ASRM: Annual Meeting Final Program

Meet the Professor: Martha K. McClintock, Ph.D.
(A ticket is required for this activity. Lunch included.)
Why Human Pheromones? Pheromones in the Reproductive Health of Women
Room: 206

Needs Assessment:
Human pheromones regulate the timing of ovulation, sexual motivation and processing of emotional information. In what context did they evolve and what function do they serve?

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Distinguish the function of pheromones from body scents and other odors.
Identify the specific yet widely distributed brain regions that are modulated by human pheromones.
Link the evolutionary function of these compounds with potential treatments of disease and dysfunction.

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In Vitro Maturation of Oocytes
The Society for Assisted Reproductive Technology
Room: 207B

Chair: David F. Albertini, Ph.D.

Presenters:
David F. Albertini, Ph.D.
Marcus W. Jurema, M.D.

Needs Assessment:
IVM is quickly entering the armamentarium of reproductive endocrinologists worldwide to treat patients in need of ART. IVM is distinguished from IVF, as it requires less or no ovarian stimulation and nurturing of immature oocytes in vitro. Recent advances in Graffian follicle physiology are lending crucial knowledge to maturing competent oocytes in vitro for human reproduction. However, several issues need to be optimized in order for IVM to be successful, including patient selection, protocol development, laboratory technology (i.e. media), and endometrial support.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Describe the physiology of in vivo follicular maturation and how it applies to IVM.
Summarize the clinical applications of IVM technology and its potential benefits and risks.
Identify laboratory conditions for optimization of IVM.
Formulate hypotheses for further research aimed at improving clinical IVM outcomes.

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The Role of Directed Genetic Testing in Male Infertility Evaluation and Treatment: Necessity and Advantages
Society for Male Reproduction and Urology
Room: 151A

Chair: Robert D. Oates, M.D.

Presenters:
Mark Sigman, M.D.
Paul J. Turek, M.D.

Needs Assessment:
In the era of ICSI, more and more men previously considered sterile are able to have biologic children. However, a significant portion of these men have genetic causes for their infertility. This session will address the genetic evaluation of these men, as well as the limitations of the current tests, and go over potential future tests.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Describe the current genetic tests available for the evaluation of the infertile male, as well as the indications for their use.
Interpret the results of genetic testing, as well as recognize the limitations of these tests.
Describe the future of genetics testing for male infertility, including future tests.

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The Impact of Infertility on Male and Female Sexual Function and Mental Health
Sexuality Special Interest Group
Room: 144ABC

Chair: Cynthia Ziemer, M.Div., Psy.D.

Presenters:
Carin V. Hopps, M.D.
Sheryl A. Kingsberg, Ph.D.

Needs Assessment:
Infertility has been associated with depression, anxiety, relationship difficulties, and sexual dysfunction. However, research on the impact of infertility on mental health and sexual function, and the role of psychological factors in pregnancy success rates is limited.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Discuss the impact of infertility and treatment on the couple relationship, mental health, and sexual function.
Discuss the role of psychological factors in the etiology of infertility and success of infertility treatment.
Discuss the assessment and treatment of sexual dysfunction in the infertile couple.
Discuss the assessment and treatment of depression in infertile couples and during pregnancy.

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TUESDAY, OCTOBER 16, 2007
12:15 pm-1:15 pm

Meet the Professor: Liza Mundy
(A ticket is required for this activity. Lunch included.)
Choice in the New Reproductive Landscape
Room: 206

Needs Assessment:
Liza Mundy, a Washington Post staff writer and author of a major new book on Assisted Reproductive Technology, Everything Conceivable: How Assisted Reproduction is Changing Men, Women, and the World, discusses the concept of “choice,” and reproductive liberty, when it comes to assisted reproduction. Twenty years ago, “choice” was a term that had only one connotation. To be “pro choice” meant one thing: it meant favoring a woman’s right to terminate a pregnancy she didn't think she could bring to term. Since then, thanks to ART, the choices available to people making reproductive decisions are relentless, and often unexpected. Patients can--and often must--choose how many embryos to transfer; they can choose their sperm or egg donor; they can choose to use an anonymous donor, depriving a child of the right to meet that donor later; they can choose to use PGD to test for genetic disease or select the sex of their baby; and at the end of treatment, they must choose what to do with excess frozen embryos. ART professionals would benefit from a discussion exploring reproductive liberty in the context of ART. What choices are most difficult? How could doctors and clinics help? Should patients always be allowed to make the choice?

