CONTINUING EDUCATION MATERIAL

DAILY SCHEDULE • POSTGRADUATE COURSES • PLENARY SESSIONS • SYMPOSIA • INTERACTIVE SESSIONS • VIDEO SESSIONS

ASRM ASRM

health affects reproduction affects health

Participate in the ASRM 2014 Twitter Wall! health affects reproduction affects health

PANTONE 200

During the ASRM 2014 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 “#2014ASRM” 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 ASRM 2014 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 #2014ASRM at the end, such as:

Watching a grt pres. on endometriosis by Dr. Jones. Fantastic new data w/2000 pts! #2014ASRM

Plenary Speaker Dr. Jones starting now hall packed, exciting, standing rm only! #2014ASRM

or

TWITTER ETIQUETTE

All incoming tweets are monitored by ASRM staff, and those tweets that show up with the hashtag #2014ASRM 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 ASRM 2014 MEETING IN OCTOBER!

You can use the hashtag #2014ASRM for Instagram, too! ASRM 2014 Annual Meeting

2

A

WELCOME TO HONOLULU

ASRM health affects reproduction affects health

Honolulu, Oahu Highlights

Home to the State Capitol, Honolulu is the vibrant epicenter of Hawaii. Here you’ll find everything from historic landmarks and treasured monuments to world-class shopping and a flourishing arts and culture scene. Home to the majority of Oahu’s population, the sprawling city of Honolulu spreads throughout the southeastern shores of Oahu, from Pearl Harbor to Makapuu Point, encompassing world famous Waikiki. Honolulu has it all. This is the home of some of Hawaii’s most historic places from Iolani Palace, the Kawaiahao Church, the Hawaiian Mission Houses Historic Site and Archives and the treasured artifacts of the Bishop Museum to iconic landmarks like the Aloha Tower, the King Kamehameha I Statue, the Duke Kahanamoku Statue and the historic Hawaii Theatre. Honolulu is also Hawaii’s hot spot for arts, culture and entertainment. Whether you’re looking for Hawaii’s finest museums, or Hawaii’s finest Hawaii Regional Cuisine chefs, the best resorts, festivals, and events, or just some fun things to do, you’ll find it all in Honolulu.

Aloha Tower, Oahu Aloha Tower is a historic Honolulu landmark and home to an outdoor shopping and dining marketplace.

Kawaiahao Church, Oahu The historic Kawaiahao Church was the first Christian Church built on Oahu in 1842.

Kapahulu, Oahu Kapahulu is a small neighborhood right next to Waikiki where you can find unique shops and some of Honolulu’s best local food.

King Kamehameha Statue, Oahu The most famous Kamehameha Statue stands in front of Aliiolani Hale in Downtown Honolulu.

Leahi (Diamond Head), Oahu Hike to the top of the iconic Diamond Head State Monument for panoramic views of Waikiki and Honolulu. Hanauma Bay Nature Preserve, Oahu This Marine Life Conservation District is one of Oahu’s most popular snorkeling destinations. Waikiki, Oahu Once a playground for Hawaiian royalty, Waikiki is now a vibrant gathering place for visitors from around the world. Duke Kahanamoku Statue, Oahu This iconic statue of “The father of modern surfing” welcomes visitors to Waikiki with open arms. Downtown Honolulu and Chinatown, Oahu Downtown Honolulu and Chinatown are Oahu’s historic centers for government, business and the arts. National Memorial Cemetery of the Pacific, Oahu One of the nation’s prominent national cemeteries, the National Memorial of the Pacific honors the sacrifices of America’s Armed Forces. 3

h r a

Honolulu Museum of Art and Shangri La, Oahu The Honolulu Museum of Art is Hawaii’s largest fine-arts museum. Shangri La is one of Hawaii’s most architecturally significant homes. Bishop Museum, Oahu Bishop Museum houses the largest collection of Hawaiian artifacts in the state and is a popular destination for the whole family. Iolani Palace, Oahu The only official state residence of royalty in the U.S., Iolani Palace’s grounds and galleries are now open to the public as a museum. Washington Place, Oahu Visit Washington Place in Downtown Honolulu, the residence of Queen Liliuokalani, Hawaii’s last reigning monarch. It is located in Hawaii’s Capital Historic District and is open for private tours. Queen Emma Summer Palace The summer retreat of Queen Emma and King Kamehameha IV.

ASRM 2014 Annual Meeting

PANTONE 200

Write the Next Chapter Sustaining education, research, and advocacy programs for the future

The American Society for Reproductive Medicine has had a long and distinguished history, contributing to reproductive medicine for more than 70 years. Please join us in ensuring our continued excellence in education, research and advocacy by supporting the ASRM Fund Development Program.

Ways to be a Champion Donate to support these programs:

Education • SMRU Traveling Scholar • Contraception Lecturer • Menopause Lecturer • Resident Reporter Program • ASRM Fellows Retreat • Resident Education eLearn® Program Research • ASRM Distinguished Researcher Award • Trainee Travel Fund • CREST Program

Advocacy • J. Benjamin Younger Office of Public Affairs • Reproduction and Public Policy Fellowship in the J. Benjamin Younger Office of Public Affairs Other Programs • Memorial and Special Occasion Giving • Planned Giving • Bequests • Charitable Remainder Trusts • Life Insurance

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

ASRM’s Write the Next Chapter

BRICK CAMPAIGN

Paving the Way for Reproductive Health

You now have the opportunity to be a part of the landscape of ASRM’s headquarters and help the Society build pathways to sustainable reproductive health programs in education, research and advocacy.

Be part of the journey!

• Donate an 8” x 8” engraved brick in a prime location for a gift of $1,000. • Donate an 8” x 8” engraved brick for a gift of $500. • Donate a 4” x 8” engraved brick for a gift of $200. • Two benches will be available for a gift of $2,000 each and will be tastefully installed within the landscape of the ASRM office site. Take this opportunity! • Commemorate your clinic, business, institution or ASRM special interest or professional group. • Celebrate the birth of a child. • Recognize a colleague. • Honor the memory of a loved one. • Note a special achievement or milestone. • Friends, family members, colleagues and co-workers may purchase bricks jointly. Have your brick inscribed with a personal message. It will serve as a lasting reminder of your support and dedication to the American Society for Reproductive Medicine. For more ways to support ASRM, visit our website: www.writethenextchapter.org or contact Pam Nagel at 205-978-5000, ext. 121 or [email protected].

Creating Your ASRM Legacy... One Brick at a Time

ASRM ASRM

health affects reproduction affects health

health affects reproduction affects health

PANTONE 200

WELCOME I would like to personally welcome you to Honolulu, Hawaii for the 70th Annual Meeting of the American Society for Reproductive Medicine. This year’s meeting theme, “SURFING THE WAVES OF CHANGE” reflects the focus of the meeting. Guided by Dr. Richard Reindollar in his role as Executive Director, Dr. Lawrence Layman, the Scientific Program Chair, and the Scientific Program Committee have developed an outstanding program that addresses the clinical and research challenges of all aspects of reproductive medicine.  This year’s program has incorporated innovative formats that emphasize interprofessional team learning. Because exciting new genetic tools are permeating basic science and clinical medicine, these will be highlighted in relation to the practice of reproductive medicine. A wide variety of topics will be handled in a multidisciplinary approach—from oncofertility and fertility preservation in both sexes to evidence-based treatment for infertility, endometriosis, fibroids, surgery and PCOS.

Rebecca Z. Sokol, M.D., M.P.H.

The Scientific Program will include state-of-the-art plenary lectures, oral and poster presentations, roundtable discussions, video sessions, inter-professional symposia, and interprofessional interactive sessions which have been redesigned to allow for more audience participation. The program includes the popular Contraceptive, Menopause and Surgery Days. Dr. Lisa Halvorson and the Postgraduate Program Committee have worked closely with the affiliated societies, professional groups, and special interest groups to develop stimulating postgraduate courses that meet the needs of our clinicians, scientists, laboratory technologists, nurses, and other healthcare professionals. The 2014 Postgraduate Program will include 7 inter-professional courses taught by interdisciplinary teams and designed to address healthcare problems from multiple perspectives. Hands-on courses for laboratory techniques and surgery will be offered. We welcome our members and trainees, as well as our colleagues from abroad, to attend the meeting. Indeed, several symposia will be presented by a group of experts from sister societies around the world. As always, opportunities for networking and interaction abound.  The meeting will offer an enjoyable social program for attendees and their guests in the beautiful city of Honolulu. I look forward to meeting you in Honolulu, where together we will be “Surfing the Waves of Change.” 

Sincerely,  Rebecca Z. Sokol, M.D., M.P.H. ASRM President 2013-2014

ASRM 2014 Annual Meeting

6

A

SCIENTIFIC PROGRAM COMMITTEE

INSIDE

ASRM health affects reproduction affects health

Lawrence C. Layman, M.D. Scientific Program Chair

Marc C. Portmann, M.T. SRBT Program Chairs

Kurt T. Barnhart, M.D., M.S.C.E. Interactive Sessions Chair

Lisa A. Rinehart, R.N., J.D. LPG Program Chair

Clarisa R. Gracia, M.D., M.S.C.E. Roundtables Chair

Angela K. Lawson, Ph.D. MHPG Program Chairs

Catherine Racowsky, Ph.D. At Large

Deborah L. Jaffe, B.S.N. NPG Program Chair

Mark Sigman, M.D. At Large

Joseph J. Travia, M.B.A. ARM Program Chair

DISCLOSURE STATEMENTS & CONFLICT OF INTEREST POLICY . . . . . . . . . . . . . . . . . 10

Keith B. Isaacson, M.D. At Large

Rebecca Z. Sokol, M.D., President President, ASRM

POSTGRADUATE PROGRAM . . . . . . . . . . . . . . . . . . 11-28

James P. Toner, M.D., Ph.D. SART Program Chair

Richard H. Reindollar, M.D. Executive Director

James H. Segars, M.D. SREI Program Chair

Andrew R. La Barbera, Ph.D., H.C.L.D. Chief Scientific Officer

SCIENTIFIC PROGRAM DAILY SCHEDULE . . . . . . . . 33-41

Lee Hutchison Boughton, M.A. Program Administrator

EDUCATIONAL SUPPORT . . . . . . . . . . . . . . . . . . . . . . 43

Ajay K. Nangia, M.D. SMRU Program Chair Steven F. Palter, M.D. SRS Program Chairs

POSTGRADUATE PROGRAM COMMITTEE Lisa Halvorson, M.D. Chair Kathleen Hwang, M.D. Co-Chair Glenn Schattman, M.D. Coordinating Chair Richard H. Reindollar, M.D. Executive Director Andrew R. La Barbera, Ph.D., H.C.L.D., Chief Scientific Officer Lee Boughton, M.A. Staff

WELCOME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 ASRM MEETING PROGRAM PLANNING COMMITTEES . . . . . . . . . . . . . . . . . . . . . . 7 ANNUAL MEETING POLICIES & DISCLAIMERS . . . . . . . . 8 CONTINUING EDUCATION CREDIT . . . . . . . . . . . . . . . . 9

NEEDS ASSESSMENT & LEARNING OBJECTIVES . . . . . . 29 SCIENTIFIC PROGRAM EDUCATIONAL TRACKS . . . . 30-31

EXHIBIT HOURS . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

SURGERY DAY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 CONTRACEPTION DAY . . . . . . . . . . . . . . . . . . . . . . . 45

VIDEO COMMITTEE

MENOPAUSE DAY . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Steven F. Palter, M.D. Chair Balasubramanian Bhagavath M.D. Tien-Cheng Chang, Ph.D. Tommaso Falcone, M.D. Emilio Fernandez, M.D. Antonio R. Gargiulo, M.D. Kathleen Hwang, M.D. Edward D. Kim, M.D. Philip Li, M.D. Steven R. Lindheim, M.D. Marius Meintjes, Ph.D. Ceana H. Nezhat, M.D. David L. Olive, M.D. Marc P. Portmann, M.T. Togas Tulandi, M.D. Michael I. Eisenburg, M.D. James M. Hotaling M.D.,M.S.

PLENARY SESSIONS . . . . . . . . . . . . . . . . . . . . . . 47-57

7

h r a

ASRM SYMPOSIA . . . . . . . . . . . . . . . . . . . . . . . . 58-84 INTERACTIVE SESSIONS . . . . . . . . . . . . . . . . . . . 85-105 ASRM VIDEO SESSIONS . . . . . . . . . . . . . . . . . . . 106-116 AAGL FILM FESTIVAL VIDEO SESSION . . . . . . . . . . . . . 117 PARTICIPANT & SPOUSE/PARTNER DISCLOSURES INDEX . . . . . . . . . . . . . . . . . . . . . 118-121 VIDEO DISCLOSURES INDEX . . . . . . . . . . . . . . . . . . 122 PROGRAM PARTICIPANTS - NON-ORAL/ POSTER PRESENTERS . . . . . . . . . . . . . . . . . 123-124

ASRM 2014 Annual Meeting

PANTONE 200

ASRMANNUAL MEETING POLICIES AND DISCLAIMERS ASRM ASRM

health affects reproduction affects health

CANCELLATION POLICY health affects reproduction affects health

The American Society for Reproductive Medicine reserves 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. PANTONE 200

REFUND/NON-ATTENDANCE POLICY Cancellations received before or by September 12th will receive a full refund minus a $50 processing fee. Cancellations received after September 12th will not be eligible for a refund.

ADA STATEMENT The American Society for Reproductive Medicine fully complies with the legal requirements of the ADA and the rules and regulations thereof. Accommodations for Disabilities: Please notify the American Society for Reproductive Medicine, 1209 Montgomery Highway, Birmingham, Alabama, USA 35216, telephone 1-205-978-5000, a minimum of 10 working days in advance of the event if a reasonable accommodation for a disability is needed.

EQUAL OPPORTUNITY STATEMENT The American Society for Reproductive Medicine values and promotes diversity among its members, officers and staff. The Society prohibits 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. ASRM strives to achieve gender, racial and ethnic balance in hiring and governance. ASRM maintains policies, procedures and personnel actions that conform to the letter and spirit of all laws and regulations pertaining to equal opportunity and nondiscrimination in employment, appointments and elections to office.

DISCLAIMER STATEMENT The content and views presented in this educational activity are those of the faculty/authors and do not necessarily reflect those of the American Society for Reproductive Medicine. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity to make clinical decisions about individual patients.

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center. ASRM 2014 Annual Meeting

8

CONTINUING EDUCATION CREDIT Continuing Education Credit Information will be located in the front of each Postgraduate Course syllabus and the Final Program.

of their participation in the activity. Course 24 is approved for a maximum of 4.0 AMA PRA Category 1 Credits™. Courses 12 and 23 are non-CME.

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, Nursing, NASW, and NSGC credits, or to request a certificate of attendance. The linked website contains detailed instructions on how to complete the report. 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, 2014.

The American College of Obstetricians and Gynecologists The American College of Obstetricians and Gynecologists has assigned 21 cognates to the Scientific Program and 7 cognates to the one-day Postgraduate Program.

Credits other than those specified below are the responsibility of each attendee. The Accreditation Council for Continuing Medical Education (ACCME) The American Society for Reproductive Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Scientific Program Designation Statement The American Society for Reproductive Medicine designates this live activity for a maximum of 20.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Postgraduate Program Designation Statement The American Society for Reproductive Medicine designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent NONCME

All activities are for CME, unless ARS CE noted. otherwise

NONCME

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. Up to 1.7 PEER CEUs (17 hours) will be recognized for the Scientific Program. CEUs will be recognized for postgraduate courses 1, 3, 4, 7, 9, 11, 13, 15, 18, 19, and 21. PEER credit forms for eligible postgraduate courses and for the Scientific Program will be available at the American Association of Bioanalysts (AAB) booth in the Exhibit Hall. ABB certification exams will be administered Friday, October 17, 2014, in the South Pacific Ballroom. Nursing Credits The Continuing Education Approval Program of the National Association of Nurse Practitioners in Women’s Health has approved the Scientific Program for a maximum of 20.25 contact hours of continuing education credit, including 15 hours of pharmacology. Postgraduate Course 19 has been approved for 6.50 contact hours of continuing education credit, including 1.5 hours of pharmacology. Postgraduate Course 22 has been approved for 6.50 contact hours of continuing education credit, including 0 hours of pharmacology.

CE

Indicates a postgraduate course that ARS for CE credit andNONCME qualifies CME. CE

A ASRM

American Psychological Association (APA)reproduction affects health 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.

health affects

National Association of Social Workers (NASW) Postgraduate courses 5 and 18 have each been approved by the National Association of Social Workers (approval #886496548-2603 and #886496548-2604) for 6.5 Social Work continuing education hours. Genetic Counselor CEUs The National Society of Genetic Counselors (NSGC) has authorized the American Society for Reproductive Medicine to offer up to 2.825 CEUs or 28.25 contact hours (Category 1) for the event 70th Annual Meeting of the ASRM. The American Board of Genetic Counseling (ABGC) will accept CEUs earned at this program for the purposes of certification and recertification. Postgraduate courses 02 and 18 and selected sessions in the Scientific Program have been approved. 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.

ARS

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

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. Certificate Of Attendance Proof of attendance is available on request from J Spargo at the registration desk. Continuing Education Credit information is located in the front of the Postgraduate Course syllabi, and the Final Program and online.

Admission Badges Name badges will be issued for the Postgraduate and Scientific Programs and are required for admission. Spouse/guest badges will be issued and are required for admission to spouse/guest activities and the Exhibit Hall.

9

h r a

Photo/Audio/Video Recording Photographing or audio/video recording of any session for personal or commercial purposes without permission is prohibited.

ASRM 2014 Annual Meeting

PANTONE 200

ASRM DISCLOSURE STATEMENTS/CONFLICT OF INTEREST POLICY ASRM

health affects reproduction affects health

health affects reproduction affects health

HONORARIA

The following speakers may receive honoraria and/or discounted or free registration:

2014 ASRM CONFLICT OF INTEREST POLICY FOR INVITED SPEAKERS

PANTONE 200

• Plenary Speakers • Postgraduate Course Faculty • Symposia Speakers • Interactive Session Speakers The following speakers do not receive honoraria: • Roundtable Presenters • Abstract Presenters • Video Presenters

DISCLOSURE STATEMENTS

Postgraduate Faculty, Symposium Speakers, Plenary Lecturers, Abstract Authors, Abstract Graders, Roundtable Presenters, Video Presenters, and Interactive Speakers are required to disclose commercial relationships or other activities that might be perceived as potential conflicts of interest. Postgraduate course faculty disclosures will be listed in the course syllabi. Symposium speakers’ disclosures will be presented in handout materials, as well as on slides. Disclosures from speakers in the Plenary Sessions, Interactive Sessions, Roundtables, Videos and Symposia will be published in the Final Program.

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 will be published in the 2014 Program Supplement.

Abstract authors’ disclosures are listed in the 2014 Program Supplement.

Each presenter should reveal his/her disclosure information during his/her presentation, preferably with the visual aid of a slide.

Speakers in the Symposia, 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.

Roundtable presenters should provide a copy of their disclosure forms to the participants at their table.

ASRM 2014 Annual Meeting

CONTINUING MEDICAL EDUCATION AND CONTINUING EDUCATION CREDITS WILL BE AVAILABLE. 10

A ASRM

POSTGRADUATE PROGRAM

health affects reproduction affects health

PANTONE 200

47th Annual POSTGRADUATE PROGRAM COMMITTEE CHAIR

WEEKEND COURSES DATES Courses PG1-PG11 are Saturday, October 18TH one-day courses on Saturday.

Lisa M. Halvorson, M.D.

CO-CHAIR

Kathleen Hwang, M.D.

COORDINATING CHAIR

Glenn Schattman, M.D.

Sunday, October 19TH

HOURS 8:15 a.m.-5:00 p.m. Lunch is from Noon-1:00 p.m.

POSTGRADUATE COURSE SYLLABI WILL BE POSTED ONLINE ONLY IN SEPTEMBER 2014. ELECTRONIC COPIES MAY BE DOWNLOADED IN THE CONVENTION CENTER.

Courses PG12-PG22 are one-day courses on Sunday. Course PG23 is a one-day workshop on Sunday. Course PG24 is a half-day hands-on intensive on Monday.

ONE-DAY COURSES SATURDAY, OCTOBER 18, 2014

PG01

NONCE ARS CME INTERPROFESSIONAL COURSE: APPLICATION OF A QUALITY MANAGEMENT SYSTEM MODEL TO REPRODUCTIVE HEALTH CARE NONCE ARS CME Course PG1 (Saturday) Developed in Cooperation with SRBT, SART, ARM, and LPG

FACULTY Carli W. Chapman, B.S., E.L.D., Chair Reproductive Medicine Institute Sharon T. Mortimer, Ph.D. Oozoa Biomedical Bruce S. Shapiro, M.D. Fertility Center of Las Vegas

system and how to measure its impact on quality control and quality assurance in the medical practice as well as in the assisted reproductive technology laboratory. The target audience includes all areas of the RE practice including physicians, clinical staff, laboratory staff, senior management, and business partnerships. ACGME Competency Practice-based Learning and Improvement

NEEDS ASSESSMENT AND COURSE DESCRIPTION Reproductive medicine practices have mastered the tasks of quality control and quality assurance throughout various aspects of the practice. However, integrated quality management systems are often poorly understood by biomedical scientists and physicians, resulting in few reproductive endocrinology (RE) practices achieving the goal of quality management. An integrated quality and risk-management system can provide consistent, high-quality, and cost-effective reproductive health care. Establishing a practice-wide quality management system will provide control of systems leading to reduced medical errors, improved customer and employee satisfaction, and sustainable attainment of quality objectives as well as facilitate accreditation assessments. This live course will discuss how to create and implement a quality management

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Describe the concepts of a quality management system. 2. Implement a quality management system within their practice using concrete methods and tools. 3. Develop sound teamwork among all stakeholders in the reproductive endocrinology practice.

11

h r a

ASRM 2014 Annual Meeting

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

health affects reproduction affects health

IT PAST THE FIRST TRIMESTER: CAUSES AND TREATMENTS OF EARLY PREGNANCY DISORDERS PG02 MAKING Course PG2 (Saturday) health affects reproduction affects health

Developed in Cooperation with SREI and EPSIG

FACULTY Ruth B. Lathi, M.D., Chair Stanford University Kelle H. Moley, M.D. Washington University School of Medicine Danny J. Schust, M.D. University of Missouri Mary D. Stephenson, M.D., M.Sc. University of Illinois College of Medicine

CE

ARS

the goal of reducing early pregnancy loss. Eight related topics will be presented with a combination of 30-minute lectures, audience questions, and interactive sessions.

PANTONE 200

ACGME Competency Patient Care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Define early pregnancy states and losses and assess the prognosis of recurrent biochemical pregnancy loss. 2. Summarize the evidence for genetic causes of early pregnancy failure and the role of preimplantation genetic testing. 3. Discuss the role of immune factors in the establishment of early pregnancy and the impact of maternal obesity. 4. Assess factors contributing to oocyte quality. 5. Recommend therapeutic approaches to the patient with recurrent implantation failure. 6. Recommend appropriate medical and surgical management of a nonviable pregnancy.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Clinical pregnancy loss affects 10%-20% of recognized pregnancies, and studies using careful biochemical surveillance of women attempting pregnancy show that preclinical losses are even more common. Recurrent early pregnancy loss frequently remains unexplained using current evidence-based evaluations; therefore, unproven testing and treatment is rampant in the field. In this live course for clinicians involved in the care of childbearing women, faculty will present the latest data and a comprehensive summary of the available literature on topics relevant to diagnosis and management of early pregnancy disorders. The faculty will not only review the relevant scientific advances in the field but also discuss applications of these discoveries to clinical practice with

ASRM 2014 Annual Meeting

NONCME

12

47TH ANNUAL POSTGRADUATE PROGRAM

PG03

h r a

ASRM CODING FOR REPRODUCTIVE MEDICINE PRACTICES 2014 Course PG3 (Saturday) Developed in Cooperation with the ASRM Coding Committee

FACULTY John T. Queenan Jr., M.D., Chair University of Rochester Medical Center George A. Hill, M.D. Nashville Fertility Center

health affects

CE

NON- reproduction CME affects health NONCME

CE

ARS

ARS

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.

PANTONE 200

ACGME Competency Systems-based practice

NEEDS ASSESSMENT AND COURSE DESCRIPTION Every reproductive medicine practice has a legal and ethical obligation to follow a specific set of rules and regulations that determine how reimbursements are calculated. Failure to follow these rules can result in unfair practices to patients and/or legal consequences from government or third-party payers. The problem is those rules and regulations have become so complex that most people cannot understand them without receiving special training.

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Demonstrate correct coding of diagnostic conditions that are typically encountered in the practice of reproductive endocrinology. 2. Identify the correct Current Procedural Terminology (CPT) code for surgical procedures encountered in the practice of reproductive endocrinology and list additional resources available to aid with correct coding procedures in the future. 3. Summarize the rules and regulations required by thirdparty 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.

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 improving quality 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 ability to continue updating

PG04

A

BIOMARKERS IN REPRODUCTIVE MEDICINE Course PG4 (Saturday)

NONCME

FACULTY Carlos Simón, M.D., Ph.D., Chair Fundación IVI David K. Gardner, Ph.D. University of Melbourne David L. Keefe, M.D. New York University School of Medicine Denny Sakkas, Ph.D. Boston IVF Inc.

NONCME

CE

CE

ARS

ACGME Competency Medical Knowledge LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: Discuss the need for personalized reproductive medicine. 1. Present biomarkers for the clinical evaluation and selection of human oocytes and sperm. 2. Explain the potential benefits of emerging invasive and noninvasive techniques for embryo assessment. 3. Discuss how the biomarkers of the endometrium predict receptive status. 4. Explain the diagnostic efficiency of fetal DNA in maternal blood. 5. Summarize future trends in the in vitro fertilization (IVF) laboratory and the clinical practice.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Biomarkers in reproductive medicine have potential for clinical utility in improving outcomes. The purpose of this live course is to provide clinicians and laboratory professionals involved in assisted reproductive technology a state-of-the-art overview of the developments and novel technologies in personalized medicine, which allow us to improve our clinical success using biomarkers for the different steps of the reproductive process and during pregnancy. 13

ASRM 2014 Annual Meeting

ARS

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

PG05 health affects reproduction affects health

health affects reproduction affects health

GLOBAL GAMETES: LEGAL, ETHICAL, AND PSYCHOSOCIAL IMPLICATIONS IN CROSS-BORDER REPRODUCTIVE CARE NONCourse PG5 (Saturday) Developed in Cooperation with MHPG CME

FACULTY Elizabeth A. Grill, Psy.D., Chair Weill Cornell Medical Center Lindsay Childress-Beatty, J.D., Ph.D. American Psychological Association Susan L. Crockin, J.D. Georgetown University Law Center Marcia C. Inhorn, Ph.D., M.P.H. Yale University

NONCME

CE

CE

ARS

most salient psychosocial, legal, and ethical issues and propose standard-of-care practice guidelines for the CBRC industry. Each group will submit proposed guidelines to the entire group, and participants will have the unique opportunity to vote on the proposed solutions.

PANTONE 200

ACGME Competency Practice-based Learning and Improvement LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Examine the fundamental reasons why patients seek cross-border reproductive care and explain the harms and benefits for all of the CBRC stakeholders. 2. Identify the relevant psychosocial issues involved in counseling patients who pursue CBRC. 3. Assess telehealth issues involved in CBRC and evaluate professional guidelines. 4. Summarize the legal issues that are relevant to all stakeholders in cross-border reproductive care and consider key professional ethical issues that arise in CBRC. 5. Develop ethically based minimum standard-of-care guidelines.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Cross-border reproductive care (CBRC) involves the travel of patients seeking assisted reproductive technology (ART) from a country where such care is unavailable to a country where they can receive the treatment they desire. This live course will provide insight and guidance into the psychological, ethical, legal, and social issues that have been continuously reported to challenge the numerous stakeholders of CBRC. Utilizing an interactive format, course participants will first hear lectures and then discuss controversial cases with a faculty panel to learn about the complicated issues raised by CBRC. Faculty will then lead breakout sessions designed to identify the

ULTRASONOGRAPHY IN REPRODUCTIVE MEDICINE PG06 MASTERING Course PG6 (Saturday)

Developed in Collaboration with IRMSIG and AIUM

FACULTY Todd D. Deutch, M.D., Chair Advanced Reproductive Center Jacques S. Abramowicz, M.D. Wayne State University Alfred Z. Abuhamad, M.D. Eastern Virginia Medical School Laurel A. Stadtmauer, M.D., Ph.D. Eastern Virginia Medical School

of physicians, nurses, ultrasonographers, and other providers of gynecologic ultrasonography. ACGME Competency Patient Care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the appropriate use of gynecologic ultrasound and sonohysterogram in the evaluation of abnormalities and pathology of the female reproductive tract. 2. Discuss the role that three-dimensional (3-D) ultrasound plays as part of the gynecological ultrasound examination. 3. Summarize ways to improve ultrasound technique and enhance ultrasound safety. 4. Explain the usefulness of ultrasound as a tool to accurately assess and manage early pregnancy.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Ultrasound is used daily by practitioners around the world. Rapid developments in ultrasonography necessitate new education. The faculty will utilize an evidence-based approach as they educate the audience on topics such as: three-dimensional ultrasound, sonohysterography, ovarian cancer screening, ultrasound safety, first-trimester ultrasound screening, and new guidelines for differentiating normal vs abnormal pregnancies. The course will also include a hands-on component. Emphasis will be placed on ways in which new advances in ultrasound technologies and changes in guidelines can be utilized to improve clinical situations on a daily basis. This live course is designed to meet the needs ASRM 2014 Annual Meeting

14

ARS

47TH ANNUAL POSTGRADUATE PROGRAM

PG07

A

h r a

ASRM INTERPROFESSIONAL COURSE: MINIMIZING ERRORS IN ART Course PG7 (Saturday) Developed in Cooperation with SRBT, LPG, and SART

NONCME NONCME

CE

health affects reproduction affects health

CE

ARS

ACGME Competency Patient Care

FACULTY C. Brent Barrett, Ph.D., H.C.L.D., Chair Boston IVF and Harvard Medical School Michael M. Alper, M.D. Boston IVF and Harvard Medical School Jacob F. Mayer, Ph.D., H.C.L.D. Eastern Virginia Medical School Lisa A. Rinehart, R.N., B.S.N., J.D. LegalCare Consulting, Inc.

PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Identify areas in the laboratory and clinic where errors are more likely to occur. 2. Establish effective quality systems for minimizing errors. 3. Establish procedures for corrective action after errors are made. 4. Prepare for possible legal consequences associated with serious errors.

NEEDS ASSESSMENT AND COURSE DESCRIPTION The consequences of a serious error in assisted reproductive technology (ART) can be devastating for an embryologist, physician, or an entire clinic; therefore, it is critical to establish systems throughout the ART process that can minimize the chance of errors, both serious and minor. There are very few published reports on errors in ART, and this live course provides a forum in which to discuss an issue that affects all laboratories and clinics. The goals of this course include identifying areas where mistakes are more likely to happen, discussing effective systems for prevention of mistakes, and knowing what to do when an error occurs.

AND ETHNIC DIFFERENCES IN THE POLYCYSTIC OVARY SYNDROME PG08 RACIAL Course PG8 (Saturday) Developed in Cooperation with HDSIG

FACULTY Ruben J. Alvero, M.D., Chair University of Colorado School of Medicine Rebecca Carron, R.N, Ph.D. University of Colorado Denver Lauren Roth, M.D. Denver Health Medical Center Shunping Wang, Ph.D. University of Colorado School of Medicine

NONCME

CE

ARS

effective strategies based on a multidisciplinary approach to PCOS will be discussed and a community-based program will be offered. ACGME Competency Patient Care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Discuss the epidemiology of PCOS based on race and ethnicity. 2. Explain the predisposition to PCOS based on the patient’s vulnerability to obesity or overweight. 3. Describe the effectiveness of lifestyle modification in ameliorating the PCOS phenotype. 4. Use cultural competency to enhance compliance with attempts at lifestyle modification. 5. Encourage effective and discourage ineffective coping strategies among PCOS patients and identify cultural, racial, and ethnic differences where they exist.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Polycystic ovary syndrome (PCOS) is thought to be the most common endocrinopathy in women of reproductive age. Practitioners use a “one-size-fits-all” approach to evaluation and treatment of the disorder when there may be significant variation in phenotype based on genetic predisposition, socioeconomic disparities, and environmental differences. This live course for clinicians seeks to explore the current state of knowledge with regard to racial and ethnic predisposition to PCOS and identify areas where current strategies are not effective. More 15

ARS

ASRM 2014 Annual Meeting

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

health affects reproduction affects health

COURSE: EVALUATION AND SPERM RETRIEVAL MANAGEMENT OF OBSTRUCTIVE AND NONOBSTRUCTIVE PG09 INTERPROFESSIONAL AZOOSPERMIA AND/OR SEVERE OLIGOZOOSPERMIA health affects reproduction affects health

Course PG9 (Saturday) PANTONE 200

Developed in Cooperation with SRS, SRBT, and SMRU

NONCME

FACULTY Ajay K. Nangia, M.D., Chair University of Kansas Medical Center Mohit Khera, M.D., M.B.A., M.P.H. Baylor College of Medicine Mark Sigman, M.D. Brown University Amy E. Sparks, Ph.D. Center for Advanced Reproductive Care

CE

CE

ARS

recovery for in vitro fertilization; surgical techniques that yield the highest retrieval rates; usage of ejaculated sperm vs. testicular sperm; guidance to performing the procedures and maximizing quality; indications and ethics of how to counsel patients about cost, risks, and outcomes; tracking outcomes and limitations of current national data collection; and future directions. ACGME Competency Practice-based Learning and Improvement

NEEDS ASSESSMENT AND COURSE DESCRIPTION Obstructive and nonobstructive azoospermia and severe oligozoospermia can be significant contributors to a couple’s infertility. Current advances in treatment and methods of sperm recovery have expanded the options available for patients. The most appropriate techniques should allow retrieval of adequate sperm for fertilization as well as cryopreservation while minimizing patient complications. This live course is for urologists, surgeons, and ART laboratory personnel. The course will cover appropriate testing and evaluation; methods of sperm

ASRM 2014 Annual Meeting

NONCME

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Discuss appropriate testing and evaluation for obstructive and nonobstructive azoospermia and oligozoospermia. 2. Explain methods of sperm recovery and how to perform the procedures and maximize quality. 3. Counsel patients on cost, risks, and outcomes. 4. Discuss future directions in sperm recovery.

16

ARS

47TH ANNUAL POSTGRADUATE PROGRAM

PG10

A ASRM

PREVENTING AND MANAGING ENDOSCOPIC COMPLICATIONS: A HANDS-ON COURSE Course PG10 (Saturday) Developed in Cooperation with SRS

health affects reproduction affects health

ACGME Competency Patient Care

FACULTY Ceana Nezhat, M.D.,Chair Nezhat Medical Center Keith B. Isaacson, M.D. Harvard Medical School Grace M. Janik, M.D. Reproductive Specialty Center

PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Identify normal intra- and retroperitoneal anatomy and anatomic variations. 2. Implement methods to restore abnormal anatomy. 3. Improve patient outcomes in minimally invasive surgery through improved suturing/knot tying, new instrumentation, and advanced techniques. 4. Improve patient outcomes in minimally invasive surgery through increased self-confidence and attitude change. 5. Identify early recognition and treatment options and the newly recognized complications in laparoscopic surgery that affect the diagnostic and management options for treating patients.

TUTORS: Dobie Giles, M.D., M.S., F.A.C.O.G.; Elizabeth Ball, M.D., Ph.D.; Shan Biscette, M.D.; Douglas N. Brown, M.D.; Aarathi Cholkeri-Singh, M.D.; Michael Lewis, M.D.; Vadim Morozov, M.D.; Mary Ellen Pavone, M.D., M.C.S.I; Samantha M. Pfeifer, M.D.; Divya K. Shah, M.D.; Jessica Shepherd, M.D., M.B.A. NEEDS ASSESSMENT AND COURSE DESCRIPTION Advancement in technology and appropriate training in minimally invasive surgery are the preferred methods of managing gynecologic pathology. Limiting factors are knowledge of anatomy, devices and energy sources, and skill and experience of the surgeon. In this live course for clinicians and surgeons we aim to alleviate the fear of complications by teaching the best practices and advanced skills. This course is designed to cover normal intra- and retroperitoneal anatomy with pelvic sidewall dissection and identification of vessels, ureters, and nerves; restoration of abnormal anatomy; and methods to prevent, recognize, and manage gastrointestinal, genitourinary, and vascular complications during minimally invasive gynecologic surgery. Emphasis will be placed on visual presentation with extensive use of video examples involving major blood vessels, nerves, bowel, bladder, and ureter in addition to common gynecologic pathology. The laboratory portion will focus on laparoscopic suturing and hysteroscopic simulation. The key to being an advanced and efficient minimally invasive surgeon is suturing. The laboratory exercises will focus on utilizing and improving suturing techniques in managing complications as well as simulation training for hysteroscopic procedures.

