Oct 18, 2016 - infertility and differential access to infertility treatments is necessary to eliminate reproductive health disparities and barriers to health care.
RESULTS: Overall, 8.7% of all women (n¼25,270) reported ever using infertility services of any kind. Hispanics (POR: 0.79, 95% CI: 0.64, 0.98) and NH blacks (POR: 0.57, 95% CI: 0.46, 0.70) had a lower adjusted odds of using infertility services compared to NH whites, with a higher odds in NH others (POR: 1.16, 95% CI: 0.85, 1.57). Use of specific infertility services differed by race/ethnicity, with statistically significant differences (p < 0.05) observed for use of drugs to induce ovulation, infertility testing on female or her partner, advice, IUI, IVF or other assisted reproduction, and surgery or drug treatment for endometriosis or uterine fibroids. No differences were observed for surgery to correct blocked tubes (p¼0.46). CONCLUSIONS: Understanding potential racial/ethnic disparities in infertility and differential access to infertility treatments is necessary to eliminate reproductive health disparities and barriers to health care access and assure equality of care for all patients. These disparities in infertility service utilization may be attributed to the cost of care and lack of health insurance for affordable diagnostic testing and treatment, which are barriers to infertility care that may disproportionately affect minorities. Supported by: This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under 1 R40MC29449-01-00. Support is also provided by Oklahoma Shared Clinical and Translational Resource Institute NIGMS U54 GM104938. The information, content and/or conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. P-18 Tuesday, October 18, 2016 AN EX VIVO MODEL FOR ASSESSING ACUTE EFFECTS OF TRANSCERVICAL POLIDOCANOL FOAM IN THE MACAQUE FALLOPIAN TUBE. S. Yao,a C. Hanna,a O. D. Slayden,a J. Jensen.b a Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Beaverton, OR; bDepartment of OB/GYN, OHSU, Portland, OR. OBJECTIVE: To develop a model to evaluate candidate agents to create tubal occlusion for nonsurgical permanent contraception DESIGN: Descriptive nonhuman primate study. MATERIALS AND METHODS: Reproductive tracts were collected from rhesus macaques (n¼10) at necropsy. Tubal patency was assessed by passing a small balloon catheter transcervically into the uterine cavity, and infusing foam until it was observed to pass freely from the fimbriae end of the fallopian tubes. The specimens were infused with 5% polidocanol foam (PF), 3% PF, or methylcellulose (control) foam (10mL). Following the foam infusion, the specimen was incubated at 37C in a humidity chamber for 15 min, and then a solution of 8ml of 4% paraformaldehyde was delivered through the same catheter to rinse out the tube. The tract was then dissected to the cornua, isthmic, ampulla, and fimbriae portions and then embedded in paraffin, sectioned, and stained with hematoxylin and eosin for histologic evaluation. RESULTS: Controls treated with inert methylcellulose foam displayed normal tubal epithelium. In contrast, treatment with PF led to varying degrees of epithelial cell damage progressing in severity from patchy epithelial disruption to complete epithelial exfoliation, and lumen dilation confined to the intramural zone. Mucosal damage after 5% PF was more marked and consistent than the effect of 3% PF. CONCLUSIONS: Transcervical perfusion of the reproductive tract PF results in acute epithelial damage to the fallopian tubes. Previous studies report that PF treatment results in permanent tubal occlusion. Effects of PF reported here represent the initial events in this process. These results support the use of ex vivo experiments to evaluate novel sclerosing agents prior to nonhuman primate in vivo experiments. Reference: 1. OPP1025233, NIH P51OD011092. Supported by: Support: Bill and Melinda Gates Foundation. P-19 Tuesday, October 18, 2016 DIGITAL WOMENS HEALTH BASED ON WEARABLES AND BIG L. Falco,a F. Kuebler,a S. Annaheim,b DATA. P. Stein,a A. Lemkaddem,c R. Delgado-Gonzalo,c C. Verjus,c B. Leeners.d aAva
FERTILITY & STERILITYÒ