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Summarize at least two points in the ART process where patients are called upon to make difficult choices.
Outline the reasons and motivations that may inform these choices.
Describe their own views on which choices should belong to the patients, and which to the physician, and how patients can best be assisted in the decision-making process.

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From Pronuclear Stage to Blastocyst: How to Select the Best Embryo for Transfer
Federacion Latinoamericana de Sociedades de Esterilidad y Fertilidad (FLASEF) Professional Group
Room: 209ABC

Chair: Carlos E. Sueldo, M.D.

Presenters:
Vanesa Rawe, Ph.D.
Denny Sakkas, Ph.D.

Needs Assessment:
There is a trend in ART toward reducing the number of fresh embryos transferred in order to alleviate the incidence of multiple pregnancies, long recognized as one of the most serious ART-related complications. This Interactive Session aims to present a comprehensive review of the actual role of human gametes in embryo quality, as well as the value of morphological and non-morphological parameters of embryo quality, to best select the embryo for transfer with the highest implantation potential.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Discuss the impact of human gametes on embryo quality.
Describe the different morphological and non-morphological parameters used by embryologists and their value in establishing embryo quality in vitro.
Outline the differences and significance of embryo quality parameters at the pronuclear stage, early cleavage and blastocyst, and its impact on the number of embryos to be transferred in different ART patients.

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How Fast Should We Freeze Oocytes? Vitrification vs. Controlled Rate
A Joint Session of the Society for Reproductive Endocrinology and Infertility and the Fertility Preservation Special Interest Group
Room: 143AB

Chairs:
Michael P. Diamond, M.D.
Kutluk Oktay, M.D.

Presenters:
Kutluk Oktay, M.D.
Gary D. Smith, Ph.D.

Needs Assessment:
Oocyte cryopreservation is a promising technology with a potential to revolutionize fertility preservation, controlled hyperstimulation management, and egg donation. Recent data indicate improved success rates and there is growing interest in this technique. Because there are fragmented reports on two different techniques of egg freezing, a comprehensive workshop is needed to summarize the current state of technology.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Describe the main methods of oocyte freezing.
List the current and comparative success rates for slow and fast freezing.
Recognize the areas of research in oocyte cryopreservation technology.

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WEDNESDAY, OCTOBER 17, 2007
12:15 pm-1:15 pm

Imaging of the Infertile Male -What is Necessary (and What Isn’t)
The Society for Male Reproduction and Urology
Room: 201

Chair: Jay I. Sandlow, M.D.

Presenters:
Robert E. Brannigan, M.D.
Ajay K. Nangia, M.D.

Needs Assessment:
Radiographic imaging is an important diagnostic tool in the evaluation of the infertile male. Clinicians must be familiar not only with the correct utilization of these tests, but also the proper techniques given that a growing number of these tests are being performed by urologists in the office and OR settings. In this session we will discuss imaging techniques used in the evaluation of the infertile male. Several interesting case studies with accompanying illustrative radiographic images will be presented for discussion.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Describe the technique for transrectal ultrasonography in the evaluation of the infertile male.
Identify patients who should undergo scrotal ultrasonography as part of their infertility workup.
Discuss the utility of seminal vesiculography in the diagnosis of men with suspected ejaculatory duct obstruction.
Describe the role of vasography in the evaluation of men with azoospermia.