17

h r a

ASRM 2014 Annual Meeting

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

PG11

health affects reproduction affects health

health affects reproduction affects health

VITRIFICATION: A HANDS-ON COURSE Course PG11 (Saturday) Developed in Cooperation with SRBT

NONCME

ACGME Competency Patient Care

FACULTY Susan A. Gitlin, Ph.D., Co-Chair Eastern Virginia Medical School Charles L. Bormann, Ph.D., Co-Chair Brigham and Women’s Hospital Thomas Huang, Ph.D. Pacific IVF Institute PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the cryobiological/cryophysical principles behind vitrification (VTF) technology. 2. Via a “hands-on” workshop, evaluate, demonstrate and practice with various commercially available VTF systems. 3. Assess the pros and cons of establishing a VTF program and 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.

TUTORS: Amber Brewer, B.S.; Pauline Garrison, M.S.; Michael Lee, M.S.; Cassandra Mallard, B.S.; Erin Obillo, B.S.; Kristin Sieren, M.S.; Tyl Taylor, M.S.; Michael W. Vernon, Ph.D.; Shane Zozula, B.S. Mark Dow, Ph.D., H.C.L.D. NEEDS ASSESSMENT AND COURSE DESCRIPTION Vitrification (VTF) is rapidly becoming the cryopreservation method of choice for many in vitro fertilization 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. 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 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.

ASRM 2014 Annual Meeting

CE

18

ARS

47TH ANNUAL POSTGRADUATE PROGRAM

A

h r a

ASRM

ONE-DAY COURSES

health affects reproduction affects health

SUNDAY, OCTOBER 19, 2014

PANTONE 200

YOUR PRACTICE WITH ANALYTICAL DATA PG12 IMPROVING Course PG12 (Sunday)

Developed in Cooperation with ARM

NONCME

FACULTY Faith E. Ripley, B.S., C.P.C., Co-Chair Piedmont Reproductive Endocrinology Group, P.A. Joseph J. Travia, Jr., M.B.A., Co-Chair Center for Reproductive Medicine Lisa Duran, B.A. RMA Texas

CE

information to enable every participant to be able to evaluate their practice’s productivity and profitability. ACGME Competency Systems-based Practice LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Develop a team-building plan for their center to engage their staff members. 2. Utilize coaching skills for practice management to provide a nurturing environment that promotes staff development and growth. 3. Analyze, review, and compare industry-specific benchmarking data and evaluate their practice’s performance and identify areas that may need improvement. 4. Implement performance goals at all levels of the practice utilizing the data provided.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Administrators and managers of reproductive medicine practices are faced with more challenges than ever before from insurance mandates, contracts, implementation of ICD-10, and provision of comprehensive data analysis to the shareholders, to ensuring profitability of the practice, recruiting and hiring the right staff, and keeping the team engaged while taking care of the physicians and patients. This course is designed to help reproductive medicine physicians, allied health professionals, and business administrators analyze the performance of their centers. It will provide benchmarking data specific to reproductive medicine, team-building and coaching tools, as well as

COURSE: PRESERVATION OF OVARIAN FUNCTION IN CHRONIC DISEASE: CRYOPRESERVATION, PG13 INTERPROFESSIONAL MEDICAL/SURGICAL INTERVENTIONS, AND EDUCATIONAL OPPORTUNITIES Course PG13 (Sunday) Developed in Cooperation with SRBT and SREI

NONCME

NONCME

CE

CE

ARS

ACGME Competency Practice-based Learning and Improvement

FACULTY Catherine Racowsky, Ph.D., Chair Brigham and Women’s Hospital and Harvard Medical School Francesca E. Duncan, Ph.D. Northwestern University Elizabeth S. Ginsburg, M.D. Brigham and Women’s Hospital Clarisa R. Gracia, M.D., M.S.C.E. University of Pennsylvania

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Discuss the clinical indications for ovarian tissue cryopreservation. 2. Review the limitations to medical interventions to preserve ovarian function. 3. Assess methods for ovarian tissue cryopreservation and tissue transport and compare and contrast methods for the actual use of ovarian tissue long term. 4. Describe methods to interact with oncologists, pediatricians, and surgical oncologists to coordinate ovarian tissue harvest with other surgical interventions. Review ways to integrate these methods into actual clinical practice. 5. Explain the limitations of experimental techniques such as follicle maturation and “artificial ovaries” in real world clinical application.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Ovarian tissue cryopreservation may be the only fertility preservation option for prepubertal girls and those who require immediate treatment for cancer and other chronic diseases, yet it is not as widely utilized and available in the United States as it is elsewhere in the world. This live course for clinicians and laboratory professionals will provide information about indications, best practices for centralized transport, freezing, and actual utilization of the tissue and how it can be combined with other surgical interventions. The efficacy of the method will be contrasted with medical interventions (e.g., leuprolide acetate) used to preserve ovarian function, which still may compromise fertility. 19

ASRM 2014 Annual Meeting

ARS

ARS

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

health affects reproduction affects health

AND EXPERIMENTAL DESIGN: USING EVIDENCE-BASED MEDICINE TO UNDERSTAND CONTRACEPTIVE CONTROVERSIES PG14 EPIDEMIOLOGY Course PG14 (Sunday) health affects reproduction affects health

Developed in Cooperation with CSIG

FACULTY Bliss Kaneshiro, M.D., M.P.H., Chair University of Hawaii David A. Grimes, M.D. University of North Carolina School of Medicine Kenneth Schulz, Ph.D. FHI360/Quantitative Sciences

on examples from reproductive health, particularly contraception. The course will consist of a mixture of didactic sessions and class discussions.

PANTONE 200

ACGME Competency Patient Care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Identify the major types of epidemiologic studies and state at least one strength and one weakness of each. 2. Define the terms “relative risk” and “attributable risk.” 3. Name at least three different types of control groups used in epidemiologic studies and specify at least one strength and one weakness of each. 4. Discuss which studies most appropriately address a given clinical question. 5. Define four measures of test validity.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Current practice in reproductive health is based upon evidence-based medicine. Most interprofessional team members will have a basic understanding of the hierarchy in the quality of evidence used to create practice guidelines. However, for some individuals, this course may be their first introduction to evidence-based principles. For all, using the medical literature to answer controversial contraceptive questions can be intimidating. This live course for health-care professionals will introduce the participant to the major epidemiologic and experimental study designs and will draw heavily

SPERMATOGENESIS TO MORE TAKE-HOME BABIES - THE IMPORTANCE OF THE SPERM PG15 FROM Course PG15 (Sunday) Developed in Cooperation with ESHRE

CE

ACGME Competency Medical Knowledge

FACULTY Sheena E.M. Lewis, B.Sc., Ph.D., Chair Queens University Belfast Mona Bungum, Ph.D. Lund University Nicolás Garrido, Ph.D. Andrología IVI Valencia

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Describe the anatomy, endocrinology, and physiology of male reproduction and describe male reproduction from spermatogenesis to ejaculation. 2. Evaluate recent sperm function tests for diagnosis and prediction of success with each form of ART (intrauterine insemination [IUI], in vitro fertilization [IVF], and intracytoplasmic sperm injection [ICSI]). 3. Explain the hazards for sperm in the clinical laboratory. 4. Assess value and need for novel testing as part of the routine male workup on evidence-based evaluation. 5. Evaluate new tests for the management of male infertility for normozoospermic men and couples with idiopathic infertility. 6. Discriminate usefulness of new frontier research of various sperm function tests for sperm and their application to ART and their application to the investigation of recurrent miscarriage.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Male infertility is the primary cause for 40% of couples presenting for assisted reproductive technology (ART). Yet, after 30 years of ART, neither normal male reproduction nor its anomalies are regularly addressed or updated for clinical professionals. Over the past few years, the continued necessity, despite limitations, of current routine tests such as semen analysis have been highlighted. In this live course for male infertility specialists and andrologists, an overview of novel tests and biomarkers will be given so that physicians can update their practice patterns where appropriate through a thorough and objective evaluation of the plethora of tests for sperm function currently available.

ASRM 2014 Annual Meeting

NONCME

20

ARS

47TH ANNUAL POSTGRADUATE PROGRAM

PG16

A ASRM

OBESITY, NUTRITION, AND FERTILITY Course PG16 (Sunday) Developed in Cooperation with NutriSIG and SREI

health affects reproduction affects health

NONCME

CE

ARS

ACGME Competency Patient Care

FACULTY Jorge E. Chavarro, M.D., Sc.D., Chair Harvard School of Public Health and Harvard Medical School    Emily S. Jungheim, M.D., M.S.C.I. Washington University School of Medicine Kelle H. Moley, M.D. Washington University School of Medicine Judy Simon, M.S., R.D., C.D., C.H.E.S. University of Washington and Mind Body Nutrition, PLLC

PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Describe the impact of obesity and its related metabolic effects on reproductive function, including pubertal development, gametogenesis, embryo development, early pregnancy outcomes, and obstetric outcomes. 2. Describe the role of diet composition on infertility and fertility treatment outcomes. 3. Discuss the competing risks of obesity and age in the fertility patient. 4. Explain the role of weight management and medical nutrition therapy on the care of fertility patients. 5. Identify the role of the Registered Dietitian/ Nutritionist in the care of fertility patients.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Obesity is related to poor outcomes among fertility patients, and more than 40% of embryo transfers are performed among overweight or obese women. Nevertheless, there is limited knowledge among fertility-care providers on how to address weight-management issues. There is also a lack of appreciation of the role that diet composition has on fertility and infertility treatment outcomes. This live course for fertility-care providers will present the latest research as seen by basic and population scientists. It also will address a competence gap on weight management by presenting expert clinical perspectives of a reproductive endocrinology/ infertility specialist and a dietitian.

21

h r a

ASRM 2014 Annual Meeting

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

health affects reproduction affects health

DYSFUNCTION: MEDICAL, SURGICAL AND ART ALTERNATIVE MANAGEMENT PG17 OVULATORY Course PG17 (Sunday)

health affects reproduction affects health

Developed in Cooperation with MEFS

ACGME Competency Patient Care

FACULTY Mohamed Aboulghar, M.D., Chair Cairo University and the Egyptian IVF Center Johnny T. Awwad, M.D., Co-chair American University of Beirut David R. Meldrum, M.D. Reproductive Partners La Jolla, Inc. Alan S. Penzias, M.D. Boston IVF PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Diagnose and treat the rare type of hypogonadotropic hypogonadism. 2. Explain the long-term risks of PCOS and how to avoid them, as well as evaluate the advantages and risks of surgical treatment of PCOS. 3. Discuss different oral and injectable protocols for ovulation induction in PCOS. 4. Explain the action of different gonadotropin-releasing hormone (GnRH) analogues and their value in treating ovulatory disorders. 5. Identify uncommon causes of ovulatory disorders and treat them correctly and discuss the risks of treating ovulatory disorders. 6. Decide if there is a need for ART in treating anovulatory infertility.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Ovulatory disorders are the most common medical problem seen by the infertility specialist. It is estimated that the prevalence of polycystic ovary syndrome (PCOS) alone is 5% in China, 7.3% in Palestine, and 8.5% in Brazil. During the past few decades, marked improvement has occurred in the field of diagnosis and treatment of ovulatory disorders. New modalities of fast and accurate hormone assays, as well as advanced ultrasound equipment and techniques, have resulted in rapid and accurate diagnosis of ovulatory disorders. There is a need for our target audience to study all these procedures and to develop the ability to assess the outcome of these tests and ultrasound examinations to be able to reach a correct diagnosis. Still, the field is open for new innovations. A decade ago, follicle-stimulating hormone (FSH) was the basic test to assess ovarian reserve; now, antimüllerian hormone (AMH) and antral follicle count (AFC) have become the more accurate modalities. Treatment of ovulatory disorders now includes medical, surgical, and assisted reproductive technology (ART) treatment. Drugs used for treatment of infertility could be dangerous and can lead to serious complications, which are rarely fatal. Training and careful choice of the drug and the dosage is essential. Follow-up is an integral part of the treatment. This live course targets a variety of medical personnel including physicians, infertility specialists, residents, nurses, and embryologists. The faculty will address the types of ovulatory disorders, the methods of diagnosis of each type, the investigations required, and the line of treatment suitable for each type. Complications of treatment will be discussed in detail, including methods of prevention and treatment of complications. The audience will learn all new modalities in the diagnosis of ovulatory disorder and its treatment. All lectures, which will cover diagnostic and therapeutic fields, will be evidence-based with the most up-to-date information. ASRM 2014 Annual Meeting

22

47TH ANNUAL POSTGRADUATE PROGRAM

PG18

A

h r a

ASRM CREATION, CONFLICT, AND CONTROVERSY Course PG18 (Sunday) Developed in Cooperation with MHPG, LPG, and SRBT

NONCME NONCME

CE

health affects reproduction affects health

CE

ARS

ACGME Competency Practice-based Learning and Improvement

FACULTY Dorothy Greenfeld, M.S.W., L.C.S.W., Co-Chair Yale University School of Medicine Margaret E. Swain, R.N., J.D., Co-Chair The Law Office of Margaret E. Swain G. David Ball, Ph.D. Seattle Reproductive Medicine

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Identify ethical issues associated with the embryo in ART, including grading, and the moral implications associated with laboratory selection of embryos. 2. Describe mental health diagnosis and intervention for ART clients who create extracorporeal embryos and distinguish the legal and emotional difference between embryos created with gametes of intended parents and those created with donated gametes. 3. Discuss legal and ethical issues/trends associated with the creation, storage, and disposition of embryos, including those surrounding disputed ownership. 4. Identify new developments in embryo science, as well as scientific concerns regarding embryo status, research, preimplantation genetic diagnosis, education and selection of embryologists, and strategies for identifying and preventing laboratory errors. 5. Define the potential effect of personhood legislation and current state statutes on the medical practice of ART and on access to care for infertility patients. 

NEEDS ASSESSMENT AND COURSE DESCRIPTION Misconceptions of the underlying scientific, psychological, ethical, and legal issues within assisted reproductive technology (ART) foster uncertainty among clinicians, allied professionals, and patients. This is especially important when the extracorporeal embryo, a touchstone of reproductive advancements, and also a flashpoint for controversy, is involved. In this interprofessional course, recognized experts in the fields of embryology, mental health, and the legal aspects of ART will present on topics covering the broad range of scientific and practice issues related to the embryo. This course will provide basic science, psychological, and legal perspectives on the embryo, with reviews of national and international issues and suggestions for conflict resolutions available for the practitioner. The course will feature a practice-based approach, while relying on sound ethical, legal, and psychological principles and research.

23

ARS

ASRM 2014 Annual Meeting

PANTONE 200

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

PG19 health affects reproduction affects health

health affects reproduction affects health

INTERPROFESSIONAL COURSE: A WOMB WITH A VIEW: EXPLORING THE COMPLEXITIES OF THE UTERUS Course PG19 (Sunday) Developed in Cooperation with NPG, SART, and SRBT

CE

CE

ARS

ACGME Competency Medical Knowledge

FACULTY Valerie L. Baker, M.D., Co-Chair Stanford University Medical Center Sue Jasulaitis, M.S.N., B.S.N., Co-Chair Fertility Centers of Illinois Barry Behr, Ph.D., H.C.L.D. Stanford University Paul Lin, M.D. Seattle Reproductive Medicine PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Review the role of fibroids/polyps on fertility and pregnancy and discuss indications for surgical intervention. 2. Examine endometrial receptivity and ovarian stimulation and its effect on the endometrium. 3. Describe the role of the nurse in educating patients about sonography and uterine evaluation, endometriosis, fibroids, intervention and treatment, and implantation. 4. Identify the laboratory scientist’s role in the advances in embryo implantation success.

NEEDS ASSESSMENT AND COURSE DESCRIPTION The uterus is fundamental to human existence and yet remains complex with many unanswered questions. This live course for nurses and allied health professionals will include an interprofessional team of reproductive endocrinology/ infertility (REI) physicians, a reproductive surgeon, a laboratory scientist and a nurse who will share their expertise. The aim is to review the multiple intricacies related to the uterus, including endometrium, implantation, and pregnancy outcome. The role of fibroids/polyps and their impact on fertility and pregnancy will be discussed. Uterine evaluation methods, findings, pathophysiology, and medical treatment options as well as uterine anomalies will be explored. Additionally, data on ovarian stimulation and its effect on the endometrium as well as a review of endometrial receptivity will be examined. The goal of this course is to increase the knowledge base of the many complexities involving the uterus, review pros and cons of surgical intervention, and to give strategies to improve pregnancy outcomes. The nurse’s role in educating and guiding patients through these complexities and their fertility and pregnancy journey will be discussed. The diverse faculty will focus on different areas from their varied yet interrelated perspectives.

ASRM 2014 Annual Meeting

NONCME

NONCME

24

ARS

47TH ANNUAL POSTGRADUATE PROGRAM

PG20

A ASRM

PREVENTING AND MANAGING ENDOSCOPIC COMPLICATIONS: A HANDS-ON COURSE Course PG20 (Sunday) Developed in Cooperation with SRS

health affects reproduction affects health

ACGME Competency Patient Care

FACULTY Ceana Nezhat, M.D.,Chair Nezhat Medical Center Keith B. Isaacson, M.D. Harvard Medical School Grace M. Janik, M.D. Reproductive Specialty Center

PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Identify normal intra- and retroperitoneal anatomy and anatomic variations. 2. Implement methods to restore abnormal anatomy. 3. Improve patient outcomes in minimally invasive surgery through improved suturing/knot tying, new instrumentation, and advanced techniques. 4. Improve patient outcomes in minimally invasive surgery through increased self-confidence and attitude change. 5. Identify early recognition and treatment options and the newly recognized complications in laparoscopic surgery that affect the diagnostic and management options for treating patients.

TUTORS: Dobie Giles, M.D., M.S., F.A.C.O.G.; Elizabeth Ball, M.D., Ph.D.; Shan Biscette, M.D.; Douglas N. Brown, M.D.; Aarathi Cholkeri-Singh, M.D.; Michael Lewis, M.D.; Vadim Morozov, M.D.; Mary Ellen Pavone, M.D., M.C.S.I; Samantha M. Pfeifer, M.D.; Divya K. Shah, M.D.; Jessica Shepherd, M.D., M.B.A. NEEDS ASSESSMENT AND COURSE DESCRIPTION Advancement in technology and appropriate training in minimally invasive surgery are the preferred methods of managing gynecologic pathology. Limiting factors are knowledge of anatomy, devices and energy sources, and skill and experience of the surgeon. In this live course for clinicians and surgeons we aim to alleviate the fear of complications by teaching best practices and advanced skills. This course is designed to cover normal intra- and retroperitoneal anatomy with pelvic sidewall dissection and identification of vessels, ureters, and nerves; restoration of abnormal anatomy; and methods to prevent, recognize, and manage gastrointestinal, genitourinary, and vascular complications during minimally invasive gynecologic surgery. Emphasis will be placed on visual presentation with extensive use of video examples involving major blood vessels, nerves, bowel, bladder, and ureter in addition to common gynecologic pathology. The laboratory portion will focus on laparoscopic suturing and hysteroscopic simulation. The key to being an advanced and efficient minimally invasive surgeon is suturing. The laboratory exercises will focus on utilizing and improving suturing techniques in managing complications as well as simulation training for hysteroscopic procedures.

25

h r a

ASRM 2014 Annual Meeting

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

health affects reproduction affects health

A HANDS-ON COURSE PG21 VITRIFICATION: Course PG21 (Sunday) health affects reproduction affects health

Developed in Cooperation with SRBT

NONCME

ACGME Competency Patient Care

FACULTY Susan A. Gitlin, Ph.D., Co-Chair Eastern Virginia Medical School Charles L. Bormann, Ph.D., Co-Chair Brigham and Women’s Hospital Thomas Huang, Ph.D. Pacific IVF Institute PANTONE 200

LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain the cryobiological/cryophysical principles behind vitrification (VTF) technology. 2. Via a “hands-on” workshop, evaluate, demonstrate, and practice with various commercially available VTF systems. 3. Assess the pros and cons in establishing a VTF program and 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.

TUTORS: Amber Brewer, B.S.; Pauline Garrison, M.S.; Michael Lee, M.S.; Cassandra Mallard, B.S.; Erin Obillo, B.S.; Kristin Sieren, M.S.; Tyl Taylor, M.S.; Michael W. Vernon, Ph.D.; Shane Zozula, B.S. NEEDS ASSESSMENT AND COURSE DESCRIPTION Vitrification (VTF) is rapidly becoming the cryopreservation method of choice for many in vitro fertilization 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 acceptance of VTF eggs/embryos in unfamiliar VTF devices. We are entering a new era of cryobiology where we are faced with serious quality-control challenges. 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 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.

ASRM 2014 Annual Meeting

CE

26

ARS

47TH ANNUAL POSTGRADUATE PROGRAM

PG22

A

h r a

ASRM INTERPROFESSIONAL COURSE; MANAGING INFORMED CONSENT IN ART: UNIQUE MEDICAL, LEGAL, AND OPERATIONAL CHALLENGES IN EVOLVING RELATIONSHIPS, PRACTICES, AND TECHNOLOGIES Course PG22 (Sunday) Developed in Cooperation with LPG, NPG, and SART

FACULTY Susan L. Crockin, J.D., Chair Georgetown University Law Center Judith F. Daar, J.D. Whittier Law School James P. Toner, Jr., M.D., Ph.D. Atlanta Center for Reproductive Medicine Elizabeth B. West, R.N.C., B.S.N. Institute for Reproductive Health

health affects reproduction affects health

NONCME

CE

is obtained from them (online documents, videos, Skype intakes, and “docu-sign” options, among others), raising new legal issues on the use of electronic documentation. This live course for clinicians, practice managers, and legal professionals involved in ART will explore these issues from a cross-professional perspective, present updates on the state of the law on informed consent in ART treatment, review the Society for Assisted Reproductive Technologies (SART) Model ART consents, and examine the tensions and challenges created by these new technologies on both a theoretical and applied level through hypothetical and actual case studies.

NEEDS ASSESSMENT AND COURSE DESCRIPTION Informed consent is a cornerstone of medical treatment, necessitating both the provision of comprehensive information to patients and obtaining informed consent from them. Applying it in the context of assisted reproductive technology (ART) can involve a complex interplay involving a myriad of both patients and professionals. ART always involves at least two potential patients. With the rapidly expanding use of ART both globally and with third parties (including gamete or embryo donors and gestational surrogates), there may be multiple patients in numerous locations (which also may include their partners or spouses) involved in ART medical treatment, each of whom needs to be fully informed of, and consent to, a large number of potential treatments. In addition, the informed consent process must take into account both the immediate ART treatment being used and increasing potential future uses of cryopreserved genetic material—a challenge beyond the traditional use of informed consent.

ACGME Competency Systems-based Practice LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Explain how to fully inform and gain consent from multiple patients involved in ART medical treatments. 2. Discuss how the informed consent process must take into account both the immediate ART treatment being used and increasing potential future uses of cryopreserved genetic material. 3. Discuss emerging issues in informed consent, including egg freezing, cross-border reproductive care, and new technologies in which information is provided to patients and informed consent is obtained from them.

Finally, three newly emerging challenges are creating specific novel issues for providing informed consent: 1) The introduction and expansion of egg freezing raises new questions of informed consent, as treatment may be literally suspended indefinitely for both patients freezing their own eggs and between donors and recipients, creating issues of updating medical information, privacy, and the Health Insurance Portability and Accountability Act (HIPAA) concerns, among other issues; 2) Cross-border reproductive care (including international surrogacy) challenges professionals’ ability to secure adequate informed consent from all participants and also raises new vulnerabilities for all parties arising from foreign laws and practices and immigration complexities; and 3) Internet technologies change both the methods in which information is provided to patients and the manner in which informed consent 27

ASRM 2014 Annual Meeting

ARS

PANTONE 200

ASRM 47TH ANNUAL POSTGRADUATE PROGRAM ASRM

health affects reproduction affects health

ROOM: FERTILITY AND STERILITY WORKSHOP FOR AUTHORS, REVIEWERS, AND READERS (non-CME) PG23 WAR Workshop PG23 (Sunday) health affects reproduction affects health

Developed in Cooperation with F & S

FACULTY Antonio Pellicer, M.D., Co-Chair Instituto Valenciano Infertilidad (IVI) Craig S. Niederberger, M.D., Co-Chair UIC College of Medicine Kurt T. Barnhart, M.D., M.S.C.E. Marcelle I. Cedars, M.D. University of California San Francisco University of Pennsylvania Richard S. Legro, M.D. The Pennsylvania State University, College of Medicine Steven F. Palter, M.D. Gold Coast IVF Richard J. Paulson, M.D. University of Southern California Fertility

NONCME

for appropriate study design and manuscript preparation will be presented, as well as an explanation of the role and responsibilities of reviewers. In addition, Fertility and Sterility’s publishing innovations will be described, including citable video articles and the Online Journal Club. Participants will learn how to access these new features and maximize their journal experience.

PANTONE 200

LEARNING OBJECTIVES At the conclusion of this workshop, participants should be able to: 1. Describe Fertility and Sterility’s peer-review process. 2. Discuss strategies for study design and manuscript preparation. 3. Explain the role and responsibilities of journal reviewers. 4. Describe Fertility and Sterility’s publishing innovations and how to access these new features to maximize their journal experience.

NEEDS ASSESSMENT AND COURSE DESCRIPTION This non-CME workshop for authors, reviewers, and readers of Fertility and Sterility will provide insight into navigating the journal’s peer-review process. Strategies AND HANDS-ON INTENSIVE PG24 SIMULATION Course PG24 (Monday)

Developed in Cooperation with SRS

FACULTY Jeffrey M., Goldberg, M.D., Chair Cleveland Clinic Ceana Nezhat, M.D., Co-Chair Nezhat Medical Center Keith B. Isaacson, M.D. Harvard Medical School Grace M. Janik, M.D. Reproductive Specialty Center

on laparoscopic suturing and hysteroscopic simulation. The key to being an advanced and efficient minimally invasive surgeon is suturing. The laboratory exercises will focus on utilizing and improving suturing techniques in managing complications as well as simulation training for hysteroscopic procedures. ACGME Competency Patient Care LEARNING OBJECTIVES At the conclusion of this course, participants should be able to: 1. Improve patient outcomes in minimally invasive surgery through improved suturing/knot tying, new instrumentation, and advanced techniques. 2. Improve patient outcomes in minimally invasive surgery through increased self-confidence and attitude change.

TUTORS: Dobie Giles, M.D., M.S., F.A.C.O.G.; Elizabeth Ball, M.D., Ph.D.; Shan Biscette, M.D.; Douglas N. Brown, M.D.; Aarathi Cholkeri-Singh, M.D.; Tommaso Falcone, M.D.; Lydia Garcia, M.D.; Michael Lewis, M.D.; Vadim Morozov, M.D.; Mary Ellen Pavone, M.D., M.C.S.I; Samantha M. Pfeifer, M.D.; Divya K. Shah, M.D.; Jessica Shepherd, M.D., M.B.A. NEEDS ASSESSMENT AND COURSE DESCRIPTION Advancement in technology and appropriate training in minimally invasive surgery are the preferred methods of managing gynecologic pathology. Limiting factors are knowledge of anatomy, devices and energy sources, and skill and experience of the surgeon. This course will focus ASRM 2014 Annual Meeting

28

CE

ARS

A ASRM

ASRM 2014 SCIENTIFIC PROGRAM

health affects reproduction affects health

NEEDS ASSESSMENT AND PROGRAM DESCRIPTION The theme of the 2014 meeting of the American Society for Reproductive Medicine is “Surfing the Waves of Change,” which is appropriate not just for the venue in Hawaii, but also for the profound changes that are now happening in reproductive medicine. Although encountering many challenges, reproductive medicine has many exciting new opportunities for development. Both the challenges and opportunities will be addressed by the wide array of educational activities of the 2014 scientific program. The program is balanced among the various healthcare professions because all members of the healthcare team must work together to provide innovative and optimal reproductive care of patients. This includes physicians, nurses, andrology and IVF laboratory personnel, genetic counselors, social workers, practice and laboratory managers, as well as specialists in mental health, law, and ethics. However, the primary goal of the meeting is to advance exemplary medical care for both males and females and cutting edge research. The educational program at this year’s meeting in Honolulu will address these needs. The Scientific Program will include a series of plenary lectures, symposia, interactive sessions, and roundtable luncheons. An interweaving theme of the scientific program will be to incorporate genetics into reproductive medicine since new methodologies have resulted in an explosion of new genomic capabilities for our patients in genetic diagnosis and preimplantation genetic screening. Plenary lectures will feature outstanding speakers covering the topics of sperm cell biology, surgery, reproductive genetic disorders, bariatric surgery, endometriosis, and relevant methods of genomic medicine. The symposia will provide a more in-depth coverage of basic and clinical topics. Included in our diverse array of areas are several two-part symposia–Oncofertility (I and II) and Fertility Preservation (I and II)–so that both male and female considerations will be covered in detail. Relevant genetic implications will also be discussed in these contexts. We will also learn about randomized, evidence-based infertility trials from the perspective of US, European, and Asian investigators. The interactive sessions cover a wide range of controversial topics and are meant to be a forum for discussion and interaction. This year, they will take one of several different formats to ensure a truly interactive process. The always popular roundtable luncheons provide participants in-depth discussion with an expert in a small group setting. Lastly, oral and poster presentations will provide investigators the opportunity to present cutting-edge scientific research. Attending interesting orals and discussing shared interests at a poster session are always valuable for learning and potential collaborations. The 2014 Annual Meeting Scientific Program will be a tremendous educational opportunity to combine reproductive medicine with an extraordinarily beautiful meeting site.

LEARNING OBJECTIVES At the conclusion of the postgraduate and scientific programs, participants should be able to: 1. Discuss the relevance of genetics and genomics to our reproductive medicine patients. 2. Summarize the latest scientific advances in the biology of hypothalamic-pituitary-gonadal axis, gamete and embryo development, endometriosis, fibroids, stem cells, and polycystic ovary syndrome. 3. Describe optimal methods for producing, culturing, assessing, selecting, and cryopreserving human embryos and oocytes. 4. Discuss evidence-based treatment of male and female reproductive disorders, including the role of surgery. 5. Discuss complete infertility management including ethical, legal, and psychosocial aspects. 6. Discuss treatment of reproductive options and dysfunction for females and males at different ages throughout life— childhood, adolescence, adulthood, and reproductive senescence. 7. Discuss the effect of cancer and its treatment upon reproduction.

29

h r a

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM EDUCATIONAL TRACKS ASRM

health affects reproduction affects health

health affects reproduction affects health

Andrology

Monday Monday

9:45 am - 10:30 am

Plenary 2

AUA Bruce Stewart Memorial Lecture: Klinefelter Syndrome: From Mice to Men

1:15 pm - 2:15 pm

Interactive Session

Monday

5:15 pm - 5:45 pm

Minisymposium

SMRU Minisymposum - Space, the Final Frontier: Impact of Space Flight and Zero Gravity on Male and Female Reproductive Health

Tuesday

1:15 pm - 2:15 pm

Interactive Session

Aggressive or Delayed Management of the Klinefelter Adolescent: What Do the Data Show? An Interactive Debate

Tuesday

1:15 pm - 2:15 pm

Interactive Session

Varicocele—If and When to Treat

Tuesday

4:15 pm - 6:15 pm

Symposium

Tuesday

5:15 pm - 5:45 pm

Minisymposium

SMRU Minisymposum - Gateways to Success: The Sperm’s Perspective for Finding and Penetrating the Egg

Wednesday

1:15 pm - 2:15 pm

Interactive Session

Predictive Value of Hormonal and Genetic Assays in the Evaluation of the Infertile Male

Wednesday

1:15 pm - 2:15 pm

Interactive Session

Meet the Professor

Wednesday

2:45 pm - 3:30 pm

Plenary 8

Wednesday

5:15 pm - 5:45 pm

Minisymposium

PANTONE 200

Meet the Professor

Gamete Reserve I - Testis

Sperm Cell Biology: Revelations on the Road to Conception SMRU Minisymposum - How to Counsel the Infertile Man—An Under-recognized Mental Health Issue ART

Monday

4:15 pm - 6:15 pm

Symposium

Howard and Georgeanna Jones Symposium: A New Paradigm for IVF: Reducing the Burden of Care

Monday Tuesday

4:15 pm - 6:15 pm

Symposium

ESHRE Symposium - Health of Children Following ART

1:15 pm - 2:15 pm

Interactive Session

Mayo Preconception Risk Stratification for ART and Fertility Care

Wednesday

1:15 pm - 2:15 pm

Interactive Session

How to Deal with Poor Responders?

Wednesday

3:45 pm - 5:45 pm

Symposium

MEFS Symposium: Complete Prevention of OHSS—Is It Possible?

Wednesday

3:45 pm - 5:45 pm

Symposium

ISAR Symposium: Third-party Reproduction

Monday

11:15 am - 1:00 pm

Workshop

Contraception Day Workshop: Demography of Contraceptive Use, Unintended Pregnancy, and Abortion

Monday

1:15 pm - 2:15 pm

Interactive Session

Monday

2:45 pm - 3:30 pm

Keynote

Wednesday

1:15 pm - 2:15 pm

Interactive Session

Recurrent Pregnancy Loss: One Should Evaluate for Chronic Endometritis

Wednesday

1:15 pm - 2:15 pm

Interactive Session

Early Pregnancy Monitoring—Pregnancy of Unknown Location vs. Ectopic Pregnancy vs. Intrauterine Pregnancy

Wednesday

1:15 pm - 2:15 pm

Interactive Session

Immunotropic vs. Immunesuppressive Treatment to Enhance Implantation

Monday

1:15 pm - 2:15 pm

Interactive Session

Use of Aromatase Inhibitors in Endometriosis and Ovulation Induction

Monday

4:15 pm - 6:15 pm

Symposium

Tuesday

2:45 pm - 3:30 pm

Plenary 6

Contraception

Contraception Day: CSIG and HDSIG Interactive Session - Contraceptive Strategies for Disadvantaged Women Contraception Day Keynote: The Future of Female and Male Contraceptive and the NIH’s Role in the Development of New Contraceptive Methods Early Pregnancy

Endometriosis AMMR Symposium - ¿Cuál es el mejor manejo de la paciente con endometriosis para mejorar la fertilidad? Systems Biology of Endometriosis Fertility Preservation Monday

4:15 pm - 6:15 pm

Symposium

Oncofertility I - Male

Tuesday

4:15 pm - 6:15 pm

Symposium

Oncofertility II - Female

Tuesday

4:15 pm - 6:15 pm

Symposium

Gamete Reserve I - Testis

Wednesday

1:15 pm - 2:15 pm

Interactive Session

Wednesday

3:45 pm - 5:45 pm

Symposium

ASRM 2014 Annual Meeting

Is Oocyte Cryopreservation Preferable to Ovarian Tissue Freezing for Fertility Preservation? Gamete Reserve II - Ovary

30

SCIENTIFIC PROGRAM EDUCATIONAL TRACKS

A ASRM health affects reproduction affects health

Genetics Tuesday

11:15 am - 1:15 pm

Symposium

Tuesday

1:15 pm - 2:15 pm

Interactive Session

Recurrent Pregnancy Loss and Preimplantation Genetic Screening Errors

Tuesday

1:15 pm - 2:15 pm

Interactive Session

Preimplantation Genetic Diagnosis—The Near Future

Wednesday

9:00 am - 9:45 am

Plenary 7

ABOG Foundation - Kenneth J. Ryan Ethics Symposium: Incidental Findings in the Era of Whole Genome Sequencing

Herbert H. Thomas Lecture: Preconception, Preimplantation, and Prenatal Genomic Medicine Lab

Monday

1:15 pm - 2:15 pm

Interactive Session

Wednesday

2:45 pm - 3:30 pm

Plenary 9

Wednesday

3:45 pm - 5:45 pm

Symposium

Tuesday

1:15 pm - 2:15 pm

Interactive Session

Tuesday

2:45 pm - 3:30 pm

Keynote

Best Practices to Prevent Serious Laboratory Errors SSR Exchange Lecture: Colony Stimulating Factor 2: Example of a Maternal Embryokine that Programs the Mammalian Embryo for Pregnancy Success How to Choose the Best Embryo - Proteomic, Metabolomic, Genomic, Imaging Menopause Menopause Day Interactive Session - Tailoring Management Strategies to Patient Needs: A Case-based Interactive Discussion on Common Concerns Menopause Day Keynote -The Evolving Role of SERMs in Menopausal Women’s Health Mental Health

Monday

11:15 am - 1:00 pm

Symposium

MHPG Symposium - How Far is too Far? The Medical, Embryological, Psychological, and Legal Aspects of Sex Selection. Just Because We Can…

Tuesday

11:15 am - 1:00 pm

Symposium

MHPG Symposium -Blurring the Line Between Life and Death: The Psychological and Ethical Issues of Posthumous Reproduction

Wednesday

11:15 am - 1:00 pm

Symposium

MHPG Symposium -Controversies and Cutting Edge in Third-party ART: Helping HIV Positive and Serodiscordant Couples Become Pregnant Nursing

Monday

11:15 am - 1:00 pm

Symposium

NPG in Collaboration with the LPG Symposium - Egg Cryopreservation and Banking— Where Are We Going and What Do We Need to Know? 

