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Transforming Reproductive 
Medicine Worldwide 
Continuing Education Material 
DAILY SCHEDULE • POSTGRADUATE COURSES • PLEN...
Participate 
in 
the 
IFFS/ASRM 
2013 
Twitter 
Wall! 
During 
the 
IFFS/ASRM 
2013 
Annual 
Meeting, 
all 
participants 
...
Welcome to Boston! 
Boston is more vibrant than ever! New green spaces are sprouting up all over, and a revitalized waterf...
museum-ad.indd 2 8/29/13 1:53 PM
NIGHTATMUSEUM 
THE 
OF SCIENCE 
BOSTON • MA 
Party at Boston’s Museum of Science: 
THREE FLOORS TO EXPLORE 
THE RED, GREEN...
Shuttle Bus Routes 
Route # 1 
HOTELS PICK UP LOCATION 
Sheraton Boston Curbside on Dalton St. 
Route # 2 
HOTELS PICK UP ...
Shuttle Bus Schedule 
DATE SERVICE HOURS FREQUENCY 
Saturday, October 12, 2013 6:30am-9:30am 
4:30pm-6:30pm 
30 MINUTE SER...
Reception will be held in the Boston Convention and Exhibition Center's Exhibit Hall following the Opening Ceremony.
Write the Next Chapter 
Sustaining education, research, and advocacy programs for the future 
The American Society for Rep...
IFFS WELCOME 
As President of the International Federation of Fertility Societies (IFFS), I am delighted that our organiza...
INSIDE Be Sure to Visit the Exhibit Hall 
IFFS WELCOME . . . . . . . . . . . . . . . . . . . . . 8 
ASRM WELCOME . . . . ....
IFFS/ASRM CONJOINT MEETING 
PROGRAM PLANNING COMMITTEE 
IFFS SCIENTIFIC COMMITTEE 
Basil Tarlatzis (Greece), Chair 
Joe Le...
IFFS OFFICERS AND BOARD OF DIRECTORS 2010 - 2013 
IFFS OFFICERS 
Joe Leigh Simpson (USA), President 
Richard Kennedy (UK),...
IFFS/ASRM Annual Meeting 
Policies and Disclaimers 
CANCELLATION POLICY 
The International Federation of Fertility Societi...
Continuing Education Credit 
Continuing education/continuing medical education credit is not 
offered during meals, breaks...
Disclosure Statements/Conflict of Interest Policy 
2013 IFFS/ASRM Conflict of Interest 
Honoraria Policy for Invited Speak...
Postgraduate Program 
17 
46TH ANNUAL 
POSTGRADUATE 
PROGRAM 
COMMITTEE 
CHAIR 
Anuja Dokras, M.D., Ph.D. 
CO-CHAIR 
Lisa ...
46TH ANNUAL POSTGRADUATE PROGRAM 
ability to continue updating their knowledge of correct coding in the future. Special at...
46TH ANNUAL POSTGRADUATE PROGRAM 
CRYOPRESERVATION OF REPRODUCTIVE CELLS AND TISSUES: 
REAL WORLD APPROACHES AND LABORATOR...
46TH ANNUAL POSTGRADUATE PROGRAM 
with stimulation protocols. The faculty will address minimal monitoring, newer options f...
46TH ANNUAL POSTGRADUATE PROGRAM 
ULTRASOUND IMAGING IN ART 
Course PG7 (Saturday) 
Developed in Collaboration with the Am...
46TH ANNUAL POSTGRADUATE PROGRAM 
CRITERIA FOR WORLD-CLASS PERFORMANCE EXCELLENCE 
Course PG8 (Saturday) 
Non- 
CME 
Devel...
46TH ANNUAL POSTGRADUATE PROGRAM 
and the application of such testing discussed. Current PGS/PGD test techniques and appli...
46TH ANNUAL POSTGRADUATE PROGRAM 
THIRD PARTY REPRODUCTION IN THE UNITED STATES: 
LEGAL, MEDICAL AND PSYCHOLOGICAL/ETHICAL...
46TH ANNUAL POSTGRADUATE PROGRAM 
LEARNING OBJECTIVES 
At the conclusion of this course, participants should be able to: 
...
46TH ANNUAL POSTGRADUATE PROGRAM 
One-Day Courses 
Sunday, October 13, 2013 
PCOS: CARING FOR A WOMAN OVER HER LIFETIME 
C...
46TH ANNUAL POSTGRADUATE PROGRAM 
LEARNING OBJECTIVES 
At the conclusion of this course, participants should be able to: 
...
46TH ANNUAL POSTGRADUATE PROGRAM 
This workshop is geared primarily toward those who would like to implement and optimize ...
46TH ANNUAL POSTGRADUATE PROGRAM 
ULTRASOUND IMAGING IN REPRODUCTIVE MEDICINE: A PRACTICAL APPROACH 
Course PG19 (Sunday) ...
46TH ANNUAL POSTGRADUATE PROGRAM 
GLOBAL FAMILY PLANNING: THE KEY TO ACHIEVING MILLENNIUM DEVELOPMENT GOALS 
Course PG20 (...
46TH ANNUAL POSTGRADUATE PROGRAM 
ACGME Competency 
Patient care 
LEARNING OBJECTIVES 
At the conclusion of this course, p...
46TH ANNUAL POSTGRADUATE PROGRAM 
TRAINING PEOPLE IN LOW-COST INFERTILITY AND ART TREATMENT 
Course PG23 (Sunday) 
Develop...
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  1. 1. Transforming Reproductive Medicine Worldwide Continuing Education Material DAILY SCHEDULE • POSTGRADUATE COURSES • PLENARY SESSIONS TRILOGIES • SYMPOSIA • INTERACTIVE SESSIONS • VIDEO SESSIONS OCTOBER 12 - 17, 2013
  2. 2. Participate in the IFFS/ASRM 2013 Twitter Wall! During the IFFS/ASRM 2013 Annual Meeting, all participants are invited to post opinions, reports, and feedback on the meeting’s Twitter Wall. The Twitter Wall can be viewed at the Convention Center’s Main Lobby. All you need is a mobile device with an installed Twitter app, or a web browser. Setting Up A Twitter Account Go to www.twitter.com, and sign up. You will need to enter identifying information and agree to the terms of service. You will need to verify your email address before continuing. Twitter will walk you through a setup wizard of sorts, and ask you to follow five or more people. This is optional, though the website doesn’t give you an option to skip it. Search for “#IFFSASRM” if you wish to follow the messages at the conference, and search for “@ReprodMed” if you also wish to follow ASRM’s Twitter feed. Otherwise, at this point, if you don’t want to go any further in the setup wizard, go back to www.twitter.com and independently update your profile page and if desired, add a photo. Other Twitter users like to see photos of tweeters. Install a Twitter Application on your Mobile Device One option for using Twitter is to install a Twitter app on your mobile device. Go to https://twitter.com/download and select your device. If you do not wish to install an app for Twitter, you can still use Twitter within your web browser. Sending a Tweet to the IFFS/ASRM 2013 Twitter Wall You can do this within the Twitter app on your mobile device, or on the Twitter website. On the website, you can post a tweet by clicking on Home and then type inside the left-­‐hand box that says “Compose new Tweet”. You are limited to 140 characters in a single tweet. At the end of each message, in order for your message to appear on the Twitter wall, you must put #IFFSASRM at the end, such as: Watching a grt pres. on endometriosis by Dr. Jones. Fantastic new data w/2000 pts! #IFFSASRM Plenary Speaker Dr. Jones starting now – hall packed, exciting, standing rm only! #IFFSASRM or Twitter Etiquette All incoming tweets are monitored by ASRM staff, and those tweets that show up with the hashtag #IFFSASRM and that pass moderation will be posted to the Twitter Wall. In order for a tweet to pass moderation, the following guidelines should be kept in mind: • Messages must be about Meeting content or activities. • Messages cannot contain personal information. • Messages cannot personally attack another person. • Messages that ASRM considers unprofessional will not be displayed on the Twitter Wall. We hope you’ll join us in tweeting the #IFFS/ASRM Meeting in October!
