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Transforming Reproductive Medicine Worldwide

OCTOBER 12 - 17, 2013

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

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:

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!

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.

Welcome to Boston!

Information on Boston provided by the Greater Boston Convention and Visitors Bureau

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museum-ad.indd 2 8/29/13 1:53 PM

NIGHT MUSEUMATTHE

OF SCIENCEBOSTON • MA

Party at Boston’s Museum of Science:

THREE FLOORS TO EXPLORETHE 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 ActivitiesPLUS Transportation to/from ASRM hotels

museum-ad.indd 1 8/29/13 1:53 PM

Shuttle Bus RoutesShuttle Bus Routes

Route # 1Route # 1HOTELS PICK UP LOCATION

Sheraton Boston Curbside on Dalton St.


Westin Copley Walking to Marriott (Curbside on Huntington)Fairmont Copley Walking to Marriott (Curbside on Huntington)Boston Marriott Copley Place Curbside on Huntington


Hilton Financial Main EntranceOmni Parker House Curbside on Tremont, across St. next to bank

Hyatt Regency Curbside on Avenue de Lafayette


Boston Park Plaza Columbus Ave. EntranceCourtyard Tremont Tremont St. Entrance


Renaissance Waterfront Side Entrance on CongressSeaport Boston Plaza Level of Hotel

Walking HotelWalking HotelHOTELS PICK UP LOCATION

Westin Boston Waterfront No Shuttle Service Provided

Shuttle Bus Schedule

DATE SERVICE HOURS FREQUENCY

Saturday, October 12, 2013 6:30am-9:30am4:30pm-6:30pm

30 MINUTE SERVICE30 MINUTE SERVICE

Sunday, October 13, 2013 6:30am-9:30am4:30pm-10:30pm


Monday, October 14, 20136:30am-9:30am9:30am-3:30pm3:30pm-7:30am

15 MINUTE SERVICE30 MINUTE SERVICE15 MINUTE SERVICE

Tuesday, October 15, 20136:30am-9:30am9:30am-3:30pm3:30pm-7:30am


Wednesday, October 16, 20136:30am-9:30am9:30am-3:30pm

**3:30pm-10:30pm**


Thursday, October 17, 2013 6:30am-9:30am9:30am-3:30pm


**Wednesday, October 16, 2013: Shuttle Service will run from the HOTELS to the MUSEUM OF SCIENCE from 6:45pm-10:30pm EVERY 15 Minutes**

Reception will be held in the Boston Convention and Exhibition Center's Exhibit Hall following the Opening Ceremony.

Ways to be a Champion

For more information about these programs, please contact Pam Nagel, ASRM Director of Society Advancement, at 205-978-5000, ext. 121 or [email protected].

JOINT MEETING WITH IFFS/ASRM • OCT. 12-17, 2012 • BOSTON, MA. ASRM MEMBER GUIDE - 7

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.

Write the Next ChapterSustaining education, research, and advocacy programs for the future

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

Donate to support these programs:

IFFS WELCOMEAs 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

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

Joe Leigh Simpson, M.D.IFFS President 2012-2016

ASRM WELCOMEAs 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 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

Linda C. Giudice, M.D., Ph.D.ASRM President 2012-2013

IFFS WELCOME . . . . . . . . . . . . . . . . . . . . . 8

ASRM WELCOME . . . . . . . . . . . . . . . . . . 8

EXHIBIT HOURS . . . . . . . . . . . . . . . . . . . . . 9

IFFS/ASRM CONJOINTMEETING PROGRAMPLANNING COMMITTEE . . . . . . . . . . . 10

IFFS OFFICERS & BOARD OF DIRECTORS . . . . . . . . . . . . . . . . . . . . . . . 11

ASRM OFFICERS & BOARD OF DIRECTORS . . . . . . . . . . . . . . . . . . . . . . . 11

IFFS/ASRM ANNUAL MEETINGPOLICIES & DISCLAIMERS . . . . . . . . . 12

CONTINUINGEDUCATION CREDIT . . . . . . . . . . . . . 13

DISCLOSURE STATEMENTS &CONFLICT OF INTEREST POLICY . . . . 14

POSTGRADUATE PROGRAM . . . . . . . . . . . . . . . . . . 15-34

NEEDS ASSESSMENT &LEARNING OBJECTIVES . . . . . . . . . . . 35

SCIENTIFIC PROGRAMDAILY SCHEDULE . . . . . . . . . . . . . 36-47

NICHD DETERMINANTS OFGAMETE & 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 FESTIVALVIDEO SESSION . . . . . . . . . . . . . . . . 109

PARTICIPANT & SPOUSE/PARTNER DISCLOSURES INDEX . . . . . . . . 110-112

VIDEO DISCLOSURES INDEX . . . . . . 113

PROGRAM PARTICIPANTS - NON-ORAL/POSTER PRESENTERSINDEX . . . . . . . . . . . . . . . . . . . . 114-116

INSIDE Be Sure to Visit the Exhibit Hall

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.

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.

CERTIFICATE OF ATTENDANCEProof 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 BADGESName 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 RECORDINGPhotographing or audio/video recording of any session for personal or commercial purposes without permission is prohibited.

Morning Poster SessionsPoster 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.

IFFS/ASRM CONJOINT MEETINGPROGRAM PLANNING COMMITTEE

IFFS SCIENTIFIC COMMITTEEBasil Tarlatzis (Greece), Chair

Joe Leigh Simpson (USA), PresidentLiselotte Mettler (Germany), 2010 Chair Local SC

Linda Giudice (USA), 2013 Congress ChairSerdar Bulun (USA), 2013 Chair Local SCDhiraj Gada (India), 2016 Congress Chair

Narendra Malhotra (India), 2016 Chair Local SCRichard Kennedy (UK), Secretary General, ex officio member

Paul Devroey (Belgium), Director of Medical Education, ex officio memberDavid 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 COMMITTEESLinda C. Giudice, M.D., Ph.D., ASRM PresidentSerdar E. Bulun, M.D., Scientific Program Chair

Lawrence C. Layman, M.D., Interactive Sessions ChairKurt T. Barnhart, M.D., Roundtable Program Chair

Anuja Dokras, M.D., Ph.D., Postgraduate Program ChairLisa M. Halvorson, M.D., Postgraduate Program Co-Chair

Kathleen Hwang, M.D., Postgraduate Program Coordinating ChairBradley 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 ChairsKurt 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 ChairsGrace M. Janik, M.D., and Jeffrey M. Goldberg, M.D., Society of Reproductive Surgeons Program Chairs

Nidhi Desai, J.D., Legal Professional Group Program ChairClaudia 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 ChairThomas G. Turner, M.S., and Charles L. Bormann, Ph.D. Society of Reproductive Biologists and Technologists Program

ChairsJoseph J. Travia, Jr., B.S., M.B.A., Association of Reproductive Managers Program Chair

Catherine Racowsky, Ph.D., Ad Hoc MemberMarcelle I. Cedars, M.D., Ad Hoc Member

Robert E. Brannigan, M.D., Ad Hoc MemberRobert W. Rebar, M.D., ASRM Executive Director

Andrew R. La Barbera, Ph.D., H.C.L.D., ASRM Scientific DirectorLee Hutchison Boughton, M.A., ASRM Scientific Program CoordinatorPenelope Fenton, M.A., ASRM Postgraduate Program Coordinator

ASRM VIDEO COMMITTEESteven 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.

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 SOCIETIESMarc 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 DIRECTORRobert W. Rebar, M.D.

ASRM SCIENTIFIC DIRECTORAndrew R. La Barbera, Ph. D., H.C.L.D.

Ex Officio

IFFS OFFICERS AND BOARD OF DIRECTORS 2010 - 2013

IFFS OFFICERSJoe Leigh Simpson (USA), President

Richard Kennedy (UK), Secretary GeneralGabriel de Candolle (Switzerland), Assistant Secretary General

Edgar Mocanu (Ireland), TreasurerMauricio Abrao (Brazil), Assistant Treasurer

Basil Tarlatzis (Greece), Past PresidentPaul 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

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Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance

and on signage throughout the convention center.

IFFS/ASRM Annual Meeting Policies and Disclaimers

CANCELLATION POLICYThe 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 POLICYCancellations 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 STATEMENTThe 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 STATEMENTThe 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 STATEMENTThe 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.

15

Continuing Education CreditContinuing 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 SymposiaCommercially 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 StatementThe 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 StatementThe 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 GynecologistsTthe 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 creditforms 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 CreditsThe 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 CEUsPostgraduate 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 ATTENDANCEProof 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 BADGESName 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 RECORDINGPhotographing or audio/video recording of any session for personal or commercial purposes without permission is prohibited.

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.

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, unlessotherwise noted.

Indicates a postgraduate course that qualifies for CE credit.

Indicates Audience Response System (ARS) will be used during session.

CE ARSNon-CME

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Disclosure Statements/Conflict of Interest Policy

2013 IFFS/ASRM Conflict of Interest Policy for Invited SpeakersHonoraria

The following speakers may receivehonoraria and/or discounted or freeregistration:

• 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 StatementsPostgraduate Faculty, Symposium Speakers, Plenary Lecturers, Abstract Authors, Trilogy Speakers, Abstract Graders, Roundtable Presenters, VideoPresenters, and Interactive Speakersare 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 andContinuing Education Credits will be available.

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46TH ANNUAL POSTGRADUATE

PROGRAM COMMITTEE

CHAIRAnuja Dokras, M.D., Ph.D.

CO-CHAIRLisa M. Halvorson, M.D., Ph.D.

COORDINATING CHAIRKathleen Hwang, M.D.

AD HOCBradley J. Van Voorhis, M.D.

WEEKEND COURSESDates:

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 courseon Saturday and Sunday.

Postgraduate Course Syllabi will be posted

online in September 2013.

Printed copies will be distributed on-site.

Postgraduate ProgramOne-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

FACULTYDeborah 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 DESCRIPTIONDifferent 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 CompetencyPatient care

LEARNING OBJECTIVESAt 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 2013Course PG2 (Saturday)

Developed in Cooperation with the American Society for Reproductive Medicine Coding Committee

FACULTYJohn T. Queenan Jr., M.D., Chair University of Rochester Medical Center

George A. Hill, M.D. Nashville Fertility Center

NEEDS ASSESSMENT AND COURSE DESCRIPTIONEvery 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

ARS

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46TH ANNUAL POSTGRADUATE PROGRAM

COMPLICATIONS OF ART: IN SEARCH OF A HAPPY ENDINGCourse PG3 (Saturday)

Developed in Cooperation with the Nurses’ Professional Group

FACULTYAngela 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 DESCRIPTIONThe 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 CompetencyPractice-based learning and improvement

LEARNING OBJECTIVESAt 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.

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 CompetencySystems-based practice

LEARNING OBJECTIVESAt 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

services.

Non-CME

CE ARS

19


Developed in Cooperation with the Society of Reproductive Biologists and Technologists

FACULTYAmy 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 DESCRIPTIONCryopreservation 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 storage of cells and tissues.


LEARNING OBJECTIVESAt 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?”

CRYOPRESERVATION OF REPRODUCTIVE CELLS AND TISSUES:REAL WORLD APPROACHES AND LABORATORY PEARLS


A SIMPLIFIED RISK-FREE IVF WITHOUT COMPROMISING OUTCOMECourse PG5 (Saturday)

Developed in Cooperation with the Middle East Fertility Society

FACULTYMohamed 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 DESCRIPTIONThe 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

ARS

20

46TH ANNUAL POSTGRADUATE PROGRAMwith 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.


LEARNING OBJECTIVESAt 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.

Developed in Cooperation with the Legal Professionals Group

FACULTYNidhi 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 DESCRIPTIONThe 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.


LEARNING OBJECTIVESAt 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.

CROSSING BORDERS AND OTHER HOT LEGAL ISSUESFOR THE HEALTHCARE PROVIDER AND LEGAL PRACTITIONER


21

ULTRASOUND IMAGING IN ARTCourse PG7 (Saturday)


Developed in Collaboration with the American Institute of Ultrasound in Medicine

FACULTYLaurel 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 DESCRIPTIONUltrasound 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.


LEARNING OBJECTIVESAt 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

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.

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CRITERIA FOR WORLD-CLASS PERFORMANCE EXCELLENCECourse PG8 (Saturday)


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 DESCRIPTIONReproductive 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.


LEARNING OBJECTIVESAt 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

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.

Developed in Cooperation with the Genetic Counseling Special Interest Group

FACULTYJill 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 DESCRIPTIONReproductive 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

THE ART OF GENETICS: REPRODUCTIVE GENETICS IN THE ART SETTINGCourse PG9 (Saturday)

Non-CME

CE

23

46TH ANNUAL POSTGRADUATE PROGRAMand 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.


LEARNING OBJECTIVESAt 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

PGD.

NEW FAMILIES ON TRIALCourse PG10 (Saturday)

Developed in Cooperation with the Mental Health Professional Group

FACULTYAndrea Mechanick Braverman, Ph.D., ChairJefferson Medical College

Nanette Elster, J.D., M.P.H.Health Law Institute

Julia Woodward, Ph.D.Duke University Medical Center

NEEDS ASSESSMENT AND COURSE DESCRIPTIONThe 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 CompetencyInterpersonal and communication skills

LEARNING OBJECTIVESAt 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

THIRD PARTY REPRODUCTION IN THE UNITED STATES:LEGAL, MEDICAL AND PSYCHOLOGICAL/ETHICAL ASPECTS



Developed in Cooperation with the Society for Assisted Reproductive Technology

FACULTYJames 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 DESCRIPTIONThird-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.


LEARNING OBJECTIVESAt 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

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 SUCCESSCourse PG12 (Saturday)

Developed in Cooperation with the European Society of Human Reproduction and Embryology

FACULTYAntonis 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 DESCRIPTIONDuring 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 CompetencyMedical knowledge

ARS

25

46TH ANNUAL POSTGRADUATE PROGRAMLEARNING 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 ADOLESCENTSCourse PG13 (Saturday)

Developed in Cooperation with the Pediatric and Adolescent Gynecology Special Interest Group

FACULTYJennifer 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 DESCRIPTIONPolycystic 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.


LEARNING OBJECTIVESAt 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

and early intervention.4. Discuss the available treatment options for adolescents with PCOS.

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PCOS: CARING FOR A WOMAN OVER HER LIFETIMECourse PG14 (Sunday)

Developed in Cooperation with the Society for Reproductive Endocrinology and Infertility

FACULTYKurt 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 DESCRIPTIONPolycystic 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 CompetencyPractice-based learning and improvement

LEARNING OBJECTIVESAt 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

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 INFERTILITYCourse PG15 (Sunday)

Developed in Cooperation with the Endometriosis Special Interest Group

FACULTYHugh 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 DESCRIPTIONEndometriosis 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.


One-Day CoursesSunday, October 13, 2013

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46TH ANNUAL POSTGRADUATE PROGRAMLEARNING OBJECTIVESAt 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 DEVELOPMENTSAND 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

FACULTYGloria 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 DESCRIPTIONUterine 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.


LEARNING OBJECTIVESAt 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 CONTROLCONCERNS OF GAMETE, EMBRYO AND TISSUE VITRIFICATION


Developed in Cooperation with the Society of Reproductive Biologists and Technologists

FACULTYCharles 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 DESCRIPTIONVitrification (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.

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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.


LEARNING OBJECTIVESAt 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

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


Developed in Cooperation with the Environment and Reproduction Special Interest Group and the Nutrition Special Interest Group

FACULTYKevin 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 DESCRIPTIONFetal 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.


LEARNING OBJECTIVESAt 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.

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ULTRASOUND IMAGING IN REPRODUCTIVE MEDICINE: A PRACTICAL APPROACHCourse PG19 (Sunday)

Developed in Collaboration with the American Institute of Ultrasound in Medicine

FACULTYIlan 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 DESCRIPTIONUltrasound 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.


LEARNING OBJECTIVESAt 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

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.

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GLOBAL FAMILY PLANNING: THE KEY TO ACHIEVING MILLENNIUM DEVELOPMENT GOALSCourse PG20 (Sunday)

Developed in Cooperation with the Contraception Special Interest Group

FACULTYAlison 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 DESCRIPTIONUnintended 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.


LEARNING OBJECTIVESAt 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

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 FERTILIZATIONCourse PG21 (Sunday)

Developed in Cooperation with the Society for Assisted Reproductive Technology

FACULTYValerie 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 DESCRIPTIONAlthough 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.

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46TH ANNUAL POSTGRADUATE PROGRAMACGME CompetencyPatient care

LEARNING OBJECTIVESAt 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

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 DISEASECourse PG22 (Sunday)

Developed in Cooperation with the Society for Male Reproduction and Urology

FACULTYPaul 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 DESCRIPTIONThe 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.


LEARNING OBJECTIVESAt 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.

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TRAINING PEOPLE IN LOW-COST INFERTILITY AND ART TREATMENTCourse PG23 (Sunday)

Developed in Cooperation with the International Federation of Fertility Societies

FACULTYIan 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 DESCRIPTIONAccess 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.


LEARNING OBJECTIVESAt 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.


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PGD IMPACT ON ART EFFICIENCY WITH INTRODUCTION OF MICROARRAY TECHNOLOGY FOR 24 CHROMOSOME ANEUPLOIDY TESTING

Course PG24 (Sunday)Developed in Cooperation with the Preimplantation Genetic Diagnosis Special Interest Group

FACULTYAnver Kuliev, M.D., Ph.D., Chair Reproductive Genetics Institute

Santiago Munné, Ph.D., Co-Chair Reprogenetics

Dagan Wells, Ph.D., FRCPath University of Oxford

Joe Leigh Simpson, M.D. March of Dimes Foundation

NEEDS ASSESSMENT AND COURSE DESCRIPTIONAt least 50% of oocytes and embryos from in vitro fertilization (IVF) patients of advanced reproductive age are chromosomally abnormal, contributing significantly to infertility and pregnancy loss. Because of the present controversy on the impact of preimplantation genetic testing (PGT) for aneuploidies on the improvement of assisted reproductive technology (ART), there is a need for the development of efficient and robust methods for preselection of aneuploidy-free embryos for transfer. The available methods based on morphological criteria are not sufficient for selection of embryos with the highest developmental potential. The previous methods for aneuploidy testing were based on the fluorescence in situ hybridization (FISH) technique, which has an important limitation of not detecting abnormalities of all the chromosomes. In addition, the procedure is predominantly applied at the cleavage stage, which is compromised by the high risk of mosaicism that may contribute to false positive and false negative results. This live course is aimed at increasing the knowledge and competence of fertility specialists and laboratory professionals, but will also be of interest to a wider audience, taking into consideration the recent controversy regarding preimplantation aneuploidy testing. Faculty will introduce microarray technology, which tests for all 24 chromosomes, and the application of this technology to different biopsy materials, including polar bodies, blastomeres and blastocysts. Participants will analyze the different platforms for 24 chromosome aneuploidy testing and review data on the clinical outcome of the application of this methodology.


LEARNING OBJECTIVESAt the conclusion of this course, participants should be able to:1. Evaluate the contribution of the FISH technique to the false positive and false negative results and the impact on the clinical

outcome data.2. Describe the practical application of preimplantation 24 chromosome testing to PGD for chromosomal disorders.3. Explain the importance of selection of the optimal biopsy procedure for the highest accuracy of preimplantation 24 chromosome

aneuploidy testing.4. Discuss the expected efficiency of 24 chromosome aneuploidy testing, depending on the type of microarray technique used and

the differences of the applied biopsy procedures.


MANAGING MENOPAUSE...WITH FINGERS ON THE PULSE AND EYES ON THE FUTURECourse PG25 (Sunday)

Developed in Cooperation with the Menopause Special Interest Group

FACULTYLubna Pal, M.B.B.S., M.S., Chair Yale University School of Medicine

Nanette F. Santoro, M.D. University of Colorado at Denver

Genevieve Neal-Perry, M.D., Ph.D. Albert Einstein College of Medicine and Montefiore Medical Center

NEEDS ASSESSMENT AND COURSE DESCRIPTIONMenopausal management has transformed over the past decade, with an obvious shift from a relatively liberal use of exogenous hormones in the pre-Women’s Health Initiative era, to a more cautious stance regarding the place of menopausal hormone therapy in the management of menopause-related symptoms. Concerns regarding long-term implications of menopausal hormone therapy appear to underlie this change in clinical practice. Although today’s clinicians are sensitized to the unique needs of an individual menopausal woman, and are better aware of the expanding spectrum of therapeutic options, the management paradigms still remain ambiguous for many and the dichotomy of findings from observational studies and randomized trials continue to confuse patients and providers alike. Easy access to “proverbial” and “anecdotal” information via the Internet has magnified the complexity of clinician-patient discussions and frequently influences patient choices and decisions related to menopause management. Early diagnosis and advances in the field of oncology are contributing to increasing numbers of relatively young cancer survivors

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who are experiencing premature ovarian insufficiency after chemo-radiation therapy. Clinical evidence suggests that the health burden attributable to premature cessation of ovarian function in this population may not be adequately appreciated or addressed. It is thus essential for clinicians who care for young female cancer survivors to understand the needs and concerns relating to iatrogenic menopause in this unique population. Today’s targeted approach to clinical practice may restrict a clinician’s ability to explore an individual patient’s non-verbalized concerns, an aspect that is of particular relevance for women transgressing the spectrum of peri and early menopause. In addition to being cognizant of climacteric symptoms and the available strategies for symptom control, providers should also be prepared to treat the needs of perimenopausal and early menopausal women, including preventive care, risk quantification and risk reduction, and contraceptive and procreative preferences. The future of menopausal management, driven by concepts of selective estrogen receptor modulators (SERMs), tissue selective estrogen complexes (TSECs) and stem cell therapy, promises a dynamic terrain that is likely to redefine how we care for the perimenopausal and menopausal woman. The decision to offer a particular management strategy is dictated by the patient’s clinical presentation and a thorough evaluation of the individualized risk versus benefit profile. Large gaps exist between patient expectations and provider competency to help guide patient decision making. Consistent with the literature, surveys conducted by the American Society for Reproductive Medicine (ASRM) in 2009 and 2011 members identified personal practice gaps in the treatment of menopause-related issues, and requested educational activities to specifically address their understanding of individualized treatment approaches. The goal of this live course is to offer a critical review of evidence-based recommendations that will give clinicians the skill set to provide comprehensive, competent care to women making the transition into menopause.


LEARNING OBJECTIVESAt the conclusion of this course, participants should be able to:1. Individualize risk assessment and recommend risk reduction strategies for peri and postmenopausal women, and develop optimal,

individualized management strategies of contraceptive and procreative needs in the perimenopausal population.2. Compare and contrast the efficacy, safety and side effects of available therapies (hormonal and non-hormonal) for common

menopausal disorders, and design treatment plans for women with diverse disease states and of different ages with menopausal symptoms and/or osteoporosis.

3. Distinguish the unique needs and risks of women experiencing unnatural menopause (premature, surgical or following chemo-radiation), and develop individualized management strategies.

4. Explain emerging concepts in menopausal medicine (e.g., SERMs, TSECs and stem cell).


HYSTEROSCOPY FOR THE REI SURGEON: INDICATIONS, PROCEDURES AND HANDS-ON EXPERIENCECourse PG26 (Sunday)

Developed in Cooperation with the Society of Reproductive Surgeons

FACULTYSteven F. Palter, M.D., Chair Gold Coast IVF

Keith B. Isaacson, M.D., Co-Chair Harvard Medical School

Jeffrey M. Goldberg, M.D. Cleveland Clinic

NEEDS ASSESSMENT AND COURSE DESCRIPTIONHysteroscopic surgery is the main modality available to treat anatomic uterine disorders, yet many expert reproductive endocrinology and infertility (REI) surgeons are limited in hysteroscopic expertise and lack familiarity with new technological advances. This live course has been designed for reproductive surgeons who want to advance their hysteroscopic skills by becoming familiar with the major diseases that can be treated and the new technological instrumentation available. Surveys of reproductive surgeons have consistently demonstrated greater utilization of laparoscopy than hysteroscopy despite the fact that both are basic endoscopic tools learned in postgraduate training. Technological advances have produced many new therapeutic options designed to simplify and increase the safety of hysteroscopic surgery. Major advances have made procedures less invasive and have enabled more office-based therapeutics. Many practitioners are unsure if they should implement these new tools into their practice and who are the ideal candidates for them. A hands-on course offers the bridge between didactic learning and actual practical familiarity with hysteroscopic tools and procedures for reproductive surgeons. This course will give participants the knowledge when to perform hysteroscopic surgery for a variety of classical and new indications and then the basic skills of using the gamut of instrumentation now available. The faculty will demonstrate and then assist attendees in learning these procedures. While didactic lectures will improve attendee knowledge, the hands-on components will directly lead to improvement in skills and allow participants to choose which tools to implement into their practice.

ACGME CompetencyPatient Care

LEARNING OBJECTIVESAt the conclusion of this course, participants should be able to:

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HUMAN EMBRYOLOGY AND ANDROLOGY FOR PHYSICIANSCourse PG27 (Saturday & Sunday)

Developed in Cooperation with the American Association of Bioanalysts

FACULTYTammie Schalue, Ph.D., H.C.L.D., E.L.D., Chair Heartland Center for Reproductive Medicine

Joe Conaghan, Ph.D., H.C.L.D. (ABB) Pacific Fertility Center

Brooks Keel, Ph.D., H.C.L.D. (ABB) Georgia Southern University

Dolores Lamb, Ph.D., H.C.L.D. (ABB) Baylor College of Medicine

Richard T. Scott, Jr., M.D., A.L.D., H.C.L.D. Robert Wood Johnson Medical School

Nichola Winston, Ph.D., H.C.L.D. (ABB) University of Illinois College of Medicine at Chicago

NEEDS ASSESSMENT AND COURSE DESCRIPTIONA complete and thorough understanding of male and female reproductive physiology as well as laboratory andrology and assisted reproductive technology (ART) laboratory techniques are essential to any clinician working in the field of reproduction but are critical for a successful ART clinical practice. This live course will provide residents, fellows, physicians, nurses, and ART laboratory personnel with a greater understanding of the principles related to reproduction and those factors necessary for ART clinical success. An overview of male and female reproductive functions will be presented covering topics from the hypothalamic gonadal axis to gamete and embryo biology. Other areas of presentation will include cryobiology and cryopreservation principles, genetic factors affecting reproduction in humans, preimplantation genetic diagnosis, and regulatory issues related to ART. Heavy emphasis will be given to the biology/physiology behind the processes. Poor understanding of reproductive biology and physiology makes it impossible for a clinician to provide his/her patients with the best possible care. This course will familiarize the participant with the essential anatomical and physiological components to ensure the production of viable human male and female gametes. The participant will learn how mature male and female gametes are produced as well as how they arrive at the point of fertilization, how they interact to bring about fertilization and oocyte activation, and how the fertilized zygote develops through the stages of preimplantation development. Participants will come away with a firm understanding of the various tests used in semen analysis testing and the physiological basis for these tests. Additionally, the participants will learn the limitation of the embryo selection process, how to perform proficient embryo transfer procedures to optimize pregnancy, and the physiology and mechanisms behind ovarian stimulation protocols. Ample time will be allowed for discussion and interaction to further the participant’s knowledge base and disseminate information.

ACGME CompetencyMedical Knowledge

LEARNING OBJECTIVESAt the conclusion of this course, participants should be able to:1. Review male and female reproductive physiology and identify areas that are critical for successful ART.2. Explain semen analysis procedures and what the analysis results may indicate clinically.3. Discuss cryobiology principles and techniques and how these principles and techniques are applied to ART. 4. Identify critical steps within the ART process where quality control and quality assurance impact outcomes.5. Formulate practical quality control and quality assurance programs for the ART clinic and laboratory.6. Review regulatory issues related to ART clinics and laboratories and discuss how these regulations may be implemented and

compliance documented.


Two-Day CourseSaturday, October 12, 2013 - Sunday, October 13, 2013

1. Discuss the advantages and disadvantages of different techniques of uterine cavity assessment, including hysterosalpingography, vaginal ultrasound, sonohysterography, and office hysteroscopy, and diagnose uterine anomalies that impact fertility.2. Summarize when to treat myomas, describe various new treatment options, and counsel patients regarding treatment options for uterine anomalies.3. Choose between the methods and new technologies for hysteroscopically correcting conditions such as uterine fibroids, uterine polyps, and synechiae as well as congenital uterine anomalies.4. Assemble, disassemble, and troubleshoot commonly used and advanced hysteroscopic tools.5. Demonstrate hysteroscopic techniques, including diagnostic procedures, myomectomy, polypectomy, lysis of adhesions, and septum repair.

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CAP COURSEREPRODUCTIVE LABORATORY ACCREDITATION PROGRAM INSPECTOR TRAINING SEMINAR


To register for this course, please contact CAP Learning at 800-323-4040 Option 1 or [email protected]

FACULTYErica J. Behnke, Ph.D., H.C.L.D.Kepler Johnson, E.L.DJacob Meyer, Ph.D., H.C.L.D.

CAP STAFFKathleen Passerelli, M.T. (ASCP)Lyn Weiglos, M.T. (ASCP)

NEEDS ASSESSMENT AND COURSE DESCRIPTIONIn collaboration with ASRM, the College of American Pathologists (CAP) has developed an accreditation program specifically designed for the unique needs of reproductive laboratories. This program was created with the primary objective of improving the quality of laboratory services through voluntary participation, professional peer review, education, and compliance with established performance standards. Due to recent changes in accreditation inspection requirements, additional laboratorians may be involved in the inspection process. Experience has shown that laboratorians already possess the technical knowledge regarding good laboratory practices. The purpose of this live course is to demonstrate effective inspecting techniques so that inspectors will be more confident and comfortable performing inspections. The morning sessions focus on the overall inspection process including team preparation, resources, and practical “how to” tips of conducting the inspection. The afternoon consists of sessions highlighting the accreditation requirements unique to embryology, andrology, and cryobiology testing. Sessions include PowerPoint presentations, small and large group discussions regarding inspection scenarios, and hands-on document reviews. This seminar fulfills both the team leader and team member training requirements.

LEARNING OBJECTIVESAt the conclusion of this course, participants should be able to:1. Prepare and perform an inspection using CAP resources.2. Perform generally accepted techniques to produce consistent inspection findings. 3. Identify deficiencies and recommendations and appropriately document findings.4. Discuss compliance requirements unique to embryology, andrology and cryobiology.

NOTE: To fulfill the CAP inspector training requirement, you must complete the online post-test. Instructions and a link to the post-test will be provided after the live seminar.


UPCOMING IFFS ANNUAL

MEETING

2016INDIA

October 18-22, 2014Honolulu, HIHawaii Convention Center

October 17-21, 2015Baltimore, MDBaltimore Convention Center

FUTURE ASRMANNUAL MEETINGS

CAP CourseSaturday, October 12, 2013

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IFFS/ASRM 2013 Scientific ProgramNeeds Assessment and Description

The field of reproductive medicine is evolving rapidly with advances reflecting the multicultural contributions of the global community of healthcare professionals. The IFFS Scientific Committee and the ASRM Scientific Program Committee selected as their theme for the 2013 conjoint meeting “Transforming Reproductive Medicine Worldwide” to emphasize international collaborative efforts to improve every patient’s ability to fulfill his or her reproductive destiny. Reproductive healthcare is challenged globally by technology, ethics, clinical skill, social customs, religious beliefs, emotions, legal restrictions and cost. Clinicians, scientists and allied health professionals must improve their ability to navigate these uncharted territories in order to provide optimal care for their patients. The educational activities of the 2013 postgraduate and scientific programs are designed to enhance the medical and scientific knowledge, clinical and laboratory competence, and professional performance of the healthcare team in helping patients achieve their goals with regards to reproduction. The program committees have designed postgraduate courses, plenary lectures, symposia, interactive sessions, debates, roundtable discussions and oral and poster free-communication sessions to provide participants with a variety of formats and venues to teach and learn, discuss and debate, and give and receive new information, insight and skill. New to ASRM will be the popular IFFS trilogy format in which three speakers discuss the basic, translational and clinical aspects of a particular topic. The educational and program committees have identified educational needs through gap analyses for education in the areas of male and female infertility, assisted reproductive technology, andrology, endometriosis, reproductive perturbations by environmental toxicants, sexuality, menopause, contraception, gamete and embryo biology, polycystic ovary syndrome, fibroids, regenerative medicine and stem cell biology, and access to reproductive care in low-resource regions. Experts from around the world will present the most recent cutting-edge evidence regarding diagnosis and treatment of reproductive problems. The 2013 IFFS/ASRM conjoint meeting will provide abundant educational opportunities for reproductive endocrinologists, gynecologists, urologists, family practitioners, internists, embryologists, andrologists, nurses, psychologists, social workers, geneticists, and practice managers. Both the postgraduate and scientific programs will include mentored, hands-on training for those reproductive surgeons wishing to enhance their skills in minimally invasive and robotic surgery. The goal is for every professional in the field of reproductive medicine and biology to leave the meeting as a better practitioner stimulated to make new discoveries that will advance reproductive healthcare.

Learning Objectives

At the conclusion of the postgraduate and scientific programs, participants should be able to:

1. Compare and contrast clinical approaches to fertility care in resource-rich and low-resource regions.2. Summarize the latest scientific advances in the biology of gamete and embryo development, fibroids,

endometriosis, stem cells and polycystic ovary syndrome.3. Discuss optimal methods for producing, culturing, assessing, selecting and cryopreserving human embryos.4. Design evidence-based interventions to treat male reproductive disorders.5. Implement protocols for preimplantation genetic testing to prevent propagation of genetic diseases in assisted

reproductive technologies.6. Counsel infertile patients regarding the costs, both emotional and financial, of using the latest medical therapies

to build a family.7. Assist postmenopausal women in coping with vasomotor symptoms, bone loss, mood disorders and sleep

disturbances.8. Recommend the most appropriate contraceptive methods for patients in different physiological, cultural and

financial circumstances.

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Saturday, October 12, 2013

5:15 pm – 6:00 pm • Members’ Meetings• Mental Health Professional Group• Association of Reproductive Managers

Sunday, October 13, 2013

12:00 pm - 5:00 pm • Poster Set-up

5:15 pm - 6:00 pm • Members’ Meetings• Preimplantation Genetic Diagnosis (5:00 pm – 6:30 pm)• Nurses’ Professional Group

6:30 PM • Opening Ceremony and Opening Reception

Monday, October 14, 2013

7:00 am - 12:00 pm • Poster Set-up

7:00 am - 8:45 am • Regional MeetingsJapan Society for Reproductive Medicine (JSRM) - Recent Progress and New Trends of ART in Japan

7:00 am - 8:45 am • Regional MeetingsItalian Society of Fertility - Factors Influencing Embryos Implantation and their Use in Clinical Practice

7:00 am - 8:45 am • Regional MeetingsTurkish Society for Reproductive Medicine - Implantation Problems in an IVF Patient

7:00 am - 8:45 am • WorkshopASRM Reviewer WorkshopAntonio Pellicer, M.D. Fertility and Sterility

Craig Niederberger, M.D. Fertility and Sterility

8:00 am - 8:45 am • Members’ Meetings• Society for Assisted Reproductive Technology

9:00 am - 9:45 am • Plenary Lecture 1American Society for Reproductive Medicine President’s Guest Lecture - Chromosome Ends: Why We Care About ThemEndowed by a 1987 grant from Ortho Women’s Health

Linda C. Giudice, M.D., Ph.D. (Moderator) University of California, San Francisco

Serdar E. Bulun, M.D. (Moderator) Northwestern University

Elizabeth H. Blackburn, Ph.D. University of California, San Francisco

9:45 am - 10:30 am • Plenary Lecture 2International Federation of Fertility Societies - DeWatteville Lecture - Early Genetic Testing and the Architecture of Human Genetic Disease Joe Leigh Simpson, M.D. (Moderator) March of Dimes

Gamal I. Serour, M.D. (Moderator) Al Azhor University, Egypt

Richard A. Gibbs, Ph.D. Baylor College of Medicine

10:30 am - 11:15 am • Break/Exhibits

11:15 am - 12:45 pmScientific Program Prize Paper Abstract Session 1Anuja Dokras, M.D., Ph.D. (Moderator) University of Pennsylvania

Edgar V. Mocanu, M.D. (Moderator) RCSI and HARI, Rotunda Hospital

11:15 am - 12:45 pm • Trilogy 1David Healy, M.D., Ph.D., Memorial Trilogy: EndometriosisJoe Leigh Simpson, M.D. (Moderator) March of Dimes

Cynthia Farquhar, M.D., M.P.H. (Moderator) University of Auckland

Genetics and Epigenetics of EndometriosisGrant W. Montgomery, M.D. Queensland Institute of Medical Research

Clinical Applications of Stem CellsHugh S. Taylor, M.D. Yale University

The Management of Pelvic Pain with InfertilityMauricio S. Abrão, M.D. São Paulo University

11:15 am - 12:45 pm • Trilogy 2Female Fertility PreservationSupported in-part by an educational grant from Ferring Pharmaceuticals, Inc.

