Google Tag

PC01: Use of Genetic Tests in an Infertility Practice

Developed in cooperation with SREI

Faculty

Bradley S. Hurst, M.D. (Chair)
Carolinas Healthcare System
Marcelle Cedars, M.D.
University of California San Francisco Center for Reproductive Health
Joe Leigh Simpson, M.D.
March of Dimes
Richard Scott, M.D.
Reproductive Medicine Associates of New Jersey
Svetlana Rechitsky, Ph.D.
Reproductive Genetic Innovations

Needs Assessment and Description

Genetic testing is rapidly changing the clinical evaluation and treatment of infertile couples, but most health-care providers have limited education and experience in this evolving field. Today, it is essential to understand the expanding application of clinical genetics to provide optimal care to infertile couples. For example, advances in preimplantation genetic testing have revolutionized assisted reproduction and provided insight into reproductive biology, but awareness of embryonic mosaicism has also raised new controversy and misunderstanding among physicians and patients. This course will enhance knowledge of the application and limitations of new clinical genetic tests for infertility. Topics will include new infertility diagnostic panels, expanded carrier screening, endometrial receptivity testing, embryonic aneuploidy screening and mosaicism, and mitochondrial diseases and treatment, preimplantation genetic testing for monogenic and structural rearrangement defects, and recurrent pregnancy loss. This course is designed to assist physicians and health-care professionals in reproductive endocrinology and infertility practices in applying genetic testing to improve the likelihood that treatments will result in the birth of a healthy baby.
 
ACGME Competency
Patient Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Discuss the applications, limitations, and controversies surrounding preimplantation genetic testing.
  2. Counsel patients about targeted or expanded carrier screening.
  3. Determine how and when to perform genetic infertility panels and molecular endometrial receptivity testing.

PC02: Critical Laboratory Factors Affecting Embryo Quality and Outcomes

Developed in cooperation with SRBT

Faculty

Gerard Celia, Ph.D. (Co-chair)
Dominion Fertility and Endocrinology
Rebecca Krisher, Ph.D. (Co-chair)
Colorado Center for Reproductive Medicine
Mitchell Rosen, M.D.
University of California San Francisco Center for Reproductive Health
Tom Turner, M.S.
Texas Fertility Center, Austin IVF


Needs Assessment and Description

Human assisted reproductive technology (ART) is not only a highly technical field of medicine, it is also a business subject to influences based on efficiency, availability, cost, and client (patient) pressures. As such, it is often difficult for laboratorians to distill the factors critical for success from the corporate “noise” that surrounds us. Additionally, as each individual factor evolves it influences other aspects of treatment so that no single paradigm is ever likely to be appropriate for all situations. This course, based on an active-learning format, aims to elucidate a range of factors that affect embryo quality and influence the success of ART and will utilize problem-solving and team-based learning strategies to discuss pre-retrieval influences that impact oocyte quality and development, the physiology of oocyte development and controlled ovarian stimulation, culture systems and their impact on embryo development, and laboratory equipment selection and environment. Topical presentations will be brief, followed by guided interaction and questions and answers between the presenter and audience. The learning momentum of the course will evolve around group discussions enhancing thought exchange and experience sharing. Upon completion, participants should be able to tailor evidence-based strategies appropriate to their individual patient profiles. Designed for a wide range of providers, including laboratory scientists, embryologists, and technologists, laboratory directors and managers, reproductive biology researchers, and physicians, practice managers, and nurses in reproductive endocrinology and infertility practices, participants will have a platform to critically evaluate both current and future efforts to achieve success in the form of a competent embryo and singleton pregnancy, as well as identify confounding influences arising from the increasingly corporate nature of our field.
 
ACGME Competency
Patient Care
Systems-based Practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Identify patient-driven factors that influence outcomes and adapt protocols and methodologies to account for these factors.
  2. Explain the impact of events prior to retrieval on egg and embryo quality and select ovarian stimulation protocols appropriate to a patient’s profile.
  3. Discuss actions in response to follicle growth patterns and identify the optimal day for ovulation trigger.
  4. Evaluate laboratory equipment and instrumentation and select equipment appropriate to a given scenario.
  5. Describe the key elements of an effective culture system and tailor a system to a particular clinical setting.
  6. Identify new technologies or techniques that may impact ART outcomes and evaluate the practicality and impact of introducing them to a new or existing program.
  7. Describe the risks associated with multiple-embryo transfer and design a paradigm for implementing single-embryo transfer without jeopardizing a program’s success.