  3. 3. Welcome to Boston! Boston is more vibrant than ever! New green spaces are sprouting up all over, and a revitalized waterfront has added to the city’s already dynamic downtown neighborhoods. These developments are thanks in part to the city’s Big Dig project, which is now complete. Additionally, Logan International Airport’s recent upgrades are making it easier than ever to get in and out of the city, and new sights and attractions are providing more for everyone to see and do while in Boston. Boston’s Waterfront has become an idyllic setting for watching sailboats and ferries glide in and out of the harbor and an excellent destination for classic New England seafood restaurants. Boston’s Rose Kennedy Greenway consists of three parks and a total of 30 acres of beautiful, tree-lined corridors. Visitors will find more than 900 trees, public art, fountains and great places for exercise or contemplation. In the works for the Greenway are the Boston Museum Project, which will focus on the last 200 years of Boston history, and The New Center for Arts and Culture, which will present a variety of dance performances, films, music, lectures and art. The new 44-mile Boston HarborWalk includes the downtown Boston waterfront and continues north and south along wharves, piers, museums, historic forts, bridges, beaches and shoreline from Chelsea Creek to the Neponset River. The HarborWalk also connects to new and existing trails: The Freedom Trail, the new Walk To The Sea, the Emerald Necklace, the Charles River Esplanade, the Rose Kennedy Greenway, and in the future, the South Bay Harbor Trail. The one-mile Walk To The Sea is a Beacon Hill-to-the-waterfront marked walkway. Beginning at the Massachusetts State House, the visitor learns about the four centuries of maritime history from Beacon Hill to State Street to the 18th century Long Wharf. Constructed from dirt excavated from the Big Dig’s extensive network of tunnels, Spectacle Island in Boston Harbor features a marina, visitor center, sandy beaches and five miles of walking trails that lead to the crest of a 157-foot hill offering panoramic views of the harbor and the city. Visitors are welcome from dawn to dusk during the summer months. Passenger ferry service is available from Boston. Chinatown Park, a beautiful parcel of land in Chinatown, is populated by bamboo trees, azaleas, stones and a peaceful stream. The new park is situated at the south end of the Greenway and is the perfect place to experience the Chinese ideal of Feng Shui, followed by an authentic dim sum meal. History around every corner, and so much more! Boston’s rich art, music and dance institutions, theatre and cultural attractions, distinguished dining and nightlife venues, world-class shopping and championship sports teams make it a unique place for travelers to visit. The city’s downtown neighborhoods offer endless unique experiences and its proximity to other must-see sites all around New England make it one of the country’s most diverse and exciting locales. Here in Boston, visitors are never at a loss for things to do. The many museums, concert halls, theaters and nightclubs are always showcasing great talent and events. There’s the internationally acclaimed Museum of Fine Arts, the Museum of Science, New England Aquarium and the John F. Kennedy Presidential Library & Museum. Beyond the museum scene, there’s the world-famous Boston Symphony Orchestra and Boston Pops, local and pre-Broadway theater, distinctive dining, endless opportunities for shopping and sightseeing, and a year-round calendar of special events and celebrations. Boston is home to a grand tradition of sporting excellence. This is where storied franchises such as the Red Sox (2004 and 2007 World Series Champions), the Celtics (2008 World Champions), the Bruins, and the New England Patriots (2001, 2003 and 2004 Super Bowl Champions) all play their games. Visiting sports fans can’t help getting caught up in the enthusiasm. In addition to everything within the city limits, some of Massachusetts’ most scenic and historic towns are just a short distance from the city center. There are sights to see at every turn. Cambridge is often referred to as “Boston’s Left Bank” with an atmosphere — and attitude — all its own. It’s the spirited, slightly mischievous side of Boston, just a bridge away on the other side of the Charles River. Packed with youthful vitality and international flair, it’s a city where Old World meets New Age in a mesmerizing blend of history and technology. As the East Coast’s leading hub for high tech and biotech, Cambridge has a creative, entrepreneurial spirit. It is also the birthplace of higher education in America. Harvard College was founded in 1636, and across town, Massachusetts Institute of Technology (MIT) is known as the epicenter of cyberculture. Both universities house renowned museum collections and tours that are open to the public. As a captivating, offbeat alternative to Boston’s urban center, the “squares” of Cambridge are charming neighborhoods rich in eclectic shopping, theaters, museums and historic sites. Cambridge also offers a tantalizing array of dining options for the visitor with a sophisticated palate. Information on Boston provided by the Greater Boston Convention and Visitors Bureau 3
  4. 4. museum-ad.indd 2 8/29/13 1:53 PM
  5. 5. NIGHTATMUSEUM THE OF SCIENCE BOSTON • MA Party at Boston’s Museum of Science: THREE FLOORS TO EXPLORE THE RED, GREEN AND BLUE WINGS OPEN TO YOU INCLUDES: THEATER OF ELECTRICITY • MUGAR OMNI THEATER (IMAX) • SOUNDSTAIR • BUTTERFLY GARDEN • CHARLES HAYDEN PLANETARIUM • AND MUCH MORE WEDNESDAY, OCTOBER 16, 2013 7:00 PM - 10:00 PM • TICKETS $100 Food provided by Wolfgang Puck Catering Beer, Wine & a Specialty Drink • 3-D Movie Music and Live DJ • Interactive Activities PLUS Transportation to/from ASRM hotels
  6. 6. Shuttle Bus Routes Route # 1 HOTELS PICK UP LOCATION Sheraton Boston Curbside on Dalton St. Route # 2 HOTELS PICK UP LOCATION Westin Copley Walking to Marriott (Curbside on Huntington) Fairmont Copley Walking to Marriott (Curbside on Huntington) Boston Marriott Copley Place Curbside on Huntington Route # 3 HOTELS PICK UP LOCATION Hilton Financial Main Entrance Omni Parker House Curbside on Tremont, across St. next to bank Hyatt Regency Curbside on Avenue de Lafayette Route # 4 HOTELS PICK UP LOCATION Boston Park Plaza Columbus Ave. Entrance Courtyard Tremont Tremont St. Entrance Route # 5 HOTELS PICK UP LOCATION Renaissance Waterfront Side Entrance on Congress Seaport Boston Plaza Level of Hotel Walking Hotel HOTELS PICK UP LOCATION Westin Boston Waterfront No Shuttle Service Provided
  7. 7. Shuttle Bus Schedule DATE SERVICE HOURS FREQUENCY Saturday, October 12, 2013 6:30am-9:30am 4:30pm-6:30pm 30 MINUTE SERVICE 30 MINUTE SERVICE Sunday, October 13, 2013 6:30am-9:30am 4:30pm-10:30pm 30 MINUTE SERVICE 30 MINUTE SERVICE Monday, October 14, 2013 6:30am-9:30am 9:30am-3:30pm 3:30pm-7:30am 15 MINUTE SERVICE 30 MINUTE SERVICE 15 MINUTE SERVICE Tuesday, October 15, 2013 6:30am-9:30am 9:30am-3:30pm 3:30pm-7:30am 15 MINUTE SERVICE 30 MINUTE SERVICE 15 MINUTE SERVICE Wednesday, October 16, 2013 6:30am-9:30am 9:30am-3:30pm **3:30pm-10:30pm** 15 MINUTE SERVICE 30 MINUTE SERVICE 15 MINUTE SERVICE Thursday, October 17, 2013 6:30am-9:30am 9:30am-3:30pm 15 MINUTE SERVICE 30 MINUTE SERVICE **Wednesday, October 16, 2013: Shuttle Service will run from the HOTELS to the MUSEUM OF SCIENCE from 6:45pm-10:30pm EVERY 15 Minutes**
  8. 8. Reception will be held in the Boston Convention and Exhibition Center's Exhibit Hall following the Opening Ceremony.
  9. 9. Write the Next Chapter Sustaining education, research, and advocacy programs for the future The American Society for Reproductive Medicine has had a long and distinguished history, contributing to reproductive medicine for more than 69 years. Please join us to ensure our continued excellence in education, research and advocacy by supporting the ASRM Fund Development Program. Ways to be a Champion Donate to support these programs: Education • SMRU Traveling Scholar • Contraception Lecturer • Menopause Lecturer • Resident Reporter Program • ASRM Fellows Retreat • Resident Education through ASRM eLearn® Research • ASRM Distinguished Researcher Award • Trainee Travel Fund • CREST Program Advocacy • J. Benjamin Younger Offi ce of Public Affairs • Reproduction and Public Policy Fellowship in the J. Benjamin Younger Offi ce of Public Affairs Other Programs • Memorial and Special Occasion Giving • Planned Giving • Bequests • Charitable Remainder Trusts • Life Insurance For more information about these programs, please contact Pam Nagel, ASRM Director of Society Advancement, at 205-978-5000, ext. 121 or pnagel@asrm.org. JOINT MEETING WITH IFFS/ASRM • OCT. 12-17, 2012 • BOSTON, MA. ASRM MEMBER GUIDE - 7
  10. 10. IFFS WELCOME As President of the International Federation of Fertility Societies (IFFS), I am delighted that our organization is holding its triennial meeting conjointly with ASRM in Boston, October 12-17, 2013. The first triennial IFFS congress was held in 1953 in New York City and since then has returned to the United States on two occasions. The last conjoint meeting was in 1998 (San Francisco), at that time the largest aggregation of reproductive medicine specialists and scientists ever assembled. The San Francisco meeting leveraged the IFFS toward its now vigorous efforts that include workshops conducted throughout the developing world, active public relations, guidelines for topics requiring international interaction (e.g., cross border care), and online resources. A regional IFFS international meeting is held in years during which the IFFS Triennial Congress is not held. In 2014, we will be meeting in Yokahama, Japan, conjointly with the Japanese Fertility Society. Given the many international participants who regularly attend ASRM as well as IFFS, the IFFS/ASRM program will be familiar in format. ASRM staples remain, and IFFS strives to be complementary. The IFFS Joe Leigh Simpson, M.D. IFFS President 2012-2016 mission is to stimulate basic and clinical research, disseminate education, and encourage superior clinical care of patients in infertility and reproductive medicine worldwide. Our national member societies, which now number 54 including ASRM, help carry this out. IFFS/ASRM 2013 thus offers postgraduate programs of international focus, talks by colleagues from all geographic regions, and topics covered that are not typical for ASRM. A special feature is the presentation of the IFFS Surveillance Report on Assisted Reproductive Technologies, a triennial compilation and synthesis providing information on ART that began in 1998. The IFFS scientific program is robust throughout. Distinct from ASRM are the IFFS trilogies. Three talks per session on a single topic by three different experts who focus on their forté – basic science, translating discoveries into clinical application, or integrating recent knowledge into clinical management. The IFFS Scientific Committee, composed of elected representatives from nine member societies, worked assiduously with Professor Basil Tarlatzis and the ASRM Scientific Program team. IFFS is grateful to ASRM for hosting this Congress, using its good offices, and providing IFFS access to its exemplary staff. As a Past ASRM President myself, I truly appreciate the inconvenience that such an “out of sync” meeting entails. Yet IFFS is confident that this conjoint meeting will underscore the old adage that the product should be greater than the sum of the individual parts. On a personal note, I look forward to seeing colleagues in Boston and enjoying a delightful social program - the Museum of Science on Wednesday night is a “can’t miss” event. And, of course, I shall enjoy coming away with the best science that reproductive medicine offers. Sincerely, Joe Leigh Simpson, M.D. IFFS President 2012-2016 ASRM WELCOME As President of the American Society for Reproductive Medicine, I enthusiastically welcome you to the 69th Annual Meeting of the ASRM conjoint with the 21st Meeting of the International Federation of Fertility Societies (IFFS) in Boston, Massachusetts, October 12-17, 2013. Serdar Bulun and the ASRM Scientific Program Committee, along with Basil Tarlatzis and the IFFS Scientific Committee, have put together a phenomenal program, along with Anuja Dokras for the Postgraduate Program and Steven Palter for the Video Program. As a conjoint meeting, we have extended the program by one day to accommodate additional interactive poster sessions, the traditional IFFS trilogies, and regional meetings for our international societies. The theme of our conjoint meeting is “Transforming Reproductive Medicine Worldwide,” and we have planned plenary lectures by international luminaries addressing state-of-the-art issues in reproductive medicine and science. We shall continue to have roundtables, videos, interactive sessions, symposia, and the popular sessions focused Linda C. Giudice, M.D., Ph.D. ASRM President 2012-2013 on menopause and contraception. During the 2013 meeting, we also plan hands-on robotic and other surgical intensives, and to focus more broadly on global applications of infertility therapies and reproductive health in low resource settings. As a conjoint meeting, our U.S. and international members will join the membership of the IFFS in reaching out to specialists in reproductive medicine worldwide to learn from each other about issues that are unique in different parts of the world and those that are common to us all. This conjoint meeting provides an opportunity to learn the latest research in the oral and poster presentations and other venues. Our many special interest and professional groups within ASRM will be presenting data that can be considered by all. The conjoint meeting of the IFFS/ASRM in Boston 2013 will provide an opportunity to learn, to see old friends, meet new friends, and see the world of reproductive medicine through a new lens. We are developing a social program for all in Boston, a vibrant city with great historical significance in the U.S. and globally. I look forward to seeing you in Boston in 2013, as we all participate in the process of “Transforming Reproductive Medicine Worldwide!” Sincerely, Linda C. Giudice, M.D., Ph.D. ASRM President 2012-2013
  11. 11. INSIDE Be Sure to Visit the Exhibit Hall IFFS WELCOME . . . . . . . . . . . . . . . . . . . . . 8 ASRM WELCOME . . . . . . . . . . . . . . . . . . 8 EXHIBIT HOURS . . . . . . . . . . . . . . . . . . . . . 9 IFFS/ASRM CONJOINT MEETING PROGRAM PLANNING COMMITTEE . . . . . . . . . . . 10 IFFS OFFICERS & BOARD OF DIRECTORS . . . . . . . . . . . . . . . . . . . . . . . 11 ASRM OFFICERS & BOARD OF DIRECTORS . . . . . . . . . . . . . . . . . . . . . . . 11 IFFS/ASRM ANNUAL MEETING POLICIES & DISCLAIMERS . . . . . . . . . 12 CONTINUING EDUCATION CREDIT . . . . . . . . . . . . . 13 DISCLOSURE STATEMENTS & CONFLICT OF INTEREST POLICY . . . . 14 POSTGRADUATE PROGRAM . . . . . . . . . . . . . . . . . . 15-34 NEEDS ASSESSMENT & LEARNING OBJECTIVES . . . . . . . . . . . 35 SCIENTIFIC PROGRAM DAILY SCHEDULE . . . . . . . . . . . . . 36-47 NICHD DETERMINANTS OF GAMETE & EMBRYO QUALITY SYMPOSIUM . . . . . . . . . . . . . . . . . . . . 48 MENOPAUSE DAY . . . . . . . . . . . . . . . 19 SURGERY DAY . . . . . . . . . . . . . . . . . 50-51 CONTRACEPTION DAY . . . . . . . . . . . 52 ENDOCRINE DISRUPTORS & REPRODUCTIVE HEALTH ACROSS THE LIFESPAN PANEL PRESENTATION . . . . . . . . . . . . . . . . . . 53 EDUCATIONAL SUPPORTERS . . . . . . . 54 PLENARY SESSIONS . . . . . . . . . . . . 55-60 TRILOGIES . . . . . . . . . . . . . . . . . . . 61-65 ASRM SYMPOSIA . . . . . . . . . . . . 66-88 INTERACTIVE SESSIONS . . . . . . . 89-101 ASRM VIDEO SESSIONS . . . . . . 102-108 AAGL FILM FESTIVAL VIDEO SESSION . . . . . . . . . . . . . . . . 109 PARTICIPANT & SPOUSE/PARTNER DISCLOSURES INDEX . . . . . . . . 110-112 VIDEO DISCLOSURES INDEX . . . . . . 113 PROGRAM PARTICIPANTS - NON-ORAL/POSTER PRESENTERS INDEX . . . . . . . . . . . . . . . . . . . . 114-116 Sunday, October 13 . . . . . . . . . 7:30 p.m. - 9:30 p.m. Monday, October 14 . . . . . . . . . 9:00 a.m. - 5:00 p.m. Tuesday, October 15 . . . . . . . . . 9:00 a.m. - 5:00 p.m. Wednesday, October 16 . . . . . . 9:00 a.m. - 5:00 p.m. For the safety of your child and in order to maintain the scientific nature of the display, no children under the age of 16 (except infants under 6 months of age carried in arms at all times) will be allowed in the Exhibit Hall. Strollers and infants in backpacks are not permitted in the Exhibit Hall or Poster Hall at anytime. CERTIFICATE OF ATTENDANCE Proof of attendance is available on request from J. Spargo at the registration desk. Continuing Education Credit information is located in the front of the Postgraduate Course syllabi, in the Final Program and online. ADMISSION BADGES Name badges will be issued for the Postgraduate and Scientific Programs and are required for admission. Spouse/guest badges will be issued and are required for admission to spouse/guest activities and the Exhibit Hall. PHOTO/AUDIO/VIDEO RECORDING Photographing or audio/video recording of any session for personal or commercial purposes without permission is prohibited. Morning Poster Sessions Poster Sessions will be held on Tuesday, Wednesday, and Thursday mornings from 7:00 a.m. until 8:45 a.m. Complimentary continental breakfast will be available. No reservations are required.
