PC01 Preimplantation Genetic Testing: Toward Next-generation In Vitro Fertilization

Developed in Cooperation with SART, SRBT, and PGDSIG

Faculty

Svetlana Rechitsky, Ph.D. (Chair)
Reproductive Genetic Innovations
Dagan Wells, Ph.D.
University of Oxford
Jamie Grifo, M.D., Ph.D.
NYU Langone Medical Center
Dawn Kelk, Ph.D., H.C.L.D.
Yale University

Needs Assessment and Description

Single-embryo transfer (SET) requires a rigorous pre-selection of embryos for transfer, with the genetic contents representing one of the major factors for predicting in vitro fertilization (IVF) outcome. The introduction of next-generation technologies in preimplantation genetic testing further confirms that more than half of preimplantation embryos in IVF patients of advanced reproductive age are chromosomally imbalanced. As only 10% of recognized pregnancies are aneuploid, it is obvious that the majority of chromosomal imbalances are not surviving implantation, contributing significantly to low implantation and pregnancy rates. So it is not surprising that at least one third of IVF centers in the United States are utilizing preimplantation testing to avoid transfer of aneuploid embryos and improve assisted reproductive technology (ART) efficiency, which is still far from perfect. However, despite compelling evidence of aneuploidy impact on reproductive outcome, there are still reported failures to achieve such an improvement. This may be due to limitations of available diagnostic technology, invasiveness of the biopsy procedures, and differences in patient selection and interpretation of the results in pre-selection of embryos for transfer. These limitations must be addressed in light of recent progress in the next-generation technologies, along with the discussion of possible approaches to overcome them. An emerging problem in pre-selection of embryos for transfer is a high rate of genetic instability throughout preimplantation development, such as chromosomal mosaicism and segmental aneuploidy. While more research is clearly needed to investigate the actual origin and clinical significance of these phenomena, the best policies in a clinical setting are yet unclear. This live course, designed for obstetric/gynecologic clinicians, specialty physicians, laboratory scientists and technologists, genetics professionals, nurses, and legal advisors, will examine the current diagnostic problems, as well as advantages and disadvantages of available technologies to better utilize the advances of preimplantation genetic testing in a wider ART application. 

ACGME Competency
Medical Knowledge
Patient Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Summarize the requirements and implications of the introduction of preimplantation testing as part of IVF.
  2. Define standardized terminology and guidelines for good practice of preimplantation testing for ART patients.
  3. Explain the limitations and advantages of introduction of next-generation technologies for preimplantation genetic testing and clinical relevance of the genetic instability detected by these sensitive techniques.

PC02 Treating with Cell-based Therapies What Cannot Be Treated with Drugs

Developed in Cooperation with RMSCBSIG

Faculty

Carlos Simon, M.D., Ph.D. (Chair)
Valencia University
Margot Damaser, Ph.D.
Lerner Research Institute
Kyle Orwig, Ph.D.
University of Pittsburgh School of Medicine

Rene Reijo Pera, Ph.D. 
Montana State University

Needs Assessment and Description

Regenerative medicine offers the potential for replacement or repair of different types of cells within damaged tissue sor the tissues themselves, typically through cell therapy or tissue engineering. Stem cells are critical to these approaches. However, many patients are seeking innovative treatments involving stem cells from various sources including reproductive tissues. Physicians and other caregivers are frequently confronted with patients requesting cell therapies for menopause, ovarian failure, infertility, and other diseases; frequently, these patients are encouraged to participate in unproven “stem cell/tissue therapies.” The Food and Drug Administration and other professional associations are trying to discourage these unapproved and unwarranted therapies while still maintaining enthusiasm for the development of reliable regenerative medicine research. While most of these breakthroughs are highly promising from a research perspective, and typically are successful using inbred strains of certain mouse models, the gap between the announcement of a breakthrough in lay publications and its actual successful translation to the clinic as a responsible and reliable therapy can take many years. This live course is designed for a wide variety of clinicians, researchers, and advisors in obstetrics/gynecology, urology, genetics, urology, pediatrics, surgery, and oncology, including physicians, laboratory scientists and technicians, genetic counselors, and mental health, nursing, and legal professionals, and will address emerging stem cell therapies and tissue engineering approaches as they apply to reproductive and urology disorders, review clinically relevant animal studies as well as outcomes of clinical trials, and provide insight into the long process for safely translating them to routine clinical practice.
 

