Poromaa, Sweden F.MacCallum, UK M.Fritz, USA R.Sullivan, Canada S.Missmer, USA USA K.Gemzell-Danielsson, Sweden A.Sutcliffe, UK S.Missmer, USA K.Gemzell-Danielsson, Sweden A.Sutcliffe, H. F. Escobar-Morreale, Spain USA M. McGowan, R. Sullivan, CanadaUK S.Missmer, Sweden A.Sutcliffe, UKB.Tarlatzis, H K.Gemzell-Danielsson, Falconer, Sweden A Nap, Netherlands G.Montgomery, Australia D.Goulis, Greece Greece Greece G.Montgomery, Australia A. Sutcliffe, B.Tarlatzis, A. Ferlin,D.Goulis, Italy H. Mertes, Belgium UK Greece G.Montgomery, Australia D.Goulis, Greece B.Tarlatzis, Greece Finland FinlandZ.Van derZ.Van G.Griesinger, GermanyGermany L.Morin-Papunen, Spuy,der Republic of L.Morin-Papunen, G.Griesinger, Spuy, Republic of M. Fritz, USA S. Missmer, USA B. Talatzis, Greece L.Morin-Papunen, Finland G.Griesinger, Germany Z.Van der Spuy, Republic of M.Munro, USA Advisory L.Guilbert, Canada Canada Statistical Board South Africa M.Munro, USA L.Guilbert, South Africa M.Munro, USA L.Guilbert, Canada South Africa M. Gauster, AustriaChina G Montgomery, Australia Z. VanLangendonckt, der Spuy, South Africa Belgium Z.P.Nagy, USA S-W.Guo, China A.Van Belgium Z.P.Nagy, USA S-W.Guo, A.Van Langendonckt, Olga Basso (Canada) Z.P.Nagy, Stephen Roberts (UK) Stacey Missmer (USA) Christos Venetis (Greece) USA S-W.Guo, China A.Van Langendonckt, Belgium D. Goulis,K.Hammarberg, Greece Z.P. Nagy, USA P. Vercellini, Italy Greece A.Nap, The Netherlands K.Hammarberg, AustraliaAustralia Greece A.Nap, The Netherlands C.Venetis, C.Venetis, A.Nap, The Netherlands K.Hammarberg,G.Harton, AustraliaUSA C.Venetis, Greece Founding Editor L.M.Nelson, USA P.Vercellini, Italy G. Griesinger, Germany A Nap, Netherlands W. Verpoest, BelgiumItaly L.M.Nelson, USA G.Harton, USA P.Vercellini, L.M.Nelson, USA G.Harton, USA E.Harville, USA P.Vercellini, Italy D.Nogueira, France L.Wilton, Australia D.Nogueira, France E.Harville, USA L.Wilton, Australia R.G. Edwards Guo, China D.Nogueira, V. Nordhoff, Germany L. Wilton, Australia France E.Harville, USAS.-W. L.Wilton, Australia V.Nordhoff, Germany M.HedgerM.Hedger AustraliaAustralia T.Wischmann, GermanyGermany V.Nordhoff, Germany T.Wischmann, K. Hammarberg, Australia L. Pal, USA T. Wischmann, Germany V.Nordhoff, Germany Editor Emeritii M.Hedger Australia T.Wischmann, Germany

EditorD.H. Emeritus Editor Emeritus Barlow Editor Emeritus Editor Emeritus D.H.Barlow D.H.Barlow VanBarlow Steirteghem D.H.Barlow A. D.H.

Managing Editor Managing Editor Managing Editor Managing Editor Managing Editor A.C.Williams (ESHRE Journals)

A.C.Williams (ESHRE Journals) A.C.Williams (ESHRE Journals) A.C. Williams (ESHRE Journals) A.C. Williams (ESHRE Journals)

Assistant Managing Editor Assistant ManagingAssistant Editor Managing Editor

Assistant Managing Editor Assistant Managing Editor K.R.Watkins (ESHRE Journals) K.R.Watkins (ESHRE Journals) K.R.Watkins (ESHRE Journals) KWatkins R Watkins KR Editorial Administrator Editorial Administrator Editorial Administrator Editorial Administrator Editorial Administrator K.E.Parks (ESHRE Journals)Journals) K.E.Parks (ESHRE