  12. 12. IFFS/ASRM CONJOINT MEETING PROGRAM PLANNING COMMITTEE IFFS SCIENTIFIC COMMITTEE Basil Tarlatzis (Greece), Chair Joe Leigh Simpson (USA), President Liselotte Mettler (Germany), 2010 Chair Local SC Linda Giudice (USA), 2013 Congress Chair Serdar Bulun (USA), 2013 Chair Local SC Dhiraj Gada (India), 2016 Congress Chair Narendra Malhotra (India), 2016 Chair Local SC Richard Kennedy (UK), Secretary General, ex officio member Paul Devroey (Belgium), Director of Medical Education, ex officio member David Healy, IFFS President 2010-2012 IFFS SCIENTIFIC COMMITTEE MEMBER SOCIETIES Brazilian Society of Human Reproduction Artur Dzik British Fertility Society Sue Avery Finnish Gynecological Association Antti Perheentupa Japan Society of Reproductive Medicine Minoru Irahara Fertility Society of Australia Cynthia Farquhar Korean Society for Reproductive Medicine Seok Hyun Kim American Society for Reproductive Medicine Alan DeCherney (ex officio) American Society for Reproductive Medicine Andrew La Barbera (ex officio) American Society for Reproductive Medicine Robert Rebar (ex officio) ASRM SCIENTIFIC AND POSTGRADUATE PLANNING COMMITTEES Linda C. Giudice, M.D., Ph.D., ASRM President Serdar E. Bulun, M.D., Scientific Program Chair Lawrence C. Layman, M.D., Interactive Sessions Chair Kurt T. Barnhart, M.D., Roundtable Program Chair Anuja Dokras, M.D., Ph.D., Postgraduate Program Chair Lisa M. Halvorson, M.D., Postgraduate Program Co-Chair Kathleen Hwang, M.D., Postgraduate Program Coordinating Chair Bradley J. Van Voorhis, M.D., Postgraduate Program Ad Hoc Member G. David Ball, Ph.D., and Charles Coddington, III, M.D., Society for Assisted Reproductive Technology Program Chairs Kurt T. Barnhart, M.D., and James Segars, M.D., Society for Reproductive Endocrinology and Infertility Program Chairs Paul J. Turek, M.D., and Ajay Nangia, M.D., Society for Male Reproduction and Urology Program Chairs Grace M. Janik, M.D., and Jeffrey M. Goldberg, M.D., Society of Reproductive Surgeons Program Chairs Nidhi Desai, J.D., Legal Professional Group Program Chair Claudia Pascale, Ph.D., and Alice D.Domar, Ph.D., Mental Health Professional Group Program Chairs Deborah L. Jaffe, B.S.N., Nurses’ Professional Group Program Chair Thomas G. Turner, M.S., and Charles L. Bormann, Ph.D. Society of Reproductive Biologists and Technologists Program Chairs Joseph J. Travia, Jr., B.S., M.B.A., Association of Reproductive Managers Program Chair Catherine Racowsky, Ph.D., Ad Hoc Member Marcelle I. Cedars, M.D., Ad Hoc Member Robert E. Brannigan, M.D., Ad Hoc Member Robert W. Rebar, M.D., ASRM Executive Director Andrew R. La Barbera, Ph.D., H.C.L.D., ASRM Scientific Director Lee Hutchison Boughton, M.A., ASRM Scientific Program Coordinator Penelope Fenton, M.A., ASRM Postgraduate Program Coordinator ASRM VIDEO COMMITTEE Steven F. Palter, M.D., Chair Tien-cheng A. Chang, Ph.D. Tommaso Falcone, M.D. Emilio Fernandez, M.D. Antonio R. Gargiulo, M.D. Arik Kahane, M.D. Philip S. Li, M.D. Stephen R. Lindheim, M.D. Marius Meintjes, D.V.M., Ph.D. Dana A. Ohl, M.D. David L. Olive, M.D. Marc P. Portmann, M.T. Togas Tulandi, M.D. Paul J. Turek, M.D.
  13. 13. IFFS OFFICERS AND BOARD OF DIRECTORS 2010 - 2013 IFFS OFFICERS Joe Leigh Simpson (USA), President Richard Kennedy (UK), Secretary General Gabriel de Candolle (Switzerland), Assistant Secretary General Edgar Mocanu (Ireland), Treasurer Mauricio Abrao (Brazil), Assistant Treasurer Basil Tarlatzis (Greece), Past President Paul Devroey (Belgium), Director of Medical Education David Healy (Australia), President 2010-2012 IFFS BOARD OF DIRECTORS AND THEIR MEMBER SOCIETIES American Society for Reproductive Medicine G. David Adamson 2007-2016 Argentine Society for Reproductive Medicine Marcos Horton 2010-2019 Colombian Association of Fertility and Reproductive Medicine Jose Ignacio Madero 2004-2013 Fertility Society of Australia Ossie Petrucco 2004-2013 German Society of Reproductive Medicine Tina Buchholz 2004-2013 Indian Society of Assisted Reproduction Dhiraj Gada 2010-2019 Japan Society of Reproductive Medicine Minoru Irahara 2007-2016 Jordanian Society for Fertility and Genetics Mazen El-Zibdeh 2010-2019 Swedish Society of Obstetrics and Gynecology Pietro Gambadauro 2007-2016 ASRM OFFICERS AND BOARD OF DIRECTORS 2012 - 2013 ASRM OFFICERS Linda C. Giudice, M.D., Ph.D., President Richard H. Reindollar, M.D., President-Elect Rebecca Z. Sokol, M.D., M.P.H., Vice President Dolores J. Lamb, Ph.D., H.C.L.D., Immediate Past President Roger A. Lobo, M.D., Past President Catherine Racowsky, Ph.D., H.C.L.D., Secretary Stuart S. Howards, M.D., Treasurer ASRM BOARD OF DIRECTORS AND THEIR MEMBER SOCIETIES Marc Fritz, M.D. Nancy Brackett, Ph.D. Marcelle I. Cedars, M.D. Christos Coutifaris, M.D., Ph.D. Richard S. Legro, M.D. Hugh S. Taylor, M.D. Steven T. Nakajima, M.D. (SREI) Grace Janik, M.D. (SRS) Grace Centola, Ph.D., H.C.L.D. (SMRU) Thomas Turner, Jr., E.L.D., M.S. (SRBT) David Ball, Ph.D., H.C.L.D. (SART) ASRM EXECUTIVE DIRECTOR Robert W. Rebar, M.D. ASRM SCIENTIFIC DIRECTOR Andrew R. La Barbera, Ph. D., H.C.L.D. Ex Officio
  14. 14. IFFS/ASRM Annual Meeting Policies and Disclaimers CANCELLATION POLICY The International Federation of Fertility Societies and the American Society for Reproductive Medicine reserve the right to cancel this activity due to unforeseen circumstances. In the event of such cancellation, the full enrollment fee will be returned to the registrant. REFUND/NON-ATTENDANCE POLICY Cancellations received before or by September 12th will receive a full refund minus a $50 processing fee. Cancellations received after September 12th will not be eligible for a refund. ADA STATEMENT The International Federation of Fertility Societies and the American Society for Reproductive Medicine fully comply with the legal requirements of the ADA and the rules and regulations thereof. Accommodations for Disabilities: Please notify the American Society for Reproductive Medicine, 1209 Montgomery Highway, Birmingham, Alabama, USA 35216, telephone 1-205-978-5000, a minimum of 10 working days in advance of the event if a reasonable accommodation for a disability is needed. EQUAL OPPORTUNITY STATEMENT The International Federation of Fertility Societies and the American Society for Reproductive Medicine value and promote diversity among its members, officers and staff. The Societies prohibit discrimination toward any member or employee due to race, color, religion, age, gender, sexual orientation, national origin, citizenship, disability, military status or other basis prohibited by law. IFFS and ASRM strive to achieve gender, racial and ethnic balance in hiring and governance. IFFS and ASRM maintain policies, procedures and personnel actions that conform to the letter and spirit of all laws and regulations pertaining to equal opportunity and nondiscrimination in employment, appointments and elections to office. DISCLAIMER STATEMENT The content and views presented in this educational activity are those of the faculty/authors and do not necessarily reflect those of the International Federation of Fertility Societies and the American Society for Reproductive Medicine. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity to make clinical decisions about individual patients. Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance and on signage throughout the convention center. 14
  15. 15. Continuing Education Credit Continuing education/continuing medical education credit is not offered during meals, breaks, receptions/cocktail parties, training sessions, satellite meetings or any private group meeting (e.g., council meetings, invitation-only meetings, editorial board meetings, etc.). In addition, CME credit is not offered during poster sessions, oral abstract presentations, or roundtable luncheon discussions. All activities are for CME, unless otherwise noted. Indicates a postgraduate course that qualifies for CE credit. Indicates Audience Response System (ARS) will be used during session. Non- CE ARS CME Continuing medical education is a lifelong learning modality enabling physicians to remain current with medical advances. The goal of ASRM is to sponsor educational activities that provide learners with the tools needed to practice the best medicine and provide the best, most current care to patients. As an accredited CME provider, ASRM adheres to the Essentials and Policies of the Accreditation Council for Continuing Medical Education (ACCME). CME activities now must first, address specific, documented, clinically important gaps in physician knowledge, competence or performance; second, be documented to be effective at increasing physician knowledge, skill or performance; and third, conform to the ACCME Standards for Commercial Support. ASRM must not only obtain complete disclosure of commercial and financial relationships pertaining to reproductive medicine but also resolve any perceived conflicts of interest. All postgraduate course faculty members and all organizers, moderators and speakers in the Scientific Program have completed disclosures of commercial and financial relationships with manufacturers of pharmaceuticals, laboratory supplies and medical devices and with commercial providers of medically-related services. The disclosures were reviewed by the Subcommittee for Standards of Commercial Support of the ASRM CME Committee, which resolved perceived potential conflicts of interest. The next few years will be an exciting time for the community of reproductive medicine practitioners as we adapt to the changing environment of healthcare and CME. The American Medical Association is advancing a transition of CME from a system of credits based on hours of attendance to a system based on improvement in physician performance. 15 Continuing Education Credit Information will be located in the front of each Postgraduate Course syllabus and the Final Program. CE/CME Credit reporting is done online. You will receive an email requesting you to log-in to complete evaluations of the Postgraduate and Scientific Programs and claim your AMA, ACOG, NASW and Nursing credits, or to request a Certificate of Attendance. The Website contains detailed instructions on how to complete the report and you will be able to print or email a certificate to the email address you provided at registration. Final date to report credit is December 31, 2013. Credits other than those specified below are the responsibility of each attendee. Commercially Supported Symposia Commercially Supported Symposia presented at the Annual Meeting of the ASRM are a part of the Scientific Program, unless otherwise noted. The Accreditation Council for Continuing Medical Education (ACCME) The American Society for Reproductive Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Scientific Program Designation Statement The American Society for Reproductive Medicine designates this live activity for a maximum of 25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Postgraduate Program Designation Statement The American Society for Reproductive Medicine designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Postgraduate Course 27 is approved for a maximum of 13 AMA PRA Category 1 Credits™. The American College of Obstetricians and Gynecologists Tthe American College of Obstetricians and Gynecologists has assigned 25 cognates to the Scientific Program and 7 cognate to the one-day Postgraduate Program. American Board of Bioanalysis (ABB) The American Society for Reproductive Medicine has applied to provide Professional Enrichment Education Renewal (PEER) credit through the American Board of Bioanalysis. PEER CEUs will be recognized for the Scientific Program. CEUs will be recognized for postgraduate courses 1, 4, 11, 12, 17, 21, 22, 24 and 27. PEER credit forms for eligible postgraduate courses and for the Scientific Program will be available at the American Association of Bioanalysts (AAB) booth in the Exhibit Hall. ABB certification exams will be administered Friday, October 11, 2013. American Psychological Association (APA) The Mental Health