ACGME Competency
Medical Knowledge
Patient Care
Systems-based Practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Summarize potential regenerative tissue therapies and their applications in regenerative medicine urology and reproductive medicine.
  2. Discuss stem cell research in progress for generation of artificial gametes.
  3. Summarize potential cell therapies in the management of secretory azoospermia, Asherman’s syndrome and urological disorders.
  4. Discuss the potential application of regenerative medicine for fertility preservation in males and females.

PC03 Hormonal Contraception over the Reproductive Lifespan

Developed in Cooperation with CSIG, MOISIG, and PAGSIG

Faculty

Lisa Haddad, M.D., M.P.H. (Co-chair)
Emory University School of Medicine
Robert A. Wild, M.D., Ph.D., M.P.H. (Co-chair)
Oklahoma University Health Sciences Center
Beth W. Rackow, M.D.
Columbia University
 Xiomara Santos, M.D.
Orlando Health

Needs Assessment and Description

Unintended pregnancy remains a significant public health burden. Appropriate hormonal contraceptive use requires an understanding of benefits and risks. Misconceptions, particularly regarding patient selection and optimal choice, continue to limit appropriate use. This live course is designed for physicians and allied health professionals who provide contraceptive care for adolescent, reproductive-age, and perimenopausal women and provides fundamental tools to appropriately counsel, initiate, and discontinue (when and how) contraception for women throughout their lifespan. Hormonal mechanisms of action and physiologic bleeding in these patients will be reviewed, and using case-based discussion, participants will apply United States Medical Eligibility Criteria for Contraceptive Use and select hormonal contraceptives for women with complex medical conditions. Discussion will include the return of fertility upon discontinuation of contraceptives, impact of hormonal contraceptives on chronic disease states (cancer prevention, atherosclerosis), bone development with depot medroxyprogesterone acetate in early and late reproductive years, and lipid screening through the lifespan. Best practices in contraceptive care for women with endometriosis and primary ovarian insufficiency will be presented along with the effects of surgical treatment.

ACGME Competency

Patient care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Discuss unique contraceptive concerns for women in adolescence and reproductive years, and through menopause.
  2. Select optimum contraceptive options for women with a variety of medical conditions using the latest data and tools.
  3. Effectively counsel women regarding hormonal contraceptive advantages and disadvantages.

PC04 Genetic Screening and Evaluation of Gamete Donors: An Overview of Current Guidelines and Trends

Developed in Cooperation with GCSIG, LPG, and MHPG

Faculty

Amy Vance, M.S., L.C.G.C. (Chair)
Bay Area Genetic Counseling
Lauren Isley, M.S., L.C.G.C.
Counsyl
Claudia Pascale, Ph.D. 
The Institute for Reproductive Medicine and Sciences at Saint Barnabas
Lisa A. Rinehart, J.D., R.N., B.S.N.
LegalCare Consulting, Inc.

Needs Assessment and Description

The 2013 ASRM Practice Committee opinion “Recommendations for gamete and embryo donation” supports gamete providers in establishing criteria for donor eligibility based on genetic test results or findings that may be associated with a heritable disorder. However, specific methods and protocols to identify these genetic risks have not been established, and practices are variable in the gamete industry. The aim of this live, interprofessional course is to cover a variety of issues related to genetic screening and evaluation of semen and oocyte donors. Designed for reproductive medicine clinicians, endocrinologists, nurses, genetic counselors, third-party coordinators, legal professionals, mental health professionals, and reproductive endocrinology and infertility practice managers, this course will address several different clinical and legal aspects of the donor genetic screening process, including personal and family history evaluations, mental health evaluations, genetic testing, consenting, and newly identified risks related to long-term follow-up of donors and donor-conceived individuals. The 2015 ASRM gap- analysis data indicate an educational need for topics related to semen and oocyte donor screening.

ACGME Competency

Patient care

Interprofessional Competency
Interprofessional Teamwork and Team-based Care
Interprofessional Communication

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Describe the different aspects of gamete donor screening that are crucial to make a determination of eligibility for a donor.
  2. Identify existing professional guidelines related to gamete donor screening and detect when these guidelines may differ from current practices.
  3. Summarize basic information about genetic carrier screening for donors and intended parents.
  4. Discuss the roles of the various health-care professionals required to effectively screen gamete donors and identify strategies for interprofessional communication and team-based care.

