Abstracts of the 15th Annual Meeting of the ESHRE, Tours, France 1999 reproductive process. Such ethical issues can be raised even in relation to adoption, which can be viewed as a form of institution-assisted reproduction. Our objective was to dis- cuss 17 methods of assisted reproduction taking into considera- tion seven criteria: risk presented by the procedure, exposure of the embryo to potential damage, use unrelated to fertility, involvement of commercial and economic interests, eugenic potential, third party involvement (anonymous third party; identified unrelated third party; identified related third party), and parenthood disputes (anonymous claimant; identified unre- lated claimant; identified and related claimant). Materials and methods: The criteria for categorization of moral/ethical implications was proposed by Elias and Annas (1986) and Orr et ale (1990) for analysis of five and seven assisted reproduction procedures, respectively. In the present study, 17 forms of non-coital reproduction were analysed using the same criteria. These methods were divided into three broad categories: in-vivo fertilization procedures, in-vitro fertilization procedures, and surrogate motherhood. Each of the seven criteria analysed for each method received a score ranging from 0 (no ethical implications) to 5. A score of 5 in any criterion means that, due to moral and ethical considerations, the procedure should be prevented. Intermediate scores vary according to an increasing degree of ethical implication of the procedure in terms of each of the criteria assessed. The scores for each criterion were added and each procedure received a final score ranging from 0 to 55 (the higher the score, the higher the degree of ethical implication). Results: The evaluation of assisted reproduction procedures has revealed that surrogate motherhood is the most problematic method in ethical terms. In-vivo fertilization procedures received a final score ranging from 1 to 11; scores for in-vitro fertilization procedures ranged from 11 to 19; and surrogate motherhood methods received scores that were always above 19. Conclusion: The bioethical assessment regarding the available forms of assisted reproduction should not determine medical or legal decisions, but should be used instead to guide those people who are directly involved in the process in choosing the most adequate alternative ethically and technically, according to each specific situation. Acknowledgement: This work was supported by Hospital de Clinicas de Porto Alegre. R-075. Human embryo development in a modified human tubal fluid medium (PI medium preimplantation stage one) lacking glucose and phosphate Fabbri R., Ciotti P.M., Magrini 0., Marsella T., Lagalla C., Porcu E., Venturoli S. and Flamigni C. Infertility and IVF Center, Human Reproductive Medicine Unit, Institute of Obstetrics and Gynaecology, University of Bologna, Bologna, Italy Introduction: Recent studies have reported that the in-vitro development of early mammalian embryos is reduced in the presence of glucose and, in some cases, of phosphate. The 312 present study was undertaken to compare the effect of PI medium (glucose/phosphate-free) with the conventional HTF medium on the embryo development. Materials and methods: In this study the embryos of 88 patients with different infertility diseases were cultured into two different culture media: PI medium (Irvine Scientific, Santa Ana, CA, USA) supplemented with 10% v/v plasma protein fraction (Plasmanate) and human tubal fluid (HTF) medium (Irvine Scientific) added with 0.5% v/v albumin. The patients were divided into three groups. First group: a total of 158 fresh embryos, obtained from 15 patients (mean age of 33.6 ± 3.9 years), was cultured in PI medium (experimental group) and compared with a total of 172 fresh embryos obtained from 15 patients (mean age of 34.7 ± 3.6 years), retrospectively and randomly chosen, cultured in HTF medium (control group). All embryos were cultured from day 1 to day 3 at 37°C in 5% CO 2 and evaluated daily. Second group: a total of 29 thawed embryos (10 patients, mean age of 35.1 ± 3.1 years) was cultured in PI medium (experimental group) for 1 day before transfer and was compared with 26 thawed embryos (10 patients, mean age of 35.7 ± 4.6 years), cultured in HTF medium (control group) for 1 day before transfer. Third group: eight embryos, obtained from thawed oocytes (four patients, mean age of 31.2 ± 3.3 years) were cultured in PI medium (experimental group) and compared with 16 embryos, obtained from thawed oocytes (four patients, mean age of 330.2 ± 2.1 years) cultured in HTF medium (control group). All the embryos were incubated from day 1 to day 3 and evaluated daily. All developed embryos were scored for cleavage and EDR rates [Cummins I.M. et ale (1986) J. In Vitro Fertil. Embryo Transfer, 3, 284-295]. Furthermore the embryo morphological quality was evaluated according to A.B.Copperman et ale [(1995) Fertil. Steril., 64, 88-92]. Results: No significant difference was found in embryo development rates observed in PI medium compared to HTF medium all three groups. In the first group, the cleavage and the EDR rates were similar in both media (PI: 93.5 and 89.6 ± 9.1; HTF: 91.5 and 92.9 ± 6.8). In addition, a higher percentage of good quality embryos was found in PI medium than in HTF medium, but difference was not statistically significant (PI: 69.0%; HTF: 59.3%). Similar proportions were found when the same parameters were evaluated on day 3 of culture. Three pregnancies (pregnancy rate: 20%) were achieved in patients whose embryos were cultured in PI medium, while only one pregnancy (pregnancy rate: 6.7%) was achieved in patients whose embryos were cultured in HTF medium. In the second group, a loss of cells per embryo was observed after thawing: a mean of 3.6 ± 0.1 cells per embryo was cryopreserved and at thawing a mean of 2.7 ± 0.2 cells per embryo was found. After an incubation day a rescue of embryo development was observed, both in PI medium (3.8 ± 2.0 cells/embryo) and in HTF medium (3.7 ± 2.9 cells/ embryo). Two pregnancies (pregnancy rate: 20%) were achieved in patients whose thawed embryos were cultured in PI medium, while no pregnancy was achieved in patients whose thawed embryos were cultured in HTF medium. In the third group, the cleavage rate, the EDR rate and the percentage Downloaded from https://academic.oup.com/humrep/article-abstract/14/Suppl_3/312/2914739 by guest on 02 June 2020