Professional Group (MHPG) of the American Society for Reproductive Medicine is approved by the American Psychological Association to sponsor continuing education for psychologists. The MHPG maintains responsibility for this program and its content. Application for credits has been made. National Association of Social Workers (NASW) Mental Health Professional Group postgraduate course 10 has been approved by the National Association of Social Workers (approval #886496548-2006) for 6.5 Social Work continuing education hours. Nursing Credits The Continuing Education Approval Program of the National Association of Nurse Practitioners in Women’s Health has approved the Scientific Program for 23.25 contact hours of continuing education credit, including 15 of pharmacology. Postgraduate Course 03 has been approved for 6.50 contact hours of continuing education credit, including 2.0 hours of pharmacology. Genetic Counselor CEUs Postgraduate Course 09 has been submitted to the National Society of Genetic Counselors (NSGC) for approval of Category 1 CEUs. The American Board of Genetic Counseling (ABGC) accepts CEUs approved by NSGC for purposes of recertification. Approval for the requested CEUs and Contact Hours is currently pending. Note: No credits will be given for Association of Reproductive Managers Continuing Education Course PG8. CERTIFICATE OF ATTENDANCE Proof of attendance is available on request from J Spargo at the registration desk. Continuing Education Credit information is located in the front of the Postgraduate Course syllabi, and the Final Program and online. ADMISSION BADGES Name badges will be issued for the Postgraduate and Scientific Programs and are required for admission. Spouse/guest badges will be issued and are required for admission to spouse/guest activities and the Exhibit Hall. PHOTO/AUDIO/VIDEO RECORDING Photographing or audio/video recording of any session for personal or commercial purposes without permission is prohibited.
  16. 16. Disclosure Statements/Conflict of Interest Policy 2013 IFFS/ASRM Conflict of Interest Honoraria Policy for Invited Speakers The following speakers may receive honoraria and/or discounted or free registration: 16 • Plenary Speakers • Postgraduate Course Faculty • Trilogy Speakers • Symposia Speakers • Interactive Session Speakers The following speakers do not receive honoraria: • Roundtable Presenters • Abstract Presenters • Video Presenters Disclosure Statements Postgraduate Faculty, Symposium Speakers, Plenary Lecturers, Abstract Authors, Trilogy Speakers, Abstract Graders, Roundtable Presenters, Video Presenters, and Interactive Speakers are required to disclose commercial relationships or other activities that might be perceived as potential conflicts of interest. Postgraduate course faculty disclosures will be listed in the course syllabi. Symposium speakers’ disclosures will be presented in handout materials, as well as on slides. Disclosures from speakers in the Plenary Sessions, Interactive Sessions, Roundtables, Videos and Symposia will be published in the Final Program. Abstract authors’ disclosures will be published in the 2013 Program Supplement. Each presenter should reveal his/her disclosure information during his/her presentation, preferably with the visual aid of a slide. Roundtable presenters should provide a copy of their disclosure forms to the participants at their table. As a provider of continuing medical education (CME) accredited by the Accreditation Council for Continuing Medical Education (ACCME), the American Society for Reproductive Medicine must ensure balance, independence, objectivity and scientific rigor in all its educational activities. All presenters must disclose to the learners any commercial or financial interests and/or other relationships with manufacturers of pharmaceuticals, laboratory supplies and/or medical devices. All relationships, whether or not they directly apply to this CME event, must be disclosed. All non-FDA approved uses of products must be clearly identified. Disclosures may be made in the form of a slide, printed material, or oral statement. The intent of this disclosure is not to prevent a speaker with a commercial or financial interest from making a presentation. The intent is to assist ASRM in resolving conflicts of interest and to provide learners with information on which they can make their own judgments regarding any bias. Although ASRM reviews and resolves potential conflicts of interest, it remains for the audience to determine whether the speaker’s interests or relationships may influence the presentation with regard to exposition or conclusion. Disclosures will be revealed to the learners. For postgraduate courses, disclosure information will be provided in the syllabus. For other activities, where no syllabus or other similar printed material is available, disclosures must be made verbally to the audience by the speakers, preferably with the visual aid of a slide. For those situations where there is no potential for conflict of interest, the portion of the form that so states should be completed. In those situations where a speaker does not complete a form or refuses to complete a form, the individual is ineligible to participate as a speaker in the CME activity. Speakers should also reveal to the audience any “off label” uses (not approved by the FDA) of any drugs or products discussed. Abstract authors’ disclosures are listed in the 2013 Program Supplement. Speakers in the Symposia and Interactive, Video, Roundtable and Abstract Sessions have also complied with ASRM policies and their disclosures are printed in the ASRM Final Program. The speaker should reveal this information during his/her presentation, preferably with the visual aid of a slide. Continuing Medical Education and Continuing Education Credits will be available.
  17. 17. Postgraduate Program 17 46TH ANNUAL POSTGRADUATE PROGRAM COMMITTEE CHAIR Anuja Dokras, M.D., Ph.D. CO-CHAIR Lisa M. Halvorson, M.D., Ph.D. COORDINATING CHAIR Kathleen Hwang, M.D. AD HOC Bradley J. Van Voorhis, M.D. WEEKEND COURSES Dates: Saturday, October 12TH Sunday, October 13TH Hours: 8:15 a.m.-5:00 p.m. Lunch is from Noon-1:00 p.m. Courses PG1-PG13 are one-day courses on Saturday. Courses PG14-PG26 are one-day courses on Sunday. Course PG27 is a two-day course on Saturday and Sunday. Postgraduate Course Syllabi will be posted online in September 2013. Printed copies will be distributed on-site. One-Day Courses Saturday, October 12, 2013 GLOBAL APPROACHES TO PREVENTING INFECTIONS IN THE ART LABORATORY: FROM THEORY TO PRACTICE Course PG1 (Saturday) Developed in Cooperation with the International Federation of Fertility Societies FACULTY Deborah J. Anderson, Ph.D., Chair Boston University School of Medicine Carole M. Gillings-Smith, Ph.D. Agora Gynecology and Fertility Center Augusto Enrico Semprini, M.D. University of Milan Medical School NEEDS ASSESSMENT AND COURSE DESCRIPTION Different regions of the world have different infections in the population that impact the practice of assisted reproductive technologies. The challenge for laboratory and clinical staff of ART clinics is to prevent transmission of infectious agents to the mother or gestational carrier and to the offspring of ART procedures. The objective of this live course is to train all members of the professional ART team to implement clinical and laboratory procedures to reduce the risk of transmission of infectious agents. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Summarize the prevalence and characteristics of concern in different populations around the world. 2. Design and implement practices to prevent infection in ART clinics in developed countries. 3. Discuss implementation of procedures to prevent infection in ART clinics in developing countries. CODING FOR REPRODUCTIVE MEDICINE PRACTICES 2013 Course PG2 (Saturday) ARS Developed in Cooperation with the American Society for Reproductive Medicine Coding Committee FACULTY John T. Queenan Jr., M.D., Chair University of Rochester Medical Center George A. Hill, M.D. Nashville Fertility Center NEEDS ASSESSMENT AND COURSE DESCRIPTION Every reproductive medicine practice has a legal and ethical obligation to follow a specific set of rules and regulations that determine how reimbursements are calculated. Failure to follow these rules can result in unfair practices to patients and/or legal consequences from government or third-party payers. The problem is those rules and regulations have become so complex that most people cannot understand them without receiving special training. This live course, designed for physicians, practice managers, billers, office managers, sonographers, laboratory managers, and physician assistants, will include didactic lectures, panel discussions, case presentations and interactive question and answer sessions. The correct way to report diagnostic codes and select the appropriate procedure codes will be explained, with a focus on quality improvement and minimizing errors. Systems-based resources available to aid in improving patient billing accuracy will be addressed, as will information technology resources that provide participants with the
  18. 18. 46TH ANNUAL POSTGRADUATE PROGRAM ability to continue updating their knowledge of correct coding in the future. Special attention will be given to the upcoming changes in the International Statistical Classification of Diseases and Related Health Problems (ICD), 10th Revision. ACGME Competency Systems-based practice LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Demonstrate correct coding of diagnostic conditions that are typically encountered in the practice of reproductive endocrinology. 2. Identify the correct Current Procedural Terminology (CPT) code for surgical procedures encountered in the practice of reproductive endocrinology and list additional resources available to aid with correct coding procedures in the future. 3. Summarize the rules and regulations required by third-party payers regarding documentation guidelines to verify that physician services were rendered according to medical necessity and in accordance with the requirements of CPT. 4. Describe the proper steps for successful verification or negotiation of coverage in obtaining third-party payer coverage for fertility COMPLICATIONS OF ART: IN SEARCH OF A HAPPY ENDING Course PG3 (Saturday) Developed in Cooperation with the Nurses’ Professional Group FACULTY Angela Smith, N.P., Chair Anderson-Smith Associates Tamara M. Tobias, A.R.N.P., Co-Chair Seattle Reproductive Medicine Joanne Stone, M.D. Mt. Sinai School of Medicine Lauri A. Pasch, Ph.D. University of California, San Francisco NEEDS ASSESSMENT AND COURSE DESCRIPTION The successful outcome of fertility treatment brings joy to many couples. Unfortunately, some treatments result in complications that present complex issues and require special management strategies. These may include ovarian hyperstimulation syndrome (OHSS), ectopic pregnancy, pregnancy loss, multiple pregnancy and treatment failure. Psychological complications such as depression, isolation and relationship strain may add additional obstacles. Health care providers must understand the problems that may occur, discuss treatment and management strategies, and recognize when referrals or other resources are needed. The factors that may prevent or reduce the risk of ovarian hyperstimulation syndrome and management strategies for ectopic and multifetal pregnancy will be addressed in this course. The psychological complications of pregnancy loss and treatment failure will be examined. In addition, the psychosocial issues of depression, isolation and relationship stressors will be explored. The goal of this live course is to increase the ability of nursing professionals to avoid potential complications of fertility treatment and to provide patients with strategies to navigate their fertility journeys. ACGME Competency Practice-based learning and improvement LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Discuss OHSS and various strategies to prevent this syndrome and the effectiveness of those strategies. 2. Review the management and impact of an ectopic pregnancy. 3. Explore the emotional influence of treatment failure and pregnancy loss. 4. Explain the unique issues confronting multifetal pregnancies and current treatment strategies. 5. Examine the psychological implications of depression, isolation and relationship stressors that may ensue from fertility treatment. 18 services. Non- CME CE ARS
