ASRM: Annual Meeting Preliminary Program

40th Annual Postgraduate Program Committee
William C. Dodson, M.D. - Chair
Valerie L. Baker, M.D. - Co-Chair
Mary D. Stephenson, M.D., M.Sc. - Coordinating Chair

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General Postgraduate Course Information

Weekend Courses
Dates: Saturday, October 13 and Sunday, October 14
Hours: 8:15 a.m.-5:00 p.m. Lunch is from Noon-1:00 p.m.

Courses 1-3 are two-day courses on Saturday and Sunday.

Courses 4-14 are one-day courses on Saturday.

Courses 15-24, 26 and 27 are one-day courses on Sunday.

Course 25 is a special one-day workshop on Sunday.

Postgraduate Course Syllabi will be posted online at the ASRM website in September 2007. Printed copies will be distributed on-site.

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Two Day CME Courses -
Saturday, October 13th & Sunday, October 14th

Course 1 (Saturday & Sunday)

Requirements For A Successful Outcome Of Infertility Treatment
Developed in Cooperation with the European Society of Human Reproduction and Embryology (ESHRE)

Faculty:
Stephan Gordts, M.D., Chair
Marco Filicori, M.D.
Luca Gianaroli, M.D.
Philippe Koninckx, M.D., Ph.D.
Kersti Lundin, Ph.D.

Needs Assessment and Course Description
Theoretically, most infertile couples desiring fertility should be able to conceive with currently available methods of diagnosis and treatment. In reality, many couples fail to respond to fertility treatments for unknown reasons. The problem is exacerbated by delaying conception and pregnancy. Participants in previous postgraduate courses expressed a desire for educational activities that address the problems of poor responders and incorporation of pre-implantation genetic diagnosis into fertility treatment.

This course will provide reproductive medicine professionals with a better understanding of common pathogenic processes underlying infertility and of the utility of different diagnostic and treatment modalities. Faculty members will review critically the indications for and approaches to exploratory surgery. Lectures and discussion will focus on improvement in the quality of ART, the avoidance of multiple pregnancies and the importance of pre-implantation genetic diagnosis in the achievement of positive pregnancy outcomes.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Incorporate an accurate, minimally invasive diagnostic assessment into daily practice.
Compare the therapeutic and prognostic values of available surgical procedures.
Summarize the requirements for a highly effective ART program.
Describe the importance of preimplantation genetic procedures in the achievement of healthy singleton pregnancies.

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Course 2 (Saturday & Sunday)

Men And Art: The Missing Voice
Developed in Cooperation with the Mental Health Professional Group (MHPG)

Faculty:
William D. Petok, Ph.D., Chair
Peter Chan, M.D., C.M., M.Sc.
Nanette R. Elster, J.D., M.P.H.
Marcia C. Inhorn, Ph.D., M.P.H.
Mark A. Womack, Ed.D.

Needs Assessment and Course Description
Approximately 50% of cases of infertility involve at least some degree of male-factor infertility, a diagnosis with distinct emotional and social implications. Since the first reported use of donor insemination in 1884, a variety of techniques have been developed to overcome male-factor infertility. It behooves healthcare professionals in reproductive medicine to understand both the medical and the psychosocial issues presented by male-factor infertility patients since they invariably will encounter men with reproductive difficulties.

This course is designed for a wide range of health care professionals who care for men and their partners who wish to become parents. The focus is decidedly on the man’s perspective. Faculty members will discuss male sexuality, male-factor infertility and male-specific psychological issues; controversial ethical issues impacting men, e.g., gay or single men seeking to become parents or sperm donors, or seeking for surrogate carriers; gender-specific issues of culture, role and stigma; the genetics of male infertility; and medical diagnoses and treatments for male-factor infertility.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Summarize putative causes and evidence-based treatments for male infertility.
Describe the role of genetics in male-factor infertility.
Explain the range and significance of male psychosocial concerns regarding infertility.
Discuss the issues in effective counseling of men with malefactor infertility and their partners.
Summarize the ethical, psychological and legal issues that impact men using ART.