Laura Rienzi, B.Sc., M.Sc. (Moderator) GENERA Centre for Reproductive Medicine, Rome, Italy

Osamu Ishihara, M.D., Ph.D. (Moderator) Saitama Medical University

Fundamentals of CryobiologyClaus Yding Andersen, M.Sc., D.M.Sc. University Hospital of Copenhagen

Contemporary Approaches to Ovarian Tissue and Oocyte CryopreservationJacques G. Donnez, M.D. Universite catholique de Louvain

Clinical Application of Fertility PreservationMitchell P. Rosen, M.D. University of California, San Francisco

11:15 am - 12:45 pm • Trilogy 3IFFS/WHO Trilogy: ContraceptionSupported in-part by an educational grant from TEVA Women's Health

Richard Kennedy, M.B.B.Ch. (Moderator) University Hospital, Coventry

Research on Male ContraceptionRegine L. Sitruk-Ware, M.D. The Population Council

Scientific Program Daily Schedule

Continued on Next Page...

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Evaluation of New Approaches to Female ContraceptionNarendra Malhotra, M.D. Malhotra Hospitals

Global Perspectives on ContraceptionSheryl Ziemin van der Poel, Ph.D. World Health Organization

11:15 am - 12:45 pm • Trilogy 4Obesity and ReproductionBart C. Fauser, M.D., Ph.D. (Moderator) University Medical Center Utrecht

Dhiraj B. Gada, M.D. (Moderator) GadaLife ART Center

Pathophysiological Effects of Obesity on ReproductionRenato Pasquali, M.D. St. Orsola-Malpighi Hospital, Bologna

Reproductive Outcomes After Bariatric SurgeryRoland Devlieger, M.D., Ph.D. University Hospitals Leuven

Weight Management to Improve Outcomes in InfertilityLisa Moran, Ph.D. The University of Adelaide

11:15 am - 12:45 pm • SymposiumMenopause Day Symposium - Focus on Psychological Well-being in Aging WomenSupported in-part by an educational grant from Shionogi, Inc.

Lubna Pal, M.B.B.S., M.Sc. (Chair) Yale University

JoAnn E. Manson, M.D., Dr.P.H. Harvard Medical School

Nanette F. Santoro, M.D. University of Colorado School of Medicine

Marcelle I. Cedars, M.D. University of California, San Francisco

11:15 am - 12:45 pm • SymposiumAssociation of Reproductive Managers Symposium - Improving Patient Retention and ExperienceJoseph J. Travia, Jr., M.B.A. (Chair) Center for Reproductive Medicine, Boston, MA

Brad Senstra, M.H.A. Seattle Reproductive Medicine

Carol Levy, B.S.W. Integramed

11:15 am - 12:45 pm • SymposiumMental Health Professional Group Symposium - Challenges and Controversies in Providing Fertility Preservation to Cancer PatientsElizabeth A. Grill, Psy.D. (Chair) Weill Cornell Medical College

Melissa B. Brisman, J.D. Melissa B. Brisman, Esq. LLC

Glenn L. Schattman, M.D. Weill Cornell Medical College

11:15 am - 12:45 pm • SymposiumNurses’ Professional Group Symposium - Research and the NurseMonica R. Benson, B.S.N., R.N. (Chair) Reproductive Medicine Associates of New Jersey

Patricia Hershberger, Ph.D., M.S.N., R.N. University of Illinois at Chicago

Mary Dawn Hennessy, R.N., Ph.D., C.N.M. University of Illinois at Chicago

11:15 am - 12:45 pm • TelesurgerySurgery Day Telesurgery: Fertility-preserving Endometriosis SurgeryJeffrey M. Goldberg, M.D. (Chair) Cleveland Clinic

Steven F. Palter, M.D. (Chair) Gold Coast IVF and Fertility

Grace M. Janik, M.D. (Chair) Reproductive Specialty Center

Ceana H. Nezhat, M.D. Atlanta Center for Special Minimally Invasive Surgery and Reproductive Medicine

12:45 pm - 2:30 pm • Lunch break

12:45 pm - 2:30 pm • Interactive SessionInternational Committee Monitoring Assisted Reproductive Technologies Interactive Session: Comparisons of International Access to ARTElizabeth Sullivan, M.D. (Chair) University of New South Wales

Fernando Zegers-Hochschild, M.D. Clinica Las Condes

G. David Adamson, M.D. PAMF Fertility Physicians of Northern California

Joe Leigh Simpson, M.D. March of Dimes

Sheryl Ziemin Vanderpoel, Ph.D. World Health Organization

1:00 pm - 2:30 pm • Surgical TutorialSurgery Day Interactive Video Tutorial: Tubal and Adnexal SurgeryJeffrey M. Goldberg, M.D. (Chair) Cleveland Clinic

Michel Canis, M.D. Polycliniques Hôtel Dieu

Liselotte Mettler, M.D. University of Schleswig-Holstein

1:00 pm - 2:30 pm • Panel DiscussionCollaborative on Health and the Environment and ASRM Environment and Reproduction Special Interest Group Panel Presentation - Endocrine Disruptors and Reproductive Health Across the LifespanRuss B. Hauser, M.D., Sc.D., M.P.H. (Chair) Harvard School of Public HealthAna Soto, M.D. Tufts UniversityR. Thomas Zoeller, M.D. University of MassachusettsJerry Heindel, Ph.D. National Institute of Environmental Health Services

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\1:00 pm - 2:00 pm • Interactive SessionSurgery Day Interactive Session - Role of Medical Therapy Prior to TESE for Men with Non-obstructive AzoospermiaCraig Niederberger, M.D. (Chair) University of Illinois

Peter N. Schlegel, M.D. Weill Cornell Medical College

Paul J. Turek, M.D. Turek Clinic, San Francisco

1:00 pm - 2:00 pm • Interactive SessionMenopause Day Interactive Session - Cognitive Issues and Sleep Concerns: Hormones, Aging, or Both?Supported in part by an educational grant from Shionogi, Inc.

Melissa Wellons, M.D. (Chair) Vanderbilt University

Hadine Joffe, M.D., M.Sc. Harvard Medical School

Martha Hickey, M.D., Ph.D. University of Melbourne

1:00 pm - 2:00 pm • Interactive SessionAndrogen Excess Special Interest Group Interactive Session - Hirsutism TreatmentFrank Gonzalez, M.D. (Chair) Indiana University School of Medicine

Daniel A. Dumesic, M.D. University of California, Los Angeles

1:00 pm - 2:00 pm • Interactive SessionNurses’ Professional Group, Mental Health Professional Group and the Society for Male Reproduction and Urology Interactive Session - Nursing and Mental Health Care for the Infertile MaleJames F. Smith, M.D. (Chair) University of California, San Francisco

Susanne Quallich, N.P. University of Michigan

William D. Petok, Ph.D. Private Practice, Baltimore

Alan W. Shindel, M.D. University of California at Davis

1:00 pm - 2:00 pm • Interactive SessionSociety for Assisted Reproductive Technology Interactive Session - Multiple Pregnancies: Risks and BenefitsGlenn L. Schattman, M.D. (Chair) Weill Cornell Medical College

Eric S. Surrey, M.D. Colorado Center for Reproductive Medicine

1:00 pm - 2:00 pm • Interactive SessionRegenerative Medicine and Stem Cell Biology Special Interest Group Interactive Session - Biology of Male Germ Cell DifferentiationSherman J. Silber, M.D. (Chair) Infertility Center of St. LouisAns M. M. van Pelt, Ph.D. University of Amsterdam

Sjoerd Repping, Ph.D. University of Amsterdam

1:00 pm - 2:00 pm • Interactive SessionSociety for Male Reproduction and Urology Interactive Session - Advanced Paternal Age: Cause for Concern?Mark Sigman, M.D. (Chair) Brown University and Lifespan

Rebecca Z. Sokol, M.D., M.P.H. Keck School of Medicine of the University of Southern California

1:00 pm - 2:00 pm • Roundtables

2:30 pm - 3:15 pm • Plenary Lecture 3Society of Reproductive Surgeons Lecture - Modern HysteroscopyEndowed by a 1999 grant from Ethicon Endo-Surgery, Inc.

Grace Janik, M.D. (Moderator) Reproductive Specialty Center

Keith B. Isaacson, M.D. Newton Wellesley Hospital

3:15 pm - 4:00 pm • Break/Exhibits

3:15 pm - 5:00 pm • Workshop(Advance registration required.)Surgery Day Hands-on Hysteroscopy IntensiveKeith B. Isaacson, M.D. (Chair) Newton Wellesley Hospital

3:15 pm - 6:00 pm • IFFS General Assembly

4:00 pm - 6:00 pmFree Communication/Oral Abstract Sessions• Reproductive Endocrinology and Infertility Fellows Research I• Society for Male Reproduction and Urology Traveling Scholars• Assisted Reproductive Technologies - Laboratory I• Menopause• Environment and Toxicology• Cryopreservation and Frozen Embryo Transfer - Clinical ART• Ovarian Stimulation - ART I• Early Pregnancy I• Endometriosis I• Mental Health• Embryo Culture• Male Factor - ART• Female Reproductive Tract• Leiomyoma• Preimplantation Genetic Diagnosis I• Polycystic Ovary Syndrome I• Stem Cells• Assisted Reproductive Technologies - Clinical I• Fertility Preservation I• Genetic Counseling




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4:00 pm - 6:00 pm • SymposiumMenopause Day Symposium - Aging and SexualitySupported in part by an educational grant from Shionogi, Inc.

Sandra A. Carson, M.D. (Chair) American College of Obstetricians & Gynecologists

Sheryl A. Kingsberg, Ph.D. Case Western Reserve University

Jan L. Shifren, M.D. Massachusetts General Hospital

4:00 pm - 6:00 pm • SymposiumSurgery Day Symposium - Congenital Müllerian AnomaliesSamantha M. Pfeifer, M.D. (Chair) University of Pennsylvania

Marjan Attaran, M.D. Cleveland Clinic

Assia A. Stepanian, M.D. Center for Women’s Core and Reproductive Surgery

4:00 pm - 6:00 pm • SymposiumKY Cha Symposium in Stem Cell Technology and Reproductive Medicine - Uterine Stem CellsSupported by the Asia-Pacific Biomedical Research Foundation

Carlos A. Simón, M.D., Ph.D. (Chair) Fundacion IVI, University of Valencia

Erin F. Wolff, M.D. The Eunice Kennedy Shriver National Institute of Child Health and Human Development

Robert F. Casper, M.D. Toronto Centre for Advanced Reproductive Technology

4:00 pm - 6:00 pm • SymposiumChinese Society of Reproductive Medicine Symposium - Female Fertility Preservation in ChinaZi-Jiang Chen, M.D., Ph.D. (Chair) Shandong Provincial Hospital, Shandong University

Xiang Wang, M.D., Ph.D. Huashan Hospital

Jie Qiao, M.D., Ph.D. Peking University Third Hospital

4:00 pm - 6:00 pm • SymposiumMexican Association of Reproductive Medicine Symposium: Simposio de Técnicas en Reproducción AsistidaCarlos Salazar, M.D. (Chair) Hospital Español de MexicoJulio de la Jara Procrea Centro de ReproducciónCarlos Felix Arce Centro de Reproducción Asistida S.C.J. Ricardo Loret de Mola, M.D. Southern Illinois UniversityJose M. Mojarra-Estrada Asociación Mexicana de Medicina de la Reproducción

4:00 pm - 6:00 pm • SymposiumUterine Function and DysfunctionHilary O.D. Critchley, M.D. (Chair) University of EdinburghFrancesco J. DeMayo, Ph.D. Baylor College of MedicineS.K. Dey, Ph.D. Cincinnati Children’s Hospital Medical Center

4:00 pm - 6:00 pm • SymposiumLifestyle Factors and Reproductive Health: What Matters?Stacey A. Missmer, D.Sc. (Chair) Harvard Medical School

Kathleen M. Hoeger, M.D., M.P.H. University of Rochester Medical Center

Elizabeth Bertone-Johnson, Sc.D. University of Massachusetts

4:00 pm - 6:00 pm • SymposiumSupported by an educational grant by Merck

Empiric Medical Therapy for the Infertile Male: A Critical AssessmentEdmund S. Sabanegh, M.D. (Chair) Cleveland Clinic

Edward D. Kim, M.D. University of Tennessee Graduate School of Medicine

Robert D. Oates, M.D. Boston University School of Medicine

5:30 pm - 6:00 pm • MinisymposiumSociety for Male Reproduction and Urology Minisymposium- How to Get a Walrus Pregnant: A Proven RecipeHolley Muraco, B.S. Vallejo Six Flags Discovery Kingdom

6:15 pm - 7:00 pm • Members’ MeetingsSociety of Reproductive Surgeons (6:15 pm - 8:00 pm)Society of Reproductive Biologists and TechnologistsReproductive Immunology Special Interest GroupChinese Special Interest GroupComplementary and Alternative Medicine Special Interest GroupIndian GroupGenetic Counseling Special Interest GroupImaging in Reproductive Medicine Special Interest GroupRegenerative Medicine and Stem Cell Biology Special Interest GroupFertility Preservation Special Interest GroupMenopause Special Interest GroupEndometriosis Special Interest GroupLegal Professionals Group


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Tuesday, October 15, 2013

7:00 am - 8:45 am • Poster Abstract Session(with continental breakfast)P-1- P-460 Menopause Nursing Ovarian Reserve Cancer Fertility Preservation Cryopreservation Genetic Counseling Preimplantation Genetic Diagnosis Male Reproductive Endocrinology Male Reproductive Urology Sperm Biology Oocyte Biology Fertilization Embryo Biology Embryo Culture Ovarian Stimulation

7:00 am - 8:45 am • Regional MeetingsIndian Society for Assisted Reproduction

7:00 am - 8:45 am • Regional MeetingsFertility and Sterility Special Interest Group Polish Gynaecological Society: The Problems of Infertility Treatment in Countries with Unfavorable Political, Social and Legal Background.

7:00 am - 8:45 am • WorkshopIFFS Author WorkshopJacques Cohen, Ph.D. Editor-in-Chief, Reproductive BioMedicine Online

7:00 am - 8:45 am • Workshop(Advance registration required.)Surgery Day Hands-on Hysteroscopy IntensiveKeith B. Isaacson, M.D. (Chair) Newton Wellesley Hospital

9:00 am- 9:45 am • Plenary Lecture 4International Federation of Fertility Societies - Jean Cohen Lecture - Endometriosis Related to Infertility: Global ApproachBasil C. Tarlatzis, M.D., Ph.D. (Moderator) Medical School of Aristotle University of Thessaloniki

Robert F. Harrison, M.D. (Moderator) Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland

Charles Chapron, M.D. L’Université Paris Descartes

9:45 am - 10:30 am • Plenary Lecture 5Camran Nezhat, M.D. Lecture - Small RNAs, Stem Cells, and Self-RenewalEndowed by a 2011 Gift from Camran Nezhat, M.D.Dr. Camran Nezhat pioneered techniques of video-assisted endoscopic surgery, which revolutionized modern day surgery. He along with his brothers, Drs. Farr and Ceana Nezhat, performed some of the most

advanced procedures with these techniques for the first time, thus opening the vistas for endoscopic surgeons all over the world.

Yasunori Yoshimura, M.D. (Moderator) Keio University, Japan

Dolores J. Lamb, Ph.D. (Moderator) Baylor College of Medicine

Haifin Lin, Ph.D. Yale Stem Cell Center


11:15 am - 12:45 pmScientific Program Prize Paper Abstract Session 2John J. Sciarra M.D.,Ph.D. (Moderator) Northwestern University

Caleb B. Kallen, M.D., Ph.D. (Moderator) Thomas Jefferson University

11:15 am - 12:45 pm • Trilogy 5Adhesions and Reproductive SurgeryLiselotte Mettler, M.D. (Moderator) University of Schleswig-Holstein

Gabriel de Candolle, M.D. (Moderator) Clinique Generale Beaulieu

Molecular Biologic Regulation of Peritoneal Repair and Adhesion DevelopmentMichael P. Diamond, M.D. Georgia Regents University

Decision Making in Reproductive SurgeryLuk Rombauts, Ph.D. World Endometriosis Research Foundation

New Technologies in Reproductive SurgeryGeoffrey H. Trew Hammersmith Hospital, London

11:15 am - 12:45 pm • Trilogy 6Endometrial ReceptivityHenning Beier, Ph.D. (Moderator) University of Aachen, Germany

Science of ImplantationJan J. Brosens, M.D., Ph.D. University of Warwick

Trophoblasts and ImplantationChristos Coutifaris, M.D., Ph.D. University of Pennsylvania

Hormonal Conditioning of the EndometriumClaire Bourgain, M.D., Ph.D. Vrije Universiteit Brussel

11:15 am - 12:45 pm • Trilogy 7IFFS/WHO Trilogy: ART in the Developing WorldSheryl Ziemin Vanderpoel, Ph.D. (Moderator) World Health Organization

Ernestine Gwet Bell, M.D. (Moderator) Clinique Medicale Odysee


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Access to Reproductive Medicine in the Developing WorldWillem Ombelet, M.D., Ph.D. University of Hasselt - Genk Institute for Fertility Technology

Cost Effective Protocol in In Vitro FertilizationKorula George, M.D. Bangalore Baptist Hospital

Towards Universal Infertility Care: An IVF System Designed for Low Settings in the Developing World.Jonathan Van Blerkom The University of Colorado

11:15 am - 12:45 pm • Trilogy 8Premature Ovarian Failure and PerimenopauseNanette F. Santoro, M.D. (Moderator) University of Colorado School of Medicine

Yingying Qin, M.D., Ph.D. Shandong University

Genetics of Premature Ovarian Failure (POF)Joe Leigh Simpson, M.D. March of Dimes

Female Health Implications of Premature Ovarian InsufficiencyBart C. Fauser, M.D., Ph.D. University Medical Center, Utrecht

Reproductive Aging and Fertility TherapyMarcelle I. Cedars, M.D. University of California, San Francisco

11:15 am - 12:45 pm • SymposiumContraception Day Symposium - IUDs in Nulliparous WomenSupported in-part by an educational grant from TEVA Women's Health

Rebecca H. Allen, M.D. (Chair) Brown University

Katharine O’Connell White, M.D., M.P.H. Tufts University School of Medicine

11:15 am - 12:45 pm • SymposiumAssociation of Reproductive Managers Symposium - The Integration of Mental Health Professionals in the REI PracticeEric J. Forman, M.D. (Chair) Reproductive Medicine Associates of New Jersey

Andrea M. Braverman, Ph.D. Braverman Center for Health Journeys

Elizabeth A. Grill, Psy.D. Weill Cornell Medical College

11:15 am - 12:45 pm • SymposiumMental Health Professional Group Symposium - What’s Good for the Goose Should Also be Good for the Gander: A Medical and Psychological Discussion of Differences in Donor Oocyte and Donor Sperm Screening, Compensation, and MatchingLinda D. Applegarth, Ed.D. (Chair) Weill Cornell Medical College

Rene Almeling, Ph.D. Yale University

Alice H. Ruby, M.P.H., M.P.P.M. The Sperm Bank of California

11:15 am - 12:45 pm • SymposiumNurses’ Professional Group and the Society of Reproductive Biologists and Technologists Joint Symposium - A Review of Multi-Cell Embryo and Blastocyst Grading Systems: Stages, Methods, and Timing of their CryopreservationCarli W. Chapman, M.S. (Chair) Reproductive Medicine Institute, Chicago, IL

Catherine Racowsky, Ph.D. Brigham & Women’s Hospital ART Center

Barry R. Behr, Ph.D. Stanford Fertility and Reproductive Medicine Center

Holly A. Hughes, B.S.N. Brigham & Women’s Hospital ART Center

11:15 am - 12:45 pm • ASRM Video Session 1


1:00 pm - 2:00 pm • Interactive SessionFertility Preservation Special Interest Group Interactive Session - Ovarian Stimulation Protocols in the Cancer PopulationSupported in-part by an educational grant from Ferring Pharmaceuticals, Inc.

Lynn M. Westphal, M.D. (Chair) Stanford University

Nicole L. Noyes, M.D. New York University

1:00 pm - 2:00 pm • Interactive SessionSociety of Reproductive Biologists and Technologists and the Society for Male Reproduction and Urology Interactive Session - Merits of the WHO 5th Edition Semen Analysis Parameters and their Predictive Value for IVF Success.Michael A. Stout, Ph.D. (Chair) Shady Grove Fertility Reproductive Science

Kristen Ivani, Ph.D. Reproductive Science Center of the Bay Area

Ajay K. Nangia, M.D. University of Kansas Medical Center

1:00 pm - 2:00 pm • Interactive SessionPediatric and Adolescent Gynecology Special Interest Group Interactive Session - Sexual Abuse of Children/AdolescentsMichael J. Heard, M.D. (Chair) Heard Clinic

R. Walton Weaver, J.D. Private Practice, Amarillo, TX

1:00 pm - 2:00 pm • Interactive SessionChinese Special Interest Group Interactive Session - Natural Cycle and Minimal Stimulation IVF and IVMRi-Cheng Chian, Ph.D. (Chair) McGill University

Frank D. Yelian, M.D., Ph.D. Life IVF Center




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Scientific Program Daily Schedule1:00 pm - 2:00 pm • Interactive SessionSociety for Male Reproduction and Urology Interactive Session - Physiologic Sperm Selection for ICSI: What Is It and Why Do It?Denny Sakkas, Ph.D. (Chair) Boston IVF

Gianpiero Palermo, M.D., Ph.D. Weill Cornell Medical College

Erma Z. Drobnis, Ph.D. University of Missouri-Columbia

1:00 pm - 2:00 pm • Interactive SessionImaging in Reproductive Medicine Special Interest Group Interactive Session - To Doppler or Not to Doppler for Adnexal MassesElizabeth E. Puscheck, M.D. (Chair) Wayne State University School Of Medicine

Laurel A. Stadtmauer, M.D., Ph.D. Jones Institute for Reproductive MedicineJames M. Shwayder, M.D., J.D. University of Mississippi

1:00 pm - 2:00 pm • Interactive SessionSociety of Reproductive Surgeons Interactive Session - Management of Ectopic PregnancyTogus Tulandi, M.D., M.H.C.M. (Chair) McGill University

Kurt T. Barnhart, M.D., M.S.C.E. University of Pennsylvania

1:00 pm - 2:00 pm • Interactive SessionPros and Cons of Robotics in Benign GynecologySteven F. Palter, M.D. (Chair) Gold Coast IVF and Fertility


Balasubramanian Bhagavath, M.D. University of Rochester Medical College

1:00 pm - 2:00 pm • Interactive SessionContraception Day Interactive Session: Thrombosis Risk with Hormonal ContraceptivesSupported in-part by an educational grant from TEVA Women's Health

Michael A. Thomas, M.D. (Chair) University of Cincinnati

Juergen Dinger, M.D., Ph.D. Berlin Center for Epidemiology and Health Research


2:30 pm - 3:15 pm • Contraception Day Keynote LectureSupported in-part by an educational grant from TEVA Women's Health

High Hopes versus Harsh Realities: The Public-Health Impact of Emergency Contraceptive PillsJames Trussell, Ph.D. Princeton University

2:30 pm - 3:15 pm • Plenary Lecture 6American Society for Reproductive Medicine/International Federation of Fertility Societies Plenary Joint Lecture - Hormone Therapy During Menopause and Its Relation to Breast Cancer and Bone HealthEndowed by a 1992 grant from Wyeth

Pier G. Crosignani, M.D. (Moderator) The University of Milan

Richard J. Santen, M.D. University of Virginia Health System


3:15 pm - 5:00 pm • Workshop(Advance registration required.)Surgery Day Hands-on Hysteroscopy IntensiveKeith B. Isaacson, M.D. (Chair) Newton Wellesley Hospital

4:00 pm - 6:00 pmFree Communication/Oral Abstract SessionsReproductive Endocrinology and Infertility Fellows Research IIOocyte BiologyContraceptionOvarian Stimulation - ART IIOvarian FunctionFertility Preservation IINursing/SexualityEmbryo Biology IMale Reproduction and Urology - ClinicalFemale Reproductive SurgeryImplantationClinical Female Gynecology and Infertility IObesity, Metabolism, Nutrition and Health DisparitiesPreimplantation Genetic Diagnosis IIObesity and MetabolismSperm BiologyAssisted Reproductive Technologies - Clinical IIAssisted Reproductive Technologies - Laboratory IICryopreservation and Frozen Embryo Transfer - Procedures and TechniquesOutcome Predictors

4:00 pm - 6:00 pm • SymposiumHoward and Georgeanna Jones Symposium on ART - The Gamete and InfertilityEndowed by a 2010 educational grant from EMD Serono, Inc.

Marco Conti, M.D. (Chair) University of California, San Francisco


Andrea Borini, M.D. Tecnobios Procreazione


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Scientific Program Daily Schedule4:00 pm - 6:00 pm • SymposiumIndian Society of Assisted Reproduction Symposium - Optimizing ART Results: Step By StepHrishikesh D. Pai, M.D. (Chair) Lilavati Hospital

Rishma Dhillion Pai, M.D. Jaslok and Lilavati Hospitals, Mumbai

Nandita P. Palshetkar, M.D. Lilavati Hospital

4:00 pm - 6:00 pm • SymposiumMiddle East Fertility Society Symposium - High Dose Gonadotropin Stimulation for IVF: Is it Necessary and Does it Have a Negative Effect or Outcome?Suheil J. Muasher, M.D. (Chair) Duke University

Johnny T. Awwad, M.D. American University of Beirut

Fady I. Sharara, M.D. Virginia Center for Reproductive Medicine

4:00 pm - 6:00 pm • SymposiumAsia Pacific Initiative on Reproduction Symposium - Strategies for Implantation Disorder in ARTBruno Lunenfeld, M.D., Ph.D. (Chair) Bar Ilan University, Ramat Gan IsraelYoshiharu Morimoto, M.D., Ph.D. IVF Namba ClinicRobert J. Norman, M.D. University of AdelaideAndon Hestiantoro, M.D. Division of Reproductive Immunoendocrinology

Jaideep Malhotra, M.D. Malhotra Hospitals

4:00 pm - 6:00 pm • SymposiumEndometriosis UpdateRobert N. Taylor, M.D., Ph.D. (Chair) Wake Forest School of Medicine

Hugh S. Taylor, M.D. Yale University

Pamela Stratton, M.D. The Eunice Kennedy Shriver National Institute of Child Health and Human Development

4:00 pm - 6:00 pm • SymposiumPolycystic Ovary Syndrome (PCOS)Richard S. Legro, M.D. (Chair) Penn State College of Medicine



4:00 pm - 6:00 pm • SymposiumSupported by an educational grant from Merck

Health Policy and ARTAlan H. DeCherney, M.D. (Chair) National Institutes of HealthEric D. Levens, M.D. Shady Grove Fertility, Reproductive Science CenterChristine Grady, R.N., Ph.D. National Institutes of Health Clinical Center

5:30 pm - 6:00 pm • MinisymposiumSociety for Male Reproduction and Urology Minisymposium- Can Sperm Contribute to Poor Embryo Quality? The Role of Sperm RNAStephen A. Krawetz, Ph.D. Wayne State University School of Medicine

6:15 pm - 7:00 pm • Members’ Meetings• Early Pregnancy Special Interest Group• Health Disparities Special Interest Group• Turkish Special Interest Group• Androgen Excess Special Interest Group• Pediatric and Adolescent Gynecology Special Interest Group• Society for Male Reproduction and Urology• Society for Reproductive Endocrinology and Infertility• Fibroids Special Interest Group• Contraception Special Interest Group• Environment and Reproduction Special Interest Group• Nutrition Special Interest Group• Sexuality Special Interest Group

Wednesday, October 16, 20137:00 am - 8:45 am • Poster Abstract Session(with continental breakfast)P-461 – P-893 Embryo Transfer Implantation Luteal Phase Support Early Pregnancy Contraception/Family Planning Female Reproductive Endocrinology Reproductive Hormones Obesity and Metabolism Polycystic Ovary Syndrome Endometriosis Reproductive Immunology Female Reproductive Tract Imaging Endometrium Female Reproductive Surgery Leiomyoma

7:00 am - 8:45 am • Regional MeetingsTurkish German Gynecological Education and Research Foundation - Endometriosis Related Pain: From Pathophysiology to the New Treatment Options

7:00 am - 8:45 am • Regional MeetingsThe Philippine Society of Reproductive Endocrinology and Infertility (PSREI) - REI in the Philippine Setting


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Scientific Program Daily Schedule9:00 am - 9:45 am • Plenary Lecture 7American Urological Association Bruce Stewart Memorial Lecture: Moving the Needle on Male Reproductive HealthGrace Centola, Ph.D. (Moderator) CryoBank Compliance Services

Thinus F. Kruger (Moderator) Stellenbosch Universiteit

David de Kretser, M.D. Monash University

9:45 am - 10:30 am • Plenary Lecture 8Society for the Study of Reproduction Exchange Lecture: Endometrial Development, Differentiation and Function: Keys to Early Pregnancy SuccessWilliam E. Gibbons, M.D. (Moderator) Baylor College of Medicine

Thomas E. Spencer, Ph.D. Washington State University


11:15 am - 12:45 pmScientific Program Prize Paper AbstractSession 3Emre Seli, M.D. Yale University

Artur Dzik, M.D. Womens Hospital, Perola Byngton Hospital-Health Secretary of State of São Paulo

11:15 am - 12:45 pm • Trilogy 9FibroidsElizabeth A. Stewart, M.D. (Moderator) Mayo Clinic

Highlights in the Basic Science of Uterine FibroidsErica E. Marsh, M.D., M.C.S.I. Feinberg School of Medicine, Northwestern University

The Natural History of FibroidsCeline Lönnefors, M.D. Lund University

Treatment Options in the Management of Uterine FibroidsMichal Mara, M.D. Centre for Gynaecological Endoscopy and Minimally Invasive Surgery

11:15 am - 12:45 pm • Trilogy 10Preimplantation Genetic DiagnosisJoyce Harper, Ph.D. (Moderator) University College, London

Semra Kahraman, M.D. (Moderator) Istanbul Memorial Hospital

Meiotic Errors and Polar Body DiagnosisAnver Kuliev, M.D., Ph.D. Reproductive Genetics Institute

Microarray-comparative Genomic HybridizationDagan Wells, Ph.D. University of Oxford

Does PGD Improve Live Birth Rates?Luca Gianaroli, M.D. Società Italiana Studi di Medicina della Riproduzione

11:15 am - 12:45 pm • Trilogy 11Multiple Pregnancy (Evidence-based Practice)Vladislav Korsak, M.D., Ph.D. (Moderator) International Centre of Reproductive Medicine, Russia

Marcos Horton, M.D. Pregna Center, Buenos Aires

Embryo SelectionArne Sunde, M.D. St. Olav’s Hospital

Single-Blastocyst TransferOsamu Ishihara, M.D., Ph.D. Saitama Medical University

Economics in the Development of Embryo Transfer PoliciesG. David Adamson, M.D. PAMF Fertility Physicians of Northern California

11:15 am - 12:45 pm • Trilogy 12Safety in ARTAnna Veiga, Ph.D. (Moderator) Institut Universitari Dexeus, Barcelona

Towards an Ovarian Hyperstimulation Syndrome-free ClinicEdgar V. Mocanu, M.D. RCSI and HARI, Rotunda Hospital

Safety Analysis of ART Laboratory ProceduresKersti Lundin, Ph.D. Sahlgrenska University Hospital

Birth Defect Risk Following Assisted Reproduction Technology (ART)Richard Kennedy, M.D. University Hospital, Coventry

11:15 am - 12:45 pm • SymposiumAssociation of Reproductive Managers Symposium - The Essential Review of RE Science & Technology and Clinician LiabilityRita Gruber, B.A. (Chair) Reproductive Medicine Associates of New Jersey

Lisa A. Rinehart, M.S.N., J.D. Reproductive Medicine Institute, Chicago, IL

Stephanie Sgambati, Esq Duane Morris, LLP

Demetrios C. Batsides, Esq Duane Morris, LLP

11:15 am - 12:45 pm • SymposiumMental Health Professional Group Symposium - Developments in Egg Freezing: Medical, Psychological and Ethical PerspectivesJulianne E. Zweifel, Ph.D. (Chair) University of WisconsinLisa Schuman, L.C.S.W. Reproductive Medicine Associates of New York


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Scientific Program Daily ScheduleAlan B. Copperman, M.D. Reproductive Medicine Associates of New York

Andrea M. Braverman, Ph.D. Jefferson Medical College

11:15 am - 12:45 pm • SymposiumNurses’ Professional Group Symposium - Risk Management for Nurses: Don’t Make it RiskyJeanette Rodriquez, M.S., R.N.C. (Chair) Cornell University

Margaret Swain, R.N., J.D. Private Practice, Baltimore

Sharon G. Edwards, R.N., B.S.N. Boston IVF

11:15 am - 12:45 pm • ASRM Video Session 2


1:00 pm - 2:00 pm • Interactive SessionRegenerative Medicine & Stem Cell Biology Special Interest Group Interactive Session - Properties of Spermatogonial Stem CellsStefan Schlatt, Ph.D. Centrum fur Reprodktiosmedizin und Andrologie, Westfalische Wilhelms- Universitat Munster

1:00 pm - 2:00 pm • Interactive SessionNutrition Special Interest Group Interactive Session- Interactive Roles of Nutrition and Medicine and the Importance of Taking Into Account a Patient’s Nutritional Status Prior to Medical Management of DiseaseKaylon L. Bruner-Tran, Ph.D. (Chair) Vanderbilt University Medical Center

Dian Shepperson-Mills, M.A. Endometriosis and Fertility Clinic

1:00 pm - 2:00 pm • Interactive SessionSociety of Reproductive Surgeons Interactive Session - Male Fertility PreservationSupported in-part by an educational grant from Ferring Pharmaceuticals, Inc.

Peter Chan, M.D. (Chair) McGill University

Kirk C. Lo, M.D. University of Toronto

Robert E. Brannigan, M.D. Northwestern University

1:00 pm - 2:00 pm • Interactive SessionSociety of Reproductive Surgeons Interactive Session - Endometriosis and Cancer: Is There a Link?Farr R. Nezhat, M.D. (Chair) St. Luke’s Roosevelt Hospital

Fernando M. Reis, M.D., Ph.D. Universidade Federal de Minas Gerais

1:00 pm - 2:00 pm • Interactive SessionHealth Disparities Special Interest Group Interactive Session - Biological, Social and Environmental Disparities in ReproductionGloria Richard-Davis, M.D. (Chair) University of Arkansas Medical Sciences

Ayman Al-Hendy, M.D., Ph.D. Meharry Medical College

Victor Y. Fujimoto, M.D. University of California, San Francisco

1:00 pm - 2:00 pm • Interactive SessionNurses’ Professional Group Interactive Session - Current Trends with Endometriosis ManagementTamara M. Tobias, N.P. (Chair) Seattle Reproductive Medicine

Paul C. Lin, M.D. Seattle Reproductive Medicine


2:30 pm - 3:15 pm • Plenary Lecture 9Herbert H. Thomas Lecture - The Effect of ART and IVF on Epigenetic Programming in the EmbryoEndowed by a 1990 grant from TAP Pharmaceutical

Richard H. Reindollar, M.D. (Moderator) Dartmouth University

Tina Buchholz, M.D. (Moderator) Gyn-Gen-Lehel, Germany

Renee A. Reijo Pera, Ph.D. Stanford University


3:15 pm - 6:00 pm • IFFS General Assembly

4:00 pm - 6:00 pmFree Communication/Oral Abstract SessionsEndometriosis IIOvarian Stimulation - Poor RespondersCryopreservation - Laboratory/BasicOvarian Stimulation - ART IIIEarly Pregnancy IIOvarian ReserveFertility Preservation IIIEmbryo Biology IIEmbryo TransferMale Reproduction and Urology - ResearchEndometriumPolycystic Ovary Syndrome IIPreimplantation Genetic Diagnosis IIIPreimplantation Genetic Diagnosis IV Female Reproductive EndocrinologyReproductive ImmunologyAssisted Reproductive Technologies - Clinical Outcome Predictors IIClinical Female Infertility and Gynecology IIAssisted Reproductive Technologies - Clinical III Reproductive Medicine - General


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Scientific Program Daily Schedule4:00 pm - 6:00 pm • SymposiumABOG Foundation - Kenneth J. Ryan Ethics Symposium - Moving Innovations to PracticeSupported by a 2013 endowment from the American Board of Obstetrics and Gynecology

Paula Amato, M.D. (Chair) Oregon Health and Science University

Richard T. Scott, M.D. Reproductive Medicine Associates of New Jersey

Elena Gates, M.D. University of California, San Francisco

Robert J. Levine, MD Yale University

4:00 pm - 6:00 pm • SymposiumPioneer Symposium: Physiology of the Oocyte and Embryo: From Reproductive Biology to Reproductive Medicine - A Celebration of Professor John D. BiggersSupported, in part, from an educational grant by LifeGlobal (IVF Online)

Catherine Racowsky, Ph.D. (Chair) Brigham & Women’s Hospital ART Center

John Eppig, Ph.D. Jackson Laboratory

David Whittingham, Ph.D. St. George’s, University of London

Ginny Papaioannou, Ph.D. Columbia University

Jay Baltz, Ph.D. Ottawa Hospital Research Institute

4:00 pm - 6:00 pm • SymposiumEuropean Society of Human Reproduction and Embryology Symposium - Present and Future of Personalized Reproductive MedicineAnna Veiga, Ph.D. (Chair) Institut Universitari Dexeus, Barcelona

Luca Gianaroli, M.D. Società Italiana Studi di Medicina della Riproduzione

Anna Maria Suikkari, M.D. Family Federation of Finland

4:00 pm - 6:00 pm • SymposiumLatin American Association for Reproductive Medicine and the Argentinean Society for Reproductive Medicine Symposium: El Diagnóstico y Tratamiento Integral de la Paciente con EndometriosisJ. Ricardo Loret de Mola, M.D. (Chair) Southern Illinois University

Marcos Horton, M.D. (Chair) Pregna Center, Buenos Aires

Guillermo Marconi, M.D. IVI Buenos Aires

Guido Parra, M.D. Asociación Latinoamericana de Medicina Reproductiva

Juan Garcia-Velasco, M.D. IVI Madrid, Spain

Claudio Ruhlmann, M.D. Fertilidad San Isidro

4:00 pm - 6:00 pm • SymposiumHuman Oocyte Development and Egg Quality in the Oncofertility SettingSupported in-part by an educational grant from Ferring Pharmaceuticals, Inc.