  19. 19. 46TH ANNUAL POSTGRADUATE PROGRAM CRYOPRESERVATION OF REPRODUCTIVE CELLS AND TISSUES: REAL WORLD APPROACHES AND LABORATORY PEARLS Course PG4 (Saturday) Developed in Cooperation with the Society of Reproductive Biologists and Technologists ARS FACULTY Amy E. T. Sparks, Ph.D., Chair Reproductive Biology Resources, Inc. Alison Finn, M.S. University of Connecticut Health Center Kyle E. Orwig, Ph.D. University of Pittsburgh Linda J. Siano, M.A., M.S., E.L.D. University of Connecticut Health Center NEEDS ASSESSMENT AND COURSE DESCRIPTION Cryopreservation of reproductive cells and tissues has been practiced for more than half a century. However, lack of consensus on best practices has led to variable cryopreservation success rates that may hamper clinical utilization. While human sperm has been cryopreserved for decades, techniques such as oocyte vitrification are relatively recent technology breakthroughs. The learning curve for some of these techniques can be steep and best practices for how to determine a laboratory’s competence to perform the procedures are still evolving. As the types of patients who are candidates for cryopreservation procedures expand beyond fertility patients to include those with chronic diseases, it may not be feasible to mount multiple attempts at cryopreservation. Optimizing outcomes from the outset will be critical. Review of the Society for Assisted Reproductive Technology (SART) outcome statistics indicate the outcomes with cryopreservation of embryos vary by center, and strategies for assessing the cause of the variability must be developed before the technique is offered to patients who may have only one chance for a successful outcome (e.g., cancer patients). At the same time, long-term storage of these frozen cells and tissues presents challenges to long-term success. Cells formerly stored for several years may now be stored for decades. As frozen egg banks become more common, the lessons learned from years of sperm banking should not be lost and good tissue-banking practices must be implemented. Finally, experimental techniques that broaden the types of tissues that can be cryopreserved are in use at some centers. Knowledge of these methods, including their strengths, weaknesses and limitations, is essential in determining if they are safe and efficacious and ready to move into widespread use or should be reserved for specialized centers. This live course for laboratory clinicians will cover current cryopreservation techniques and their application outside of infertility treatment, instituting competency-based training in laboratories, and issues of long-term 19 storage of cells and tissues. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Describe the scope of the clinical use of cryopreservation of reproductive tissues and cells outside of infertility treatment. 2. Assess the best methods for cryopreservation according to tissue type, including factors that can limit success. 3. Design a plan for competency-based training that can be instituted for each cell or tissue type. 4. Discuss the unique technical, financial, logistical and regulatory challenges of long-term storage of reproductive cells and tissues. 5. Compare and contrast the practice of long-term banking of anonymous sperm donors with that of egg donors and answer the question: “What can egg banks learn from sperm banks?” A SIMPLIFIED RISK-FREE IVF WITHOUT COMPROMISING OUTCOME Course PG5 (Saturday) Developed in Cooperation with the Middle East Fertility Society FACULTY Mohamed Aboulghar, M.D., Chair Cairo University and the Egyptian IVF Center Mina Alikani, Ph.D., H.C.L.D. Tyho-Galileo Research Laboratories Paul Devroey, M.D., Ph.D. University Hospital Brussels David R. Meldrum, M.D. Reproductive Partners Medical Group, Inc. NEEDS ASSESSMENT AND COURSE DESCRIPTION The success of in vitro fertilization (IVF) is affected by patients’ reproductive status, the stimulation protocol and the quality of gametes and embryos. These parameters can vary greatly among IVF clinics. It is necessary to optimize the clinical and laboratory procedures to ensure the highest quality embryos. This live course for physicians, nurses and laboratory staff of IVF clinics is designed to highlight the latest medical evidence in assisted reproductive technology. The course will describe how to simplify the IVF procedure beginning
  20. 20. 46TH ANNUAL POSTGRADUATE PROGRAM with stimulation protocols. The faculty will address minimal monitoring, newer options for triggering ovulation, assuring safety of IVF by prevention of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy, and simplifying the laboratory and freezing procedures without reducing the pregnancy rate. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Perform natural- and clomiphene-cycle IVF. 2. Describe the soft protocols for ovarian stimulation in IVF. 3. Explore newer options for triggering ovulation with minimum risk. 4. Avoid OHSS in performing IVF. 5. Discuss the benefits and risks of single-embryo transfer and cryopreservation. CROSSING BORDERS AND OTHER HOT LEGAL ISSUES FOR THE HEALTHCARE PROVIDER AND LEGAL PRACTITIONER Course PG6 (Saturday) Developed in Cooperation with the Legal Professionals Group FACULTY Nidhi Desai, J.D., Chair Ballard, Desai & Miller Judith F. Daar, J.D. Whittier Law School Andrew W. Vorzimer, J.D. Vorzimer Masserman Colleen M. Wagner-Coughlin, M.S. aParent IVF NEEDS ASSESSMENT AND COURSE DESCRIPTION The involvement of third parties in assisted reproduction as gamete and embryo donors and as gestational carriers has produced a plethora of legal issues for the reproductive healthcare professional. Confronted with the complicated relationships among intended parents, gamete donors and gestational surrogates, the medical team often does not appreciate the legal implications of treating patients from different countries. While medical practitioners should not offer legal advice, awareness of the legal complexities and possible landmines their patients may encounter with respect to immigration, contract enforceability and parentage will help better serve practices and patients. Recognition of those arrangements that require a partnership of legal and medical experts is essential in the creation of legally-secure families. The medical practitioner often has a lack of understanding of legal issues related to developments in new technologies and the interaction of the laws of various jurisdictions when treating or advising international clients. This live course will provide guidance to the healthcare practitioner and lawyer advising patients who are traveling from other countries as well as those patients traveling out of the United States for treatment. Topics will include treatment, parentage, immigration, and contract enforceability given the intersection of multiple jurisdictions. The course will further explore current hot topics in assisted reproductive technology such as egg freezing and international regulations. This presentation is designed to review commonly-encountered situations that are subject to legal scrutiny, define the legal issues and potential pitfalls, provide practical solutions to roadblocks in assisted reproductive technology arrangements and explore the legal significance of treating clients from other countries. The various speakers will further address issues emerging as a result of newer technology based on legal precedent and principles. Each presenter will field questions from attendees that will allow for discussion of particular clinical conundrums, with the opportunity to develop usable solutions for clinical practice. This program will feature a practical approach to help lawyers and physicians better field situations as they arise. ACGME Competency Systems-based practice LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain problematic issues arising out of cross-border care. 2. Construct specific steps for clinics to take to protect their programs and patients. 3. Discuss some of the emerging legal challenges brought on by newer assisted reproductive technologies. 4. Formulate practical methods of dealing with these emerging issues. 20
  21. 21. 46TH ANNUAL POSTGRADUATE PROGRAM ULTRASOUND IMAGING IN ART Course PG7 (Saturday) Developed in Collaboration with the American Institute of Ultrasound in Medicine FACULTY Laurel A. Stadtmauer, M.D., Ph.D., Chair Eastern Virginia Medical School Todd Deutch, M.D., Co-Chair Advanced Reproductive Center Botros Rizk, M.D. University of South Alabama James M. Shwayder, M.D., J.D. University of Mississippi Medical Center NEEDS ASSESSMENT AND COURSE DESCRIPTION Ultrasound has become the most widely used and important tool in diagnosis and treatment of infertility. Ultrasound and ultrasound-guided procedures have become integral components not just of assisted reproductive technology (ART), but also in the day-to-day practice of reproductive medicine, infertility and gynecology. 3-D ultrasound allows better imaging, as well as more accurate volume rendering. It has become the gold standard for the diagnosis of uterine anomalies, and may assist in more accurate follicular monitoring measurements. In 2009, new practice guidelines for ultrasound in reproductive medicine were published by the American Institute of Ultrasound in Medicine (AIUM) and in collaboration with the American Society for Reproductive Medicine (ASRM). Surveys of members of the Society for Reproductive Endocrinology and Infertility, the Imaging Special Interest Group and ASRM have revealed a strong desire for CME credits in ultrasonography that would prepare reproductive medicine professionals and gynecologists for accreditation by AIUM. In addition, there is an interest in training and credentialing reproductive nurses and nurse practitioners to perform limited ultrasounds in the office. This live one-day course, designed to meet the needs of physicians and other healthcare providers who use gynecologic sonography, will fulfill CME requirements for AIUM credentialing. The objective of this course is to provide a comprehensive survey of the use of ultrasonography in the female pelvis for physicians, nurses and ultrasonographers actively involved in reproductive medicine, infertility and gynecology. This course will emphasize the use of ultrasound in maximizing ART success and including follicular monitoring with 3-D sonographic automatic volume calculation, assessment of the uterine lining during retrieval and embryo transfer in an evidence-based manner. Newer technologies, such as 3-D ultrasound, Doppler and the use of CT- and MRI-guided procedures, will also be discussed, along with cost-effective current or potential applications. Participants will be encouraged to actively take part in case presentations and discussions of controversies. Practical applications of the technology will be addressed along with case presentations, and participants will have the opportunity to manipulate 3-D images. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Summarize the appropriate use of ultrasonography in the evaluation of infertility, uterine abnormalities and the pathology of the 21 reproductive tract. 2. Describe the proper assessment of early pregnancy and list findings on early pregnancy assessments that are associated with poor outcome. 3. Discuss the importance of 3-D ultrasonography in reproductive medicine, and the importance of Doppler blood-flow assessment in reproductive medicine and gynecology. 4. Evaluate the use of fallopian tube patency with ultrasound. 5. Critically evaluate how ultrasound can maximize the success of ART.