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Course 3 (Saturday & Sunday)

ART: The Power In Your Hands
Developed in Cooperation with the Society for Assisted Reproductive Technology (SART)

Faculty:
Marcelle I. Cedars, M.D., Chair
Andrea M. Braverman, Ph.D.
Frank Broekmans, M.D., Ph.D.
John A. Collins, M.D.
Thomas Pool, Ph.D., H.C.L.D.
Stanley P. Leibo, Ph.D.

Needs Assessment and Course Description
Despite advances in techniques for ovarian stimulation and gamete and embryo culture, the chance for any single embryo to implant remains low. An improvement in implantation rates likely would cause specialists in assisted reproductive technologies (ART) to incorporate single embryo transfer into their protocols, almost certainly resulting in a reduction in the rate of multiple pregnancies. Participants in previous courses and meetings of the Society for Assisted Reproductive Technology repeatedly ask whether there are specific clinically driven options to improve the outcome of ART.

The goal of this course is to employ a multi-faceted approach to review critically the available clinical approaches to enhance implantation rates and, therefore, improve patient outcome. The course will integrate established and new, emerging principles of clinical care. Faculty will discuss clinically derived components of the ART process in an interactive fashion, focusing on patient-specific parameters that must be evaluated prior to stimulation. Participants also will learn the latest information regarding endometriosis, polycystic ovary syndrome, endometrial receptivity, and the interplay between the clinic and laboratory useful for optimizing pregnancy outcome.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Describe the impact of stimulation protocols on follicular and oocyte health.
Critically assess the impact of precycle testing, management of endometriosis and polycystic ovary syndrome, and laboratory practices on implantation.
Summarize the current knowledge of implantation and clinical factors that impact pregnancy outcome.
Compare therapeutic options to enhance implantation.
Critically assess the current state of oocyte cryopreservation and the implications of applying this technology to ovarian preservation for elective indications.
Formulate plans to achieve a healthy singleton delivery.

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One Day CME Courses - Saturday, October 13th

Course 4 (Saturday)

Environmental Contaminants And Female Reproduction
Developed in Cooperation with the Society for Reproductive Endocrinology and Infertility (SREI)

Faculty:
Hugh S. Taylor, M.D., Chair
Andrea Jurisicova, Ph.D.
Kevin G. Osteen, Ph.D.
Julia J. Wirth, Ph.D., M.S.

Needs Assessment and Course Description
There is widespread concern regarding the possible role of environmental endocrine disruptors on human growth and development. This concern stems both from widespread examples of abnormalities in animals, such as near extinction of the bald eagle, to sexual infantilism and ambiguity of alligators and to development of endometriosis in monkeys. Additionally, in humans there is concern for international decreases in semen quality leading to male infertility. However, it is not certain that these occurrences are related to environmental endocrine disruptors. In the 2005 needs assessment survey, members of the Society for Reproductive Endocrinology and Infertility identified a need for updated information pertaining to the putative role of endocrine disruptors in perturbation of reproductive function.

This one-day course for obstetrician-gynecologists and other professionals with an interest in effects of endocrine disruptors on growth and development will address many of the postulated hormonal modulators and their effects on human growth, development, fertility and reproduction. Faculty members will critique reports of animal and human abnormalities possibly induced by environmental toxicants. Additionally, participants will discuss postulated mechanisms for the observed effects of these compounds.

Learning Objectives
At the conclusion of this course, the participant should be able to:

List chemical agents that have been postulated to be environmental endocrine disruptors.
Describe how environmental toxicants have affected animals adversely.
Summarize suspected effects of environmental endocrine disruptors on reproductive function in males and females and on the growth and development of embryos.

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Course 5 (Saturday) A Hands-On Surgical Course

Hysteroscopy For Infertility, Menorrhagia And Sterilization: Hands On Experience And Technology Update
Developed in Cooperation with the Society of Reproductive Surgeons (SRS)

Faculty:
Keith B. Isaacson, M.D., Co-Chair
Anthony A. Luciano, M.D., Co-Chair
Gary Frishman, M.D.
Eugenio E. Solima, M.D.

Needs Assessment and Course Description
Hysteroscopic surgery is a minimally invasive diagnostic and operative technique useful for the management of several intrauterine pathologies. The majority of gynecologic surgeons are not trained adequately in hysteroscopic surgery and do not use it effectively in their practice. In response to overwhelming expressions of need for practical education in advanced gynecologic surgery, the SRS has designed this course for gynecologists who wish to learn about or advance their skill in operative hysteroscopy.