Teresa K. Woodruff, Ph.D. (Chair) Northwestern University

Kutluk Oktay, M.D. Institute for Reproductive Medicine and Fertility Preservation, New York Medical College

Johan E. Smitz, M.D. Laboratory for Hormonology and Clinical Chemistry

4:00 pm - 6:00 pm • SymposiumAssessment of Embryo and Blastocyst QualityBarry R. Behr, Ph.D. (Chair) Stanford Fertility and Reproductive Medicine Center

Carli W. Chapman, M.S. Reproductive Medicine Institute, Chicago, IL

Juergen Liebermann, Ph.D., H.C.L.D. Fertility Centers of Illinois-River North IVF

5:30 pm - 6:00 pm • MinisymposiumSociety for Male Reproduction and Urology Minisymposium- Where Are We With Germ Line (Sperm and Eggs) Stem Cells?Amander Clark, Ph.D. University of California, Los Angeles

6:15 pm - 7:00 pm • Members’ Meetings• Society for Assisted Reproduction and Technology International Members Meeting

7:00 pm - 11:00 pm • IFFS/ASRM PartyMuseum of Science, Boston

Thursday, October 17, 2013

7:00 am - 8:45 am • Poster Abstract Session(with continental breakfast)P-894 – P-1343 Sexuality Nutrition Practice Management Environment and Toxicology Oxidative Stress Male Factor Sperm Preparation Stem Cells ART-Clinical ART-Laboratory/Basic Outcome Predictors-Clinical: ART Outcome Predictors-Lab: ART ART- In Vitro Fertilization


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Scientific Program Daily Schedule7:00 am - 8:45 am • Regional MeetingsAsociación LatinoAmericana de Medicina Reproductive (ALMER) and Sociedad Argentina de Medicina Reproductiva (SAMeR) - Men and ART, What is New?

7:00 am - 8:45 am • Regional MeetingsArab Associations of OBGYN Societies - Pan Arab Fertility Meeting

9:00 am - 9:45 am • Plenary Lecture 10Stem Cells in Endometrium and EndometriosisEndowed by a 1990 grant from Astra-Zeneca

Thomas D’Hooghe, M.D., Ph.D. (Moderator) Universitair Ziekenhuis Leuven

Robert N. Taylor, M.D., Ph.D. (Moderator) Wake Forest School of Medicine


9:45 am - 10:30 am • ASRM Members’ Meeting


11:15 am - 12:45 pm • Trilogy 13Toxicants and ReproductionGermaine M. Buck Louis, Ph.D. (Moderator) National Institutes of Health

The Testis: Environmental Toxicants and Male ReproductionNiels Jørgensen, M.D., Ph.D. University Department of Growth and Reproduction, Denmark

The Ovary: The Impact of Environmental Toxicants on Ovarian FunctionRobert F. Casper, M.D. Toronto Centre for Advanced Reproductive Technology

Toxicants in Pregnancy and Neonatal OutcomeTracey Woodruff, Ph.D., M.P.H. University of California, San Francisco

11:15 am - 12:45 pm • Trilogy 14Contemporary Approaches to PCOS Management (PCOS Update)Juha S. Tapaneinen, M.D., Ph.D. (Moderator) University of Helsinki

Enrico Carmina, M.D. (Moderator) University of Palermo

Genetics of PCOSZi-Jiang Chen, M.D., Ph.D. Shandong Provincial Hospital, Shandong University

Global Differences in Presentation of PCOSFahrettin Kelestimur, M.D. Erciyes University Medical School, Turkey

Management of PCOSBasil C. Tarlatzis, M.D., Ph.D. Medical School of Aristotle University of Thessaloniki

11:15 am - 12:45 pm • Trilogy 15Supported by an educational grant from Merck

Optimizing ART Outcomes / Evidence-based MedicineArtur Dzik, M.D. (Moderator) Womens Hospital, Perola Byngton Hospital-Health Secretary of State of São Paulo

Mohamed A. Aboulghar, M.D. (Moderator) Cairo University

Chasing the Holy Grail of Pregnancy Rates - at the Expense of Safety?Paul Devroey, M.D., Ph.D. Centre for Reproductive Medicine, Belgium

Systematic Reviews: Building Blocks for the Best Practice of ARTCynthia Farquhar, M.D., M.P.H. University of Auckland

Translating Evidence into PracticeSiladitya Bhattacharya, M.D. The University of Aberdeen

11:15 am - 12:45 pm • IFFS Surveillance

11:15 am - 12:45 pm • AAGL Film Festival Video Session

12:45 pm - 1:30 pm • Plenary Lecture 11Mechanisms of Energy Expenditure in Oocytes and Implications for Pregnancy OutcomesEndowed by a 1992 grant from EMD Serono, Inc.

Rebecca Z. Sokol, M.D., M.P.H. (Moderator) Keck School of Medicine of the University of Southern California

Jacques Cohen, Ph.D. (Moderator) Reproductive BioMedicine Online

Kelle H. Moley, M.D. Washington University

1:30 pm - 2:15 pmAwards/Closing Ceremony


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Separate registration is required. Attendance is limited.Register online at www.asrm.org.

DETERMINANTS OF GAMETE AND EMBRYO QUALITY

Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the American Society for Reproductive Medicine

Thursday, October 17, 3:30 pm – Friday, October 18, 2013, 12:45 pm Boston Convention and Exhibition Center – Boston, Massachusetts

Organizing Committee: Andrew R. La Barbera, Dolores J. Lamb, Kelle H. Moley, Stuart B. Moss, Neelakanta

Ravindranath, Robert W. Rebar NEEDS ASSESSMENT AND DESCRIPTION Successful outcomes of assisted reproductive technology procedures for the treatment of infertility require developmentally competent oocytes, spermatozoa and embryos. Despite decades of research into the molecular and cellular processes of gamete and embryo development and maturation, clinicians and scientists in the area of reproductive medicine and biology are unable to reliably identify gametes and embryos likely to yield normal, live births. Gap analysis data gleaned from the responses of learners to case study questions at the 2011 ASRM annual meeting scientific and postgraduate programs indicate a distinct need for education regarding harvest, culture, and assessment of gametes and embryos. This live conference will bring together experts in molecular, cellular, developmental, and reproductive biology and medicine to summarize the current state of the art. Through lectures and discussion, the conference participants will define the gaps in basic knowledge and clinical practice in assessing and selecting gametes and embryos. The goal of the activity is to identify targets for future research and funding. LEARNING OBJECTIVES At the conclusion of this conference, participants should be able to:

1. Discuss the impact of epigenetic modifications on gene expression in male and female germ cells and early embryos.

2. Describe how genetic errors result in human reproductive disorders, including male infertility, Turner syndrome, and sex reversal.

3. Summarize the evidence that the maternal nutritional environment and aging alter cellular processes in oocytes and embryos.

4. Describe how exposure to environmental and occupational chemicals impacts fertility and pregnancy. Plenary: John D. Biggers Session I: Epigenetics Alexander Meissner (keynote), Douglas T. Carrell, Mellissa R.W. Mann, Amander T. Clark Session II: Genetics David C. Page (keynote), Steven A. Krawetz, Emre U. Seli, Dolores J. Lamb Session III: Metabolism and Aging Kelle H. Moley (keynote), Mark Puder, Francesca E. Duncan Session IV: Environment Tracey J. Woodruff (keynote), Kim Boekelheide, Dagan Wells, Russ B. Hauser ACCME Accreditation: The American Society for Reproductive Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Society for Reproductive Medicine designates this live activity for a maximum of 5.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Register at www.asrm.org

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MENOPAUSE DAY MONDAY, OCTOBER 14, 2013

Supported in-part by an educational grant from Shionogi, Inc.

11:15 am - 12:45 pm • SymposiumMenopause Day Symposium - Focus on Psychological Well-being in Aging Women

Lubna Pal, M.B.B.S., M.Sc. (Chair)Yale University

JoAnn E. Manson, M.D., Dr.P.H.Harvard Medical School

Nanette F. Santoro, M.D.University of Colorado School of Medicine

Marcelle I. Cedars, M.D.University of California, San Francisco

1:00 pm - 2:00 pm • Interactive SessionMenopause Day Interactive Session - Cognitive Issues and Sleep Concerns:

Hormones, Aging, or Both?Melissa Wellons, M.D. (Chair)

Vanderbilt UniversityHadine Joffe, M.D., M.Sc.

Harvard Medical SchoolMartha Hickey, M.D., Ph.D.

University of Melbourne

1:00 pm - 2:00 pm • Menopause Day Roundtables

Osteoporosis: Diagnostic Pearls and Emerging TherapiesLubna Pal, M.B.B.S., M.Sc.

Yale University

Menopause and Weight Gain - Myth or FactAlex J. Polotsky, M.D.

University of Colorado Denver

4:00 pm - 6:00 pm • SymposiumMenopause Day Symposium - Aging and Sexuality

Sandra A. Carson, M.D. (Chair)American College of Obstetricians & Gynecologists

Sheryl A. Kingsberg, Ph.D.Case Western Reserve University

Jan L. Shifren, M.D.Massachusetts General Hospital

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SURGERY DAY MONDAY, OCTOBER 14, 2013

11:15 am - 12:45 pm • TelesurgerySurgery Day Telesurgery: Fertility-preserving Endometriosis Surgery

Jeffrey M. Goldberg, M.D. (Chair)Cleveland Clinic

Steven F. Palter, M.D. (Chair)Gold Coast IVF and Fertility

Grace M. Janik, M.D. (Chair)Reproductive Specialty Center

Ceana H. Nezhat, M.D.Atlanta Center for Special Minimally Invasive Surgery and Reproductive Medicine

1:00 pm - 2:30 pm • Surgical TutorialSurgery Day Interactive Video Tutorial: Tubal and Adnexal Surgery

Jeffrey M. Goldberg, M.D. (Chair)Cleveland Clinic

Michel Canis, M.D.Polycliniques Hôtel Dieu

Liselotte Mettler, M.D.University of Schleswig-Holstein

1:00 pm - 2:00 pm • Interactive SessionSurgery Day Interactive Session - Role of Medical Therapy Prior to TESE for Men with Non-obstruc-

tive AzoospermiaCraig Niederberger, M.D. (Chair)

University of IllinoisPeter N. Schlegel, M.D.

Weill Cornell Medical CollegePaul J. Turek, M.D.

Turek Clinic, San Francisco

1:00 pm - 2:00 pm • Surgery Day Roundtables

Reproductive Surgery in the IVF EraTogas Tulandi, M.D., M.H.C.M.

McGill University

Integrating Robotic Surgery in the Infertility PracticeAntonio R. Gargiulo, M.D.

Brigham and Women’s Hospital, HMS

Endometriosis and Cancer: Is There a Relationship?Farr R. Nezhat, M.D.

St. Luke’s Roosevelt Hospital

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2:30 pm - 3:15 pm • Plenary Lecture 3Society of Reproductive Surgeons Lecture - Modern Hysteroscopy

Grace M. Janik, M.D. (Moderator)Reproductive Specialty CenterKeith B. Isaacson, M.D.Newton Wellesley Hospital

3:15 pm - 5:00 pm • WorkshopSurgery Day Hands-on Hysteroscopy Intensive

Keith B. Isaacson, M.D. (Chair)Newton Wellesley Hospital

(Advance registration required.)

4:00 pm - 6:00 pm • SymposiumSurgery Day Symposium - Congenital Müllerian Anomalies

Samantha M. Pfeifer, M.D. (Chair)University of PennsylvaniaMarjan Attaran, M.D.

Cleveland ClinicAssia A. Stepanian, M.D.

Center for Women’s Core and Reproductive Surgery

(SURGERY DAY CONTINUED)

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CONTRACEPTION DAYS MONDAY, OCTOBER 14, 2013 • TUESDAY, OCTOBER 15, 2013

Supported in-part by an educational grant from TEVA Women's Health

Contraception Day 1: Monday, October 14, 201311:15 am – 12:45 pm • Trilogy

International Federation of Fertility Societies/World Health Organization: ContraceptionMarleen Temmerman, M.D. and Richard Kennedy, M.B.B.Ch., Co-Chairs

Research on Male ContraceptionRegine L. Sitruk-Ware M.D.

Population CouncilEvaluation of New Approaches to Female Contraception

Narendra Malhotra, M.D.Rainbow Hospital

Global Perspectives on ContraceptionSheryl Ziemin van der Poel, Ph.D.

World Health Organization

Contraception Day 2: Tuesday, October 15, 201311:15 am - 12:45 pm • Contraception Day Symposium

IUDs in Nulliparous WomenRebecca H. Allen, M.D.

Brown UniversityKatharine O’Connell White, M.D., M.P.H.

Tufts University School of Medicine

1:00 pm - 2:00 pm • Contraception Day Interactive SessionContraception Day Interactive Session: Thrombosis Risk with Hormonal Contraceptives

Michael A. Thomas, M.D. University of Cincinnati

Juergen Dinger, M.D., Ph.D.Berlin Center for Epidemiology and Health Research

1:00 pm - 2:00 pm • Contraception Day RoundtablesUse of Hormonal Contraceptives for Treatment of Heavy Menstrual Bleeding

Kristen A. Matteson, M.D., M.P.H. Women and Infants Hospital of Rhode Island

Contraception for Underserved PopulationsReni Soon, M.D.

University of Hawaii

2:30 pm - 3:15 pm • Contraception Day Keynote LectureHigh Hopes versus Harsh Realities: The Public-Health Impact of Emergency Contraceptive Pills

James Trussell, Ph.D.Princeton University

Non-CME

ARS

ARS

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IFFS and ASRM would like to thankthe following for their support of

the ASRM Educational Programs:BioDiseno

Ferring Pharmaceuticals, Inc.

GE Healthcare

Innovative Cryo Enterprises, LLC

Irvine Scientific

LifeGlobal (IVFonline)

Merck

Olympus Corporation of the Americas

ORIGIO, Inc.

Pfizer, Inc.

Shionogi, Inc.

Smith & Nephew

TEVA Women’s Health

SCIENTIFIC PROGRAM • PLENARY SESSIONS

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American Society for Reproductive Medicine President’s Guest Lecture - Chromosome Ends: Why We Care About Them Endowed by a 1987 grant from Ortho Women’s Health

Elizabeth H. Blackburn, Ph.D. University of California, San Francisco

Linda C. Giudice, M.D., Ph.D. (Moderator) University of California, San Francisco

Serdar E. Bulun, M.D. (Moderator) Northwestern University

Needs Assessment and DescriptionTelomere maintenance is increasingly recognized as an underlying process whose systemic impairment can impact a wide variety of clinically important disease processes. Through extensive clinical studies, telomere shortening has been linked to several major, often co-morbid, diseases that increase with aging in human populations, and telomere attrition has a causal role in at least some of these diseases. In turn, more telomere shortening has been linked to, and can be caused by, chronic psychological stress. Telomere shortness has emerged as a potential marker for the biologic aging that limits “health span.” This live lecture for clinicians and basic scientists will assist participants in applying the growing knowledge of telomeres and telomerase to improving patient care.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the basic molecular and cellular biologic principles underlying telomere structure and function.2. Explain how telomerase acts to maintain telomeres.3. Describe the cellular consequences of failure to maintain telomeres in human cells.4. Describe recent clinical studies that relate telomere shortness in humans to risks of chronic diseases of aging, and describe influences on telomere shortening including psychological stress.


TEST QUESTIONA young woman patient presents with aplastic anemia. She has a family history of pulmonary fibrosis. Which one of the following is correct?A. The patient’s anemia could only have been caused by a dietary iron deficiency and cannot be explained any other way.B. A test for telomere length of the immune cells prepared from a blood draw specimen from the patient may be appropriate.C. The pulmonary fibrosis condition cannot have any relevance to the aplastic anemia diagnosis.

Monday, October 14, 2013 9:00 am - 9:45 am

Plenary Lecture 1

International Federation of Fertility Societies - DeWatteville Lecture - Early Genetic Testing and the Architecture of Human Genetic Disease

Richard A. Gibbs, Ph.D. Baylor College of Medicine

Joe Leigh Simpson, M.D. (Moderator) March of Dimes

Gamal E. Serour, M.D. (Moderator) Al Azhar University, Egypt

Needs Assessment and DescriptionIt has long been recognized that diseases have an underlying genetic component. The latest technologies for whole genome sequencing are opening doors to precise disease diagnosis and treatment. The target audience for this live course is health professionals involved in the care of children – from prenatal and neonatal infants to young adults. These health professionals will benefit from hearing information regarding developments in genetic testing and analysis and the impact they will have on patient care.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss state-of-the-art DNA technologies.2. Describe the rate of discovery in genetics and its impact on clinical care.


TEST QUESTIONA family presents with a 3-month-old infant with signs of slow development and general failure to thrive. Clinical evaluation, including clinical genetic evaluation, fails to provide a definitive diagnosis. There is no prior relevant family history. After participating in this session, in my practice, as part of the diagnosis, whole genome sequencing (or whole exome sequencing) will be:A. Recommended for the proband only to identify recessive disorders.B. Not recommended as there is no family history.C. Not recommended unless there are specific biochemical indicators. D. Recommended for the proband and the parents in order to identify possible new mutations.E. Not applicable to my area of practice.


Plenary Lecture 2


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Society of Reproductive Surgeons Lecture - Modern Hysteroscopy Endowed by a 1999 grant from Ethicon Endo-Surgery, Inc.

Keith B. Isaacson, M.D. Newton Wellesley Hospital

Grace M. Janik, M.D. (Moderator) Reproductive Specialty Center

Needs Assessment and DescriptionIntrauterine pathology is estimated to be present in 10%-15% of patients with primary and secondary infertility. Numerous studies have shown that the repair of these defects improves take-home baby rates in patients conceiving spontaneously as well as those undergoing assisted reproductive technology. Modern hysteroscopy has allowed the health care provider to diagnose and often treat these intrauterine pathologies in an office-based setting with little to no anesthesia, thus providing benefits to the patient and the provider while reducing costs to the health care system. This live course is for clinicians and allied health professionals involved in gynecologic care.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss the evolution of modern hysteroscopy and the benefits of this technique for the infertile population.2. Describe the technique for performing hysteroscopic procedures with no or minimal anesthesia.


TEST QUESTIONHysteroscopic treatment of uterine pathology has not been shown to improve fertility rates in patients with the following:A. Intrauterine polyps <1 cmB. Submucosal myomas < 1 cmC. Subseptate uteriD. Cervical polypsE. Retained products of conception

Monday, October 14, 2013 2:30 pm - 3:15 pm

Plenary Lecture 3

International Federation of Fertility Societies - Jean Cohen Lecture - Endometriosis Related to Infertility: Global Approach

Charles Chapron, M.D. L’Université Paris Descartes

Basil C. Tarlatzis, M.D., Ph.D. (Moderator) Medical School of Aristotle, University of Thessaloniki

Robert F. Harrison, M.D. (Moderator) Ireland Rotunda Hospital

Needs Assessment and DescriptionIf the association between endometriosis and infertility is recognized, the cause of infertility associated with endometriosis remains elusive, with current findings suggesting a multifactorial mechanism. Medical and surgical treatments for endometriosis have different effects on a woman’s chances of conception, either spontaneously or via assisted reproductive technology (ART). Weighing the relative advantages of these three options (surgery, medical treatment, ART) justifies the necessity for a global approach to infertility associated with endometriosis. This live course is designed for gynecologists and scientists who want to correctly manage endometriosis related to infertility.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Select the possible mechanisms by which endometriosis could affect fertility.2. Explain why questioning of patients about the presence and intensity of pelvic pain is important.3. Describe the practical respective benefits of medical treatments, surgery, and assisted reproductive technology on conception chances.4. Explain the specific management of ovarian endometriomas for patients with endometriosis related to infertility.5. Explain why a global approach to infertility associated with endometriosis is necessary.


TEST QUESTIONAfter participating in this session, in my practice patient care will be based on the following propositions on pathogenesis and management of endometriosis related to infertility:A. Infertility in endometriosis is due to a single factor.B. Questioning of patients about the presence and intensity of pain is irrelevant.C. Prescription of hormonal treatments after surgery improves the pregnancy rate.D. Ovarian reserve testing is not needed during the infertility workup.E. Management of endometriosis related to infertility needs a global approach.F. Not applicable to my area of practice.

Tuesday, October 15, 2013 9:00 am- 9:45 am

Plenary Lecture 4


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Camran Nezhat, M.D. Lecture - Small RNAs, Stem Cells, and Self-Renewal Endowed by a 2011 Gift from Camran Nezhat, M.D.

Dr. Camran Nezhat pioneered techniques of video-assisted endoscopic surgery, which revolutionized modern day surgery. He along with his brothers, Drs. Farr and Ceana Nezhat, performed some of the most advanced procedures with these techniques for the first time, thus opening the vistas for endoscopic surgeons all over the world.

Haifin Lin, Ph.D. Yale Stem Cell Center

Yasunori Yoshimura, M.D. (Moderator) Keio University, Japan

Dolores J. Lamb, Ph.D. (Moderator) Baylor College of Medicine

Needs Assessment and DescriptionResearch in the reproductive biology field is progressing at an unprecedented rate, with new discoveries having profound implications in medicine. This is especially true in the noncoding ribonucleic acid (RNA) and epigenetic programming area. This live course is intended to update reproductive health care clinicians and clinical researchers on this progress and provide them with potential diagnostic and therapeutic tools.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the latest developments in the noncoding RNA- mediated mechanism in the reproductive process.2. Discuss the potential for small noncoding RNAs as diagnostic and therapeutic tools.


TEST QUESTIONP-element induced wimpy testis (PIWI) proteins are:A. Ubiquitously present in all types of cells in our bodies.B. Most abundant in the heart and lung.C. Normally are easily detectable in the ovary and testis but become abundantly expressed in some types of somatic cancers.D. Signal transduction molecules that are on the cell surface.E. Factors that cause infertility.

Tuesday, October 15, 2013 9:45 am - 10:30 am

Plenary Lecture 5

American Society for Reproductive Medicine/International Federation of Fertility Societies Plenary Joint Lecture - Hormone Therapy During Menopause and Its Relation to Breast Cancer and Bone Health Endowed by a 1992 grant from Wyeth

Richard J. Santen, M.D. University of Virginia Health System

Pier G. Crosignani, M.D. (Moderator) University of Milan

Roger A. Lobo, M.D. (Moderator) Columbia University Hospital

Needs Assessment and DescriptionThe results of the Women’s Health Initiative (WHI) will be re-interpreted in light of a tumor kinetic model examining the significance of occult, undiagnosed breast cancer in the population. This analysis suggests that menopausal hormone therapy does not cause de novo breast cancer but promotes existing cancers. This conclusion has important implications for prescribing currently approved hormonal therapies and developing new ones. This live course is for clinicians and allied health professionals involved in the care of perimenopausal and menopausal women.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the time required for occult de novo breast tumors to reach a size that enables them to be detected by mammography.2. Discuss how the effects of estrogen alone and estrogen combined with a progestin differ with respect to the incidence of breast cancer in patients receiving menopausal hormone therapy.


TEST QUESTIONA 52-year-old woman starts on an estrogen/progestin combination of hormones for hot flashes related to menopause. A breast cancer is diagnosed by mammography two years later. She asks if the hormone therapy caused the breast cancer. After participating in this session, in my practice I will tell this woman that the chances that the hormonal combination caused a de novo tumor to develop that rapidly and to grow to a size allowing detection by mammography are:A. 50%B. 25%C. 10%D. <5%E. Not applicable to my area of practice.

Tuesday, October 15, 2013 2:30 pm - 3:15 pm

Plenary Lecture 6


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American Urological Association Bruce Stewart Memorial Lecture: Moving the Needle on Male Reproductive Health

David de Kretser, M.D. Monash University

Grace M. Centola, Ph.D. (Moderator) Cryobank Compliance Services

Thinus F. Kruger (Moderator) Stellenbosch Universiteit

Needs Assessment and DescriptionMale reproductive disorders are common but often are neglected in medical curricula, leaving gaps in the knowledge base of practitioners. Furthermore, community education about these issues is poor and discussion of topics such as erectile dysfunction is rarely raised openly. Hence, there is a need to improve the training of practitioners in order to improve care of male patients with reproductive disorders and to increase the knowledge base of the community about these disorders. This live course will describe approaches to education about male reproductive disorders through a unique program called “Andrology Australia”. This program (www.andrologyaustralia.org) provides materials suitable for community and professional education in male reproductive disorders such as androgen deficiency, male infertility, and prostate disease. Reproductive endocrinologists, andrologists, urologists, and primary care physicians as well as the non-medical community will benefit from this course.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the physiologic and psychologic issues that underlie erectile dysfunction and the associated risk factors associated with this disorder.2. Discuss the importance of professional and public education in improving the management of erectile dysfunction and its associated risk factors.


TEST QUESTIONA 45-year-old male presents with a history of erectile dysfunction of 6 months’ duration. After participating in this session, in my practice I will:A. Reassure him and prescribe a phosphodiesterase type 5 inhibitor such as sildenafil, vardenafil, or tadalafil.B. Tell him that because of his 2% risk of a stroke or myocardial infarction in the first 12 months and an 11% risk of such cardiovascular-based events over the subsequent 5 years his erectile dysfunction cannot be treated.C. Take a thorough history about his erectile dysfunction, including clinical evaluation of his cardiovascular, lipid, and diabetic status and recommend that he and his wife be seen together at the second visit to discuss the impact of the erectile dysfunction on their relationship.D. Refer him to a sex therapist.E. Not applicable to my area of practice.

Wednesday, October 16, 2013 9:00 am - 9:45 am

Plenary Lecture 7

Society for the Study of Reproduction Exchange Lecture: Endometrial Development, Differentiation and Function: Keys to Early Pregnancy Success

Thomas E. Spencer, Ph.D. Washington State University

William E. Gibbons, M.D. (Moderator) Baylor Family Fertility Program

Needs Assessment and DescriptionA knowledge of the biologic role and genetic mechanisms of the uterus is critical to understanding the process of reproduction. This live course will discuss new information related to how the uterus prepares for embryo implantation using information gleaned from animal models and humans. This information for clinicians and scientists involved in assisted reproductive technology will provide a background of knowledge to impact patient care.

Learning ObjectivesAt the conclusion of this presentation, participants should be able to:1. Explain the biologic role of uterine secretions in endometrial receptivity and blastocyst implantation.2. Describe the genetic mechanisms underlying uterine dysfunction that lead to early pregnancy loss.


TEST QUESTIONEndometrial secretions, particularly those from uterine glands, do not have a biologic role in:A. Endometrial receptivityB. Blastocyst implantationC. Stromal cell decidualizationD. Myometrial quiescence

Wednesday, October 16, 2013 9:45 am - 10:30 am

Plenary Lecture 8


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Herbert H. Thomas Lecture - The Effect of ART and IVF on Epigenetic Programming in the Embryo Endowed by a 1990 grant from TAP Pharmaceutical

Renee A. Reijo Pera, Ph.D. Stanford University

Richard H. Reindollar, M.D. (Moderator) Dartmouth-Hitchcock Medical Center

Tina Buchholz, M.D. (Moderator) Gyn-Gen-Lenel, Germany

Needs Assessment and DescriptionHuman preimplantation embryo development encompasses cell fusion; a series of cleavage divisions; and complex molecular, genetic, and epigenetic changes. Our understanding of these processes has increased over the last decade and may affect our transfer of basic science into clinical practice. The target audience for this live course is basic scientists, clinical embryologists, and physicians and their trainees.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Review what is known of human embryo development and genetic and epigenetic determinants of success.2. Describe upcoming scientific developments that may be relevant to assisted reproduction.


TEST QUESTIONEpigenetic remodeling in human development is most prominent in:A. AgingB. Preimplantation developmentC. Gastrulation

Wednesday, October 16, 2013 2:30 pm - 3:15 pm

Plenary Lecture 9

Stem Cells in Endometrium and Endometriosis Endowed by a 1990 grant from Astra-Zeneca


Thomas M. D’Hooghe, M.D., Ph.D. (Moderator) Universitair Zieken-huis Leuven

Robert N. Taylor, M.D., Ph.D. (Moderator) Wake Forest School of Medicine

Needs Assessment and DescriptionStem cells contribute to the regeneration of the endometrium and can also differentiate in ectopic locations causing endometriosis. This live course for clinicians and scientists will describe current research on stem cells and their role in the endometrium and in endometriosis to improve the clinical care of women with endometriosis.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the role of stem cells in endometrial regeneration.2. Present recent evidence that stem cells can contribute to endometriosis.


TEST QUESTIONWhich one of the following types of stem cells has been demonstrated to contribute to endometrium?A. Bone marrow-derived mesenchymal stem cellsB. Estrogen-sensitive menstrual stem cellsC. Induced pluripotent stem (IPS) cellsD. Peripheral natural killer (NK) cells

Thursday, October 17, 2013 9:00 am - 9:45 am

Plenary Lecture 10


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Mechanisms of Energy Expenditure in Oocytes and Implications for Pregnancy Outcomes Endowed by a1992 grant from EMD Serono, Inc.

Kelle H. Moley, M.D. Washington University

Rebecca Z. Sokol, M.D., M.P.H. (Moderator) Keck School of Medicine of the University of Southern California

Jacques Cohen, Ph.D. (Moderator) Reproductive BioMedicine Online

Needs Assessment and DescriptionMaternal metabolic conditions can adversely affect oocyte quality and function. This live course will discuss how the manifestations of this condition not only affect in vitro fertilization (IVF) outcomes, but also have implications for metabolic, fertility, and developmental problems in the offspring. The target audience is reproductive endocrinologists, reproductive biologists, and all professionals caring for women of reproductive age.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the basic mechanisms responsible for poor reproductive outcomes in obese women attempting conception.2. Explain to patients the potential risks of obesity on their reproductive success and potential disorders experienced by their offspring, both in the immediate postpartum period as well as when they become adults.

ACGME CompetencyMedical KnowledgeInterpersonal and Communication Skills

TEST QUESTIONEpidemiologic studies have demonstrated that:A. Oocytes from donor patients are more likely to result in a clinical pregnancy when used with obese recipients than oocytes from the obese recipient herself.B. Clinical pregnancy rates for oocytes from donor patients are the same when used with obese recipients as the rates with oocytes from the obese recipient herself.C. Children of obese women have higher rates of congenital deafness than non-obese women.D. Children of obese women have lower rates of autism spectrum disorder than non-obese women.

Thursday, October 17, 2013 12:45 pm - 1:30 pm

Plenary Lecture 11

Fertility Preservation Program IFFS/ASRM 2013 Scientific Program ~ October 14-17, 2013 Supported by an educational grant from Ferring Pharmaceuticals, Inc.

Monday, October 14 11:15 a.m. – 12:45 p.m. Trilogy 2: Female Fertility Preservation – Osamu Ishihara, Laura Rienzi (Moderators)

Fundamentals of Cryobiology – Claus Yding Andersen Contemporary Approaches to Ovarian Tissue and Oocyte Cryopreservation – Jacques G.

Donnez Clinical Application of Fertility Preservation – Mitchell P. Rosen

Tuesday, October 15 1:00 p.m. – 2:00 p.m. Interactive Session: Ovarian Stimulation Protocols in the Cancer Population

Lynn M. Westphal and Nicole L. Noyes Wednesday, October 16 1:00 p.m. – 2:00 p.m. Interactive Session: Male Fertility Preservation

Peter Chan and Kirk L. Lo Wednesday, October 16 4:00 p.m. – 6:00 p.m. Symposium: Human Oocyte Development and Egg Quality in the Oncofertility Setting – Teresa K. Woodruff (Moderator)

Kutluk Oktay and Johan E. Smitz

SCIENTIFIC PROGRAM • TRILOGIES

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Joe Leigh Simpson, M.D. (Moderator)March of Dimes

Cynthia Farquhar, M.D, M.P.H. (Moderator)University of Auckland

Genetics and Epigenetics of EndometriosisGrant W. Montgomery, M.D.

Queensland Institute of Medical Research

Clinical Applications of Stem CellsHugh S. Taylor, M.D.

Yale University

The Management of Pelvic Pain with InfertilityMauricio S. Abrão, M.D.

São Paulo University

Monday, October 14, 2013 11:15 am - 12:45 pm

Trilogy 1: David Healy, M.D., Ph.D., Memorial Trilogy: Endometriosis

Osamu Ishihara, M.D., Ph.D. (Moderator)Saitama Medical University

Laura Rienzi, B.Sc., M.Sc. (Moderator)GENERA Centre for Reproductive Medicine, Rome, Italy

Fundamentals of CryobiologyClaus Yding Andersen, M.Sc., D.M.Sc.

University Hospital of Copenhagen

Contemporary Approaches to Ovarian Tissue and Oocyte CryopreservationJacques G. Donnez, M.D.Universite catholique de Louvain

Clinical Application of Fertility PreservationMitchell P. Rosen, M.D.

University of California, San Francisco


Trilogy 2: Female Fertility PreservationSupported in-part by an educational grant from Ferring Pharmaceuticals, Inc.

Richard Kennedy, M.B.B.Ch. (Moderator)University Hospital, Coventry

Research on Male ContraceptionRegine L. Sitruk-Ware, M.D.

The Population Council

Evaluation of New Approaches to Female ContraceptionNarendra Malhotra, M.D.

Malhotra Hospitals

Global Perspectives on ContraceptionSheryl Ziemin van der Poel, Ph.D.

World Health Organization


Trilogy 3: IFFS/WHO Trilogy: ContraceptionSupported in-part by an educational grant from TEVA Women's Health.


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Bart C. Fauser, M.D., Ph.D. (Moderator)University Medical Center Utrecht

Dhiraj B. Gada, M.D. (Moderator)GadaLife ART Center

Pathophysiological Effects of Obesity on ReproductionRenato Pasquali, M.D.

St. Orsola-Malpighi Hospital, Bologna

Reproductive Outcomes After Bariatric SurgeryRoland Devlieger, M.D., Ph.D.

University Hospitals Leuven

Weight Management to Improve Outcomes in InfertilityLisa Moran, Ph.D.

The University of Adelaide


Trilogy 4: Obesity and Reproduction

Liselotte Mettler, M.D. (Moderator)University of Schleswig-Holstein

Gabriel de Candolle, M.D. (Moderator)Clinique Generale Beaulieu

Molecular Biologic Regulation of Peritoneal Repair and Adhesion DevelopmentMichael P. Diamond, M.D.

Georgia Regents University

Decision Making in Reproductive SurgeryLuk Rombauts, Ph.D.

World Endometriosis Research Foundation

New Technologies in Reproductive SurgeryGeoffrey H. Trew

Hammersmith Hospital, London

Tuesday, October 15, 2013 11:15 am - 12:45 pm

Trilogy 5: Adhesions and Reproductive Surgery

Henning Beier, Ph.D. (Moderator)University of Aachen, Germany

Science of ImplantationJan J. Brosens, M.D., Ph.D.

University of Warwick

Trophoblasts and ImplantationChristos Coutifaris, M.D., Ph.D.

University of Pennsylvania

Hormonal Conditioning of the EndometriumClaire Bourgain, M.D., Ph.D.

Vrije Universiteit Brussel


Trilogy 6: Endometrial Receptivity


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Sheryl Ziemin Vanderpoel, Ph.D. (Moderator)World Health Organization

Ernestine Gwet Bell, M.D. (Moderator)Clinique Medical Odysee

Access to Reproductive Medicine in the Developing WorldWillem Ombelet, M.D., Ph.D.