  22. 22. 46TH ANNUAL POSTGRADUATE PROGRAM CRITERIA FOR WORLD-CLASS PERFORMANCE EXCELLENCE Course PG8 (Saturday) Non- CME Developed in Cooperation with the Association of Reproductive Managers FACULTY Joseph J. Travia, M.B.A., Chair Center for Reproductive Medicine Paul A. Bergh, M.D. Reproductive Medicine Associates of New Jersey Barbara Schmidt-Kemp, B.A. North Star Consultants, LLC NEEDS ASSESSMENT AND COURSE DESCRIPTION Reproductive medicine facilities are confronted with more challenges than ever before from patients expecting world-class service and results. With slower annual growth and a competing global economy, being good is no longer an option; patients want the best. Patients are well informed through social media and other Internet resources, and their expectations for good outcomes continue to rise. Their initial selection of a clinic will be based on cutting-edge technology and published results. If patients remain with their initial selection, that decision will be based on the level of service they received during their first visit. Scientific breakthroughs continue to provide new opportunities for meeting the needs of assisted reproductive technology (ART) patients world-wide. This live course is designed for practitioners wanting to create a world-class experience for their patients through performance excellence at every level of their organization. From creative leadership, strategic planning, patient focus, measurement, analysis and knowledge management to work environment and employee engagement, this course will enable every participant to contribute significantly to their practice's reach for excellence. ACGME Competency Systems-based practice LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Formulate the critical logistics of strategic planning and implementation, with a focus on patient recruitment and retention. 2. Convert strategic objectives into action plans, along with key action plan indicators to measure competency and performance THE ART OF GENETICS: REPRODUCTIVE GENETICS IN THE ART SETTING Course PG9 (Saturday) 22 results in the practice. 3. Provide a world-class work environment that promotes creative leadership and employee engagement. 4. Determine the best, most competitive healthcare service offerings for the practice, and the most effective patient and stakeholder communication vehicles to market those opportunities. 5. Measure, analyze, review and improve performance at all levels of the organization through the information already available in clinical, laboratory, and operations databases. CE Developed in Cooperation with the Genetic Counseling Special Interest Group FACULTY Jill M. Fischer, M.S., C.G.C., Chair Reprogenetics Lauri D. Black, M.S., L.C.G.C. Pacific Reproductive Genetic Counseling Gabriel A. Lazarin, M.S., C.G.C. Counsyl Amy C. Vance, M.S., C.G.C. Bay Area Genetic Counseling NEEDS ASSESSMENT AND COURSE DESCRIPTION Reproductive genetics is an increasing part of the assisted reproductive technology (ART) practice. Daily, ART centers use genetic information when couples undergo ethnicity screening, when donors are screened and chosen for recipient couples, to determine the cause of infertility or recurrent pregnancy loss, and when utilizing preimplantation genetic screening (PGS) and preimplantation genetic diagnosis (PGD). However, the application of genetic information and genetic testing is often limited due to lack of knowledge by the medical providers in the ART practice. Education of these medical providers is incomplete and most ART centers do not have a genetic counselor on staff. This live course serves to provide basic to complex genetic information to help such practices start to fill this education gap and competently apply genetic information to improve patient care. The course will provide both basic genetics education and review of real time application. The faculty will address current knowledge of the genetic causes of male infertility not limited to cystic fibrosis and genetic causes of female infertility, including the latest research on and testing for fragile X syndrome. As high throughput carrier testing options become more readily available, current American Society for Reproductive Medicine (ASRM), American College of Obstetricians and Gynecologists (ACOG) and American College of Medical Genetics (ACMG) carrier testing guidelines will be outlined
  23. 23. 46TH ANNUAL POSTGRADUATE PROGRAM and the application of such testing discussed. Current PGS/PGD test techniques and applications will be examined. Overall, this course should educate the ART medical professionals on current genetic information and test options so they can improve patient care in their practices. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain genetic inheritance patterns, risk assessment and ethnicity screening. 2. Describe genetic and chromosomal causes of male and female infertility and infertility test options. 3. Define genetic and chromosomal test options for recurrent pregnancy-loss patients. 4. Outline donor carrier screening guidelines by ASRM, ACOG and ACMG and their application to current practice. 5. Evaluate the value of high throughput carrier screening in the ART setting and review current test techniques and applications of 23 PGD. NEW FAMILIES ON TRIAL Course PG10 (Saturday) Developed in Cooperation with the Mental Health Professional Group FACULTY Andrea Mechanick Braverman, Ph.D., Chair Jefferson Medical College Nanette Elster, J.D., M.P.H. Health Law Institute Julia Woodward, Ph.D. Duke University Medical Center NEEDS ASSESSMENT AND COURSE DESCRIPTION The idea of Mommy and Daddy and baby makes three as depicted in the 1950s “Leave it to Beaver” representation of the family has been put into rerun by the new American family of “Modern Family” and “Two and a Half Men.” Many of the new families are made possible only by assisted reproductive technology (ART). Single mothers by choice and single fathers by choice are emerging as “choice” families. Co-in vitro fertilization (IVF) with lesbian partners sharing the genetic and gestational contribution to their children is now a common procedure. On the horizon are families where Mom freezes her eggs in her 20s or 30s but is now ready to fertilize an egg and get pregnant in her 40s and 50s. This live course will increase mental health professionals’ understanding of the many new ART families. This course will provide participants with the current research and theories explaining the needs and challenges for these families. Utilizing an interactive format of a mock trial, participants will have the opportunity to hear “testimony” and be “the jury” to identify the issues and concerns of these ART families. This course will equip mental health professionals in providing competent understanding and sensitivity to the ever-expanding All-American family. ACGME Competency Interpersonal and communication skills LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Describe the different types of families made possible by ART. 2. Discuss the current literature on the new ART families. 3. Explain the challenges to providers in counseling these new ART families. Non- CME CE ARS
  24. 24. 46TH ANNUAL POSTGRADUATE PROGRAM THIRD PARTY REPRODUCTION IN THE UNITED STATES: LEGAL, MEDICAL AND PSYCHOLOGICAL/ETHICAL ASPECTS Course PG11 (Saturday) Developed in Cooperation with the Society for Assisted Reproductive Technology FACULTY James M. Goldfarb, M.D., Chair University Hospitals of Cleveland Susan L. Crockin, J.D. Georgetown University Law Center/Crockin Law & Policy Group, LLC Julianne E. Zweifel, Ph.D. University of Wisconsin NEEDS ASSESSMENT AND COURSE DESCRIPTION Third-party reproduction, particularly oocyte donation (OD) and gestational surrogacy (GS), has received much professional and public attention recently. Both of these procedures have been utilized since the mid-1980s, but as they have evolved, the medical, legal and psychological/ethical complexities have all increased. It is imperative that individuals involved with these procedures be aware of all the complex issues involved. Embryo donation (ED) and sperm donor insemination (DI) have attracted less attention and are medically not as complex as OD and GS. However, they, too, are associated with significant legal and psychological/ethical issues. This live course, designed for medical professionals involved in assisted reproductive technology (ART), examines the medical, legal and psychological/ethical issues involved in OD and GS, and to a lesser extent, ED and DI. Medical topics to be discussed include: safety considerations and inclusion/exclusion criteria for egg and sperm donors and gestational surrogates, number of embryos to transfer in egg and embryo donor and gestational surrogate cycles, and role of oocyte cryopreservation in OD cycles. Legal topics will include: model legislation by the American Bar Association, variation in regulation of third-party reproduction in different states, new legislative proposals to regulate third-party reproduction, informed consent and legal pitfalls. Psychological/ethical issues will include: egg donor and gestational surrogate payment, participant coercion, shared egg donation, divulging to offspring, and psychological aspects and screening tools of third-party reproduction. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the legal issues regarding OD, GS, ED and DI, particularly regarding state legislative efforts to regulate third-party 24 reproduction. 2. Discuss issues with egg donation, including establishment of a national egg donor registry, differences between anonymous and directed egg donation, and guidelines for payment of egg donors. 3. Discuss the medical procedures involved with third party reproduction. ENDOMETRIUM AND EMBRYO CROSS-TALK: HOW TO PREDICT AND ACHIEVE IMPLANTATION SUCCESS Course PG12 (Saturday) ARS Developed in Cooperation with the European Society of Human Reproduction and Embryology FACULTY Antonis Makrigiannakis, M.D., Ph.D., Chair University of Crete Medical School Roy G. Farquharson, M.D. Liverpool Womens Hospital Sophia N. Kalantaridou, M.D., Ph.D. University of Ioannina Medical School Ioannis E. Messinis, M.D., Ph.D. University of Thessalia NEEDS ASSESSMENT AND COURSE DESCRIPTION During implantation, the cross-talk between the embryo and the endometrium remains largely unknown. Local and systemic players interact for the achievement of human pregnancy. Impaired implantation is currently considered the most important limiting factor for the establishment of viable pregnancies in assisted reproduction. It is expected that elucidating the molecular background of the process will enable accurate diagnosis and effective treatment of implantation failure and/or miscarriages. The purpose of this live course for embryologists and clinical reproductive medicine specialists is to identify factors that predict implantation success and investigate potential treatment modalities to manage implantation failure and/or miscarriages. ACGME Competency Medical knowledge
  25. 25. 46TH ANNUAL POSTGRADUATE PROGRAM LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Summarize the physiology and pathophysiology of implantation. 2. Describe local and systemic factors leading to miscarriages and/or implantation failure. 3. Discuss the challenges of predicting and achieving implantation success. MODERN MANAGEMENT OF POLYCYSTIC OVARY SYNDROME IN ADOLESCENTS Course PG13 (Saturday) Developed in Cooperation with the Pediatric and Adolescent Gynecology Special Interest Group FACULTY Jennifer E. Dietrich, M.S., M.Sc., Chair Baylor College of Medicine Beth W. Rackow, M.D. Columbia University Samantha M. Pfeifer, M.D. University of Pennsylvania Medical School Staci Pollack, M.D. Albert Einstein College of Medicine NEEDS ASSESSMENT AND COURSE DESCRIPTION Polycystic ovary syndrome (PCOS) affects an estimated 5-7% of women of reproductive age. True estimates are difficult to define in adolescents, but have been postulated to be higher. Because PCOS is associated with comorbidities such as diabetes mellitus type II, hypertension, non-alcoholic steatosis and obesity as well as other health problems, it is critical to establish an early diagnosis to avoid significant health problems later in life. This live course designed for clinicians who care for adolescent females will cover current scientific papers and new areas of research that focus on adolescent needs and screening. Through a lecture/audience participation format, participants will discuss early warning signs such as precocious adrenarche that help providers determine the best time to screen adolescents for PCOS, which should result in improved patient lifelong health. ACGME Competency Medical knowledge LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Confidently perform an evaluation for PCOS on an adolescent female. 2. Differentiate adult criteria from adolescent criteria in making the diagnosis of PCOS. 3. Detect early warning signs indicating a possible diagnosis of PCOS in the adolescent and evaluate the need for early screening 25 and early intervention. 4. Discuss the available treatment options for adolescents with PCOS.