AG, Zurich, Switzerland; bEMPA - Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland; cCSEM - Centre Suisse d’Electronique et de Microtechnique, Neuch^atel, Switzerland; dUniversity Hospital Zurich - Clinic for Reproductive Endocrinology, Zurich, Switzerland. OBJECTIVE: Currently available options for family planning are often cumbersome and imprecise. Moreover, women’s demand for insights into their cycles has increased due to older age at pregnancy and the need for better planning of life and career. The goal of the presented research project was to find out if physiological data measured at the wrist allows for natural family planning. DESIGN: Observational study. The study received approval by the Ethical Commission of the Canton of Zurich. 41 healthy women between 20 and 40 were recruited and kept anonymous throughout the study. Once trained about the proceedings of the study, subjects were able to conduct all measurements at home. 180 menstrual cycles were documented. MATERIALS AND METHODS: In a collaboration of scientists from the field of gynecology, physiology, sensor technology, and data science, a new solution for family planning was developed. It consists of a wrist worn sensor bracelet and intelligent algorithms. The bracelet contains various sensors which measure cardiovascular, movement, thermal, skin, and sleep parameters during sleep at night. The smart sensor bracelet was tested in a trial conducated by University Hospital Zurich and referenced with hormonal measurements. Daily surveys were filled out by the subjects to document confounding parameters. RESULTS: In a first step, skin temperature and pulse rate readings were analyzed. Both show significant differences between follicular and luteal phase. Minimum average resting pulse rate occurs in the follicular phase with 55.5 beats per minute and maximum resting pulse rate in the luteal phase with 59.3 beats per minute. Wrist skin temperature follows the same pattern with 34.3 degrees Celsius respectively 34.7 degrees Celsius. Alcohol intake in the evening decreased skin temperature non-significantly and increased pulse rate readings throughout the night significantly. Further confounding parameters and physiological parameters like breathing rate and sleep will be analyzed soon. CONCLUSIONS: The results show that wrist-based measurements allow for measuring parameters which correlate with the changes throughout the menstrual cycle. Compensating confounding parameters will be key for achieving precise information about the status of the menstrual cycle. Further analysis of the measured parameters will be conducted. Ava AG, Raeffelstr. 26, 8045 Zurich, Switzerland Supported by: Swiss Commission for Technology and Innovation CTI, Einsteinstrasse 2, 3003 Bern, Switzerland P-20 Tuesday, October 18, 2016 SHARED MEDICAL APPOINTMENTS FOR VASECTOMY CONSULTATION: PROSPECTIVE ASSESSMENT OF PATIENT SATISFACTION AND COUNSELING EFFECTIVENESS. E. Chan,a D. J. Mazur,a J. Kashanian,b A. W. Choi,a J. Moss,a R. E. Brannigan.a aDepartment of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL; bDepartment of Urology, Weill Cornell Medicine, New York, NY. OBJECTIVE: While a large number of publications support the use of shared medical appointments (SMA), to date no studies have assessed the utility of this approach for men seeking evaluation for vasectomy. The purpose of this study was to compare shared medical appointments (SMA) vs individual medical appointments (IMA) for men pursuing vasectomy consultations. DESIGN: Prospective, IRB-approved, questionnaire-based cohort study of men presenting for vasectomy consultation in both SMAs and IMAs. MATERIALS AND METHODS: At the time of vasectomy consultation scheduling, men were permitted to choose the SMA or IMA setting. All men were then given pre- and post-appointment questionnaires assessing their satisfaction, preferences, and knowledge about vasectomy. At the time of the vasectomy procedure, men were given a 3rd questionnaire also assessing satisfaction, preferences, and retention of knowledge. RESULTS: A total of 119 men presented for vasectomy consultation (51% SMA vs 49% IMA). 76% of men completed the post-consultation questionnaire, and 71% presented for vasectomy and completed the third
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