University of Hasselt - Genk Institute for Fertility Technology

Cost Effective Protocol in In Vitro FertilizationKorula George, M.D.Bangalore Baptist Hospital

Towards Universal Infertility Care: An IVF System Designed for Low Settings in the Developing World.Jonathan Van Blerkom

The University of Colorado


Trilogy 7: IFFS/WHO Trilogy: ART in the Developing World

Nanette F. Santoro, M.D. (Moderator)University of Colorado School of Medicine

Yingying Qin, M.D., Ph.D. (Moderator)Shadong University

Genetics of Premature Ovarian Failure (POF)Joe Leigh Simpson, M.D.

March of Dimes

Female Health Implications of Premature Ovarian InsufficiencyBart C. Fauser, M.D., Ph.D.

University Medical Center, Utrecht

Reproductive Aging and Fertility TherapyMarcelle I. Cedars, M.D.

University of California, San Francisco


Trilogy 8: Premature Ovarian Failure and Perimenopause

Elizabeth A. Stewart, M.D. (Moderator)Mayo Clinic

Highlights in the Basic Science of Uterine FibroidsErica E. Marsh, M.D., M.C.S.I.

Feinberg School of Medicine, Northwestern University

The Natural History of FibroidsCeline Lönnefors, M.D.

Lund University

Treatment Options in the Management of Uterine FibroidsMichal Mara, M.D.

Centre for Gynaecological Endoscopy and Minimally Invasive Surgery

Wednesday, October 16, 2013 11:15 am - 12:45 pm

Trilogy 9: Fibroids


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Semra Kahraman, M.D. (Moderator)Istanbul Memorial Hospital

Joyce Harper, Ph.D. (Moderator)University College, London

Meiotic Errors and Polar Body DiagnosisAnver Kuliev, M.D., Ph.D.Reproductive Genetics Institute

Microarray-comparative Genomic HybridizationDagan Wells, Ph.D.

University of Oxford

Does PGD Improve Live Birth Rates?Luca Gianaroli, M.D.

Società Italiana Studi di Medicina della Riproduzione


Trilogy 10: Preimplantation Genetic Diagnosis

Vladislav Korsak, M.D., Ph.D. (Moderator)International Centre of Reproductive Medicine, Russia

Marcos Horton, M.D. (Moderator)Pregna Center, Buenos Aires

Embryo SelectionArne Sunde, M.D.

St. Olav’s Hospital

Single-Blastocyst TransferOsamu Ishihara, M.D., Ph.D.

Saitama Medical University

Economics in the Development of Embryo Transfer PoliciesG. David Adamson, M.D.

PAMF Fertility Physicians of Northern California


Trilogy 11: Multiple Pregnancy (Evidence-based Practice)

Anna Veiga, Ph.D. (Moderator)Institut Universitari Dexeus, Barcelona

Towards an Ovarian Hyperstimulation Syndrome-free ClinicEdgar V. Mocanu, M.D.

RCSI and HARI, Rotunda Hospital

Safety Analysis of ART Laboratory ProceduresKersti Lundin, Ph.D.

Sahlgrenska University Hospital

Birth Defect Risk Following Assisted Reproduction Technology (ART)Richard Kennedy, M.D.University Hospital, Coventry


Trilogy 12: Safety in ART


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Germaine M. Buck Louis, Ph.D. (Moderator)National Institutes of Health

The Testis: Environmental Toxicants and Male ReproductionNiels Jørgensen, M.D., Ph.D.

University Department of Growth and Reproduction, Denmark

The Ovary: The Impact of Environmental Toxicants on Ovarian FunctionRobert F. Casper, M.D.

Toronto Centre for Advanced Reproductive Technology

Toxicants in Pregnancy and Neonatal OutcomeTracey Woodruff, Ph.D., M.P.H.University of California, San Francisco

Thursday, October 17, 2013 11:15 am - 12:45 pm

Trilogy 13: Toxicants and Reproduction

Juha S. Tapaneinen, M.D., Ph.D. (Moderator)University of Helsinki

Enrico Carmina, M.D. (Moderator)University of Palermo

Genetics of PCOSZi-Jiang Chen, M.D., Ph.D.

Shandong Provincial Hospital, Shandong University

Global Differences in Presentation of PCOSFahrettin Kelestimur, M.D.

Erciyes University Medical School, Turkey

Management of PCOSBasil C. Tarlatzis, M.D., Ph.D.

Medical School of Aristotle University of Thessaloniki


Trilogy 14: Contemporary Approaches to PCOS Management (PCOS Update)

Artur Dzik, M.D. (Moderator)Womens Hospital, Perola Byngton Hospital - Health Secretary of State of São Paulo

Mohamed A. Aboulghar, M.D. (Moderator)Cairo University

Chasing the Holy Grail of Pregnancy Rates - at the Expense of Safety?Paul Devroey, M.D., Ph.D.

Centre for Reproductive Medicine, Belgium

Systematic Reviews: Building Blocks for the Best Practice of ARTCynthia Farquhar, M.D., M.P.H.

University of Auckland

Translating Evidence into PracticeSiladitya Bhattacharya, M.D.

The University of Aberdeen


Trilogy 15: Optimizing ART Outcomes / Evidence-based MedicineSupported by an educational grant from Merck

SCIENTIFIC PROGRAM • SYMPOSIA

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ASRM Reviewer Workshop

Antonio Pellicer, M.D Fertility and Sterility

Craig Niederberger, M.D. Fertility and Sterility


Workshop


Symposium

Menopause Day Symposium - Focus on Psychological Well-being in Aging Women Supported in part by an educational grant from Shionogi, Inc.

Lubna Pal, M.B.B.S., M.Sc. (Chair) Yale University

JoAnn E. Manson, M.D., Dr.P.H. Harvard Medical School

Nanette F. Santoro, M.D. University of Colorado School of Medicine

Marcelle I. Cedars, M.D. University of California, San Francisco

Needs Assessment and DescriptionThe magnitude and spectrum of mood disorders, depressive symptoms, and sense of psychological well-being are influenced by a number of endogenous and exogenous variables. Mood disorders and depressive symptoms are prevalent in the aging population, with women being disproportionately afflicted compared to men. Deterioration in mood parameters is particularly perceptible during the periods of perimenopause and early menopause. While temporal relationships between reproductive aging and mood disorders are well described across populations, causative implications of hypoestrogenemia for deterioration in mood and affect are by no means absolute, and both patients and providers are unclear about therapeutic implications of menopausal hormone therapy for psychological well-being in early menopause. Vitamin D is historically recognized for its relevance to bone health. Recent years have witnessed a shift in focus to nonskeletal benefits, and an accruing body of literature suggests a relevance of vitamin D for psychological well-being. This live course for clinicians and mental health professionals will cover the spectrum of mood and depressive symptoms encountered in perimenopause and early menopause and discuss oral and transdermal menopausal hormone therapy and the role of vitamin D for psychological well-being in this population.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the spectrum of mood and depressive symptoms commonly encountered in perimenopause and early menopause.2. Identify demographic and individual characteristics that relate to psychological well-being in perimenopausal and early menopausal women.3. Compare and contrast the efficacy of oral versus transdermal menopausal hormone therapy against common mood and depressive symptoms experienced by early menopausal women.4. Discuss the role of vitamin D for psychological well-being in the aging population.

ACGME CompetencyPatient CareInterpersonal and Communication Skills

TEST QUESTION1. A 49-year-old woman whose last menstrual period was 6 months ago presents with a history of early morning awakening, a 10-pound weight loss, lack of sex drive and feelings of worthlessness. She does not endorse suicidal ideation.

After participating in this session, in my practice I will recommend initially:A. Talk therapyB. St. John’s wortC. Venlafaxine 75 mg nightlyD. Transdermal estradiol 100 mcg weeklyE. Immediate psychiatric hospitalizationF. Not applicable to my area of practice.

2. A 58-year-old woman has a 10-year history of depression, which has been treated with selective serotonin reuptake inhibitors (SSRIs) with moderate efficacy. Depressive symptoms have recurred in the past month, characterized by weight loss, low libido, and poor sleep. She is not suicidal. Her final menstrual period was 7 years ago. She has never had bothersome vasomotor symptoms and has never been treated with menopausal hormone therapy. As part of a panel of tests in the month of January (winter), a serum 25(OH) vitamin D level is measured and comes back at 26 ng/mL (65 nmol/L).

After participating in this session, in my practice I will use the following approach to vitamin D management in treating this woman’s depression:A. Begin 50,000 IU of vitamin D2 per week for 8 weeks, then maintenance dose to achieve a serum 25(OH)D level > 40 ng/mL (100 nmol/L)B. Begin 5000 IU of vitamin D3 daily to achieve serum 25(OH) D level >40 ng/mL (100 nmol/L)C. Begin 2000 IU of vitamin D3 daily to achieve serum 25(OH) D level >30 ng/mL (75 nmol/L)D. Do not supplement with vitamin D but recheck serum 25(OH)D level every 3 months E. Do not supplement with vitamin D and do not recheck serum 25(OH)D unless new health problems indicate the necessity.F. Not applicable to my area of practice.

Non-CME

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Monday, October 14, 201311:15 am - 12:45 pm

Symposium

Association of Reproductive Managers Symposium - Improving Patient Retention and Experience

Joseph J. Travia, Jr., M.B.A. (Chair) Center for Reproductive Medicine, Boston, MA

Brad Senstra, M.H.A. Seattle Reproductive Medicine

Carol Levy, B.S.W. Integramed

Needs Assessment and DescriptionHealth care in general (and fertility care specifically) is becoming more competitive in today’s marketplace. Patients are better informed, have a much higher level of access to information, and are demanding more from their health care providers. We must learn what corporate America already knows: Delivering outstanding service is the key to attracting and retaining patients and is the best way to ensure a viable and long-lasting business model. This live course for clinic directors, practice managers and administrative personnel will show several important aspects of a fertility clinic’s customer service program and how these aspects can be implemented successfully.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Develop a comprehensive Customer Service Program at their practice, including tools to measure ongoing performance and ensuring all levels of staff buy-in.2. Discuss the importance of tracking a patient’s progress through his/her own unique treatment path, and how to systematically interact with the patient during this journey.3. Review the outcomes of one clinic’s customer service efforts, and provide interactive feedback to help inform future efforts.

ACGME CompetencyProfessionalism

TEST QUESTIONWhich of the following is likely to result in a successful clinical Customer Service Program?A. Mandates and directives from the management team without staff involvement.B. Extensive media promotion about the practice.C. Sporadic patient interaction to understand their individual needs and to set performance expectations.D. Ongoing feedback mechanisms to monitor success and correct deficiencies in real time.


Symposium

Mental Health Professional Group Symposium - Challenges and Controversies in Providing Fertility Preservation to Cancer Patients

Elizabeth A. Grill, Psy.D. (Chair) Weill Cornell Medical College

Melissa B. Brisman, J.D. Melissa B. Brisman, Esq. LLC

Glenn L. Schattman, M.D. Weill Cornell Medical College

Needs Assessment and DescriptionReproductive health care providers of all disciplines are often called upon to educate patients about the risks and benefits of treatment and to discuss potential outcomes of treatment as well as child-related issues with prospective parents. This live course will address the medical, psychosocial, ethical, and legal impact of fertility preservation for cancer patients and will provide direction to providers in how to address these issues with patients and families.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe current and future medical options to preserve fertility before cancer treatment.2. Examine the psychosocial issues to consider in communicating with cancer patients about fertility.3. Identify unique legal and ethical issues when providing fertility preservation to cancer patients.


TEST QUESTIONA successful female physician, age 37, was divorced 10 years ago and had no luck finding “Mr. Right.” She was recently diagnosed with breast cancer and had a double mastectomy. Her oncologist referred her to a reproductive endocrinologist to discuss fertility preservation options prior to beginning potentially sterilizing chemotherapy treatment. She noted that she would like to freeze eggs and embryos using a friend’s sperm. After participating in this session, in my practice I will recommend that she take the following steps as she moves forward with treatment:A. Talk with her reproductive endocrinologist about cryopreservation options, discuss options and delay of cancer treatment with her oncologist, and talk with an attorney about legal rights for her and her “donor” friend.

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B. Talk with her reproductive endocrinologist about cryopreservation options, talk with a psychologist about digesting the “double blow” and thinking through treatment options, and talk with an attorney about legal rights for her and her “donor” friendC. Talk with her reproductive endocrinologist about cryopreservation options, discuss options and delay of cancer treatment with her oncologist, talk with a psychologist about digesting the “double blow” and thinking through treatment options, and talk with an attorney about legal rights for her and her “donor” friend.

D. Talk with her reproductive endocrinologist about cryopreservation options, discuss options and delay of cancer treatment with her oncologist, and talk with a psychologist about digesting the “double blow” and thinking through treatment options.E. Talk with her reproductive endocrinologist about cryopreservation options and discuss options and delay of cancer treatment with her oncologist.F. Not applicable to my area of practice.


Symposium

Nurses’ Professional Group Symposium - Research and the Nurse

Monica R. Benson, B.S.N., R.N. (Chair) Reproductive Medicine Associates of New Jersey

Patricia Hershberger, Ph.D., M.S.N., R.N. University of Illinois at Chicago

Mary Dawn Hennessy, R.N., Ph.D., C.N.M. University of Illinois at Chicago

Needs Assessment and DescriptionNursing research has slowly become accepted in the academic community as a way to scientifically develop, test, and evaluate nursing interventions and best practice guidelines. Despite advances, it remains challenging for nurses to implement research whether it is due to lack of time in their day-to-day schedules, insufficient knowledge, or limited awareness of available resources to guide nurses in protocol development and implementation. What is evident is that nurses ask questions daily as to whether a particular protocol or nursing intervention may be best for a particular type of patient. Assisting the nurse to formalize information about nursing research and scientific protocols will ultimately benefit a wider range of practitioners and ultimately improve care and outcomes for patients. This live course will provide the novice nurse researcher with basic tools and information on how and where to start implementation of a nursing research project and give examples of nurse-led qualitative and quantitative research studies.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the requirements for regulatory submission and implementation of a clinical protocol.2. Discuss the differences in oversight required for conducting investigator-sponsored vs. industry-sponsored research.3. Describe evidence-based research and explain the main types of study designs that may be utilized: qualitative vs. quantitative.

ACGME CompetencySystems-based Practice

TEST QUESTIONAs a clinic nurse, you have been given a consent form and asked by the physician to review and consent the patient for a research study. After participating in this session, in my practice I will:A. Give the consent form to the patient and ask him/her to review and sign it.B. Give the consent form to the patient and allow the patient to take it home for review.C. Tell the physician I am not comfortable reviewing the consent form with the patient, as I know nothing about the protocol, but will give it to the patient to take home and ask questions later.D. Explain to the patient only the parts of the protocol you understand.E. Not applicable to my area of practice.

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Telesurgery

Surgery Day Telesurgery: Fertility-preserving Endometriosis Surgery

Jeffrey M. Goldberg, M.D. (Chair) Cleveland Clinic


Grace M. Janik, M.D. (Chair) Reproductive Specialty Center

Ceana H. Nezhat, M.D. Atlanta Center for Special Minimally Invasive Surgery and Reproductive Medicine

Needs Assessment and DescriptionIt is estimated that 25% to 50% of infertile women have endometriosis and 30% to 50% of women with endometriosis are infertile. A minimally invasive approach to surgical treatment of endometriosis has become the gold standard; however, this requires expertise, knowledge of anatomy, and utilization of new technology. Depending on the depth of penetration of the disease, location, and fertility status, different surgical techniques should be employed. Additionally, knowledge of different types of endometriosis lesions and the effect on surrounding tissue is imperative. This live course is designed for reproductive surgeons and clinicians involved in the care of women with endometriosis.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Differentiate between normal and abnormal female pelvic anatomy. 2. Select the appropriate surgical treatment and technology for different types of endometriosis given its location in the pelvis. 3. Review fertility-sparing techniques in the surgical treatment of endometriosis.


TEST QUESTIONA 37-year-old woman has been diagnosed with Stage III-IV endometriosis with a 7-cm endometrioma, deep infiltrating lesions, and adhesions. Among other concerns, she asks if having endometriosis will increase her risk of cancer. After participating in this session, in my practice I will tell her: A. Endometriosis increases the risk for breast and ovarian cancer. B. Because of her age at time of endometriosis diagnosis, she is more likely to develop breast cancer. C. She is at increased risk for cervical and endometrial cancer. D. There is no increased risk for any type of gynecologic cancer. E. Not applicable to my area of practice.


Surgical Tutorial

Surgery Day Interactive Video Tutorial: Tubal and Adnexal Surgery

Jeffrey M. Goldberg, M.D. (Chair) Cleveland Clinic

Michel Canis, M.D. Polycliniques Hôtel Dieu

Liselotte Mettler, M.D. University of Schleswig-Holstein

Needs Assessment and DescriptionThe interactive video tutorial on adnexal surgery will provide a dynamic format for the panelists to demonstrate their laparoscopic techniques for treating ovarian cysts, ectopic pregnancy, and hydrosalpinges, as well as reversal of tubal sterilization. This live course for reproductive surgeons and clinicians will allow participants and panelists to interact while viewing the videos of the various surgical techniques.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Discuss the laparoscopic management of benign ovarian cysts. 2. Describe the procedure and outcomes for tubal anastomosis. 3. Review the indications and techniques for performing laparoscopic salpingostomy and salpingectomy for hydrosalpinges and ectopic pregnancy.


TEST QUESTIONA 34-year-old woman presents with progressive severe dysmenorrhea and secondary infertility. Ultrasonography reveals a 6-cm complex left ovarian cyst consistent with an endometrioma. After participating in this session, in my practice I will perform the following in this situation: A. Laparoscopic left salpingo-oophorectomy B. Laparoscopic incision and drainage of the endometrioma C. Laparoscopic ovarian cystectomyD. In vitro fertilization without surgical interventionE. Not applicable to my area of practice


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Workshop

Surgery Day Hands-on Hysteroscopy Intensive

Keith B. Isaacson, M.D. (Chair) Newton Wellesley Hospital

Needs Assessment and DescriptionThis intensive hysteroscopy surgery course will provide one-on-one faculty-to-participant interaction and hands-on training. It is designed for physicians who wish to develop or improve surgical hysteroscopy skills.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Describe the skills necessary for hysteroscopic surgery.2. Identify surgical techniques and challenges involved with hysteroscopy.3. Review pertinent clinical case series and outcomes and how to avoid and manage complications.4. Identify patients most likely to benefit from hysteroscopy.


TEST QUESTIONA surgeon has decided to perform a hysteroscopy in the office with a 5 mm rigid hysteroscope and normal saline for distention as part of an infertility workup prior to in vitro fertilization (IVF). During the examination, a 3 mm polyp is noted in the right cornua and the surgeon decides to remove it in the office. While cutting the base with a 5 Fr. scissors, the uterus is perforated and bowel is seen. After participating in this session, in my practice I will do the following next step:

A. Transfer the patient to the hospital for a diagnostic laparoscopy.B. Ignore the injury.C. Observe the patient in the office for 30 minutes to ensure she is stable prior to discharge.D. Inform the patient there is a hole and she will need a cesarean section.E. Perform a trans-uterine laparoscopic evaluation of the tubes and the ovaries.F. Not applicable to my area of practice.

NOTE: This course repeats Tuesday, 7:00 am – 8:45 am and Tuesday, 3:15 pm -5:00 pm


Symposium

Menopause Day Symposium - Aging and Sexuality Supported in part by an educational grant from Shionogi, Inc.

Sandra A. Carson, M.D. (Chair) American College of Obstetricians & Gynecologists

Sheryl A. Kingsberg, Ph.D. Case Western Reserve University

Jan L. Shifren, M.D. Massachusetts General Hospital

Needs Assessment and DescriptionProviders caring for aging couples are confronted with problems of aging sexual function. Desire disorders, vaginal atrophy resulting in arousal disorders, and sexual pain syndromes interfere with sexual functions in women. Men experience erectile dysfunction and premature ejaculation. This live course for practitioners who treat menopausal women and their partners will cover diagnostic and treatment regimens for sexual dysfunction.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Execute a diagnostic algorithm to identify the specific cause of sexual dysfunction.2. Offer diagnosis-specific treatment to couples experiencing sexual dysfunction.


TEST QUESTIONA 56-year-old woman presents because she no longer is interested in sex. She has no sexual fantasies and no longer masturbates. She is tired and life has become lackluster. Her husband is irritated because she avoids any intimacy with him. After participating in this session, in my practice I will select the following as the most likely diagnosis:A. Clinical depressionB. Relationship disorderC. Hypoactive sexual desire disorderD. Hypoactive sexual arousal disorderE. Not applicable to my area of practice

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Symposium

Surgery Day Symposium - Congenital Müllerian Anomalies

Samantha M. Pfeifer, M.D. (Chair) University of Pennsylvania

Marjan Attaran, M.D. Cleveland Clinic

Assia A. Stepanian, M.D. Center for Women’s Core and Reproductive Surgery

Needs Assessment and DescriptionMüllerian anomalies usually present in the adolescent years. Diagnosis is often delayed causing distress to the adolescent and her family and, in some cases, the development of endometriosis and adhesive disease and subsequent infertility. Surgical treatment is the preferred approach for most, but not all, of these anomalies. Management should take into consideration the timing of the intervention as well as future fertility options for the individual. This live course is designed for clinicians and allied health care professionals who care for adolescents and women of reproductive age.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the etiology and characterization of müllerian anomalies.2. Explain the surgical and nonsurgical approaches to vaginal agenesis.3. Demonstrate the surgical approaches to obstructed müllerian anomalies.

ACGME CompetencyMedical KnowledgePatient Care

TEST QUESTIONA 14-year-old female with increasingly severe dysmenorrhea presents to the Emergency Department for the third time in 5 months with disabling right lower quadrant pain that started with onset of her menses. Her medical history is otherwise notable for right renal agenesis diagnosed during prenatal ultrasound.

After participating in this session, in my practice I will do the following as the next step in management:Prescribe nonsteroidal medication to be given prior to the onset of her menses.A. Prescribe combined oral contraceptive pills to treat dysmenorrhea.B. Order a renal ultrasound.C. Order a pelvic ultrasound.D. Perform a diagnostic laparoscopy.E. Not applicable to my area of practice.


Symposium

KY Cha Symposium in Stem Cell Technology and Regenerative Medicine - Uterine Stem Cells Supported by the Asia-Pacific Biomedical Research Foundation

Carlos A. Simón, M.D., Ph.D. (Chair) Fundacion IVI, University of Valencia

Erin F. Wolff, M.D. The Eunice Kennedy Shriver National Institute of Child Health and Human Development


Needs Assessment and DescriptionDuring reproductive life, the human endometrium undergoes around 500 cycles of growth, breakdown, and regeneration. This outstanding regenerative capability is the basis for cyclic endometrial preparation and its dysfunction is involved in pathological disorders. Endometrial regeneration is mediated by the existence of a specialized endometrial stem cell population recently identified. This live course for clinicians and reproductive scientists will cover the existence and function of human endometrial stem cells to provide a foundation for clinical application.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss the evidence available for the existence and function of endometrial stem cells in human endometrium and the translation to clinic in ongoing clinical projects.


TEST QUESTIONWhat is the proof of concept to demonstrate that cells isolated in the human endometrium are bona fide endometrial stem cells?A. These cells must have molecular and morphological markers of stem cells.B. These cells must display clonogenic activity.C. They must demonstrate differentiation capability in vitro to mesoderm such as adipogenic, osteogenic, and chondrogenic lineages.D. Bona fide endometrial stem cells must be able to reconstruct human endometrium after subcutaneous or subcapsular kidney injection in nonobese diabetic severe-combined immunodeficiency (NOD-SCID) mice.E. These cells must be pluripotent.


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Symposium

Chinese Society of Reproductive Medicine Symposium - Female Fertility Preservation in China

Zi-Jiang Chen, M.D., Ph.D. (Chair) Shandong Provincial Hospital, Shandong University

Xiang Wang, M.D., Ph.D. Huashan Hospital

Jie Qiao, M.D., Ph.D. Peking University Third Hospital

Needs Assessment and DescriptionCancer patients are surviving at increasing rates, but successful treatment in younger patients often leads to reduced fertility and, therefore, the need for fertility preservation. This live course will cover female fertility preservation in China as well as the different methods of female fertility preservation. The target audience for this live course is physicians and reproductive scientists involved in the care of women undergoing fertility preservation.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss female fertility preservation in China.2. Discuss the significance and methods of female fertility preservation.


TEST QUESTION1. Which one of the following techniques has not been effectively used in female fertility preservation?A. Immature oocytes cryopreservationB. Ovarian cortex cryopreservationC. Full ovary cryopreservation

2. Which one of the following permeable cryoprotectants is used least frequently in female fertility preservation?A. Ethylene glycol (EG)B. Dimethyl sulfoxide (DMSO)C. 1, 2-propanediol (PROH)D. Sucrose


Symposium

Simposio de Técnicas en Reproducción Asistida: Mexican Association of Reproductive Medicine Symposium

Carlos Salazar, M.D. (Chair) Hospital Español de Mexico

Julio de la Jara Procrea Centro de Reproducción

Carlos Felix Arce Centro de Reproducción Asistida S.C.

J. Ricardo Loret de Mola, M.D. Southern Illinois University

Jose M. Mojarra-Estrada Asociación Mexicana de Medicina de la Reproducción

Needs Assessment and DescriptionEl manejo de la infertilidad tiene cambios continuos, de acuerdo a los avances en el área de la Reproducción asistida (ART) alrededor del mundo, particularmente en el campo de la disminución de embarazo múltiple, sin duda la complicación más importante de estas tecnologías especialmente en América Central y Sudamérica. Por ende hay una necesidad de compartir experiencias entre los países, con el objeto de incrementar las tasas de éxito, disminuir las complicaciones con el objetivo final de disminuir la tasa de embarazos múltiples a través de la transferencia de embrión único (SET). Con el objeto de conseguir estos objetivos es necesario para nosotros discutir y evaluar los protocolos y procedimientos vigentes, y compartir nuestro conocimiento común y publicar los datos para incrementar la práctica de SET en los países en desarrollo.

The management of infertility continues to change as advances are made in assisted reproductive technology (ART) around the world, particularly in the area of reducing the multiple pregnancy rate. Multiple pregnancy is currently

the most significant complication of these technologies, particularly in Central and South America. Communicating experiences between countries is vital in order to improve success rates and reduce complications, with the ultimate goal to achieve a significant reduction of multiple pregnancies via single embryo transfer (SET). This live course for clinicians, scientists, and allied health care professionals involved in ART will cover why it is imperative for us to discuss and evaluate our current protocols and procedures and share our common knowledge and published data to increase the rate of SET in developing countries.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Demostrar las ventajas y desventajas de la trasferencia embrionaria en día 3 ó 5./ Demonstrate advantages and disadvantages of embryo transfer on day 3 or 5.2. Mejorar las tasas de embarazo utilizando protocolos modernos de inducción de ovulación en ART./ Improve pregnancy rates utilizing contemporary ovulation induction protocols in ART.3. Discutir las indicaciones para utilizar soporte de progesterona en ART./ Discuss the indications of progesterone for luteal support in ART.4. Comparar las tasas de embarazo e impacto de SET entre las clínicas del SART y REDLARA./ Compare pregnancy rates and penetration of SET between SART and REDLARA clinics.


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TEST QUESTION1. Después de participar en esta sesión, cambiaré mi práctica para la transferencia de embriones a: / After participating in this session, I will change my practice for embryo transfer to:A. Realizar todas las transferencias en día 3./ Perform all embryo transfers on day 3.B. Transferir embriones en día 5 (blastocisto)./ Perform all embryo (blastocyst) transfers on day 5. C. Transferencias en día 3 y 5 dependiendo de la paciente./ Perform day 3 and day 5 transfers depending on the patient.D. Transferencias en día 3 y 5 pero solo transferir un blastocisto en día 5./ Perform day 3 and day 5 transfers but transfer only one blastocyst on day 5.E. No aplica a mi área de práctica./ Not applicable to my area of practice.

2. After participating in this session, I will change my practice for ovarian stimulation to:/ Después de participar en esta sesión, cambiaré mi práctica en estimulación ovárica a:A. Uso de citrato de clomifeno y estimulación solo con “ciclos naturales”./ Use clomiphene citrate and only do “natural cycle” stimulations. B. Uso solo de menotropinas urinarias en protocolos de estimulación./ Use urinary menotropins alone in stimulation protocols. C. Uso de agonistas de hormona liberadora de gonadotrofinas (GnRH) como método de regulación a la baja de elección para estimulación ovárica./ Use gonadotropin-releasing hormone (GnRH) agonists as the preferred down-regulation method of ovarian stimulation.D. No aplica a mi área de práctica./ Not applicable to my area of practice.

3. Después de esta sesión cambiaré mi práctica de soporte lúteo después de TRA a:/ After participating in this session, I will change my practice for luteal support after ART to:A. Uso de progesterona micronizada oral./ Use oral micronized progesterone.B. Uso de progesterona vaginal./ Use vaginal progesterone. C. Uso de inyecciones intramusculares de progesterone./ Use intramuscular progesterone injections.D. Uso de inyecciones de hCG./ Use hCG injections.E. No utilizo soporte lúteo después de TRA./ I do not use luteal support after ART.F. No aplica a mi área de práctica./ Not applicable to my area of practice.


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Symposium

Uterine Function and Dysfunction

Hilary O.D. Critchley, M.D. (Chair) University of Edinburgh

Francesco J. DeMayo, Ph.D. Baylor College of Medicine

S.K. Dey, Ph.D. Cincinnati Children’s Hospital Medical Center

Needs Assessment and DescriptionThe physiological function of the uterine endometrium is to prepare for implantation. In the absence of pregnancy, decline in circulating progesterone levels triggers an inflammatory cascade that culminates in menstruation. By the mid-secretory phase of the next cycle the endometrium is again “receptive” to implantation, should fertilization occur. The pivotal reproductive events of implantation and menstruation are regulated by steroid hormones. The goal of this live course is to enable clinicians and scientists to improve management of disorders of implantation and menstruation that result in infertility/early pregnancy failure and abnormal uterine/heavy menstrual bleeding (AUB/HMB).

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain local uterine mechanisms that regulate implantation and menstruation.2. Classify and manage menstrual disorders.


TEST QUESTIONAfter sequential exposure of the uterine endometrium to estradiol and progesterone, withdrawal of progesterone results in which of the following:A. Immediate development of a receptive endometrium for implantationB. A coordinated expression of local endometrial factors responsible for shedding of the functional layer of the endometriumC. Decidualization of endometrial stromal cellsD. A release of leukocytes from the endometrium


Symposium

Lifestyle Factors and Reproductive Health: What Matters?

Stacey A. Missmer, D.Sc. (Chair) Harvard Medical School

Kathleen M. Hoeger, M.D., M.P.H. University of Rochester Medical Center

Elizabeth Bertone-Johnson, Sc.D. University of Massachusetts

Needs Assessment and DescriptionClinicians caring for women experiencing gynecologic pathology, such as endometriosis, premenstrual syndrome, uterine fibroids, and polycystic ovary syndrome (PCOS), and for couples with infertility are frequently asked what the woman or couple did to “cause” the condition and/or what the patient(s) can do to affect the prognosis. During this live course we will review the current literature on lifestyle/modifiable factors and reproductive health, consider research methods needed to advance science confirming or refuting these relationships, and discuss patient-clinician interactions to improve understanding of what is influencing their disease and prognosis. The target audience for this symposium is both clinicians and scientists.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Review the current literature regarding the effects of lifestyle and modifiable factors on reproductive health.2. Identify research methods needed to advance science confirming or refuting relationship.3. Counsel patients about the effects of lifestyle and modifiable factors on their disease and prognosis.


TEST QUESTIONA 38-year-old woman with a body mass index (BMI) of 35 kg/m2 presents for infertility. She has irregular menstrual cycles and has previously been diagnosed with polycystic ovary syndrome (PCOS). The remainder of her fertility investigation is otherwise normal. She states her weight is up about 15 pounds since stopping oral contraceptives last year in an attempt to conceive. She would like to begin fertility treatments. After participating in this session, in my practice I will advise her that:A. The detrimental effect of obesity is due solely to PCOS.B. If she begins vigorous physical activity it will improve fertility.C. She should attempt anything to lose weight rapidly to improve fertility prior to beginning ovulation induction.D. She should begin treatment but focus on a healthy diet and light to moderate exercise.E. Not applicable to my area of practice.

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Symposium

Empiric Medical Therapy for the Infertile Male: A Critical Assessment Supported by an educational grant from Merck

Edmund S. Sabanegh, M.D. (Chair) Cleveland Clinic

Edward D. Kim, M.D. University of Tennessee Graduate School of Medicine

Robert D. Oates, M.D. Boston University School of Medicine

Needs Assessment and DescriptionMale infertility is a multifactorial problem and to achieve specific therapies an understanding of exact mechanisms or etiology is important. With much of male infertility being idiopathic, current specific therapies are limited and empiric treatments may be viable options. The purpose of this live course is to provide a state-of-the-art review of a variety of empiric therapies to improve male fertility, including hormonal and nutraceutical therapies as well as lifestyle modifications. This course is for clinicians who provide care for infertile men.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain when hormonal treatments are disease-directed versus empiric in nature. The participant will be able to utilize this knowledge to provide patients realistic expectations regarding outcomes.2. Discuss the role of lifestyle modifications to improve male factor fertility.3. Identify and critically analyze male fertility effects of antioxidant nutraceuticals.

ACGME Competency

TEST QUESTIONA 42-year-old male has been trying to initiate a pregnancy for 4 years. His semen analysis demonstrates a volume of 2 mL, sperm density of 3 x 106 sperm/mL, motility of 30%, and forward progression of 2+. His body mass index is 26 kg/m2, but the physical exam is otherwise normal. Genetic testing is normal. The serum testosterone is low normal and the estradiol level is normal. Pituitary hormones are normal. The couple cannot afford in vitro fertilization/intracytoplasmic sperm injection but would like to consider any other alternative therapy. After participating in this session, in my practice I will recommend the following treatment option for this man:A. Clomiphene citrate therapy has mixed results regarding improvement in semen parameters, but its use appears to be relatively safe.B. Weight loss and a diet high in antioxidants have consistent benefits for improving fertility in overweight men.C. Carnitine-based oral therapies improve sperm motility in >60% of men.D. Subcutaneous hCG therapy will improve testosterone levels and semen parameters.E. Anastrozole and/or testolactone could be recommended because he is overweight and has a borderline testosterone level.F. Not applicable to my area of practice.


Minisymposium

Society for Male Reproduction and Urology Minisymposium - How to Get a Walrus Pregnant: A Proven Recipe

Holley Muraco, B.S. Vallejo Six Flags Discovery Kingdom

Needs Assessment and DescriptionThe walrus is an understudied iconic Arctic species, whose reproductive behavior is largely unknown, incorrectly reported, or based on assumptions from seal and sea lion biology. Currently, the walrus is a species at risk, as climate change challenges the adaptability of this specialized Arctic mammal. In addition, walrus infertility is widespread in zoos with only 11 live births in 80 years in the United States. This highlights the need for systematic study of walrus reproductive physiology to help protect the species. We began an exhaustive research program utilizing trained zoological walruses and garnered physiologic data that

shed light on reasons for their infertility. Based on this research, a successful treatment protocol was implemented and pregnancies achieved. This live course for clinicians and scientists will cover this research and show how, with continued research, walrus fertility in zoos and aquariums can be improved and how it can benefit other wild species whose reproductive potential might be affected by climate change. Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain how the treatment for walrus hypogonadotropic hypogonadism can result in a pregnancy.2. Summarize one fundamental way in which male walrus reproductive hormonal physiology differs from humans.


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TEST QUESTIONIn the high Arctic, puberty occurs seasonally and is sensitive to photoperiod cues in many native mammals. Even in adulthood, the hypothalamic-pituitary-gonadal (HPG) axis is typically down-regulated for part of the year. It has been suggested that the annual onset of fertility in mature Arctic mammals (rut) is essentially a re-enactment of puberty, complete with seasonal up-regulation of gonadotropin-releasing hormone (GnRH) secretion. During the walrus period of “non-rut,” when an adult male has nadir testosterone and luteinizing hormone (LH) levels and is azoospermic, what human male infertility condition does this most mimic? A. Diabetes mellitusB. Primary hypogonadismC. Undescended testisD. Chemotherapy-induced testis failureE. Secondary hypogonadismF. Stress

Tuesday, October 15, 2013 7:00 am - 8:45 am

Workshop

IFFS Author Workshop

Jacques Cohen, Ph.D. Editor-in-Chief, Reproductive BioMedicine Online


SymposiumContraception Day Symposium - IUDs in Nulliparous Women Supported by an educational grant from TEVA Women's Health

Rebecca H. Allen, M.D. (Chair) Brown University

Katharine O’Connell White, M.D., M.P.H. Tufts University School of Medicine

Needs Assessment and DescriptionIntrauterine devices (IUDs), a form of long-acting reversible contraception (LARC), are safe and highly effective. Some providers are hesitant about recommending IUDs in women who are nulligravid or nulliparous due to concerns about pain during insertion and symptoms of pain and/or bleeding while using the device. In addition, there are unfounded beliefs that IUDs may cause pelvic inflammatory disease (PID) and infertility in young women. This live course will review the evidence for the safety of IUDs in this population as well as efficacy, continuation rates, management of side effects, and pain control during IUD insertion. This session is designed for clinicians who care for adolescents and young women who need contraception to prevent unintended pregnancy or for the medical treatment of heavy menstrual bleeding.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe best practices for pain control during IUD insertion.2. Discuss the evidence for IUD safety in nulliparous women.