  26. 26. 46TH ANNUAL POSTGRADUATE PROGRAM One-Day Courses Sunday, October 13, 2013 PCOS: CARING FOR A WOMAN OVER HER LIFETIME Course PG14 (Sunday) Developed in Cooperation with the Society for Reproductive Endocrinology and Infertility FACULTY Kurt T. Barnhart, M.D., M.S.C.E., Chair University of Pennsylvania Heather G. Huddleston, M.D. University of California, San Francisco Robert A. Wild, M.D., Ph.D., M.P.H. Oklahoma University Health Sciences Center NEEDS ASSESSMENT AND COURSE DESCRIPTION Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of reproductive age and is highly prevalent. The etiology of this heterogeneous condition remains obscure and its phenotype expression varies. PCOS affects many aspects of a woman’s life and this live course will supply the reproductive endocrinologist and general gynecologist with the latest information on PCOS in order to provide up-to-date recommendations for patient care. Topics to be covered will include how PCOS affects reproductive health over a woman’s lifespan, hirsutism and acne, contraception, fertility, menstrual cycle abnormalities, quality of life, ethnicity, pregnancy complications, long-term metabolic and cardiovascular health and, finally, cancer risk. Information will include material from The Consensus on Women’s Health Aspects of Polycystic Ovary Syndrome. ACGME Competency Practice-based learning and improvement LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Contrast the signs and symptoms of PCOS in women of different ages and ethnicities. 2. Interpret how aspects of the phenotype of PCOS correlate with risk factors for insulin resistance, diabetes mellitus (DM) type II and 26 cardiovascular health. 3. Develop a practical approach to testing for precursors of DM and cardiovascular disease in women with PCOS. 4. Distinguish the medical and reproductive needs of a women with PCOS based on where she is in her lifetime. BRIDGING THE GAP BETWEEN SCIENCE AND CLINICAL CARE IN ENDOMETRIOSIS-RELATED INFERTILITY Course PG15 (Sunday) Developed in Cooperation with the Endometriosis Special Interest Group FACULTY Hugh S. Taylor, M.D., Chair Yale University School of Medicine Thomas M. D’Hooghe, M.D., Ph.D. Leuven University Hospital Bruce A. Lessey, M.D., Ph.D. Greenville Hospital System NEEDS ASSESSMENT AND COURSE DESCRIPTION Endometriosis is a highly prevalent disease. However, there are many gaps in physicians’ competence to diagnose patients with endometriosis. This disease places a tremendous burden on society, both economically and related to quality of life. The principal manifestations of this disease, which causes both infertility and chronic pain, mandate that all general gynecologists and subspecialists be involved in the care of these patients. This live course is designed to improve physicians’ competence in the medical and surgical management of endometriosis. Topics to be discussed include: pathophysiology of endometriosis-associated pain syndromes; pathophysiology of endometriosis-associated infertility; choosing an appropriate medical or surgical therapy; technical aspects of surgical approaches; in vitro fertilization (IVF) approaches, including pre-IVF optimization; and new genetic etiologies of endometriosis. Coherent summaries with key learning points will be provided and reinforced during the session of case reports. ACGME Competency Patient care
  27. 27. 46TH ANNUAL POSTGRADUATE PROGRAM LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Discuss clinical implications of the pathophysiology of endometriosis in patients with infertility. 2. Explain the new genetic etiologies for endometriosis and ways to identify those at risk. 3. Describe the options for managing endometriosis before an IVF cycle. 4. Summarize the optimal approach for an IVF cycle in a woman with endometriosis. LEIOMYOMATA: CLINICAL UPDATES, RESEARCH DEVELOPMENTS AND DISPARITIES IN DISEASE, OUTCOMES AND ACCESS TO CARE Course PG16 (Sunday) Developed in Cooperation with the Fibroid Special Interest Group and the Health Disparities Special Interest Group FACULTY Gloria Richard-Davis, M.D., Chair University of Arkansas Medical Sciences Ayman Al-Hendy, M.D., Ph.D., Co-Chair Meharry Medical College Donna Baird, Ph.D. National Institute of Environmental Health Services (NIEHS) James H. Segars, M.D. National Institute of Health (NIH) NEEDS ASSESSMENT AND COURSE DESCRIPTION Uterine leiomyomata (fibroids), benign estrogen-dependent tumors of the uterine wall, are a common cause of acute and chronic pelvic pain in women. Uterine fibroids affect 40-80% of women of reproductive age and are the leading indication for hysterectomy in African- American women. More than 600,000 hysterectomies were done in the United States in 2000 because of leiomyomata. At a mean cost of $8 billion per year, African-American women are particularly affected as the prevalence of uterine fibroids is about three times higher in that ethnic group compared with Caucasians. Currently there is no effective medical treatment for this common disease, and the impact of uterine fibroids on fertility remains controversial. Treatment options for the management of fibroids have largely focused on surgical options with few focusing on reproductive-sparing procedures. Healthcare providers show no agreement on the best management option, partially because of their lack of current evidence-based knowledge (including the cause), of uterine fibroids. This live course, designed for gynecologists, will provide a clear and meaningful overview of the problem, discuss current fibroid treatment options and their effect on fertility, and probe the future of these treatments. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the developmental origin of uterine fibroids. 2. Describe non-surgical, reproductive-sparing approach for treatment of uterine leiomyomata. 3. Summarize the scientific data on why uterine leiomyomata are more common in African Americans. 4. Discuss the role of myomectomy in the outcomes of assisted reproductive technologies. CRYOBIOLOGY, CRYOPHYSICS AND QUALITY CONTROL CONCERNS OF GAMETE, EMBRYO AND TISSUE VITRIFICATION Course PG17 (Sunday) Developed in Cooperation with the Society of Reproductive Biologists and Technologists FACULTY Charles L. Bormann, Ph.D., Chair Brigham and Women’s Hospital Wayne A. Caswell, M.S. Fertility Centers of New England Joseph Conaghan, Ph.D. Pacific Fertility Center Michael J. Tucker, Ph.D. Shady Grove Fertility RSC NEEDS ASSESSMENT AND COURSE DESCRIPTION Vitrification (VTF) is rapidly becoming the cryopreservation method of choice for many in vitro fertilization (IVF) laboratories. Without careful preparation and training, the transition from a slow-rate freeze program to a vitrification program can be very challenging. Most demonstration and training in VTF techniques have come through workshops sponsored by industry, which may be biased toward a specific commercial medium and/or storage vessel. However, there are several media and vitrification vessels that can be used effectively within the IVF laboratory, each with potential strengths and weaknesses. Overview and training with various approaches are essential, especially with growing concerns over the safety of VTF solutions used, cryo-security, and accepting VTF eggs/embryos in unfamiliar VTF devices. We are entering a new era of cryobiology where we are faced with serious quality control challenges. 27 ARS
  28. 28. 46TH ANNUAL POSTGRADUATE PROGRAM This workshop is geared primarily toward those who would like to implement and optimize VTF in their laboratory. This live course will provide a solid background in the theories and basic science that has led to the current state of VTF in human systems. We will demonstrate good tissue practices (GTPs) and discuss quality control concerns. Participants will have an opportunity to train on the most common commercially available VTF systems being utilized in the United States. Following hands-on experience, each participant will be able to compare and contrast commonly utilized VTF systems on the market. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the cryobiological/cryophysical principles behind VTF technology via a “hands-on” workshop and contrast VTF and 28 standard slow-freeze preservation. 2. Evaluate, demonstrate, and practice with various commercially available VTF systems and assess the pros and cons in establishing a VTF program. 3. Describe the steps necessary to implement VTF in their laboratory (training, validation, and quality control). 4. Discuss methods for optimizing and maintaining high success rates with VTF. EARLY LIFE TOXICANT EXPOSURES AND ADULT REPRODUCTIVE DISORDERS: A POTENTIAL ROLE FOR NUTRITIONAL INTERVENTION IN BOTH SEXES Course PG18 (Sunday) Developed in Cooperation with the Environment and Reproduction Special Interest Group and the Nutrition Special Interest Group FACULTY Kevin G. Osteen, Ph.D., H.C.L.D., Chair Vanderbilt University Medical Center Kaylon L. Bruner-Tran, Ph.D. Vanderbilt University Medical Center Antoni J. Duleba, M.D. University of California, San Diego NEEDS ASSESSMENT AND COURSE DESCRIPTION Fetal programming is a normal component of developmental processes leading to appropriate organ system function in adults. However, early life programming processes can be negatively impacted by various environmental factors, including maternal stress, poor nutrition and exposure to various toxicants. Emerging evidence implies that disruption of fetal and neonatal programming may significantly affect an individual’s risk of adult disease, including reproductive failure. This concept, known as Developmental Origins of Health and Disease (DOHaD), requires clinical providers of reproductive medicine to examine the potential role of fetal/neonatal programming on adult pathology affecting fertility. This live course will present experimental evidence and clinical observations linking developmental toxicant exposure to reproductive disorders. Additionally, the faculty will discuss the significance of epigenetic programming on the heritability of toxicant-associated disorders and will describe the influence of nutrition on reducing the impact of a previous toxicant exposure. Finally, this course will present the emerging evidence that environmental toxicant exposure of animals and humans impacts adult reproductive function for multiple generations and will provide specific recommendations for providers to optimize patient care in fertility clinics. ACGME Competency Medical knowledge LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Evaluate the evidence implicating environmental toxicant exposure at different stages of life to disruption of adult reproductive tract function and development of disease. 2. List specific toxicants, their routes of exposure, and mechanisms of action that may negatively impact reproductive processes in humans. 3. Describe the DOHaD hypothesis and its relevance to reproductive medicine. 4. Discuss how nutrition may modify the negative impact of a prior toxicant exposure and improve reproductive outcomes. 5. Develop improved strategies for ascertaining a couple’s exposure history relevant to infertility treatment.
  29. 29. 46TH ANNUAL POSTGRADUATE PROGRAM ULTRASOUND IMAGING IN REPRODUCTIVE MEDICINE: A PRACTICAL APPROACH Course PG19 (Sunday) Developed in Collaboration with the American Institute of Ultrasound in Medicine FACULTY Ilan Tur-Kaspa, M.D., Chair Institute for Human Reproduction Beryl R. Benacerraf, M.D. Harvard Medical School Steven Goldstein, M.D. NYU School of Medicine Elizabeth Puscheck, M.D. Wayne State Medical Center NEEDS ASSESSMENT AND COURSE DESCRIPTION Ultrasound and ultrasound-guided procedures have become integral components, not just of assisted reproductive technology (ART), but also in the day-to-day practice of reproductive medicine, infertility and gynecology. In 2009, new practice guidelines for ultrasound in reproductive medicine were published by the American Institute of Ultrasound in Medicine (AIUM) and in collaboration with the American Society for Reproductive Medicine (ASRM). Surveys of members of the Society for Reproductive Endocrinology and Infertility, the Imaging Special Interest Group and ASRM have revealed a strong desire for CME credits in ultrasonography that would prepare reproductive medicine professionals and gynecologists for accreditation by the AIUM. In addition, there is an interest in training and credentialing reproductive nurses and nurse practitioners to perform limited ultrasounds in the office. The objective of this course is to provide comprehensive survey of the use of ultrasonography in the female pelvis for physicians and other healthcare providers who use gynecologic ultrasonography. A practical problem-solving approach will be implemented with case presentations. The faculty will critically review the application of ultrasonography to the infertility evaluation, diagnosis, treatments and complications as a way to maximize ART success. Ultrasound has helped in the early pregnancy evaluation and monitoring as well as in assessing pregnancy complications. Many other gynecologic findings on ultrasound such as congenital uterine anomalies, ovarian masses, tubal disease and other uterine pathologies will be discussed along with their impact on fertility and the decision for surgery. A variety of reproductive problems throughout the reproductive lifespan, from puberty through menopause, will be addressed from an ultrasound perspective. Newer technologies with current or potential applications, such as 3-dimensional (3-D) ultrasound, Doppler, and cost-effective use of CT- and MRI-guided procedures will also be covered. There will be interactive discussion of cases and controversies, and participants will also have the opportunity to learn practical applications and manipulate 3-D images. This course will fulfill CME requirements for AIUM credentialing. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Summarize the appropriate use of ultrasonography in the evaluation of infertility, uterine abnormalities and the pathology of the 29 reproductive tract. 2. Describe the proper assessment of early pregnancy and list findings on early pregnancy assessments that are associated with poor outcome. 3. Discuss the importance of 3-D ultrasonography in reproductive medicine, and the importance of Doppler blood flow assessment in reproductive medicine and gynecology. 4. Evaluate patients with pelvic pain, abnormal bleeding and adnexal masses using a practical approach. 5. Evaluate when surgical intervention is needed, when cancer is suspected and when imaging procedures can be performed to treat abnormalities on ultrasound.