Tuesday

11:15 am - 1:00 pm

Symposium

NPG Symposium - PCOS and the Multidisciplinary Team Approach

Wednesday

11:15 am - 1:00 pm

Symposium

NPG Symposium - Freeze All Cycles—Eggs and Embryos

Monday

1:15 pm - 2:15 pm

Interactive Session

Tuesday

4:15 pm - 6:15 pm

Symposium

ALMER Symposium: PCOS from a Worldwide Perspective

Monday

11:15 am - 1:00 pm

Symposium

ARM Symposium - Maximizing the Physician’s Schedule and Revenue by Bringing Surgery and Diagnostic Procedures In-house

Tuesday

11:15 am - 1:00 pm

Symposium

ARM Symposium - Strategic Planning and Implementing - Human Resources

Wednesday

11:15 am - 1:00 pm

Symposium

ARM Symposium - The Patient-Team Approach

PCOS Dilemmas in the Care of Polycystic Ovary Syndrome Patients Practice Management

Reproductive Surgery Monday

8:00 am - 12:00 pm

Monday Monday

Workshop

Simulation and Hands-On Intensive

11:15 am - 1:00 pm

Telesurgery

Surgery Day Telesurgery: Laparoscopic Myomectomy and Tissue Removal Techniques

1:15 pm - 2:15 pm

Interactive Session

Monday

2:45 pm - 3:30 pm

Plenary 3

Monday

4:15 pm - 6:15 pm

Symposium

Tuesday

1:15 pm - 2:15 pm

Interactive Session

Reproductive Abnormalities: How to Optimize Future Fertility SRS Surgery Day Lecture: Uterine Transplantation SRS Symposium: How to Detect, Characterize, and Treat Uterine Fibroids Uterine Fibroids—Which Treatment for Which Patients?

31

h r a

ASRM 2014 Annual Meeting

PANTONE 200

ASRM health affects reproduction affects health

ASRM

Daily Schedule Key to Abbreviations health affects reproduction affects health

Affiliated Societies SART Society for Assisted Reproductive Technology SMRU Society for Male Reproduction and Urology SRBT Society of Reproductive Biologists and Technologists SREI Society for Reproductive Endocrinology and Infertility SRS Society of Reproductive Surgeons

ROOM NUMBERS OF

PANTONE 200

Professional Groups ARM Association of Reproductive Managers LPG Legal Professional Group MHPG Mental Health Professional Group NPG Nurses’ Professional Group

SESSIONS ARE LISTED IN THE MEETING APP, THE FOLD-OUT SCHEDULE-AT-A-GLANCE,

Special Interest Groups AESIG Androgen Excess Special Interest Group ChSIG Chinese Special Interest Group CSIG Contraception Special Interest Group EndoSIG Endometriosis Special Interest Group EPSIG Early Pregnancy Special Interest Group ERSIG Environment and Reproduction Special Interest Group FPSIG Fertility Preservation Special Interest Group FSIG Fibroids Special Interest Group GCSIG Genetic Counseling Special Interest Group HDSIG Health Disparities Special Interest Group IRMSIG Imaging in Reproductive Medicine SIG MSIG Menopause Special Interest Group NutriSIG Nutrition Special Interest Group PAGSIG Pediatric and Adolescent Gynecology Special Interest Group PGDSIG Preimplantation Genetic Diagnosis Special Interest Group RISIG Reproductive Immunology Special Interest Group RMSCBSIG Regenerative Medicine and Stem Cell Special Interest Group TSIG Turkish Special Interest Group WC Women’s Council Partner Groups ALMER AMMR ASPIRE CSRM ESHRE MEFS SSR

Latin American Association for Reproductive Medicine Mexican Association of Reproductive Medicine Asia Pacific Initiative in Reproduction Chinese Society of Reproductive Medicine European Society of Human Reproduction and Embryology Middle East Fertility Society Society for the Study of Reproduction

ASRM 2014 Annual Meeting

32

AND ON SIGNAGE THROUGHOUT THE CONVENTION CENTER

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM 2014 SCIENTIFIC PROGRAM DAILY SCHEDULE SATURDAY, OCTOBER 18, 2014

SUNDAY, OCTOBER 19, 2014

NONCME

NONCME

5:15 pm - 6:00 pm * Members’ Meetings Nutrition Special Interest Group Nurses’ Professional Group Preimplantation Genetic Diagnosis Special Interest Group (5:00 pm - 6:15 pm)

NONCME

6:30 PM * Opening Ceremony and Opening Reception

NONCME

7:00 am - 12:00 pm * Poster Set-up

NONCME

8:00 am - 8:45 am * Members’ Meetings Androgen Excess Special Interest Group Complementary and Alternative Medicine Special Interest Group Chinese Special Interest Group Health Disparities Special Interest Group Reproductive Immunology Special Interest Group Indian Group Society for Assisted Reproductive Technology

NONCME

8:00 am - 12:00 pm * PG24 Simulation and Hands-On Intensive Jeffrey M. Goldberg, M.D. (Chair) Cleveland Clinic Ceana Nezhat, M.D. Nezhat Medical Center Keith B. Isaacson, M.D. Harvard Medical School Grace M. Janik, M.D. Reproductive Specialty Center 9:00 am - 9:45 am * Plenary 1 President’s Guest Lecture: Don’t Wipe Out! Riding the Wave of Health Reform Endowed by a 1987 grant from Ortho Women’s Health Rebecca Z. Sokol, M.D. M.P.H. (Introducer) Richard H. Reindollar, M.D. (Introducer) Robert M. Wah, M.D. American Medical Association

CE

10:30 am – 11:15 am * Break/Exhibits

NONCME

CE

ARS

11:15 am - 1:00 pm * Oral Abstracts Scientific Program Prize Paper Session

NONCME

CE

ARS

ARS

11:15 am - 1:00 pm * Telesurgery Surgery Day Telesurgery: Laparoscopic Myomectomy and Tissue Removal Techniques CE ARS Steven F. Palter, M.D. (Introducer) Jon I. Einarsson, M.D., M.P.H. 11:15 am - 1:00 pm * Workshop ARS Contraception Day Workshop: Demography of Contraceptive Use, Unintended Pregnancy, and ARS CE Abortion Supported by an educational grant from Merck Lawrence B. Finer, Ph.D. Guttmacher Institute CE

CE ARS CME 11:15 am - 1:00 pm * Symposium MHPG Symposium - How Far is too Far? The Medical, Embryological, Psychological, and Legal Aspects of Sex Selection. Just Because We Can Claudia Pascale, Ph.D. (Chair) Institute for Reproductive Medicine & Science Serena H. Chen, M.D. Institute for Reproductive Medicine & Science Jacques Cohen, Ph.D. A.R.T. Institute of Washington, Inc. Melissa B. Brisman, J.D. Private Practice, Montvale, NJ NON-

CE ARS CME 11:15 am - 1:00 pm * Symposium NPG in Collaboration with the LPG Symposium - Egg Cryopreservation and Banking—Where Are We Going and What Do We Need to Know? Susan L. Crockin, J.D. (Chair) Crockin Law & Policy Group, Georgetown University Law Center Andrea M. Braverman, Ph.D Thomas Jefferson University Lindsay E. Canning, R.N., M.S.N. Seattle Reproductive Medicine NON-

33

h re a

health affects reproduction affects health

MONDAY

MONDAY, OCTOBER 20, 2014

9:45 am - 10:30 am * Plenary 2 ARS Bruce Stewart Memorial Lecture: CE AUA Klinefelter Syndrome: From Mice to Men Supported by a grant from the American Urological Association Paul J. Turek, M.D. (Introducer) Ronald S. Swerdloff, M.D. Harbor-UCLA Medical Center CE ARS

SUNDAY

12:00 pm - 5:00 pm * Poster Set-up

ASRM

SATURDAY

5:15 pm - 6:00 pm * Members’ Meetings Association for Reproductive Managers Mental Health Professionals Group

A

ASRM 2014 Annual Meeting

PANTONE 200

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM2014 SCIENTIFIC PROGRAM DAILY SCHEDULE ASRM ASRM health affects reproduction affects health

health affects reproduction affects health

11:15 am - 1:00 pm * Symposium ARM Symposium - Maximizing the Physician’s Schedule and Revenue by Bringing Surgery and Diagnostic Procedures In-house Faith E. Ripley, B.S. (Chair) Piedmont Reproductive Endocrinology Group PA John E. Nichols, M.D. Piedmont Reproductive Endocrinology Group PA

MONDAY

PANTONE 200

1:15 pm - 2:15 pm * Interactive Session Contraception Day: CSIG and HDSIG Interactive Session Contraceptive Strategies for Disadvantaged Women Supported by an educational grant from Merck Alternate Panel (Letterman) Alicia Y. Armstrong, M.D., M.H.S.C.R. (Chair) National Institutes of Health Bliss Kaneshiro, M.D., M.P.H. University of Hawaii David F. Archer, M.D. Eastern Virginia Medical School Tessa Madden, M.D., M.P.H. Washington University School of Medicine

1:15 pm - 2:15 pm * Interactive Session Reproductive Abnormalities: How to Optimize Future Fertility Case Presentations Staci E. Pollack, M.D. (Chair) Montefiore’s Institute for Reproductive Medicine and Health Samantha M. Pfeifer, M.D. Weill Cornell Medical College Beth W. Rackow, M.D. Columbia University Medical Center 1:15 pm - 2:15 pm * Interactive Session Meet the Professor Meet the Professor Ronald S. Swerdloff, M.D. Harbor-UCLA Medical Center

1:15 pm - 2:15 pm * Interactive Session Update from WHO/UNEP-Endocrine -disrupting Chemicals 2012 Roving Microphone Sheryl Ziemin Vanderpoel, Ph.D. World Health Organization 1:15 pm - 2:15 pm * Interactive Session Dilemmas in the Care of Polycystic Ovary Syndrome Patients Roving Microphone Kathleen M. Hoeger, M.D., M.P.H. (Chair) University of Rochester Medical Center Anuja Dokras, M.D., Ph.D. University of Pennsylvania Helena Teede, M.B.B.S, Ph.D. Monash Centre for Health Research and Implementation, Monash University 1:15 pm - 2:15 pm * Interactive Session Best Practices to Prevent Serious Laboratory Errors Panel Discussion of Cases Anthony R. Anderson, M.S. (Chair) Reproductive Medicine Associates of Texas, PA Richard T. Scott, M.D. Reproductive Medicine Associates of New Jersey Marius Meintjes, Ph.D. Frisco Institute for Reproductive Medicine

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm * Interactive Session Use of Aromatase Inhibitors in Endometriosis and Ovulation Induction Panel Discussion Richard S. Legro, M.D. (Chair) Pennsylvania State University Michael P. Diamond, M.D. Georgia Regents University Serdar E. Bulun, M.D. Northwestern University

2:45 pm - 3:30 pm * Plenary 3 SRS Surgery Day Lecture: Uterine Transplantation Endowed by a 1999 grant from Ethicon Endo-Surgery, Inc. Jeffrey M. Goldberg, M.D. (Introducer) Mats Brännström, M.D. University of Gothenburg 2:45 pm - 3:30 pm * Keynote Contraception Day Keynote: The Future of Female and Male Contraceptive and the NIH’s Role in the Development of New Contraceptive Methods Supported by an educational grant from Merck Bliss Kaneshiro, M.D., M.P.H. (Introducer) Diana Blithe, Ph.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health 3:30 pm – 3:45 pm * Break/Exhibits

34

NONCME

CE

ARS

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM 2014 SCIENTIFIC PROGRAM DAILY SCHEDULE 4:15 pm - 6:15 pm * Oral Abstracts • REI Fellows Research I • SMRU Traveling Scholars • Endometriosis I • Contraception • Mental Health • ART Outcome Predictors - Clinical I • Embryo Biology • Ovarian Stimulation - ART I • Preimplantation Genetic Diagnosis I • Polycystic Ovary Syndrome • ART - In Vitro Fertilization • Fertility Preservation I • Clinical Female Infertility I

NONCME

CE ARS CME 4:15 pm - 6:15 pm * Symposium Howard and Georgeanna Jones Symposium: A New Paradigm for IVF: Reducing the Burden of Care Endowed by a 2010 educational grant from EMD Serono, Inc. Richard T. Scott, M.D. (Chair) Reproductive Medicine Associates of New Jersey Alexander M Dlugi, M.D., M.B.A. Optum Kevin J. Doody, M.D. Center for Assisted Reproduction, Texas NON-

4:15 pm - 6:15 pm * Symposium ESHRE Symposium - Health of Children Following ART Juha S. Tapanainen M.D., Ph.D. (Chair) Helsinki University Tom Tanbo, M.D., Ph.D. Oslo University Hospital Anja Pinborg, M.D. Copenhagen University Hospital Rebecca C. Painter, M.D., Ph.D. Academic Medical Centre, University of Amsterdam

ARS pm - 6:15 pm * Symposium CE ARS 4:15 AMMR Symposium - ¿Cuál es el mejor manejo de la paciente con endometriosis para mejorar la fertilidad? Alfonso Orta-García, M.D. (Chair) Mexican Association for Reproductive Medicine J. Ricardo Loret de Mola, M.D. Southern Illinois University Ranferi Gaona-Arreola, M.D. Specialized Center of Sterility and Human Reproduction, Mexico Carlos Salazar-López Ortiz, M.D. Hospital Español de Mexico Victor Saúl Vital Reyes, M.D., Ph.D. Hospital de Ginecobstetricia NONCME

CE ARS CME 4:15 pm - 6:15 pm * Symposium Oncofertility I - Male Supported by an educational grant from Ferring Pharmaceuticals, Inc. Robert E. Brannigan, M.D. (Chair) Northwestern University Feinberg School of Medicine John P. Mulhall, M.D. Memorial Sloan Kettering Cancer Center James F. Smith, M.D., M.S. UC San Francisco

ASRM

PANTONE 200

NON-

CE ARS CME 4:15 pm - 6:15 pm * Symposium Randomized Clinical Trials in Reproduction: What Have We Learned from Different Parts of the World? Richard S. Legro, M.D. (Chair) Pennsylvania State University Siladitya Bhattacharya, M.D. University of Aberdeen Cynthia Farquhar, M.D., M.P.H. The New Zealand Branch of the Australasian Cochrane Centre Xiaoke Wu, M.D., Ph.D. Heilongjiang University of Chinese Medicine NON-

CE ARS CME 5:15 pm - 5:45 pm * Minisymposium SMRU Minisymposum - Space, the Final Frontier: Impact of Space Flight and Zero Gravity on Male and Female Reproductive Health Joseph S. Tash, Ph.D. University of Kansas Medical Center NON-

CME 6:15 pm - 7:00 pm * Members’ Meetings Contraception Special Interest Group Endometriosis Special Interest Group Environment and Reproduction Special Interest Group Fertility Preservation Special Interest Group Genetic Counseling Special Interest Group

NON-

35

h re a

health affects reproduction affects health

MONDAY

4:15 pm - 6:15 pm * Symposium SRS Symposium: How to Detect, Characterize, and Treat Uterine Fibroids James H. Segars, M.D. (Chair) National Institute of Child Health and Human Development Elizabeth A. Stewart, M.D. Mayo Clinic Assisted Reproductive Technologies Bala Bhagavath, M.D. University of Rochester Medical Center-Strong Memorial Hospital

CE

A

CE

ARS

ASRM 2014 Annual Meeting

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM2014 SCIENTIFIC PROGRAM DAILY SCHEDULE ASRM ASRM health affects reproduction affects health

health affects reproduction affects health

Imaging in Reproductive Medicine Special Interest Group Pediatric and Adolescent Gynecology Special Interest Group Regenerative Medicine and Stem Cell Biology Special Interest Group Turkish Special Interest Group Legal Professionals Group The Society of Reproductive Surgeons The Society of Reproductive Biologists & Technologists PANTONE 200

TUESDAY, OCTOBER 21, 2014 6:45 am - 8:45 am * Women’s Council Breakfast

TUESDAY

MONDAY

7:00 am - 8:45 am * Posters Poster Abstract Session

NONCME

NONCME

CME Tuesday, October 21, 2014 7:00 am - 8:45 am * Workshop Pediatric and Adolescent Gynecology – Tools to Teach Your Residents Carol Wheeler, M.D. (Chair) Warren Alpert Medical School of Brown University

NON-

9:00 am- 9:45 am * Plenary 4 Camran Nezhat, M.D. Lectureship in Innovations in Medicine: Reproductive Disorders—What We Have Learned from Mutations in Steroidogenesis 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. Richard J. Paulson, M.D. (Introducer) J. Larry Jameson, M.D., Ph.D. University of Pennsylvania 9:45 am - 10:30 am * Plenary 5 Bariatric Surgery: It’s Not What You Think It Is. Molecular Targets for the Beneficial Effects of Surgery on Obesity and Diabetes Endowed by a 1990 grant from Astra-Zeneca Owen K. Davis, M.D. (Introducer) Randy J. Seeley, Ph.D. University of Cincinnati

ASRM 2014 Annual Meeting

36

10:30 am – 11:15 am * Break/Exhibits

NONCME

CE

ARS

11:15 am - 1:00 pm * Oral Abstracts Scientific Program Prize Paper Session

NONCME

CE

ARS

11:15 am - 1:00 pm * Video Session ASRM Video Session 1 11:15 pm - 1:15 pm * Symposium ABOG Foundation - Kenneth J. Ryan Ethics Symposium: Incidental Findings in the Era of Whole Genome Sequencing Supported by a 2013 endowment from the American Board of Obstetrics and Gynecology Paula Amato, M.D. (Chair) CE ARS Oregon Health & Science University Laurence B. McCullough, Ph.D. Baylor College of Medicine ARS CE John J. Hutton, M.D. University of Cincinnati College of Medicine CE

ARS

NONCE ARS CME 11:15 am - 1:00 pm * Symposium MHPG Symposium -Blurring the Line Between Life and Death: The Psychological and Ethical Issues of Posthumous Reproduction Angela K. Lawson, Ph.D. (Chair) Northwestern University Julianne E. Zweifel, Ph.D. University of Wisconsin Nidhi Desai, J.D. Private Practice, Illinois

11:15 am - 1:00 pm * Symposium NPG Symposium - PCOS and the Multidisciplinary Team Approach Catherine M. Bergh, M.S.N. (Chair) Reproductive Medicine Associates of New Jersey Heather Huddleston, M.D. University of California San Francisco Lauri A. Pasch, Ph.D. University of California San Francisco 11:15 am - 1:00 pm * Symposium ARM Symposium - Strategic Planning and Implementing - Human Resources Joseph J. Travia, M.B.A. (Chair) Center for Reproductive Medicine Paul A. Verrastro, M.B.A. Center for Advanced Reproductive Services CE CME 1:15 pm - 2:15 pm * Interactive Session Menopause Day Interactive Session - Tailoring Management Strategies to Patient Needs: A NON-

ARS

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM 2014 SCIENTIFIC PROGRAM DAILY SCHEDULE Case-based Interactive Discussion on Common Concerns (Wellness, Breast, and Bones) Supported by an educational grant from Shionogi, Inc. Case Presentations Genevieve Neal-Perry, M.D., Ph.D. (Chair) Albert Einstein College of Medicine Cynthia A. Stuenkel, M.D. University of California, San Diego Hugh S. Taylor, M.D. Yale University Lubna Pal, M.B.B.S., M.Sc. Yale University CE ARS CME 1:15 pm - 2:15 pm * Interactive Session Did You Know That WHO— A UN Agency—Is Committed to Global Reproductive Health for all Individuals? Roving Microphone Sheryl Ziemin Vanderpoel, Ph.D. (Chair) World Health Organization NON-

NON-

1:15 pm - 2:15 pm * Interactive Session Aggressive or Delayed Management of the Klinefelter Adolescent: What Do the Data Show? An Interactive Debate Debate Peter N. Schlegel, M.D. (Chair) Weill Cornell Medical College Darius A. Paduch, M.D. Weill Cornell Medical College Robert D. Oates, M.D. Boston Medical Center 1:15 pm - 2:15 pm * Interactive Session Uterine Fibroids—Which Treatment for Which Patients? Roving Microphone Shannon Laughlin-Tommaso, M.D. (Chair)

ASRM

Mayo Clinic Maureen Kohi, M.D. University of California, San Francisco

PANTONE 200

1:15 pm - 2:15 pm * Interactive Session Varicocele—If and When to Treat Alternate Panel (Letterman) James H. Segars, M.D. (Chair) National Institute of Child Health and Human Development Daniel H. Williams, M.D. University of Wisconsin School of Medicine and Public Health, Madison Edward D. Kim, M.D. University of Tennessee Graduate School of Medicine Margareta Pisarska, M.D. Cedars Sinai Medical Center, Los Angeles 1:15 pm - 2:15 pm * Interactive Session Preimplantation Genetic Diagnosis—The Near Future Alternate Panel (Letterman) Santiago Munné, Ph.D. (Chair) Reprogenetics Dagan Wells, Ph.D. Reprogenetics Russell Durrett Recombine Moses Cesario, M.S. Previvo Genetics 1:15 pm - 2:15 pm * Interactive Session Mayo Preconception Risk Stratification for ART and Fertility Care Charles C. Coddington, M.D. (Chair) Mayo Clinic Kristi S. Borowski, M.D. Mayo Clinic 1:15 pm - 2:15 pm * Interactive Session Meet the Professor Meet the Professor Randy J. Seeley, Ph.D. (Chair) University of Cincinnati 2:45 pm - 3:30 pm * Plenary 6 Systems Biology of Endometriosis Endowed by a 1992 grant from EMD Serono, Inc. Linda C. Giudice, M.D., Ph.D. (Introducer) Linda G. Griffith, Ph.D. Massachusetts Institute of Technology

37

h re a

health affects reproduction affects health

TUESDAY

CE ARS CME 1:15 pm - 2:15 pm * Interactive Session Recurrent Pregnancy Loss and Preimplantation Genetic Screening Errors Case Presentations with ARS William E. Roudebush, Ph.D. (Chair) University of South Carolina School of Medicine, Greenville Creighton E. Likes, III, M.D., M.S. Fertility Center of the Carolinas Dennis Peffley, J.D., Ph.D. University of South Carolina School of Medicine Greenville David J. Wininger, Ph.D. Premier Fertility Center

A

ASRM 2014 Annual Meeting

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM2014 SCIENTIFIC PROGRAM DAILY SCHEDULE ASRM ASRM health affects reproduction affects health

health affects reproduction affects health

2:45 pm - 3:30 pm * Keynote Menopause Day Keynote -The Evolving Role of SERMs in Menopausal Women’s Health Supported by an educational grant from Shionogi, Inc. Melissa Wellons, M.D. (Introducer) (Chair) Vanderbilt University Medical Center Cynthia A. Stuenkel, M.D. University of California, San Diego

TUESDAY

PANTONE 200

3:30 pm – 3:45 pm * Break/Exhibits

NONCME

4:15 pm - 6:15 pm * Oral Abstracts • REI Fellows Research II • Menopause • Male Reproduction and Urology – Clinical • Endometriosis II • Cancer • Early Pregnancy I • Other: ART - Clinical I • ART Outcome Predictors - Clinical II • ART Outcome Predictors - Lab I • Ovarian Stimulation - Poor Responders • Male Factor I • Reproductive Biology - Research • Reproductive Surgery

NONCME

4:15 pm - 6:15 pm * Symposium ALMER Symposium: PCOS from a Worldwide Perspective J. Ricardo Loret de Mola, M.D. (Chair) Southern Illinois University ARS CE Marcelo Barrionuevo, M.D. IVF FLORIDA Reproductive Associates ARS CE Richard Legro, M.D. Pennsylvania State University Carlos Moran, M.D. Mexican Institute of Social Security Teresa Sir-Petermann, M.D. University of Chile CE CME 4:15 pm - 6:15 pm * Symposium Oncofertility II - Female Supported by an educational grant from Ferring Pharmaceuticals, Inc. Mitchell P. Rosen, M.D. (Chair) University of California San Francisco Center for Reproductive Health Kutluk Oktay, M.D. New York Medical College Richard A. Anderson, M.D., Ph.D. University of Edinburgh Janine Mash, M.S. UCSF Center for Reproductive Health NON-

4:15 pm - 6:15 pm * Video Session ASRM Video Session 2 4:15 pm - 6:15 pm * Symposium KY Cha Symposium in Stem Cell Technology and Regenerative Medicine: Endometrial Stem Cells: From Reproductive Biology to Regenerative Medicine Supported by the Asia-Pacific Biomedical Research Foundation Hugh S. Taylor, M.D. (Chair) Yale University School of Medicine Kyle E. Orwig, Ph.D. University of Pittsburgh Allan C. Spradling, Ph.D. Carnegie Institution of Washington 4:15 pm - 6:15 pm * Symposium CSRM Symposium: The Interaction Between Traditional Chinese Medicine and Western Medicine Jie Qiao, M.D., Ph.D. (Chair) Peking University Third Hospital Zi-Jiang Chen, M.D. Shandong University Dongzi Yang, M.D.

ASRM 2014 Annual Meeting

Sun Yat-Sen Memorial Hospital Xuehong Zhang, M.D. Lanzhou University Xiaoke Wu, M.D., Ph.D. Heilongjiang University of Chinese Medicine

38

ARS

NONCE ARS CME 4:15 pm - 6:15 pm * Symposium Gamete Reserve I - Testis Supported by an educational grant from Ferring Pharmaceuticals, Inc. Stefan Schlatt, Ph.D. (Chair) Institute of Reproductive Medicine and Andrology, University of Münster Daniel H. Williams, M.D. University of Wisconsin Cigdem Tanrikut, M.D. Massachusetts General Hospital Richard Chaillet, M.D., Ph.D. University of Pittsburgh

5:15 pm - 5:45 pm * Minisymposium SMRU Minisymposum - Gateways to Success: The Sperm’s Perspective for Finding and Penetrating the Egg David F. Albertini, Ph.D. University of Kansas Medical Center

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM 2014 SCIENTIFIC PROGRAM DAILY SCHEDULE 6:15 pm - 7:00 pm * Members’ Meetings Early Pregnancy Special Interest Group Fibroids Special Interest Group Menopause Special Interest Group Society for Male Reproduction and Urology Society for Reproductive Endocrinology and Infertility Physicians-Scientists Group

NONCME

CE

WEDNESDAY, OCTOBER 22, 2014

10:00 am - 10:30 am * ASRM Members’ Meeting Award Cermony and ASRM Members’ Meeting

NONCME

10:30 am – 11:15 am * Break/Exhibits

NONCME

11:15 am - 1:00 pm * Symposium ARM Symposium - The Patient-Team Approach ARS Duran, B.A. (Chair) CE Lisa RMA of New York, LLP Brad Senstra, M.H.A. Seattle Reproductive Medicine CE

PANTONE 200

ARS

CE ARS CME 1:15 pm - 2:15 pm * Interactive Session CE ARS Recurrent Pregnancy Loss: One Should Evaluate for Chronic Endometritis Debate Danny J. Schust, M.D. (Chair) University of Missouri Mary D. Stephenson, M.D., M.Sc. University of Illinois at Chicago Steven L. Young, M.D. University of North Carolina School of Medicine NON-

CE CME 11:15 am - 1:00 pm * Symposium MHPG Symposium -Controversies and Cutting Edge in Third-party ART: Helping HIV Positive and NON-

ARS

1:00 pm - 2:00 pm * Members’ Meetings Alternative Family Building Group 39

NONCME

WEDNESDAY

11:15 am - 1:00 pm * Video Session AAGL Film Festival Video Session

1:15 pm - 2:15 pm * Interactive Session Predictive Value of Hormonal and Genetic Assays in the Evaluation of the Infertile Male Alternate Panel (Letterman) Ajay K. Nangia, M.D. (Chair) University of Kansas Hospital and Medical Center Craig S. Niederberger, M.D University of Illinois Jay Sandlow, M.D. Medical College of Wisconsin

TUESDAY

11:15 am - 1:00 pm * Oral Abstracts • Special Research Presentations • Genetic Counseling • Endometriosis III • Early Pregnancy II • Other: ART - Clinical II • ART Outcome Predictors - Lab II • Leiomyoma • Environment and Reproduction • Ovarian Function • Preimplantation Genetic Diagnosis II • Male Factor II • Sperm Biology • Cryopreservation and Frozen Embryo Transfer I • Stem Cells NONCME

h re a

health affects reproduction affects health

11:15 am - 1:00 pm * Symposium NPG ARS Symposium - Freeze All Cycles—Eggs and Embryos Carolyn Collins, B.S.N., R.N. (Chair) Reproductive Medicine Associates on New Jersey G. David Ball, Ph.D. Seattle Reproductive Medicine Wen-Hui Shen, M.D., Ph.D. Kaiser Permanente Center for Reproductive Health

CE

9:00 am - 9:45 am * Plenary 7 Herbert H. Thomas Lecture: Preconception, Preimplantation, and Prenatal Genomic Medicine Endowed by a 1990 grant from TAP Pharmaceutical Lawrence C. Layman, M.D. (Introducer) David H. Ledbetter, Ph.D. Geisinger Health System

ASRM

ARS Serodiscordant Couples Become Pregnant Kim Bergman, Ph.D (Chair) Growing Generations Bradford A. Kolb, M.D. HRC Fertility - Pasadena Daniel Bowers, M.D. Callen-Lorde Community Health Center Richard B.Vaughn, J.D. International Fertility Law Group

NONCME

7:00 am - 8:45 am * Posters

A

CE

ARS

ASRM 2014 Annual Meeting

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM2014 SCIENTIFIC PROGRAM DAILY SCHEDULE ASRM ASRM health affects reproduction affects health

health affects reproduction affects health

CME 1:15 pm - 2:15 pm * Interactive Session How to Deal with Poor Responders? Case Presentations with ARS Suheil J. Muasher, M.D. (Chair) Duke University Rony T. Elias, M.D. Weill Cornell Medical College

NON-

CE

ARS

PANTONE 200

1:15 pm - 2:15 pm * Interactive Session Is Oocyte Cryopreservation Preferable to Ovarian Tissue Freezing for Fertility Preservation? Supported by an educational grant from Ferring Pharmaceuticals, Inc. Debate Samantha M. Pfeifer, M.D. (Chair) Weill Medical College of Cornell University Nicole L. Noyes, M.D. New York University School of Medicine Kutluk Oktay, M.D. New York Medical College CE ARS CME 1:15 pm - 2:15 pm * Interactive Session Early Pregnancy Monitoring—Pregnancy of Unknown Location vs. Ectopic Pregnancy vs. Intrauterine Pregnancy Case Presentations with ARS Todd D. Deutch, M.D. (Chair) Advanced Reproductive Center Laura Detti, M.D. University of Tennessee Memphis Elizabeth E. Puscheck, M.D., M.S. Wayne State University School Of Medicine Ilan Tur-Kaspa, M.D. Institute for Human Reproduction (IHR)

WEDNESDAY

NON-

1:15 pm - 2:15 pm * Interactive Session Immunotropic vs. Immune-suppressive Treatment to Enhance Implantation Debate Joanne Kwak-Kim, M.D., M.P.H. (Chair) The Chicago Medical School at Rosalind Franklin University of Medicine and Science Zev Williams, M.D. Ph.D. Albert Einstein College of Medicine George Ndukwe, M.D. Zita West Fertility Center, London 2:45 pm - 3:30 pm * Plenary 8 Sperm Cell Biology: Revelations on the Road to Conception Endowed by a 1992 grant from Wyeth

ASRM 2014 Annual Meeting

40

Rebecca Z. Sokol, M.D. M.P.H. (Introducer) R. John Aitken, Sc.D. University of Newcastle 2:45 pm - 3:30 pm * Plenary 9 SSR Exchange Lecture: Colony Stimulating Factor 2: Example of a Maternal Embryokine that Programs the Mammalian Embryo for Pregnancy Success Dolores J. Lamb, Ph.D. (Introducer) Peter J. Hansen, Ph.D. University of Florida NONCME

CE

ARS

CME 3:45 pm - 5:45 pm * Oral Abstracts • Nursing/Sexuality • Male Reproduction and Urology - Research • Other: ART - Clinical III • Ovarian Reserve • Oocyte Biology • Ovarian Stimulation - ART II • Cryopreservation and Frozen Embryo Transfer II • Fertility Preservation II • Reproductive Biology - Laboratory • Clinical Female Infertility II • Procedures and Techniques - ART • Reproductive Biology - Human • Androgen Excess

CE

ARS

3:30 pm – 3:45 pm * Break/Exhibits

NON-

CME 3:45 pm - 5:45 pm * Symposium CE MEFS Symposium: Complete Prevention of OHSS— Is It Possible? Botros R.M.B. Rizk, M.D. (Chair) University of South Alabama William E. Gibbons, M.D. Baylor Family Fertility Program NON-

ARS

Room numbers of sessions are listed in the meeting app, the fold-out Schedule-at-a-Glance, and on signage throughout the convention center

ASRM 2014 SCIENTIFIC PROGRAM DAILY SCHEDULE

A ASRM

3:45 pm - 5:45 pm * Symposium CE ARS ISAR Symposium: Third-party Reproduction Narendra Malhotra, M.D. (Chair) Global Rainbow Healthcare Jaideep Malhotra, M.D. Indian College of Obsetrics and Gynecology Manish R. Banker, M.D. Nova IVI Fertility Duru S. Shah, M.D. Gynaecworld- The Center for Women’s Health & Fertility

health affects reproduction affects health

NONCME

PANTONE 200

3:45 pm - 5:45 pm * Symposium Gamete Reserve II - Ovary Supported by an educational grant from Ferring Pharmaceuticals, Inc. Marcelle I. Cedars, M.D. (Chair) University of California San Francisco Center for Reproductive Health Aleksander Rajkovic, M.D. University of Pittsburgh David B. Seifer M.D. Genesis Fertility & Reproductive Medicine NON-

ARS

WEDNESDAY

CE CME 3:45 pm - 5:45 pm * Symposium How to Choose the Best Embryo - Proteomic, Metabolomic, Genomic, Imaging Tien-cheng Arthur Chang, Ph.D. (Chair) University of Texas Health Science Center at San Antonio Wayne A. Caswell, M.S. Fertility Centers of New England Mandy Katz-Jaffe, Ph.D. Colorado Center for Reproductive Medicine Nathan R. Treff, Ph.D. Reproductive Medicine Associates of New Jersey

h re a

5:15 pm - 5:45 pm * Minisymposium SMRU Minisymposum - How to Counsel the Infertile Man—An Under-recognized Mental Health Issue William D. Petok, Ph.D. Private Practice, Baltimore

41

ASRM 2014 Annual Meeting

ASRM ASRM

health affects reproduction affects health

health affects reproduction affects health

PANTONE 200

BE SURE TO VISIT THE EXHIBIT HALL

Monday, October 20 . . . . . . . . . . . . . . . . . 9:00 am - 5:00 pm Tuesday, October 21. . . . . . . . . . . . . . . . . . 9:00 am - 5:00 pm Wednesday, October 22 . . . . . . . . . . . . . . . . . 9:00 am - noon

For the safety of your child and in order to maintain the scientific nature of the display, no children under the age of 16 (except infants under 6 months of age carried in arms at all times) will be allowed in the Exhibit Hall.

Strollers and infants in backpacks are not permitted in the Exhibit Hall or Poster Hall at anytime. CERTIFICATE OF ATTENDANCE Proof of attendance is available on request from J. Spargo at the registration desk. Continuing Education Credit information is located in the front of the Postgraduate Course syllabi, in the Final Program and online. ADMISSION BADGES Name badges will be issued for the Postgraduate and Scientific Programs and are required for admission. Spouse/guest badges will be issued and are required for admission to spouse/guest activities and the Exhibit Hall. PHOTO/AUDIO/VIDEO RECORDING Photographing or audio/video recording of any session for personal or commercial purposes without permission is prohibited.

Morning Poster Sessions Poster Sessions will be held on Tuesday and Wednesday mornings from 7:00 a.m. until 8:45 a.m. Complimentary continental breakfast will be available. No reservations are required.

ASRM 2014 Annual Meeting

42

A

ASRM gratefully acknowledges the educational support for the 2014 Scientific Program provided by the following companies:

ASRM health affects reproduction affects health

Ferring Pharmaceuticals, Inc. Merck Pfizer Shionogi, Inc.

