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also plotted by gestational week to determine a significant increase in levels which would suggest the luteo-placental shift has occurred. The graphical interpretation shows the steepest slope between weeks 5-6 (m¼4.54) followed by weeks 6-7 (m¼4.34). The average estrogen levels were also graphically evaluated with the greatest rise between week 6-7 (m¼303.8). CONCLUSIONS:Frozen embryo transfer provides an excellent model for the assessment of the luteal-placental shift, as pregnant patients produce essentially no endogenous E2 or P4 until that time. By evaluating both absolute E2 and P4 levels as well as the rate of rise, we can surmise the timing of the actual shift. These data suggest that the actual shift occurs around 7 weeks' gestation, and that patients undergoing FET should continue to receive estradiol replacement until at least 7 weeks' gestational age and progesterone replacement until at least 8-9 weeks' gestational age.

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the presence of pelvic free fluid during SIS, laparoscopy, or evidence of an intrauterine pregnancy within the previous 3 years. Logistic regression was conducted with clinical pregnancy as the outcome and HSG or SIS as the key independent variable. Results are reported as adjusted odds ratios (OR) and 95% confidence intervals.RESULTS: Tubal patency was confirmed in 511 subjects (68.1%) with SIS and 217 subjects (28.9%) with HSG (minimum of 1 patent tube). Unilateral occlusion was observed in 32 subjects (2.9%) during HSG. After adjustment for treatment arm, body mass index, duration of infertility, smoking and education, the likelihood of clinical pregnancy was similar with HSG or SIS (OR 1.16, 95% CI 0.80,1.70, p¼0.440). Clinical pregnancy rates remained similar between groups following sensitivity analysis for ovulatory cycles (n¼619). Ectopic pregnancy occurred more often in subjects with tubal patency confirmed by HSG compared to SIS (2.8% versus 0.6%, p¼0.02). Two out of 32 women (6.3%) with unilateralocclusion on HSG were diagnosed with ectopic pregnancy.CONCLUSIONS: In this large cohort of women with PCOS, there was no significant difference in clinical pregnancy rate between subjects who had tubal patency confirmed by SIS versus HSG. SIS is an acceptable imaging modality for assessment of tubal patency in this population. The increased incidence of ectopic pregnancy with unilateral occlusion on HSG merits further evaluation.Supported by: NICHD R25HD075737