MEFS Exchange course & Symposium- ASRM2017

ASRM 2017 PRE-CONGRESS

Sunday, October 29

PC19 Brave New In Vitro Fertilization World: Safety and Efficiency Is All That Matters

Developed in Cooperation with MEFS

Faculty

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). 
 
ACGME Competency
Patient Care
Practice-based Learning and Improvement

Learning Objectives

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

1.     Summarize the usefulness of biomarkers in designing ovarian stimulation protocols and appraise the evidence on the clinical impact of biomarkers on final IVF outcome. 

2.     Describe the morphokinetic events associated with in vitro embryo development and assess the clinical benefits of time-lapse imaging on improving embryo selection. 

3.     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. 

4.     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. 

5.     Discuss the principles of molecular screening for endometrial receptivity and explore the cost-effectiveness of screening for failed IVF cycles. 

6.     Describe the physiologic events associated with GnRHa trigger of follicle maturation and design protocols to optimize success without compromising safety. 

7.     Explain the physiologic events associated with the window of implantation and explore the clinical value of luteal interventions beyond conventional progesterone supplementation. 

8.     Summarize the evidence on the outcome of eSETs and develop strategies to implement eSET in an IVF program. 

9.     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.