PC03: Understanding Clinical Operations throughout the Reproductive Endocrinology and Infertility (REI) Practice

Developed in cooperation with ARM

Faculty

Lindsey N. McBain, B.A. (Chair)
IVI-RMA of New Jersey
Sara Mooney, B.A.
Seattle Reproductive Medicine
Marianne Kreiner, M.S.
Shady Grove Fertility
Kathleen Hong, M.D., H.C.L.D.
IVI-Reproductive Medicine Associates of New Jersey
Shawn Dever
Seattle Reproductive Medicine


Needs Assessment and Description

Management in a reproductive endocrinology and infertility (REI) practice requires collaboration among many departments to ensure a successful program. Developing management skills in key individuals within clinical departments is often a challenge in health care, which requires special management techniques not found in other businesses. This course is designed to provide managers and supervisors from all levels and practice sizes with effective management tools to use in their practice, including key skills and business knowledge.

ACGME Competency

Systems-based Practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Identify basic management techniques that can be used at various management levels.
  2. Apply tools for addressing clinical operation challenges.
  3. Discuss current operational issues facing administrators.

PC04: Empowering Your Front Line: Recognizing and Meeting the Needs of the New Reproductive Endocrinology and Infertility (REI) Workforce

Developed in cooperation with NPG

Faculty

Jeanette R. Tomasino, M.S., R.N.C., Ph.D. (Chair)
Northwell Health Fertility
Ester Lopez, M.P.A.
Northwell Health Fertility
Margaret E. Swain, R.N., J.D.
Law Offices of Margaret E. Swain
Christine Bowes
Integramed Fertility


Needs Assessment and Description

Reproductive medicine practices require a multidisciplinary team of professionals to work together seamlessly. How do we empower our employees during a time of immense change in the field, including growing practices, new technologies and scientific developments, and a new generation (“millennials”) of employees? ASRM’s 2016-2017 gap analysis identified recognition of factors important for employee training as a practice gap with the educational need to optimize clinical practice efficiency. This interprofessional course for physicians, advanced practice providers, nurses, managers, and attorneys will focus on the various ways reproductive medicine practices can empower their workforce, which can have a significant impact on the success of a practice. The course will identify the educational needs of new generations of reproductive medicine practice employees as well as continuous learning activities for the experienced health-care professional in the field. The course will outline best strategies for recruitment, training, and retention of these new employees, as well as establishment of competencies and clinical ladders. This course will review the legalities regarding medical and nursing personnel, including the scope of practice and risk management. In terms of practice management, the course will address cost analysis for employee turnover and the management and organization of a team with various acuities. The emphasis will be on techniques employed by the best practices that contribute to the strength of their workforces and ultimately, to the success of their practices.

ACGME Competency

Systems-based Practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Identify common issues faced when training new employees in an REI practice and also establish nursing competencies and clinical ladders to help retain and strengthen REI health-care professionals.
  2. Discuss various legalities regarding medical and nursing personnel, including proper risk management technique and scope of practice issues.
  3. Describe what the reproductive medicine workforce looks like today and identify various practice management issues such as marketing, recruitment, training, and continuing education.
  4. Explain how to organize and manage a team with various acuities, and discuss cost analysis for REI employee turnover.

PC05: Interactions between Environmental Chemicals and Diet and Implications for Fertility

Developed in cooperation with NutriSIG and ERSIG

Faculty

Audrey J. Gaskins, Sc.D. (Chair)
Harvard Medical School and Brigham and Women's Hospital
Jorge E. Chavarro, Sc.D., M.D.
Harvard T.H. Chan School of Public Health
Patricia A. Hunt, Ph.D.
Washington State University
Judy Simon, M.S., R.D.N., C.D., C.H.E.S.
Mind Body Nutrition, PLLC
Irene Souter, M.D.
Massachusetts General Hospital Fertility Center and Harvard Medical School


Needs Assessment and Description

Environmental chemicals and dietary factors have been increasingly related to reproductive endpoints in both animals and humans; however, emerging research suggests that diet could be not only an important source of exposure to these environmental chemicals but also used to counteract the negative reproductive consequences associated with environmental exposures. There is limited knowledge among fertility-care providers on how to counsel patients on consuming a healthy diet while limiting environmental exposures. The ASRM 2016-2017 Gap Analysis identified preconception counseling about environmental exposures as an educational need. This interprofessional course targeted to primary-care physicians, reproductive-medicine and specialty physicians, physician assistants, nurses, nurse practitioners, laboratory scientists, and dietitians will address this need by presenting the latest research and points of view from basic scientists, population scientists, reproductive-medicine physicians, and registered dieticians and translating this into usable advice from an expert clinical perspective. The course will also address practical concerns on how to adequately interact across disciplines for furthering research in this area and obtaining the best outcomes in fertility patients.