ASRM gratefully acknowledges the “in-kind” support for the 2014 Postgraduate Program provided by the following companies: BioDiseño Cryoport GE Healthcare Hologic Irvine Scientific Karl Storz Endoscopy LifeGlobal/IVF Online Origio, Inc. Nikon Repro-Support Medical Research Institute Richard Wolf Vitrolife 43

h r a

ASRM 2014 Annual Meeting

PANTONE 200

ASRM ASRM

health health affects affects reproduction reproduction affects affects health health

health health affects affects reproduction reproduction affects affects health health

PANTONE PANTONE 200 200

SURGERY DAY MONDAY, OCTOBER 20, 2014

11:15 am - 1:00 pm * Telesurgery Surgery Day Telesurgery: Laparoscopic Myomectomy and Tissue Removal Techniques Jon I. Einarsson, M.D., M.P.H. Brigham and Women’s Hospital 1:15 pm – 2:15 pm * Surgery Day Roundtables

NONCME

CE

ARS

Fertility Preservation in Adolescents with Klinefelter Syndrome Paul J. Turek, M.D. Turek Clinic Fibroid Morcellation and Cancer Risk - Must We Now Change Practice? Bala Bhagavath, M.D. University of Rochester Medical Center MicroTese Testicular Sperm Retrieval Peter N. Schlegel, M.D. Weill Cornell Medical College 2:45 pm - 3:30 pm * Plenary 3 Society of Reproductive Surgeons Lecture: Uterine Transplantation Mats Brännström, M.D. University of Gothenburg 4:15 p.m. - 6:15 p.m. * Symposium SRS Symposium: How to Detect, Characterize, and Treat Uterine Fibroids James H. Segars, M.D. (Chair) National Institute of Child Health and Human Development Elizabeth Stewart, M.D. Mayo Clinic Assisted Reproductive Technologies

Bala Bhagavath, M.D. University of Rochester Medical Center

ASRM 2014 Annual Meeting

44

A ASRM

h re r a

health affects reproduction affects health

PANTONE 200

CONTRACEPTION DAY MONDAY, OCTOBER 20, 2014

Supported by an educational grant from Merck 11:15 am - 1:00 pm * Workshop Contraception Day Workshop: Demography of Unintended Pregnancy, Contraception and Abortion

Lawrence B. Finer, Ph.D. Guttmacher Institute

1:15 pm – 2:15 pm * Interactive Session (Alternate Panel - Letterman) Contraception Day: CSIG and HDSIG Interactive Session - Contraceptive Strategies for Disadvantaged Women

Alicia Y. Armstrong, M.D., M.H.S.C.R. (Chair) National Institutes of Health Bliss Kaneshiro, M.D., M.P.H. University of Hawaii David F. Archer, M.D. Eastern Virginia Medical School Tessa Madden, M.D., M.P.H. Washington University School of Medicine

1:15 pm – 2:15 pm * Contraception Day Roundtables

NONCME

CE

ARS

Cultural Considerations in Contraceptive Provision

Reni Soon, M.D., M.P.H. University of Hawaii

Hormonal Contraception Use in Overweight and Obese Women

Thomas D. Kimble, M.D. Eastern Virginia Medical School

2:45 pm - 3:30 pm * Contraception Day Keynote Lecture The Future of Female and Male Contraceptive and the NIH’s Role in the Development of New Contraceptive Methods

Diana Blithe, Ph.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development

45

ASRM 2014 Annual Meeting

ASRM ASRM

health affects affects health reproduction reproduction affects health health affects

health affects affects health reproduction reproduction affects health health affects

PANTONE 200 200 PANTONE

ASRM 2014 SURGERY DAY MENOPAUSE DAY TUESDAY, OCTOBER 21, 2014

Supported by an educational grant from Shionogi, Inc. CE ARS CME 1:15 pm – 2:15 pm * Interactive Session (Case Presentation) Menopause Day Interactive Session - Tailoring Management Strategies to Patient Needs: A Case-based Interactive Discussion on Common Concerns (Wellness, Breast, and Bones) Genevieve Neal-Perry, M.D., Ph.D. (Chair) Einstein College of Medicine Cynthia A. Stuenkel, M.D. University of California, San Diego Hugh S. Taylor, M.D. Yale University School of Medicine Lubna Pal, M.B.B.S., M.Sc. Yale University NON-

1:15 pm – 2:15 pm * Menopause Day Roundtable CME CE Wellness for the Modern Postmenopausal Woman Staci E. Pollack, M.D. Montefiore’s Institute for Reproductive Medicine & Health NON-

ARS

2:45 pm - 3:30 pm * Keynote Lecture Menopause Day Keynote Lecture: The Evolving Role of SERMs in Menopausal Women’s Health Cynthia A. Stuenkel, M.D. University of California, San Diego

ASRM 2014 Annual Meeting

46

SCIENTIFIC PROGRAM • PLENARY SESSIONS

A ASRM

h r a

health affects reproduction affects health

Monday, October 20, 2014

9:00 am - 9:45 am

Plenary 1 President’s Guest Lecture: Don’t Wipe Out! Riding the Wave of Health Reform Endowed by a 1987 grant from Ortho Women’s Health

PANTONE 200

Learning Objectives: 1. Discuss the changes coming in health care due to the Affordable Care Act and other regulations at national and state levels. 2. Describe the efforts that are being made to improve the Affordable Care Act for patients and their physicians.

Rebecca Z. Sokol, M.D., M.P.H. (Introducer) Richard H. Reindollar, M.D. (Introducer) Robert M. Wah, M.D. American Medical Association

ACGME Competency Systems-based Practice

Needs Assessment and Description The Affordable Care Act (ACA) has some of its largest impacts in 2014 and 2015. There have been and will be even more changes in the delivery and payment systems in healthcare. Physicians need to be ready to navigate this sea change across health care.

PRE/POST TEST QUESTION Which of the following best describes The Affordable Care Act of 2010: a. It is 2500 pages of legislation that will be implemented over several years without changes. b. It will help doctors due to national medical liability and tort reform improvements. c. It will not be implemented since the House of Representatives have voted to repeal it. d. It has potential to help women’s healthcare with provisions for well-woman visits and prenatal care coverage.

47

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • PLENARY SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Plenary 2

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss how a mouse model for Klinefelter syndrome relates to the clinical disorder. 2. Gain insight from the XXY mouse model on the relative roles of genes and testosterone on the abnormalities seen in Klinefelter syndrome.

AUA Bruce Stewart Memorial Lecture: Klinefelter Syndrome: From Mice to Men Supported by a grant from the American Urological Association Paul J. Turek, M.D. (Introducer) Ronald S. Swerdloff, M.D. Harbor-UCLA Medical Center

ACGME Competency Medical Knowledge

Needs Assessment and Description 41,XXY mouse models share many characteristics of the human 47,XXY Klinefelter syndrome (KS). This lecture for clinicians and researchers discusses the relative role of androgen deficiency and X chromosome genes resulting in the XXY mouse phenotype. The similarities in phenotype between 47,XXY men and 41,XXY mice suggest that the clinical manifestations in XXY men may relate principally to gene-dosage effect from genes that escape X inactivation in mice. Some manifestations, however, are related to low serum testosterone levels.

ASRM 2014 Annual Meeting

9:45 am - 10:30 am

TEST QUESTION A 20-year-old man is referred to an endocrinologist for hypogonadism (low serum testosterone). The patient has a past history of poor school performance and on physical examination has small testes. After participating in this session, in my practice I will recommend the following: a. Serum testosterone level that afternoon b. Karyotype c. Serum DHEAS d. Reviewing family history for cryptorchidism e. Not applicable to my area of practice

48

SCIENTIFIC PROGRAM • PLENARY SESSIONS

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Plenary 3

SRS Lecture: Uterine Transplantation Endowed by a 1999 grant from Ethicon Endo-Surgery, Inc.

2:45 pm - 3:30 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify the causes of absolute uterine factor infertility. 2. Discuss the investigations needed before uterus transplantation. 3. Describe the surgical technique at uterus transplantation from a live donor. 4. Assess outcomes (12 months) of the first clinical uterus transplantation trial.

Jeffrey M. Goldberg, M.D. (Introducer) Mats Brännström, M.D. University of Gothenburg Needs Assessment and Description The presentation provides an update on a new and emerging technique in assisted reproductive technology, and especially in the treatment of uterine factor infertility. The lecture is designed for clinicians and scientists involved in infertility care and will highlight a sound, scientific process from animal-based research to an experimental human procedure for uterine transplantation.

ACGME Competency Medical Knowledge TEST QUESTION What is the absolute uterine factor infertility cause of the majority of women (9 out of 11) worldwide who have undergone uterus transplantation? a. Hysterectomy b. Intrauterine adhesions c. Uterine agenesis (Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome) d. Leiomyoma

49

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • PLENARY SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Keynote

Learning Objectives At the conclusion of this session, participants should be able to: 1. Summarize how hormonal contraception alters normal physiology. 2. Evaluate evidence for communication between sperm and the oocyte complex. 3. Identify potential targets for development of novel, safe, and effective methods of contraception for men and women.

Contraception Day Keynote: The Future of Female and Male Contraceptive and the NIH’s Role in the Development of New Contraceptive Methods Supported by an educational grant from Merck Bliss Kaneshiro, M.D., M.P.H. (Introducer) Diana Blithe, Ph.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health

ACGME Competency Patient Care

Needs Assessment and Description Nearly half of all pregnancies in the United States are unintended, and discontinuation rates for existing methods are very high. The National Institute of Child Health and Human Development (NICHD) supports basic and clinical research to discover and develop new, safe, and effective contraceptive methods for men and women. Reproductive health professionals will learn about the products in the pipeline and potential targets for future contraceptive development.

ASRM 2014 Annual Meeting

2:45 pm - 3:30 pm

TEST QUESTION A young nulliparous woman (age 18) is seeking an effective birth-control method. After participating in this session, in my practice based on typical use effectiveness rates, I will advise the following as the most effective methods for her: a. Combined oral contraceptive pills (OCPs) and etonogestrel/ethinyl estradiol vaginal ring b. Combined OCPs and intrauterine devices (IUDs) c. Etonogestrel/ethinyl estradiol vaginal ring and IUDs d. IUDs and progestin implants e. Progestin implants and combined OCPs f. Not applicable to my area of practice

50

SCIENTIFIC PROGRAM • PLENARY SESSIONS

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Plenary 4

9:00 am- 9:45 am

PANTONE 200

Camran Nezhat, M.D. Lectureship in Innovations in Medicine: Reproductive Disorders—What We Have Learned from Mutations in Steroidogenesis 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.

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe the role of SF-1 in adrenal and gonadal development. 2. Discuss the spectrum of reproductive disorders caused by mutations in SF-1.

Richard J. Paulson, M.D. (Introducer)

TEST QUESTION A 2-year-old phenotypic female presents with adrenal insufficiency. The karyotype is 46,XY. The most likely cause is: a. DAX-1 mutation b. Adrenoleukodystrophy c. Steroidogenic factor-1 (SF-1) mutation d. 21-hydroxylase deficiency

ACGME Competency Medical Knowledge

J. Larry Jameson, M.D., Ph.D. University of Pennsylvania Needs Assessment and Description Genetic causes of reproductive dysfunction are being increasingly recognized. This session will provide clinicians and researchers with a deeper understanding of discoveries that clarify the pathways that control reproduction and modify differential diagnoses and treatment.

51

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • PLENARY SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Plenary 5

Bariatric Surgery: It’s Not What You Think It Is. Molecular Targets for the Beneficial Effects of Surgery on Obesity and Diabetes Endowed by a 1990 grant from Astra-Zeneca

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe the different effects of various bariatric procedures on metabolism and hormone secretion. 2. Identify key molecular mediators of the potent effects of bariatric surgery on weight and metabolism.

Owen K. Davis, M.D. (Introducer) Randy J. Seeley, Ph.D. University of Cincinnati

ACGME Competency Medical Knowledge

Needs Assessment and Description Various bariatric procedures do not simply cause weight loss but also exert powerful metabolic effects. Understanding how procedures differ in these effects is critical for physicians who must treat obese patients and the complications that come with their obesity, including reproductive problems.

ASRM 2014 Annual Meeting

9:45 am - 10:30 am

TEST QUESTION A 34-year-old woman with a body mass index (BMI) of 38 kg/m2 was diagnosed with type II diabetes 2 years ago. Her hemoglobin A1c (HbA1c) is 8.5%, despite taking several diabetes drugs. She is considering either a vertical sleeve gastrectomy or gastric bypass surgery to lose weight. After participating in this session, in my practice I will tell this patient that she might expect the following from either procedure 1 year after the surgery: a. Her HbA1c is not likely to be improved by either surgery. b. Her HbA1c will be improved only if she has a gastric bypass. c. Her HbA1c will be improved only if she has a vertical sleeve gastrectomy. d. Her HbA1c will be improved after both surgeries. e. Not applicable to my area of practice

52

SCIENTIFIC PROGRAM • PLENARY SESSIONS

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Plenary 6

Systems Biology of Endometriosis Endowed by a 1992 grant from EMD Serono, Inc.

2:45 pm - 3:30 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Explain how computational systems biology approaches are being used to classify disease processes in endometriosis patients. 2. Explain how computational systems biology approaches can potentially identify disease mechanisms in endometriosis.

Linda C. Giudice, M.D., Ph.D. (Introducer) Linda G. Griffith, Ph.D. Massachusetts Institute of Technology Needs Assessment and Description Genomic, proteomic, and other highly multiplexed molecular measurements are increasingly being applied to gain biological insight into endometriosis. These methods also have potential implications in clinical management of disease, including classifying patients for therapy. This session will provide clinicians and researchers with context for how to bridge between basic science and clinical use as these methods continue to advance.

ACGME Competency Medical Knowledge TEST QUESTION Genome-wide association studies of patients with endometriosis have resulted in a genetic test, which, when combined with a blood test for a set of biomarkers: a. Can diagnose endometriosis preoperatively, but only for deep infiltrating endometriosis b. Can diagnose endometriosis preoperatively, but only for patients with endometriomas c. Cannot diagnose endometriosis preoperatively

53

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • PLENARY SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Keynote

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe indications and contraindications for currently available SERM therapies. 2. Identify women for whom SERM therapy for breast cancer prevention is recommended by the USPSTF (and therefore, covered by the Affordable Care Act).

Menopause Day Keynote -The Evolving Role of SERMs in Menopausal Women’s Health Supported by an educational grant from Shionogi, Inc. Melissa Wellons, M.D. (Introducer) Cynthia A. Stuenkel, M.D. University of California, San Diego

ACGME Competency Patient Care

Needs Assessment and Description Although most practitioners are aware of the clinical indications for preventing breast cancer and osteoporosis with the selective estrogen receptor modulators (SERMs) tamoxifen and raloxifene, in the past year new analyses of risks and benefits have been completed. Additionally, the US Food and Drug Administration (FDA) has approved two new SERM therapies for use in postmenopausal women: ospemifene, for treatment of dyspareunia associated with vaginal atrophy following menopause, and bazedoxifene, coupled with conjugated estrogens for relief of vasomotor symptoms and prevention of bone loss. Furthermore, the United States Preventive Services Task Force (USPSTF) now recommends that clinicians engage in “shared, informed decision-making with women who are at increased risk for breast cancer about medications to reduce their risk.” Given the provisions of the Affordable Care Act, familiarity with these agents and current recommendations for use is timely for clinicians and allied health-care providers caring for women in perimenopause and menopause.

ASRM 2014 Annual Meeting

2:45 pm - 3:30 pm

TEST QUESTION After participating in this session, I will do the following in my practice: a. Formally evaluate breast cancer risk in women older than age 35 using a risk calculator, and if they meet criteria, advise patients regarding risks and benefits of tamoxifen and raloxifene for breast cancer prevention. b. Monitor bone mineral density and recommend treatment with raloxifene to women who have experienced a hip fracture. c. Take a careful history and recommend ospemifene as an option for women with recurrent urinary tract infections. d. Counsel women with a uterus who don’t tolerate progestogens concurrent with estrogen therapy that unopposed estrogen with annual endometrial biopsy is a safe alternative. e. Recommend tamoxifen or raloxifene therapy for prevention of breast cancer to all women with a family history of breast cancer. f. Not applicable to my area of practice

54

SCIENTIFIC PROGRAM • PLENARY SESSIONS

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Plenary 7

9:00 am - 9:45 am

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss current performance capabilities and costs of genome sequencing technologies and appropriate applications in research vs. clinical settings today. 2. Summarize contributors to clinical variability in phenotypic expression of specific genetic disorders, including copy number variants and single gene disorders, in relation to the classic genetic concepts of penetrance and variable expressivity.

Herbert H. Thomas Lecture: Preconception, Preimplantation, and Prenatal Genomic Medicine Endowed by a 1990 grant from TAP Pharmaceutical Lawrence C. Layman, M.D. (Introducer) David H. Ledbetter, Ph.D. Geisinger Health System Needs Assessment and Description As the price of DNA sequencing and associated analysis continues to drop, whole exome or whole genome sequencing increasingly will enter routine clinical settings, including preconception evaluation and counseling, infertility, prenatal screening and diagnosis, newborn screening, newborn intensive care evaluations, and other early pediatric cohorts. This session for clinicians and researchers involved in infertility care will provide an update on the status of the clinical utility and value of these technologies with an emphasis on implications of reproductive planning and management from patient and provider perspectives.

ACGME Competency Medical Knowledge Practice-based Learning and Improvement TEST QUESTION A couple comes to see you for evaluation of infertility, and upon family history, you learn that the female’s brother has a son with clubfoot, microphthalmia, and a heart defect. His geneticist ordered whole exome sequencing (WES), and the patient comes back to discuss the results with you. After participating in this session, in my practice I will tell the patient the following regarding WES: a. WES is a reliable method to identify copy number variants. b. WES cannot be informative unless available family members are studied. c. WES will identify a causative mutation in nearly all patients studied. d. WES will permit analysis of only the genes of interest. e. WES covers only a small percentage of the entire genome. f. Not applicable to my area of practice

55

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • PLENARY SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Plenary 8

Sperm Cell Biology: Revelations on the Road to Conception Endowed by a 1992 grant from Wyeth

Learning Objectives At the conclusion of this session, participants should be able to: 3. Summarize some of the major pathways that determine the viability and functionality of spermatozoa and oocytes. 4. Outline how this information can affect clinical decision-making during the management of infertility.

Rebecca Z. Sokol, M.D., M.P.H. (Introducer) R. John Aitken, Sc.D. University of Newcastle Needs Assessment and Description Very little is understood about the molecular mechanisms that mediate the process of human conception, despite its role as arguably the most important single event in biology. This live session for physicians, laboratory scientists, researchers, and other allied health professionals involved in the care of infertile couples will focus on the biology of the sperm cell. It will also provide an update on knowledge about the role of sperm in conception and allow providers to accurately counsel patients about the risks and benefits associated with assisted reproductive technology (ART).

ASRM 2014 Annual Meeting

2:45 pm - 3:30 pm

ACGME Competency Medical Knowledge Patient Care TEST QUESTION After participating in this session, I will do the following in my practice: a. Routinely use a TUNEL assay to determine the level of DNA damage in the spermatozoa during the initial workup of the male patient. b. Routinely perform assays of sperm-zona binding in the workup of the male partner. c. Routinely prepare spermatozoa on discontinuous density gradients comprised of colloidal silica suspensions. d. Routinely place all male patients on antioxidant therapy as a prelude to ART. e. Advise patients on their chances of a successful outcome following ART using the age of the male and female partner. f. Not applicable to my area of practice

56

SCIENTIFIC PROGRAM • PLENARY SESSIONS

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Plenary 9

2:45 pm - 3:30 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Explain how changes in the maternal environment during the preimplantation period can have short-term and long-term effects on development that can extend into postnatal life. 2. Discuss the importance of the environment of the preimplantation embryo for its development. 3. Describe how the actions of one maternally derived regulatory molecule, colony-stimulating factor 2, regulate development of the preimplantation embryo in a sex-dependent manner.

SSR Exchange Lecture: Colony Stimulating Factor 2: Example of a Maternal Embryokine that Programs the Mammalian Embryo for Pregnancy Success Dolores J. Lamb, Ph.D. (Introducer) Peter J. Hansen, Ph.D. University of Florida Needs Assessment and Description Changes in the maternal environment during the preimplantation period can have short- and long-term effects on development that can extend into postnatal life. It is important to understand how specific molecules produced by the reproductive tract change the trajectory of development so that an optimal environment for the embryo can be established. This information is relevant for clinicians and allied health professionals involved in women’s health and assisted reproductive technologies.

ACGME Competency Medical Knowledge TEST QUESTION Treatment of the bovine preimplantation embryo with colony-stimulating factor 2 (CSF2) results in which of the following changes in development? a. Increased number of inner cell mass cells and resistance to apoptotic signals b. Reduced number of trophectoderm cells c. Death by apoptosis d. Activation of WNT signaling

57

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Telesurgery

11:15 am - 1:00 pm

Surgery Day Telesurgery: Laparoscopic Myomectomy and Tissue Removal Techniques

ACGME Competency Patient Care

Steven F. Palter, M.D. (Introducer) Jon I. Einarsson, M.D.,M.P.H. Brigham and Women’s Hospital

TEST QUESTION A 39-year-old, gravida 0, woman has a 9 cm intramural fibroid that indents the endometrial cavity. She has heavy periods and desires future fertility. A laparoscopic myomectomy is planned. The fibroid is close to the fundal area. After participating in this session, in my practice I will use the following myometrial incision as it results in the least amount of blood loss: a. Horizontal incision b. Vertical incision c. Diagonal incision d. Similar blood loss with all e. Not applicable to my area of practice

Needs Assessment and Description Laparoscopic myomectomy offers patients the traditional benefits of minimally invasive surgery yet many providers do not feel comfortable performing this procedure. Challenging steps include fibroid extraction, myometrium closure, and maintenance of hemostasis. A new challenge involves specimen extraction given recent morcellation controversy. All these challenges will be addressed in this event. This live telesurgery is designed for gynecologists in clinical practice. Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe methods for efficient and secure laparoscopic myometrial closure. 2. Discuss various options for tissue extraction in minimally invasive gynecologic surgery.

ASRM 2014 Annual Meeting

58

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Symposium

11:15 am - 1:00 pm NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe the current status of sex selection in assisted reproduction in the United States today. 2. Discuss the pros and cons and material risks and benefits of sex selection, as well as its technical limitations and potential problems. 3. Identify questions to propose to those considering sex selection for nonmedical reasons. 4. Counsel patients effectively regarding the issues for the child, parent, and family. 5. Ascertain the difference between what constitutes an “ethical” decision and a “legal” one.

MHPG Symposium - How Far is too Far? The Medical, Embryological, Psychological, and Legal Aspects of Sex Selection. Just Because We Can Claudia Pascale, Ph.D. (Chair) Institute for Reproductive Medicine & Science Serena H. Chen, M.D. Institute for Reproductive Medicine & Science Jacques Cohen, Ph.D. A.R.T. Institute of Washington, Inc. Melissa B. Brisman, J.D. Private Practice, Montvale, NJ Needs Assessment and Description Most patients come into the reproductive medical world with various levels of knowledge regarding its science, implications, and legalities. As we enter the brave new world of genetic sequencing, selection, and (soon) modification, it is important for health-care providers to assess the implications of this technology. Although sex-selection strategies have been available for many years in the service of eradicating sex-linked conditions, this treatment is entering the world of commercialism with patients/clients knocking at our doors. This live symposium for clinicians and mental health and allied health-care professionals poses the following questions about sex selection: Just because we can should we? What is the state of the current technology? Where are we headed in the near and distant future? How might the practice of social sex selection impact individuals, families, populations, and society as a whole? What are the questions patients/consumers might want to think about in making this decision? Is this an individual right? Or should public policy prevail? What do patients expect when they inquire about sex selection? Why do patients inquire about sex selection? How do we counsel our patients regarding the use of this technology?

ACGME Competency Medical Knowledge Interpersonal and Communication Skills TEST QUESTION An American couple (male, 35 years old; female, 31 years old) presents to the infertility clinic for their initial visit. They have read about sex selection and want to balance their family of 3 boys with at least 1 girl. Neither spouse has an infertility issue. The wife reports that she has always wanted a daughter and says she “needs a daughter.” They tell you that “money is no object” and would be willing to do in vitro fertilization (IVF) if necessary. After participating in this session, in discussing this with them in my practice, I will: a. Recommend that they proceed with sex selection with no additional explanation of success rates or additional requirements. b. Explain that IVF and preimplantation genetic testing is the only guaranteed method for sex selection. c. Explain that sperm sorting is their best option, as it provides completely separate female and male sperm pools. d. Require standardized psychological testing of the couple by a reproductive mental health professional. e. Require them to sign a release that the IVF clinic cannot 100% guarantee that the baby will be the sex of their choosing and recommend that the couple complete a psychosocial interview with a reproductive mental health professional. f. Not applicable to my area of practice 59

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Symposium

NPG in Collaboration with the LPG Symposium - Egg Cryopreservation and Banking—Where Are We Going and What Do We Need to Know?

NONCME

CE

ARS

arrangements and address novel technologies such as egg freezing and genetic testing that will create future vulnerabilities and unique needs for informed consent.

Susan L. Crockin, J.D. (Chair) Crockin Law & Policy Group, Georgetown University Law Center Andrea M. Braverman, Ph.D. Thomas Jefferson University Lindsay E. Canning, R.N., M.S.N. Seattle Reproductive Medicine

ACGME Competency Professionalism TEST QUESTION An international couple approaches your clinic: through a third-party matching program, they have identified a local woman willing to be a gestational carrier for them. She has been screened by the matching program, including a consultation with a mental health professional. She is separated, but not divorced, from her husband, living in a neighboring state to your program, and has no health insurance of her own. The international couple has informed you, through an interpreter, that they and their matching program will provide for all necessary nonmedical aspects of the arrangement, and all they need you to do is thaw and transfer the frozen embryos they will ship to your program (made with donor egg). They are eager to move forward as soon as possible, and will be returning home after the transfer until closer to the time of birth when they intend to fly back to the United States. After participating in this session, in my practice I will: a. Move forward with the requested medical services and transfer embryos without further delay. b. Advise the international patients that there are legal risks that you need to explain to them before proceeding to ensure they understand their vulnerabilities. c. Advise the gestational carrier that since a matching program in the United States has made all arrangements she has nothing to worry about and may proceed as soon as her cycle can be coordinated. d. Require that all parties have independent legal counsel and provide you with a statement from one or both lawyers explaining that they have represented their respective clients in putting a legal agreement in place and that all legal issues, including citizenship and immigration, have been addressed to the satisfaction of all parties. e. Tell them what they are attempting to do is impossible and neither you nor any other IVF program can assist them. f. Not applicable to my area of practice

Needs Assessment and Description Informed consent is a cornerstone of medical treatment, and professionals involved in assisted reproductive technology (ART) should understand the unique issues this type of medical care raises for myriad patients who may be involved in a single case. ART treatment always involves at least 2 patients, frequently involves several, and presents a complex situation for medical, mental health, and legal professionals, intended parents, donors, and gestational surrogates, as well as expanding geographic boundaries that increasingly cross both state and national borders. ART treatments also raise novel consent issues, including freezing and future uses of genetic material, changing laws surrounding ART and reproductive genetics, and rapidly expanding internet technologies such as Skype and “docu-sign” that may be transforming how informed consent is obtained. This course will approach these issues from a cross-disciplinary perspective. All ART professionals involved in medical care, psycho-education and counseling, or legal representation of ART patients will benefit from learning about these new challenges and how they are being addressed. The session will include interactive discussions of “hypothetical” cases in which the faculty panel will discuss and analyze the intricacies of informed consent. Attendees will be invited to present hypothetical cases both in advance and during the course, and will use the interactive participation system as part of these sessions. Learning Objectives At the conclusion of this session, participants should be able to: 1. Review and revise their ART consent forms to address the multiple patient participants in many ART arrangements. 2. Identify the multiple patients involved in ART ASRM 2014 Annual Meeting

11:15 am - 1:00 pm

60

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Symposium

11:15 am - 1:00 pm

PANTONE 200

ACGME Competency Systems-based Practice

ARM Symposium - Maximizing the Physician’s Schedule and Revenue by Bringing Surgery and Diagnostic Procedures In-house

TEST QUESTION Performing in-house hysterosalpingograms (HSG) can affect the reimbursement/revenue stream by: a. An increase in physician charges but a decrease in facility fees and need for radiologist reading fees. b. A decrease in physician and facility charges but an increase in physician productivity scheduling. c. An increase in physician and facility charges and productivity. d. Being detrimental to the long-term revenue stream due to upfront expenses, equipment, implementation, and staffing issues.

Faith E. Ripley, B.S. (Chair) Piedmont Reproductive Endocrinology Group PA John E. Nichols, M.D. Piedmont Reproductive Endocrinology Group PA Needs Assessment and Description This live presentation for physicians, medical staff, and practice managers will describe ways to bring diagnostic/ treatment technologies and surgical procedures into the office to maximize physician time and revenue. Learning Objectives At the conclusion of this presentation, participants should be able to: 1. Identify different diagnostic and treatment procedures that can be performed in an office setting—including implementation, equipment, staffing expenses, and reimbursement issues—to determine revenue efficacy. 2. Discuss additional surgical procedures that can be performed in a surgery-center office suite— including costs of implementation, equipment, staffing expenses, and reimbursement issues—to determine revenue efficacy.

61

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Symposium

Learning Objectives At the conclusion of this session, participants should be able to: 1. Summarize evidence regarding the effects of fibroids of different types and sizes on fertility and pregnancy outcomes. 2. Describe an evidence-based approach for the treatment of the infertile patient with fibroids among the various treatment modalities available.

SRS Symposium: How to Detect, Characterize, and Treat Uterine Fibroids James H. Segars, M.D. (Chair) National Institute of Child Health and Human Development Elizabeth A. Stewart, M.D. Mayo Clinic Assisted Reproductive Technologies Bala Bhagavath, M.D. University of Rochester Medical Center-Strong Memorial Hospital

ACGME Competency Practice-based Learning and Improvement

Needs Assessment and Description Uterine fibroids are a highly prevalent disease that affects millions of women and contributes to infertility and adverse pregnancy outcomes. The location, number, size, and extent of uterine involvement with fibroids vary greatly among affected women, requiring practitioners to individualize care and tailor diagnostic and treatment approaches to each individual case. The requirement for individualized care necessitates a clear understanding of the relationship of specific fibroids with specific symptoms and the benefits of different therapeutic approaches for individual cases. This symposium will provide practitioners with the latest information regarding the optimal diagnostic methods and review evidence for effective treatment of fibroids in the woman interested in fertility or preserving fertility.

ASRM 2014 Annual Meeting

4:15 pm - 6:15 pm

TEST QUESTION A 30-year-old woman presents after an intracytoplasmic sperm injection (ICSI) cycle ended in miscarriage at 12 weeks. The couple has a 5-year history of infertility due to severe male factor. On saline infusion sonohysterography a single 3.5 cm fibroid is noted with 50% intrusion into the endometrial cavity. After participating in this session, in my practice I will recommend the following as the most appropriate treatment that is most likely to improve the pregnancy outcome for this couple: a. Hysteroscopic myomectomy b. Laparoscopic myomectomy with morcellation c. Open myomectomy d. MRI-guided focused ultrasound procedure e. Uterine fibroid embolization f. Not applicable to my area of practice

62

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Symposium

4:15 pm - 6:15 pm NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe strategies to simultaneously enhance clinical outcomes while reducing the burden of treatment to individual patients as well as the overall health care system.

Howard and Georgeanna Jones Symposium: A New Paradigm for IVF: Reducing the Burden of Care Endowed by a 2010 educational grant from EMD Serono, Inc. Richard T. Scott, M.D. (Chair) Reproductive Medicine Associates of New Jersey Alexander M Dlugi, M.D., M.B.A. Optum Kevin J. Doody, M.D. Center for Assisted Reproduction, Texas

ACGME Competency Systems-based Practice TEST QUESTION A 38-year-old, gravida 0, with bilateral tubal obstruction and severe male factor is attempting conception through assisted reproductive technology (ART). All care is compliant with current ASRM guidelines. After participating in this session, I will understand that the greatest potential health care risk attributable to this couple’s treatment is: a. Ovarian neoplasia in the female partner b. Imprinting disorder in the offspring c. Sequelae of prematurity in the offspring d. Perioperative hemorrhage e. Not applicable to my area of practice

Needs Assessment and Description This symposium for ART clinicians, program administrators, and other providers of assisted reproductive health care will discuss different strategies to reduce the burden of treatment to the patient and the health care system. These include simplified approaches to care in low-complexity patients, the application of enhanced screening paradigms to reduce transfer order while enhancing cycle outcomes and safety, and a discussion of how the insurance industry may embrace these new paradigms to provide greater access to care while simultaneously enhancing safety and reducing overall health care costs.

63

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Symposium

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss recent developments around health issues in children born after ART. 2. Assess the scale of the problem and the impact of congenital anomalies, birth weight, blood pressure, the role of culture media, and epigenetics.

ESHRE Symposium - Health of Children Following ART Juha S. Tapanainen M.D., Ph.D. (Chair) Helsinki University Tom Tanbo, M.D., Ph.D. Oslo University Hospital Anja Pinborg, M.D. Copenhagen University Hospital Rebecca C. Painter, M.D., Ph.D. Academic Medical Centre, University of Amsterdam

ACGME Competency Medical Knowledge

Needs Assessment and Description Despite the long-term presence of assisted reproductive technology (ART) and the minimal reported adverse health effects in ART-born children, awareness of safety is a crucial aspect of these treatments. Moreover, new research technologies, large registries, and follow-up studies give new insight into safety aspects. This symposium will provide an overview of new developments within this field for clinicians, researchers, nurses, and embryologists with an interest in infertility, fertility care, reproductive technologies, and safety issues.

ASRM 2014 Annual Meeting

4:15 pm - 6:15 pm

TEST QUESTION The risk of poor perinatal outcomes in singletons born after assisted reproductive technology (ART) is increased with an odds ratio of: a. 1.1-1.4 b. 1.5-2.5 c. 5.0-6.0 d. 10.0

64

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Symposium

AMMR Symposium - ¿Cuál es el mejor manejo de la paciente con endometriosis para mejorar la fertilidad?

4:15 pm - 6:15 pm NONCME

CE

ARS

Endometriosis is an enigmatic disease associated with significant morbidity and reduction of fertility among women of reproductive age. 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 Mexican and Latin-American physicians in Spanish and open the door for dialogue and exchange of ideas among different countries. This educational activity 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 effectually diagnose, make wise treatment decisions, and optimize the fertility outcome in their affected patients. This program is targeted to a Spanish-speaking contingency attending the meeting.

Alfonso Orta-García, M.D. (Chair) Mexican Association for Reproductive Medicine Ranferi Gaona-Arreola, M.D. Specialized Center of Sterility and Human Reproduction, Mexico Claudio Serviere Zaragoza, M.D. AFF HERE Carlos Salazar-López Ortiz, M.D. Hospital Español de Mexico Victor Saúl Vital Reyes, M.D., Ph.D. Hospital de Ginrcobstetricia 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 en español para médicos en México y América Latina, y poder abrir la puerta para el diálogo e intercambio de ideas entre los diferentes países.

Learning Objectives En la conclusión de esta actividad, el participante debe ser capaz de: At the conclusion of this session, participants should be able to: 1. Entender resumir la evaluación contemporánea de la paciente con endometriosis./Summarize the contemporary evaluation of endometriosis. 2. Describir las terapias más efectivas para pacientes con endometriosis leve y severa. Describe effective therapeutic strategies for patients with mild and severe endometriosis. 3. Demostrar la habilidad de recomendar terapias médicas, quirúrgicas y de reproducción asistida apropiadas para pacientes con endometriosis. / Recommend appropriate medical, surgical, and assisted reproductive management of endometriosis.

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. Este programa está enfocado a una audiencia hispano-parlante que asista al congreso.

65

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

ACGME Competency Patient Care

2. Paciente de 40 años G1P1 con historia de cirugía previa (laparotomía con resección de endometrioma izquierdo y lisis de adherencias por endometriosis estadio III), se presenta a la consulta con recurrencia de sus síntomas, y además quisiera embarazarse. Su hormona Anti-Mulleriana es 0.5 pmol/L. Examen físico demuestra dolor significativo con nódulos en ligamentos útero-sacros en examen recto-vaginal y una masa adnexal derecha. Después de participar en esta sesión voy a hacer lo siguiente en mi práctica.

PANTONE 200

TEST QUESTION 1. Una paciente de nuligravida de 23 años con infertilidad primaria, se presenta al consultorio con dismenorrea central progresivamente severa. En el examen pélvico bi-manual el útero y ovarios son de tamaño normal, móviles, con dolor pélvico moderado y difuso al movimiento. Ella quisiera mejorar su dolor menstrual y también embarazarse.

A 40-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 0.5 pmol/L. Physical examination reveals significant pain with nodules on her uterosacral ligaments and a right pelvic mass on rectovaginal examination.

A 23-year-old nulligravid patient with primary infertility presents to your office with central, progressively worsening severe dysmenorrhea. Bimanual pelvic examination reveals her uterus and ovaries to be normal-sized, mobile, with diffuse moderate pelvic pain associated with movement. She would like to improve her pain during menstruation, and also become pregnant.

After participating in this session, I will do the following in my practice: 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 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. e. No aplica a mi área de práctica/ Not applicable to my area of practice.

After participating in this session, I will do the following in my practice: a. Resonancia magnética nuclear (MRI)/Nuclear magnetic resonance imaging (MRI) b. Ultrasonido pélvico/Pelvic ultrasound c. Agonistas de GnRH por 6 meses/Gonadotropinreleasing hormone (GnRH) agonists for 6 months d. Laparoscopia diagnostica/Diagnostic laparoscopy e. Antigeno-125 (CA125)/CA125 f. No aplica a mi área de práctica/ Not applicable to my area of practice.

ASRM 2014 Annual Meeting

66

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Symposium

4:15 pm - 6:15 pm NONCME

CE

ARS

ACGME Competency Patient Care

Oncofertility I - Male Supported by an educational grant from Ferring Pharmaceuticals, Inc.

