decrease in mRNA RBPj, Notch1 and Hey1. Ishikawa cells with silenced RBPj failed to upregulate CD94 expression in NK cells in contrast to a con- trol co-culture. Corresponding experiments with endometrial stromal cells are in progress. CONCLUSIONS: The endometrium from women with either RPL or RIF is characterized with significantly lower expression of RBPj than in fertile women. Our data indicate that disregulated Notch signaling could contribute to reproductive failures and provide important insight into potential bio- markers related to endometrial receptivity. Supported by: Clinical Immunology Laboratory at Rosalind Franklin Uni- versity of Medicine and Science, North Chicago, IL. P-47 Tuesday, October 9, 2018 6:30 AM UTERINE NATURAL KILLER CELL DENSITYAS A PRE- DICTOR FOR IMPLANTATION SUCCESS OR FAILURE IN FERTILE SURROGATES AND IN WOMEN WITH IM- PLANTATION FAILURE. D. P. Shivalingegowda, a V. Rao, b K. Rathinam, a G. T. Pranesh, c M. Dwarakanath, d S. Mummadi, e K. A. Rao. a a Reproductive Medicine, Milann, Bangalore, India; b Reproductive Medicine, Milann,The fertility center, Bangalore, India; c Laboratory Medicine, Milann, Bangalore, India; d Reproductive Medicine, Milann the Fertility Centre, Banga- lore, India; e Milann, Bangalore, India. OBJECTIVE: To assess the uterine NK(uNK)cell subpopulation in the peri-implantation endometrium in prospective surrogate and in women with implantation failure To correlate uterine NK cell density with implatation failure or success DESIGN: A prospective observational study MATERIALS AND METHODS: The study was conducted over a period of 1 year at Milann-the fertility centre, Bangalore. Total of 21 prospective surrogates and 87 women with implantation failure were studied. Patients with uterine abnormalities and/or endocrine disorders were excluded. Trans- vaginal ultrasound was done on day 2/3 of the menses. Natural cycle or Hor- mone Replacement Therapy (HRT) cycle was followed. Diagnostic hysteroscopy with endometrial biopsy for uNK cell was done on day 5 after ultrasound documentation of ovulation in natural cycle or after 5 days of pro- gesterone therapy in HRT cycle. Flow cytometry was used to assess CD56 and CD3 NK cells in the endometrial biopsies and the percentage was iden- tified by immunocytochemistry. Embryo transfer or Frozen embryo transfer was performed in the subsequent menstrual cycle either in stimulated cycle or HRT cycle. Primary outcome was to find the percentage of uterine NK cells in prospective surrogate with proven fertility so as to create a normogram. Secondary outcome measured was the reproductive outcome in surrogates and in women with implantation failure in relation to percentage of uterine NK cell RESULTS: The 10th and 90th percentile cut offs for NK cells in surro- gates was determined to be 19.58% and 44.3% respectively. Patients with history of implantation failure had a wider distribution of NK cells. 10.5% (versus 9.5% in surrogates) of implantation failure patients had NK cells below the 19.58% cut off. 17.5% (versus 9.5% in surrogates) were found to have NK cell values above 44.3%. However there was no sta- tistically significant difference in terms of implantation failure or success in relation to uNK cell density, both in surrogates and in women with implan- tation failure. CONCLUSIONS: Previous studies have implicated both low NK cell activity and high NK cell activities to be associated with implantation fail- ure. The data from our study did not find this correlation. This study proves that increased uterine NK cell number in the secretory phase may not be the sole reason that affects embryo implantation. There is some evidence regarding relationship between maternal uterine natural killer cell immunoglobulin receptor (KIR) genotype and trophoblastic HLA-C(human leukocyte antigen) genotype. Further studies are required to evaluate maternal KIRs along with trophoblastic HLA-C, so the effect of various KIR/HLA-C combinations on miscarriage risk/implantation failure can be analysed. References: 1. Moffet A, Shreeve N. First do no harm: uterine natural killer (NK) cells in assisted reproduction. Hum Reprod 2015;30:1519-25. 