TEST QUESTIONA 17-year-old nulligravid female presents to your office seeking contraception. Her menstrual period began today. She desires an intrauterine device (IUD), the levonorgestrel intrauterine system (IUS). After participating in this session, in my practice I will:A. Inform the patient she cannot have an IUD because she has never had a child.B. Inform the patient she can have the IUD, but only after tests for gonorrhea and chlamydia return negative.C. Inform the patient she can have the IUD inserted, but she must use misoprostol a few hours ahead of time.D. Inform the patient she can have the IUD inserted today.E. Not applicable to my area of practice.

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Non-CME


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SymposiumAssociation of Reproductive Managers Symposium - The Integration of Mental Health Professionals in the REI Practice

Eric J. Forman, M.D. (Chair) Reproductive Medicine Associates of New Jersey

Andrea M. Braverman, Ph.D. Braverman Center for Health Journeys

Elizabeth A. Grill, Psy.D. Weill Cornell Medical College

Needs Assessment and DescriptionStudies have shown that many infertile patients struggle with emotional distress and that the requisite interventions of the assisted reproductive technologies may add additional burdens. Mental health professionals play a vital role in aiding distressed patients through the infertility treatment process. Can integrating the mental health professional into the reproductive endocrinology and infertility (REI) practice lead to happier patients who stay engaged in treatment and are less demanding on practice staff?

This live course will review the evidence for benefits to patients and their caretakers by integrating mental health professionals into the REI practice. It is intended for REI practice staff members who have interactions with patients, including nurses, physicians, practice managers, and mental health professionals.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Summarize indications for referring infertility patients for mental health counseling and the reasons why patients discontinue attempts at assisted conception.2. Identify the most effective counseling interventions for infertility patients.3. Discuss strategies for introducing mental health professionals into the interprofessional care team and how this can impact patient satisfaction and staff productivity.

ACGME CompetencyInterpersonal Skills and Communication

TEST QUESTIONA 41-year-old woman with diminished ovarian reserve has insurance coverage for 3 cycles of in vitro fertilization (IVF). During her first IVF cycle she was emotionally labile and frequently called her nurse with questions regarding her medication instructions. That IVF cycle resulted in a negative pregnancy test after the transfer of 3 embryos on day 3. Despite attempts by the office to contact her, she did not schedule a follow-up visit. After participating in this session, I will understand that the most likely reason that she discontinued treatment at this clinic was:A. Cost of copaymentsB. Discomfort from egg retrievalC. Emotional/psychological burdenD. Number of medication injections requiredE. Frequency of visits for monitoringF. Not applicable to my area of practice.


SymposiumMental Health Professional Group Symposium - What’s Good for the Goose Should Also be Good for the Gander: A Medical and Psychological Discussion of Differences in Donor Oocyte and Donor Sperm Screening, Compensation, and Matching

Linda D. Applegarth, Ed.D. (Chair) Weill Cornell Medical College

Rene Almeling, Ph.D. Yale University

Alice H. Ruby, M.P.H., M.P.P.M. The Sperm Bank of California

Needs Assessment and DescriptionBroad differences exist in the screening, selection, and compensation of oocyte and sperm donors despite the fact that female and male gamete donors make equal reproductive contributions to the creation of life. Similarly, recipients of donor sperm are often not given the same psychosocial preparation that is generally provided to recipients of donor oocytes. This live course, aimed at mental health professionals and health care providers, will examine the medical and psychosocial differences that currently exist in the screening, selection, and compensation policies for oocyte and sperm donors in the United States. We will discuss what changes may need to be implemented to better serve all involved parties.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe and discuss basic differences in the medical and psychological screening, preparation, identification, and compensation of oocyte donors versus sperm donors.2. Describe and discuss discrepancies in psychosocial consultation and preparation of sperm recipients versus oocyte recipients.


TEST QUESTIONAfter participating in this session, in my practice standardized psychological testing generally will be required as part of the screening protocol for:A. Sperm donorsB. Egg donorsC. Donor gamete recipientsD. Partners of egg donorsE. All parties involved in third-party reproductionF. Not applicable to my area of practice.

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SymposiumNurses’ Professional Group and the Society of Reproductive Biologists and Technologists Joint Symposium - A Review of Multi-Cell Embryo and Blastocyst Grading Systems: Stages, Methods, and Timing of their Cryopreservation

Carli W. Chapman, M.S. (Chair) Reproductive Medicine Institute, Chicago, IL

Catherine Racowsky, Ph.D. Brigham & Women’s Hospital ART Center

Barry R. Behr, Ph.D. Stanford Fertility and Reproductive Medicine Center

Holly A. Hughes, B.S.N. Brigham & Women’s Hospital ART Center

Needs Assessment and DescriptionThere are numerous multi-cell embryo and blastocyst grading systems in use in the field of assisted reproductive technology. With the current mobile society, patients often move their cryopreserved embryos around locally, nationally, and internationally. These different systems of grading warrant comprehensive review and explanation so receiving institutions can accurately assess embryo quality and counsel patients accordingly. This live course will update clinicians, nurses, and laboratorians on the various grading systems for embryos of all stages as well as the sentinel timing of embryonic developmental events.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Compare and contrast the Alpha-ESHRE Consensus on Embryo Assessment and Society for Assisted Reproductive Technology (SART) grading systems for embryos.2. Describe the cleavage timing sequences for embryos.3. Discuss the characteristics and assessment of blastocyst- stage embryos.


TEST QUESTIONThe Alpha-ESHRE Consensus on Embryo Assessment and Society for Assisted Reproductive Technology (SART) grading systems for embryos both classify all embryos, regardless of stage, as:A. Great, Fair, MediocreB. Good, Fair, PoorC. A, B, C


SymposiumHoward and Georgeanna Jones Symposium on ART - The Gamete and Infertility Endowed by a 2010 educational grant from EMD Serono, Inc.

Marco Conti, M.D. (Chair) University of California, San Francisco


Andrea Borini, M.D. Tecnobios Procreazione

Needs Assessment and DescriptionThe quality of the female and male gamete remains a major limitation, preventing further improvements in reproductive technologies. Recent experimental findings need to be evaluated and incorporated into practice to establish novel evaluation criteria for gamete quality and to develop new tools to predict the effectiveness of reproductive technology intervention. This live course for clinicians and reproductive scientists will discuss new concepts in gamete biology and in the development of new reproductive technologies.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Describe new concepts in assessing oocyte quality for in vitro fertilization (IVF). 2. Describe critical developments of new and effective reproductive techniques.


TEST QUESTIONThe competence of an oocyte to develop as an embryo is affected by: A. Gene transcription during oocyte maturation B. The program of maternal mRNA translation C. The morphology of the polar body and cumulus cells D. Circulating steroid measurements

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Symposium

Indian Society of Assisted Reproduction Symposium - Optimizing ART Results: Step By Step

Hrishikesh D. Pai, M.D. (Chair) Lilavati Hospital

Rishma Dhillion Pai, M.D. Jaslok and Lilavati Hospitals, Mumbai

Nandita P. Palshetkar, M.D. Lilavati Hospital

Needs Assessment and DescriptionClinical pregnancy rates in assisted reproductive technology (ART) have dramatically increased over the past decade. Yet, there is much variation across the globe. This live course for clinicians, scientists, and allied health care professionals involved in ART will cover establishing standardized protocols based on scientific research and evidence to produce clarity and uniform outcome.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe various ovarian stimulation protocols.2. Discuss the importance of embryo transfer technique and luteal support and the impact on pregnancy rates.3. Identify specific clinical skills that can potentially improve pregnancy rates in ART.


TEST QUESTIONAfter participating in this session, I will do the following in my practice:A. Use the agonist for all ART stimulation cycles except for poor responders.B. Use mild stimulation protocols for all patients.C. Perform embryo transfer (ET) using ultrasound guidance.D. Transfer 3 embryos for all patients on day 3.E . Not prescribe progestogens during the luteal phase.F. Never use human chorionic gonadotropin (hCG) for luteal support.G. Use adjuvants such as sildenafil/aspirin/steroids during luteal phase.H. Not applicable to my area of practice.


Symposium

Middle East Fertility Society Symposium - High Dose Gonadotropin Stimulation for IVF: Is it Necessary and Does it Have a Negative Effect or Outcome?

Suheil J. Muasher, M.D. (Chair) Duke University

Johnny T. Awwad, M.D. American University of Beirut

Fady I. Sharara, M.D. Virginia Center for Reproductive Medicine

Needs Assessment and DescriptionOvarian stimulation for the purpose of multiple follicular recruitment is considered to be a vital part of the in vitro fertilization (IVF) treatment process. This allows for the availability of multiple embryos for fresh transfer, either on day 3 or day 5; elective single embryo transfer for select patients; and cryopreservation of excess embryos. Excessive ovarian response to gonadotropin stimulation, in terms of peak estradiol levels and number of oocytes retrieved, has been recently correlated with a higher percentage of aneuploidy in the cohort and a detrimental effect on endometrial receptivity, but the issue is still debatable among IVF practitioners. The incidence of severe ovarian hyperstimulation syndrome increases with higher peak estradiol levels (>3000 pg/mL) and number of oocytes (>15). This live course will educate practitioners on the negative effects of excessive stimulation on outcome and debate the desirability, based on the available and sometimes contradictory literature, to use high dosage gonadotropin stimulation for IVF.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Debate the advantages and disadvantages of excessive ovarian stimulation on outcome.2. Examine the desirability to eliminate ovarian hyperstimulation syndrome without negatively impacting the live birth rates from fresh transfer.


TEST QUESTIONAfter participating in this session, in my practice I will:A. Strive to recruit the maximum number of oocytes for all patients.B. Individualize ovarian stimulation protocols so as to maximize success rates and minimize complications.C. Use one stimulation protocol for all patients.D. Not worry about endometrial receptivity as it is not impacted by the ovarian response.E. Not applicable to my area of practice.

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Symposium

Asia Pacific Initiative on Reproduction Symposium - Strategies for Implantation Disorder in ART

Bruno Lunenfeld, M.D., Ph.D. (Chair) Bar Ilan University, Ramat Gan Israel

Yoshiharu Morimoto, M.D., Ph.D. IVF Namba Clinic

Robert J. Norman, M.D. University of Adelaide

Andon Hestiantoro, M.D. Division of Reproductive Immunoendocrinology

Jaideep Malhotra, M.D. Malhotra Hospitals

Needs Assessment and DescriptionImplantation is fundamental to biologic success and is poorly understood in women. In in vitro fertilization (IVF) procedures, implantation frequently does not occur despite transfer of excellent embryos. This live course will cover the environmental, immunological, endocrinological, and embryonic origins of successful implantation and its failure. It will concentrate on practical issues relevant to the clinician who is assessing fertility and recommend key tests and procedures to optimize outcomes.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the biology of implantation and its dysfunction.2. Describe preconception factors that can be modified.3. Discuss immunological and endocrine factors in implantation dysfunction.4. Develop strategies to improve outcomes.

ACGME CompetencyMedical Knowledge, Patient Care

TEST QUESTIONWhich one of the following best describes the pathophysiologic mechanisms involved in implantation failure?A. Extremes of weight may affect endometrial receptivity and embryo quality.B. Measurement of immune and hormone parameters are useful in the majority of implantation failures.C. The majority of IVF failures are due to endometrial factors.D. Immunological interventions have a strong evidence base for success.


Symposium

Endometriosis Update

Robert N. Taylor, M.D., Ph.D. (Chair) Wake Forest School of Medicine


Pamela Stratton, M.D. The Eunice Kennedy Shriver National Institute of Child Health and Human Development

Needs Assessment and DescriptionEndometriosis is a common gynecological disease that has been recognized for centuries. Nevertheless, many knowledge gaps exist in our understanding of its etiology, mechanisms, and symptomatic consequences. Endometriosis exacts a burdensome price on medical economics and quality of life. This live course for physicians, nurses, and laboratory scientists who deal with endometriosis patients is designed to critically assess our growing knowledge of the causes and effects of endometriosis in order to improve patient care and quality of life.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe new theories of the cellular origins of endometriosis.2. Discuss the role of immune activation in endometriosis.3. Assess the effects of endometriosis on quality-of-life measures.


TEST QUESTIONA 29-year-old woman presents with regular cycles, worsening dysmenorrhea, dyspareunia, constipation, and dyschezia. Her internist has recommended dietary fiber supplements and a selective serotonin reuptake inhibitor. After participating in this session, I will do the following:A. Proceed directly to colonoscopy.B. Undertake a detailed history, physical exam, and ultrasound imaging.C. Perform a diagnostic laparoscopy.D. Suppress the ovaries with leuprolide for 3 months.E. Not applicable to my area of practice.

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SymposiumPolycystic Ovary Syndrome (PCOS)

Richard S. Legro, M.D. (Chair) Penn State College of Medicine



Needs Assessment and DescriptionPolycystic ovary syndrome (PCOS) is associated with reproductive dysfunction, including anovulatory infertility and hirsutism, as well as metabolic abnormalities, including dyslipidemia and glucose intolerance. The treatment for these disorders and for prevention of cardiovascular complications is controversial. This live course for clinicians and allied health professionals who care for women will focus on the evaluation and treatment of reproductive and metabolic dysfunction in women with PCOS.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. List initial treatment options for anovulatory infertility in women with PCOS with risk/benefit ratios.2. Discuss the options for prevention of cardiovascular disease in women with PCOS.


TEST QUESTIONA 25-year-old woman with a body mass index of 29 kg/m2 presents with a history of anovulatory infertility and a diagnosis of polycystic ovary syndrome (PCOS) based on anovulation, hirsutism, and polycystic ovaries on ultrasound examination. She has no criteria for the metabolic syndrome and has normal glucose tolerance. An evaluation of her husband reveals normal sexual function and a normal semen analysis. On hysterosalpingogram, she has a normal uterine cavity and bilateral patent fallopian tubes. After participating in this session, in my practice first-line treatment for this woman will be: A. Expectant managementB. Weight lossC. Clomiphene citrateD. LetrozoleE. Low-dose gonadotropin therapyF. Not applicable to my area of practice.


SymposiumHealth Policy and ART Supported by an educational grant from Merck

Alan H. DeCherney, M.D. (Chair) National Institutes of Health

Eric D. Levens, M.D. Shady Grove Fertility, Reproductive Science Center

Christine Grady, R.N., Ph.D. National Institutes of Health Clinical Center

Needs Assessment and DescriptionThe use of assisted reproductive technology (ART) often causes societal and financial ramifications and raises ethical issues, such as the potential conflict of interest in risk-sharing programs. This live course for clinicians, practice managers, and allied health providers will cover shared risk in assisted reproduction, ethical concerns, and how the Affordable Care Act will impact fertility treatment in the future.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss the broad societal and financial ramifications of ART.2. Discuss specific ethical issues in regards to ART.


TEST QUESTIONA 35-year-old woman conceived 2 years ago with in vitro fertilization and is now divorced from the father of that child. The patient wants custody of the cryopreserved embryos from that cycle. After participating in this session, in my practice I will recommend the following: A. Ask the Clinic to FEDEX the embryos to the patient.B. Ask the patient obtain a letter from her former husband saying it’s okay for her to have possession of the embryos.C. The Clinic should hold on to the embryos but they belong to the wife and not release them to anyone.D. The wife should hire a lawyer to adjudicate the disposition of the embryos.E. The divorce agreement must address the frozen embryo issue.F. Not applicable to my area of practice.

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MinisymposiumSociety for Male Reproduction and Urology Minisymposium- Can Sperm Contribute to Poor Embryo Quality? The Role of Sperm RNA

Stephen A. Krawetz, Ph.D. Wayne State University School of Medicine

Needs Assessment and DescriptionSperm are essentially transcriptionally and translationally silent having purged the majority of their cytoplasm and reducing their nuclear volume to a fraction of that of the oocyte. Irrespective, sperm deliver a complement of ribonucleic acids (RNAs) to the oocyte at fertilization. Considering the consequences of embryo loss at or before implantation has prompted a search for function. An initial survey using microarrays of sperm RNAs from individuals presenting teratozoospermia identified a series of common affected elements within a quality control pathway. This yielded important clues to the mechanism of molecular selection, but did not directly address the role of sperm RNAs during early embryo development. Using Next Generation Sequencing the extent of the contribution of RNAs and thus likely impact on the birth of a healthy child was highlighted. These studies exposed a complex steady state population of messenger RNAs, epigenetic RNAs, and small non-coding RNAs delivered to the oocyte. We have proposed that this suite of paternally derived and delivered transcripts sets the stage for successful early development. Primed for function but lacking male ribosomal RNAs, they hijack the maternal machinery likely to confront – consolidate genomes,

provide a signal for the first cell division, and determine early lineage. These studies are currently being extended to assess the effect of the environment on male reproductive fitness and its impact on the birth of a healthy child. This live course is for reproductive care clinicians, scientists and researchers with an interest in andrology and care of the male infertility patient.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Describe the extent of the paternal contribution at fertilization. 2. Appraise the complexity of the population of RNAs delivered at fertilization. 3. Consider the role of paternal RNAs at fertilization and their contribution to early embryo development.


TEST QUESTIONPaternal RNAs are likely to contribute to early development by delivering the following RNAs. Which RNA may be involved in regulating the first cell division? A. INTS1 B. pri-miRNA 181cC. miRNA 34c D. CARM-1 E. PRM2


SymposiumAssociation of Reproductive Managers Symposium - The Essential Review of RE Science & Technology and Clinician Liability

Rita Gruber, B.A. (Chair) Reproductive Medicine Associates of New Jersey

Lisa A. Rinehart, M.S.N., J.D. Reproductive Medicine Institute, Chicago, IL

Stephanie Sgambati, Esq Duane Morris, LLP

Demetrios C. Batsides, Esq Duane Morris, LLP

Needs Assessment and DescriptionAs in vitro fertilization (IVF) science and technology evolve, and clinicians use more comprehensive and evidence-based embryo selection to improve patient outcomes, there are increasing concerns about the potential risk related to many of these options. To remain competitive, clinicians must be able to offer their patients the best clinical and laboratory services available. Whether they have all these skills in-house or outsource all or some laboratory services, recent high profile cases have shown us that a new kind of law has come to reproductive medicine. The professional and financial consequences of a “mistake” or failed expectation can be devastating, and everybody shares in the consequences. In addition, there are new concerns regarding the more traditional legal issues related to reproductive medicine. Long-term embryo storage, the rise in surrogacy, and revisions in the Health Insurance

Portability and Accountability Act (HIPAA) (i.e., The Health Information Technology for Economic and Clinical Health [HITECH] Act) are just a few examples of older issues with new liabilities. This live course will give participants a detailed understanding of what is happening in and out of court from attorneys specializing in these types of cases and discussion will include advice on how to manage your risks.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain that the benefits of new science and technology far outweigh the risk.2. Identify potential risks.3. Proactively addressi potential problems.


TEST QUESTIONI offer genetic screening on embryos but always tell my patients to seek genetic counseling to better understand the implications and limitations of screening. If a patient has a bad outcome, after participating in this session I understand that:A. I would not be responsible.B. I would be responsible.C. I may or may not be responsible.D. Not applicable to my area of practice.

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SymposiumMental Health Professional Group Symposium - Developments in Egg Freezing: Medical, Psychological and Ethical Perspectives

Julianne E. Zweifel, Ph.D. (Chair) University of Wisconsin

Lisa Schuman, L.C.S.W. Reproductive Medicine Associates of New York

Alan B. Copperman, M.D. Reproductive Medicine Associates of New York

Andrea M. Braverman, Ph.D. Jefferson Medical College

Needs Assessment and DescriptionEgg freezing is a relatively new but widely used technique that was recently removed from the ASRM “experimental” classification. There is less debate on the use of this technology when it is used for medical purposes (i.e., cancer patients) than for elective fertility preservation. Little is known about this specific population of elective egg freezing patients and the effects this treatment may have on them. Therefore, this live course will address the interest and on-going need for ASRM professionals to gain further understanding of these patients in order to improve patient treatment.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the general profile and needs of the elective egg freezing patient.2. Summarize the medical, psychological, and ethical elements to consider when treating the elective egg freezing patient.


TEST QUESTIONAfter participating in this session, in my practice I will:A. View egg freezing patients as single female fertility patients.B. Understand this growing population of patients may have similar infertility issues as my other fertility patients, but may be coming to the office with a different perspective and set of needs than my other patients.C. Think egg freezing is a short-lived trend.D. Believe that not being in a relationship doesn’t affect the way these patients see treatment.E. Think egg freezing is still considered “experimental.”F. Not applicable to my area of practice.


SymposiumNurses’ Professional Group Symposium - Risk Management for Nurses: Don’t Make it Risky

Jeanette Rodriquez, M.S., R.N.C. (Chair) Cornell University

Margaret Swain, R.N., J.D. Private Practice, Baltimore

Sharon G. Edwards, R.N., B.S.N. Boston IVF

Needs Assessment and DescriptionThe dramatic changes that have occurred in assisted reproductive technology have impacted patient safety and quality. The technology associated with patient communication also has changed. Reducing risk through the improvement of communication requires the wholehearted commitment of the fertility health care organization and staff. This live course will cover strategies in addressing cultural diversity, improving patient treatment literacy, and empowering patients, all of which have an impact on reducing risks and improving patient satisfaction.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the need to address cultural needs of patients and clinicians.2. Examine clinician-patient online interaction, telemedicine, and social media.3. Discuss the constraints to communication and strive to mitigate and improve these factors.4. Predict the consequences of poor-quality health information.

ACGME CompetencyInterpersonal Skills and Communication

TEST QUESTIONAfter participating in this session, I will do the following:A. Facilitate development of communication skills that best utilize technologies and human factors while not compromising patient care and the risk posture of the facility.B. Rely on the medical record to determine what information the patient already has.C. Understand that a patient’s societal demands and culture do not affect the risk posture of the facility.D. Not applicable to my area of practice.

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SymposiumABOG Foundation - Kenneth J. Ryan Ethics Symposium - Moving Innovations to Practice Supported by a 2013 endowment from the American Board of Obstetrics and Gynecology

Paula Amato, M.D. (Chair) Oregon Health and Science University

Richard T. Scott, M.D. Reproductive Medicine Associates of New Jersey

Elena Gates, M.D. University of California, San Francisco

Robert J. Levine, M.D. Yale University

Needs Assessment and DescriptionThe development of effective new medical and surgical interventions involves an evolution from an original new idea, through innovative practice, experimentation under a formal research paradigm, and dissemination through appropriate use of the intervention in clinical practice. The distinction between innovative practice and research is not always clear, nor is the point at which a new intervention transitions from experimental to established practice. This live course for clinicians, researchers, and allied health professionals will provide a discussion of key ethical aspects of the transition from innovation to practice.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Distinguish between innovative treatment and research and established practice.2. Discuss the ethical challenges related to the dissemination of new practices in reproductive health.


TEST QUESTIONYour center is considering trying a new intervention for uterine synechiae. You are preparing to make a presentation to your colleagues about this procedure. Which element is least important to your decision about whether adoption of this new technique is ethically appropriate? A. Data from well-designed studies have been peer reviewed.B. Your group will have access to training in this new procedure.C. Another clinical practice in your region has had radio ads touting this new approach.D. Published data include information on short- and longer- term risks.E. There is a mechanism in place for collecting data on treatment outcomes going forward.


SymposiumPioneer Symposium: Physiology of the Oocyte and Embryo: From Reproductive Biology to Reproductive Medicine - A Celebration of Professor John D. Biggers Supported, in part, by an educational grant by LifeGlobal (IVF Online)

Catherine Racowsky, Ph.D. (Chair) Brigham & Women’s Hospital ART Center

John Eppig, Ph.D. Jackson Laboratory

David Whittingham, Ph.D. St. George’s, University of London

Ginny Papaioannou, Ph.D. Columbia University

Jay Baltz, Ph.D. Ottawa Hospital Research Institute

Needs Assessment and DescriptionNow that clinical in vitro fertilization (IVF) is coming of age, it may be easy to forget the pioneering work of those who laid the scientific foundation for our field. One of these pioneers is Professor John D. Biggers. This live course will celebrate the extraordinary contributions Professor John D. Biggers has made, and continues to make, to our understanding of mammalian gamete and embryo physiology. The course will cover topics including fertilization, oocyte-cumulus cell interactions, and the development of culture medium to support the growth of preimplantation mammalian embryos in vitro as they relate to Professor Biggers’ contributions and to current concepts. Reproductive practitioners and scientists will apply the tremendous depth, breadth, and significance of many of the discoveries made by Professor Biggers to the latest principles of gamete and embryo

biology in the current practice of assisted reproductive technology (ART). Reproductive specialists also will realize the impact of Professor Biggers’ research on establishing a single medium to support growth of human embryos from the one-cell to blastocyst stage in clinical IVF.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss the wide range of discoveries made by Professor Biggers involving our basic understanding of fertilization.2. Summarize the importance of Professor Biggers’ original observation of the metabolic dependency of the oocyte on its surrounding cumulus cells.3. Describe the landmark studies by Professor Biggers and his colleagues in laying the foundation for development of mammalian embryo culture medium and for establishing a single-step medium for routine use in clinical IVF.


TEST QUESTIONA 34-year-old, gravida 0, para 0, has undergone 3 failed IVF cycles with her 36-year-old partner who presents with a normal semen analysis. A total of 11, 9, and 8 oocytes were retrieved in these 3 failed attempts, but all retrieved oocytes were found to be immature. The couple has read about in vitro maturation and they wonder whether this should be


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used in an attempt to mature her oocytes in their fourth cycle, in the event of oocyte immaturity. After participating in this session, in my practice I will advise this couple before attempting their fourth cycle that: A. In vitro maturation is only successful when the oocytes are cultured for at least 5 days.B. In vitro maturation is most successful when all the cumulus

cells are removed.C. In vitro maturation is most successful when all the cumulus cells are left undisturbed around the oocyte.D. Embryos derived from oocytes matured in vitro are equally capable of forming a viable fetus compared with those derived from oocytes matured in vivo.E. Not applicable to my area of practice.


SymposiumEuropean Society of Human Reproduction and Embryology Symposium - Present and Future of Personalized Reproductive Medicine

Anna Veiga, Ph.D. (Chair) Institut Universitari Dexeus, Barcelona

Luca Gianaroli, M.D. Società Italiana Studi di Medicina della Riproduzione

Anna Maria Suikkari, M.D Family Federation of Finland

Needs Assessment and DescriptionIn the last 30 years, assisted reproduction techniques have been constantly evolving. Some of them are now routinely used all over the world, while others are still being developed. New categories of patients with specific reproductive needs have been emerging as a consequence of the social and demographic changes that have occurred in the last few years. In order to provide the best possible personalized treatments offering the highest chances of success, medical and paramedical staff of in vitro fertilization (IVF) units need to be acquainted with all the available treatment options, as well as with the specific needs of all categories of patients. This live course will cover current and developing techniques and treatment in the field of assisted reproduction.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss the current indications and techniques available in the field of assisted reproduction; as well provide an overview on techniques that are currently being developed.2. Describe how the modern treatment of clinical male and female reproductive dysfunction includes genetic, biochemical, anatomic, and behavioral assessment and introduce evidence-based approaches to medical and surgical therapies.


TEST QUESTIONAfter participating in this session, in my IVF program:A. Ovarian stimulation protocols will be standardized and uniform for all patients.B. Embryo quality will not be related to the outcome of the IVF cycle.C. Preimplantation genetic screening (PGS) will be done in all couples with women >35 years of age.D. Oocyte vitrification is an experimental technique.E. Both ovarian stimulation and transfer policy will be personalized in order to optimize the results.F. Not applicable to my area of practice.

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SymposiumEl Diagnóstico y Tratamiento Integral de la Paciente con Endometriosis:/ Latin American Association for Reproductive Medicine and the Argentinean Society for Reproductive Medicine Symposium

J. Ricardo Loret de Mola, M.D. (Chair) Southern Illinois University

Marcos Horton, M.D. (Chair) Pregna Center, Buenos Aires

Guillermo Marconi, M.D. IVI Buenos Aires

Guido Parra, M.D. Asociación Latinoamericana de Medicina Reproductiva

Juan Garcia-Velasco, M.D. IVI Madrid, Spain

Claudio Ruhlmann, M.D. Fertilidad San Isidro

Needs Assessment and Description La endometriosis es una enfermedad enigmática asociada a una morbilidad significativa y reducción de la fertilidad entre las mujeres de edad reproductiva. Un diagnóstico temprano y manejo eficaz de la enfermedad representan un reto importante para los médicos y pacientes. El tratamiento adecuado de la endometriosis requiere un enfoque multidisciplinario para efectivamente controlar los síntomas y mejorar la fertilidad. El objetivo de este programa es revisar el estado actual de las opciones para la evaluación, diagnóstico y tratamiento de la endometriosis para médicos en América Latina, y en español para abrir la puerta para el diálogo e intercambio de ideas entre los diferentes países. Esta actividad académica está diseñada para obstetras/ginecólogos, especialistas en endocrinología reproductiva y fertilidad, así como también otros profesionales de la salud involucrados en el diagnóstico y tratamiento de la endometriosis, con énfasis en las habilidades fundamentales y esenciales para el diagnóstico, evaluación y tratamiento adecuado de la enfermedad. Aplicando conceptos clave y empleando técnicas fundamentales, profesionales de la salud serán capaces de diagnosticar eficazmente, tomar decisiones sabias sobre los tratamientos y optimizar los resultados de fertilidad en las pacientes afectadas.

Endometriosis is an enigmatic disease associated with significant morbidity and reduction of fertility among women of reproductive age. Timely diagnosis and effective management of the disease represent a significant challenge for both clinicians and patients. Efficacious treatment of endometriosis requires a multidisciplinary approach to effectively manage symptoms and improve fertility. Our goal is to review the current status of endometriosis evaluation, diagnosis, and treatment options for Latin American physicians in Spanish and open the door for dialog and exchange of ideas between different countries. This live course is intended for obstetricians/gynecologists, reproductive endocrinology and infertility specialists, and other health care professionals involved in the diagnosis and treatment of endometriosis, with emphasis on the fundamental skills essential for diagnosis, evaluation, and adequate treatment(s). By applying key concepts and employing fundamental techniques, healthcare professionals will be able to effectively diagnose, make wise

treatment decisions, and optimize the fertility outcome in their affected patients.

Learning ObjectivesEn la conclusión de esta actividad, los participantes deben ser capaz de:/ At the conclusion of this session, participants should be able to: 1. Describir la historia, la fisiopatología y el manejo actual de la endometriosis./ Describe the history, pathophysiology, and current management of endometriosis.2. Describir los principios para el diagnóstico oportuno y una intervención eficaz en la endometriosis./ Describe the principles for early diagnosis and effective intervention in endometriosis.3. Demostrar la capacidad de aplicar juiciosamente los tratamientos médicos y quirúrgicos en casos de endometriosis./ Demonstrate an ability to recommend appropriate medical and surgical management of endometriosis. ACGME CompetencyPatient Care

TEST QUESTION Paciente de 37 años G1P1 con historia de cirugía previa (laparotomía con resección de endometrioma izquierdo y lisis de adherencias) para endometriosis estadio III, y ahora con recurrencia de sus síntomas, y además quisiera embarazarse. Su hormona antimülleriana (AMH) es 0.7 pmol/L. Examen físico demuestra dolor significativo durante el examen bimanual, con nódulos en ligamentos útero-sacros en examen recto-vaginal y masa derecha. Ultrasonido demuestra endometrioma derecho que mide 4 cm en diámetro. ¿Cuál de las siguientes opciones es la correcta?A 37-year-old patient, gravida 1, para 1, with a history of previous surgery (laparotomy with resection of left endometrioma and lysis of adhesions for stage III endometriosis), is in your office with recurrence of her symptoms. She would like to get pregnant in the near future. Her antimüllerian hormone (AMH) level is 0.7 pmol/L. Physical examination revealed significant pain during the bimanual examination and during the rectovaginal exam it was noticed that she had nodules on her utero-sacral ligaments and a right pelvic mass. Ultrasound shows a right mass consistent with an endometrioma measuring 4 cm in diameter. Which of the following would be the most correct statement in this case? A. Re-operaciones para endometriosis infiltrante mejora las tasas de embarazo./ Re-operations for infiltrating endometriosis improve pregnancy rates.B. Re-operaciones para endometriosis son más efectivas en tasas de embarazo que FIV./ Re-operations for recurrent endometriosis have higher pregnancy rates than in vitro fertilization (IVF).C. Numero y tamaño de endometriomas predicen la tasa de embarazo./ Number and size of endometriomas predict pregnancy rates.D. Edad y AMH ≤1 son los más importantes en predecir la tasa de embarazo/ Age and AMH ≤1 are most important in predicting pregnancy rates.

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SymposiumHuman Oocyte Development and Egg Quality in the Oncofertility Setting Supported by an educational grant from Ferring Pharmaceuticals, Inc.

Teresa K. Woodruff, Ph.D. (Chair) Northwestern University

Kutluk Oktay, M.D. Institute for Reproductive Medicine and Fertility Preservation, New York Medical College

Johan E. Smitz, M.D. Laboratory for Hormonology and Clinical Chemistry

Needs Assessment and DescriptionSurvival rates among young cancer patients have steadily increased over the past four decades in part because of the development of more effective cancer treatments. Today, both women and men can look forward to life after cancer, yet many may face the possibility of infertility as a result of the disease itself or these lifesaving treatments. This live course discusses The Oncofertility Consortium® that addresses the complex health care and quality-of-life issues that concern young cancer patients whose fertility may be threatened by their disease or its treatment. This live course is for physicians and allied health professionals involved in fertility preservation.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Define oncofertility.2. Discuss the fertility interventions that can be provided prior to sterilizing cancer treatments.3. Identify experimental methods that are emerging to meet future needs of cancer patients.


TEST QUESTIONA 17-year-old woman with acute lymphocytic leukemia and her parents are interested in options for preserving her fertility. After participating in this session, in my practice I will consider the following as an investigational intervention for protection of fertility in women undergoing chemotherapy: A. In vitro fertilizationB. Follicle cultureC. Ovarian transpositionD. Ovum cryopreservationE. Embryo cryopreservationF. Not applicable to my area of practice


SymposiumAssessment of Embryo and Blastocyst Quality

Barry R. Behr, Ph.D. (Chair) Stanford Fertility and Reproductive Medicine Center

Carli W. Chapman, M.S. Reproductive Medicine Institute, Chicago, IL

Juergen Liebermann, Ph.D., H.C.L.D. Fertility Centers of Illinois-River North IVF

Needs Assessment and DescriptionMuch debate exists between the relationship of embryo and blastocyst morphological traits and their ability to implant. It is difficult to accurately assess embryo viability from static morphological assessments alone. New technology is emerging that may aid in these determinations. These technologies require new applications of embryo viability assessments. This live course will inform clinicians and embryologists involved in assisted reproductive technologies of new approaches to embryo and blastocyst viability assessment for potential clinical application.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the new approaches to embryo and blastocyst viability assessment.2. List characteristics of embryo and blastocyst quality.


TEST QUESTIONExtended embryo culture in an autologous cycle:A. Improves embryo qualityB. Degrades embryo qualityC. Improves embryo selectionD. Improves endometrial receptivityE. Is appropriate for all patients

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MinisymposiumSociety for Male Reproduction and Urology Minisymposium - Where Are We With Germ Line (Sperm and Eggs) Stem Cells?

Amander Clark, Ph.D. University of California, Los Angeles

Needs Assessment and DescriptionTreatment for infertility requires good-quality egg and sperm. For individuals who no longer make functional eggs or sperm there are no options for having a biologically related child. This live course for reproductive health care clinicians and scientists examines a new technology that involves differentiating new healthy egg and sperm from stem cells and its potential for expanding reproductive options for infertile couples.

Learning ObjectivesAt the conclusion of this session, participants should be able to: 1. Identify the different types of stem cells currently in use by scientists and physicians.2. Describe the state of the science for generating egg and sperm cells in the laboratory for the treatment of infertility.