K.E.Parks (ESHRE Journals) K.E. Parks K.E. Parks

Editorial Office Office Editorial Editorial Office

Editorial Office Office ESHRE Journals, 5 MillEditorial Yard, Childerley, Cambs, CB23 8BA ESHRE Journals, 5 Mill Yard, Childerley, Cambs, CB23 8BA ESHRE Journals,ESHRE 5ESHRE Mill Yard, Childerley, Cambs, CB23 8BA Journals, 5 Mill Yard, Childerley, Cambs, CB23 Journals, 5 Mill Yard, Childerley, 8BA8BA Tel: þ44Tel: (0)1954 Fax: þ44Fax: (0)1954 E-mail:Cambs, [email protected] þ44 212404; (0)1954 212404; þ44 212359; (0)1954 212359; E-mail:CB23 [email protected] Tel: þ44 (0)1954Tel.: 212404; Fax: þ44 (0)1954 212359; E-mail: [email protected] Tel.: +44 (0)1954 212404, Fax: +44 (0)1954 212359; E-mail: [email protected] +44 (0)1954 212404, Fax: +44 (0)1954 212359; E-mail: [email protected] Published for the Published for Published Published forthe the for the Published foroftheHuman European Society of Human Reproduction and Embryology European Society and Embryology European Society ofReproduction Human Reproduction and Embryology European Society of Human Reproduction and Embryology European Society of Human Reproduction and Embryology by Oxford Press,Press,Press, By Oxford University byUniversity Oxford University By Oxford University Press, by Oxford University Press, Oxford, UK Oxford, UK Oxford, Oxford, UK Oxford, UKUK

The coverThe of Human shows histone in two human germinal vesicle (GV) stage oocytes. upperThe panels show an early-stage cover ofReproduction Human Reproduction showsacetylation histone acetylation in two human germinal vesicle (GV) stage The oocytes. upper panels show an early-stage The cover of Human Reproduction shows histone acetylation in two human germinal vesicle (GV) stage oocytes. The upper panels show an early-stage GV oocyte with a non-surrounding nucleolusnucleolus stained for (A) chromatin (DAPI; blue) andblue) (B) histone (anti-H4K12ac; red). Notered). the regions GV oocyte with a non-surrounding stained for (A) chromatin (DAPI; and (B)acetylation histone acetylation (anti-H4K12ac; Note the regions GV oocyte with a non-surrounding nucleolus stained for (A) chromatin (DAPI; blue) and (B) histone acetylation (anti-H4K12ac; red). Note the regions of intenseofchromatin staining in some areas, whereas show no acetylation (C; overlay). The lowerThe panels, a moreofdeveloped oocyte with a with a intense chromatin staining in some areas, others whereas others show no acetylation (C; overlay). lowerofpanels, a more developed oocyte of intense chromatin staining in some areas, whereas others show no acetylation (C; overlay). The lower panels, of a more developed oocyte with a surrounding nucleus stained chromatin (D) and histone (E), show(E), more condensed chromatinchromatin than in the early-stage oocyte (above), surrounding nucleusfor stained for chromatin (D) andacetylation histone acetylation show more condensed than in the early-stage oocyte (above), surrounding nucleus stained for chromatin (D) and histone acetylation (E), show more condensed chromatin than in the early-stage oocyte (above), although although the oocytethestill has some acetylated chromatinchromatin as shownas inshown E and in overlay For more details van den et al., pp.et1181 oocyte still has some acetylated E and(F). overlay (F). For moreseedetails see Berg van den Berg al., –1190. pp. 1181 –1190. although the oocyte still has some acetylated chromatin as shown in E and overlay (F). For more details see van den Berg et al., pp. 1181 – 1190.

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Contents Oral Presentations

Monday 30 June 2014

O-001-O-002 O-003-O-008 O-009-O-014 O-015-O-020 O-021-O-026 O-027-O-032 O-033-O-038 O-039-O-040    O-041    O-042 O-043-O-044 O-045-O-046 O-047-O-048 O-049-O-052 O-053-O-057 O-058-O-062 O-063-O-067 O-068-O-072 O-073-O-077 O-078-O-082 O-083-O-084 O-085-O-088

Session 01 – Robert G. Edwards’ memorial keynote session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i1 Session 02 – Revisiting embryo culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i1 Session 03 – Recent advances in PCOS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i4 Session 04 – Male infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i7 Session 05 – Managing endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i9 Session 06 – Ovarian reserve and ageing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i12 Session 07 – Developments in genetic analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i15 Session 08 – Fertility preservation and the role of surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i17 Session 09 – Fertility Society of Australia Exchange Lecture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i18 Session 10 – Data reporting session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i18 Session 11 – Paramedical invited session - Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i19 Session 12 – When the Fallopian tube fails . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i19 Session 13 – From pluripotent stem cells to gametes and back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i20 Session 14 – Novel techniques in the laboratory and IVF ­outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i20 Session 15 – IVF from a vitrified perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i22 Session 16 – Ovarian stimulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i24 Session 17 – ART: Economics and epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i27 Session 18 – Quality within the laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i29 Session 19 – New evidence in early pregnancy outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i31 Session 20 – Psychosocial issues and care in infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i33 Session 21 – The latest findings from the Reprotrain consortia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i36 Session 22 – Reproductive surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i36