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Does Surgical Removal of Endometriosis Have an Impact on Endometrial Receptivity and Improve Pregnancy Rates?
A Joint Session of the Society of Reproductive Surgeons and the Endometriosis Special Interest Group
Room: 143ABC

Chair: Robert N. Taylor, M.D., Ph.D.

Presenters:
Tommaso Falcone, M.D.
Robert N. Taylor, M.D.

Needs Assessment:
Surgical approaches to the treatment of endometriosis are evolving, as is our knowledge of the molecular underpinnings of endometrial receptivity. The results of recent needs assessment surveys of the membership of the ASRM indicated a common desire for additional activities designed to update physicians regarding advances in infertility treatment. This interactive session is a joint effort of the Society of Reproductive Surgeons and the Endometriosis SIG to consider the effects of surgical treatment of endometriosis on pregnancy outcomes in these patients.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Summarize specific strategies and techniques to remove peritoneal endometriotic lesions.
Integrate potential molecular and biochemical mechanisms by which ectopic endometriotic lesions negatively impact eutopic endometrial function.

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Adoption of a Uniform Embryo Morphology Classification System for Prediction of Pregnancy Outcome - Can a Single Observation Reveal True Zygote Morphology?
A Joint Session of the Reproductive Biologists Professional Group (RBPG) and the Reproductive Laboratory Technologists Professional Group (RLTPG)
Room: 144ABC

Chairs:
Karen Elkind-Hirsch, Ph.D.
Michael L. Reed, Ph.D.

Presenters:
Douglas W. Gliedt, Ph.D.
Kathleen A. Miller, B.S.

Needs Assessment:
External quality control proficiency testing programs have taught us that variation is significant for subjective determinations between laboratories, e.g. sperm morphology as one example, and further, that intra-laboratory quality control must be practiced to maintain proficiency within the laboratory. The concept that all infertility practices can, and should adopt a universal embryo morphology scoring system is intriguing, particularly in light of the growing movement towards elective or mandatory single embryo transfer. Grading systems exist where a single morphological observation represents a decision process – to transfer or not to transfer – while other systems employ multiple observations (multipoint inspections) prior to a decision process. And either of these morphology-based systems may be augmented by chemical or other assays. Which selection method is correct, or preferable, for any given day of embryo transfer? Who would be responsible for designing the optimal grading system? How could the system be implemented, maintained, and evaluated on a realtime basis? These are some of the questions that the faculty will address, in a pro and con discussion format.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Discuss the options available to laboratory personnel and clinicians for the establishment of a more unified approach to embryo selection methods based on morphology.
Critique the existing embryo selection technique(s) in the participants own clinical setting against ideas presented by faculty and course participants.
Consider the potential of an applied universal embryo scoring system for increased regulation of laboratory performance.

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Preselection of Aneuploidy-Free Oocytes in a Setting with a Few Permitted to Fertilize and Its Impact on IVF Outcome
A Joint Session presented by the Preimplantation Genetic Diagnosis Special Interest Group (PGDSIG) and the Genetic Counseling Special Interest Group (GCSIG)
Room: 206

Chair: Yury Verlinsky, Ph.D.

Presenters:
Luca Gianaroli, M.D.
Renee L. Genovese, M.S., C.G.C.

Needs Assessment:
With the restriction of a number of oocytes permitted to fertilize in some countries, preconception diagnosis for chromosomal disorders is the only approach to preselect aneuploidy-free oocytes prior to ICSI, the impact of which on implantation, pregnancy and take-home baby rates has not been evaluated. So, the results of the recent study in the area need careful assessment to increase the awareness of the possibilities of preselection of embryos with the optimal developmental potential before fertilization, and development of the appropriate genetic counseling services within ART.

Learning Objectives:
At the conclusion of the Interactive Session, participants should be able to:

Evaluate the feasibility of preselection of aneuploidy-free oocytes prior to ICSI, its safety, accuracy and practical relevance to the improvement of IVF effectiveness.
Outline limitations of preconceptional aneuploidy testing compared with preselection of aneuploidy-free embryos at the cleavage stage.

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