TEST QUESTIONWhat is the technique called when fibroblasts are turned into pluripotent stem cells?A. Reprogramming B. Molecular biology C. Induction D. Fusion

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

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International Committee Monitoring Assisted Reproductive Technologies Interactive Session: Comparisons of International Access to ART

Elizabeth Sullivan, M.D. (Chair) University of New South Wales

Fernando Zegers-Hochschild, M.D. Clinica Las Condes

G. David Adamson, M.D. PAMF Fertility Physicians of Northern California

Joe Leigh Simpson, M.D. March of Dimes

Sheryl Ziemin Vanderpoel, Ph.D. World Health Organization

Needs Assessment and DescriptionThe global growth of assisted reproductive technology (ART) has occurred in different socioeconomic and regulatory environments. This has resulted in wide variations in access, effectiveness, and safety of ART, as well as cross-border care to overcome regional limitations on ART treatment. Very little information is available to professionals or patients regarding the national and global impact of these differences. This live course for clinicians, allied health professionals, legal professionals, and reproductive managers will review international legal barriers to access to ART and recent major successes in international courts, provide the first sophisticated analytical estimate of the number of babies

born globally from ART, and describe the perspectives and actions of major international reproductive medicine organizations in dealing with these limitations on ART.

Learning ObjectivesAt the conclusion of this presentation, participants should be able to: 1. Discuss why and how the legal system interferes with access to ART in some countries, and list two recent successes in overcoming these barriers. 2. List five ways in which knowledge of international ART registry data compiled by The International Committee Monitoring Assisted Reproductive Technologies (ICMART) can be used to increase access, effectiveness, and safety of ART.


TEST QUESTIONWhich of the following is the most important factor in limiting global access to ART for women?A. Roman Catholic Church B. Muslim religion C. Laws restricting access to ART D. Limited societal reproductive rights of women


Interactive Session

Surgery Day Interactive Session - Role of Medical Therapy Prior to TESE for Men with Non-obstructive Azoospermia

Craig Niederberger, M.D. (Chair) University of Illinois

Peter N. Schlegel, M.D. Weill Cornell Medical College


Needs Assessment and DescriptionModern advances in testicular sperm extraction have substantially expanded the number of azoospermic men in whom sperm may be obtained from the testis for in vitro fertilization (IVF). Many of these men harbor identifiable medical disease, including endocrine dysfunction. The purpose of this live course is to review and discuss how medical therapy prior to testicular sperm extraction may be applied to potentially improve outcomes. The target audience is clinical male and female specialists involved in testis sperm extraction and IVF and embryology laboratory personnel.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. List the medical conditions that can affect the yield of testis sperm extraction2. Discuss the available therapies for azoospermic men.


TEST QUESTIONA 36-year-old man would like to have a biological child with his 32-year-old wife. Her evaluation is normal. Two semen analyses reveal volumes of 2.2 mL and 2.6 mL, and both are azoospermic. His testes are both 3.5 cm in longitudinal axis. His testosterone is 290 ng/mL, his follicle-stimulating hormone (FSH) level is 36 IU/L, and his luteinizing hormone (LH) level is 30 IU/L. After participating in this session, in my practice I will recommend the following as the next step in treatment:A. Antioxidant vitaminsB. Clomiphene citrate 50 mg every other day for 3 monthsC. HCG 5,000 IU twice weekly for 3 monthsD. Transrectal ultrasonographyE. Sperm retrievalF. Not applicable to my area of practice.


Interactive Session

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Interactive Session

Menopause Day Interactive Session - Cognitive Issues and Sleep Concerns: Hormones, Aging, or Both? Supported in part by an educational grand from Shionogi, Inc.

Melissa Wellons, M.D. (Chair) Vanderbilt University

Hadine Joffe, M.D., M.Sc. Harvard Medical School

Martha Hickey, M.D., Ph.D. University of Melbourne

Needs Assessment and DescriptionSleep disturbance is a core problem associated with the menopause transition, which can be present with varied types of sleep symptoms and can be caused by several different conditions. Common causes of sleep disturbance related specifically to the menopause transition include hot flashes, sleep apnea, insomnia, and depression. Other factors include age-related sleep changes and medical conditions. Evaluation of sleep disturbance in midlife women involves ascertaining the nature of the sleep disturbance and obtaining an overnight sleep study if sleep apnea is suspected. Treatment considerations vary with the type of sleep disturbance and include therapies targeting nighttime hot flashes, sleep hygiene, cognitive behavioral therapy for insomnia, hypnotic agents, and treatments for primary sleep disorders of sleep apnea. This live course will guide clinicians and allied health care professionals as they care for perimenopausal women with sleep disturbances.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the most common causes of sleep disturbance in midlife women.

2. Determine how to evaluate and treat sleep disturbances related to the menopause transition.


TEST QUESTIONYou are seeing a 52-year-old divorced postmenopausal woman with a history of depression who reports restless, unrefreshing sleep, including problems staying asleep, as well as hot flashes and fatigue. Her symptoms have been bothersome for over a month. She has recently gained 15 lb after a foot injury and her body mass index (BMI) is up to 32 kg/m2. It takes her less than 10 minutes to fall asleep at the beginning of the night and then she wakes up several awakenings per night but is unsure what awakens her. She is unrefreshed when she awakens in the morning and is tired all day and prefers to have a daytime nap. She does not have a bed partner to provide further information but has been told by others that she snores when she falls asleep during daytime. Her only medications are a selective serotonin re-uptake inhibitor (SSRI) and a statin. After participating in this session, in my practice I will consider the following next step for her sleep-related complaints:A. Advise her about key sleep hygiene techniques. B. Prescribe a sleep aid.C. Refer her for a sleep study.D. Treat her hot flashes.E. Refer her for review of her depression and its treatment. F. Reassure her that sleep problems are age related and will resolve with time.G. Not appiicable to my area of practice.

Monday, October 14, 2013 1:00 pm - 2:00 pmPanel Presentation

Collaborative on Health and the Environment and ASRM Environment and Reproduction Special Interest Group Panel Presentation - Endocrine Disruptors and Reproductive Health Across the Lifespan Developed in conjunction with the Collaborative on Health and the Environment and the ASRM Environment and Reproduction Special Interest Group.

Russ B. Hauser, M.D., Sc.D., M.P.H. (Chair) Harvard School of Public Health

Ana Soto, M.D. Tufts University

R. Thomas Zoeller, M.D. University Massachusetts

Jerry Heindel, Ph.D. National Institutes of Health

Needs Assessment and DescriptionChemicals that can alter the function of the endocrine system are ubiquitous in our environment. The Endocrine Society has defined an endocrine-disrupting chemical (EDC) as an exogenous chemical, or mixture of chemicals, that can interfere with any aspect of hormone action. EDCs may affect the regulation of hormone synthesis, secretion, and actions and the variability in regulation of these events across the life cycle. Endocrine disruptors present significant risks to reproductive health and fetal development, as well

as other health endpoints such as thyroid function, changes in metabolism, and obesity. This live session for clinicians and reproductive scientists will discuss the role of EDCs in infertility.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Identify four common endocrine disrupting compounds (EDCs).2. Describe the importance of timing and dose of exposure to EDCs on health impacts.3. List five health endpoints associated with exposure to EDCs.


TEST QUESTIONA 39-year-old Caucasian female has been trying to get pregnant for the past 2 years. An initial work-up found no structural or hormonal abnormalities; her husband’s sperm count was within normal limits. Her medical and occupational histories are unremarkable, and her nutritional status is adequate. The patient is a non-


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smoker. After 3 unsuccessful cycles of IVF, she is back in the office and asks about environmental exposure as a cause of their infertility. After participating in this session, in my practice, based on available human and animal evidence, I will counsel this patient that an environmental factor NOT likely to be a potential risk factor for failure to get pregnant and carry a pregnancy to term is:

A. Polychlorinated biphenyls from fish intake B. Flame retardant exposure from house dust C. Bisphenol A consumption from canned foods D. Parabens from personal care product useE. Not applicable to my area of practice.


Interactive SessionAndrogen Excess Special Interest Group Interactive Session- Hirsutism Treatment

Frank Gonzalez, M.D. (Chair) Indiana University School of Medicine


Needs Assessment and DescriptionHirsutism is the presence of excessive male pattern terminal hair in women. It is usually a consequence of elevated circulating androgens or increased local conversion of weaker androgens to the potent androgen, dihydrotestosterone, within the hair follicle environment. Although hirsutism in varying degrees can result from several pathological conditions, the most common cause is polycystic ovary syndrome. Hirsutism is also associated with a significant psychosocial burden. The evaluation of hirsutism often involves baseline severity scoring, endocrine testing when indicated, radiographic imaging in less common instances, and clarification of patient goals. Treatment of hirsutism typically requires medical therapy to suppress circulating androgens and/or block peripheral androgen action in combination with mechanical hair removal or adjuvant cosmetic strategies. Clinicians who manage hirsute patients should be aware of optimal strategies to ameliorate the condition and know where to refer patients for mechanical hair removal in their communities. They should also be prepared to individualize care based on the underlying medical condition and the perceived goals of the patient. This live course is for clinicians who manage hirsute patients and will cover evaluating hirsutism, strategies to ameliorate the condition, the risk and benefits of the various treatment approaches, and developing individualized treatment plans for patients.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the approach for evaluating hirsutism in relation to the medical condition encountered and the patient’s view of her condition.2. Describe the modalities available to treat hirsutism in relation to their risks and benefits.3. Develop an individualized treatment plan that addresses the underlying medical condition and the patient’s goals.

ACGME CompetencyMedical KnowledgePatient CareInterpersonal and Communication Skills

TEST QUESTIONA 26-year-old healthy, sexually active woman presents with perimenarchal onset of oligomenorrhea and a moderate amount of dark coarse hair on her upper lip, chin, chest, and lower abdomen that began in her mid-teens. She expresses a desire to eliminate the unwanted hair because it makes her self-conscious, particularly in social situations. Her weight and blood pressure are normal. A total testosterone level is mildly elevated and polycystic ovaries are present on ultrasound. After participating in this session, I will do the following in this situation:A. Start oral contraceptives and add spironolactone if no improvement in 2 months.B. Start electrolysis and add oral contraceptives if hirsutism recurs.C. Start oral contraceptives for 6 months and add laser hair removal once hair growth diminishes.D. Start finasteride and add oral contraceptives if no improvement in 9 months.E. Start gonadotropin-releasing hormone (GnRH) agonist for 3 months and add oral contraceptives with laser hair removal.F. Not applicable to my area of practice.

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Interactive SessionNurses’ Professional Group, Mental Health Professional Group and the Society for Male Reproduction and Urology Interactive Session - Nursing and Mental Health Care for the Infertile Male

James F. Smith, M.D. (Chair) University of California, San Francisco

Susanne Quallich, N.P. University of Michigan

William D. Petok, Ph.D. Private Practice, Baltimore

Alan W. Shindel, M.D. University of California at Davis

Needs Assessment and DescriptionMale infertility is implicated in up to 50% of all infertile couples. For many of these men and their partners, anxiety about this diagnosis, the demands of reproductive treatment, and the high costs of treatment take a very significant toll on their mental health. Nurses are frequently the ones providing information to these couples about infertility care and treatment, and this live course is designed to assist nurses in accomplishing this role.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe factors contributing to male factor infertility and an overview of current male infertility treatments.2. Discuss the ideal role of the nurse in the care of the male seeking (in)fertility evaluation.3. Explain the mental health impact of male infertility.


TEST QUESTION

1. A 34-year-old man and his 33-year-old wife are being treated by your staff reproductive urologist for nonobstructive azoospermia. The patient calls you to ask a few questions about his treatment options. Over the course of this discussion several questions arise. He first asks, “What exactly is a micro-TESE?” After participating in this session, in my practice my response will be:

A. A new kind of kitchen applianceB. A surgery to reconstruct the testicle so a man can ejaculate spermC. A surgery using a microscope to extract sperm from the testicleD. A surgery to diagnose the cause of male infertility

E. Not applicaple to my area of practice.

2. A 34-year-old man and his 33-year-old wife are being treated by your staff reproductive urologist for nonobstructive azoospermia. The patient calls you to ask a few questions about his treatment options. Over the course of this discussion several questions arise. He asks, “How can I best get help for the anxiety and stress my wife and I are experiencing?” After participating in this session, in my practice, my response will be:

A. Make an appointment to see your primary care doctor.B. Make a visit to see a psychiatrist.C. Visit websites of ASRM to get additional information.D. Make an appointment to see a specially trained counselor, nurse, or psychologist with experience caring for patients with reproductive mental health concerns.E. Not applicable to my area of practice.


Interactive SessionSociety for Assisted Reproductive Technology Interactive Session - Multiple Pregnancies: Risks and Benefits

Glenn L. Schattman, M.D. (Chair) Weill Cornell Medical College

Eric S. Surrey, M.D. Colorado Center for Reproductive Medicine

Needs Assessment and DescriptionMultiple pregnancy is the most common risk of assisted reproductive technology (ART). It is also the greatest risk to the mother and fetus. Limiting this risk while at the same time maintaining acceptable pregnancy rates and limiting exposure is the goal of all ART programs. This goal is difficult to reach without patient education since it is oftentimes the patient who has the final decision with regard to number of embryos to transfer. This live course will describe some of the risks associated with twin pregnancy as well as demonstrate how programs can maximize the patient’s pregnancy rate while making it acceptable to the patient to defer risk. It is intended for anyone who counsels patients regarding ART procedures and embryo transfer, including nurses, physicians and embryologists.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the maternal and neonatal risks associated with multiple gestation.2. Identify tools to counsel patients to make appropriate decisions regarding avoiding multiple gestation.3. Utilize current technology to maximize singleton pregnancy rates.


TEST QUESTIONA 33-year-old gravida 0 has been attempting conception for 2 years with her current partner when she sought treatment. Despite regular menses, her gynecologist placed her on clomiphene citrate for 6 cycles and when she did not get pregnant, ordered a hysterosalpingogram and semen analysis, both of which were normal. She underwent 4 cycles of gonadotropin superovulation with intrauterine insemination producing 3-4 mature follicles each time without success. Frustrated and desperate, the couple proceeded to an in vitro fertilization (IVF) cycle where she

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Interactive SessionRegenerative Medicine and Stem Cell Biology Special Interest Group Interactive Session - Biology of Male Germ Cell Differentiation

Sherman J. Silber, M.D. (Chair) Infertility Center of St. Louis

Ans M. M. van Pelt, Ph.D. University of Amsterdam

Sjoerd Repping, Ph.D. University of Amsterdam

Needs Assessment and DescriptionFertility preservation for young men and women post-puberty is already becoming standard care. Most young cancer patients are much more scared of becoming sterile than dying. The biggest problem has been prepubertal boys who are not yet making sperm. We present the solution to that problem in this live course for health care professionals involved in fertility preservation.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Discuss the techniques of spermatogonial stem cell culture.2. Discuss the clinical uses of spermatogonial stem cell culture.


TEST QUESTIONIf an 8-year-old boy develops leukemia and requires a bone marrow transplant:A. He will retain his fertility as an adult because he has not yet begun spermatogenesis.B. He will become irreversibly sterile because there is no way today to preserve his fertility.C. Freezing testicular tissue is of no benefit because it will have in it leukemic cells.D. One should freeze his testis tissue because leukemic cells die in culture before spermatogenic germ cells.


Interactive SessionSociety for Male Reproduction and Urology Interactive Session - Advanced Paternal Age: Cause for Concern?

Mark Sigman, M.D. (Chair) Brown University and Lifespan

Rebecca Z. Sokol, M.D., M.P.H. Keck School of Medicine of the University of Southern California

Needs Assessment and DescriptionMen have been fathering children at increasingly advanced ages. This has raised concerns about potential paternal age effects on pregnancy and offspring. This area in reproductive medicine remains a knowledge gap as demonstrated by the pre-test results from the 2012 ASRM Annual Meeting survey about paternal age effects. This live course for clinicians and allied health care professionals will present an update on what is known about paternal age effects on sperm, pregnancy, and offspring as well as provide guidance in counseling couples on this topic.

Learning ObjectivesAt the conclusion of this session, participant should be able to:1. Describe the effect of age on sperm DNA mutations.2. List some of the conditions that are related to paternal age.3. Counsel couples about effects of paternal age on pregnancy and pregnancy outcomes.


TEST QUESTIONAs men age:A. The sperm DNA mutation rates increase exponentially.B. The sperm DNA mutation rate increases at a constant rate.C. The sperm mutation rate increases to the same degree that mutations in ova DNA increase.D. Sperm mutation rates increase but the prevalence of genetic diseases in the offspring does not increase.E. They contribute fewer mutations to offspring than women do.

produced 16 metaphase II oocytes, of which 10 fertilized. On day 3, there are only 3 top-quality embryos and the rest are developing abnormally with fragmentation. She wants all 3 transferred. The action consistent with ASRM recommendations is:A. Transfer all 3 top-quality day-3 embryos since the patient is paying for the IVF cycle.B. Transfer one top-quality embryo and 2 of the poor-quality embryos.C. Delay transfer until day 5 or 6 and consider single blastocyst embryo transfer (ET).

D. Biopsy all embryos >4 cells on day 3 with preimplantation genetic screening (PGS) and transfer 2 genetically normal blastocysts on day 5.E. Biopsy embryos that make blastocysts for genetic analysis with subsequent cryopreservation and single-embryo transfer.F. Transfer 2 top-quality embryos on day 3.G. Not applicable to my area of practice.

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Interactive SessionFertility Preservation Special Interest Group Interactive Session - Ovarian Stimulation Protocols in the Cancer Population Supported by an educational grant from Ferring Pharmaceuticals,

Lynn M. Westphal, M.D. (Chair) Stanford University

Nicole L. Noyes, M.D. New York University

Needs Assessment and DescriptionAs survival rates improve for cancer patients, there is an increasing use of fertility preservation methods. Gap analysis of members of the Fertility Preservation Special Interest Group has shown a need for education on the most effective way to manage these patients for improved outcomes. This live course for physicians and allied health professionals involved in fertility preservation will cover ovarian stimulation protocols in the cancer population.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Identify the challenges in treating cancer patients.2. Explain the options available to safely stimulate these patients.


TEST QUESTIONA 35-year-old single woman is recently diagnosed with breast cancer. Her oncologist plans to start chemotherapy in the next 2-3 weeks. After participating in this session, in my practice I will:A. Counsel her that tamoxifen causes rapid depletion of follicles.B. Advise her that there is no risk of infertility or premature menopause from standard chemotherapy.C. Tell her that it would not be possible to complete a fertility preservation cycle in that short of a time.D. Would discuss fertility preservation options and start ovarian stimulation promptly if she wanted to cryopreserve oocytes.E. Not applicable to my area of practice.


Interactive SessionSociety of Reproductive Biologists and Technologists and the Society for Male Reproduction and Urology Interactive Session- Merits of the WHO 5th Edition Semen Analysis Parameters and their Predictive Value for IVF Success.

Michael A. Stout, Ph.D. (Chair) Shady Grove Fertility Reproductive Science

Kristen Ivani, Ph.D. Reproductive Science Center of the Bay Area

Ajay K. Nangia, M.D. University of Kansas Medical Center

Needs Assessment and DescriptionWhile evaluating semen samples for use in clinical procedures ranging from intrauterine insemination (IUI) to in vitro fertilization (IVF) to intracytoplasmic sperm injection (ICSI), it is necessary to obtain accurate information that will help the physician choose the best course of treatment for the couple. The World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen (5th edition) is the latest attempt to accurately characterize the semen sample so that the correct course of action may be taken. Even though the 5th edition is the most thorough attempt yet to characterize the semen sample, there are those critics who insist that this effort is not necessary for those patients who are to undergo the IVF process with the use of ICSI. This live course for assisted reproductive technology (ART) laboratory scientists and technicians and clinicians involved in reproductive care will consider these approaches and their impact on patient management.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the WHO 5th edition and how it differs from previous editions.2. Identify the cases when the use of this diagnostic test might be helpful.3. Determine whether the added expenses of a diagnostic test are justified when there is certainty that ICSI will be used.


TEST QUESTIONA couple has primary infertility. The male partner has a normal history and physical. His wife is 26 years old, has regular menstrual cycles and a normal workup. His semen parameters are as follows: volume = 1.5 mL; concentration = 15 million/mL; motility = 40%; strict morphology = 4%. After participating in this session, in my practice the next treatment step for this couple would be:A. Intrauterine insemination (IUI)B. In vitro fertilization (IVF)C. Intracytoplasmic sperm injection (ICSI)D. Timed intercourseE. Not applicable to my area of practice.

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Interactive SessionPediatric and Adolescent Gynecology Special Interest Group Interactive Session - Sexual Abuse of Children/Adolescents

Michael J. Heard, M.D. (Chair) Heard Clinic

R. Walton Weaver, J.D. Private Practice, Amarillo, TX

Needs Assessment and DescriptionSexual abuse and neglect has become a growing epidemic among children and adolescents. In order to provide excellent patient care, all providers should be aware and educated on the appropriate evaluation and treatment of the young female who has been a victim of sexual assault. This live course for physicians and other clinicians will cover sexual abuse examinations in this special population as well as collection of forensic evidence, appropriate reporting to law enforcement, and interaction with the legal system.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the sexual abuse forensic examination, including collection of evidence along with treatment and follow- up of the child/adolescent.2. Discuss guidelines for reporting to law enforcement and interaction with the judicial system once a potential sexual abuse case goes to trial.

ACGME CompetencyPatient CareSystems-based Practice

TEST QUESTIONAfter participating in this session, in my practice I will:A. Be aware of specific state regulations related to reporting of sexual abuse.B. Be aware of a mandatory requirement to report suspected abuse regardless of specialty.C. Refer patients to appropriate authorities for initial reporting to be completed.D. Not see children or adolescents.E. Not applicable to my area of practice.


Interactive SessionChinese Special Interest Group Interactive Session - Natural Cycle and Minimal Stimulation IVF and IVM

Ri-Cheng Chian, Ph.D. (Chair) McGill University

Frank D. Yelian, M.D., Ph.D. Life IVF Center

Needs Assessment and DescriptionThe world’s first in vitro fertilization (IVF) baby was born from a natural cycle. Superovulation later became a common practice in IVF and has been considered the ‘standard’ or ‘conventional’ procedure. Conventional IVF is widely used globally. However, concerns regarding side effects and risks of gonadotropin stimulation on women’s health and embryo safety have initiated a scientific movement towards a more physiologic and milder approach in assisted reproductive technology (ART). Furthermore, there is an urgent need to make ART accessible, affordable, and patient-friendly. Therefore, this live course will be important for clinicians and reproductive scientists involved in ART.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the differences between natural cycle IVF and minimal stimulation IVF.2. Describe natural cycle IVF combined with in vitro maturation (IVM).


TEST QUESTIONAfter participating in this session, in my practice I will use the following to define natural cycle IVF treatment:A. Low dosage of stimulationB. Only follicle-stimulating hormone (FSH) stimulationC. No stimulation for follicular developmentD. Short stimulation protocolE. Clomiphene citrate stimulationF. Not applicable to my area of practice.


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Interactive Session

Society for Male Reproduction and Urology Interactive Session - Physiologic Sperm Selection for ICSI: What Is It and Why Do It?

Denny Sakkas, Ph.D. (Chair) Boston IVF

Gianpiero Palermo, M.D., Ph.D. Weill Cornell Medical College

Erma Z. Drobnis, Ph.D. University of Missouri-Columbia

Needs Assessment and DescriptionThe use of intracytoplasmic sperm injection (ICSI) has led to concerns regarding the quality of the paternal genome inherited by embryos. Novel technologies are now being adopted to limit the chance of selecting “abnormal” sperm during the ICSI procedure. This live course for clinicians and reproductive scientists involved in the care of infertile couples will discuss how an abnormal paternal genome can influence reproductive outcomes and why selecting for a “better” sperm could enhance outcomes.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain what can be evaluated in a sperm population and in an individual spermatozoon.2. Describe novel sperm evaluation techniques on the horizon.3. Explain how new evaluation techniques will work and what information they will provide.4. Discuss how these treatments will be incorporated into routine.


TEST QUESTIONWhich targets are NOT being used to perform physiologic sperm selection?A. Apoptotic marker proteinsB. Cell membrane proteinsC. Morphological markersD. Array CGH


Interactive Session

Imaging in Reproductive Medicine Special Interest Group Interactive Session - To Doppler or Not to Doppler for Adnexal Masses

Elizabeth E. Puscheck, M.D. (Chair) Wayne State University School Of Medicine

Laurel A. Stadtmauer, M.D., Ph.D. Jones Institute for Reproductive Medicine

James M. Shwayder, M.D., J.D. University of Mississippi

Needs Assessment and DescriptionDuring several previous ultrasound programs, audience members have asked several questions about Doppler and its uses. Ovarian masses are often detected in women of reproductive age. Differentiating benign from malignant masses is important. Doppler enables one to see vascular flow into the mass and, since malignancies begin with neovascularization, Doppler may be able to identify the lower resistance caused by neovascularization of a malignant mass. Arguably, no ovarian cancer screening test exists, including Doppler. So can Doppler really help in diagnosing ovarian masses? This live course for clinicians, ultrasonographers, and other gynecologic health care professionals will debate the usefulness of Doppler in evaluating adnexal masses.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the basic Doppler principles and parameters, and describe how to optimize Doppler parameters in evaluating adnexal masses.2. Debate the usefulness of Doppler in identifying or differentiating adnexal masses given the current literature.


TEST QUESTIONA 32-year-old gravida 1, para 1 presents with right lower quadrant pain. She is uncertain of her period but it may have been a few weeks ago. Her history is only significant for infertility and dysmenorrhea. Doppler was performed and the following image was noted.

After participating in this session, in my practice I will use the following rationale regarding Doppler use in making this diagnosis: A. Doppler is not useful in this case. The history was sufficient. Laboratory tests are needed.B. Doppler is useful to identify this septated ovarian mass as suspicious for malignancy.C. Knowing the Doppler parameters is necessary to confirm that it is benign.D. Doppler shows that the vasculature is surrounding the mass and is benign.E. Doppler needs to show vascular patterns going into the mass to be of use in making the diagnosis.F. Not aplicable to my area of practice.

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99


Interactive Session

Society of Reproductive Surgeons Interactive Session - Management of Ectopic Pregnancy

Togus Tulandi, M.D., M.H.C.M. (Chair) McGill University

Kurt T. Barnhart, M.D., M.S.C.E. University of Pennsylvania

Needs Assessment and DescriptionEctopic pregnancy is a significant cause of morbidity and mortality in the first trimester of pregnancy. The decision of medical vs. surgical treatment is based on a number of clinical signs and careful patient selection. In this live course the experts will review available data on tubal and non-tubal pregnancies and their management, pragmatically and critically. This will be followed by discussion with audience participation, including in-depth interactive dialogues. This course is designed for practicing gynecologists, reproductive endocrinologists, residents, fellows, and allied health professionals.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Summarize risk factors for ectopic pregnancy, pathology of ectopic pregnancy, and diagnosis of tubal and non- tubal ectopic pregnancies.2. Describe medical and surgical management of ectopic pregnancy, including management after in vitro fertilization (IVF) treatment and prognosis for subsequent fertility.


TEST QUESTIONA 30-year-old woman presented to the emergency department with mild, left-sided abdominal pain and vaginal bleeding. Conception had occurred after embryo transfer 4 weeks before. Physical examination revealed slight abdominal tenderness on the left lower abdominal quadrant. No guarding or rebound tenderness were found. Her serum beta human chorionic gonadotropin (hCG) level was 4,500 IU/L. Transvaginal ultrasound examination revealed a tubal ectopic pregnancy of 3 cm in diameter, and no fetal cardiac activity was seen. After participating in this session, in my practice I will recognize that the most important criterion for methotrexate treatment failure is:A. Serum hCG concentrationB. Diameter of the ectopic massC. Fetal cardiac activityD. Maternal ageE. Endometrial thicknessF. Not applicable to my area of practice


Interactive Session

Pros and Cons of Robotics in Benign Gynecology



Balasubramanian Bhagavath, M.D. University of Rochester Medical College

Needs Assessment and DescriptionRobotic surgery is a rapidly expanding tool for both gynecologic and urologic reproductive surgeons. Despite this, there is controversy regarding risks and benefits and cost effectiveness of this new technology. This live course will explore these controversies and fill the knowledge gap regarding optimal patient and case selection.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Appropriately counsel patients about risks vs. benefits of robotic-assisted surgery.2. Critically evaluate the potential utility of this new technology.


TEST QUESTIONA 38-year-old woman presents with an isolated 5 cm intramural myoma and otherwise unexplained infertility for 3 years. Day 3 follicle-stimulating hormone (FSH), hysterosalpingogram (HSG), semen analysis, and antimüllerian hormone (AMH) are all normal. The myoma does not distort the cavity. Which of the following treatments is NOT supported by the evidence and one I will not recommend after participating in this session?A. Myomectomy via laparotomyB. Robotic-assisted laparoscopic myomectomyC. Hysteroscopic office myomectomyD. No surgical interventionE. Not applicable to my area of practice

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100


Interactive Session

Contraception Day Interactive Session: Thrombosis Risk with Hormonal Contraceptives Supported by an educational grant from TEVA Women's Health

Michael A. Thomas, M.D. (Chair) University of Cincinnati

Juergen Dinger, M.D., Ph.D. Berlin Center for Epidemiology and Health Research

Needs Assessment and DescriptionEstrogen-containing contraceptives have been linked to an increase in venous thromboembolism (VTE). However, decreasing doses of ethinyl estradiol (EE) (50 mcg or lower) are currently in combination oral contraceptive pills (OCPs), which has been associated with a decreased incidence of VTE. Despite this, recent data suggest that increasing obesity in women using OCPs may negate the decline in VTE associated with lower estrogen doses. This live course for clinicians and allied healthcare professionals who care for women using contraceptives will look at the evidence concerning the risk of VTE in combination oral contraceptive users.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Summarize the current evidence concerning the incidence of VTE risk in combination oral contraceptive users.2. Identify women who may be at higher risk for VTE if administered a combination oral contraceptive agent.3. Summarize the CDC US Medical Eligibility Criteria (MEC) for contraceptive use in women in the postpartum period.


TEST QUESTIONA 32-year-old healthy woman recently delivered her first child without complications. She has no risk factors for venous thromboembolism (VTE). The patient has requested to restart her combination oral contraceptive pills (OCPs), which contained 35 mcg ethinyl estradiol and 1 mg of norethindrone. After participating in this session, in my practice the earliest time that I would start her combination OCPs is:A. Postpartum days 7-20B. Postpartum days 21-42C. Postpartum days 43-90D. Any time after postpartum day 91E. Not applicable to my area of practice.


Interactive Session

Regenerative Medicine & Stem Cell Biology Special Interest Group Interactive Session - Properties of Spermatogonial Stem Cells

Stefan Schlatt, Ph.D. Centrum fur Reprodktiosmedizin und Andrologie, Westfalische Wilhelms- Universitat Munster

Needs Assessment and DescriptionIn recent years the role of spermatogonial stem cells in male fertility has raised the interest of the research community. New strategies like germ cell transplantation have revolutionized the field and created opportunities to perform experimental studies, to create a new entry into transgenesis, and to eventually provide clinically relevant options for infertility treatment. This live course will provide an introduction into the physiology of male germline stem cells and will provide basic scientists and clinicians with an up-to-date insight into novel options for research and treatment.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Explain the physiology of testicular stem cells and the important role of spermatogonia in maintaining the process of spermatogenesis.2. Discuss the role of spermatogonia as targets for gonadotoxic treatment and potential stem-cell based strategies to maintain fertility options in tumor survivors.


TEST QUESTIONGonadotoxic exposure during oncological therapy leads to the loss of spermatogonia and subsequent male infertility. Which one of the following accurately describes this process?A. The loss is always temporary as only differentiating germ cells are destroyed while stem cells are protected.B. Depending on the dose of exposure the damage can be permanent and no recovery of spermatogenesis will occur.C. In boys, the absence of active spermatogenesis protects the mitotically inactive stem cells from gonadotoxic insult.

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101


Interactive Session

Nutrition Special Interest Group Interactive Session - Interactive Roles of Nutrition and Medicine and the Importance of Taking Into Account a Patient’s Nutritional Status Prior to Medical Management of Disease

Kaylon L. Bruner-Tran, Ph.D. (Chair) Vanderbilt University Medical Center

Dian Shepperson-Mills, M.A. Endometriosis and Fertility Clinic

Needs Assessment and DescriptionMany babies are born preterm, with low birth weight, or with other problems that may be avoided if both parents are at optimum health prior to pregnancy. Thus, treatment of infertility should not begin when a couple enters the reproductive endocrinology and infertility (REI) realm. Support and maintenance of optimum fertility requires a proactive approach prior to the active pursuit of pregnancy. This live course will discuss the interactive roles of nutrition, medical interventions, and environmental exposures that can influence an individual or couple’s fertility status, including risk for infertility. We also will discuss the role of preconception nutritional medicine in males and females in order to enhance fertility and reduce the occurrence of adverse pregnancy outcomes. This live course is designed for pediatricians and gynecologic primary care providers as well as physicians, nurses, and researchers specializing in reproductive endocrinology and infertility.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe the influence, both positive and negative, of diet on male and female fertility.2. Discuss how patients in fertility clinics may best use preconception nutrition in a cost-effective way to improve fertility and improve pregnancy outcomes.


TEST QUESTIONOmega-3 fatty acids are essential for normal reproductive function and act as potent anti-inflammatory agents. After participating in this session, in my practice I will advise women considering pregnancy to do the following to maintain appropriate levels of omega-3 fatty acids in the body:A. Consume a diet rich in omega-3s (i.e., fish such as tuna and salmon, flaxseed oil, walnuts) or take a high-quality fish oil supplement.B. Adjust her diet and the diet of her partner to ensure adequate omega-3 intake (i.e., fish such as tuna and salmon or a high-quality fish oil supplement) as well as reduce consumption of foods high in omega-6 fatty acids (i.e., red meat, processed foods).C. Consider a vegetarian/vegan lifestyle that includes flaxseed and walnuts to ensure adequate omega-3 consumption.D. Consume a diet rich in omega-3s (i.e., fish such as tuna and salmon, flaxseed oil, walnuts) or take a high-quality fish oil supplement AND reduce consumption of foods high in omega-6 fatty acids (i.e., red meat, processed foods).E. Not applicable to my area of practice.


Interactive Session

Society of Reproductive Surgeons Interactive Session - Male Fertility Preservation Supported by an educational grant from Ferring Pharmaceuticals, Inc.

Peter Chan, M.D. (Chair) McGill University

Kirk C. Lo, M.D. University of Toronto

Robert E. Brannigan, M.D. Northwestern University

Needs Assessment and DescriptionWith an increase in the availability and success of assisted reproductive technology (ART), combined with an alarming rise in the incidence of various cancers that affect men of reproductive age, male fertility preservation has been gaining interest among reproductive and cancer specialists. Indeed, semen cryopreservation, currently the only clinically feasible option to preserve sperm, has been regarded as an important part of the management for young men with newly diagnosed cancer. When providing fertility preservation counseling, reproductive specialists often are

faced with challenging questions such as whether fresh sperm produced by cancer survivors after cytotoxic cancer therapy is better than cryopreserved sperm, what options are available for fertility preservation for pre-adolescent young boys, and what to offer cancer survivors experiencing recurrent ART failure with cryopreserved and fresh sperm. This live course for clinicians and laboratory scientists will address these issues as well as evaluate the available evidence in the current literature to allow clinicians to better counsel and manage this existing and growing population of young cancer survivors.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Evaluate the options and limitations of various strategies of male fertility preservation.2. Formulate the various experimental strategies being developed for pre-adolescent male fertility preservation and restoration.3. Discuss the issues of using sperm cryopreserved before cancer treatment versus fresh sperm after cancer

ARS


102


Interactive Session

Society of Reproductive Surgeons Interactive Session - Endometriosis and Cancer: Is There a Link?

Farr R. Nezhat, M.D. (Chair) St. Luke’s Roosevelt Hospital

Fernando M. Reis, M.D., Ph.D. Universidade Federal de Minas Gerais

Needs Assessment and DescriptionAlthough not yet fully delineated, recent studies suggest that there is a strong relationship between endometriosis and ovarian cancer. This live course for general gynecologists, gynecologic oncologists, and reproductive endocrinologists will cover the significance of the association between endometriosis and ovarian cancer, abnormal endometrial pathology such as hyperplasia and cancer, and clinical implications and future directions.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Assess the prevalence of cancer in women with endometriosis.2. Identify pathogenetic similarities between endometriosis and cancer.3. Discuss clinical implications and future directions.


TEST QUESTIONThe most common cancer histology associated with endometriosis is:A. Mucinous carcinomaB. Clear cellC. EndometrioidD. Borderline serous carcinoma

treatment with assisted reproduction.4. Outline the current evidence evaluating the quality of sperm obtained before and after cytotoxic cancer therapy from young cancer survivors.