PC05 Leiomyomas: Pregnancy Loss, Health Disparities, and Therapeutic Options

Developed in Cooperation with SRS, FSIG, EPSIG, and HDSIG

Faculty

William H. Catherino, M.D., Ph.D. (Chair)
Uniformed Services University of the Health Sciences
Jeffrey M. Goldberg, M.D.
Cleveland Clinic
Ayman Al-Hendy, M.D., Ph.D.
Augusta University
Sacha Krieg, M.D., Ph.D.
Oregon Health & Science University

Needs Assessment and Description

Uterine leiomyomas are present in 70%–80% of women by the end of their reproductive years and are the most frequent cause for hysterectomy. In this live course, participants will learn about the structural and molecular mechanisms by which leiomyomas interact with the endometrium to result in implantation failure, pregnancy loss, and the need for in vitro fertilization (IVF). This information will be placed into the context of differences in racial predilection. In addition, participants will learn about the latest advances in medical management and advances in surgical intervention, including the role of laparoscopic and robotic surgery morcellation and Food and Drug Administration regulation, all with the goal to minimize pregnancy loss, diminish symptoms, and improve IVF outcomes. The course is designed for a wide range of health-care professionals, including general obstetric/gynecologic practitioners, infertility specialists, primary care practitioners, urogynecologists, general urologists, gynecologic oncology specialists, maternal-fetal medicine specialists, nurse midwives, nurse practitioners, nurse specialists in various gynecologic subspecialties, and the lay population.

ACGME Competency

Medical Knowledge
Patient Care
Systems-based Practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Assess the impact of leiomyomas on implantation, pregnancy, and assisted reproductive technology.
  2. Discuss the role that race plays in the development of fibroids, the symptoms associated with the disease, and the outcomes of therapy.
  3. Identify therapies that may provide therapeutic benefit to women suffering from fibroids.

PC06 Understanding Endometriosis: Medical Overview, Old and New Diagnostics, Psychological Support Interventions, Nutritional Guidelines, and Best Care Practices

Developed in Cooperation with EndoSIG and MHPG

Faculty

Julia T. Woodward, Ph.D. (Chair)
Duke University Health
Bruce A. Lessey, M.D., Ph.D.
Greenville Health System - University of South Carolina School of Medicine
Danielle A. Kaplan, Ph.D.
Private Practice
Dian Shepperson, M.A.
The Endometriosis and Fertility Clinic

Needs Assessment and Description

Endometriosis is a common but often misunderstood disease affecting women across the lifespan. Yet many clinicians and other care providers are not familiar with the etiology, diagnosis, treatment options, and complications of endometriosis. The disease may significantly impact quality of life and daily functioning. In some cases, exacerbation of symptoms may impact relationships, social and work activities, and sexual functioning, as well as affect fertility. Up to 85% of unexplained subfertility is due to undiagnosed endometriosis and there is an 11-year lag in diagnosis that is only growing in the setting of assisted reproductive technology (ART). This live interprofessional course is designed to enable mental health professionals, medical practitioners, nurses, and allied health care providers to utilize best care practices, clarify common misconceptions and odd aspects of the disease, identify old and new diagnostic procedures including biomarkers for diagnosis, provide effective techniques for quality of life management and pain assessment, utilize psychological interventions for symptom relief, and recommend nutritional guidelines. New data on endometriosis as a cause of infertility and recurrent pregnancy failure will be presented.

ACGME Competency
Medical Knowledge
Patient Care

Interprofessional Competency

Interpersonal and Communication Skills 
Interprofessional Teamwork and Team-based Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Review the diagnosis and symptoms of endometriosis and identify common misconceptions, odd aspects, and new biomarkers of the disease.
  2. Discuss endometriosis as a cause of infertility and recurrent pregnancy failure.
  3. Assess quality of life, pain management, and psychosocial functioning in women with endometriosis.
  4. Describe how psychological interventions including cognitive behavior therapy, mindfulness-based cognitive therapy, meditation, and stress management skills can be used to lessen symptoms of endometriosis-related discomfort and distress.
  5. Discuss the role of nutrition and the effects of environmental toxins in endometriosis care.
  6. Utilize a team-based approach to integrate comprehensive care practices for women with endometriosis.