ACGME Competency

Patient Care

Interprofessional Competency

Interprofessional Communication

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Describe the interactive role of environmental exposures and diet on markers of fertility and outcomes of fertility treatments.
  2. Describe the competing risks of exposure to environmental factors through diet and how to best minimize this exposure.
  3. Explain the importance of preconception dietary advice to potentially alleviate the negative effects of certain environmental exposures.

PC06: What’s New for Uterine Fibroids?

Developed in cooperation with FSIG

Faculty

Elizabeth A. Stewart, M.D. (Chair)
Mayo Clinic Assisted Reproductive Technologies
Ayman Al-Hendy, M.D.
Medical College of Georgia
Shannon Laughlin-Tommaso, M.D., M.P.H.
Mayo Clinic
William Catherino, M.D., Ph.D.
Uniformed Services University of the Health Sciences


Needs Assessment and Description

Uterine fibroids impact approximately 77% of women by the time of menopause and account for $5.9–$34.4 billion in annual health-care costs in the United States. Health disparities are also present in fibroid disease, with black women having greater incidence and prevalence, earlier age of onset, and more severe disease. Fibroid treatments quickly change as knowledge is gained from comparative effectiveness research trials and basic science research. This course will provide needed knowledge in the best practices for the clinical management of fibroids and will inform clinicians, clinician scientists, and basic-science researchers on the latest findings regarding fibroid etiology to guide clinicians on how to best treat patients with fibroids.

ACGME Competency
Medical Knowledge
Patient Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Describe the current best practices for the treatment of uterine fibroids.
  2. Discuss emerging non-surgical alternative treatments for uterine fibroids.
  3. Summarize the current state of understanding of the biological determinants of uterine fibroids.

PC07: How Old Is Too Old? The Pursuit of Parenthood at Advanced Age

Developed in cooperation with MHPG and SART

Faculty

Julianne E. Zweifel, Ph.D. (Co-chair)
University of Wisconsin
Robert W. Rebar, M.D. (Co-chair)
Western Michigan University
Julia T. Woodward, Ph.D.
Duke University Health System
Mark V. Sauer, M.D.
Rutgers Robert Wood Johnson Medical School


Needs Assessment and Description

Data from the Centers for Disease Control and Prevention indicate that birth rates for women in their 40s and 50s have been steadily rising. Experts suggest that this trend will accelerate and increasingly include women in their 60s. Although medical risks associated with advanced maternal and paternal age are more evident, delayed parenting is becoming “normalized” and clinicians are facing increased patient pressure to provide care to older prospective parents. Unchecked, this trend potentially can lead to the development or worsening of a number of medical, psychological, social, and ethical dilemmas, including but not limited to pregnancy complications, involuntary childlessness, surplus/abandoned embryos, parental age-related health and psychological risks for children, children facing parental death at earlier ages, decreased or absent grandparent relationships, and complex/emotional balancing acts between the reproductive autonomy of the parent generation and the resulting impact on the child. ASRM has identified gaps in knowledge that are related to the rise in delayed parenting, including a need to better understand the effects of advanced paternal age on offspring, health issues in children and adults conceived via assisted reproductive technology, embryo abandonment, health and societal factors, and medical ethics. Similarly, several professionals have raised the alarm that reproductive health professionals are underprepared to respond to increased demand for delayed parenting. This interprofessional course will examine the driving forces of this trend, short- and long-term medical risks associated with delayed pregnancy/older parents, psychosocial impact for the child, and the broader impact on society. The best interests of the parents and child will be examined from a pragmatic and ethical perspective. The prospect of establishing age-related limits to care will be explored. This course will prepare reproductive-medicine clinicians, obstetricians/gynecologists, family-practice clinicians, advanced-practice and mental-health providers, attorneys/legal advisors, and clinic managers to address this challenging clinical trend and will involve significant interaction between the faculty and participants.