TEST QUESTION A 32-year-old male with a solitary left testicle presents with a firm, nontender 3 cm left testicular mass. Alphafetoprotein (AFP) and beta-human chorionic gonadotropin (b-hCG) tumor markers are both significantly elevated, and imaging reveals left retroperitoneal adenopathy. He wants to father numerous biological children in the future. He provides 2 ejaculated semen samples for fertility preservation; both samples reveal severe oligoasthenoteratospermia (200,000 sperm/mL; 30% motility; 3% normal morphology for each specimen), and 2 vials of sperm are cryopreserved. He then undergoes a left radical orchiectomy, and pathology reveals a mixed germ cell tumor. After completion of a platinum-based chemotherapy regimen, he and his wife decide to pursue a pregnancy. He asks about the use of his cryopreserved sperm in the future. After participating in this session, in my practice I will: a. Encourage him and his partner to undergo preimplantation genetic diagnosis at the time of in vitro fertilization (IVF) due to the increased risk of genetic anomalies in the offspring of oncology patients. b. Counsel him that reproductive outcomes (fertilization, pregnancy, live-birth rates) for cryopreserved sperm from oncology patients are similar to outcomes for sperm from non-oncology patients. c. Encourage him and his partner to undergo intrauterine insemination as a first step because it is less invasive than IVF/ intracytoplasmic sperm injection (ICSI). d. Discourage him from using his sperm until he has greater than 5-year cancer survival due to his risk of relapse and death. e. Not applicable to my area of practice

Robert E. Brannigan, M.D. (Chair) Northwestern University Feinberg School of Medicine John P. Mulhall, M.D. Memorial Sloan Kettering Cancer Center James F. Smith, M.D., M.S. UC San Francisco Needs Assessment and Description Cancer therapies can have permanent, deleterious effects on male reproductive potential. Health-care providers must have an awareness of the impact of cancer and cancer treatments on male reproductive potential, and they must also understand how to deliver effective fertility preservation care to males across the age spectrum. This symposium, which will comprehensively address fertility preservation in males, is aimed at the target audience of urologists, andrologists, reproductive endocrinologists, nurses, and laboratory professionals. Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe key aspects of the American Society of Clinical Oncology Fertility Preservation recommendations. 2. Discuss state-of-the-art fertility preservation procedures for male oncology patients across the age spectrum. 3. Overview the investigational methods being studied for fertility preservation in prepubertal males.

67

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Symposium

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify steps necessary to conduct a multi-center clinical trial. 2. Discuss means to establish a governance structure and publication policy for a clinical trial.

Randomized Clinical Trials in Reproduction: What Have We Learned from Different Parts of the World? Richard S. Legro, M.D. (Chair) Pennsylvania State University Siladitya Bhattacharya, M.D. University of Aberdeen Cynthia Farquhar, M.D., M.P.H. The New Zealand Branch of the Australasian Cochrane Centre Xiaoke Wu, M.D., Ph.D. Heilongjiang University of Chinese Medicine

ACGME Competency Practice-based Learning and Improvement TEST QUESTION In my practice after participating in this session, to publish a clinical trial in a high-impact journal, I will complete the following as a first step prior to enrollment of the first study subject: a. Establish a steering committee of investigators. b. Develop a written protocol to standardize the intervention(s). c. Develop a written publication policy to avoid authorship disputes. d. Register the trial at a recognized clinical trial registration website. e. Not applicable to my area of practice.

Needs Assessment and Description This symposium will examine various models of randomized clinical trials in reproductive medicine and discuss strengths and weaknesses as well as hurdles in designing and implementing them from worldwide experience. This symposium is designed to educate and encourage the next generation of researchers to engage in clinical research.

ASRM 2014 Annual Meeting

4:15 pm - 6:15 pm

68

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Symposium

11:15 am - 1:00 pm NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss the history, definition, and types of posthumous reproduction. 2. Sensitively explore the psychological issues related to posthumous reproduction with patients who freeze their gametes, and with surviving family members who return to use those gametes in the event of the patient’s death. 3. Identify unique ethical and legal issues when discussing posthumous reproduction with patients who freeze their gametes, and with surviving family members who return to use those gametes in the event of the patient’s death.

MHPG Symposium -Blurring the Line Between Life and Death: The Psychological and Ethical Issues of Posthumous Reproduction Angela K. Lawson, Ph.D. (Chair) Northwestern University Julianne E. Zweifel, Ph.D. University of Wisconsin Nidhi Desai, J.D. Private Practice, Illinois Needs Assessment and Description Assisted reproductive technology (ART) practitioners routinely offer embryo and oocyte/sperm cryopreservation services to patients and couples who are interested in future family-building. Unfortunately, some patients, whether due to disease or accident, die after cryopreserving their genetic material. In the event of a patient’s death, their partner or other family members may desire to use those materials to achieve pregnancy. However, posthumous reproduction (reproductive attempts after the death of a partner) has resulted in a number of legal and ethical issues regarding pre-death consent from the deceased patient and ambiguous legal and social status for the resulting child(ren).

ACGME Competency Patient Care Interpersonal and Communication Skills Professionalism TEST QUESTION After 2 years of trying to conceive, a 37-year-old woman and her 45-year-old husband with no children undergo their first cycle of in vitro fertilization (IVF). The couple does not get pregnant following the transfer of 2 fresh embryos. While the couple is preparing to undergo a frozen embryo transfer, the female partner is diagnosed with advanced brain cancer and subsequently dies. Her husband returns to the fertility clinic 1 month after her death to discuss having the deceased patient’s sister serve as a gestational carrier to conceive a child with the remaining frozen embryos. After participating in this session, I will do the following in my practice: a. Decline to work with the patient as they are requesting posthumous reproduction. b. Counsel the patient in the same way as I would any patient undergoing treatment with frozen embryos. c. Inform the patient that there are no potential legal concerns regarding posthumous reproduction. d. Discuss with the patient the unique psychological and ethical issues associated with posthumous reproduction and refer them for legal consultation. e. Inform the patient that posthumous reproduction is morally wrong and encourage them to destroy or donate the cryopreserved embryos. f. Not applicable to my area of practice

Multiple psychological issues also arise during the course of posthumous reproduction. These include decision-making in the context of grieving the death of a loved one, experiencing family disagreements about posthumous reproduction, and coping with potential pregnancy-related adverse events. Further, it is unknown what, if any, psychological burden posthumously conceived children or their family members will bear as the child grows. From a legal standpoint, it is often unclear as to who has the rights to these gametes or embryos, and what action an ART practitioner can or should take to release them to an interested family member. Furthermore, myriad issues arise concerning the child’s parentage and legal status. Because of the psychological, legal, and ethical concerns regarding posthumous reproduction, many practitioners have concerns about facilitating such treatment. This live course will address the psychological, ethical, and legal issues in posthumous reproduction and will provide direction to providers about how to address these issues with surviving family members.

69

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Symposium

Learning Objectives At the conclusion of this session, participants should be able to: 1. Summarize the multidisciplinary team management of PCOS. 2. Apply principles of adult learning to improving health literacy in women with PCOS.

NPG Symposium - PCOS and the Multidisciplinary Team Approach Catherine M. Bergh, M.S.N. (Chair) Reproductive Medicine Associates of New Jersey Heather Huddleston, M.D. University of California San Francisco Lauri A. Pasch, Ph.D. University of California San Francisco

ACGME Competency Patient Care Interpersonal and Communication Skills

Needs Assessment and Description Multidisciplinary health-care teams are comprised of members from different health-care professions with specialized skills and expertise. The purpose of the group is to facilitate safe, high-quality, patient-centered care. The strength of the team is its ability to simplify and facilitate the patient journey and deliver care that is based on recognized “best practices.” Polycystic ovary syndrome (PCOS) is an example of an endocrine and reproductive disorder with serious comorbidities. Working together, the multidisciplinary team can prioritize the care of women with PCOS to meet their individual physical and psychological needs. In the case of PCOS, this means delivering care to reduce symptoms and improve fertility, and providing medical, psychological, nutritional, and lifestyle support to promote optimal health. This live course for nurses and other allied health professionals who care for women with PCOS will focus on coordination and delivery of services, as well as tips for reducing chronic disease risk and improving reproductive potential through improved health literacy.

ASRM 2014 Annual Meeting

11:15 am - 1:00 pm

TEST QUESTION A 31-year-old woman with a body mass index of 33 kg/m2 presents at the office with a 2-year history of anovulatory infertility off oral contraceptives (OC) and a diagnosis of polycystic ovary syndrome (PCOS) based on anovulation, hirsutism, and polycystic ovaries on ultrasound. She offers that as a slightly obese teenager she was told she had PCOS and was placed on OCs. Her weight has steadily increased over the years. Blood work includes a fasting blood sugar of 100 mg/dL. After participating in this session, in my practice I will recommend the following as a first step in management: a. Weight loss b. Glucose tolerance test c. Metformin d. Clomiphene citrate e. Letrozole f. Not applicable to my area of practice

70

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Symposium

11:15 am - 1:00 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify basic elements of successful strategic decision making and planning. 2. Explain the different elements involved in the successful implementation of a strategic plan.

ARM Symposium - Strategic Planning and Implementing Human Resources Joseph J. Travia, M.B.A. (Chair) Center for Reproductive Medicine Paul A. Verrastro, M.B.A. Center for Advanced Reproductive Services

ACGME Competency Systems-based Practice

Needs Assessment and Description Medical practice management involves managing a broad spectrum of personnel, compliance with regulations, and financial operations, and interpreting constant changes in reimbursement policies. Strategic planning is a key function of a reproductive endocrinology and infertility-in vitro fertilization (REI-IVF) practice manager to avoid pitfalls that come with handling operational systems reactively rather than proactively. This live session for practice managers and clinicians involved in practice management will review the basic elements of successful strategic planning, keys to implementing the plans and anticipating change, and evaluation of results for improving future performance. Also included in this session are strategies for successful human resource management.

TEST QUESTION The most effective way to engage staff in the implementation of a strategic plan is to: a. Provide an in-service training to present the organization’s strategic plan. b. Create a handout of the organization’s strategic plan and distribute it to appropriate staff. c. Involve staff in the strategic-planning process.

71

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Symposium

Learning Objectives At the conclusion of this session, participants should be able to: 1. Evaluate current evidence that stem cells may give rise to eggs, sperm, or endometrium. 2. Identify potential applications of reproductive tract stem cells in regenerative medicine.

KY Cha Symposium in Stem Cell Technology and Regenerative Medicine: Endometrial Stem Cells: From Reproductive Biology to Regenerative Medicine Supported by the Asia-Pacific Biomedical Research Foundation Hugh S. Taylor, M.D. (Chair) Yale University School of Medicine Kyle E. Orwig, Ph.D. University of Pittsburgh Allan C. Spradling, Ph.D. Carnegie Institution of Washington

ACGME Competency Medical Knowledge TEST QUESTION Stem cells from the reproductive tract: a. Are widely used in clinical applications b. Are identical in function across all species b. Have potential for clinical application in reproductive and regenerative medicine d. Have not been proven to exist

Needs Assessment and Description The ability to obtain and maintain pluripotent stem cells from individuals in culture and differentiate them into multiple cell types that reflect any underlying disease provides a fundamental change in our ability to diagnose, screen, or treat human diseases. This symposium will review the latest research on stem cells in reproductive tissues. Topics include egg, sperm, and endometrial stem cells. Interspecies comparisons and potential human applications will be explored. This symposium is intended for reproductive endocrinologists, reproductive biologists, embryologists, andrologists, and stem cell biologists.

ASRM 2014 Annual Meeting

4:15 pm - 6:15 pm

72

SCIENTIFIC PROGRAM • SYMPOSIA Tuesday, October 21, 2014

A

ASRM XXXXXXXXXX 4:15 pm - 6:15 pm changed to 11:15pm to 1:15pm

h r a

health affects reproduction affects health

Symposium

ABOG Foundation - Kenneth J. Ryan Ethics Symposium: Incidental Findings in the Era of Whole Genome Sequencing

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Review clinical genetic testing methodologies. 2. Provide guidelines for the appropriate use of genetic tests. 3. Discuss ethical issues related to genetic testing. 4. Discuss adverse genetic outcomes of assisted reproductive technology (ART).

Supported by a 2013 endowment from the American Board of Obstetrics and Gynecology Paula Amato, M.D. (Chair) Oregon Health & Science University Laurence B. McCullough, Ph.D. Baylor College of Medicine John J. Hutton, M.D. University of Cincinnati College of Medicine

ACGME Competency Patient Care Professionalism

Needs Assessment and Description Genetic testing is playing an increasingly important role in medically assisted reproduction. Clinicians should be familiar with currently available genetic tests, their limitations, and ethical challenges.

TEST QUESTION Both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Medical Genetics (ACMG) recommend that fragile X carrier screening be offered to: a. Only those with a family history of fragile X b. Only those with ovarian insufficiency c. Only those who request it d. All couples, regardless of race/ethnicity e. Those with a family history of fragile X, undiagnosed mental retardation/developmental delay/autism, or those with ovarian insufficiency

73

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Symposium

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss the concepts and diagnostic methods used in Traditional Chinese Medicine. 2. Describe the role of Chinese herbs and acupuncture to decrease OHSS risk and relieve symptoms.

CSRM Symposium: The Interaction Between Traditional Chinese Medicine and Western Medicine Jie Qiao, M.D., Ph.D. (Chair) Peking University Third Hospital Dongzi Yang, M.D. Sun Yat-Sen Memorial Hospital Xuehong Zhang, M.D. Lanzhou University Xiaoke Wu, M.D., Ph.D. Heilongjiang University of Chinese Medicine

ACGME Competency Patient Care TEST QUESTION What are the four diagnostic methods of Traditional Chinese Medicine (TCM)? a. Observation, questioning, laboratory testing, and tasting b. Auscultation, questioning, palpation, and a trial of herbal therapy c. Observation, auscultation and olfaction, questioning, and palpation and pulse-taking d. Temperature-taking, auscultation, palpation, and pulse-taking e. Balance assessment, auscultation, questioning, and palpation and pulse-taking

Needs Assessment and Description Ovarian hyperstimulation syndrome (OHSS) is a complication of ovarian stimulation. Depending on the severity, symptoms range from mild abdominal discomfort to ascites and renal dysfunction and reflect the pathophysiologic extravasation and increased leakage of follicular blood and fluid into the abdominal cavity. This session for reproductive health care clinicians will explore the use of Traditional Chinese Medicine, including Chinese herbs and acupuncture, in the prevention and treatment of OHSS.

ASRM 2014 Annual Meeting

4:15 pm - 6:15 pm

74

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Symposium

4:15 pm - 6:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Summarize recent PCOS genetic data from a worldwide population. 2. Describe how the environment affects the expression of PCOS and its effects during pregnancy, childhood, and adulthood. 3. Discuss the impact of ethnic differences among patients with PCOS.

ALMER Symposium: PCOS from a Worldwide Perspective J. Ricardo Loret de Mola, M.D. (Chair) Southern Illinois University Richard Legro, M.D. Pennsylvania State University Carlos Moran, M.D. Mexican Institute of Social Security Teresa Sir-Petermann, M.D. University of Chile

ACGME Competency Practice-based Learning and Improvement

Needs Assessment and Description Polycystic ovary syndrome (PCOS) is an enigmatic disease associated with significant morbidity and reduction of fertility among women of reproductive age. Evidence suggests that the maternal-fetal environment plays an important role in the developmental programming of adult PCOS. Fetal androgen excess from congenital adrenal hyperplasia or virilizing tumors precede the development of PCOS-like symptoms after birth, while fetal metabolic, hormonal, and ovarian dysfunction also accompany gestational diabetes, which is common in PCOS mothers. There are clear clinical differences in how the disease affects different populations. These differences relate to the metabolic impact of PCOS and are particularly important in Latin-American countries. Although it has long been suggested that genetics play a role in the condition, recent data suggest a more important involvement in the genesis of the disease.

TEST QUESTION An 18-year-old woman with a history of hirsutism since puberty continues to worsen in her condition despite therapy with combined oral contraceptives. On physical exam she has sideburns and dark facial hair on her upper lip, chest, and abdomen. She has no evidence of acanthosis nigricans or clitoromegaly. After participating in this session, in my practice I will order the following test to make her diagnosis: a. Follicle-stimulating hormone (FSH) b. Dehydroepiandrosterone sulfate c. Random serum cortisol d. 17a-hydroxyprogesterone e. Not applicable to my area of practice

This educational activity is intended for obstetricians, gynecologists, reproductive endocrinologists, infertility specialists, and other health-care professionals involved in the diagnosis and treatment of PCOS, with emphasis on the fundamental skills essential for diagnosis, evaluation, and adequate treatment(s). By applying key concepts and employing fundamental techniques, health-care professionals will be able to effectively diagnose, wisely treat, and optimize outcomes in their affected patients.

75

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Symposium

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Counsel patients regarding the risk of gonadal failure after cancer treatments. 2. Describe how to optimally manage/stimulate patients undergoing fertility preservation. 3. Determine a plan for patients with inherited conditions who may desire preimplantation genetic diagnosis.

Oncofertility II - Female Supported by an educational grant from Ferring Pharmaceuticals, Inc. Mitchell P. Rosen, M.D. (Chair) University of California San Francisco Center for Reproductive Health Kutluk Oktay, M.D. New York Medical College Richard A. Anderson, M.D., Ph.D. University of Edinburgh Janine Mash, M.S. UCSF Center for Reproductive Health

ACGME Competency Patient Care Interpersonal and Communication Skills TEST QUESTION Which of the following would be least accurate when managing cancer patients who are considering fertility preservation? a. An assessment of ovarian reserve is required at the initial consultation. b. Patients must wait until their menses begin to start ovarian stimulation for the purpose of egg/embryo cryopreservation. c. Genetic evaluation is required to determine the genetic predisposition of their disease. d. If menses resume after chemotherapy, early menopause is inversely associated with the age of the patient.

Needs Assessment and Description Many young adult women diagnosed with cancer will have treatment that can reduce reproductive lifespan, although many don’t learn this fact before their treatment commences. Yet, obtaining information about the risk of treatment-associated infertility and premature menopause is a top concern for patients. Our understanding of how cancer treatment affects ovarian reserve and how we manage patients undergoing fertility preservation continues to evolve. This symposium will provide reproductive endocrinologists and oncologists with the most current information on how to counsel and individualize the potential loss in reproductive capacity. Faculty will also discuss current treatments for fertility preservation and focus on additional factors that should be considered when caring for these patients.

ASRM 2014 Annual Meeting

4:15 pm - 6:15 pm

76

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Symposium

4:15 pm - 6:15 pm NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe the devastating effects of genetic changes or exposure to cytotoxic treatments on male germline stem cells leading to male infertility. 2. Identify the options provided by modern ART procedures (cryopreservation, ICSI) for male fertility preservation, and potential risks for genetic or epigenetic changes in sperm. 3. Estimate the potential of spermatogonial stem cells as target cells for generation of sperm via transplantation, grafting, or in vitro culture.

Gamete Reserve I - Testis Supported by an educational grant from Ferring Pharmaceuticals, Inc. Stefan Schlatt, Ph.D. (Chair) Institute of Reproductive Medicine and Andrology, University of Münster Daniel H. Williams, M.D. University of Wisconsin Cigdem Tanrikut, M.D. Massachusetts General Hospital Richard Chaillet, M.D., Ph.D. University of Pittsburgh

ACGME Competency Medical Knowledge

Needs Assessment and Description Fertility preservation in the male is routinely performed by cryopreservation of sperm. However, prepubertal or azoospermic patients do not have this option. In recent years many scientific breakthroughs were achieved, creating novel options for male fertility preservation based primarily on the existence of spermatogonial stem cells. Testicular stem cells can be cryopreserved from birth onward, and strategies to create sperm by transplantation of the stem cell back to the testis, auto- or xenografting, or in vitro spermatogenesis may provide exciting novel clinical treatment options. Many centers have therefore started to create banks of cryopreserved immature testis tissue. This translational symposium deals with several relevant aspects of the introduction of intracytoplasmic sperm injection (ICSI) on fertility preservation in male patients, causes of infertility in oncological patients or men with Klinefelter syndrome, and the role of genetic or epigenetic patterns in germ cells. Preclinical perspectives for male fertility preservation will be presented. In addition to reproductive scientists, the symposium is highly relevant for a wide range of clinicians who are needed to perform these procedures in a clinical setting, including (pediatric) endocrinologists and oncologists, urologists, andrologists, and other assisted reproductive technology (ART) providers.

TEST QUESTION Future treatment for fertility preservation in prepubertal boys undergoing oncological treatment may be performed by: a. Combined treatment with LH and FSH to induce stimulation of spermatogenesis after cancer therapy. b. Bioptic retrieval and cryopreservation of immature testicular tissue and subsequent generation of sperm from cryopreserved stem cells by transplantation, grafting, or in vitro culture. c. Suppression of spermatogonial stem cell turnover via down-regulation of the gonadotropic hormones through treatment with GnRH antagonists. d. Cryopreservation of sperm obtained by electroejaculation.

77

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Symposium

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Conclude that HIV is a long-term manageable disease. 2. Increase their sensitivity to the psychological issues of gestational surrogates carrying for HIV-positive men as well as the psychological issues faced by the HIV-positive parents and their children. 3. Describe how the HIV virus affects reproductive risk and how to provide safe and ethically sound treatment options to those who are HIV-positive. 4. Discuss the ethical and legal ramifications and special factors that need attending to when working with HIV-positive and serodiscordant couples. 5. Explore the historical, cultural, and political drivers in the field of ART, using sperm from HIV-positive donors.

MHPG Symposium -Controversies and Cutting Edge in Thirdparty ART: Helping HIV Positive and Serodiscordant Couples Become Pregnant Kim Bergman, Ph.D. (Chair) Growing Generations Bradford A. Kolb, M.D. HRC Fertility - Pasadena Daniel Bowers, M.D. Callen-Lorde Community Health Center Richard B.Vaughn, J.D. International Fertility Law Group Needs Assessment and Description While assisted reproductive technology (ART) practitioners now routinely offer services to patients with advanced cancer, lesbians and gay men, transgendered people, single men or women, women well past menopause, and celebrities who choose not to carry their own babies, helping HIV-positive men and serodiscordant couples have their own biological children is one of the last taboos for the ART practitioner. Advances in treatment have made HIV a long-term manageable disease, creating a growing pool of HIV-positive men who see themselves as healthy fathers who can raise children. Advances in science and medical technology coupled with growing public acceptance and legal recognition of same-sex marriage and decreased discrimination and stigma for HIV-positive individuals are all generating more role models and opportunities for HIV-positive men to think about having children. The literature continues to show that HIV-positive men with undetectable viral loads are essentially noninfectious. Through gestational surrogacy, men who are HIV-positive and serodiscordant couples can now safely have their own biological children. Despite all of these legal, social, and medical advances, many practitioners continue to have concerns about serving this population. By exploring the history, science, medical procedures, psychological issues, legal status, and ethics of helping HIV-positive and serodiscordant couples have their own biological children through third-party ART, this course will increase the cultural competency of psychologists, lawyers, and medical doctors working with this newest population of prospective parents.

ASRM 2014 Annual Meeting

11:15 am - 1:00 pm

ACGME Competency Patient Care TEST QUESTION After participating in this session, in my practice I will use the following as an accepted method to minimize the risk of transmission of the HIV virus in procedures for reproductive purposes: a. Stopping antiviral therapy only a month prior to treatment b. Separating the sperm from leukocytes and seminal plasma by gradient separation followed by a swim-up technique c. Treating a heterosexual couple with ovulation induction with timed intercourse d. Maintaining a strict policy prohibiting the treatment of HIV-affected patients e. Prescribing prophylactic interferon therapy for the recipient at the time of treatment f. Not applicable to my area of practice

78

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Symposium

11:15 am - 1:00 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe current options to preserve fertility and emerging techniques targeted at improving oocyte cryopreservation. 2. Discuss indications for freeze-all embryo cycles as a means to optimize patient outcomes. 3. Counsel patients regarding implications of freeze-all cycles.

NPG Symposium - Freeze All Cycles—Eggs and Embryos Carolyn Collins, B.S.N., R.N. (Chair) Reproductive Medicine Associates on New Jersey G. David Ball, Ph.D. Seattle Reproductive Medicine Wen-Hui Shen, M.D., Ph.D. Kaiser Permanente Center for Reproductive Health Needs Assessment and Description Freeze-all cycles are becoming increasingly more common in assisted reproductive technology (ART) due to improvements in oocyte and embryo cryopreservation techniques. Freeze-all oocyte cycles provide patients with the option of fertility preservation. As such, it is an appropriate option for patients who wish to delay reproduction for elective purposes, those who are experiencing fertility-threatening illness (such as cancer), as well as those who may be unable to freeze embryos for legal, medical, or social reasons. In addition, freeze-all embryo cycles are useful in ART and especially benefit patients with ovarian hyperstimulation syndrome (OHSS) and uterine dyssynchrony. This live course for nurses and other allied health professionals will discuss current and future trends in the management of freeze-all cycles used to optimize patient outcomes.

ACGME Competency Patient Care TEST QUESTION A 27-year-old woman with polycystic ovary syndrome (PCOS) has an antimüllerian hormone (AMH) level of 19 ng/mL and a basal antral follicle count (AFC) of 42. The patient is undergoing an in vitro fertilization (IVF) cycle with an antagonist protocol and presents on cycle day 12 with a serum estradiol level of 6,300 pg/mL. The physician performing the day-12 ultrasound determines that the patient is ready to be triggered for her oocyte retrieval (OR). After participating in this session, in my practice I will recommend the following: a. Administer a gonadotropin-releasing hormone antagonist (GnRHa). b. Convert the patient to a freeze-all cycle due to her risk of ovarian hyperstimulation syndrome (OHSS). c. Trigger the patient with 10,000 units of human chorionic gonadotropin (hCG) and proceed with a double-embryo transfer (DET). d. Prevent spontaneous ovulation by withholding the trigger dose and cancel the cycle. e. Not applicable to my area of practice

79

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Symposium

Learning Objectives At the conclusion of this session, participants should be able to: 1. Create an onboarding program so each team member understands the emotional impact of infertility. 2. Discuss ways that health-care team members directly impact the patient’s experience. 3. Track patient satisfaction through analyzing retention and formulate a game plan for improvement.

ARM Symposium - The Patient-Team Approach Lisa Duran, B.A. (Chair) RMA of New York, LLP Brad Senstra, M.H.A. Seattle Reproductive Medicine Needs Assessment and Description Health care in general and fertility care specifically are becoming more competitive. Fertility practices can compete on the elements of price, success rates, and the patient experience. Furthermore, a fertility center’s marketing approaches to the patient are different from any other specialty. The patient experience is where the entire team can make an impact. Even if a clinic has great success rates and a great price, if the experience is not one in which the patient feels cared for regardless of the outcome, the clinic’s reputation suffers. This session for assisted reproductive technology (ART) practice managers and health-care professionals will examine the patient experience in terms of patient satisfaction and retention.

ASRM 2014 Annual Meeting

11:15 am - 1:00 pm

ACGME Competency Professionalism TEST QUESTION You are concerned about patient retention in your ART program as a competing clinic has recently opened its doors. After participating in this session, in my practice I will: a. Offer our team a referring incentive to bring in new patients. b. Tell our patients that the new clinic down the street does not have good success rates. c. Lower our prices. d. Create a patient services initiative, because there is a correlation between the patient experience and retention. e. Not applicable to my area of practice

80

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Symposium

3:45 pm - 5:45 pm NONCME

CE

ARS

Learning Objectives At the conclusion of this presentation, participants should be able to: 1. Outline strategies for prediction, prevention, and management of OHSS. 2. Present ideal protocols to eliminate OHSS or at least diminish its incidence. 3. Discuss the incidence of arterial thrombosis after OHSS and its detection and management. 4. Discuss fluid management in severe OHSS.

MEFS Symposium: Complete Prevention of OHSS—Is It Possible? Botros R.M.B. Rizk, M.D. (Chair) University of South Alabama William E. Gibbons, M.D. Baylor Family Fertility Program Needs Assessment and Description Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of ovarian stimulation resulting in strokes, renal failure, acute respiratory distress syndrome (ARDS), and death. Despite extensive research and study of this condition, every year these serious complications occur in the United States and worldwide. Accurate prediction and prompt prevention could abolish these complications. Management of cerebrovascular thrombosis and fluid management are key issues in reducing morbidity and mortality. This session is for reproductive endocrinologists involved in assisted reproductive technology (ART) and gynecologists with special interest in infertility, as well as fellows in reproductive medicine, radiologists, and ultrasonographers involved in the clinical care of patients suffering from OHSS.

ACGME Competency Patient Care TEST QUESTION After participating in this session, in my practice I will promptly start anticoagulant therapy in the following patients after an in vitro fertilization (IVF) cycle: a. Patients with ovaries that are 5 cm or more in diameter b. Patients admitted to the hospital with severe ovarian hyperstimulation syndrome (OHSS) c. Patients with a twin gestation d. Patients with moderate OHSS e. Not applicable to my area of practice

81

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Symposium

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe the intricacies of oocyte donation. 2. Explain how surrogacy works. 3. Summarize the need for and legal aspects of crossborder reproduction (shipping of sperm, oocytes, and embryos). 4. Explore the ethical and legal aspects of this complex mode of reproduction, with attention to how aspects differ in various countries and various religions.

ISAR Symposium: Third-party Reproduction Narendra Malhotra, M.D. (Chair) Global Rainbow Healthcare Jaideep Malhotra, M.D. Indian College of Obstetrics and Gynecology Manish R. Banker, M.D. Nova IVI Fertility Duru S. Shah, M.D. Gynaecworld- The Center for Women’s Health & Fertility Needs Assessment and Description Third-party reproduction has become a mainstay in the armamentarium of assisted reproductive technology (ART) practice. More and more couples are seeking to have babies with the involvement of a third party (donor sperm, donor eggs, surrogate mothers). This rise is due to a medical need for cases of untreatable azoospermia, premature ovarian failure, disorders of the uterus, and many medical diseases that make carrying a pregnancy difficult and risky. There is also a demand from single parents and same-sex couples.

ASRM 2014 Annual Meeting

3:45 pm - 5:45 pm

ACGME Competency Patient Care TEST QUESTION Which of the following best describes gestational surrogacy? a. A woman becomes pregnant with assisted reproductive technology using her own eggs. b. The ovum of the surrogate is used for embryo creation via in vitro fertilization. c. The sperm of the male of the commissioning couple is used to inseminate the surrogate woman. d. The intended mother receives a donor embryo from a third party. e. The surrogate is not genetically related to the child.

82

SCIENTIFIC PROGRAM • SYMPOSIA

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Symposium

3:45 pm - 5:45 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify potential genetic risks in women with low ovarian reserve. 2. Interpret markers of ovarian reserve. 3. Utilize markers of ovarian reserve in clinical management of women of reproductive age.

Gamete Reserve II - Ovary Supported by an educational grant from Ferring Pharmaceuticals, Inc. Marcelle I. Cedars, M.D. (Chair) University of California San Francisco Center for Reproductive Health Aleksander Rajkovic, M.D. University of Pittsburgh David B. Seifer M.D. Genesis Fertility & Reproductive Medicine

ACGME Competency Patient Care Interpersonal Skills and Counseling TEST QUESTION A 32-year-old single woman comes for her annual examination. She asks you about egg freezing as she read about it in a newspaper article. She’s not sure if she really wants to proceed but is currently in graduate school, not in a serious relationship, and is taking oral contraceptive pills (OCPs). She is interested in having children as part of her life plan. You decide to order an antimüllerian hormone (AMH) level to better assess her reproductive potential. Her AMH returns at 0.25 ng/mL. After participating in this session, in my practice I will do the following as the next step: a. Counsel her about likelihood for menopause before the age of 35. b. Refer her immediately for egg freezing. c. Discuss potential implications and need for her to stop the OCPs and have additional testing. d. Request she repeat testing in 1 year. e. Not applicable to my area of practice

Needs Assessment and Description Assessment of ovarian reserve in infertility patients has been part of infertility care and management since the late 1980s when follicle-stimulating hormone (FSH) therapy was first introduced. Since 2002-2005, antral follicle count (AFC) and antimüllerian hormone (AMH) have been increasingly utilized for this purpose. While most would agree that these markers have more specificity for response to stimulation, there is still controversy regarding exactly what they measure and how they should be utilized. This symposium will focus on the latest information regarding genetic causes of decreased ovarian reserve (particularly those that may be of special relevance to reproductively active women), factors that may impact the specific results and hence interpretation of ovarian reserve testing, and how these markers of ovarian reserve should be utilized in clinical practice. This information will be useful for all physicians in clinical practice as even those physicians who do not use assisted reproductive technology need to know when to apply these tests and how to interpret them. Most importantly will be knowledge gained in counseling patients regarding results.

83

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • SYMPOSIA ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Symposium

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify new technologies in embryo selection. 2. Describe the necessary and accumulating evidence to demonstrate the utility of comprehensive chromosome screening-based embryo selection. 3. Discuss the importance of and methodology for controlling the multiple known and unknown variables that may impact embryonic reproductive potential. 4. Explore current proteomics and metabolomics techniques that are being developed for embryo selection in in vitro fertilization (IVF). 5. Identify the applications and potential benefits of time-lapse technology, and emerging research in the use of time-lapse imaging.

How to Choose the Best Embryo - Proteomic, Metabolomic, Genomic, Imaging Tien-cheng Arthur Chang, Ph.D. (Chair) University of Texas Health Science Center at San Antonio Wayne A. Caswell, M.S. Fertility Centers of New England Mandy Katz-Jaffe, Ph.D. Colorado Center for Reproductive Medicine Nathan R. Treff, Ph.D. Reproductive Medicine Associates of New Jersey Needs Assessment and Description With the goal to help couples undergoing assisted reproductive technology (ART) treatments achieve a higher success rate and a lower number of multiple pregnancies, many technologies are being developed for embryo selection. The ideal technology will provide a reliable, costeffective, and efficient predictive test of embryo viability and pregnancy outcome. This live session for reproductive laboratory professionals, physicians, genetic testing professionals, and other reproductive medicine clinicians and researchers will explore the updates and the latest trends in embryo selection technologies.

ASRM 2014 Annual Meeting

3:45 pm - 5:45 pm

ACGME Competency Medical Knowledge Practice-based Learning and Improvement TEST QUESTION What does the non-selection clinical trial help to establish? a. The predictive value of the test for actual clinical outcomes b. The clinical efficacy of a new biomarker c. The impact of the intervention on the embryo’s reproductive potential d. The preclinical accuracy of the test

84

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify major barriers to contraceptive access among disadvantaged women. 2. Describe several strategies for improving contraceptive access among disadvantaged women.

Contraception Day: CSIG and HDSIG Interactive Session Contraceptive Strategies for Disadvantaged Women Supported by an educational grant from Merck Alternate Panel (Letterman) Alicia Y. Armstrong, M.D. (Chair) National Institutes of Health Bliss Kaneshiro, M.D., M.P.H. University of Hawaii David F. Archer, M.D. Eastern Virginia Medical School Tessa Madden, M.D., M.P.H. Washington University School of Medicine

ACGME Competency Patient Care TEST QUESTION A 34-year-old woman presents with symptomatic leiomyomata (which do not distort the uterine cavity) and mild anemia. She is recently postpartum and does not plan to have additional children for at least 3 years. She is uninsured and has an income of less than $25,000 a year. After participating in this session, in my practice I will recommend the following contraceptive option to provide the lowest failure rate, greatest noncontraceptive benefits, and be the most cost-effective: a. Combined oral contraceptives b. Depot medroxyprogesterone c. Levonorgestrel-containing intrauterine device (IUD) d. Contraceptive implant e. Contraceptive vaginal ring f. Not applicable to my area of practice

Needs Assessment and Description Unintended pregnancies are a worldwide problem and disproportionately impact disadvantaged women. Globally, 86 million pregnancies were unintended, of which 41 million ended in abortion, 33 million unplanned births, and 11 million miscarriages. Healthcare providers, policy makers, and basic scientists involved in contraceptive research all play an important role in identifying effective contraceptive options and making them available to all women, particularly disadvantaged women.

85

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Interactive Session

Learning Objectives At the conclusion of this session, participants should be able to: 1. Review trends in reproductive health disorders and endocrine-disrupting chemicals. 2. Describe the evidence linking select endocrine disruptors with reproductive outcomes. 3. Identify what health-care professionals can do to increase their knowledge and minimize exposures for patients at risk.

Update from WHO/UNEP-Endocrine -disrupting Chemicals 2012 Roving Microphone Sheryl Ziemin Vanderpoel, Ph.D. World Health Organization Needs Assessment and Description In 2013 the World Health Organization (WHO) and the United Nations Environment Programme (UNEP) issued a 260-page report, State of the Science of Endocrine Disrupting Chemicals – 2012, which provided an update on the scientific knowledge about endocrine disruptors and concerns about their potential adverse health effects on humans and wildlife. This symposium will review the salient points of this report and provide an update on new information about these chemicals and reproductive and developmental health outcomes. It will also include information of value for health-care professionals and learners in reproductive science and medicine about “next steps” to learn more about these issues and the efforts of our professional organizations toward increasing awareness among our patients and integrating environmental reproductive health into curricula, while assuring that all evidence is supported by the highest quality science.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

ACGME Competency Practice-based Learning and Improvement TEST QUESTION A 28-year-old bank executive and her 34-year-old husband have been trying to get pregnant for the past 2 years. Her workup is negative to date; however, her antral follicle count and antimüllerian hormone (AMH) level reflect low ovarian reserve, and his semen analysis is abnormal. They exercise, eat a balanced diet, and come to your office to inquire about how lifestyle might contribute to their infertility. After participating in this session, in my practice I will: a. Tell them that nothing is going to affect their fertility potential; “it’s all in your genes.” b. Tell them that some things may be detrimental to reproductive performance, but there’s nothing certain so you may as well not bother. c. Ask about their personal care products, canned food usage, bottled water usage, and where they live. d. Send them to an occupational and environmental health specialty clinic for routine chemical testing. e. Not applicable to my area of practice

86

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Explain the rationale for the diagnostic criteria in PCOS. 2. Discuss the potential complications of obesity in the management of PCOS.