PC07 Approach to Comprehensively Manage Your Male Clients’ Needs: From Sexual CME Dysfunction and Poor Semen Quality to Genetic, Psychological, and Aging Issues

Developed in Cooperation with SMRU, SRS, SRBT, SART, and MHPG

Faculty

Peter T. K. Chan, M.D., C.M., M.Sc., F.R.C.S.I.C., (Chair)
McGill University Health Center
Paul R. Shin, M.D.
Urologic Surgeons of Washington
Dolores J. Lamb, Ph.D.
Baylor College of Medicine
William D. Petok, Ph.D.
Thomas Jefferson University, Sidney Kimmel Medical College

Needs Assessment and Description

The significance of optimizing male reproductive status in maximizing the overall success of assisted reproduction has been gradually recognized. In reality, men are less health oriented when compared with female partners. Particularly when it comes to potentially embarrassing health issues such as infertility and sexual dysfunction, men are often unwilling to face the relevant issues to explore solutions to resolve problems early on. Simultaneously, due to a poorly recognized knowledge gap, health-care professionals in reproductive medicine are generally not well equipped to handle the wide spectrum of men’s health issues ranging from psychosocial stress, poor sperm quality, sexual dysfunction, to malerelated genetic issues. As a result, male partners’ needs in reproductive care are often ignored. A well-coordinated interprofessional approach, through the collaborative efforts of a multidisciplinary team of health-care professionals including nurses, embryologists, andrologists, urologists, reproductive endocrinologists, and mental health professionals, is the key to successful management of these couples. In this live course, a panel of expert male reproductive medicine professionals will present management strategies for male-related bio-psycho-social issues in a series of challenging cases with the goal to optimize male reproductive health, leading ultimately to improved assisted reproductive outcomes and patient satisfaction. Topics will include: tips on psychosocial counseling of the male partner before and after assisted reproduction; how to optimize male sexual and reproductive health; various men’s health issues related to aging, lifestyle, metabolic status, and environmental hazards; tips on surgical sperm retrieval; an advanced approach to evaluate sperm quality at the molecular levels; how to select best sperm for intracytoplasmic sperm injection using various new approaches on the horizon; and how to integrate other health-care professionals to build an effective multidisciplinary team.

ACGME Competency

Patient care

Interprofessional Competency
Interprofessional Teamwork and Team-based Care
Interprofessional Communication

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Describe the indications of various evaluation approaches to common men’s physical and mental health issues seen in patients undergoing fertility care.
  2. Outline counseling, medical, and surgical management strategies to enhance the general and reproductive health of the male partner in infertile couples.
  3. Discuss ways to optimize the quality of sperm to be used with assisted reproduction to minimize reproductive failure.
  4. Develop team-based strategies for multidisciplinary care and communication for these patients.

PC08 Growing Your Reproductive Endocrinology and Infertility Practice in a Competitive Marketplace

Developed in Cooperation with ARM

Faculty

Brad J. T. Senstra, M.H.A. (Chair) S
eattle Reproductive Medicine

F. Richard Dietz, M.B.A.
Boston IVF
Sheri Raymer, M.H.A.
Integramed America
Lindsey N. McBain, B.A.
RMA New Jersey
Sara Mooney, B.A.
Seattle Reproductive Medicine
Becky Waldman, R.N.
Vivere Health

Needs Assessment and Description

The fertility care market is growing throughout the United States and internationally. As a result, reproductive endocrinology and infertility (REI) practices need to increase their capacity or face increasing competition in their market. Practice administrators and managers face many challenges as they grow to meet this demand and contend with increasing competition. This live course is designed to help reproductive medicine physicians, allied health professionals, and business administrators develop tools to grow an REI practice in a competitive market by sharing ideas and processes, and potentially join forces with others to meet this increasing demand.

ACGME Competency

Systems-based practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Assess growth opportunity in a practice market.
  2. Utilize proven strategies to grow capacity within their practice.
  3. Identify advantages and pitfalls of merging with or acquiring another practice.