Tuesday 1 July 2014

O-089-O-090 O-091-O-092 O-093-O-094 O-095-O-096 O-097-O-102 O-103-O-108 O-109-O-114 O-115-O-120 O-121-O-126    O-127 O-128-O-129 O-130-O-133 O-134-O-135 O-136-O-139

Session 23 – Progress in ovarian stimulation for IVF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i38 Session 24 – Oocyte activation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i39 Session 25 – ASRM exchange session - “Omics of infertility” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i40 Session 26 – Paramedical invited session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i40 Session 27 – Embryonic biomarkers - Are we getting nearer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i41 Session 28 – Live surgical tutorial: Uterine pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i44 Session 29 – Novel techniques in andrology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i44 Session 30 – Basic science endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i46 Session 31 – Clinical trials in ovarian stimulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i49 Session 32 – Patients’ needs and wishes: Where to draw the line? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i52 Session 33 – European and Global ART Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i54 Session 34 – Long-term health in Turner syndrome women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i55 Session 35 – The voice of donor sperm recipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i56 Session 36 – Advances in genetic testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i58 Session 37 – Assisted reproduction and human rights (Joint ­session ESHRE SIG Ethics and Law and FIGO’s Ethics Committee) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i58 Session 38 – Invited patient session - Social infertility (e.g. gamete freezing for social reasons; delayed pregnancy; age factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i60 Session 39 – Paramedical invited session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i60 Session 40 – Time-lapse imaging - Which embryo gets the Oscar? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i61 Session 41 – Improving ART outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i63 Session 42 – Sperm DNA integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i65 Session 43 – Safety issues for mother and child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i67 Session 44 – Underlying mechanisms of early pregnancy pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i70 Session 45 – Epigenetics in gamete competence and implantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i72 Session 46 – Clinical endocrinology (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i74 Session 47 – Basic physiology in embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i76

O-140-O-143 O-144-O-145 O-146-O-150 O-151-O-155 O-156-O-160 O-161-O-165 O-166-O-170 O-171-O-175 O-176-O-179 O-180-O-183

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O-184-O-187 O-188-O-191 O-192-O-195

Session 48 – Implantation failure and the endometrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i78 Session 49 – Nurses’ perspective in patient care and quality of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i80 Session 50 – The psychology of fertility preservation and gamete donation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i81



Wednesday 2 July 2014

O-196-O-197 O-198-O-199 O-200-O-201

Session 51 – Improving medical decision making . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i83 Session 52 – Update on ultrasound in reproductive health care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i83 Session 53 – Paramedical invited debate session - Laboratory (Debate) Is there time for time-lapse in the laboratory? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i84 Session 54 – Clinical endocrinology (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i85 Session 55 – Genes and embryo development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i88 Session 56 – Stem cells & Translational research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i91 Session 57 – Female reproductive physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i94 Session 58 – Male and female fertility preservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i97 Session 59 – Does delayed transfer give better results (freeze all policy)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i100 Session 60 – Society of Reproductive Surgeons Symposium - “Prevention and management of laparoscopic complications” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i101 Session 61 – Infertility trials: Roadmap to success . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i101 Session 62 – A look inside the occyte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i102 Session 63 – Basic endocrinology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i104 Session 64 – How to get the most out of your embryos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i106 Session 65 – Origin and diagnosis of meiotic errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i108 Session 66 – Female infertility: Diagnosis and treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i110 Session 67 – Genetics in andrology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i112

O-202-O-208 O-209-O-215 O-216-O-222 O-223-O-229 O-230-O-236 O-237-O-238 O-239-O-240 O-241-O-244 O-245-O-249 O-250-O-254 O-255-O-259 O-260-O-264 O-265-O-269 O-270-O-274