Dilemmas in the Care of Polycystic Ovary Syndrome Patients Roving Microphone Kathleen M. Hoeger, M.D., M.P.H. (Chair) University of Rochester Medical Center Anuja Dokras, M.D., Ph.D. University of Pennsylvania Helena Teede, M.B.B.S, Ph.D. Monash Centre for Health Research and Implementation, Monash University

ACGME Competency Patient Care TEST QUESTION A 25-year-old woman with 35- to 40-day menstrual cycles presents for evaluation. She has been on hormonal contraception since age 17 and stopped recently to attempt conception. She recalls similar menses as an adolescent. She has noted a modest increase in facial hair since stopping the oral contraceptive, and her evaluation thus far indicates no thyroid dysfunction and normal folliclestimulating hormone (FSH) and prolactin levels. She has a normal physical exam with absence of clitoromegaly or Cushing stigmata, and her total testosterone is 60 ng/ dL (upper limits of normal for the lab = 50 ng/dL). Her body mass index is 25 kg/m2. After participating in this session, in my practice the next step in the diagnosis of her menstrual dysfunction would be: a. Dehydroepiandrosterone sulfate (DHEAS) level b. Luteinizing hormone (LH) testing c. Ovarian ultrasound d. Free testosterone level e. Not applicable to my area of practice

Needs Assessment and Description Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women and impacts 5%-10% of the population. The management of PCOS is often challenging and can vary by presentation and age. This session for clinicians and allied health professionals will provide a discussion of the challenges of diagnosis in various age groups, treatment options in the infertile patient including metformin, and the challenge of obesity in the management of this condition.

87

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Interactive Session

Learning Objectives At the conclusion of this session, participants should be able to: 1. Determine the points of preventable adverse events in the ART laboratory. 2. Identify strategies for implementing patient safety– focused protocols.

Best Practices to Prevent Serious Laboratory Errors Panel Discussion of Cases Anthony R. Anderson, M.S. (Chair) Reproductive Medicine Associates of Texas, PA Richard T. Scott, M.D. Reproductive Medicine Associates of New Jersey Marius Meintjes, Ph.D. Frisco Institute for Reproductive Medicine

ACGME Competency Professionalism

Needs Assessment and Description To Err Is Human: Building a Safer Health System made its debut in 1999 by the Institute of Medicine National Academy of Sciences. Through observation of various industries, such as the airline industry, many changes have been made in the health care system, either through self-regulation or government intervention. This session for assisted reproductive technology (ART) laboratory clinicians and laboratorians will provide strategies in continued quality management.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

TEST QUESTION The primary purpose of contemporaneous written documentation of a laboratory risk event is to: a. Offer a reason for the adverse event in a patient’s medical record in order to be able to answer any questions the patient may ask b. Create protected information that will only be used by the ART laboratory’s defense attorney in the event of a lawsuit c. Provide a truthful, objective summary of facts, excluding blame or personal opinion, that can be used to document the event, write an action plan, and defend a potential lawsuit d. Enforce further policies and procedures necessary to prevent the event from happening again

88

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Interactive Session

Use of Aromatase Inhibitors in Endometriosis and Ovulation Induction Panel Discussion

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss the common side effects, adverse events, and any teratogenicity of aromatase inhibitors in the treatment of reproductive disorders. 2. Identify the relative efficacy of aromatase inhibitors to treat PCOS vs. unexplained infertility.

Richard S. Legro, M.D. (Chair) Pennsylvania State University Michael P. Diamond, M.D. Georgia Regents University Serdar E. Bulun, M.D. Northwestern University

ACGME Competency Practice-based Learning and Improvement

Needs Assessment and Description This interactive session for reproductive-care physicians and allied health-care providers will examine the role of aromatase inhibitors in the treatment of common reproductive disorders, including polycystic ovary syndrome (PCOS), unexplained infertility, endometriosis, and uterine fibroids.

TEST QUESTION A 31-year-old female presents with a history of unexplained infertility of 36 months’ duration, confirmed by evaluation of the male partner and tubal factor assessment. They have had no prior infertility treatment. The couple now presents for consultation to discuss treatment options and desires a safe and effective therapy to achieve a healthy singleton live-born baby. After participating in this session, in my practice I will recommend the following: a. Expectant management for another 12 months b. Clomiphene/intrauterine insemination (IUI) for 3-6 cycles c. Letrozole/IUI for 3-6 cycles d. Gonadotropin/IUI for 3-6 cycles e. Immediate in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) f. Not applicable to my area of practice

89

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Monday, October 20, 2014 PANTONE 200

Interactive Session

Learning Objectives At the conclusion of this session, participants should be able to: 1. Describe treatment options to maximize fertility for girls with various reproductive abnormalities. 2. Determine the best time for intervention to maximize fertility for girls with various reproductive abnormalities.

Reproductive Abnormalities: How to Optimize Future Fertility Case Presentations Staci E. Pollack, M.D. (Chair) Montefiore’s Institute for Reproductive Medicine and Health Samantha M. Pfeifer, M.D. Weill Cornell Medical College Beth W. Rackow, M.D. Columbia University Medical Center

ACGME Competency Patient Care

Needs Assessment and Description Many reproductive disorders present during adolescence, either with abnormal pubertal development, menstrual cycle abnormalities, pelvic pain, or as incidental findings on imaging. Early suspicion and diagnosis afford the best opportunity for maximizing future fertility. This interactive session will discuss adolescents with various reproductive conditions, such as “impending” primary ovarian insufficiency and reproductive tract anomalies, as well as approaches to managing such issues for those clinicians who take care of adolescent girls.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

TEST QUESTION An 18-year-old, gravida 0, virginal, adolescent girl presents to your office complaining of irregular menses since menarche at age 13, often going 6 months without a period. Her height is 5’5” and weight is 128 pounds, making her body mass index (BMI) 21.3 kg/m2 and in the 49th percentile for her age. She denies galactorrhea, hirsutism, excessive exercise, and any eating issues. After participating in this session, I will order the following test to best assess her future fertility and assist with counseling: a. Pelvic ultrasound b. Pelvic magnetic resonance imaging (MRI) c. Total testosterone d. Follicle-stimulating hormone (FSH) e. Antimüllerian hormone (AMH) f. Not applicable to my area of practice

90

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Monday, October 20, 2014

h r a

health affects reproduction affects health

Interactive Session

Meet the Professor Meet the Professor

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss how a mouse model for Klinefelter syndrome relates to the clinical disorder. 2. Gain insight from the XXY mouse model on the relative roles of genes and testosterone on the abnormalities seen in Klinefelter syndrome.

Ronald S. Swerdloff, M.D. Harbor-UCLA Medical Center Needs Assessment and Description 41,XXY mouse models share many characteristics of the human 47,XXY Klinefelter syndrome (KS). This lecture for clinicians and researchers discusses the relative role of androgen deficiency and X chromosome genes resulting in the XXY mouse phenotype. The similarities in phenotype between 47,XXY men and 41,XXY mice suggest that the clinical manifestations in XXY men may relate principally to gene-dosage effect from genes that escape X inactivation in mice. Some manifestations, however, are related to low serum testosterone levels.

ACGME Competency Medical Knowledge TEST QUESTION A 20-year-old man is referred to an endocrinologist for hypogonadism (low serum testosterone). The patient has a past history of poor school performance and on physical examination has small testes. After participating in this session, in my practice I will recommend the following: a. Serum testosterone level that afternoon b. Karyotype c. Serum DHEAS d. Reviewing family history for cryptorchidism e. Not applicable to my area of practice

91

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Interactive Session

Menopause Day Interactive Session - Tailoring Management Strategies to Patient Needs: A Case-based Interactive Discussion on Common Concerns (Wellness, Breast, and Bones)

NONCME

CE

ARS

3. Recommend therapies for vasomotor symptom relief in patients with cardiovascular risks. 4. Identify populations at risk for fragility fracture. 5. Initiate a workup for evaluation of metabolic causes of bone loss. 6. Discuss unique profiles and efficacy of drugs available for fracture risk reduction. 7. Individualize fracture risk reduction strategy to unique patient profile. 8. Counsel patients regarding modifiable and non-modifiable breast cancer risks 9. Counsel patients regarding current breast screening recommendations. 10. Recommend therapies to treat bothersome vasomotor symptoms in women with a personal as well as a family history of breast cancer.

Supported by an educational grant from Shionogi, Inc. Case Presentations Genevieve Neal-Perry, M.D., Ph.D. (Chair) Albert Einstein College of Medicine Cynthia A. Stuenkel, M.D. University of California, San Diego Hugh S. Taylor, M.D. Yale University Lubna Pal, M.B.B.S., M.Sc. Yale University

ACGME Competency Patient Care Interpersonal and Communication Skills

Needs Assessment and Description Optimal care of the mature woman who is transitioning through menopause or who has already become postmenopausal requires a multifaceted approach. As the focus on prevention and wellness replaces an emphasis on diagnosis and treatment of medical maladies, an individualized approach becomes essential. Careful evaluation of a patient’s medical situation must be coupled with a clear understanding of her healthcare priorities and personal treatment preferences. Despite an increasing awareness of the magnitude of health burden relating to osteoporosis, confusion exists among patients and providers regarding the optimal therapeutic intervention for fracture risk reduction based on the individual patient profile. Breast cancer is the leading cancer in women with more than 227,000 cases reported in the United States in 2012. The treatment of bothersome vasomotor symptoms in women diagnosed with breast cancer, with a history of breast cancer, or at risk for breast cancer is often area of concern for the affected patient as well as the prescribing clinician. This interactive session is designed to provide clinicians involved in the care of perimenopausal and menopausal women with the tools for developing individualized care and treatment plans.

TEST QUESTION A 49-year-old (gravida 4, para 2023) Latina woman comes to your office to discuss relief of bothersome hot flashes and weight gain. Her last menstrual period was 6 months ago and she reports no bleeding in the interim. She is a school teacher and finds herself increasingly fatigued as her symptoms disrupt her sleep. She mentions that she smokes a pack of cigarettes every 3 days. She also states that she has been told in the past that her blood pressure runs a bit high and for that she takes hydrochlorothiazide. Her blood glucose is in the ‘borderline’ range. Her examination is remarkable for a blood pressure of 145/85, body mass index of 29 kg/m2, and waist circumference of 36 inches. She has normal breast and pelvic examinations. Laboratory evaluation is remarkable for fasting blood glucose 107 mg/dL, high density lipoproteins (HDL) 42 mg/dL, and triglycerides 189 mg/dL. Mammogram demonstrates dense breasts. After participating in this session, in my practice I will advise the following: a. Initiate statin therapy for cardiovascular risk reduction b. Start metformin today to address blood glucose elevation c. Diet and lifestyle interventions to effect weight loss d. Initiate hormone therapy for VMS relief—preparation her choice e. Consider oral contraceptive therapy for symptom relief f. Not applicable to my area of practice.

Learning Objectives At the conclusion of this session, participants should be able to: 1. List criteria for diagnosing the metabolic syndrome. 2. Calculate a patient’s personal risk of cardiovascular disease and discuss the options for preventive strategies. ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

92

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm NONCME

CE

ARS

Did You Know That WHO— A UN Agency—Is Committed to Global Reproductive Medicine for all Individuals? Roving Microphone Sheryl Ziemin Vanderpoel, Ph.D. (Chair) World Health Organization Needs Assessment and Description WHO promotes reproductive health and access to reproductive health care for all people. In addition to providing access to contraception and care for sexually transmitted diseases, the WHO, which has officially classified infertility as a disease, is committed to ensuring all individuals can fulfill their reproductive potential. This interactive session will familiarize reproductive health professionals with the range of global programs and services provided by the WHO in the area of human reproduction. Learning Objectives At the conclusion of this session, participants should be able to: 1. Explore a range of reproductive health care programs appropriate for their demographics. ACGME Competency Patient Care

93

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Interactive Session

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Summarize need- and evidence-based developments for appropriate use of PGS. 2. Describe the techniques used for PGS and identify the factors associated with reducing error rates during this testing.

Recurrent Pregnancy Loss and Preimplantation Genetic Screening Errors Case Presentations with ARS William E. Roudebush, Ph.D. (Chair) University of South Carolina School of Medicine, Greenville Creighton E. Likes, III, M.D., M.S. Fertility Center of the Carolinas Dennis Peffley, J.D., Ph.D. University of South Carolina School of Medicine Greenville David J. Wininger, Ph.D. Premier Fertility Center

ACGME Competency Patient Care TEST QUESTION A 32-year-old female patient with recurrent miscarriages presents to an infertility physician for a consult. The physician and patient discuss possible treatment options, including in vitro fertilization (IVF) with preimplantation genetic screening (PGS). Included within the discussion are the day of embryo biopsy and the pros and cons of available PGS methodologies and their respective error rates. After participating in this session, in my practice I will choose the following approach to maximize the overall chance of a successful pregnancy outcome: a. Day-3 biopsy with qPCR b. Day-3 biopsy with Next-Gen Sequencing c. Day-3 biopsy with qPCR and Next-Gen Sequencing d. Day-5 biopsy with qPCR e. Day-5 biopsy with Next-Gen Sequencing f. Day-5 biopsy with qPCR and Next-Gen Sequencing g. Not applicable to my area of practice

Needs Assessment and Description Preimplantation genetic screening (PGS) is rapidly becoming a routine procedure used to determine chromosomal normality in embryos produced through in vitro fertilization (IVF). To maximize the efficiency/ proficiency and to minimize errors of the PGS procedure, many factors need to be considered, including but not limited to cell stage for embryo biopsy and screening protocol. This interactive session will address the best practices options to minimize PGS errors for practicing physicians, nurses, and laboratory staff.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

94

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss results of early vs. late fertility treatment for males with Klinefelter syndrome. 2. Identify developmental issues that can be affected by androgen therapy in the Klinefelter male.

Aggressive or Delayed Management of the Klinefelter Adolescent: What Do the Data Show? An Interactive Debate Debate Peter N. Schlegel, M.D. (Chair) Weill Cornell Medical College Darius A. Paduch, M.D. Weill Cornell Medical College Robert D. Oates, M.D. Boston Medical Center

ACGME Competency Patient Care TEST QUESTION In a 28-year-old male with Klinefelter syndrome, aromatase inhibitor therapy is most likely to: a. Increase estradiol. b. Decrease FSH. c. Increase testosterone. d. Improve sperm retrieval rates.

Needs Assessment and Description This interactive session for clinicians and researchers involved in male fertility care will provide expert review of the potential for early treatment of Klinefelter syndrome in adolescents to improve future fertility as well as the potential developmental benefits of androgen therapy. Results of early intervention with hormonal therapy and sperm retrieval will be presented. The risks and results of such treatment of adult males with Klinefelter syndrome will be discussed, and the limitations of current published literature will be reviewed in an interactive format with audience participation.

95

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Interactive Session

Uterine Fibroids—Which Treatment for Which Patients? Roving Microphone

Learning Objectives At the conclusion of this session, participants should be able to: 1. Evaluate the suitability of fibroid therapies based on symptoms and size and location of fibroids. 2. Discuss the known effects of fibroid therapies on fertility and ovarian hormones.

Shannon Laughlin-Tommaso, M.D. (Chair) Mayo Clinic Maureen Kohi, M.D. University of California, San Francisco Needs Assessment and Description One in four women will have symptoms of fibroids. While fibroids have been the leading cause of hysterectomy, there are now many alternatives. This session for clinicians and allied health care professionals will discuss how to determine the best alternatives for clinical cases of uterine fibroids.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

ACGME Competency Patient Care TEST QUESTION A 35-year-old woman (gravida 2, para 2) presents with heavy menstrual bleeding and pelvic discomfort. An ultrasound reveals a 6-cm fundal uterine fibroid that abuts the endometrium. She is considering a third child. After participating in this session, in my practice I will recommend the following for this patient: a. Focused ultrasound ablation b. Uterine artery embolization c. Oral contraceptive pills d. Hysterectomy e. Not applicable to my area of practice

96

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Summarize the evidence regarding treatment of the male with varicocele who is pursuing fertility treatment. 2. Identify modifiable semen parameters with varicocele treatment.

Varicocele—If and When to Treat Alternate Panel (Letterman) James H. Segars, M.D. (Chair) National Institute of Child Health and Human Development Daniel H. Williams, M.D. University of Wisconsin School of Medicine and Public Health, Madison Edward Kim, M.D. University of Tennessee Graduate School of Medicine Margareta Pisarska, M.D. Cedars Sinai Medical Center, Los Angeles

ACGME Competency Patient Care TEST QUESTION A couple presents with 2 years of infertility. Evaluation of the female reveals no abnormality. Evaluation of the male discloses normal levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone. A semen analysis (repeated) confirms a count of 20 million/ mL and motility of 39%, with 12% normal forms by World Health Organization (WHO) criteria. A grade 3 varicocele is detected on the left, and a grade 1 is present on the right side. The patient’s urologist recommends varicocele ligation. After participating in this session, in my practice I will advise this man that the following is MOST likely to be improved as a result of the varicocele ligation: a. Sperm concentration b. Sperm motility c. Sperm oxidative stress (DNA fragmentation assay) d. Likelihood of pregnancy e. Likelihood of live birth f. Not applicable to my area of practice

Needs Assessment and Description Varicoceles are commonly encountered in men, both incidentally and in men seeking fertility care. Evidence and indications regarding possible benefits of varicocele ligation in men can be confusing to patients and practitioners. The evidence is conflicting and opinions differ, especially regarding whether ligation can result in an increased likelihood of pregnancy. This symposium for urologists and allied health-care professionals will examine this controversy using an interactive and dynamic “no holds barred” talk show–host format to provide participants with the latest information regarding treatment of men with varicoceles in order to properly counsel couples on this topic.

97

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

Interactive Session

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss the future of in vitro fertilization and the role of PGD. 2. Explore the interdisciplinary advances in genetic analysis.

Preimplantation Genetic Diagnosis—The Near Future Alternate Panel (Letterman) Santiago Munné, Ph.D. (Chair) Reprogenetics Dagan Wells, Ph.D. Reprogenetics Russell Durrett Recombine Moses Cesario, M.S. Previvo Genetics

ACGME Competency Practice-based Learning and Improvement TEST QUESTION Once complete sequencing of embryos is available, would it have a use? a. It is cheaper to test the parents (2 samples) and do preimplantation genetic diagnosis (PGD) for a specific gene defect than a whole sequence of all embryos (6 samples average). b. Whole sequencing of embryos is preferred as it detects de novo abnormalities. c. There are no distinct differences in efficiency for sequencing the whole genome of embryos vs. PGD.

Needs Assessment and Description Different waves of technology have shaped the genetic analysis of embryos, from micromanipulation to sequencing. This session for laboratory scientists and reproductive health-care clinicians will debate the options feasible with current technology trends. Will genetics be needed once we know the function of the DNA code, and is this disruptive? Will all IVF cycles employ preimplantation genetic diagnosis (PGD), or will IVF even be needed?

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

98

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Tuesday, October 21, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify pregnancy-related risks and discuss how these are communicated among reproductive endocrinologists, obstetricians, maternal fetal medicine specialists, internists, and family medicine physicians. 2. Evaluate a communication tool that can be used in clinical practice to allow for improved team communication and coordination of care. 3. Demonstrate opportunities for improved care and the potential for improved maternal and child health utilizing the risk stratification tool prior to fertility care.

Mayo Preconception Risk Stratification for ART and Fertility Care Charles C. Coddington, M.D. (Chair) Mayo Clinic Kristi S. Borowski, M.D. Mayo Clinic Needs Assessment and Description Safety and team communication are paramount to the successful completion of pregnancy. However, assessment of obstetric outcomes relative to risk has not been well delineated for medically complex fertility patients. In addition, many medical conditions have well-documented, outcomes-based research to guide clinical decision making in pregnancy, but there are other conditions that do not have well-defined outcomes research. This interactive session for clinicians and allied health care professionals involved in women’s reproductive care will propose a preconception evaluation process to help clarify and communicate the risk involved in pregnancy for medically complex patients and to provide appropriate consultation, evaluation, and treatment recommendations prior to fertility care as needed.

ACGME Competency Patient Care Systems-based Practice TEST QUESTION After participating in this session, in my practice I will identify the following factor as one that does not play a role in assigning a patient to a risk stratification level: a. Class D diabetes with HbA1c of 11%. b. Successful liver transplantation 1½ years ago c. Moderate hypertension controlled with a 2-drug regimen d. Mild to moderate endometriosis with no ovarian involvement e. History of ovarian hyperstimulation with gonadotropin ovulation induction f. Not applicable to my area of practice

99

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Interactive Session

Recurrent Pregnancy Loss: One Should Evaluate for Chronic Endometritis Debate Danny J. Schust, M.D. (Chair) University of Missouri Mary D. Stephenson, M.D., M.Sc. University of Illinois at Chicago Steven L. Young, M.D. University of North Carolina School of Medicine Needs Assessment and Description A timed, luteal-phase endometrial biopsy was part of the standard evaluation for recurrent pregnancy loss for many years. Data demonstrating its poor predictive value for histological evaluation of the “luteal-phase defect” caused it to be dropped from this workup by most practitioners. New data have suggested that this procedure should again be employed in evaluations for recurrent pregnancy loss— however, now for the diagnosis of chronic endometritis. This debate will address the utility of the endometrial biopsy for the diagnosis of chronic endometritis in this diagnostically and therapeutically difficult patient population. The session is designed for clinicians involved in the care of infertile women and those with recurrent pregnancy loss.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Determine whether the diagnosis of chronic endometritis has prognostic or diagnostic value in a patient with a history of recurrent pregnancy loss. 2. Discuss the utility of adding this test to the recurrent pregnancy loss workup in clinical practice. ACGME Competency Patient Care TEST QUESTION A 33-year-old, gravida 3, para 0030 female has had a history of 2 miscarriages and 1 fetal demise of 10 weeks’ size. Karyotypes on the last 2 pregnancy losses were 46,XY and 46,XX (maternal contamination excluded using single-nucleotide polymorphism [SNP] analysis). After participating in this session, in my practice I will: a. Perform an endometrial biopsy as part of her diagnostic workup. b. Recommend maternal karyotyping only. c. Recommend paternal karyotyping only. d. Evaluate the uterine cavity. e. Not applicable to my area of practice

100

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Compare the roles of hormonal testing and genetic testing as they relate to predicting spermatogenesis and/or sperm recovery. 2. Demonstrate the value of hormonal and genetic testing in men with male infertility.

Predictive Value of Hormonal and Genetic Assays in the Evaluation of the Infertile Male Alternate Panel (Letterman) Ajay K. Nangia, M.D. (Chair) University of Kansas Hospital and Medical Center Craig S. Niederberger, M.D. University of Illinois Hospital Jay Sandlow, M.D. Medical College of Wisconsin

ACGME Competency Patient Care

Needs Assessment and Description The value of hormonal testing in defining correctable conditions for male infertility is important, particularly in determining when this testing should be recommended. This session for clinicians and laboratory scientists will explore the role of hormonal testing to predict when testicular biopsy is indicated to rule out obstruction with reconstruction/sperm cryopreservation. The current role of male genetic testing as it relates to diagnosis and treatment options with assisted reproductive technology (ART) as well as defining the ability to find sperm in men with nonobstructive azoospermia through microdissection will be discussed.

TEST QUESTION A 32-year-old man with primary infertility and normal volume azoospermia has a follicle-stimulating hormone (FSH) level of 20 mIU/mL. He has AZFa and AZFb region Y-chromosome microdeletions and a normal karyotype. His wife is 25 years old and has a normal gynecologic evaluation. After participating in this session, in my practice I will recommend: a. Fine-needle aspiration with intracytoplasmic sperm injection (ICSI) b. Testicular biopsy and ICSI with preimplantation genetic diagnosis (PGD) c. Donor sperm intrauterine insemination (IUI) d. Microdissection testicular sperm extraction with ICSI e. Diagnostic testicular biopsy to rule out obstruction f. Not applicable to my area of practice

101

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Interactive Session

How to Deal with Poor Responders? Case Presentations with ARS

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Review the various tests for ovarian reserve to best identify poor responders. 2. Compare the different stimulation protocols to treat poor responders with regard to efficacy, cost, and success rates.

Suheil J. Muasher, M.D. (Chair) Duke University Rony T. Elias, M.D. Weill Cornell Medical College Needs Assessment and Description Poor responders remain a challenge for practitioners offering assisted reproductive technologies. There is no universally agreed-upon definition for these patients. Multiple tests to assess ovarian reserve have been proposed to identify these patients prior to their first in vitro fertilization (IVF) cycle. Different strategies and ovarian stimulation protocols exist in the literature to handle these patients in order to achieve the best results. There is a need to continually update and educate IVF practitioners on the best strategies to identify and treat these patients.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

ACGME Competency Patient Care TEST QUESTION After participating in this session, in my practice I will: a. Stimulate all my in vitro fertilization (IVF) patients with the same protocol and use one starting dose of gonadotropins for all patients. b. Perform one or multiple tests for ovarian reserve before choosing the stimulation protocol. c. Offer intrauterine insemination for patients with unexplained infertility and poor ovarian reserve due to the low success rates for these patients with IVF. d. Not accept patients with a history of poor ovarian reserve from a prior IVF treatment cycle. e. Use one protocol for all patients with poor ovarian reserve. f. Not applicable to my area of practice

102

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Discuss the risks, benefits, and success of oocyte cryopreservation and ovarian tissue cryopreservation. 2. Evaluate the merits of each procedure for fertility preservation.

Is Oocyte Cryopreservation Preferable to Ovarian Tissue Freezing for Fertility Preservation? Supported by an educational grant from Ferring Pharmaceuticals, Inc. Debate

ACGME Competency Patient Care

Samantha M. Pfeifer, M.D. (Chair) Weill Medical College of Cornell University Nicole L. Noyes, M.D. New York University School of Medicine Kutluk Oktay, M.D. New York Medical College

TEST QUESTION After this session, I will do the following in my practice: a. Recommend elective oocyte cryopreservation to all single women of reproductive age. b. Recommend elective ovarian tissue cryopreservation to all single women of reproductive age. c. Promote oocyte cryopreservation rather than ovarian tissue cryopreservation for women of reproductive age facing gonadotoxic therapy. d. Promote oocyte cryopreservation rather than ovarian tissue cryopreservation for prepubertal females facing gonadotoxic therapy. e. Not recommend oocyte cryopreservation or ovarian tissue cryopreservation. f. Not applicable to my area of practice

Needs Assessment and Description Oocyte cryopreservation is increasingly recognized as an established technique and advocated to preserve fertility in women who are undergoing gonadotoxic therapy as an option for those who choose to electively preserve their fertility. Ovarian tissue cryopreservation is a technique still considered experimental that has been advocated as an alternative to oocyte cryopreservation for similar indications. The aim of this interactive session is to debate the advantages and disadvantages of each of these procedures and to determine which technique is preferred for each indication. The target audience is physicians, laboratory scientists, and allied health-care professionals with an interest in fertility preservation.

103

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Wednesday, October 22, 2014 PANTONE 200

Interactive Session

NONCME

CE

ARS

Learning Objectives At the conclusion of this session, participants should be able to: 1. Identify criteria to differentiate between normal and abnormal pregnancy. 2. Describe treatment strategies for pregnancy of unknown location and ectopic pregnancy.

Early Pregnancy Monitoring—Pregnancy of Unknown Location vs. Ectopic Pregnancy vs. Intrauterine Pregnancy Case Presentations with ARS Todd D. Deutch, M.D. (Chair) Advanced Reproductive Center Laura Detti, M.D. University of Tennessee Memphis Elizabeth E. Puscheck, M.D., M.S. Wayne State University School Of Medicine Ilan Tur-Kaspa, M.D. Institute for Human Reproduction (IHR)

ACGME Competency Patient Care TEST QUESTION A woman presents with spotting for 1 day, unsure dates, and a beta-human chorionic gonadotropin (b-hCG) level of 1,750 mIU/mL. She is asymptomatic, and transvaginal ultrasound shows a thickened endometrium, no gestational sac, and no adnexal masses. After participating in this session, in my practice I will do the following: a. Call my partner, I am in Hawaii! b. Perform a laparoscopy. c. Perform a dilation and curettage. d. Administer methotrexate. e. If she becomes symptomatic, reevaluate her as soon as possible; otherwise, reevaluate her in several days. f. Not applicable to my area of practice

Needs Assessment and Description Differentiating normal pregnancy from abnormal pregnancy can be a diagnostic dilemma. This interactive session will review current techniques and criteria for diagnosing and treating pregnancy of unknown location vs. ectopic pregnancy vs. normal intrauterine pregnancy. The target audience is physicians, sonographers, and nurses involved in early pregnancy monitoring.

ASRM 2014 Annual Meeting

1:15 pm - 2:15 pm

104

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS

A ASRM

Wednesday, October 22, 2014

h r a

health affects reproduction affects health

Interactive Session

1:15 pm - 2:15 pm

PANTONE 200

Learning Objectives At the conclusion of this session, participants should be able to: 1. Define the role of immune suppression to counterbalance immunotropism during implantation and early pregnancy. 2. Identify the clinical conditions that lead to immune dysregulation during implantation and early pregnancy. 3. Assess pros and cons of currently available immunotropic and immune suppression treatment for repeated implantation failure.

Immunotropic vs. Immune-suppressive Treatment to Enhance Implantation Debate Joanne Kwak-Kim, M.D., M.P.H. (Chair) The Chicago Medical School at Rosalind Franklin University of Medicine and Science Zev Williams, M.D. Ph.D. Albert Einstein College of Medicine George Ndukwe, M.D. Zita West Fertility Center, London Needs Assessment and Description Implantation failure is a common cause for repeated assisted reproductive technology (ART) failure and is often associated with immune dysregulation. During this symposium, the role of immunotropism and immune suppression, potential patient populations who are at risk of immune dysregulation, and currently available immunotropic and immune-suppressive treatments to enhance implantation will be discussed. This symposium is targeted toward health-care providers who are closely working with ART and ovulation induction cycles, including reproductive endocrinologists, nurses, and embryologists.

ACGME Competency Patient Care TEST QUESTION A 34-year-old woman with autoimmune thyroiditis and rheumatoid arthritis (RA) presents to your office for infertility treatment. She had a total 3 failed in vitro fertilization (IVF) cycles in which a total of 6 goodquality embryos were transferred. Preimplantation genetic diagnosis (PGD) was done in 2 recent IVF cycles and only the genetically normal embryos were transferred. She wants to know what the next step will be. After participating in this session, in my practice I will: a. Recommend another IVF cycle without any further evaluation, since the cumulative live-birth rate significantly increases even after 3 failed IVF cycles. b. Recommend another IVF cycle with PGD and increase the number of embryos to be transferred. c. Investigate possible immune dysregulation, since she has autoimmune conditions and unexplained repeated implantation failures. d. Provide thyroid supplementation, continue RA treatment during the next IVF cycle, and reassure the patient that no other evaluation or treatment is needed. e. Not applicable to my area of practice

105

ASRM 2014 Annual Meeting

ASRM SCIENTIFIC PROGRAM • VIDEO SESSIONS ASRM

health affects reproduction affects health

health affects reproduction affects health

Tuesday, October 21, 2014 PANTONE 200

VIDEO SESSION 1

V-1 11:15am

5 cm above the umbilicus. However, the abdominal wall is also the thickest at this point, particularly in obese patients. Thus, the overall distance from the skin to the great vessels is reduced as BMI increases. It is prudent for the surgeon to be cognizant of such distance variation and risk of vessel injury with obese patients. If supraumbilical entry is necessary, it recommended to do so at 5 cm cephalad to the umbilicus. The distal end of the falciform ligament, which is a fold of peritoneal ligament, is on average 6.5 cm from the umbilicus. These anatomical relationships should be considered to avoid injury to the aorta and IVC as well as intraligamentary preperitoneal insufflation.

SURGICAL ANATOMY OF SUPRAUMBILICAL PORT PLACEMENT: IMPLICATIONS FOR ROBOTIC AND ADVANCED LAPAROSCOPIC SURGERY. M. A. Bedaiwy1,2, A. Zhang1, D. Henry2, T. Falcone2, E. Soto2. 1Obstetrics & Gynecology, University of British Columbia, Vancouver, BC, Canada; 2Obstetrics & Gynecology, University Hospitals Case Medical Center, Cleveland, OH. OBJECTIVE: Laparoscopic surgeons often need supraumbilical ports to accommodate instruments such as morcellating devices for the removal of large pelvic masses. Robotic cases also commonly require supraumbilical port entry. The risk of injury to the aorta and IVC theoretically increases with supraumbilical entry. Conceptualizing the intraabdominal distances in each patient is useful in order to avoid vessel injury. When operating on obese women with large uteri, there is an increasing tendency for surgeons to enter supraumbilically. However, modification of technique has not been suggested for supraumbilical entry in an obese population. The objective of this study is examine the distance from these entry ports to the great vessels compared to the umbilicus, and to examine how BMI may contribute to these distances.

• • • • • • • • • • • • • • • • • ••• V-2 11:20 am URETERAL PROXIMITY SENSORS FOR PREVENTION OF URETERAL INJURY IN LAPAROSCOPIC REPRODUCTIVE SURGERY. M. J. Jung1, V. Sharma2, J.-E. Wu3, J. Huelman3, M. Child1, M. P. Milad1. 1Reproductive Endocrinology and Infertility, Feinberg School of Medicine, Northwestern University, Chicago, IL; 2Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL; 3Biomedical Engineering, McCormick School of Engineering and Applied Science, Northwestern University, Evanston, IL.

DESIGN: Measurements were collected from a convenience sample of CT images from 92 patients undergoing any robotic or laparoscopic gynecologic procedure at a tertiary hospital between 2010 and 2012. Abdominal thickness was measured from the skin to the anterior peritoneum. Distance to the aorta and IVC was measured from the anterior peritoneum to the most superficial border of the vessel. Mean values are presented for the distances from the umbilicus to the aorta and IVC and at 1-cm increments cephalad to the umbilicus. Pearson correlation coefficients and 95% confidence intervals were calculated to describe the association between BMI and the distance and thickness measurements.

OBJECTIVE: The objective of this abstract is to present a novel solution to prevent ureteral injury by utilizing a proximity sensing system that enables more precise localization of the ureter during laparoscopic reproductive surgery. DESIGN: A medical device was developed that utilizes proximity sensing in relation to the ureters The system consists of two components: a flexible magnetic ureteral stent that is placed in the distal portion of the ureter, which works in conjunction with a proximity sensor integrated into the laparoscopic tool tip. The sensor system is able to detect the magnetic field of the stent component from up to 7-8 cm away and the strength of the magnetic field increases exponentially as the sensors approach the surface of the stent. The system utilizes multimodal feedback to warn the surgeon when they are by the ureter, including a visual light, a vibration motor, and a warning buzzer. Our

MATERIALS AND METHODS: Abdominal wall thickness increases the more cephalad above the umbilicus. The distance to the great vessels decreases at 1-cm increments above the umbilicus until 2 cm. Greatest distance from the entry point to the aorta and IVC is at

ASRM 2014 Annual Meeting

11:15 am - 1:00 pm

106

SCIENTIFIC PROGRAM • VIDEO SESSIONS system has distinct advantages over existing preventative measures, including preserving the anatomy unlike lighted stents, providing visual feedback not available with traditional stents, as well as, unique non-visual feedback. In addition, the ability the calibrate the sensitivity of the sensor allows depth perception in relation to the ureter.

A ASRM

V-4

11:37 am health affects reproduction affects health

LAPAROSCOPIC EXCISION OF UTERINE DEFECT. A. E. Strohl, L. A. Bernardi, M. P. Milad. Reproductive Endocrinology and Infertility, Northwestern University, Chicago, IL. OBJECTIVE: To demonstrate a laparoscopic approach to the repair of a uterine scar dehiscence in a patient undergoing fertility treatment.

MATERIALS AND METHODS: We present a novel solution utilizing a proximity sensor that works with a magnetic ureteral stent to detect the ureter with real-time precision. Our design enables multimodal feedback for the surgeon that is applicable for a wide variety of laparoscopic reproductive surgical procedures.

DESIGN: Conventional laparoscopy was used to evaluate and repair the suspected uterine defect. MATERIALS AND METHODS: The incidence of uterine scar dehiscence after cesarean section is unknown. In patients undergoing fertility treatment, the presence of a uterine scar defect may affect fertility treatment and pregnancy outcomes. This video demonstrates that laparoscopic repair of uterine scar defects is possible to restore the anatomy of the uterine cavity.

• • • • • • • • • • • • • • • • • • • • V-3 11:24 am PLACEMENT OF UTERINE ARTERY VASCULAR CLAMPS FOR ROBOTIC MYOMECTOMY. M. E. Orady1, C. A. Salazar2. 1Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, OH; 2Obstetrics and Gynecology, CaseWestern Reserve University - MetroHealth Hospital / Cleveland Clinic Foundation, Cleveland, OH.

• • • • • • • • • • • • • • • • • ••• V-5 11:40 am SURGICAL MANAGEMENT OF CORNUAL ECTOPIC PREGNANCY BY LAPAROSCOPIC CORNUOSTOMY. E. Soto, A. Romo de Vivar, L. Goodman, C. A. Raymond, T. Falcone. Obstetrics, Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH.

OBJECTIVE: This video demonstrates the utilization of a bulldog clamp to temporarily occlude the uterine blood supply during a robotic myomectomy procedure in order to reduce blood loss. DESIGN: The patient is 27 year old G0 strongly desirous of preserving fertility who was found to have multiple large uterine fibroids including a 9 cm lateral myoma near the blood supply. Method of application of the Bulldog clamp to uterine or hypogastric arteries to minimize bleeding when dissecting the myoma from the uterine wall will be shown and proper techniques for the robotic myomectomy procedure will be discussed.

