MEFS Exchange course & Symposium- ASRM2017
Sunday, October 29
PC19 Brave New In Vitro Fertilization World: Safety
and Efficiency Is All That Matters
Developed in Cooperation with MEFS
Johnny T. Awwad, M.D. (Co-chair)
American University of Beirut Medical Center
Botros Rizk, M.D. (Co-chair)
University of South Alabama
Marcelle I. Cedars, M.D.
University of California, San Francisco
Siladitya Bhattacharya, M.D.
University of Aberdeen
Needs Assessment and Description
The practice of transferring multiple embryos to the uterus for the
purpose of enhancing implantation in humans has caused a dramatic
surge in multiple births across the world, and significant increase
in neonatal morbidity and mortality, maternal pregnancy-related
health complications, and associated short- and long-term financial
and psychological burden. The challenge we face today is to be able
to replace into the uterus a single embryo without compromising
final outcome. Another challenge is the premature adoption of
several technological innovations in the practice of assisted
reproduction long before any evidence of direct benefit to patients’
final outcome has occurred. This course is designed for physician
specialists in reproductive endocrinology and infertility and allied
health professionals, embryologists, and scientists in reproductive
medicine. The course will use an active learning style, which
consists of a team-based, problem-oriented approach that is highly
interactive, allowing sufficient time for thought exchange and
experience sharing. Participants will receive a comprehensive update
on contemporary practices originally designed for the purpose of
enhancing the efficiency and safety of in vitro fertilization (IVF)
practice. Faculty will conduct a critical appraisal of the ability
of these novel techniques and technologies to support the birth of a
healthy singleton with minimal maternal and fetal risks.
Specifically, the course will discuss the value of ovarian
biomarkers, morphokinetics, freeze-all policy, preimplantation
genetic screening for all, and molecular markers of endometrial
receptivity in improving the efficiency of embryo selection and
implantation. It will also review strategies of final follicle
maturation, luteal support, and elective single-embryo transfer (eSET).
Practice-based Learning and Improvement
At the conclusion of this course, participants should be able
Summarize the usefulness of biomarkers in designing
ovarian stimulation protocols and appraise the evidence on the
clinical impact of biomarkers on final IVF outcome.
Describe the morphokinetic events associated with in
vitro embryo development and assess the clinical benefits of
time-lapse imaging on improving embryo selection.
Contrast the advantages and limitations of the freeze-all
policy in IVF practice and evaluate the cost-effectiveness of
this policy in selected and unselected couples.
Identify the benefits and shortcomings of PGS-for-all in
standard IVF practice and explore the strengths and weaknesses
of the technology in improving final IVF outcome.
Discuss the principles of molecular screening for
endometrial receptivity and explore the cost-effectiveness of
screening for failed IVF cycles.
Describe the physiologic events associated with GnRHa
trigger of follicle maturation and design protocols to optimize
success without compromising safety.
Explain the physiologic events associated with the window
of implantation and explore the clinical value of luteal
interventions beyond conventional progesterone supplementation.
Summarize the evidence on the outcome of eSETs and
develop strategies to implement eSET in an IVF program.
Identify the need to establish quality measures of
efficiency and safety in IVF programs and develop key
performance indicators of efficiency and safety in IVF programs.