PC09 Scientific Manuscript Coaching: Maximize Your Likelihood of Publication in Fertility and Sterility

Developed in Cooperation with Fertility and Sterility®

Faculty

Antonio Pellicer, M.D. (Co-chair)
Instituto Valenciano Infertilidad
Craig S. Niederberger, M.D. (Co-chair)
University of Illinois at Chicago
Nicolás Garrido Puchalt, Ph.D., M.Sc.
Instituto Universitario IVI Valencia
Steven R. Lindheim, M.D., M.M.M.
Wright State University Boonshoft School of Medicine
Kurt Barnhart, M.D.
University of Pennsylvania
Anne Z. Steiner, M.D., M.P.H.
University of North Carolina
Richard S. Legro, M.D.
Penn State University College of Medicine

Needs Assessment and Description

Publication of studies in reproductive medicine is central to advancement in the field. Fertility and Sterility currently rejects approximately 80% of submitted manuscripts, often due to insufficiently designed studies, unsuitable analyses, incomplete checklists or submission requirements, and other addressable issues. Although much literature is available regarding how to write and submit scientific papers, interactive learning is required to educate authors. This course addresses that need based on communication among authors, reviewers, and editors as documented in Fertility and Sterility’s electronic peer-review system, EES. In this live course, physicians and scientists in reproductive medicine and biology will learn from the editors of Fertility and Sterility the keys to designing a good study and effectively communicating its results, as well as strategies for critically evaluating manuscripts. Participants will have the opportunity on the following day to discuss their manuscripts in one-on-one sessions with a Fertility and Sterility editor, who will provide individualized feedback. Note that a single, full manuscript must be submitted to Fertility and Sterility before September 30, 2017, and appointments will be filled on a first-come, first-served basis.

ACGME Competency

Professionalism

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Describe the different types of study designs, appropriate analyses, relevant checklists, disclosure procedures, and submission processes for reproductive medical communications.
  2. Evaluate critically the scientific merit and value of a submitted manuscript.
  3. Explain what constitutes ethical behavior in writing, reviewing, and publishing a scientific work in reproductive medicine.
  4. Specify the various media resources available for readers, authors, and reviewers to interact in the communication of reproductive medical science.

PC10 Current Fertility Preservation and Its Future

Developed in Cooperation with ChSIG

Faculty

Huai L. Feng, Ph.D., H.C.L.D. (Chair)
New York Hospital Queens
Jie Qiao, M.D., Ph.D.
Peking University Third Hospital
Zijiang Chen, M.D., Ph.D.
Cheeloo College of Medicine at Shandong University and Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine
Ge Lin, M.D., Ph.D.
Reproductive and Genetic Hospital of CITIC-XIANGYA

Needs Assessment and Description

Fertility preservation plays an important role in assisted reproductive medicine, particularly for cancer patients facing gonadotoxic therapy. Great progress has been achieved in techniques for oocyte vitrification, sperm and egg banking, ovary cryopreservation and transplantation, preservation of uterine function and uterine transplantation, assessments for oocyte quality and ovarian reserve, and their potential applications in in vitro fertilization clinical treatments. This live course for reproductive medicine practitioners, clinicians, scientists, and technologists will provide an update on multiple aspects of fertility preservation technology, introduce promising new techniques, and identify clinical strategies for achieving optimal patient outcomes.

ACGME Competency

Medical Knowledge
Patient Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Explain the necessity and indications for male fertility preservation and its current status.
  2. Describe strategies to preserve the function of the uterus in young women, using experiences in China of abortion at young ages, and the use of intrauterine devices and cesarean section.
  3. Discuss oocyte cryopreservation methods and classifications of vitrification devices and kits.
  4. Explain the advancement of ovarian preservation and transplantation, limiting factors in their success, and options in the strategy and safety of ovarian tissue cryopreservation.
  5. Introduce a new source for egg banking from laparoscopically retrieved immature oocytes using the technique of in vitro maturation.
  6. Describe the physiological changes in antimüllerian hormone (AMH) across the lifespan, and identify reference ranges for women in childhood, adolescence, reproductive age, and advanced age.
  7. Explore the association between AMH and assisted reproductive technology (ART) outcomes and the predictive value of AMH in older women, and determine age boundaries for women during ART treatment using AMH as a marker for ovarian reserve and a possible surrogate measure of reproductive aging.
  8. Describe possible endogenous and exogenous factors responsible for oocyte aging, and explore the cellular and molecular changes along with oocyte aging.
  9. Discuss potential strategies to improve oocyte quality in older women via decreasing meiotic chromosomal aberrations, enhancing mitochondrial functions and increasing expression of antioxidant genes.

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