Posters Presentations P-001-P-028 Andrology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i115    P-029 Cross border reproductive care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i126    P-030 Developing countries and infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i127 P-031-P-064 Early pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i127 P-065-P-184 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i141 P-185-P-220 Endometriosis/Endometrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i194 P-221-P-223 Ethics and Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i209 P-224-P-279 Female (in)fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i210    P-280 Male and female contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i233 P-281-P-316 Male and female fertility preservation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i233 P-317-P-324 Paramedical - laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i251 P-325-P-333 Paramedical - nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i254 P-334-P-379 Psychology and counselling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i258 P-380-P-404 Safety and quality of ART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i276 P-405-P-456 Reproductive (epi)genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i286 P-457-P-569 Reproductive endocrinology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i307 P-570-P-579 Reproductive epidemiology and health economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i352 P-580-P-591 Reproductive surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i357 P-592-P-596 Stem cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i361 P-597-P-600 Translational research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i363

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Abstracts of the 30th Annual Meeting of ESHRE, Munich, Germany, 29 June – 2 July, 2014

Oral Presentations INVITED SESSION SESSION 01: ROBERT G. EDWARDS’ MEMORIAL KEYNOTE SESSION Monday 30 June 2014

08:30 - 09:30

O-001  The Human Reproduction Keynote Lecture - The clinical significance of calcium-signalling pathways mediating human sperm hyperactivation C. Barratt1 1 Ninewells Hospital and Medical School, The University of Dundee, Reproductive Medicine, Dundee Scotland, United Kingdom Ca2+ signalling pathways mediating sperm motility among sub fertile patients. Study question: To determine the incidence and causes of defects in Ca2+ ­signalling pathways (calcium influx and store mobilisation) mediating sperm motility among sub fertile patients. Summary answer: Ca2+store and CatSper defects adversely affecting fertilisation competence were identified and the characteristics of these were determined using electrophysiology. What is known already: Sperm motility and hyperactivation are important for fertility and KO studies in mice have shown a key role of calcium regulation in these events with the identification of several key channels (primarily Slo1/3 and CatSper). However, there is no data on abnormalities in men and their ­effect on fertility. Study design, size, duration: A series of functional assays on motility and [Ca2+]i signalling on spermatozoa from sub-fertile men attending for ICSI/IVF identified those with phenotypic abnormalities (Alasmari et al., 2013a) and patch clamping was utilised in patients with specified abnormalities and those with apparently unexplained total fertilisation failure following ART. Participants/materials, setting, methods: Men undergoing ART at Ninewells Assisted Conception Unit, Dundee. Surplus semen samples at time of treatment, or produced specifically for research purposes and subjected to analysis including patch clamping under quasiphysiological conditions (Mansell et al., 2014; Alasmari et al., 2013ab). Main results and role of chance: A screen of 181 subfertile men showed that defects in Ca2+ signalling pathways are significantly associated with fertilisation potential. Electrophysiological studies of men with abnormalities and fertilisation defects identified (1) 2 patients with minimal outward potassium conductance compared to controls (2) a further two patients with no effective CatSper current or a rapidly inactivating Cation conductance (ITail). Limitations, reasons for caution: The electrophysiological analysis is, by definition, based on a limited numbers of cells. Wider implications of findings: The study documents the key role played by Ca2+ signalling pathways in sperm function and identified key patients to clearly determine the impact of CatSper and Slo1/3 channels on human sperm function. The possibility to identify targets for therapeutic manipulation with an effective drug screening program is now a reality. Study funding/competing interest: Funded by Chief Scientist Office [Scotland], Infertility Research Trust, NHS Tayside, Wellcome Trust and MRC, Ethical approval granted by East of Scotland Research Ethics Service (EoSRES) REC 1: 12/ES/0091. References: Alasmari W, et al., (2013a) Hum Reprod. 2013 28:866-76. Alasmari W, et al., (2013b) JBC, 288:6248-58. Mansell SA, et al., (2014) Mol Hum Reprod. Jan 16. [Epub ahead of print].

O-002  Bipedalism: the genesis of uterine fibroids G. Vilos1 London Health Sciences Centre- Victoria Campus, The Fertility Clinic, ­Obstetrics and Gynaecology, London Ontario, Canada

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Bipedalism: In 1974, Donald Johanson’s team discovered approximately 40% of a hominid skeleton who walked upright 3.2 million years ago in Northern