TEST QUESTIONA 37-year-old morbidly obese male completed chemotherapy for Hodgkin disease two years ago. He and his 35-year-old female partner wish to pursue a pregnancy at this time. She is healthy and has a normal reproductive workup. The patient did not cryopreserve sperm prior to his chemotherapy. His physical examination reveals bilateral

20 mL volume testes with normal consistency. He was found to have azoospermia on two semen analyses this month. His serum follicle-stimulating hormone (FSH) level is 17 mIU/mL, his serum testosterone level is 400 ng/dL, and his serum estradiol level is 32 pg/mL. After participating in this session, in my practice I will recommend the following as the next best step for this patient:A. Y-chromosome microdeletion testing.B. Initiate human chorionic gonadotropin (hCG) therapy.C. Initiate aromatase inhibitor therapy.D. Microdissection testicular sperm extraction procedure.E. Wait for at least one more year before attempts for a pregnancy due to the risk of transmission of genetic abnormalities caused by his chemotherapy.F. Not applicable to my area of practice.


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Interactive Session

Health Disparities Special Interest Group Interactive Session - Biological, Social and Environmental Disparities in Reproduction

Gloria Richard-Davis, M.D. (Chair) University of Arkansas Medical Sciences

Ayman Al-Hendy, M.D., Ph.D. Meharry Medical College

Victor Y. Fujimoto, M.D. University of California, San Francisco

Needs Assessment and DescriptionA growing number of reports have explored potential gaps in the quality of reproductive health and health care across racial and ethnic groups. Assisted reproductive technology (ART) outcomes, development and impact of uterine fibroids, and exposure to environmental toxins are just a few health issues where health disparities are apparent. Whether it is environmental or genetics has been a long debate in many areas. Social factors such as access to care and education are known factors affecting health outcomes. The current body of literature both supports and refutes disparities in reproductive care and outcomes. There is a need to understand the biological, social, and environmental impact on reproductive outcomes. Evaluating existing differences and standardizing reporting of racial and ethnic data may improve analysis of health issues and outcomes. This live course is for clinicians, researchers, and allied health professionals involved in women’s health care.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Describe biological, social, and environmental impact on some common reproductive disparities and outcomes.2. Discuss the interplay among environment, health disparity, and the epigenome.


TEST QUESTION1. Which one of the following vitamin deficiencies is up to 10 times more common in African-Americans compared to Caucasian-Americans?A. Vitamin AB. Vitamin BC. Vitamin CD. Vitamin DE. Vitamin EF. Vitamin F

2. Which one of the following vitamin deficiencies has been linked recently to higher risk of uterine fibroids?A. Vitamin AB. Vitamin BC. Vitamin CD. Vitamin DE. Vitamin EF. Vitamin F

ARS


Interactive Session

Nurses’ Professional Group Interactive Session - Current Trends with Endometriosis Management

Tamara M. Tobias, N.P. (Chair) Seattle Reproductive Medicine

Paul C. Lin, M.D. Seattle Reproductive Medicine

Needs Assessment and DescriptionEndometriosis is a chronic disease affecting infertility patients. This live course will address the current trends in the management of endometriosis, with a discussion of the benefits and risks of surgical versus medical therapies. Nursing implications, patient education, and resources will also be reviewed. This activity is designed to meet the educational needs of physicians, nurses, and social workers who work with patients who have endometriosis.

Learning ObjectivesAt the conclusion of this session, participants should be able to:1. Review the pathophysiology of endometriosis and its clinical impact on patient goals of fertility and pain management.2. Discuss current medical and surgical management options for endometriosis.3. Describe nursing implications, patient education, and resources available to help counsel patients newly

diagnosed with endometriosis or having chronic suffering from the disease.


TEST QUESTIONA 36-year-old female, gravida 0, presents to discuss treatment options for her endometriosis. She had a prior laparoscopy at age 31 for pelvic pain, which confirmed the diagnosis of endometriosis. She has been on oral contraceptives since age 31 and has been doing well. Her husband is present during the consultation since they would like to attempt pregnancy within the next year. On transvaginal ultrasound, her left ovary has 4 antral follicles and a complex cyst is noted with a mean diameter of 5 cm. Her right ovary is normal with 6 antral follicles. Regarding this woman’s future fertility, after participating in this session in my practice, I will:A. Tell her that endometriosis has no impact on fertility.B. Have her return for a fertility evaluation after 2 years of stopping birth control pills and no pregnancy.C. Recommend surgical removal of the endometrioma.D. Prescribe gonadotropin-releasing hormone (GnRH) analog treatment for 3 years prior to pregnancy attempt.E. Not applicable to my area of practice.

ARS

SCIENTIFIC PROGRAM • VIDEO SESSIONS

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V-1 11:18 AM

SAFE ENDOSCOPIC Co2 LASER EXCISION AND VAPORIZATION OF PERITONEAL ENDOMETRIOSIS. A. Parsa, C. Paka. Minimally Invasive and Robotic Surgery, Center for Special Minimally Invasive Surgery, Stanford University, Palo Alto, CA.

OBJECTIVE: Video Assisted Laparoscopy is being used with increasing frequency in the treatment of endometriosis. However, endometriosis of sensitive areas such as the bowel, bladder, ureter and major blood vessels are often excluded from surgical intervention due to risk of injury. The use of Co2 laser along with hydrodissection allows for safe surgical treatment of endometriosis over such sensitive areas. This is a video presentation of safe CO2 laser excision and vaporization of peritoneal endometriosis.

DESIGN: 38 year old Para 0 patient with severe dysmenorrhea and pelvic pain who did not respond to medical therapy. She underwent laparoscopic treatment of pelvic endometriosis.

MATERIALS AND METHODS: Video Assisted Laparoscopy using CO2 Laser along with hydrodissection allows for safe peritoneal excision and vaporization of endometriosis.__________________________________________________________

V-2 11:26 AM

VIDEO ASSISTED THORACOSCOPIC SURGERY FOR ENDOMETRIOSIS. E. A. Buescher, A. Parsa, C. Nezhat. Center for Special Minimally Invasive Surgery, Stanford University, Palo Alto, CA.

OBJECTIVE: Thoracic Endometriosis Syndrome (TES) is an uncommon condition with an overwhelming occurence in the right hemithorax. The symptoms of thoracic endometriosis are typically catamenial, occuring within 24 to 48 hours of the onset of menstruation. This is a video presentation of a patient with endometriosis who presented with new onset of right sided cyclic chest pain.

DESIGN: This is a case of a 40 year old female with history of extensive endometriosis, who presented with new onset of cyclic right sided chest pain and worsening pelvic pain. She underwent a video assisted thoracoscopic surgery of her right lung after consultation by a cardiothoracic surgeon.

MATERIALS AND METHODS: Women with history of endometriosis who present with new onset of cyclic chest pain, should be evaluated for the presence of TES. Video assisted thoracoscopy can be used effectively to evaluate and treat the symptomatic patients.__________________________________________________________

V-3 11:30 AM

UTERINE SEPTUM: REPRODUCTIVE IMPLICATIONS AND SURGICAL MANAGEMENT. K. Holoch, R. Flyckt, T. Falcone, J. Goldberg. Reproductive Endocrinology and Infertility, Cleveland Clinic, Cleveland, OH.

OBJECTIVE: Uterine septum is the most common uterine anomaly diagnosed in women with infertility, especially

those patients with a diagnosis of recurrent pregnancy loss. The presence of a septum has been associated with poor obstetrical outcomes, such as first and second trimester pregnancy loss and preterm birth. Development of the septum occurs early in embryogenesis and is not associated with renal or skeletal malformations. The optimal management of the septum depends on the clinical scenario. The purpose of this video is to share animations of normal and abnormal mullerian development as well as to provide an overview of surgical indications and management of this lateral fusion defect.

DESIGN: Classification, embryologic development, and clinical characteristics of complete and partial septae are reviewed. Of key importance is the differentiation of uterine septum from bicornuate uterus. Imaging modalities such as ultrasound, hysterosalpingogram, and magnetic resonance imaging for evaluating uterine anomalies are compared. Here we describe a case of uterine septum associated with recurrent miscarriage and present associated surgical footage along with tips, techniques, and an evidence based review of hysteroscopic metroplasty for the treatment of this frequently encountered entity.

MATERIALS AND METHODS: In women with recurrent pregnancy loss, hysteroscopic metroplasty is recommended following appropriate work up and imaging. Surgical management of uterine septum may also be considered in women with primary infertility of long duration or women undergoing IVF, however improved outcomes have not been demonstrated.__________________________________________________________

V-4 11:37 AM

LAPAROSCOPIC APPROACH FOR THE ABDOMINAL CERCLAGE. C. Ruhlmann, F. Gorosito, F. Ruhlmann, M. L. Pisanelli, M. Darraidou, D. C. Gnocchi. Fertilidad San Isidro, San Isidro, Buenos Aires, Argentina.

OBJECTIVE: Uterine cerclage remains controversial, especially without a previous history of late miscarriages or preterm deliveries. Transabdominal cerclage has been reported as a successful intervention in selected cases as: high amputation of the cervix, or failure of previous vaginal cerclages. The implementation of radical trachelectomy for fertility preservation for early stages of cervical cancer has expanded the indication of abdominal cerclage. Abdominal cerclage is more challenging due to the proximity of the uterine arteries, especially during pregnancy when veins are significantly dilated, and uterine wall is thinner. Due to the latter and the limitation of the use of a uterine manipulator during pregnancy, a pre pregnancy prophylactic intervention seems the optimal choice.

DESIGN: We present our second successful case of laparoscopic approach of abdominal cerclage performed in this case pre-pregnancy. The previous case was performed during pregnancy and a healthy baby was born at 37 weeks through a cesarean section.A 33 years old woman, with a previous radical trachelectomy for cervical cancer stage IA1 treatment performed in 2008, and two years of primary infertility.

Tuesday, October 15, 2013 11:15 am – 1:00 pm

ASRM VIDEO SESSION 1


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The only positive finding in the infertility work-up was an abnormal hysterosalpingogram with bilateral proximal tubal occlusion. A laparoscopy was performed in September 2012,using a 10 mm umbilical port and two 5.5 mm secondary ports. Tubal recanalization and treatment of stage 2 endometriosis with a simultaneous placement of an abdominal cerclage were done. Bladder descent was not necessary, possibly due to previous surgical descent. A mercilene band was passed through the avascular space between the ascending and descending branch of the uterine artery, posterior to anterior in the right side and anterior to posterior in the left side. The knot was tied posteriorly. The procedure took 47 minutes and the women was discharged the following morning.__________________________________________________________

V-5 11:49 AM

ASSESSMENT OF HUMAN ABNORMAL PRONUCLEAR EMBRYOS BASED ON THE EXISTENCE OF A PARENTAL GENOME REVEALED BY LIVE-CELL IMAGING. M. Tokoro1, F. Itoi1, H. Kitasaka2,3, K. Yamagata4, N. Fukunaga1,2,3, Y. Asada1,2,3. 1The Asada Institute for Reproductive Medicine, Nagoya, Aichi, Japan; 2Asada Ladies Nagoya Clinic, Nagoya, Aichi, Japan; 3Asada Ladies Kachigawa Clinic, Nagoya, Aichi, Japan; 4Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.

OBJECTIVE: In our clinic, about 8% of embryos show abnormal pronuclear numbers, of single (1PN) or multiple pronuclei (more than 3 pronuclei), at the light microscopic level following IVF or ICSI. Although such abnormal PN-stage embryos have been thought to be unsuitable for transfer to patients, some clinics have reported that babies have occasionally been obtained from those embryos. These outcomes clearly suggest that such embryos may be capable of developing. Here, we aimed to assess embryonic integrity, based on the existence of the parental genome in human embryos that show abnormal PN numbers, using live-cell imaging technology.

DESIGN: Embryos with abnormal pronuclear patterns of 1PN or 3 pronuclei (3PN) were used for research after informed consent was obtained from the patients. Embryos were microinjected with a mixture of mRNAs encoding monomeric red fluorescent protein 1 fused with histone H2B and Alexa Fluor 488-labeled Fab313, which binds to the Histone H3 Serine10 phosphorylation next to trimethylated Lysine 9 (H3K9me3). Fab313 specifically highlights maternal chromosomes during mitosis, consistent with the known maternal genome-specific epigenetic modification of H3K9me3. The existence of parental genome in these embryos was monitored using a CV1000, a box-type confocal microscopic system.

MATERIALS AND METHODS: In this study, 80.7% of 1PN embryos had a biparental chromosome, and some of these developed to blastocyst stage. However, 70% of 3PN embryos following IVF had a single female pronucleus and two male pronuclei, while all of the 3PN embryos following ICSI had a single male pronucleus and two female pronuclei. These results suggest that it is necessary to continue to culture 1PN in clinical trials, and that 3PN embryos are not suitable for embryo transfer because most 3PN embryos following IVF or ICSI were polyspermy or chromosomal aneuploidy, respectively. Therefore, abnormal PN-stage embryos must be carefully selected if they are to be used for transfer in human ART programs.__________________________________________________________

V-6 11:57 AM

MICROSURGICAL DENERVATION OF RAT SPERMATIC CORD: SAFETY AND EFFICACY DATA. M. A. Laudano, E. C. Osterberg, S. Sheth, M. Goldstein, P. N. Schlegel, P. S. Li. Urology, Weill Medical College of Cornell University, New York, NY.

OBJECTIVE: The objectives of this study were to: 1) describe a microsurgical technique for denervation of the spermatic cord, 2) use a multiphoton microscopy (MPM) laser to identify and ablate residual nerves after microsurgical denervation of the spermatic cord (MDSC) and, 3) evaluate structural and functional changes in the rat testis and vas deferens following MDSC.

DESIGN: Nine Sprague-Dawley rats were divided into 3 groups. In sham rats, we performed a midline laparotomy and mobilization of the testis. In the MDSC alone group, we performed MDSC of a 5mm segment. In the MDSC plus MPM group, we used the MPM laser to image and ablate intact nerves immediately following MDSC. Two months after surgery, we assessed testicular volume, patency of the testicular artery with Doppler, patency of the vas deferens, and structural changes to testis and vas deferens. A Kruskal-Wallis test was performed to characterize differences among groups. Median pre-surgical testicular volume was 2.9 cm3 (IQR 2.8-3.3), spermatic cord diameter was 6 mm (IQR 5-6), and vas deferens diameter was 3 mm (IQR 2.5-3). A pre and post-procedure testicular artery pulse was confirmed by Doppler in all rats. In the 3 rats that underwent MPM immediately following denervation, 2 additional nerves in each rat were identified and ablated with MPM. On post-surgical evaluation, there was no difference in testicular volume among the 3 groups (p=0.83). A Doppler pulse was present bilaterally in all rats. In one sham and one MDSC alone rat, motile sperm were absent in vasal fluid unilaterally. Vasograms were preformed in these rats and demonstrated patency. Histologically, there was no difference in testicular architecture or vasal patency.

MATERIALS AND METHODS: A microsurgical approach can be used to effectively denervate the rat spermatic cord with minimal changes to structure and function of testis and vas deferens. Multiphoton microscopy can be used as an adjunct to identify and ablate residual nerves following microsurgical denervation.__________________________________________________________

V-7 12:04 PM

ELUCIDATING HOW FRAGMENTATION AND OTHER BLASTOMERE DYNAMICS AFFECT EMBRYO DEVELOPMENT AND CLINICAL OUTCOMES. S. L. Chavez1,2, L. Tan3, F. Moussavi3, B. R. Behr2. 1Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA; 2Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA; 3Auxogyn, Inc, Menlo Park, CA.

OBJECTIVE: Fragmentation is frequently observed in human embryos and is one of the most widely assessed morphological features in IVF clinics. The objective of this study was to leverage time-lapse imaging to understand how dynamic morphological features such as fragmentation impact embryonic health and clinical outcomes.


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DESIGN: This video describes the first study combining time-lapse imaging, aCGH, and molecular analysis of embryos donated to research. In this research, euploid embryos had strict cell division timings for P1 (duration of 1st cytokinesis), P2 (duration of 2-cell) and P3 (duration of 3-cell), while 70% of aneuploid embryos did not. For the aneuploid embryos with strict division timings, most of them exhibited fragmentation. Molecular analysis revealed presence of chromosomes in some of the fragments, which may persist or resorb. We have extended the findings from basic research to the clinic to further study the impact on embryo selection. We analyzed dynamic embryo behaviors and known implantation data for 137 transferred embryos imaged by Eeva™, a test enabled by time-lapse imaging that assesses whether an embryo has high or low developmental potential based on cell division timings.

MATERIALS AND METHODS: Research suggests that combining cell division timings with fragmentation may help discriminate between euploid and aneuploid embryos. In this analysis of transferred embryos, cell division timings alone correlated with known implantation rates (high 39% vs. low 6%). However, combined with early assessment of fragmentation, high embryos were associated with a further improved known implantation (46%). Since computer vision software has recently been developed to automate cell division measurements, a preliminary framework for automatic assessment of early fragmentation is presented. With further research, computer vision technology may allow automated evaluation of fragments together with division timings to aid embryo selection.__________________________________________________________

V-8 12:18 PM

A SIMPLIFIED, NO FLIP, SHANG RING CIRCUMCISION TECHNIQUE IN ADOLESCENTS. E. C. Osterberg1, H. You2, B. Yan2, R. Lee1, P. Li1, M. Goldstein1. 1Urology, Weill Cornell Medical College, New York, NY; 2Urology, Kunming Children’s Hospital, Kunming, Yunan, China.

OBJECTIVE: The Shang Ring (SR) is a single-use, disposable device that provides sutureless circumcision performed under local anesthesia. The SR’s simple design comprises an inner and outer ring placed around the foreskin that allows for a quick (3-5 min) MC to be performed by any health care provider. However despite its ease of use, the conventional SR technique has its limitations, namely difficulty with eversion of the foreskin over the inner ring as well as ring removal postoperatively. To address these limitations, we present a simplified, no flip SR circumcision technique.

DESIGN: From August 2008 to September 2009, 824 boys aged 4 to 15 with phimosis (563/824) and redundant prepuce (261/824) were prospectively enrolled for MC using our simplified, no flip SR technique at Kunming Children’s Hospital, China. This novel technique places the inner ring at a 45-degree angle under the foreskin. Patients were followed for 30 days postoperatively. Clinical data assessed included the duration of procedure, incidence of postoperative complications, and cosmetic appearance of the penis as assessed by a satisfaction questionnaire.

Results: The average operative time was 2.6 ± 1.2 minutes. Over 78% (647/824) of patients were followed for over 30 days postoperatively. Of these, over 95% reported complete wound healing with detachment of the SR without

assistance at 13.4 ± 5.8 days. Over 98% of patients were satisfied the no flip Shang Ring technique scoring “excellent” cosmetic outcome. Only 0.6% (4/647) of patients reported mild infection, while 3.2% (21/647) reported moderate edema, and 1.5% (10/647) of patients presented with wound dehiscence leading to delayed (>20day) ring removal.

MATERIALS AND METHODS: This modified, no flip, SR technique affords shorter operative time compared to the standard SR technique while maintaining a low complication rate. Further randomized trials will be necessary to confirm its performance compared to the conventional SR circumcision technique.__________________________________________________________

V-9 12:26 PM

SEGMENTAL BLADDER RESECTION FOR ENDOMETRIOSIS. A. L. Stevens1, A. Parsa1, C. Payne2, C. Nezhat1. 1Minimally Invasive and Robotic Surgery, Stanford University, Palo Alto, CA; 2Urology, Stanford University, Palo Alto, CA.

OBJECTIVE: Endometriotic lesions of the urinary tract are present in 1 to 2 percent of women with endometriosis. The bladder is the most common site of endometriotic lesions of the urinary tract. Among women with urinary tract endometriosis, the prevalence of disease at specific sites are:

Bladder – 85 percent

Ureter – 10 percent

Kidney – 4 percent

Urethra – 2 percent

This is a video presentation of segmental bladder resection for recurrent bladder endometrioma in a patient with extensive endometriosis.

DESIGN: 41 year old female with history of extensive endometriosis, presented with hematuria and pelvic pain including bladder symptoms. She had a prior segmental bladder resection for bladder endometrioma at age 31. Cystoscopy showed a left posterior bladder endometrioma in close proximity to the ureteral orifice. Decision was made to proceed with a laparoscopic segmental bladder resection with possible ureteral re-implantation.

MATERIALS AND METHODS: Although ureteral and bladder endometriosis both occur in the urinary tract, they do not frequently coexist and their clinical presentation and management are different. Bladder endometriosis causes urinary discomfort often mimicking recurrent cystitis, but rarely results in severe sequelae. Surgical treatment entails full thickness resection of the bladder wall at the site of the lesion, with ureteroneocystostomy in some cases.__________________________________________________________

V-10 12:36 PM

THIS IS AWKWARD. J. P. Ginsberg1, S. Ogle2, M. Glassner3. 1Pediatrics/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; 2Children’s Hospital of Philadelphia, Philadelphia, PA; 3Main Line Fertility, Bryn Mawr, PA.

OBJECTIVE: This is Awkward: A resource for boys considering sperm banking


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V-11 11:18 AM

MECHANISM FOR THE FORMATION OF HUMAN EMBRYOS WITH MULTINUCLEATED BLASTOMERES IDENTIFIED BY TIME-LAPSE CINEMATOGRAPHY. Y. Mio. Reproductive Centre, Mio Fertility Clinic, Yonago, Tottori, Japan.

OBJECTIVE: We have reported several novel aspects of human embryonic development in vitro using time-lapse cinematography (TLC). By this method, we evaluated the blastomere size and fragmentation rate in 2-3-day-old embryos, based on modified Veeck criteria. At that time, we often encounter multinucleated blastomeres (MNB), which are associated with chromosomal abnormalities. However, the developmental potential and normality of such embryos remains still controversial, and the mechanism underlying their formation in humans is unknown. This study identified a mechanism for the formation of human embryos with MNB using TLC.

DESIGN: We recently developed a TLC system, as described elsewhere. Culture temperature was maintained at 37±0.2°C and pH at 7.37±0.05 by controlling CO2 flow. Digital images of the cultured embryos were acquired for 5 days at a 1/20 second exposure. We analyzed 371 donated, early-stage embryos. Of these, 83 showed MNB, and clear visualization of the MNB formation process in 59 embryos yielded two pattern classifications: 54.2% formed two nuclei of equivalent size (Pattern A) and 45.8% formed multiple small nuclei (Pattern B). The remaining 24 embryos could not be classified. The mean diameter in Pattern B nuclei was significantly smaller than those in Pattern A embryos (P<0.01), and good-quality embryos resulted from 25.0% and 51.9% of Pattern A and B embryos, respectively (P<0.05). In Pattern A embryos, cytokinesis was interrupted after the cleavage furrow was formed, but multiple small nuclei appeared in the blastomeres just after mitotic division. Immunostaining for Lamin B showed that nuclei in all embryos had intact nuclear membranes.

MATERIALS AND METHODS: This study demonstrated for the first time that two different mechanisms drive the formation of MNB during human embryonic development, that is, cytokinetic failure followed by karyokinesis and

nuclear fragmentation with abnormal formation of nuclear membrane.__________________________________________________________

V-12 11:30 AM

STRATEGIES TO MINIMIZE BLOOD LOSS DURING A MYOMECTOMY. E. Soto, M. J. Uy-Kroh, T. Falcone. Obstetrics, Gynecology and Women’s Health, Cleveland Clinic, Cleveland, OH.

OBJECTIVE: Leiomyomas that require surgical intervention are commonly managed conservatively by myomectomy in patients of reproductive age. Despite the minimally-invasive nature of many myomectomies that are currently performed, significant intra-operative blood loss continues to be a significant morbidity associated with this procedure. The purpose of this video presentation is to demonstrate the utilization of different pre-operative and intra-operative interventions that can assist with minimizing blood loss during a myomectomy. Particular attention was placed on the evidence-based strategies that have shown to decrease blood loss in minimally-invasive abdominal myomectomies.DESIGN: Video presentation that demonstrates the application of different pre-operative and intra-operative measures to decrease blood loss during a minimally-invasive myomectomy.MATERIALS AND METHODS: Surgeons that perform myomectomies should consider incorporating to their practice interventions that have been shown to decrease blood loss (e.g., injection of vasopressin, use of barbed suture).__________________________________________________________

V-13 11:38 AM

MANAGEMENT OF A 30 OVARIAN CYST USING A MINIMALLY INVASIVE APPROACH. M. Milad, A. Watters, M. Moravek. Northwestern Feinberg School of Medicine, Chicago, IL.

OBJECTIVE: To demonstrate a techniques to manage a very large ovarian cyst in a minimally invasive fashion.DESIGN: A 4 cm incision was used to perform cystectomy of a 30 cm ovarian cyst. Minimal spill was confirmed. Patient went home the same day.

Wednesday, October 16, 2013 11:15 am – 1:00 pm

ASRM VIDEO SESSION 2

As treatments for childhood cancers have improved, more and more survivors are entering their reproductive years, and are thinking about starting families of their own. Unfortunately, impaired fertility can be an unwanted consequence of the treatments used to cure pediatric cancer. The Cancer Survivorship Program at The Children’s Hospital of Philadelphia recognizes that fertility is an extremely important issue related to long-term quality of life for our survivors.

DESIGN: Thought must be given to whether a child’s fertility is likely to be impacted by treatment. Ideally, this should occur before the start of therapy, when a window of opportunity may exist to preserve the patient’s future reproductive potential. This video is focused on sperm banking as an option for pubertal boys who will soon begin cancer treatment. For males who have reached puberty, freezing sperm at diagnosis is the gold standard for fertility

preservation and it has a well-demonstrated success rate. We recommend that sperm banking be offered to all eligible patients (defined as any male newly diagnosed with cancer who has reached puberty). We work closely with the healthcare team to ensure that sperm banking is integrated into the patient and family education of newly diagnosed males. Our team facilitates this process by discussing sperm banking with families and by helping families to make appointments at a local reproductive endocrinology practice.

MATERIALS AND METHODS: While preserving fertility is an important topic for families to discuss before cancer treatment begins, it can also lead to some uncomfortable conversations. In this video, former CHOP cancer patients discuss why they made the decision to bank their sperm, and describe what the experience was like for them.


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MATERIALS AND METHODS: In this patient, laparoscopy was contraindicated. A minimally invasive approach was still feasible and safe.__________________________________________________________

V-14 11:42 AM

MANAGEMENT OF OBSTRUCTED HEMIVAGINA IN AN ADOLESCENT FEMALE WITH OBSTRUCTED HEMIVAGINA AND IPSILATERAL RENAL AGENESIS (OHVIRA) SYNDROME: DESCRIPTION OF SURGICAL TECHNIQUE. S. A. Thomas, M. L. Mann, M. Ezzati, J. Kim, E. E. Wilson. University of Texas Southwestern Medical Center, Dallas, TX.

OBJECTIVE: Describe the case of an adolescent female with OHVIRA syndrome and illustrate surgical techniques utilized during the excision of an obstructed hemivagina.DESIGN: An 11-year-old female with known unilateral renal agenesis presented for evaluation of abdominal pain. Pelvic/Abdominal CT and MRI revealed the findings of a uterine didelphys with an obstructed left hemivagina. The patient was taken to the operating room for resection of the obstructed left hemivagina. Vaginoscopy via BETTOCHHI® hysteroscope revealed a right cervix and left hemivagina. A bivalve speculum was inserted with adequate visualization. A Cook ® Medical Peel-Away introducer set was used to obtain access to the obstructed left hemivagina. The 14 gauge needle within the set was inserted into the obstructed hemivagina. Placement was confirmed with aspiration of menstrual blood. The syringe was removed and a wire guide was threaded through the needle. The needle was removed and a 16-french dilator with Peel-Away introducer sheath was inserted over the wire guide. The dilator was removed and a 16-french open-tip Foley catheter was introduced through the Peel-Away sheath into the obstructed hemivagina. The sheath was removed and the Foley bulb was insufflated. The vaginal mucosa overlying the Foley bulb was excised with sharp and electrosurgical dissection. Part of the procedure was performed with added visualization with the hysteroscope, providing the surgeons an enhanced view of the confined operative field and further direction. Vaginoscopy at the end of the procedure was able to demonstrate both cervices in a single view.

MATERIALS AND METHODS: Surgical correction may be difficult in patients with OHVIRA. Our case describes a surgical technique utilizing Cook® Peel-Away introducer set, Foley catheter, and hysteroscope for direct visualization for additional control and accuracy involving entry and resection of the obstructed hemivagina.__________________________________________________________

V-15 11:48 AM

ISOLATED LONGITUDINAL VAGINAL SEPTUM. V. A. Flores, V. V. Snegovskikh, G. N. Frishman. Obstetrics and Gynecolgy, Warren Alpert Medical School of Brown University, Providence, RI.

OBJECTIVE: Isolated longitudinal vaginal septums are a rare Mullerian anomaly. The objective of this video is to demonstrate an innovative approach for septum resection.

DESIGN: The traditional method for treatment of a longitudinal vaginal septum is suture ligation. Electrosurgical approaches have historically not been widely used based on the risk of thermal spread and inadvertent injury to

adjacent tissue. Third generation bipolar devices allow the discrete and controlled application of energy with minimal thermal spread and excellent hemostasis. Furthermore, based on not needing to suture and tie knots, the resection procedure requires less operative time.

MATERIALS AND METHODS: We present the first case of a third generation bipolar device treatment of a vaginal septum. While further studies are needed to confirm safety, efficacy, and healing, this appears to be a promising approach.__________________________________________________________

V-16 11:57 AM

LAPAROSCOPIC-ASSISTED DRAINAGE OF HEMATOCOLPOS AND MANAGEMENT OF A TRANSVERSE VAGINAL SEPTUM IN PATIENT WITH UTERINE ANOMALIES. D. A. DeUgarte1, C. Tarnay2, S. Lerman3, I. Boechat4, T. Hartshorn2, C. DeUgarte2. 1Pediatric Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA; 2Obstetrics/Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA; 3Pediatric Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA; 4Pediatric Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA.

OBJECTIVE: This video describes the urologic complications of hematocolpos in a teenage patient with uterine anomalies and a novel laparoscopic-assisted approach to the management of transverse vaginal septum.

DESIGN: A twelve year old morbidly obese adolescent with a history of multiple birth defects including sacral dysmorphism presented with lower abdominal pain. She was found to have hematometrocolpos at an outside hospital. An MRI and exam under anesthesia demonstrated findings consistent with a transverse vaginal septum. The septum could not be successfully managed using a perineal approach. The patient was started on birth control pills to suppress menses with a plan to return for definitive management. The patient subsequently developed urinary obstruction, urosepsis, and acute kidney injury. She was transferred to our institution and successfully managed with percutaneous nephrostomy tubes. After resolution of her acute kidney injury, a laparoscopic-assisted drainage of the hematocolpos was performed. A right rudimentary uterine horn was identified. The laparoscope was introduced into the vagina and used to transilluminate and apply pressure to the transverse septum facilitating identification and incision of the transverse vaginal septum. An Amplatz nephrostomy-tract dilator kit (Cook®; Bloomington, IN) was used to safely dilate the new vaginal tract. The epithelium of the vagina was then approximated to the epithelium of the introitus A vaginal mold was placed to stent open the vaginoplasty.

MATERIALS AND METHODS: Transverse vaginal septum is a form of congenital vaginal obstruction likely caused by incomplete canalization of the vagina during the fifth month of gestation. When diagnosed in an adolescent, the hematometrocolpos should be addressed promptly to prevent urinary obstruction, urosepsis, and acute kidney injury as was observed in this case. Laparoscopy can be used to facilitate identification and incision of a transverse septum.__________________________________________________________


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V-17 12:02 PM

MODIFIED MCINDOE PROCEDURE FOR NEOVAGINA CONSTRUCTION USING A COMBINATION AUTOLOGOUS SKIN GRAFT AND PORCINE DERIVED, EXTRACELLULAR MATRIX (MatriStem™). G. Bareh1, R. D. Robinson1, J. Knudtson1, N. T. Phippen2, E. E. Ferguson3, M. G. Retzloff2. 1Reproductive Endocrinology and Infertility, The University of Texas Health Science Center, San Antonio, TX; 2Reproductive Endocrinology and Infertility, San Antonio Military Medical Center, Ft Sam Houston, TX; 3Plastic Surgery, San Antonio Military Medical Center, Ft Sam Houston, TX.

OBJECTIVE: One of the options for the surgical creation of a neovagina is the use of a split thickness skin graft, “The McIndoe” procedure. Our objective is to present a modification of our traditional technique of performing the McIndoe. The modification was required because of the inability to obtain a large enough autologous split thickness skin graft due to the small body habitus of the patient. The graft modification was made utilizing a partial split thickness skin-graft obtained from the patient and the remainder of the vaginal form was covered utilizing a porcine derived, naturally occurring, extracellular matrix sheet (MatriStem™).

DESIGN: The procedure begins with harvesting a skin graft. A sterile dressing is applied to the graft donor site. The McIndoe procedure is performed in the usual fashion,The vaginal mold is then created with a block of foam modified from a wound V.A.C. packet. The autologous, partial-thickness, skin graft is retrieved and placed over the vaginal form with the epidermis facing the form and then secured with 5-0 short runs of Vicryl suture. The graft was not sufficient to cover the whole form. Otaining another skin graft was not desired to minimize postoperative pain. The decision was made to use a porcine derived, naturally occurring extracellular matrix sheet to complete the deficient area of the graft around the mold. The vaginal form and graft was inserted into the neovagina and sutured in place. The patient remained at bedrest for one week and then taken back to the OR for removal of the vaginal mold and inspection of the graft. There were no postoperative complications.

MATERIALS AND METHODS: After 6 weeks both the autologous and porcine derived matrix revealed equivalent healing and 100% graft take and fuctional vaginal length and caliber. The patient is utilizing vaginal dilators to maintain vaginal patency. We believe that MatriStem™ should be considered for use in McIndoe procedures to avoid the need for harvesting of autologous split thickness skin grafts.__________________________________________________________

V-18 12:10 PM

OVARIAN CRYOPRESERVATION AND BACK-TRANSPLANT FOR FERTILITY PRESERVATION VIA REDUCED PORT SURGERY. I. Kikuchi1, N. Kagawa2, M. Kuwayama2, J. Kumakiri1, S. Takeda1. 1OB/GY, Juntendo Univ. Faculty of Medicine, Bunkyo-ku, Tokyo, Japan; 2Repro-Support, Medical Research Centre, Shinjuku-ku, Tokyo, Japan.

OBJECTIVE: Reduced port surgery has been attracting attention in recent years for being less invasive than conventional laparoscopic surgery. For patients scheduled to undergo chemotherapy or radiotherapy, it is preferable that recovery from oophorectomy be as rapid as possible;

therefore, we considered RPS to potentially be suitable for these patients. At the time of transplant, we used RPS. The purpose of this video is a demonstration of these operative methods.

DESIGN: Cryopreservation technique: An 18-G Cathelin needle equipped with a syringe was directly inserted trans-abdominally to reach the small follicle on the ovarian surface; then, follicular fluid was recovered by aspiration through the syringe as with in vitro fertilization procedures and immature oocytes were collected from the resulting culture medium under microscopy and cryopreserved.Vitrification of the ovarian tissue and immature oocytes ware performed using Cryotissue method.Back-taransplantation technique (case): A 28-year-old woman, gravida 0, underwent bone-marrow transplantation two years after being diagnosed with malignant lymphoma.The capsule of the remaining right ovary was severed with a laparoscopic cold knife and scissors without an electric knife while heparin saline was instilled to avoid impaired blood flow, and a base 2 cm * 1 cm in size was created on the remaining ovary. On the base, two thawed ovarian capsule pieces were laparoscopically sewn up with 5-0 absorbable suture and fixed. On postoperative day 173, the ovarian follicle had increased to 10 mm in diameter, and estradiol had risen to 101 pg/ml.

MATERIALS AND METHODS: It was suggested that ovarian cryopreservation and back-transplant for fertility preservation could take safety by using RPS.__________________________________________________________

V-19 WITHDRAWN__________________________________________________________

V-20 12:31 PM

LAPAROSCOPIC EXCISION OF RETROPERITONEAL PELVIC MASS OVER RIGHT ILIAC VESSELS. J. Miller1, A. Parsa1, R. Dalman2, C. Nezhat1. 1Center for Special Minimally Invasive and Robotic Surgery, Stanford University, Palo Alto, CA; 2Vascular Surgery, Stanford University, Stanford, CA.

OBJECTIVE: Extragenital endometriosis of the major pelvic vessels has been the subject of incidental case reports. Endometriosis occuring around large pelvic vessels has been reported to cause pain, catamenial edema, and DVT. This is a video presentation of a 49 year old female with history of endometriosis who presents with a two month history of worsening right sided pelvic and lower extremity pain.

DESIGN: 49 year old female with history of endometriosis, presented with a two month history of worsening right sided pelvic and lower extremity pain. Pelvic imaging showed a 3 cm pelvic mass overlying the right common iliac vessels. Pre-operative consultation with vascular surgery was obtained and patient underwent laparoscopic excision of the retroperitonel pelvic mass.