This comprehensive course will be taught in two parts: a morning didactic session designed to familiarize the participants with the data on intrauterine conditions that impact fertility, and an afternoon session with hands-on laboratory practice. Participants will become familiar with the assembly of hysteroscopic instruments and fluid management equipment commonly used in the office and operating room. They also will practice techniques using wet and dry models utilized to simulate surgical techniques.

Learning Objectives
At the conclusion of this course, the participant should be able to:

List intrauterine conditions that negatively impact fertility.
Summarize the indications for diagnostic hysteroscopy versus imaging tests.
Select the appropriate instruments for diagnostic and operative hysteroscopy.
Safely perform operative hysteroscopy for polyps, submucosal fibroids, congenital uterine anomalies and Asherman’s Syndrome.

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Course 6 (Saturday)

Essential Concepts For The Re Nurse: Providing Comprehensive, Complete, And Current Care To The ART Patient
Developed in Cooperation with the Nurses Professional Group (NPG)

Faculty:
Monica E. Moore, M.S.N., R.N.C., Co-Chair
Lisa A. Rinehart, R.N., B.S.N., J.D., Co-Chair
Tamara M. Tobias, M.S.N., R.N.C., N.P.
James P. Toner, M.D., Ph.D.

Needs Assessment and Course Description
Recent surveys of the educational needs of members of the Nurses Professional Group have indicated a general desire for activities that focus on nursing care of patients undergoing assisted reproductive technologies (ART). This one-day course for nursing professionals underscores the ultimate goal of every ART nurse, which is to provide optimal patient care. Since patient education is a key component of patient care, this course will provide participants with an overview of the theoretical basis of common endocrine conditions and the techniques used to diagnose them. Faculty members will address the latest advances in research in reproductive endocrinology with particular emphasis on trends in caring for challenging ART patients. Finally, participants will review critically the basic concepts of obstetric and gynecologic ultrasound.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Identify current trends in ART that enhance patient care.
Interpret and apply basic gynecologic and obstetric ultrasound findings.
Formulate a plan of care for challenging ART patients.

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Course 7 (Saturday)

Infectious Diseases And The ART Laboratory: Potential Problems And Solutions
Developed in Cooperation with the Reproductive Laboratory Technologists Professional Group (RLTPG)

Faculty:
Michael L. Reed, Ph.D., E.L.D., H.C.L.D. (ABB), Chair
Ann Kiessling, Ph.D.
Naida M. Loskotoff, Ph.D.
David A. Stringfellow, D.V.M.

Needs Assessment and Course Description
Implementation of the Food and Drug Administration (FDA) final rules for site registration, good tissue practices, and donor suitability has heightened awareness in the clinical infertility community about control and prevention of transmissible diseases. The desire to help couples achieve families when one or both partners have an existing transmissible disease, requires balancing provision of quality services for these individuals and protecting other individuals seeking treatment at the same establishments. At present, there appears to be little consensus on how to achieve the balance between protection of patients and staff and provision of services. To address this issue for infertility specialists, the faculty will discuss current strategies for processing gametes and embryos in ART to prevent further contamination if the gametes already are contaminated. Participants will review available options for patients with significant disease, e.g., HIV, and techniques for transport and/or storage of gametes.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Compare strategies available to laboratory personnel, clinicians, and patients to minimize transmission of pathogenic organisms in ART procedures.
Describe animal models for studying disease cross-contamination in relation to laboratory techniques and settings.
Summarize the recent FDA final rules as they pertain to the need for validated, standardized laboratory techniques in order to maximize patient health and safety.
Critically assess techniques for preventing cross-contamination when handling gametes and embryos in the ART laboratory.

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Course 8 (Saturday)

Polycystic Ovary Syndrome: Improving Reproduction And Pregnancy Outcome
Developed in Cooperation with the Androgen Excess Special Interest Group (AESIG) and the Androgen Excess Society (AES)

Faculty:
Shahab S. Minassian, M.D., Chair
Roy Homburg, M.B., B.S.
Richard S. Legro, M.D.