OBJECTIVE: To describe the operative technique to perform a laparoscopic cornuostomy for a cornual ectopic pregnancy and to demonstrate intraoperative interventions to minimize blood loss during the procedure. DESIGN: Ectopic pregnancy remains a leading cause of maternal mortality in the first trimester. Cornual ectopic pregnancies account for approximately 2% of all tubal pregnancies and carry a significant risk for tubal rupture (22-44%). There are several management options for a cornual ectopic pregnancy but a surgical intervention is often required. A laparoscopic cornuostomy is an acceptable surgical approach. This educational video describes the step-by-step technique to perform a laparoscopic cornuostomy.

MATERIALS AND METHODS: Myomectomy is a procedure that has a risk for excessive blood loss, especially for large fibroids near vasculature. The bulldog clamp is made of stainless steel or titanium and is a spring-loaded crossover clamp with serrated blades that effectively occludes vessels without slippage or significant crush injury to the vessel. The methods shown of utilizing this tool during a laparoscopic surgical approach reveals a simple way a gynecologic surgeon can decrease anticipated blood loss during complex surgical procedures.

MATERIALS AND METHODS: Laparoscopic cornuostomy is an appropriate minimally-invasive approach for the management of cornual ectopic pregnancies that require a surgical intervention. Vasopressin injection and fulguration of the ascending

• • • • •• • • • • • • • • • • • • • •

107

h r a

ASRM 2014 Annual Meeting

PANTONE 200

SCIENTIFIC PROGRAM • VIDEO SESSIONS

ASRM ASRM

health affects reproduction affects health

segment of the uterine artery at the level of the uteroovarian ligament are useful techniques to minimize blood loss.

MATERIALS AND METHODS: The technique allows an uncomplicated single-incision laparoscopy for large adnexal pathology. Computer-assisted laparoscopy resolves in resolves most of the anti-ergonomics issues implicit in this type of surgery.

health affects reproduction affects health

PANTONE 200

• • • • • • • • • • • • • • • • • • • •

• • • • • • • • • • • • • • • • • •••

V-6 11:46 am

V-8

HYSTEROSCOPIC AND LAPAROSCOPIC RESECTION OF A RUDIMENTARY HORN PREGNANCY. K. J. Sasaki, A. CholkeriSingh, C. E. Miller. Obstetrics and Gynecology, Lutheran General Hospital, Park Ridge, IL.

A NOVEL LAPAROSCOPIC TECHNIQUE FOR ELECTROMECHANICAL MORCELLATION OF UTERINE FIBROIDS IN A CONTAINMENT SYSTEM. S. S. Srouji, D. J. Kaser, A. R. Gargiulo. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.

OBJECTIVE: In this video we will review the different types, signs and symptoms and diagnosis of lateral fusion defects, specifically a unicornuate uterus with a rudimentary horn. Furthermore, we will review rudimentary horn pregnancies and present a case and technique of a hysteroscopic, laparoscopic resection of a rudimentary horn pregnancy.

OBJECTIVE: Electromechanical morcellation allows removal of uterine fibroids through laparoscopic incisions. Intraperitoneal dispersion of specimen fragments can occur with standard open morcellation, and rarely can lead to diffuse leiomyomatosis or dissemination of an occult malignancy. The United States Food and Drug Administration has issued a safety communication to discourage power morcellation of uterine tissues, and describes the possible use of a specimen bag to prevent tissue dispersion. Here, we provide a novel, step-by-step technique for safe morcellation within a containment system.

MATERIALS AND METHODS: When a rudimentary horn pregnancy is diagnosed, the recommended treatment is termination of the pregnancy with resection of the rudimentary horn and ipsilateral fallopian tube. We present a case and technique of a successful laparosopic resection of a rudimentary horn pregnancy at 10 1/7 gestation. • • • • • • • • • • • • • • • • • • • • V-7

DESIGN: Necessary equipment for this enclosed morcellation technique includes a 15mm trocar for bag placement, a fixation trocar (5mm Kii Shielded Bladed system; Applied Medical), a containment system (Anchor bag TRS200; Anchor Products) and a power morcellator (Rotocut G1; Karl Storz). First, the specimen is placed in the right upper quadrant for easy retrieval. The Anchor bag is inserted through a 15mm port, and the specimen is placed inside. Next, the bag is drawn shut, the 15 mm port is removed, and the edges of the Anchor bag are exteriorized. The 15mm port is then replaced inside the bag, and a pseudo-pneumoperitoneum is achieved to a working pressure of 10-20mmHg. The bladed fixation trocar is used to enter the containment system from an assistant port site under direct visualization. The balloon at the tip of the fixation trocar is inflated, and the retention disk is secured to the outer abdominal surface. Gas inflow is changed to this lower port, through which the 5 mm laparoscope is placed. The 15mm port is then replaced by a 15mm morcellator, and morcellation thus proceeds within the containment system. Following morcellation, the Anchor bag is desufflated, pneumoperitoneum is re-established and the fixation trocar is removed.

12:00 pm

SINGLE SITE ROBOTIC RESECTION OF BILATERAL ENDOMETRIOMAS. A. R. Gargiulo, S. S. Srouji. Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital Harvard Medical School, Boston, MA. OBJECTIVE: The da Vinci Single Site robotic device was approved by the United States Food and Drugs Administration in 2013 for use in gynecology limited to hysterectomy and adnexal surgery. This video describes our laparoscopic technique for ovarian endometrioma resection employing this novel device. A single patient case is shown, where a 10 cm and a 5 cm endometrioma were excised. DESIGN: A single 2.5 cm linear sagittal incision is performed within the umbilicus. A dedicated silicone device is secured within the incision and accommodates four cannulas: 1) cannula for the 8 mm stereo-laparoscope, 2) 5-10 mm assistant cannula, 3) two curved cannula for semi-rigid 5 mm robotic instruments. A flexible CO2 laser fiber was introduced through the assistant port to perform superficial ablation of a small portion of endometrioma left in place over the ovarian hilum. ASRM 2014 Annual Meeting

12:06 pm

108

SCIENTIFIC PROGRAM • VIDEO SESSIONS

A

Fragments of morcellated tissue are collectively retrieved by withdrawing the Anchor bag.

ASRM

V-10

12:32 pm

health affects reproduction affects health

FERTILITY PRESERVATION. A. Li, J. V. Johnson. Obstetrics and Gynecology, University of Massachusetts, Worcester, MA.

MATERIALS AND METHODS: Electromechanical morcellation of uterine fibroids within a containment system is technically feasible and eliminates intraperitoneal dispersion of tissue fragments. Larger studies are needed to determine the safety and efficacy of this procedure.

OBJECTIVE: To equip listeners with information about fertility preservation.

• • • • • • • • • • • • • • • • • • • •

DESIGN: A literature review was performed and information about fertility preservation was synthesized into an 8 minute video lecture.

V-9 12:14 pm MULTI-PORT POWER MORCELLATION WITHIN AN INSUFFLATED ENDO-BAG. D. N. Brown. Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics & Gynecology, Massachusetts General Hospital/Harvard Medical School, Boston, MA.

MATERIALS AND METHODS: 1. There is increased expectation from the medical community and from patients to discuss the effects of radiation and chemotherapy on fertility, as well as to offer fertility preservation counseling. 2. Radiation therapy and chemotherapy are cytotoxic and harm ovarian reserve. 3. Embryo and oocyte cryopreservation are established fertility preservation methods. Other experimental options are available as well. 4. Different modes of fertility preservation can be combined. 5. Interested and appropriate patients can be referred to a reproductive endocrinologist for further counseling.

OBJECTIVE: In the following surgical video demonstration, we describe a laparoscopic multi-port approach to closed or contained power morcellation. DESIGN: In light of the recent FDA’s warning against power morcellation, we wanted to describe a technique that we feel is safe and feasible for multi-port contained power morcellation. The intent is the prevention of disseminated leiomyomatosis or dissemination of an undiagnosed uterine sarcoma. These videos were taken before the FDA warning came out on April 17, 2014. All of the patients were appropriately counseled about the risks of power morcellation, and their informed written consent was obtained prior to their procedure. This surgical technique involves the use of an abdominal isolation bag in an off-label manner and can be utilized to assist with tissue extraction after Laparoscopic or Robotic Myomectomy, Laparoscopic or Robotic Supra-Cervical Hysterectomy, & Laparoscopic or Robotic Total Hysterectomy.

• • • • • • • • • • • • • • • • • ••• V-11 12:40 pm SUCCESSFUL OVARIAN TRANSPLANT FOR 40 YEAR OLD CURED LEUKEMIA PATIENT WHOSE GRAFT WAS FROZEN WHEN SHE WAS ONLY 24 YEARS OF AGE, AND NO EVIDENCE OF RESIDUAL LEUKEMIC CELLS. S. J. Silber1, N. Barbey1, S. Fuller1, K. Lenahan1, M. DeRosa1, S. M. Pincus2. 1Infertility Center of St. Louis, St. Luke’s Hospital, St. Louis, MO; 2Division of Hematology and Oncology, Saint Louis University Cancer Center, St. Louis, MO. OBJECTIVE: A 24 year old girl was referred by her oncologist while in complete remission from acute lymphocytic leukemia. But a bone marrow transplant was feared for the future. She wound up being cured by two bone marrow transplants, and now is menopausal but healthy at age 40 and about to get married. We wished to see if fertility could be restored to a leukemic patient 16 years later who was rendered sterile by the bone marrow transplants.

MATERIALS AND METHODS: Laparoscopic multiport approach to closed or contained power morcellation within an insufflated endo-bag is safe and feasible, and may provide a minimally invasive technique to remove large specimens while minimizing the risk of disseminated leiomyomatosis or dissemination of an undiagnosed uterine sarcoma. • • • • • • • • • • • • • • • • • • • •

DESIGN: The video explains her history and her interview and preparation for the ovary thaw and transplant now 16 years later. In fact, even without the cancer indication for ovarian freezing, she states she still would have become 109

h r a

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • VIDEO SESSIONS ASRM

health affects reproduction affects health

infertile by age alone were it not for her ovarian freeze 16 years earlier. The video demonstrates the microsurgical procedure of ovary transplant and her successful post-op results in this very controversial case. The major physicians were reproductive surgeon Sherman Silber and Senior Oncologist Steven Pincus.

emphasis on post-treatment quality of life. Many patients feel that the ability to have biological children greatly impacts this, and there is a growing body of evidence that shows many cancer treatments have the potential to be gonadotoxic. Fortunately, recent advancements in the field of fertility preservation have provided several viable options for patients. The objective of this video is to explore the important emerging option of ovarian tissue cryopreservation for fertility preservation.

health affects reproduction affects health

PANTONE 200

MATERIALS AND METHODS: This is an unusual first case report (and controversial but well studied) which demonstrates preservation of fertility is possible in young leukemic patients using ovary freezing and transplantation even 16 years later.

DESIGN: This video discusses patient selection, surgical considerations and the process involved with offering patients ovarian tissue cryopreservation for fertility preservation. Surgical footage demonstrates minimally invasive techniques to remove the ovarian cortex with a plan for re-implantation of thawed ovarian tissue to occur following completion of gonadotoxic therapy.

• • • • • • • • • • • • • • • • • • • • V-12



12:48 pm

OVARIAN TISSUE CRYOPRESERVATION: AN EMERGING OPTION FOR FERTILITY PRESERVATION. L. R. Goodman, R. L. Flyckt, E. Soto, T. Falcone. Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH.

MATERIALS AND METHODS: For young women with cancer, ovarian tissue cryopreservation is an option for fertility preservation. Freezing ovarian tissue at time of diagnosis allows for the indefinite protection of potential ovarian follicles for future in vitro maturation and/or for other emerging technologies.

OBJECTIVE: In this era of increasing cancer survival rates in women of reproductive age, there has been a growing

Tuesday, October 21, 2014

VIDEO SESSION 2

V-13 4:15 pm

DESIGN: The diagnosis was confirmed with 3D ultrasound, and patients with infertility and/or recurrent pregnancy loss were included in the series.

HYSTEROSCOPIC UNIFICATION OF COMPLETE SEPTATE UTERUS WITH DUPLICATE CERVICES AND LONGITUDINAL VAGINAL SEPTUM. W. T. Lin, R. Ashby, E. Yanushpolsky. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.

Indigo carmine was instilled into one cavity. The ipsilateral exocervix was temporarily ligated to prevent egress of the distention fluid. Under transabdominal ultrasound guidance the uterine septum was penetrated until indigo carmine dye was visualized and the cavities were connected with the bipolar electrode inserted through the operating channel of a 5-mm hysteroscope. The uterine septum was completely resected to the level of fundus. Caution was taken to avoid thinning of the myometrium or uterine perforation. The thickness of myometrium/septum at fundus was constantly monitored with transabdominal ultrasound.

OBJECTIVE: Complete septate uterus with duplicate cervices and longitudinal vaginal septum is a rare subtype of congenital Mullerian anomaly reported in the literature. Some studies had reported its reproductive outcomes with or without septum resection. The consensus was that hysteroscopic septum resection may be indicated in patients with infertility or recurrent pregnancy loss. Surgical correction with hysteroscopic metroplasty is common in partial septate uterus cases, but is challenging in complete septate uterus with duplicate cervices. The new technique of hysteroscopic uterine unification with use of indigo carmine and hysteroscopic bipolar electrode is presented in a series of two patients with such diagnoses. ASRM 2014 Annual Meeting

4:15 pm - 6:30 pm

Post-operatively, patients received oral estrogen for 4 weeks, followed by medroxyprogesterone. The 3D ultrasound 1 month after withdrawl bleeding confirmed a unified uterine cavity with arcuate configuration of 110

SCIENTIFIC PROGRAM • VIDEO SESSIONS

A ASRM

the uterine fundus. One patient conceived two months after septum resection and had a vaginal delivery at term. Second patient is undergoing fertility treatments.

h r a

V-15 4:30 pm health affects reproduction affects health

HYSTEROSCOPIC TREATMENT OF ASHERMAN’S SYNDROME WITH THE MYOSURE INTRAUTERINE TISSUE REMOVAL SYSTEM. B. Rizk. Department of Obstetrics & Gynecology, University of South Alabama, Mobile, AL.

MATERIALS AND METHODS: This was a simple, safe, reproducible technique. The cervical integrity was not compromised. The use of indigo carmine and temporary exocervix ligation facilitated the ease of hysteroscopic visualization. Dissection was performed with a safe controlled energy source under ultrasound guidance. This hysteroscopic uterine unification technique may benefit patients with complete septate uteri with duplicate cervices, who suffer from infertility and/or recurrent pregnancy loss. Spontaneous conception and full term vaginal delivery was made possible.

OBJECTIVE: This video depicts the first known case report using the MyoSure Intrauterine Tissue Removal system for the treatment of intra-uterine adhesions. DESIGN: This patient is a 47 year-old G2P2 with breast cancer who underwent a modified radical mastectomy in 2013 followed by Tamoxifen therapy. She developed amenorrhea and pelvic pain which prompted an imaging study. On ultrasound, she had thickened endometrium and polyps. A hysteroscopy with polypectomy along with sharp curettage was performed in September 2013. The pathology was benign. A subsequent ultrasound demonstrated persistent thickened endometrium for which she had an endometrial biopsy. The pathology was again negative for hyperplasia or cancer. A follow-up ultrasound in March 2014 showed thickening endometrium and cystic areas. A hysteroscopy was performed.

• • • • • • • • • • • • • • • • • • • • V-14 4:22 pm SURGERY FOR THE UTERINE SEPTUM: PATIENT EDUCATION USING GRAPHICS AND SURGICAL VIDEO. F. Licciardi. Ob-Gyn, NYU Langone Medical Center, New York, NY. OBJECTIVE: When confronted with the diagnosis of uterine septum, patients can be unclear about the anatomic defects and treatment methods. The objective of this presentation is to give patients a better understanding of their uterine abnormality through graphics and video.

MATERIALS AND METHODS: There are significant potential advantages of using the MyoSure XL for treating intra-uterine adhesion. The procedure is done under direct hysteroscopic visualization reducing the risk of uterine perforation associated with blind procedures. The scar tissue is removed rather than cut in order to return the cavity to normal appearance. Since the adhesions do not need to be placed on tension, less intrauterine pressure is required resulting in potentially less fluid deficits from intravasation. With the MyoSure XL device there is no damage to the endometrial surface from cautery or myometrial dissection with potentially less risk of adhesion reformation.

DESIGN: The anatomy, embryology, and problems associated with uterine septums are reviewed. The surgical treatment is explained graphically, and then a video of the procedure is shown, with narration explaining the technique and surgical rational. Procedure risks and postoperative expectations are discussed. MATERIALS AND METHODS: This video will be very helpful to those patents who want to know more details surrounding the diagnosis and treatment of their uterine septum. For many women, exposure to a greater amount of information about their condition can reduce the anxiety surrounding pre-operative, operative and post-operative care. After viewing this video, patients will be better equipped to make a choice about having uterine septum surgery.

•••••••••••••••••••• V-16 4:37 pm MODIFIED STRASSMAN METROPLASTY TO UNIFY AN OBSTRUCTED UTERINE HORN WITH NORMAL EXTERNAL CONTOUR OF UTERINE FUNDUS. B. Bhagavath, W. Vitek. Division of REI, Department of OB/GYN, University of Rochester Medical Center, Rochester, NY.

• • • • • • • • • • • • • • • • • • • •

OBJECTIVE: Relieve pain and preserve fertility in a 21 year old patient with severe dysmenorrhea secondary to a non-communicating uterine cavity on the left side with a normal external uterine contour of the fundus. 111

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • VIDEO SESSIONS health affects reproduction affects health

ASRM

spermatozoa, specifically, sperm with aberrations in the shape and contours of the head, may be carriers of chromatinic defects. The utility of previously described sperm-imaging models are clinically limited by either the amount of time required for the high-magnification analysis, or because they require fixing and staining the sperm. We aimed to create an inexpensive, efficient, and reproducible 3-D real-time analysis of viable spermatozoa.

DESIGN: Patient was evaluated through the emergency department for severe dysmenorrhea. A degenerating fibroid was diagnosed on the left side based on ultrasound examination. Subsequent MRI revealed a non-communicating uterine cavity on the left side with a normal external contour of the uterine fundus. Five years prior to this admission, she had undergone an emergency left salping-ooporectomy for a burst ovarian cyst. 6 months prior to this, she was evaluated for dysmenorrhea via laparoscopy and had lysis of adhesion performed at a different institution. Patient underwent an attempt at hysteroscopic unification of the uterine horn which was not successful. At the same surgery, she underwent a robot assisted, modified Strassman metroplasty to successfully unify the two cavities. The location of the obstructed cavity was greatly aided by the use of laparoscopic ultrasound probe. Post-operatively, patient has been relieved of the severe and crippling dysmenorrhea she had prior to the surgery and hysterosalpingography confirmed a unified cavity with patent right fallopian tube. health affects reproduction affects health

PANTONE 200

DESIGN: We used a standard upright commercial microscope and a digital camera suited to cell microscopy. An aliquot of semen sample was placed on a slide pre-loaded with polyvinylpyrrolidone (PVP) to reduce the forward progression of sperm. Individual motile sperm were identified, analyzed at 600x magnification, and a 10-second digital video was obtained. Using the recorded videos, we utilized imaging-tracking software to take serial photographs of the sperm. Images were automatically extracted from each video frame using enhanced correlation coefficient maximization and the general shape of the sperm was extracted via space-carving. The reconstructed image was rotated to permit viewing from any direction and the final image was rendered through interpolation.

MATERIALS AND METHODS: Modified Strassman procedure can be performed to unify uterine cavities when an obstructed uterine cavity/horn is present. • • • • • • • • • • • • • • • • • • • •

• • • • • • • • • • • • • • • • • • • •

MATERIALS AND METHODS: This is the first non-invasive, three-dimensional, real-time, in-vitro assessment of sperm surface morphology. This study demonstrates that spermatozoa do in fact have a multitude of unique features on each of their surfaces that cannot be seen with standard bi-dimensional microscopic analyses.

V-18 5:00 pm

••••••••••••••••••••

V-17 4:43 pm WITHDRAWN

3D SPERM SURFACE RECONSTRUCTION- A NOVEL THREEDIMENSIONAL APPROACH TO ASSESSING SPERM MORPHOLOGY. B. A. Levine1, J. Feinstein2, Q. V. Neri1, D. Goldschlag1, S. Belongie3, Z. Rosenwaks1, G. Palermo1. 1The Ronald O. Perelman & Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, NY; 2Department of Computer Science, College of Engineering, Cornell University, Ithaca, NY; 3Cornell Tech, Cornell University, New York, NY.

V-19 5:08 pm PATERNAL CHROMOSOME DYNAMICS AFTER INSEMINATION WITH SPERM OF LOW ABILITY TO ACTIVATE OOCYTES AND THE RESCUE OF NON-ACTIVATED EMBRYOS AFTER ICSI BY ARTIFICIAL ACTIVATION. M. Tokoro1, K. Yamagata2, N. Fukunaga1,3,4, Y. Asada1,3,4. 1 Asada Institute for Reproductive Medicine, Asada Ladies Clinic, Nagoya, Aichi, Japan; 2Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan; 3 Asada Ladies Nagoya Clinic, Nagoya, Aichi, Japan; 4Asada Ladies Kachigawa Clinic, Nagoya, Aichi, Japan.

OBJECTIVE: ICSI’s effectiveness in the treatment of male factor infertility has dramatically improved worldwide fertilization and resultant pregnancy rates. However, there have been no breakthrough innovations in fertilization since the advent of ICSI. Studies have demonstrated that abnormal semen profiles are associated with a modest increase in the frequency of sperm chromosomal abnormalities and that morphologically abnormal ASRM 2014 Annual Meeting

OBJECTIVE: Intracytoplasmic sperm injection (ICSI) is a powerful technique in the field of human-assisted reproduction and improves the outcomes for patients who cannot achieve fertilization by routine IVF. However, there are reports of cases where fertilization as evidenced by the appearance of two pronuclei (2PN) is not seen after ICSI 112

SCIENTIFIC PROGRAM • VIDEO SESSIONS

A ASRM

showing that 71% of day 3 embryos were mosaic. This phenomenon results from chromosomal segregation errors and cytokinetic errors during mitosis of an embryo after fertilization. One major cause of embryo mosaicism is abnormal mitosis in which one cell divides into three or more daughter cells. However, the detailed mechanisms of this phenomenon remain largely unknown. Obtaining time-lapse images of live embryos stained with fluorescent proteins enables analysis of the dynamics of nuclei and spindles. In this presentation, we aim to demonstrate the dynamics of the nuclei and spindles using a confocal imaging system.

(nonfertilized, 0PN). Failure of pronuclear formation can be caused by defective oocytes or from a deficiency in the sperms’ ability to activate the oocyte. In this study, we examined the oocyte-activating ability and dynamics of parental chromosomes among couples with a tendency to show 0PN after ICSI and who had never obtained 2PN embryos.

h r a

health affects reproduction affects health

DESIGN: 0PN oocytes were obtained from couples with a history of 0PN after obtaining their informed consent. Ethics Committee approval was obtained for the study. The oocytes were stained with an anti-dimethylated lysine 9 on histone H3 antibody to detect the female chromosomes. To assess the oocyte-activating ability of the husband’s sperm, they were microinjected into mouse oocytes and chromosomal dynamics during the first mitosis were tracked using a live cell imaging system. KSOM with 5 mM SrCl2 and 2 mM EGTA was used for artificial activation of the mouse oocytes.

DESIGN: Frozen-thawed pronuclear embryos intended for disposal were used after obtaining informed consent from the patients and approval from the Japan Society of Obstetrics and Gynecology research ethics committees. A mixture of mRNAs encoding enhanced green fluorescent protein coupled with a-tubulin and monomeric red fluorescent protein I fused with histone H2B was injected into the cytoplasm of the pronuclear embryos by using a Piezo-drive manipulator. We used an all-in-one confocal imaging system that contains an incubator with a confocal microscope. Four-dimensional images were generated from three-dimensional confocal images, which were acquired at 6-mm intervals in the z-axis. The pronuclear embryos were cultured in KSOMAA medium under an atmosphere of 5% O2, 5% CO2, and 90% N2. Time-lapse images were captured at 15-minute intervals for 5 days, using the all-in-one confocal imaging system.

MATERIALS AND METHODS: Immunofluorescence staining of human 0PN oocytes after ICSI showed that the female chromosomes were arrested at meiosis II. However, the male chromatin was dispersed in the cytoplasm. Live cell imaging of mouse oocytes injected with the husband’s sperm showed that many of them were also not activated after ICSI and dispersal of the male chromatin was observed from 4 h after ICSI. However, when mouse oocytes which had undergone ICSI were artificially activated within 4 h,, the rate of 2PN formation increased compared with the nonactivated group. These results suggest that the ability of the husband’s sperm to activate oocytes is low in cases with a history of producing 0PN oocytes. In addition, it appears necessary to activate oocytes after ICSI to prevent dispersal of the male chromatin. Artificial activation of the oocytes at an appropriate time after ICSI might be effective technique for initiating embryo development in such cases.

MATERIALS AND METHODS: Abnormal mitoses were observed not only at the first cleavage stage but also at the second or later cleavage stages. Before division into three cells, Y-shaped metaphase plates and tripolar spindles could be observed. However, the Y-shaped metaphase plate did not always lead to abnormal mitosis. The results of this study suggest that abnormal mitosis plays a key role in the occurrence of mosaicism.

• • • • • • • • • • • • • • • • • • • •

••••••••••••••••••••

V-20 5:16 pm

V-21 5:22 pm

ABNORMAL MITOSIS IN EARLY EMBRYOS AS A CAUSE OF MOSAICISM. Y. Nakaoka1, S. Hashimoto1, A. Amo1, K. Yamagata2, T. Himeno1, T. Inoue1, K. Ito1, Y. Morimoto1. 1 IVF Namba Clinic, Osaka, Japan; 2Osaka University, Suita, Osaka, Japan.

APPLICATIONS OF LASER OBJECTIVES IN NOVEL ASSISTED REPRODUCTIVE TECHNOLOGIES. M. Tachibana1,2, H. Tozawa2, S. Mitalipov1,3. 1Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR; 2Obstetrics & Gynecology, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan; 3 Center for Embryonic Cell and Gene Therapy, Oregon Health & Science University, Portland, OR.

OBJECTIVE: Embryo mosaicism is indicated by the presence of two or more genotypes within cells of a single embryo. The incidence of embryo mosaicism is high, even in morphologically sound embryos, with one report 113

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • VIDEO SESSIONS ASRM

health affects reproduction affects health

freshly dissolved monomeric peptides were labelled at different concentrations with an amyloid-specific dye. Spermatozoa were stained with Hoechst 33342 in sperm washing medium before being mixed with the fibrils or monomeric peptides. Samples were transferred onto µ-Slide and videos/images were recorded with a confocal microscope or video microscopy over time. For viability assessment, approximately 106 human spermatozoa were stained with Hoechst 33342. Stained spermatozoa were treated with PBS or different concentrations of amyloid or monomeric peptides at 37°C for 30 minutes. Spermatozoa were incubated with 50mg/ml of the viability dye propidium iodide. Toxic effects on spermatozoa were analyzed by flow cytometry.

OBJECTIVE: Introduction to applications of laser objectives during gamete and embryo micromanipulations. health affects reproduction affects health

DESIGN: Primate and mouse gametes and/or embryos were utilized during various micromanipulation procedures. A video documentary was generated to illustrate real-time microsurgery procedures on oocytes and embryos. In this video, we demonstrate s short history of developing lasers in ART, features of current lasers, critical settings in ART laboratory and show micromanipulation procedures and laser applications in our recent scientific discoveries. PANTONE 200

MATERIALS AND METHODS: Laser objective is safe, easy, reliable, efficient and also reproducible tool in advanced ART. Therefore, it will likely become a useful tool for developing and conducting new reproductive techniques in future.

MATERIALS AND METHODS: Semen-derived amyloid fibrils but not monomeric peptides or amyloid-beta fibrils entrapped human and mouse spermatozoa at a physiological relevant dose (50 mg/ml), and this resulted in loss of progressive motility. Immobilization of spermatozoa depends on the cationic properties of semen amyloids, as heparin could inhibit spermatozoa immobilization. Amyloid fibrils and monomeric peptides were not cytotoxic to human spermatozoa at the concentrations tested.

• • • • • • • • • • • • • • • • • • • • V-22 5:30 pm SPERMATOZOA ENTRAPMENT BY SEMEN-DERIVED AMYLOID FIBRILS. N. L. Sandi-Monroy1,2, S. M. Usmani1, N. N. Roan3,4, A. Gawanbacht1, O. Sakk5, T. Wirth5, F. Gagsteiger2, F. Kirchhoff1, J. Münch1. 1Institute of Molecular Virology, Ulm University Medical Center, Ulm, BW, Germany; 2Kinderwunsch-Zentrum Ulm, Ulm, BW, Germany; 3Department of Urology, University of California at San Francisco, San Francisco, CA; 4J. David Gladstone Institutes, San Francisco, CA; 5Institute of Physiological Chemistry, Ulm University, Ulm, BW, Germany.

• • • • • • • • • • • • • • • • • ••• V-23 5:47 pm A NOVEL SINGLE-ARMED TECHNIQUE FOR MICROSURGICAL VASOEPIDIDYMOSTOMY: THE REVERSE SINGLE-ARMED 2-SUTURE LONGITUDINAL INTUSSUSCEPTION. P. Li, R. Tian, M. Ma, Y. Liu, J. Wang, C. Sun, T. Zhang, Z. Li. Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

OBJECTIVE: Human ejaculates contain amyloid fibrils that enhance human immunodeficiency virus 1 infection by increasing virion attachment to target cells (Muench et al., Cell, 2007; Usmani et al., Nature Communication, 2014). However, the natural role of amyloid fibrils in semen remains unclear. To clarify this fundamental question, we studied the effect of seminal amyloids on spermatozoa function.

OBJECTIVE: We modified the single-armed suture technique originally reported by Monoski from Cornell as a novel single-armed technique --- the reverse single-armed LIVE, and evaluate the clinical outcomes of it. DESIGN: First, a dilative tubule was chosen under microscope guidance. The anastomosis is begun by placing the first two 8-0 nylon sutures as a supporting suture to reduce the tension for the anastomosis. Then anastomosis was performed using the reverse single-armed 2-suture longitudinal intussusception vasoepididymostomy technique. A: Needles are placed in an outside-in fashion through the full layer of the vas deferens at position 5 and 7 o,clock. B: Needles are used to pierce the epididymal tubule both within the tubule itself and out longitudinally, but not pulled

DESIGN: Human semen samples were obtained from patients undergoing infertility treatment after informed consent. Seminal amyloids were generated from fragments of prostatic acid phosphatase (SEVI) and semenogelins 1 and 2 (SEMs). Human spermatozoa were purified through density gradient and swim-up. Mouse spermatozoa were collected from epididymis and vas deferens from NMRI mice and allowed to capacitate. To analyze the effect of amyloids on spermatozoa function, amyloid fibrils and ASRM 2014 Annual Meeting

114

SCIENTIFIC PROGRAM • VIDEO SESSIONS

A ASRM

through. C: Epididymal tubule opened longitudinally between the two sutures and the exuded epididymal fluid was examined for sperm. D: Needles are placed in an inside-out fashion through the full layer of the vas deferens at position 1 and 11 o,clock. all the sutures were tied together (1 to 5 o,clock and 11 to 7 o,clock), the epididymal tubule was gently intussuscepted into the lumen of the vas deferens. The epididymal tunic was then secured to the vassal muscle and adventitia with a 8–0 nylon suture, we normally placed around the anastomosis 10- 14 sutures. We passed the needle through the inferior points of the full layer of the vasa in an outside-in fashion, and finally through the superior points of the full layer of the vasa in an inside-out fashion, which does not require Surgeon’s back-hand suture placement. When the needles are in the tubule, the two sutures in a lower position can avoid the crossing of the sutures. The two knots of suture are left outside of the anastomosis during reverse single-armed LIVE procedure, which may decrease the possibility of fibrosis and anastomotic stricture.

h r a

OBJECTIVE: To investigate the surgical skills and their advantages in microsurgical subinguinal varicocelectomy.

health affects reproduction affects health

DESIGN: The location of the incision is determined by palpation of the external inguinal ring. After incision of the skin and division of Camper fascia and Scarpa fascia, the spermatic cord is grasped with an intestinal holding forceps and delivered through the cut. A rubber tube is placed under the spermatic cord. Testis is delivered through incision, followed by ligation or denudation of external spermatic veins and gubernacular veins. Then the testis is returned to the scrotum. The spermatic fascias are divided under the operating microscope. The deferent duct and its vascular system are dissected and divided with other internal spermatic tissues by a Penrose drain. The pulsations and a micro-Doppler indicate the position of the artery. The arteries are dissected after being identified, followed by being encircled with a marked band. All internal spermatic veins are ligated using titanic clamp. Cutting off a length of spermatic veins favors dissection of other veins. After hemostasis guaranteed, the spermatic cord fascias are sutured and returned. The cut is sutured layer by layer.

MATERIALS AND METHODS: From July 2007 to March 2012, a total of 192 patients with EOA underwent reverse SA-LIVE. Sperm was present in the ejaculate of 102 (53.1%) men after the surgery. The natural pregnancy rate was 19.8% (38/192) at the follow-up of 6 to 24 months. When specialized double-armed microsurgical sutures are not available, use of the reverse single-armed suture is also able to achieve a favourable patency and pregnancy. single-armed suture is a practical and effective alternative microsurgical approach. It also reduces operation time, cost of microsurgical materials and obviate the suture crossing.

MATERIALS AND METHODS: From November 2011 to October 2013, 87 varicocele patients underwent microsurgical subinguinal varicocelectomy. No severe complications happened except three case hydrocele presented in six months post-operation. (1)Rubber tube can support the spermatic cord more easily than that of Penrose drain, which benefits the appearance of spermatic cord. (2) Delivery of testis prior to the dissection of spermatic cord prevents the bleeding of spermatic cord. (3)Denudation of external spermatic veins and gubernacular veins treats the veins completely and removes the visible veins in scrotum. (4)The division of vasal vessel system from others using a Penrose drain avoided the damage to the deferent duct and its vessels. (5)Cutting off a length of dissected spermatic veins benefits the exploration of more deep-seated veins.

• • • • • • • • • • • • • • • • • • • • V-24 5:55 pm SURGICAL SKILLS IN MICROSURGICAL SUBINGUINAL VARICOCELECTOMY. R. Tian1, Z. Tiecheng1, L. Peng1, L. Yufei1, W. Junlong1, L. Zheng1. 1Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 2 Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 3Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 4 Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 5Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 6 Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

•••••••••••••••••••• V-25 6:02 pm DYNAMIC EJACULATORY ASSESSMENT USING ENDORECTAL DOPPLER ULTRASOUND. A. G. Winter, A. Bolyakov, R. Lischer, D. A. Paduch. Department of Urology and Reproductive Medicine, New York Presbyterian HosptialWeill Cornell Medical College, New York, NY. OBJECTIVE: Endorectal doppler ultrasound can provide both functional and anatomic data of ejaculatory processes in real time. This video demonstrates the use of endorectal 115

ASRM 2014 Annual Meeting

PANTONE 200

ASRM SCIENTIFIC PROGRAM • VIDEO SESSIONS ASRM

health affects reproduction affects health

doppler ultrasound in the diagnosis and management of men with ejaculatory dysfunction and infertility. health affects reproduction affects health

DESIGN: A single practitioner performed endorectal doppler ultrasound (Esatote MyLab 25 Gold, Indianapolis, IN) during ejaculation of 20 healthy volunteers. These studies were used to record and quantify baseline physiologic ejaculation parameters. Subsequently, two patients presenting for male infertility evaluation underwent endorectal doppler ultrasonographic ejaculatory studies. PANTONE 200

MATERIALS AND METHODS: Endorectal doppler ultrasound is an effective way of observing physiologic ejaculation, as well as diagnosing conditions such as ejaculatory duct obstruction and retrograde ejaculation. • • • • • • • • • • • • • • • • • • • • V-26

6:10 pm

‘THREE-STEP’ SPERM RETRIEVAL METHOD FOR NON-OBSTRUCTIVE AZOOSPERMIA PATIENTS. M. Ma, Y. Liu, P. Li, R. Tian, Z. Li, C. Sun. Urology, Shanghai Human Sperm Bank, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. OBJECTIVE: To investigate whether ‘Three-Step’ sperm retrieval method could raise Sperm Retrieval Rate (SRR) of non-obstructive azoospermia patients. And its practical application was evaluated. DESIGN: Seventy-three non-obstructive azoospermia patients accepted ‘Three-Step’sperm retrieval as follows: testicular fine needle aspiration(TFNA), testicular sperm extraction(TESE), microdissection of testicular sperm extraction(MD-TESE). Testicular tissues which were gotten from each step have put under inverted microscope at 400 times to observe whether there were spermatozoa before next step. If spermatozoa were found, the operation was stoped; If not, next step was carried out. Meantime, testicular tissue was sent to pathological examination. MATERIALS AND METHODS: ‘Three-Step’ sperm retrieval method can significantly improve SRR. SRR is asscociated with pathological types. The type of HS got higher SRR.