MATERIALS AND METHODS: Patients with history of endometriosis who present with extremity pain, edema or DVT should be evaluated for endometriosis of major pelvic vessels. Multidisciplinary approach with vascular surgeons and gynecologic surgeons are necessary to plan for the proper surgical treatment.__________________________________________________________


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V-21 12:36 PM

HEMATOURETER DUE TO ENDOMETRIOSIS. N. Lakhi, E. C. Dun, C. H. Nezhat. Atlanta Center for Special Minimally Invasive Surgery & Reproductive Medicine, Atlanta, GA.

OBJECTIVE: We present a case of a 17 year old female with uterine didelphys, a history of left nephrectomy and partial ureter resection as an infant, and partial resection of a left transverse vaginal septum due to hematocolpos at 12 years old. Her work up revealed a left retroperitonal mass, and she had reaccumulation of hematocolpos behind the partially resected left transverse vaginal septum, and dilated left uterine horn with hematometria.

DESIGN: Intraoperative findings showed bicornuate uterus with dilated left uterine horn, normal right uterine horn and normal right and left fallopian tubes and ovaries. The left transverse vaginal septum was resected vaginally and the hemoatocolpos and hematometria drained. The left uterine horn and cervix were laparoscopically resected. The left sided serpiginous retroperitoneal mass was dissected from the pelvic sidewall, ligated, and transected with spillage of thick, brown fluid. The pathology of the mass wall was smooth muscle and transitional epithelium consistent with ureter in addition to hemorrhage and glandular structures consistent with endometriosis. Endometriosis was also present in the serosa of the left uterine horn. Thus, the left retroperitoneal mass was the left ureter remnant which acquired endometriosis and collected menstrual debris, resulting in hematoureter.

MATERIALS AND METHODS: Women with Müllerian anomalies, vaginal obstruction, or imperforate hymen are at higher risk of endometriosis. Prior urogenital surgery can further complicate and distort the anatomy. Thus, a preoperative understanding of the patient’s urogenital anomalies is important in order to consider the differential diagnoses and anticipate surgical needs.


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AAGL Film Festival Video Session

Best Endoscopic Surgical Videos of the AAGL

This session will highlight the best reproductive videos from the 2012 41st Global Congress of Minimally Invasive Gynecology. A variety of innovative laparoscopic procedures and techniques will be presented. Topics will include surgical techniques for endometriosis, ectopics, myomectomy, robotic reproductive surgery, new options for single port surgery, and overviews of surgical anatomy among others. The session is designed for all levels of gynecologic and urologic surgeons.

__________________________________________________________

Introduction 11:15 AM AAGL-V1 11:18 AMLaparoscopic Removal of C-Section Scar Ectopic PregnancyAasia Romano

AAGL-V2 11:23 AMVertical and Omega Incision for Peritoneal Entry: Choosing the Best Incision for Your Patient Kevin Stepp

AAGL-V3 11:31 AMLaparoscopic Approach to the Pelvic Sidewall Deirdre Lum AAGL-V4 11:37 AMDouble TroubleDavid Redwine

AAGL-V5 11:45 AMErgonomics in the OR: Protecting the Surgeon Peter Rosenblatt

AAGL-V6 11:53 AMBleedersDavid Redwine Discussion 12:01 PM__________________________________________________________

AAGL-V7 12:04 PMUltra-Minimally Invasive Laparoscopic Myomectomy - Embryonal and Hybrid NotesMasaaki Andou

AAGL-V7 12:12 PMDifferential Diagnosis in Endometriosis: Endosalpingiosis; the Unknown Entity. An Overview of 1,100 Video-Documented LaparoscopiesRudy De Wilde

AAGL-V8 12:20 PMApplication of Knowledge of Pelvic Anatomy for Difficult Situations in Gynaecological Endoscopies - Tips and Tricks Riddhi Desai

AAGL-V9 12:26 PMTubal Reanastomosis as a Teaching Tool for Robotics Rebecca Flyckt

AAGL-V10 12:34 PMSingle Incision Robotic Myomectomy Antonio Gargiulo Discussion 12:41 PM

PARTICIPANT AND SPOUSE/PARTNER DISCLOSURES INDEX 2013

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Program participants are required to disclose commercial and financial relationships with manufactures of pharmaceuticals, laboratorysupplies, medical devices and with commercial providers of medically related services. Unless otherwise noted below, the participantshave nothing to disclose. Additional disclosures can be found online.

Abrao, Mauricio S. Bayer Schering, Advisory Board Member - VisanneAdamson, G. David Advanced Reproductive Care, Company officer and shareholder; XDHealth, Company officer and shareholder; Auxogyn,

Research grants and consultant; Schering Plough, Grant recipient; LabCorp, Grant recipientAlikani, Mina Reprogenetics, LLC, Direct stockholderAllemand, Michael C. Theralogix, Direct stockholderAllen, Rebecca H. Merck, trainer for NexplanonAlper, Michael Good Start Genetics, Scientific Advisory Board; Reprosource, Scientific Advisory Board; EMD Serono, Advisory; Merck,

SpeakerBaker, Valerie L. Roche, Paid consultant; Good Start Genetics, Paid consultantBarnhart, Kurt T. Pfizer Inc., Legal consultant; Bayer, Legal consultant; Evofem, Grant recipient; Nora Pharmaceuticals, Paid consultantBehr, Barry R. Auxogyn, Direct stockholder; Blastogen, Direct stockholder; Cooper Surgical, Paid consultant; MidAtlantic Device, Paid

consultantBenacerraf, Beryl R. GE Healthcare, Unpaid consultantBergh, Paul A. Med Software, Direct stockholderBergman, Kim Growing Generations, Company officer; Fertility Counseling Services, Company officerBlack, Lauri D. Good Start Genetics, Member of the Genetic Counseling Advisory Committee; InformedDNA, Member of the Business

Development Team; The Sperm Bank of California, Member of the Medical Advisory BoardBlackburn, Elizabeth H. Telome Health, Inc. (THI), Direct stockholderCanis, Michel Karl Storz Company, Paid consultant; COVIDIEN, Paid consultantCarmina, Enrico Bayer Pharma, Berlin, Germany, Paid consultantCarr, Bruce AbbVie, Grant recipient; Health Decisions, Grant recipient; Shionogi, Speakers bureauCasper, Robert F. Abbvie, Bayer, EMD Serono, Ferring, Merck, OvaScience, Pfizer, Watson, Paid consultant; ZircLight, OvaScience,

Insception, Direct stockholder; ZircLight, Insception, Company officer; Abbvie, Bayer, Speakers bureau; Ferring, Merck, EMD Serono, Grant recipient

Caswell, Wayne A. Irvine Scientific, Paid consultantCatherino, William H. Bayer Schering Pharma, Technology TransferCentola, Grace M. New England Cryogenic Center, Off site Lab Director (sperm bank, cord blood and stem cell bank); Cryos-NY, Off site

Andrology Lab and Tissue Bank Director; Manhattan Reproductive Center, Paid consultant; Brooklyn Fertility Center, Paid consultant; Eastern Niagara OB/GYN, Off site Andrology Lab Director

Chang, Ching-Chien My Egg Bank, Direct stockholderChapron, Charles IPSEN, Paid consultantChian, Ri-Cheng JieYing Laboratory Inc. Canada, Direct stockholderChung, Karine Ferring Pharmaceuticals, Paid consultantCohen, Jacques Reprogenetics LLC, New Jersey, USA, Direct stockholder; Reproductive Healhcare Ltd, Dry Drayton, UK, Company

officer; Althea LLC, New Jersey, USA, Direct stockholderConaghan, Joseph Auxogyn Inc, Honoraria; Irvine Scientific, Paid consultantConti, Marco Grünenthal GmbH, Paid consultantCooke, Ian D. Terumo Europe, Paid consultantCopperman, Alan B. EMD Serono, Speakers bureau; Merck, Speakers bureau; Ferring, Speakers bureauCoutifaris, Christos NORA Therapeutics, Medical Advisory Board; National Institutes of Health, Grant recipientCritchley, Hilary O. D. Bayer Pharma AG (research support), Grant recipient; Preglem (Gedeon Richter), Speakers bureau; Vifor Pharma

(Consultancy fees not received personally), Paid consultant; Preglem (Gedeon Richter) (Consultancy fees, not received personally), Paid consultant

Crockin, Susan L. BMS, Paid consultant; Merck, Paid consultant; Prometheus, Paid consultant; GSK, CoStim, Aveo, Advisory Board; Pfizer Canada; BMS, Speakers bureau

D’Hooghe, Thomas M. Ferring, Merck Seronon, MSD, Besins, Grant recipient; Bayer Pharma, Roche, Abbvie, Uteron Pharma, Astellas, Pharmaplex, Proteomika, Paid consultant; Gedeon Richter, Financial support to participate in international scientific meetings

Deutch, Todd D. GE Healthcare, Paid consultantDiamond, Michael P. NIH, EMD Serono, MDx, Grant recipient; Advanced Reprodictive Care, DS Biotech, Direct stockholder; Auxogyn, Halt

Medical, Paid consultantDietrich, Jennifer E. Duramed, Grant recipient; CSL Behring, Paid consultant; Bayer, Paid consultant; FDA, Paid consultantDinger, Jurgen Bayer AG, Germany, Grant recipient; MSD, United States, Grant recipient; Mentor, United States, Grant recipientDomar, Alice D. Merck, Grant recipient; Merck, Speakers bureau; Ovascience, Paid consultantEdelman, Alison Merck, Honoraria; Agile Pharmacueticals, Honoraria; Society of Family Planning, Grant recipient; NIH, Grant recipient;

UptoDate, royalitiesEdwards, Sharon G. Serono EMD Executive Nursing Advisory Board, Paid consultantFauser, Bart C. Ferring, Paid consultant; PregLem/Gedeon Richter, Paid consultant; Watson Laboratories, Paid consultant; Roche, Grant

recipient; Euroscreen, Paid consultantFeingold, Madeline L. Merck, Direct stockholderGarcia-Velasco, Juan A. Merck, Grant recipient; MSD, Grant recipient; Ferring, Grant recipient; Angellini, Grant recipientGargiulo, Antonio R. Omniguide, Paid consultantGerrity, Marybeth Auxogyn, Inc., Paid consultant; Genesis Genetics Institute, LLC, Paid consultantGianaroli, Luca S.I.S.Me.R., Direct stockholderGibbs, Richard A. Exilixis, Direct stockholder; Merck and Co, Direct stockholder; Amgen, Direct stockholder; GE-Clarient, Paid consultant;

BCM Diagnostic Services, Academic Employee of Institution (BCM)Ginsburg, Elizabeth S. Up To Date, Author and editorGiudice, Linda C. Merck, Direct stockholder; Pfizer, Direct stockholderGo, Kathryn J. Ferring Pharmaceuticals, Inc., Full-time company employeeGoldfarb, James M. EMD Serono, Paid consultant


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Goldstein, Steven NYU School of Medicine, Board of Directors; American Institute of Ultrasound in Medicine, President; Amgen, Bayer, Pfizer, Shionogi, Honoraria; Cook Obgyn, Philips Ultrasound, Paid consultant; Merck, Warner Chilcott, Speakers bureau

Harrington, Nancy Optum/A United Healthcare Company, Full-time company employeeHeard, Michael J. Sequenom CMM, Paid consultant; AbbVie Pharmaceuticals, Speakers bureau; TherapeuticsMD, Honoraria; Houston Board

Review PLLC, Company officer; Warner Chilcott, Speakers bureauHershberger, Patricia National Institutes of Health, Grant recipient; Sigma Theta Tau, International, Grant recipientHill, George A. UnitedHealthcare Women’s Health Scientific Advisory Board, Committee Member; EMD Serono Inc, Grant recipientHonig, Stanton C. Auxilium, Clarus, Grant recipient; Auxilium, MenMD, Coloplast, Honoraria; Lilly, Speakers bureauHorton, Marcos MerckSerono Grant for Fertility Innovation 2012, Grant recipient; MerckSerono, as speaker in Taller Regional REDLARA

2013, HonorariaIsaacson, Keith B. Karl Storz Endoscopy, Grant recipientIshihara, Osamu Merck Serono, Paid consultant; Ferring Pharma, Paid consultant; Mochida Pharmaceuticals, Honoraria; MSD, HonorariaJoffe, Hadine Cephalon/Teva, Grant recipient; Noven, Advisory Board; Sunovion, Unpaid consultantJungheim, Emily S. Celgene, Paid consultant; Spectrum, Paid consultant; Genentech, Paid consultant; Millenium, Paid consultantKeel, Brooks A. American Association of Bioanalysts Proficiency Testing Program, Scientific Advisory BoardKhera, Mohit Actient, Paid consultant; Slate, Paid consultant; Lilly, Speakers bureau; Auxilium, Speakers bureau; Merck, Paid consultantKim, Edward D. Eli Lilly, Speakers bureau; Warner Chilcott, Speakers bureau; Astellas, Speakers bureau; Auxilium, Speakers bureau; Eli

Lilly, Advisory BoardKingsberg, Sheryl A. Apricaus, Palatin, Sprout, NovoNordisk, Shionogi, Pfizer, Emotional Brain, Trimel, Paid consultant; Viveve, scientific

advisory board with stock optionsKlein, Nancy A. My Egg Bank, Shareholder in partner practice (SRM)Krawetz, Stephen A. Informa Health Care, EIC: Systems Biology in Reproductive Medicine; EMD-Serono, Grant recipient; Sigma Chemical

Company, Prerelease product accessLazarin, Gabriel A. Counsyl, Company officerLegro, Richard S. Ferring Pharmaceuticals, Speaker; Euroscreen, Clinical Advisory BoardLevi Setti, Paolo E. Merck Serono, Honoraria; MSD Merck, Speakers bureau; Ferring, HonorariaLiebermann, Juergen Copper Surgical (Sage/Origio), Paid consultant; Irvine Scientific, Speakers bureauLuciano, Anthony A. Abbott Pharmaceutical, Grant recipient; Intuitive, HonorariaLunenfeld, Bruno Merk-Serono, Speakers bureau; Ferring, Speakers bureau; MSD, Paid consultantMaki, Pauline Depomed, Paid consultantMalhotra, Narendra Owner of a medical distribution house (hospital medicine house), for distribution and sale of all types of medicines

and disposables for hospitals and clinics; Distributor, infertility drugs of Merck Serono and BSV; Partner, medical drug manufacturing unit (Gen drugs) KIN Health Care

Mersereau, Jennifer E. Ferring, Paid consultantMocanu, Edgar V. MSD, Grant recipient; Ferring, Speakers bureauMoley, Kelle Ovascience, Scientific Advisory BoardMorbeck, Dean E. Origio, Grant recipient; Fertilitech, Research equipment loan; Fertilitech, Scientific Advisory BoardMunné, Santiago Reprogenetics, Company officerNagy, Zsolt Peter MEB, Direct stockholder; MERCK, Honoraria; EMD-Serono, Honoraria; Origio, Paid consultant; Fertilitech, Paid

consultantNezhat, Ceana H. Ethicon Endo-Surgery, Speakers bureau; Lumenis, Paid consultant; PlasmaSurgical, Medical Advisor; Karl Storz

Endoscopy, Paid consultant; SurgiQuest, Scientific Advisory BoardNiederberger, Craig S. American Society for Reproductive Medicine, Journal Editor; American Urological Association, Journal Section Editor;

NexHand, Company officer; Global Advanced Medical Services, Company officerNorman, Robert J. Merck Sharp & Dohme, Honoraria; Fertility SA, Company officerOttey, Michelle A. Fairfax Cryobank, Full-time company employeePal, Lubna MERCK & Co., Paid consultantPatrizio, Pasquale EMD Serono, Speakers bureauPaulson, Richard J. Cooper Surgical, Paid consultant; Ferring, Speakers bureauPellicer, Antonio UNISENSE, IVI stockholderPfeifer, Samantha M. Best Doctors Inc, HonorariaPisarska, Margareta D. babycenter.com, Consultant medical editor; ASRM, Grant recipientPolotsky, Alex J. Bayer, Grant recipientReijo-Pera, Renee A. Auxogyn, Inc, Direct stockholderRichard-Davis, Gloria Bayer, Speakers bureauRizk, Botros Boehringer-Ingelheim, Grant recipient; Solvay, Grant recipient; Sanofi-Aventis, Grant recipient; Amgen, Grant recipient;

Duramed, Grant recipientRombauts, Luk Monash IVF, Direct stockholder; Merck-Serono, Grant recipient; Monash IVF, Company officer; Merck-Serono,

Honoraria; MSD, Honoraria; MSD, Grant recipientRosen, Mitchell P. OVAScience, Advisory BoardRuby, Alice H. The Sperm Bank of California (a 501(c)(3) non-profit), Full-time company employeeRuhlmann, Claudio Ferring Pharmaceuticals, Speakers bureau; MerckSerono, InvestigatorSakkas, Denny SAGE Reproduction, Scientific Advisory Board; Unisense, Scientific Advisory BoardSanfilippo, Joseph S. Bater Healthcare, Paid consultantSanten, Richard J. Pfizer, Paid consultant; Pfizer, Grant recipientSantoro, Nanette W. Menogenix, Direct stockholder; Bayer, Grant recipientScalia, Ann Walgreens, Full-time company employeeSchattman, Glenn L. Ferring, Speakers bureau; Abbott, Speakers bureau; Femasys, Medical Advisory board; Theralogix, Paid consultant;

Organon, Speakers bureauSchlegel, Peter N. Theralogix, Inc, Paid consultant; Ferring Pharmaceuticals, Paid consultantScott, Richard T. Ferring Pharmaceuticals, Grant recipient; Ferring Pharmaceuticals, Scientific Advisory BoardScott, Jr., Richard T. Ferring Pharmaceuticals, Grant recipient; Ferring Pharmaceuticals, Scientific Advisory BoardSee, Tricia InformedDNA, Full-time company employeeSeli, Emre Merck, Grant recipient


114

Serour, Gamal For my Unit at Al Azhar from Anecova SA, Merck Serono, Ferring, IBSA, Schering Plough. and Travel support from various companies & UN organizations for staff at IICPSR, Al Azhar University, Grant recipient

Seungdamrong, Aimee Ferring, Grant recipientSharara, Fady I. Ferring, Speakers bureau; Ferring, Grant recipientShifren, Jan L. New England Research Institutes, Paid consultantShindel, Alan W. Endo, Speakers bureau; Elsevier, Honoraria; International Society of Sexual Medicine, Honoraria; Sexual Medicine

Society of North America, HonorariaShwayder, James M. Cook Medical - Women’s Health, Royalties; Philips Ultrasound, Paid consultantSimon, Carlos A. EQUIPO IVI, Direct stockholder; IVIOMICS, Direct stockholder; Serono Symposia International Foundation, HonorariaSimpson, Joe Leigh March of Dimes, Full-time company employee; BioDx, Rarecells, Advisory Board; Schering-Plough/Merck, Principal

Investigator; Women & Infants Hospital of RI, employed until Feb 2013, Full-time company employeeSinger, Andrea J. Amgen, Grant recipient; Amgen, Speakers bureau; Amgen, Paid consultant; Medtronic, Paid consultantSitruk-Ware, Regine L. Bayer, Member of Advisory Board; Merck, Member of Advisory BoardStachecki, James J. Innovative Cryo Enterprises LLC, Company officerStadtmauer, Laurel A. Watson Pharmaceuticals, HonorariaStewart, Elizabeth A. Abbott, Paid consultant; Bayer, Paid consultant; Gynesonics, Paid consultant; Insightec, Grant recipient; UpT Date,

HonorariaSu, H. Irene Ferring, Paid consultantSunde, Arne Cellcura, Norway, Direct stockholder; Serono, Norway and Sweden, Honoraria; MSD, Norway, Honoraria; Ferring

Norway, Honoraria; Ibsa, Switzerland, HonorariaSurrey, Eric S. AbbVie, Grant recipient; AbbVie, Speakers bureauSwain, Jason E. Irvine Scientific, royalty recipient from MHM MediumTarlatzis, Basil C. Merck Serono, Merck Sharp & Dohme, Grant recipient; Merck Serono, Merck Sharp & Dohme, IBSA, Honoraria; Merck

Serono, Merck Sharp & Dohme, IBSA, Ferring, Travel Grants; MSD, Speakers bureauTaylor, Hugh S. Pfizer, Grant recipient; Abbvie, Paid consultant; Lilly, Paid consultant; Merck, Paid consultant; Medistem, Honoraria;

Bayer, HonorariaTaylor, Robert N. Abbvie Inc., North Chicago, IL, USA, Paid consultant; Alere Int’l Ltd., Galway, IR, Paid consultantThomas, Michael A. Smith and Nephew, Paid consultant; Clearblue, Advisory BoardTobias, Tamara M. EMD Serono, Speakers bureau; Walgreen’s Specialty Pharmacy, Nurse Advisory BoardTrew, Geoffrey H. Merck Serono, Paid consultant; Baxter Biosurgery, Paid consultant; Actamax, Paid consultantTrussell, James Bayer, Paid consultant; Merck, Advisory Committee, Speaker at conferences; Medicines 360, DSMBTucker, Michael J. Xytex Cryo International, Company officerTulandi, Togas Watson Pharma, Speakers bureau; Halt Medical, Grant recipientTurek, Paul J. BioQuiddity, Inc, Direct stockholder; Doximity.com, Medical Advisory Board; Healthloop.com, Medical Advisory Board;

BioQuiddity, Inc, Direct stockholder; FertilityPlanit.com, Medical Advisory BoardVan Blerkom, Jonathan Gynetics, Lommel, Belgium, once tested prototypes of SCS IVF systemVance, Amy C. Recombine, AdvisorWagner-Coughlin, Colleen EMD Serono, One time advisory meetingWalsh, Thomas J. Endo Health Solutions, Paid consultant; Coloplast, Paid consultant; Amgen, Paid consultantWells, Dagan Reprogenetics, Direct stockholderWestphal, Lynn M. Ferring, advisory boardWhite, Katharine O’Connell Teva Women’s Health, Paid consultantWidra, Eric A. Counsyl, Paid consultant; Natera, Paid consultantWild, Robert A. NIH ORWH, Paid consultant; FDA advisory commitee, Paid consultant; Atherotec, Paid consultant; Luye, Paid consultantWinston, Nicola Merck, Direct stockholderWorrilow, Kathryn C. Biocoat, Inc., Scientific consultant

VIDEO DISCLOSURES INDEX 2013

115

Behr, B. R. Auxogyn, Direct stockholder; Blastogen, Direct stockholder; Cooper Surgical, Paid consultant; MidAtlantic Device, Paid consultantChavez, S. Auxogyn, Inc., HonorariaDeUgarte, C. Ferring, Speakers bureauDeUgarte, D. A. Ferring, Speakers bureauDun, E. C. Plasma Surgical, Paid consultantMoussavi, F. Auxogyn, Inc, Full-time company employeeNezhat, C. H. Ethicon Endo-Surgery, Speakers bureau; Lumenis, Paid consultant; PlasmaSurgical, Medical Advisor; Karl Storz Endoscopy, Paid consultant;

SurgiQuest, Scientific Advisory BoardRetzloff, M. Merck, Speakers bureauRobinson, R. D. Merck Implanon trainer, HonorariaRuhlmann, C. Ferring Pharmaceuticals, Speakers bureau; MerckSerono, InvestigatorSchlegel, P. N. Theralogix, Inc, Paid consultant; Ferring Pharmaceuticals, Paid consultantTan, L. Auxogyn, Inc, Full-time company employeeUy-Kroh, M. J. S. Covidien, Paid consultant; Ethicon, Paid consultant; Gore, Paid consultant

Full Name Disclosure Last First Middle

Teede,

Helena J.

Novo Nordisk, Speakers bureau; Astra Zeneca, Speakers bureau;

sanofi, Industry international drug trial participantTeede Helena J

Donnez,

Jacques G.

PregLem SA, Board membership; Serrono, MSD, Organon, Ferring,

Payment for lectures (scientific presentations)Donnez Jacques G.

Gruber,

RitaRMA of New Jersey, LLC, Full-time company employee Gruber Rita

Levine,

Robert J.

Eli Lilly Corporation, Member of Bioethics Committee; consultant

in bioethics.Levine Robert J.

PROGRAM PARTICIPANTS - NON-ORAL/POSTER PRESENTERSParticipants are indexed by page number.

116

Aboulghar, Mohamed A. p19, p49, p67Abrao, Mauricio S. p13Adamson, G. David p13, p39, p46, p66, p91Al-Hendy, Ayman p27, p47, p103Alikani, Mina p19Allen, Rebecca H. p43, p54, p78Almeling, Rene p43, p79Amato, Paula p48, p86Anderson, Deborah J. p17Applegarth, Linda D. p43, p79Arce, Carlos Felix p41, p74Attaran, Marjan p41, p53, p73Awwad, Johnny T. p45, p81Baird, Donna p27Baker, Valerie L. p30Baltz, Jay M. p48, p86Barnhart, Kurt T. p12, p26, p44, p99Batsides, Demetrios C. p46, p84Behr, Barry R. p43, p48, p80, p89Beier, Henning p42, p64Bell, Ernestine Gwet p42, p65Benacerraf, Beryl R. p29Benson, Monica R. p39, p70Bergh, Paul A. p22Bertone-Johnson, Elizabeth R. p41, p76Bhagavath, Balasubramanian p44, p99Bhattacharya, Siladitya p49, p67Black, Lauri D. p22Blackburn, Elizabeth H. p38, p57Blumenthal, Paul D. p30Bormann, Charles L. p12, p27Bourgain, Claire p42, p64Brannigan, Robert E. p12, p47, p101Braverman, Andrea M. p23, p43, p47, p79, p85Brisman, Melissa B., p39, p69Brosens, Jan J. p42, p64Bruner-Tran, Kaylon L. p28, p47, p101Bulun, Serdar E. p12, p38, p57Canis, Michel p39, p52, p71Carmina, Enrico p49, p67Carrell, Douglas p31Carson, Sandra A. p41, p51, p72Casper, Robert F. p41, p45, p49, p67, p73, p83Caswell, Wayne A. p27Cedars, Marcelle p12, p13, p39, p43, p51, p65, p68Centola, Grace M. p13, p46, p60Chan, Peter p47, p101Chang, Tien-cheng "Arthur" p12Chapman, Carli W. p43, p48, p80, p89Chapron, Charles p42, p58Chen, Zi-Jiang p41, p49, p67, p74Chian, Ri-Cheng p43, p97Clark, Amander p48, p90Coddington, Charles C. p12Cohen, Jacques p42, p49, p62, p78Conaghan, Joseph p27, p35Conti, Marco p44, p80Cooke, Ian D. p32Copperman, Alan B. p47, p85Coutifaris, Christos p13, p42, p64Critchley, Hilary O. D. p41, p76

Crockin, Susan L. p24Crosignani, Pier G. p44, p59D'Hooghe, Thomas M. p26, p49, p61Daar, Judith F. p20de Candolle, Gabriele p13, p42, p64de Kretser, David M. p46, p60de la Jara, Julio p41, p74DeCherney, Alan H. p12, p45, p83DeMayo, Francesco J. p41, p76Desai, Nidhi p12, p20Desai, Riddhi p111Deutch, Todd D. p21Devlieger, Roland p39, p64Devroey, Paul p12, p13, p19, p49, p67Dey, Sudhansu K. p41, p76Diamond, Michael P. p42, p64Dietrich, Jennifer E. p25Dinger, Jurgen p44, p54, p100Domar, Alice D. p12Donnez, Jacques G. p38, p63Drobnis, Erma Z. p44, p98Duleba, Antoni J. p28Dumesic, Daniel A. p40, p45, p83, p93Dzik, Artur p12, p46, p49, p67Edelman, Alison p30Edwards, Sharon G. p47, p85Elster, Nanette p23Eppig, John p48, p86Farquhar, Cynthia p12, p38, p49, p63, p67Farquharson, Roy G. p24Fauser, Bart C. p39, p43, p64, p65Finn, Alison p19Fischer, Jill M. p22Forman, Eric J. p43, p79Fujimoto, Victor Y. p47, p103Gada, Dhiraj B. p12, p13, p39, p64Garcia-Velasco, Juan A. p48, p88Gargiulo, Antonio R. p12, 52, p111Gates, Elena p48, 86George, Korula p43, p65Gianaroli, Luca p32, p46, p48, p66, p87Gibbons, William E. p46, p60Gibbs, Richard A. p38, p57Giudice, Linda C. p10, p12, p13, p38, p57Goldberg, Jeffrey M. p12, p34, p39, p44, p52, p71, p99Goldfarb, James M. p24Goldstein, Steven p29Gonzalez, Frank p40, p93Grady, Christine p45, p83Grill, Elizabeth A. p39, p43, p69, p79Gruber, Rita p46, p84Harper, Joyce p46, p66Harrison, Robert F. p42, p58Hauser, Russ B. p39, p92Heard, Michael J. p43, p97Heindel, Jerrold J. p39, p92Hennessy, Mary Dawn p39, p70Hershberger, Patricia p39, p70Hestiantoro, Andon p45, p82Hill, George A. p17Hoeger, Kathleen M. p41, p76Horton, Marcos p13, p48, p66, p88

Huddleston, Heather p26Hughes, Holly A. p43, p80Isaacson, Keith B. p34, p40, p42, p44, p53, p58, p72Ishihara, Osamu p38, p46, p63, p66Ivani, Kristen p43, p96Jørgensen, Niels p49, p67Janik, Grace M. p12, p13, p39, p40, p52, p53, p58, p71Joffe, Hadine p40, p51, p92Kahraman, Semra p46, p66Kalantaridou, Sophia N. p24Keel, Brooks A. p35Kelestimur, Fahrettin p49, p67 Kennedy, Richard p12, p13, p38, p46, p54, p63, p66,Kim, Edward D. p41, p77Kim, Seok Hyun p12Kingsberg, Sheryl A. p41, p51, p72Korsak, Vladislav p46, p66Krawetz, Stephen p45, p84Kruger, Thinus p46, p60Kuliev, Anver p33, p46, p66Lönnefors, Celine p46, p65Lamb, Dolores J. p13, p35, p42, p59Lazarin, Gabriel A. p22Legro, Richard S. p13, p45, p83Lessey, Bruce A. p26Levens, Eric D. p45, p83Levine, Robert J. p48, p86Levy, Carol A. p39, p69Liebermann, Juergen p48, p89Lin, Paul C. p47, p103Lo, Kirk p47, p101Lobo, Roger A. p13, p59Loret de Mola, J. Ricardo p41, p48, p74, p88Louis, Germaine M. p49, p67Lundin, Kersti p46, p66Lunenfeld, Bruno p45, p82Magli, M. Cristina p32Makrigiannakis, Antonis p24Malhotra, Jaideep p45, p82Malhotra, Narendra p12, p39, p54, p63Manson, JoAnn E. p39, p51, p68Mara, Michal p46, p65Marconi, Guillermo p48, p88Marsh, Erica E. p46, p65Matteson, Kristen A. p54Meldrum, David R. R. p19Messinis, Ioannis p24Mettler, Liselotte p12, p39, p42, p52, p64, p72Missmer, Stacey A. p41, p76Mocanu, Edgar V. p13, p38, p46, p66Mojarra-Estrada, Jose M. p41, p74Moley, Kelle p49, p62Montgomery, Grant W. p38, p63Moran, Lisa p39, p64Morimoto, Yoshiharu p45, p82 Muasher, Suheil J. p45, p81Munné, Santiago p33Muraco, Holley p41, p71Nangia, Ajay K. p12, p43, p96Neal-Perry, Genevieve p33


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Nezhat, Ceana H. p39, p52, p71Nezhat, Farr R. p47, p52, p102Niederberger, Craig S. p38, p40, p52, p68, p91Norman, Robert J. p45, p82Noyes, Nicole p43, p96O'Connell White, Katharine p43, p54, p78Oates, Robert D. p41, p77Oktay, Kutluk p48, p89Ombelet, Willem Urbain p43, p65Orwig, Kyle E. p19Osteen, Kevin G. p28Pai, Hrishikesh D. p45, p81Pai, Rishma Dhillion p45, p81Pal, Lubna p39, p51, p68Palermo, Gianpiero D. p44, p98Palshetkar, Nandita P. p45, p81Palter, Steven F. p12, p34, p39, p44, p52, p71, p99Papaioannou, Ginny p48, p86Parra, Guido p48, p88Pasch, Lauri p18Pasquali, Renato p39, p64 Patrizio, Pasquale p32Pellicer, Antonio p38, p68Petok, William D. p40, p94Pfeifer, Samantha M. p25, p41, p53, p73Pinborg, Anja p30Pollack, Staci E. p25Polotsky, Alex J. p51Puscheck, Elizabeth E. p29, p44, p98Qiao, Jie p41, p74Qin, Yingying p43, p65Quallich, Susanne p40, p94Queenan, Jr., John T. p17Rackow, Beth W. p25Racowsky, Catherine p12, p13, p30, p43, p48, p80, p86Reeves, Matthew F. p30Reindollar, Richard H. p13, p47, p61Reis, Fernando M. p47, p102Repping, Sjoerd p40, p95Richard-Davis, Gloria p27, p47, p103Rienzi, Laura p38, p63Rinehart, Lisa A. p46, p54Rizk, Botros p21Rodriquez, Jeanette p47, p85 Rombauts, Luk p42, p64Rosen, Mitchell P. p38, p63Ruby, Alice H. p43, p79Ruhlmann, Claudio p48, p88Sabanegh, Edmund S. p41, p77Sakkas, Denny p44, p98Salazar, Carlos p41, p74Salonia, Andrea p31Santen, Richard J. p44, p59Santoro, Nanette F. p33, p39, p43, p51, p68, p65Schalue, Tammie K. p35Schattman, Glenn L. p39, p40, p69, p94Schlatt, Stefan p47, p100Schlegel, Peter N. p40, p52, p91Schmidt-Kemp, Barbara p22Schuman, Lisa p46, p85

Scott, Jr., Richard T. p35, p48, p86Segars, James H. p12, p27Semprini, Augusto Enrico p17Senstra, Brad p39, p69Serour, Gamal I. p38, p57Sgambati, Stephanie p46, p84Sharara, Fady I. p45, p81Shepperson-Mills, Dian p47, p101Shifren, Jan L. p41, p51, p72Shindel, Alan W. p40, p94Shwayder, James M. p21, p44, p98Siano, Linda J. p19Sigman, Mark p40, p95Silber, Sherman J. p40, p95Simpson, Joe Leigh p10, p12, p13, p33, p38, p39, p43, p57, p63, p65, p91Sitruk-Ware, Regine L. p38, p54, p63Smith, Angela G. p18Smith, James F. p40, p94Smitz, Johan E. p48, p89Sokol, Rebecca Z. p13, p40, p49, p62, p95Soto, Ana p39, p92Sparks, Amy E. p19Spencer, Thomas E. p46, p60Stadtmauer, Laurel A. p21, p44, p98Stepanian, Assia A. p41, p53, p73Stewart, Elizabeth A. p46, p65Stone, Joanne p18Stout, Michael A. p43, p96Stratton, Pamela p45, p82Suikkari, Anne-Maria p48, p87Sullivan, Elizabeth p39, p91Sunde, Arne p46, p66Surrey, Eric S.p40, p94Swain, Margaret p47, p85Tapaneinen, Juha S. p49, p67Tarlatzis, Basil C. p12, p13, p42, p49, p58, p67Taylor, Hugh S.p13, p26, p38, p45, p49, p61, p63, p82Taylor, Robert N. p45, p49, p61, p82Thomas, Michael A. p44, p54, p100Tobias, Tamara M. p18, p47, p103Travia, Jr., Joseph J. p12, p22, p39, p69Trew, Geoffrey H. p42, p64Trussell, James p44, p54Tucker, Michael J. p27Tulandi, Togas p12, p44, p52, p99Turek, Paul J. p12, p31, p40, p44, p52, p80, p91Tur-Kaspa, Ilan p29Van Blerkom, Jonathan p43, p65 van Pelt, Ans M. M. p40, p95Vance, Amy C. p22Vanderpoel, Sheryl Ziemin p39, p42, p65, p91Veiga, Anna p46, p48, p66, p87Vorzimer, Andrew W. p20Wagner-Coughlin, Colleen p20Walsh, Thomas J. p31Wang, Xiang p41, p74Weaver, R. Walton p43,p 97Wellons, Melissa F. p40, p51, p92Wells, Dagan p33, p46, p66

Westphal, Lynn M. p43, p96Whittingham, David p48, p86Wild, Robert A. p26Winston, Nicola p35Wolff, Erin F. p41, p73Woodruff, Teresa K. p48, p89Woodruff, Tracey p49, p67Woodward, Julia T. p23Yelian, Frank D. p43, p97Zegers-Hochschild, Fernando p39, p91 Zoeller, Robert Thomas p39, p92Zweifel, Julianne E. p24, p46, p85


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cont edmat

Documents

bostons waterfront

revitalized waterfront

new green spaces

bostons rose kennedy

idyllic setting

acres of beautiful

ferries glide

treelined corridors