Ethiopia. That evening, the radio was playing the Beatles’ song “Lucy in the sky with diamonds” and they named their new found female skeleton Lucy. In 1978, at Laetoli, Tanzania, Mary Leakey’s team found 3 australopithecine footprints, likely parents and a child, frozen in wet ash dated 3.5 million years ago. In 1994, Tim White’s team found a partial skeleton of a 110 lb, 4-foot female hominid who lived 4.4 million years ago in Ethiopia. They named their find A ­ rdipithecus ramidus – root of the ground ape subsequently nicknamed her Ardi. Narrow Pelvis: Why our ancestors came down from the trees and started walking upright, >5 millions years ago, is still a matter of debate. However bipedalism required re-alignment of the pelvic structures which resulted in narrowing of the birth canal and transformation from a simple straight cylindrical pipe to a complex convoluted structure in which the planes of the pelvic inlet, midpelvis, and outlet are all misaligned. Encephalization: Use of tools appeared approximately 2.5 millions years ago and soon after the brain of the Homo sapiens evolved and grew very rapidly. In the last 500,000 years our brain increased from 750cc to 1800cc. Evolutionary conflict: The evolutionary events of bipedalism and encephalization caused an ‘Evolutionary Conflict’ or obstetrical dilemma. The need to walk with a narrow pelvis and the need to think with a larger head would certainly eliminate natural childbirth which would lead to a dead end or extinction of our species! Counter-evolutionary adaptations: To avoid extinction, Lucy’s offspring countered the conflict of childbirth by several additional evolutionary adaptations including delivering smaller babies by shortening gestation and/or restrict fetal growth at term, both of which have been proven to be true. In addition the uterus adapted to pushing the baby through the pelvis by moulding the baby using excessive force over lengthier parturition. Neo-uterus: As the human head grew in volume, additional myometrial force was required to push a large-headed baby through a narrow pelvis. Recent ­evidence indicates that the outer two thirds (approximately 90% of the total uterine musculature) is a later acquisition of the uterus from the mesenchyme and brought with it its own blood supply - the uterine arteries. Genesis of fibroids: Angiography has shown that 94% of all uterine fibroids are supplied by the uterine arteries indicating that the majority of fibroids arise from the outer two thirds of the myometrium. The genesis of fibroids then is a direct consequence of the evolutionary adaptation of the uterus to deliver the ever enlarging human head through a narrow birth canal directly related to bipedalism.

SELECTED ORAL COMMUNICATION SESSION SESSION 02: REVISITING EMBRYO CULTURE Monday 30 June 2014

10:00 - 11:30

O-003  Molecular mouse embryo assay: a functional bioassay for studies involving assisted reproductive technologies (ART) R. Gilbert1, S. Es-slami1, H.T. Ni1 1 Irvine Scientific, Research & Development, Santa Ana, CA, U.S.A. Study question: Can transgenic mouse embryos carrying endogenous early developmental genes linked to green fluorescence protein (GFP) provide a superior molecular mouse embryo assay (MoMEATM) compared to morphological assessment alone for the screening and detection of detrimental conditions? Summary answer: Early expression of selected pluripotent markers (e.g. Oct-4) in transgenic mouse embryos was correlated with development to ­ ­blastocysts and provided earlier and more sensitive detection of suboptimal conditions. What is known already: The one-cell MEA is the most widely used for quality testing of human ART products, however concerns exist due to the insensitivity/ variability of this bioassay which lacks standardization and involves subjective analysis by morphology alone. Growing concerns about safety of ART on

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Abstracts of the 30th Annual Meeting of ESHRE, Munich, Germany, 29 June – 2 July, 2014 human gametes, embryos, clinical outcomes and long-term health of offspring require improved methods of risk assessment to provide scientifically robust and functionally relevant assays for pre-clinical studies prior to clinical implementation. Study design, size, duration: Cross sectional- control versus treatment. Transgenic mouse embryos were cultured to blastocysts in varied test and control conditions to compare assessment by standard morphology alone versus the added dynamic expression of GFP for screening of critical raw materials and detection of suboptimal culture conditions. Participants/materials, setting, methods: Fresh one-cell transgenic mouse embryos carrying GFP linked to Oct-4 were harvested and cultured (4 embryos/ 20 μL media) for 96 h in CSCM with 5 mg/mL HSA (Irvine Scientific) in control and test conditions (5 lots HSA, n = 43; 2 lots oil, n = 90) and assessed blinded for GFP-Oct-4 fluorescence intensity and morphology. Main results and the role of chance: Early fluorescence intensity (EFI) at 48 h was correlated with progression to blastocysts: EFI was 13%, 48% and 67% for early blastocysts, expanded and hatching blastocysts, respectively. Double blind assessment of morphology and EFI at 48 h showed 63% of embryos at ≥8 cells with 33% EFI in suboptimal oil conditions versus control with 90% of embryos ≥8 cells and 66% EFI; subsequent blastocyst rates were 27% versus 81%, respectively. Embryos cultured 48 h in 5 lots of HSA all showed >95% reaching ≥8 cells with 2 lots showing lower EFI (