ACGME Competency

Professionalism
Interpersonal and Communication Skills

Interprofessional Competency
Values/Ethics for Interprofessional Practice

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Review the impact of age on female and male fertility.
  2. Identify medical risks associated with advanced maternal age and paternal age for the woman and child and suggest strategies for improving public awareness of these risks.
  3. Discuss psychosocial contributors to the trend in delayed parenting and the advantages/disadvantages of this from the perspective of the parent, child, and society.
  4. Examine ethical concerns associated with delayed parenting and consider potential policy related to age limits in care.

PC08: PCOS: Multidisciplinary Insights

Developed in cooperation with AESIG, AE-PCOS, NutriSIG, MHPG, CIMSIG

Faculty

Emily S. Jungheim, M.D., M.S.C.I. (Chair)
Washington University in St. Louis
Ashley Eskew,M.D.
Washington University in St. Louis
Lee Hullender Rubin, D.A.O.M., L.A.c., F.A.B.O.R.M.
Oregon College of Oriental Medicine/Portland Acupuncture Studio, LLC
Shelley Lee, Ph.D.
New York University Langone Health


Needs Assessment and Description

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, affecting at least 10% of women globally. It is increasingly recognized as a multifactorial disorder best served by multidisciplinary efforts. Issues of infertility, mental health, cardiometabolic disease, and cancer risk are intertwined. Women with PCOS present to health-care practitioners with a focus on different aspects of this complex disorder. Conventional approaches to PCOS treatment may leave the patient’s needs unmet. Improved recognition of the complexities of PCOS presentation and individual needs, and knowing how to diagnose, manage symptoms, and institute prevention early in a patient's care can increase compliance and may prevent fragmented care leading to improved patient satisfaction and well-being. This course will assist physicians, nurse practitioners, nurses, psychologists, nutritionists, allied health providers, fellows, and residents in addressing practical, patient-centered management of PCOS through a multidisciplinary approach complemented by evidence-based diet and lifestyle modifications, nutritional supplementation, pharmacologic management, psychological support, and acupuncture. Course discussion will propose ways to integrate these modalities with conventional management for patient-centered care.

ACGME Competency

Medical Knowledge
Patient Care
Interpersonal and Communication Skills

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Review the diagnostic criteria for PCOS.
  2. Apply best evidence with individualization for fertility, hormonal management, mental health, and cardiometabolic risks.
  3. Counsel women with PCOS on the best approaches for prevention of diabetes, heart disease, and progression of mood disorders.

PC09: Early Pregnancy Loss: Maternal Factors in Egg and Embryo Competence

Developed in cooperation with EPSIG

Faculty

Sony Sierra, M.D., M.Sc. (Chair)
TRIO Fertility
Robert F. Casper, M.D.
TRIO Fertility
A. Musa Zamah
University of Illinois at Chicago
Ruth B. Lathi, M.D.
Stanford University Medical Center


Needs Assessment and Description

Recurrent early pregnancy loss (REPL) affects up to 5% of the reproductive population. ASRM identified the evaluation and management of recurrent early pregnancy loss as an educational need. This course will address this need by presenting evidence-based information on the role of maternal health and well-being of the egg and embryo in early pregnancy and as risk factors for REPL. Topics to be discussed include environmental influences, and endocrine and immune factors that lead to oocyte competence; embryonic growth factors and energy requirements for early pregnancy maintenance; and a review on the investigation and management of genetic factors in early pregnancy loss. The course is targeted to reproductive endocrinologists and obstetricians/gynecologists investigating and treating women during conception and the early pregnancy phase. Evidence-based investigations will be discussed as well as strategies to enable clinicians to investigate and manage maternal contribution in early pregnancy loss.

ACGME Competency

Medical Knowledge
Patient Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Identify the impact of maternal factors on egg competence for maintenance of early pregnancy.
  2. Explain the role of mitochondrial health and function, and growth factors in early pregnancy and risk of miscarriage.
  3. Describe the role of genetic factors in oocyte and embryo competence and diagnostic tools to investigate these.
  4. Discuss the application of preimplantation genetic testing in the management of recurrent early pregnancy loss.