Needs Assessment and Course Description
Approximately one in 15 women worldwide suffers from polycystic ovary syndrome (PCOS), making this disorder the most common cause of oligo-ovulatory infertility in women today. In addition to ovulatory dysfunction, patients with PCOS may experience an increased risk of pregnancy loss and perinatal complications. The objective of this course is to teach reproductive medicine specialists how to implement current knowledge of the pathophysiology of PCOS in order to help patients achieve healthy singleton full-term pregnancies.

In response to educational needs identified in surveys of ASRM members, this course will review critically the evidence supporting the latest concepts and management strategies for PCOS. Faculty members will consider both antenatal and perinatal complications of this pervasive disorder. Participants will discuss a variety of ovulation-induction strategies, including lifestyle interventions and insulin-sensitizing agents, as well as more traditional approaches, such as clomiphene citrate and gonadotropin therapies.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Critically compare strategies for inducing ovulation safely in women with PCOS with an emphasis on the prevention of ovarian hyperstimulation syndrome and multiple pregnancy.
Select the most appropriate therapeutic strategies for improving the outcomes of assisted reproduction in women with PCOS.
List risk factors for and means to minimize perinatal complications and spontaneous abortion in women with PCOS who achieve conception.

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Course 9 (Saturday)

Reproductive Imaging And ART Excellence
Developed in Cooperation with the Imaging in Reproductive Medicine Special Interest Group (IRMSIG)

Faculty:
Edmond Confino, M.D., F.A.C.O.G., Chair
Frances R. Batzer, M.D.
Alex Hartman, M.D.
Robert L. Vogelzang, M.D.

Needs Assessment and Course Description
Ultrasonography is a critical skill for the success of assisted reproductive technologies (ART). In recent surveys, ASRM members have indicated a need to improve ultrasound skills and to learn how to integrate other imaging techniques, such as magnetic resonance imaging (MRI) and interventional radiology, into ART. Early identification of frank and subtle uterine and ovarian pathology can improve patient screening, eliminate some ART complications and improve success rates.

The objective of this course is to provide the experienced ART practitioner with the most current information about approaches to screen and prepare patients for ART and optimize the success of oocyte harvest and embryo transfer. Course faculty will review critically alternative imaging techniques, including three-dimensional ultrasound, sonohysterography and MRI in assessing uterine, tubal and ovarian pathology.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Describe recent innovations in ultrasonic imaging techniques and novel alternative imaging techniques.
Identify subtle and frank uterine, tubal and ovarian pathology during evaluation for infertility.
Develop an integrated approach to reproductive imaging with an emphasis on the successful outcome of ART.

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Course 10 (Saturday)

Osteoporosis: Building Strong Bones And Reducing The Risk For Fractures
Developed in Cooperation with the Menopause Special Interest Group (MSIG)

Faculty:
Dale W. Stovall, M.D., Chair
Robert L. Barbieri, M.D.
Margery Gass, M.D.

Needs Assessment and Course Description
Osteoporosis affects more than 28 million Americans, 80 percent of whom are women. There is new evidence regarding the assessment of bone strength and there are several newly approved pharmaceutical agents for the treatment and/or prevention of osteoporosis. On the other hand, there are three conflicting national sets of guidelines regarding selection of patients for treatment of osteoporosis and osteopenia. The members of the Menopause Special Interest Group perceived a need for an educational activity to assess current guidelines and management strategies.

The goal of this course is to update clinicians who care for postmenopausal women regarding the molecular and cellular pathogenesis of osteoporosis and review advanced approaches to the evaluation and treatment of this disease. Faculty members will discuss future directions in the assessment and reduction of fracture risk. Clinicians then should be better equipped to determine who should be screened, who should be treated, what therapy is best suited for a given individual, and how to care for the individual with osteoporosis in the long-term.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Discuss the components of bone strength and the risk factors for osteoporosis.
Summarize the current guidelines for screening and treatment of postmenopausal osteoporosis.
Compare the agents currently approved by the United States Food and Drug Administration for the prevention and/or treatment of postmenopausal osteoporosis.
Select an appropriate therapeutic regimen for treating osteoporosis.

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Course 11 (Saturday)

Preimplantation Genetic Diagnosis To Improve ART Outcome
Developed in Cooperation with the Preimplantation Genetic Diagnosis Special Interest Group (PGDSIG)

Faculty:
Santiago Munné, Ph.D., Chair
Jacques Cohen, Ph.D.
Ilan Tur-Kaspa, M.D.