  30. 30. 46TH ANNUAL POSTGRADUATE PROGRAM GLOBAL FAMILY PLANNING: THE KEY TO ACHIEVING MILLENNIUM DEVELOPMENT GOALS Course PG20 (Sunday) Developed in Cooperation with the Contraception Special Interest Group FACULTY Alison Edelman, M.D., M.P.H., Chair Oregon Health and Science University Paul Blumenthal, M.D. Stanford University Matthew F. Reeves, M.D., M.P.H. WomanCare Global NEEDS ASSESSMENT AND COURSE DESCRIPTION Unintended pregnancies continue to be at epidemic levels in the United States and worldwide. Unsafe abortion continues to be one of the top killers of women worldwide. The use of long-acting, reversible and permanent contraceptive methods prevent both pregnancies and abortions. One important barrier to contraceptive use is lack of knowledge and hands-on experience among healthcare providers on “best practices” for contraceptive care. In addition, providers lack the skills for safe abortion care including postabortion and miscarriage management. The Contraception Special Interest Group determined that a postgraduate course with a hands-on component would benefit reproductive endocrinologists, general obstetrician-gynecologists, general internists, family medicine providers, and nurse practitioners. The topics to be covered in this live course include: achieving millennium development goals (MDG) in the current world situation; family planning and the environment; postpartum/postabortion contraception; transcervical and minilaparotomy sterilization; natural family planning; medical management of spontaneous abortions, postabortion care, and safe abortion care; manual vacuum aspiration (MVA) from biopsies, retained placentas, to abortions; resources for the clinician; medical eligibility criteria from the World Health Organization and the Centers for Disease Control; and novel, developing contraception methods. The hands-on component will allow participants to improve clinical skills in postpartum/postabortion intrauterine device (ppIUD) insertion, Essure®/Adiana®, MVA, transcervical and minilaparotomy permanent contraception, and dilatation and evacuation. ACGME Competency Medical knowledge LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Analyze the current world situation, MDG goals and environmental issues related to population and family planning and recommend resources that aid the clinician in the provision of contraceptive care. 2. Explain family-planning methods with the greatest impact for reducing maternal morbidity and mortality (use of ppIUD, permanent 30 contraception, and novel methods being developed). 3. Apply the acquired skills to perform ppIUD insertion and transcervical and minilaparotomy permanent contraception. 4. Describe safe and standardized regimens for the medical management of incomplete abortion, miscarriage or undesired pregnancy. 5. Describe and demonstrate the use of manual vacuum aspirator for gynecologic, obstetric and family planning indications. OPTIMIZING THE SAFETY OF IN VITRO FERTILIZATION Course PG21 (Sunday) ARS Developed in Cooperation with the Society for Assisted Reproductive Technology FACULTY Valerie L. Baker, M.D., Chair Stanford University Medical Center Anja Pinborg, M.D. University of Copenhagen Catherine Racowsky, Ph.D. Brigham and Women’s Hospital and Harvard Medical School NEEDS ASSESSMENT AND COURSE DESCRIPTION Although assisted reproductive technology (ART) is a widely-used treatment that often leads to the birth of healthy children without serious maternal complications, concerns have been raised about increased risk of certain adverse outcomes for both the mother and the offspring. ART has been associated with higher rates of compromised fetal growth, preterm delivery, maternal complications such as preeclampsia, and possibly congenital anomalies and epigenetic disorders. Some risks of adverse outcomes associated with ART are likely attributable to the underlying infertility. However, it is important for clinicians to be aware of ART risks that may be associated with the treatment itself. Some adverse outcomes associated with ART may be attributable to multiple gestation, laboratory practices, or the unphysiologic maternal state in which pregnancy typically begins with ART. This live course will equip clinicians to better inform patients about the risks and benefits of various aspects of ART. Faculty will provide recommendations on how to mitigate the risks, including optimization of ovulation induction, and maximize the safety of ART. Other topics covered include an up-to-date understanding of the benefits and risks of various laboratory procedures and ART treatment for patients with medical problems.
  31. 31. 46TH ANNUAL POSTGRADUATE PROGRAM ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Choose individualized ovulation stimulation protocols with consideration given to both potential short-term and long-term 31 consequences for the mother and fetus. 2. Explain the risks and benefits of laboratory practices such as extended culture, embryo biopsy at different stages, oocyte cryopreservation and open versus closed vitrification. 3. Provide recommendations that will reduce the risk of multiple gestation while still maintaining a high live-birth rate. 4. Advise patients at increased risk of pregnancy complications. THE SIGNIFICANCE, IMPLICATIONS AND HERITABILITY OF MALE INFERTILITY AS A DISEASE Course PG22 (Sunday) ARS Developed in Cooperation with the Society for Male Reproduction and Urology FACULTY Paul J. Turek, M.D., Chair The Turek Clinic Douglas T. Carrell, Ph.D., H.C.L.D. University of Utah School of Medicine Andrea Salonia, M.D. University Vita-Salute San Raffaele Thomas J. Walsh, M.D., M.S. University of Washington School of Medicine NEEDS ASSESSMENT AND COURSE DESCRIPTION The clinical significance of the male factor infertility evaluation has been underestimated to date. Given the well-described associations between male infertility and a) underlying concurrent medical conditions, b) genetic anomalies, c) environmental exposures and d) future cancers, male factor infertility is clearly a disease of clinical and epidemiological significance. However, it is estimated that less than one in four infertile males in the United States receives the recommended male factor evaluation as part of the couple infertility assessment. Educating clinicians about the implications of male factor infertility is the first step in changing clinical behavior that incorporates the male factor evaluation into every couple’s assessment. Through a thorough discussion of our current understanding of the medical, genetic and epidemiologic issues associated with male factor infertility, this course seeks to raise awareness and change practice patterns of clinicians who care for infertile couples. By emphasizing that male infertility is a window into both current and future health of the individual (i.e., is a biomarker of health), this course will: improve clinicians’ level of understanding and knowledge of relevant lifestyle issues and behaviors that are associated with infertility, help clinicians precisely identify those individuals at risk for genetic infertility, and enable clinicians to better educate their patients regarding the health risks associated with a male infertility diagnosis. It is our hope that this course will enlighten clinicians, laboratory technicians and researchers alike of the full impact of male infertility on the health, quality of life and longevity of affected individuals. ACGME Competency Patient care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Describe three metabolic or hormonal disorders that are associated with male factor infertility. 2. List the clinical criteria that define men at risk for genetic infertility due to Y chromosome deletions or karyotype anomalies. 3. Delineate four lifestyle, occupational or exposure risk factors linked to male factor infertility. 4. List two cancers that are more likely to occur in infertile men than otherwise healthy men AFTER a diagnosis of male factor infertility. 5. Explain two genetic or medical conditions in offspring that are associated with severe male factor infertility or older paternal age.
  32. 32. 46TH ANNUAL POSTGRADUATE PROGRAM TRAINING PEOPLE IN LOW-COST INFERTILITY AND ART TREATMENT Course PG23 (Sunday) Developed in Cooperation with the International Federation of Fertility Societies FACULTY Ian D. Cooke, M.B., FRCOG, F.Med.Sci., Chair University of Sheffield Luca Gianaroli, M.D. S.I.S.Me.R. M. Cristina Magli, Ph.D. S.I.S.Me.R. Pasquale Patrizio, M.D., M.B.E. Yale University NEEDS ASSESSMENT AND COURSE DESCRIPTION Access to infertility diagnosis and treatment is extremely poor in the developing world. There are too few clinics or private doctors interested in and competent to manage infertility problems, no adequate referral systems, and few trained staff. National health services provide few treatments as many countries struggle with major disease, such as human immunodeficiency virus (HIV), malaria and tuberculosis (TB). Available private services are usually too costly for the average patient and can result in catastrophic expense. The most common cause of infertility in developing nations is tubal obstruction from infection, either chlamydia, gonorrhea or postpartum or postabortion sepsis, where the only realistic management plan includes in vitro fertilization (IVF). However, public health education on reproduction is minimal and infertility is surrounded by fear and superstition and compounded by local religious attitudes. Treatment options are not widely known and sophisticated methods, such as assisted reproductive technology (ART), are not available. Management of infertility needs to be conducted within a framework of adequate reproductive health services, so that preparation for pregnancy, the pregnancy and the delivery are competently managed, in places where skilled attendance at delivery may not be standard practice. Health professionals, either nationals of low resource economies or altruistic academics from developed countries, wanting to implement infertility treatments and ART in the developing world must understand the problems and acquire the competence to approach them in ways that are cost-effective for their region and not simply attempt to transfer systems developed for more-affluent environments. This live course will describe how to develop assisted-conception services in low-resource environments. Discussion will cover how to find suitable laboratory space, provide robust equipment and maintain it in working order, maintain lab records with a view to quality control, trouble shoot, and use the laboratory data to develop the service. Identifying potential patients, patient screening, meeting with both partners, and treatment prior to ART will be emphasized as well as the principles of preparation for pregnancy and obstetric care. The indications for intra-uterine insemination (IUI) and IVF (and the need for intra-cytoplasmic sperm injection [ICSI]) will be elaborated in the context of education about reproductive biology, pathology and specific treatment for the couple and the implications for public health education. Minimal ovarian stimulation will be discussed in the context of avoiding hyperstimulation and multifetal pregnancy. The critical role of ultrasound will be presented with technical details of appropriate apparatus and the skill requirements and methods for acquiring them will be presented. The role of various staff members will be elaborated and include quality standards. Finally, an appraisal of the financial viability of developing an assisted-conception clinic and the use of data obtained from such a clinic will be detailed. Data can be reported to national and international registries and used to attract patients and influence policy related to service provision at a national level, thus helping to extend local health service to a greater proportion of the population in accordance with the World Health Organization rubric of appropriately-stratified healthcare. ACGME Competency Systems-based practice LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the rationale for providing assisted-conception services in low-resource environments. 2. Develop a clinic offering suitable ART services and competently manage patients in such a setting. 3. Specify the steps required for financial viability and for quality data retention and reporting. 4. Develop educational programs suitable for patients, the general public and health service administrators. 32
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