PC10: Current Evidence and New Advances in the Treatment of Recurrent Implantation Failure

Developed in cooperation with Chinese SIG

Faculty

Fangyin Meng, M.D., Ph.D. (Chair)
CCRM-OC
Jie Qiao, M.D., Ph.D.
Peking University Third Hospital
Dongzi Yang, M.D., Ph.D.
Sunyixian Hospital
Keli Luo, M.D., Ph.D.
Zhongxin Xiangya Hospital


Needs Assessment and Description

Recurrent implantation failure refers to repetitive failed implantation with morphologic or chromosomally normal embryos. Recurrent implantation failure has been cited as the most common reason for a plateaued success rate in assisted reproductive technology practice. This course will review current and new evidence of efficacy of preimplantation genetic testing (PGT) for this, the utility of new biomarkers of endometrial receptivity, and current consensus on using immune modulation treatments in recurrent implantation failure. Topics will address the need for solid data about efficacy of PGT calculated on intention-to-treat basis and cost-effectiveness with discussion of implantation rates for trophectoderm biopsy combined with comprehensive chromosome screening compared with blastocyst transfer without PGT. Also discussed will be challenges of determining endometrial receptivity, as dyssynchrony between the developing embryo and endometrial receptivity can occur and is well documented in fresh in vitro fertilization (IVF) cycles. There is no standard of care regarding detection of maximal endometrial receptivity in both fresh IVF and frozen-embryo transfer cycles. This course for reproductive-medicine clinicians and laboratory scientists will review current evidence-based management of recurrent implantation failure and the latest advances in understanding and treatment of recurrent implantation failure on both a molecular basis and in clinical application.

ACGME Competency

Medical Knowledge
Patient Care
Practice-based Learning and Improvement

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Cite recent advances and evidence for the use of PGT in the treatment of recurrent implantation failure.
  2. Discuss the current consensus on using immune modulation treatments in recurrent implantation failure.
  3. Describe recent advances in utilizing new biomarkers on detecting endometrial receptivity.

PC11: Master Class on Male Reproductive Surgeries: Update on the Latest Technical Advances, Tips, Pearls and Salvage Maneuvers

Developed in cooperation with SRS and SMRU

Faculty

Peter Chan, M.D., C.M., M.Sc., F.R.C.S.(C)., F.A.C.S. (Chair)
McGill University Health Center
Sheldon Marks, M.D.
International Center for Vasectomy Reversal
Mark Sigman, M.D.
Brown University and Lifespan Urology
Marc Goldstein, M.D.
Weill Medical College of Cornell University


Needs Assessment and Description

Urologists agree that among the various management approaches for male-factor infertility, surgical management poses the greatest challenge not only because of the risks and costs involved but also due to the fact that the outcomes of surgeries depend mainly on the technical skills of the surgeons. These surgeries include varicocelectomy to correct clinical varicoceles (currently the most commonly diagnosed specific cause of male infertility), vasectomy and surgical reconstruction to correct obstruction of the male reproductive tract with vasovasostomy, vasoepididymostomy, and trans-urethral resection of the ejaculatory duct. In collaboration with reproductive medicine specialists and embryologists, the various techniques to obtain sperm for intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection have also undergone significant modifications. Recent needs assessment indicates that urologists worldwide, including those in training and those with experience in reproductive medicine, constantly seek opportunity to improve their surgical knowledge to optimize the level of care they deliver to their patients. This hands-on course aims to illustrate the current standards and variations of a wide spectrum of commonly performed male reproductive surgeries by a faculty of world-renowned experts in the field. This course is designed for a broad range of health-care professionals in male reproductive medicine, ranging from urology residents and fellows to practicing urologists. Reproductive endocrinologists and infertility specialists, andrologists, and embryologists will benefit from learning surgical sperm-retrieval techniques in the context of assisted reproductive technologies.

ACGME Competency

Patient Care

Learning Objectives

At the conclusion of this course, participants should be able to:
  1. Describe the indications, as revealed by a thorough and cost-effective male reproductive evaluation, of various male reproductive surgeries.
  2. Demonstrate the preparation, equipment required, and step-by-step techniques of various male reproductive surgeries.
  3. Explain how to optimize the outcomes of male reproductive surgeries and patient satisfaction by minimizing cost and complication rates when performing male reproductive surgeries.

PC12: CAP Education Training Seminar

For more information about the CAP Course, click here