Needs Assessment and Course Description
PGD increasingly is being shown to be beneficial for enhancing ART patients’ likelihood of bearing normal, healthy offspring. As the reliance on PGD increases, practitioners must be able to determine which ART patients can benefit from PGD. Embryologists must be able to collect cells for PGD with minimal disruption of the embryos. Clinicians and embryologists in ASRM recognize there is a gap in their knowledge about the distinctions between proper and improper PGD methodologies. In recent needs assessment surveys, PGD has been a highly requested topic for educational activities.

The goal of this course for reproductive endocrinologists, reproductive urologists, nurse practitioners and embryologists is to review critically the indications for the use of PGD for ART patients. The faculty will review the criteria for selection of the most appropriate technologies to improve ART outcome and will explain the consequences of the use of inappropriate diagnostic methods Participants will learn how to assess patients in clinical practice in order to determine which patients would benefit from ART with PGD.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Summarize the evidence supporting the incorporation of PGD into ART procedures.
Select the appropriate candidates for PGD.
Correctly utilize PGD methodologies and assess the results of the procedure.

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Course 12 (Saturday)

Ovarian Stimulation For Assisted Reproduction: Strategies To Improve Outcome
Developed in Cooperation with the Middle East Fertility Society (MEFS)

Faculty:
Suheil J. Muasher, M.D., Chair
Yacoub Khalaf, M.Sc., M.D., M.R.C.O.G.
Stratis M. Kolibianakis, M.D., M.Sc., Ph.D.
Richard T. Scott, M.D., F.A.C.O.G., H.C.L.D.

Needs Assessment and Course Description
Ovarian hyperstimulation for multiple follicular recruitment remains a foundation of therapy for in vitro fertilization (IVF), providing greater opportunity for selection of optimal embryos. Potential disadvantages of the hyperstimulation regimen include a higher cost, risk of ovarian hyperstimulation syndrome, and potential adverse effects on the endometrium, compared with monofollicular stimulation. Practitioners of IVF require and request periodic updates on current stimulation protocols for different patient profiles.

This course for reproductive medicine specialists and fellows will compare optimal strategies for treating the challenging high- and low-responder patients. Course faculty will discuss evidence pertaining to issues such as the need for LH and the incorporation of low-dose hCG into the stimulation regimen, use of gonadotropin-releasing hormone antagonists in various clinical situations, and optimal supplementation of the luteal phase. Faculty and participants will utilize both lecture and interactive discussion formats.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Select the appropriate strategies to stimulate ovarian follicular development in high- and low-responder patients.
Assess critically evidence supporting inclusion of LH, low-dose hCG and GnRH agonists and antagonists in stimulation regimens.
Describe approaches to minimize the risk of ovarian stimulation syndrome in IVF patients and egg donors.
Summarize the evidence pertaining to optimal supplementation of the luteal phase with different stimulation protocols.

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Course 13 (Saturday)

Use Of Aromatase Inhibitors In Ovulation Induction
Postgraduate Program Chair Selection

Faculty:
Robert F.J. Casper, M.D., Chair
Juan A. Garcia-Velasco, M.D.
Mohamed M.F. Mitwally, M.D.

Needs Assessment and Course Description
The use of oral agents for ovulation induction or augmentation is the first line of treatment in many cases of infertility. For more than 40 years, the most widely used drug has been clomiphene citrate, despite adverse effects in some women that could preclude conception. More recently, aromatase inhibitors have been used as an alternative to clomiphene with apparently positive results. However, the use and safety of these compounds for ovulation induction in anovulatory women or for controlled ovarian hyperstimulation in women undergoing intrauterine insemination (IUI) or in-vitro fertilization (IVF) are controversial.

The objectives of this course are to review current techniques for ovulation induction and controlled ovarian hyperstimulation and to assess critically the latest developments and trends in this area, specifically in relation to aromatase inhibitors. Course faculty will provide participants, comprised of medical and paramedical infertility practitioners, with the most current information to assist them in caring for their patients.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Describe the mechanisms of action of clomiphene and aromatase inhibitors for ovulation induction.
Compare the advantages and disadvantages of clomiphene and aromatase inhibitors.
Design a stimulation protocol for the use of oral agents in combination with gonadotropins for IUI or IVF.
Assess the rates of congenital anomalies in babies born from mothers treated with either clomiphene or letrozole.