2. Alecsandru D, Garc  ıa-Velasco JA. Why natural killer cells are not enough: a further understanding of killer-cell immunoglobulin-like receptor and hu- man leukocyte antigen. Fertil Steril 2017;107: 1273-8. P-48 Tuesday, October 9, 2018 6:30 AM YOGA AND MEDITATION BASED LIFESTYLE INTER- VENTION INCREASES THE LEVELS OF SOLUBLE HUMAN LEUKOCYTE ANTIGEN-G LEVELS IN MEN WITH RHEUMATOID ARTHRITIS: CLINICAL IMPLICATIONS. S. Gautam, a M. Kumar, a A. Goswami, a U. Kumar, b R. Dada. c a Anatomy, Lab for Molecular Reproduction & Genetics, All India Institute of Medical Sciences, New Delhi, India; b Rheumatology, Professor and Head, Department of Rheumatology, New Delhi, India; c Lab For Molec- ular Reproduction and Genetics, Anatomy, AIIMS, N Delhi, India. OBJECTIVE: Human leukocyte antigen-G (HLA-G) possesses immune- modulatory, anti-inflammatory, and tolerogenic properties. Its dysregulation has important implications in different inflammatory and autoimmune dis- eases like Rheumatoid arthritis (RA). Toxic effects of anti-inflammatory and immunosuppressive drugs for men of reproductive age are common con- cerns in autoimmune disorders like RA. Methotrexate (MTX) is a major component of disease-modifying antirheumatic drugs (DMARDs) which can cross blood-testis-barrier and can induce changes in sperm. MTX induces germ cell apoptosis, mutagenic changes in germline cells, permanent gonadal failure and impaired spermatogenesis. Hence, it’s cytotoxic, mutagenic and teratogenic activities may cause ill effects in various ways to reproductive health. Yoga and meditation have shown to reduce seminal oxidative stress and oxidative DNA damage. This study aimed to evaluate the impact of yoga and meditation on inflammatory and immunomodulatory markers in Rheumatoid arthritis affected males. DESIGN: Sixty-two males with RA were enrolled in this 21 days prospec- tive, open-label, single-arm exploratory study, designed to explore the impact of yoga and meditation based lifestyle intervention (YMLI) on disease activ- ity and fertility potential in men with Rheumatoid arthritis. MATERIALS AND METHODS: Sixty-two males with RA were random- ized into two groups: yoga (30): practicing Yoga and Meditation based life- style intervention (YMLI) in addition to disease-modifying anti-rheumatic drugs (DMARDs) for 21 days; non-yoga (30): DMARDs only. All subjects were assessed pre and post intervention for erythrocyte sedimentation rate (ESR), C reactive protein (CRP), IL-6, IL-17A and soluble HLA-G levels for systemic inflammation. Parameters of the disease activity i.e. disease ac- tivity score (DAS28-ESR) and pain acuity i.e. visual analog scale (VAS) were assessed. RESULTS: There was reduction seen in mean levels of ESR (p>0.05), CRP (p<0.05***), IL-6 (p<0.05**), IL-17A (p<0.05**) and soluble HLA-G (p<0.05*) at day 21 compared to base line level (day 0). We observed reduction in VAS (p<0.05***) and DAS28-ESR (p<0.05***) after 21 days with respect to the base line levels (day 0). CONCLUSIONS: Elevation in post-yoga levels of soluble HLA-G which is immunomodulatory in nature may reduce inflammatory profile leads to fewer requirements of anti-inflammatory drugs. Management of RA patients should include regular family planning, effective treatment of high disease activity, sexual counseling and adoption of simple lifestyle intervention like yoga and meditation. YLMI not only reduces disease severity, optimize oxidative stress levels, increases periods of remission, but also minimize us- age of drugs with minimum side effects especially on sperm. Supported by: Science & Technology for Yoga & Meditation, Department of Science & Technology, India. P-49 Tuesday, October 9, 2018 6:30 AM EUPLOID MISCARRIAGE IS ASSOCIATED WITH ELEVATED SERUM C-REACTIVE PROTEIN LEVELS IN INFERTILE WOMEN. A. Weghofer, a,b S. K. Darmon, b V. A. Kushnir, b,c N. Gleicher, b,d,e,f D. H. Barad. b,d a Department of Obstetrics and Gynecology, Medical Univer- sity Vienna, Vienna, Austria; b Center for Human Reproduction, New York, NY; c Obstetrics & Gynecology, Wake Forest University, Winston-Salem, NC; d Foundation for Reproductive Medicine, New York, NY; e Medical Uni- versity Vienna, Vienna, Austria; f Stem Cell Biology and Molecular Embry- ology Laboratory, Rockefeller University, New York, NY. OBJECTIVE: Increased serum C-reactive protein (CRP) levels have recently been reported to reduce fecundity in healthy eumenorrheic women with a history of 1-2 pregnancy losses. 1 As subclinical systemic inflamma- tion may impede maternal immune tolerance, implantation and embryonic FERTILITY & STERILITY Ò e129