ASRM 2014 Annual Meeting

116

SCIENTIFIC PROGRAM • VIDEO SESSIONS

A ASRM health affects reproduction affects health

Wednesday, October 22, 2014

AAGL Film Festival Video Session

Introduction

ECTOPIC PREGNANCY 11:25 AM

AAGL-V2 Robotic Removal of Cesarean Scar Ectopic and Hysterotomy Revision Matthew Siedhoff

11:32 AM

AAGL-V3 Laparoscopic Management of a Cornual Ectopic Pregnancy Brooke Winner AAGL-V4 The Diverse Hysteroscopic Appearance in Cases of Retained Products of Conception Noam Smorgick

11:40 AM

Discussion

11:54 AM

11:15 am - 1:00 pm

PANTONE 200

MYOMAS

11:15 AM

AAGL-V1 Combined Laparoscopic and Hysteroscopic Approach to a Cervical Ectopic Pregnancy Astrid von Walter Gonzalez

AAGL-V7 12:18 PM Laparoscopic Resection of the Large Broad Ligament Fibroid Jonathan Song AAGL-V8 Strategies To Minimize Blood Loss during a Myomectomy Enrique Soto Discussion

AAGL-V6 Anatomy Retroperitoneal Dissection of the Uterine Artery in Common Surgical Scenarios Astrid von Walter Gonzalez

12:06 PM

Discussion

12:13 PM

12:34

AAGL-V9 Vasopressin Hydrodissection for Ovarian Cysts: A Demonstration of Technique Lee Hammons AAGL-V10 Surgical Techniques and Applications of Monopolar Energy Cara King Discussion

ANATOMY 11:59 AM

12:26 PM

SURGICAL TECHNIQUES

11:47 AM

AAGL-V5 Anatomy The Retroperitoneum: Practical Clinical Anatomy and Dissection Bich-Van Tran AM

h r a

117

12:39 PM

12:47 PM

12:55 PM



ASRM 2014 Annual Meeting

ASRM PARTICIPANT AND SPOUSE/PARTNER DISCLOSURE INDEX 2014 health affects reproduction affects health

ASRM

Program participants are required to disclose commercial and financial relationships with manufacturers of pharmaceuticals, laboratory supplies, medical devices and with commercial providers of medically related sservices. Unless otherwise noted below, the participants have nothing to disclose. Additional disclosures can be found online. health affects reproduction affects health

PANTONE 200

Aboulghar, Mohamed Abramowicz, Jacques S. Abuhamad, Alfred Z. Albertini, David F. Alper, Michael M. Anderson, Richard A. Archer, David F.

Baker, Valerie L. Barnhart, Kurt T. Barrett, C. Brent Behr, Barry Bergh, Catherine M. Bergman, Kim Black, Lauri D. Blithe, Diana Bocca, Silvina M. Bowers, Daniel Brisman, Melissa B. Brown, Molly M. Buster, John E. Carrell, Douglas T. Caswell, Wayne A. Catherino, William Cedars, Marcelle L. Cesario, Moses Chapman, Carli W. Chen, Serena H. Cholkeri-Singh, Aarathi Cohen, Jacques Cooper, Amber R. Coutifaris, Christos

ASRM 2014 Annual Meeting

Ferring Pharmaceuticals, received sponsorship for travel and accomodation to attend conferences abroad; IBSA, received sponsorship for travel and accomodation to attend conferences abroad GE Healthcare, Consultant Verinata/Illuminia, Clinical Advisory Board Maryland State SDtem Cell Research Fund, Paid consultant; Springer Publishing, Honoraria EMD Serono, Speakers bureau; Good Start Genetics, Paid consultant; Reprosource, Scientific Advisor Ferring Pharmaceuticals, Paid consultant; Astra Zeneca, Paid consultant; Roche Diagnostics, Paid consultant; Takeda Pharmaceuticals, Paid consultant AbbVie, Paid consultant; Agile Therapeutics, Paid consultant; Ascend Therapeutics, Paid consultant; Bayer Healthcare, Paid consultant; CHEMO, Paid consultant; Endoceutics, Paid consultant; Merck, Paid consultant; Pfizer, Paid consultant; Shionogi, Paid consultant; TherapeuticsMD, Paid consultant; Merck, Honoraria; Pfizer, Honoraria; AbbVie, Grant recipient; Endoceutics, Grant recipient; Merck, Grant recipient; Warner Chilcotte, Grant recipient; TherapeuticsMD, Grant recipient; Bayer Healthcare, Grant recipient Good Start Genetics, Advisory Board; Roche, Grant recipient; NIH, Grant recipient; TEVA, Advisory Board; Ovuline, Advisory Board Swiss Percsion Diagnistics, Paid consultant; Bayer, Paid consultant; NMS Labs, Paid consultant Reprosource Fertility Diagnostics, Paid consultant Cooper Surgical, Paid consultant; Auxogyn, Direct stockholder; Ivigen, Direct stockholder Med Software, LLC, Company officer Growing Generations, LLC, Company officer; HIV Assisted Reproductive Technologies, Company officer Good Start Genetics Laboratory, Genetic Counseling Advisory Board; InformedDNA, Business Advisory Board; Illumina, Speakers bureau HRA Pharma, My institute (NICHD) has a Collaborative Research and Development Agreement with HRA Pharma and patents are jointly held Merck-Organon, Speakers bureau Gilead, Speakers bureau Ferring Pharmaceuticals, Nursing Advisory Board Company1, test; Company2, Direct stockholder Previvogenetics, LLC, Company officer; Previvogenetics, LLC, Direct stockholder Episona, Inc, Company officer; Merck Serono, Grant recipient Irvine Scientific, Paid consultant EMD Serono, Full-time company employee Nora Therapeutics, Grant recipient; Ferring Pharmaceuticals, Grant recipient Previvo Genetics, LLC, Company officer Irvine Scientific, Honoraria Hologic, Speakers bureau; Merck, Speakers bureau Ethicon Endo Surgery, Advisory Board Member, Speakers bureau; Bayer, Advisory Board Member, Speakers bureau Reprogenetics LLC, Company officer; Life Global, Paid consultant Celmatix, Scientific Advisory Board; AstraZeneca, Associate investigator on institutional clinical trial; Beckman Coulter Inc, Study support/provided AMH assays NIH, Grant recipient; NORA, medical advisory board member; ASRM, Executive Committee and Board Member; ABOG, Examiner

118

PARTICIPANT AND SPOUSE/PARTNER DISCLOSURE INDEX 2014 Crockin, Susan L. Deutch, Todd D. Diamond, Michael P. Dietrich, Jennifer E. Doody, Kevin J. Duleba, Antoni Dumesic, Daniel A. Duncan, Francesca E. Durrett, Russell Eisenberg, Michael L. Feinberg, Eve C. Forman, Eric J. Gardner, David K. Gerrity, Marybeth Ginsburg, Elizabeth S. Giudice, Linda C. Grimes, David A. Hammond, Karen R. Hansen, Peter J. Harrington, Nancy A. Hill, George A. Honig, Stanton C. Hotaling, James M. Huddleston, Heather Isaacson, Keith B. Jasulaitis, Sue Jungheim, Emily S. Kaneshiro, Bliss Katz-Jaffe, Mandy Khera, Mohit Kimble, Thomas D. Kohi, Maureen Kolb, Bradford A. Ledbetter, David H. Legro, Richard S. Lewis, Michael L. Lewis, Sheena E. M. Lieberman, Juergen Madden, Tessa Massey, Joe B.

A ASRM

Merck, Paid consultant; BMS, Paid consultant; Genentech, Paid consultant; Prometheius, Paid consultant; GSK, Paid consultant GE Healthcare, Consultant Advanced Reproductive Care, Direct stockholder; Advanced Reproductive Care, Board of Directors; EMD, Serono, AbbVie, Grant recipient; Actamax, Auxogyn, ZSX Medical, Teijin, Paid consultant CSL Behring, Honoraria Ferring Pharmaceuticals, Speakers bureau; Ferring Pharmaceutical, Paid consultant; Merck Pharmaceutical, Speakers bureau; Merck Pharmaceutical, Paid consultant; EMD Serono Pharmaceutical, Paid consultant Channel Medsystems, Paid consultant Ferring Pharmaceuticals Inc, Paid consultant Ferring Pharmaceuticals, Contracted Research (9/1/2013-8/31/2014; $14,883.48 salary) Recombine, Full-time company employee Sandstone Diagnostics, Advisor Abbvie, Paid consultant; Ferring Pharmaceuticals, Paid consultant Ferring Pharmaceuticals, Advisory Board Vitrolife AB, Grant recipient Auxogyn, Inc., Full-time company employee Up To Date, Honoraria; Springer Inc, Honoraria; Nora Therapeutics Inc, Industry study- money to my department for participation Pfizer, Direct stockholder; Merck, Direct stockholder Bayer, Data Safety Monitoring Committees Good Start Genetics, Paid consultant Cooley Biotech LLC, Company officer; Zoetis, Paid consultant; Renova LLC, Grant recipient OPTUM/ A division of United Healthcare, Full-time company employee United Health Care, Paid consultant Lilly, Auxilium, Speakers bureau; Abbvie, Vyrix, menMD, Paid consultant; Clarus, Ferring Pharmaceuticals, clinical trial SpermDx, Company officer; Andro360, Company officer Ziva Medical, Paid consultant Karl Storz Endoscopy, Paid consultant Merck Pharmaceuticals, Speakers bureau Abbvie, Paid consultant; Genentech, Paid consultant; Spectrum, Paid consultant; Celgene, Paid consultant; Genentech, Speakers bureau Uptodate, Consultant Merck Serono - Grant for Fertility Innovation, Grant recipient Lilly, Paid consultant; Auxilium, Paid consultant; Merck, Paid consultant; Sprout, Direct stockholder; AMS, Paid consultant Merck Pharmaceuticals, Speakers bureau; Bayer Healthcare, Grant recipient BTG, Paid consultant HIV Assisted Reproductive Technology, Inc., Direct stockholder; Ferrring Pharmaceuticals, Speakers bureau Natera, Paid consultant Astra Zeneca, Paid consultant; Euroscreen, Paid consultant; Takeda, Paid consultant; Ferring Pharmaceuticals, Grant recipient PlasmaSurgical, Paid consultant Lewis Fertility Testing, Company officer Origio & Sage, Paid consultant; Irvine Scientific, Speakers bureau Bayer Healthcare Pharmaceuticals, Honoraria Optivia Medical, Direct stockholder

h r a

health affects reproduction affects health

119

ASRM 2014 Annual Meeting

PANTONE 200

ASRM PARTICIPANT AND SPOUSE/PARTNER DISCLOSURE INDEX 2014 ASRM

health affects reproduction affects health

Meintjes, Marius Moley, Kelle H. Morbeck, Dean E. Morozov, Vadim health affects reproduction affects health

PANTONE 200

Mortimer, Sharon T. Mulhall, John P.

Munné, Santiago Nadal, Alexander Nagy, Zsolt Peter Nezhat, Camran Nezhat, Ceana Nichols, John E. Niederberger, Craig Ntrivalas, Evangelos Ohl, Dana A. Oktay, Kutluk Olive, David L. Paduch, Darius A. Pal, Lubna Palter, Steven F. Patrizio, Pasquale Paulson, Richard J. Pellicer, Antonio Penzias, Alan S. Pfeifer, Samantha M. Pisarska, Margareta Puscheck, Elizabeth E. Racowsky, Catherine Richard-Davis, Gloria A. Rizk, Botros Robinson, Randal D. Roth, Lauren W. Sakkas, Denny Schattman, Glenn L. Schlegel, Peter N. Schust, Danny J. ASRM 2014 Annual Meeting

Vitrolife, Paid consultant OvaScience, Scientific Advisory Board Fertilitech, Scientific advisory board; Fertilitech, Research instrument loan Titan Medica, Direct stockholder; TEDCO/MII, Grant recipient; Solour Surgical, Honoraria; Intuitive Surgical, Paid consultant Atlantic Assisted Reproductive Technologies, Paid consultant; Grace Fertility Centre, Paid consultant; FIORE Institute, St Gallen, Switzerland, Paid consultant; Oozoa Biomedical Inc, Direct stockholder; Mellowood Medical, Paid consultant Lilly, Paid consultant; Alliance for Fertility Preservation, Leadership Position; Nexmed, Paid consultant; Absorption Pharmaceuticals, Paid consultant; AMS, Paid consultant; Meda, Paid consultant; Vivus, Paid consultant; Association of Peyronie’s Disease Advocates (APDA), Leadership Position; Pfizer, Scientific Study or Trial Reprogenetics, Company officer; Recombine LCC, Company officer Previvo Genetics, LLC, Full-time company employee My Egg Bank, Direct stockholder; Origio, Paid consultant; Fertilitech, Paid consultant; MERCK MSD, Speakers bureau Previvo Genetics LLC, Direct stockholder Karl Storz Endoscopy, Paid consultant; Plasma Surgical, Medical Advisor; SurgiQuest, Scientific Advisory Board Bayer Womens Healthcare, Paid consultant NexHand, Company officer; American Society for Reproductive Medicine, Journal Co-Editor in Chief; American Urological Association, Journal Section Editor; UCLA, Speakers bureau Nova Biomedical, Full-time company employee Auxilium Pharmaceuticals, Grant recipient; American Medical Systems, Paid consultant; Coloplast Corporation, Paid consultant OvaScience, Medical Advisory Board Member Bayer, Paid consultant; Abbvie, Speakers bureau Roche Ltd, Grant recipient; Eli Lilly and Company, Grant recipient; Auxilium, Speakers bureau; Eli Lilly, Speakers bureau; AbbVie, Speakers bureau; Antares, Paid consultant Merck, Paid consultant Boston Scientific, Paid consultant; Lodestone Technology, Inc., Company officer FertilSafe, medical advisor Ferring Pharmaceuticals, Speakers bureau; Origio, Paid consultant UNISENSE, IVI - Stockholder OvaScience, Clinical Advisory Board; Nora Therapeutics, Clinical Advisory Board; ReproSource, Board of Directors; Ferring Pharmaceuticals, UIT Scientific Committee Member Best Doctors, Inc, Paid consultant ASRM, Grant recipient; NICHD, Grant recipient ABBVIE, Grant recipient; Bayer, Grant recipient; AIUM, Board of Directors LifeGlobal Group, Paid consultant; Auxogyn, Paid consultant Pfizer, Advisory Board Hologic, Inc, Grant recipient; Hologic, Inc, Speakers bureau Merck, Honoraria; AbbVie, Grant recipient GlobeImmune, Full-time company employee Ferring Pharmaceuticals, Paid consultant; Ferring Pharmaceuticals, Grant recipient; Merck, Speakers bureau; Unisense, Scientific Advisory Board; Origio, Scientific Advisory Board Abbvie, Speakers bureau; Theralogix, medical advisory board; Femasys, medical advisory board; Ferring Pharmaceuticals, Speakers bureau Ferring Pharmaceuticals, Paid consultant; GNYUTES, Inc, Company officer; Theralogix, Inc, Direct stockholder UNIFY, non-paid consultant 120

PARTICIPANT AND SPOUSE/PARTNER DISCLOSURE INDEX 2014 Scott, Richard T. Seeley, Randy J.

Seifer, David B.

Shapiro, Bruce S. Shepherd, Jessica Simón, Carlos Stevenson, Eleanor L. Stewart, Elizabeth A. Stuenkel, Cynthia A. Swain, Jason E. Tarlatzis, Basil C.

Taylor, Hugh S. Taylor, Tyl H. Teede, Helena Jane Thomas, Michael A. Toner, James P. Toner, Jr., James P. Turek, Paul J. Valek, Jennifer M. Verrastro, Paul A. Wah, Robert Wells, Dagan West, Elizabeth B. Widra, Eric A. Williams, Zev Wolff, Erin F.

A ASRM

Ferring Pharmaceuticals, Grant recipient Endobetix, Direct stockholder; Zafgen, Direct stockholder; Ethicon Surgical Care, Grant recipient; Ethicon Surgical Care, Paid consultant; Novo Nordisk, Paid consultant; Novo Nordisk, Grant recipient; Takeda, Paid consultant; Boehringer Ingelheim, Grant recipient; Boehringer Ingelheim, Paid consultant; Novartis, Paid consultant; Givaudan, Grant recipient; Givaudan, Paid consultant; Eisai, Paid consultant Rutgers Medical School/MGH with Beckman Coulter, Receive royalties from licensing aggreement between Rutgers Medical School/MGH and Beckman Coulter for using AMH to determine ovarian reserve; Ferring Pharmaceuticals, Scientific consultant; Univfy, Medical advisory board; Beckman-Coulter, Medical consultant; WINFertility, Medical advisory board Merck, Grant recipient; Watson, Grant recipient; Glycotope, Paid consultant; Merck, Paid consultant Hologic Inc, Paid consultant; Karl Storz Inc, Paid consultant IVIOMICS, Direct stockholder; IVIOMICS, Co-author of the ERA patent; IVIOMICS, Board membership; Equipo IVI investigacion, Direct stockholder Glaxo Smith Kline, Full-time company employee InSightec, Research support paid to Mayo Clinic; Bayer, Paid consultant; GSK, Paid consultant; Gynesonics, Paid consultant Ligand Pharmaceuticals Incorporated, Paid consultant; Celladon Corporation, Paid consultant; Falco, Paid consultant; Gambro Renal, Paid consultant; Takeda Pharmaceuticals, Paid consultant Irvine Scientific, Honoraria Merck Serono, Merck Sharp & Dohme, IBSA, Honoraria; Merck Serono, Merck Sharp &Dohme, IBSA, Ferring Pharmaceuticals, Travel grants; IBSA, Ovascience, Advisory Board; Merck Serono, Merck Sharp & Dohme, Grant recipient; Merck Sharp & Dohme, Speakers bureau Pfizer - grant to Yale Univ., Grant recipient; OvaScience- grant to Yale Univ., Grant recipient; Abbvie, Pfizer, Ovascience, Merk, Paid consultant Biodiseno, Part time contract employee PHRI, Funded pharma study; organisation paid per participant; Lilly, Funded pharma study; organisation paid per participant; Jassen Cilag, Funded pharma study; organisation paid per participant; Novo Nordisk, Speakers bureau Smith and Nephew, Speakers bureau Merck, Speakers bureau Merck, Speakers bureau BioQuiddity. Inc, Direct stockholder; Doximity.com, Medical Advisory Board; Healthloop.com, Medical Advisory Board; Doximity.com, Medical Advisory Board Other Org, Other relationship Philips, Full-time company employee Merck, Direct stockholder; Express Scripts; Direct stockholder, Genentech, Innovation Advisory Board Reprogenetics, Direct stockholder; Merck Serono, Grant recipient; Life Technologies, Honoraria; BlueGnome, Paid consultant EMD Serono, Advisory Board; EMD Serono, Speakers bureau; Ferring Pharmaceuticals, Advisory Board Counsyl, Paid consultant Abbvie, Paid consultant; Abbvie, Speakers bureau; Nora Therapeutics, Paid consultant OvaScience, Grant recipient; Pivot Medical, Paid consultant

h r a

health affects reproduction affects health

121

ASRM 2014 Annual Meeting

PANTONE 200

ASRMASRM VIDEO AND SPOUSE/PARTNER DISCLOSURE INDEX 2014 ASRM

health affects reproduction affects health

Program participants were required to disclose commercial and financial relationships with manufacturers of pharmaceuticals, laboratory supplies or medical devices or with commercial providers of medically related services. All disclosures were reviewed by the Subcommittee for Standards for Commercial Support of the Continuing Medical Education Committee, which resolved any perceived conflicts of interest. Unless otherwise noted below, the participants had nothing to disclose. health affects reproduction affects health

PANTONE 200

Belongie, S. Cholkeri-Singh, A. Gargiulo, A. Kaser, D. J. Licciardi, F. Miller, C. E. Paduch, D. A. Rizk, B. Sasaki, K. J.

ASRM 2014 Annual Meeting

Johnson & Johnson, Full-time company employee; Merck, Full-time company employee Ethicon Endo Surgery, Advisory Board Member, Speakers bureau; Bayer, Advisory Board Member, Speakers bureau Omniguide Inc, Paid consultant Healthcare consultant for McKinsey & Company, Full-time company employee Merck, Speakers bureau Covidien, Femasys, Olympus, Novartis, Abbvie, Intuitive Surigical, Grant recipient; Ferring Pharmaceuticals, Ethicon, Hologic, Covidien, Femasys, Abbvie, Halt Medical, Intuitive Surgical, Paid consultant; Ferring Pharmaceuticals, Ethicon, Merck, Femasys, Smith & Nephew, Intuitive Surgical, Speakers bureau Roche Ltd, Grant recipient; Eli Lilly and Company, Grant recipient; Auxilium, Speakers bureau; Eli Lilly, Speakers bureau; AbbVie, Speakers bureau; Antares, Paid consultant Hologic, Inc, Grant recipient; Hologic, Inc, Speakers bureau Ethicon Endo-Surgery, Presenter at Resident Course

122

PROGRAM PARTICIPANTS . NON-ORAL/POSTER PRESENTERS PARTCIPANTS ARE LISTED BY PAGE NUMBER

Aboulghar, Mohamed . . . . . . . . . . 22 Abramowicz, Jacques S. . . . . . . . . 14 Abuhamad, Alfred Z. . . . . . . . . . 14 Aitken, R. John . . . . . . . . . . . 40, 56 Albertini, David F. . . . . . . . . . . . . 38 Alper, Michael M. . . . . . . . . . . . 15 Alvero, Ruben J. . . . . . . . . . . . . . 15 Amato, Paula . . . . . . . . . . . . 38, 73 Anderson, Anthony R. . . . . . 38, 76 Anderson, Richard . . . . . . . . 34, 88 Archer, David F. . . . . . . . 34, 43, 85 Armstrong, Alicia Y. . . . . 34, 43, 85 Awwad, Johnny T. . . . . . . . . . . . 22 Baker, Valerie L. . . . . . . . . . . . . . 24 Ball, Elizabeth . . . . . . . . 17, 25, 28 Ball, G. David . . . . . . . . . 23, 39, 79 Banker, Manish R. . . . . . . . . . 41, 82 Barnhart, Kurt T. . . . . . . . . . . 7, 28 Barrett, C. Brent . . . . . . . . . . . . . 15 Barrionuevo, Marcelo . . . . . . . . . 38 Bedaiwy, Mohamed A. . . . . . . . 106 Behr, Barry . . . . . . . . . . . . . . . . . 24 Bergh, Carolyn . . . . . . . . . . . 36, 70 Bergh, Catherine M. . . . . . . . 36, 70 Bergman, Kim . . . . . . . . . . . 39, 78 Bhagavath, Bala . 7, 35, 44, 62, 111 Bhattacharya, Siladitya . . . . . 35, 68 Biscette, Shan . . . . . . . . . 17, 25, 28 Blithe, Diana . . . . . . . . . 34, 45, 50 Bormann, Charles L. . . . . . . 18, 26 Borowski, Kristi . . . . . . . . . . 37, 99 Bowers, Daniel . . . . . . . . . . . 39, 78 Brannigan, Robert E. . . . . . . 35, 67 Brännström, Mats . . . . . 34, 43, 49 Braverman, Andrea M. . . . . . 33, 60 Brewer, Amber . . . . . . . . . . . 18, 26 Brisman, Melissa B. . . . . . . . . 33, 59 Brown, Douglas N. 12, 26, 29, 109 Bulun, Serdar . . . . . . . . . . . . 34, 89 Bungum, Mona . . . . . . . . . . . . . 20 Canning, Lindsay E. . . . . . . . 33, 60 Carron, Rebecca . . . . . . . . . . . . . 15 Caswell, Wayne A. . . . . . . . . . 41, 84 Cedars, Marcelle I. . . . . . 28, 41, 83 Cesario, Moses . . . . . . . . . . . 37, 98 Chaillet, Richard . . . . . . . . . 38, 77 Chang, Tien-cheng “Arthur” . . . . 7, . . . . . . . . . . . . . . . . . . . . . . . 41, 84 Chapman, Carli W. . . . . . . . . . . 11 Chavarro, Jorge E . . . . . . . . . . . . 21

Chen, Serena H. . . . . . . . . . . 33, 59 Chen, Zijiang . . . . . . . . . . . . . . . 38 Childress-Beatty, Lindsay . . . . . . 14 Cholkeri-Singh, Aarathi . . . 17, 25, . . . . . . . . . . . . . . . . . . . . . . 28, 108 Coddington, Charles . . . . . . 37, 99 Cohen, Jacques . . . . . . . . . . . 33, 59 Collins, Carolyn . . . . . . . . . . 39, 79 Crockin, Susan L. . . . 14, 27, 33, 60 Daar, Judith F. . . . . . . . . . . . . . . 27 Desai, Nidhi . . . . . . . . . . . . . 36, 69 Detti, Laura . . . . . . . . . . . . 40, 104 Deutch, Todd D. . . . . . . 14, 40, 104 Diamond, Michael P. . . . . . . . 34, 89 Dlugi, Alexander M. . . . . . . . 35, 63 Dokras, Anuha . . . . . . . . . . . 34, 87 Dongzi, Yang . . . . . . . . . . . . 38, 74 Doody, Kevin J. . . . . . . . . . . . 35, 63 Duncan, Francesca E. . . . . . . . . . 19 Duran, Lisa . . . . . . . . . . 19, 39, 80 Durrett, Russell . . . . . . . . . . 37, 98 Elias, Rony T. . . . . . . . . . . . 40, 102 Falcone, Tommaso . . . . 7, 28, 106, . . . . . . . . . . . . . . . . . . . . . 107, 110 Farquhar, Cynthia . . . . . . . . 35, 68 Finer, Lawrence . . . . . . . . . . 33, 45 Gaona-Arreola, Ranferi . . . . 35, 65 Gardner, David K. . . . . . . . . . . . 13 Garrido, Nicolás . . . . . . . . . . . . . 20 Gibbons, William E. . . . . . . . 40, 81 Giles, Dobie . . . . . . . . . . 17, 25, 28 Ginsburg, Elizabeth S. . . . . . . . . 19 Gitlin, Susan A. . . . . . . . . . . 18, 26 Giudice, Linda C. . . . 34, 37, 53, 86 Goldberg, Jeffrey M. . 28, 33, 34, 49 Gracia, Clarisa R. . . . . . . . . . . 7, 19 Greenfeld, Dorothy A. . . . . . . . . 23 Griffith, Linda G. . . . . . . . . . 37, 53 Grill, Elizabeth A. . . . . . . . . . . . 14 Grimes, David A. . . . . . . . . . . . . 20 Halvorson, Lisa M. . . . . . . . 6, 7, 11 Hansen, Peter J. . . . . . . . . . . . 40, 57 Hill, George A. . . . . . . . . . . . . . . 13 Hill, Micah . . . . . . . . . . . . . . . . 13 Hoeger, Kathleen M. . . . . . . . 34, 85 Hotaling, James M. . . . . . . . . . . . . 7 Huang, Thomas . . . . . . . . . . 18, 26 Huddleston, Heather . . . . . . 36, 70 Hutton, John J. . . . . . . . . . . . 38, 73 Hwang, Kathleen . . . . . . . . . . 7, 11 123

A ASRM

Inhorn, Marcia C. . . . . . . . . . . . 14 Isaacson, Keith B. . 7, 17, 25, 28, 33 Jameson, J. Larry . . . . . . . . . . 36, 51 Janik, Grace M. . . . . 17, 25, 28, 33 Jasulaitis, Sue . . . . . . . . . . . . . . . 24 Jungheim, Emily S. . . . . . . . . . . 21 Kaneshiro, Bliss . 20, 34, 43, 49, 85 Katz-Jaffe, Mandy . . . . . . . . 41, 84 Keefe, David L. . . . . . . . . . . . . . . 13 Khera, Mohit . . . . . . . . . . . . . . . 16 Kim, Edward . . . . . . . . . . 7, 37, 97 Kimble, Thomas D. . . . . . . . . . . . 45 Kohi, Maureen . . . . . . . . . . . 37, 96 Kolb, Bradford A. . . . . . . . . . 39, 78 Kwak-Kim, Joanne . . . . . . . 40, 105 La Barbera, Andrew . . . . . . . . . . . 7 Lamb, Dolores J. . . . . . . . . . . 40, 57 Lathi, Ruth B. . . . . . . . . . . . . . . 12 Laughlin-Tommaso, Shannon 37, 96 Lawson, Angela K. . . . . . . 7, 36, 69 Ledbetter, David H. . . . . . . . 39, 55 Lee, Michael . . . . . . . . . . . . . 18, 26 Legro, Richard S. . . . . . . 28, 34, 35, . . . . . . . . . . . . . . . . . 38, 68, 75, 89 Lewis, Michael . . . . . . . . 17, 25, 28 Lewis, Sheena E.M. . . . . . . . . . . 20 Likes, III, Creighton E. . . . . . 37, 94 Lin, Paul . . . . . . . . . . . . . . . . . . 24 Lin, Wayne . . . . . . . . . . . . . . . . 110 Loret de Mola, J. Ricardo 35, 38, 75 Madden, Tessa . . . . . . . . 34, 43, 85 Malhotra, Jaideep . . . . . . . . . 41, 82 Malhotra, Narenda . . . . . . . . 41, 82 Mallard, Cassandra . . . . . . . . 18, 26 Mash, Janine . . . . . . . . . . . . 38, 76 Mayer, Jacob F. . . . . . . . . . . . . . . 15 Meintjes, Marius . . . . . . . 7, 34, 88 Meldrum, David R. . . . . . . . . . . 22 Miller, Paul B. . . . . . . . . . . . . . . 108 Moley, Kelle H. . . . . . . . . . . 12, 21 Moran, Carlos . . . . . . . . . . . 38, 75 Morozov, Vadim . . . . . . . 17, 25, 28 Mortimer, Sharon T. . . . . . . . . . . 11 Muasher, Suheil J. . . . . . . . . 40, 102 Mulhall, John P. . . . . . . . . . . 35, 67 Munné, Santiago . . . . . . . . . 37, 98 Nangia, Ajay K. . . . . . 7, 16, 39, 101 Ndukwe, George . . . . . . . . 40, 105 Neal-Perry, Genevieve . . 36, 46, 92 Nezhat, Camran . . . . . . . . . . 36, 51

h r a

health affects reproduction affects health

ASRM 2014 Annual Meeting

PANTONE 200

ASRM PARTICIPANTS . NON-ORAL/POSTER PRESENTERS PROGRAM ASRM

PARTCIPANTS ARE LISTED BY PAGE NUMBER health affects reproduction affects health

Nezhat, Ceana . . . . . 7, 17, 25, 28, . . . . . . . . . . . . . . . . . . . . 33, 36, 51 Nichols, John E. . . . . . . . . . . 34, 61 Niederberger, Craig . . . 28, 39, 101 Noyes, Nicole L. . . . . . . . . . 40, 103 Oates, Robert D. . . . . . . . . . . 37, 95 Obillo, Erin . . . . . . . . . . . . . 18, 26 Oktay, Kutluk . . . . 38, 40, 76, 103 Olive, David L. . . . . . . . . . . . . . . . 7 Orta-García, Alfonso . . . . . . 35, 65 Orwig, Kyle E. . . . . . . . . . . . 38, 72 Paduch, Darius A. . . . . . 37, 95, 115 Painter, Rebecca C. . . . . . . . . 35, 64 Pal, Lubna . . . . . . . . . . . 36, 46, 92 Palermo, Gianpiero . . . . . . . . . 112 Palter, Steven F. . . . . . 7, 28, 33, 58 Pascale, Claudia . . . . . . . . . . 33, 59 Pasch, Lauri A. . . . . . . . . . . . 36, 70 Paulson, Richard J. . . . . . 28, 36, 51 Pavone, Mary Ellen . . . . 17, 25, 28 Pellicer, Antonio . . . . . . . . . . . . . 28 Penzias, Alan S. . . . . . . . . . . . . . 22 Petok, William D. . . . . . . . . . . . . 41 Pfeifer, Samantha M. . . . . . . 17, 25, . . . . . . . . . . . . . 28, 34, 40, 90, 103 Pinborg, Anja . . . . . . . . . . . . 35, 64 Pisarska, Margareta . . . . . . . . 37, 97 Pollack, Staci E. . . . . . . . . 34, 46, 90 Portmann, Marc . . . . . . . . . . . . . . 7 Puscheck, Elizabeth E. . . . . . 40, 104 Qiao, Jie . . . . . . . . . . . . . . . . 38, 74 Queenan, Jr., John T. . . . . . . . . . 13 Rackow, Beth W. . . . . . . . . . . 34, 90 Racowsky, Catherine . . . . . . . 7, 19 Rajkovic, Aleksander . . . . . . 41, 83 Rinehart, Lisa A. . . . . . . . . . . 7, 15 Ripley, Faith E. . . . . . . . . 19, 34, 61 Rizk, Botros R.M.B. . . . 40, 81, 111 Rosen, Mitchell P. . . . . . . . . . 38, 76 Roth, Lauren . . . . . . . . . . . . . . . 15 Roudebush, William E. . . . . . 37, 94 Sakkas, Denny . . . . . . . . . . . . . . 13 Salazar-López Ortiz, Carlos . 35, 65 Sandlow, Jay . . . . . . . . . . . . 39, 101 Schattman, Glenn . . . . . . . . . 7, 11 Schlatt, Stefan . . . . . . . . . . . 38, 77 Schlegel, Peter N. . . . . . . 37, 44, 95 Schulz, Kenneth F. . . . . . . . . . . . 20 Schust, Danny J. . . . . . . 12, 39, 100 Scott, Richard T. . . . . 34, 35, 63, 88 health affects reproduction affects health

PANTONE 200

ASRM 2014 Annual Meeting

Seeley, Randy J. . . . . . . . . 36, 37, 52 Segars, James H. 7, 35, 37, 44, 62 ,97 Seifer, David B. . . . . . . . . . . . 41, 83 Senstra, Brad . . . . . . . . . . . . 39, 80 Shah, Divya . . . . . . . . . . 17, 25, 28 Shah, Duru S. . . . . . . . . . . . . 41, 82 Shapiro, Bruce S. . . . . . . . . . . . . 11 Shen, Wen-Hui . . . . . . . . . . 39, 79 Shepherd, Jessica . . . . . . 17, 25, 28 Sieren, Kristin . . . . . . . . . . . 18, 26 Sigman, Mark . . . . . . . . . . . . 7, 16 Simón, Carlos . . . . . . . . . . . . . . 13 Simon, Judy . . . . . . . . . . . . . . . . 21 Sir-Petermann, Teresa . . . . . . 38, 75 Smith, James F. . . . . . . . . . . . 35, 67 Soon, Reni . . . . . . . . . . . . . . . . . 45 Sparks, Amy E. . . . . . . . . . . . . . . 16 Spradling, Allan C. . . . . . . . . 38, 72 Stadtmauer, Laurel A. . . . . . . . . . 14 Stephenson, Mary D. . . 12, 39 ,100 Stewart, Elizabeth A. . . . . 35, 44, 62 Stuenkel, Cynthia A. . . . . . . 36, 37, . . . . . . . . . . . . . . . . . . . . 46, 54, 92 Swain, Jason . . . . . . . . . . . . . . . . 23 Swain, Margaret E. . . . . . . . . . . . 23 Swerdloff, Ronald S. . 33, 34, 48, 91 Tanbo, Tom . . . . . . . . . . . . . 35, 64 Tanrikut, Cigdem . . . . . . . . . 38, 77 Tapanainen, Juha S. . . . . . . . . 35, 64 Tash, Joseph S. . . . . . . . . . . . . . . 35 Taylor, Hugh S. . . 36, 38, 46, 72, 92 Taylor, Tyl . . . . . . . . . . . . . . 18, 26 Teede, Helena . . . . . . . . . . . . 34, 87 Toner, James P. . . . . . . . . . . . . . . . 7 Toner, Jr., James P. . . . . . . . . . . . 27 Travia, Jr., Joseph J. . . . 7, 19, 36, 71 Treff, Nathan A. . . . . . . . . . . 41, 84 Tur-Kaspa, Ilan . . . . . . . . . 40, 104 Turek, Paul J. . . . . . . . . . 40, 44, 56 Vanderpoel, Sheryl Ziemin . . 37, 93 Vaughn, Richard B. . . . . . . . . 39, 78 Vernon, Michael W. . . . . . . . 18, 26 Verrastro, Paul A. . . . . . . . . . 36, 71 Wah, Robert M. . . . . . . . . . . 33, 47 Wang, Shunping . . . . . . . . 15, 114 Wells, Dagan . . . . . . . . . . . . 37, 98 West, Elizabeth B. . . . . . . . . . . . 27 Williams, Daniel H. . 37, 38, 77, 97 Williams, Zev . . . . . . . . . . . 40, 105 Wininger, J. David . . . . . . . . 37, 94 124

Wu, Xiaoke . . . . . . . 35, 38, 68, 74 Young, Steven L. . . . . . . . . . 39, 100 Zaragoza, Claudio Serviere . . . . . 65 Zhang, Xuehong . . . . . . . . . 38, 75 Zozula, Shane . . . . . . . . . . . . 18, 26 Zweifel, Juliann E. . . . . . . . . . 36, 69

PARTICIPANT AND SPOUSE/PARTNER DISCLOSURE INDEX 2014

A ASRM

h r a

health affects reproduction affects health

PANTONE 200

125

ASRM 2014 Annual Meeting