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One Day Non-CME Course - Saturday, October 13th

Course 14 (Saturday)

One-Day Reproductive Managers Continuing Education Course: The Fundamentals Of ART Management
Developed in Cooperation with the Association of Reproductive Managers (ARM)

Note: No credits will be given for Course #14.

Faculty:
Robin T. Mangieri, M.A., Chair
Shari D. Foley, M.A.
Karen K. Harris, J.D.
Patrick Ooley, M.S., M.T. (ASCP), C.Q.A. (ASQ)

Needs Assessment and Course Description
Achievement of a high level of success within an organization necessitates reliance on sound, basic business principles. Reproductive endocrinology and infertility (REI) practices are fluid, dynamic business models that challenge managers to be skilled in a variety of areas. Practice resources tend to be weighted towards clinical and laboratory needs, thus, requiring the practice manager to fill many diverse administrative needs. These needs include, but are not limited to, billing and reimbursement, human resources, budgeting and legal issues.

Reviews of past postgraduate course needs assessments and inquiries repeatedly identify the need for basic knowledge and management skills for entry level managers in the REI practice. This course is designed to expose new managers to fundamental skills to perform necessary managerial functions. It also will provide a refresher for developing managers as they perfect their managerial skills.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Apply basic principles of human resource management to the REI practice.
Discuss legal issues related to assisted reproductive technologies, including regulatory compliance, informed consent and patient communications.
List key skills needed to train new managers in the REI practice.
Establish an organizational frame work for creating and analyzing practice budgets.

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One Day CME Courses - Sunday, October 14th

Course 15 (Sunday)

No Man Is An Island: How The Environment Impacts Male Reproductive Health
Developed in Cooperation with the Society for Male Reproduction and Urology (SMRU)

Faculty:
Susan H. Benoff, Ph.D., Chair
Russ Hauser, M.D., Sc.D., M.P.H.
Jerrold J. Heindel, Ph.D.
Shanna H. Swan, Ph.D.

Needs Assessment and Course Description
Epidemiologic evidence is mounting that supports an association between exposure to environmental toxicants and reproductive outcome. Practicing medical professionals often are not aware that the responses to environmental exposures can be sex specific, dependent on dose and time of exposure, and transgenerational. Exposure to environmental toxicants can manifest as reduced sperm count, endometriosis, implantation failure, spontaneous abortion or structural anomalies in the offspring.

The objective of this course is to educate reproductive health professionals about the current state of knowledge concerning the effects of environmental and occupational exposures on male reproductive health so that they can inform their patients how they can modify their behavior to minimize the risk of infertility or reverse the antifertility effects of toxic exposures. Course faculty will review epidemiologic models and approaches to study environmental effects on male reproduction. Participants will learn about the potentially harmful effects of such environmental chemicals as phthalates and heavy metals on semen quality and development of the male reproductive tract.

Learning Objectives
At the conclusion of this course, the participant should be able to:

List known effects of environmental factors on male reproduction.
Describe how the timing of exposure, i.e., developmental stage, can determine the effects on male reproductive function.
Apply epidemiologic models and approaches to the study of environmental risk factors for male reproductive health.

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Course 16 (Sunday)

Ultrasonography For Reproductive Endocrinologists
Developed in Cooperation with the Society for Reproductive Endocrinology and Infertility (SREI)

Faculty:
Bradley J. Van Voorhis, M.D., Chair
Steven Goldstein, M.D.
Elizabeth Puscheck, M.D.

Needs Assessment and Course Description
Assessment of the female pelvis by ultrasonography is an integral component of the practice of reproductive medicine. Despite the importance of ultrasonography in medical practice, relatively few practices are accredited to perform this technique. Surveys of members of the Society for Reproductive Endocrinology and Infertility have revealed a strong desire for training in ultrasonography that would prepare reproductive medicine professionals for accreditation by the American Institute of Ultrasound in Medicine (AIUM).

The objective of this course for physicians, nurses and ultrasonographers actively involved in the practice of reproductive medicine is to perform a comprehensive survey of the use of ultrasonography in reproductive medicine, including an update regarding the relationship of ultrasonographic findings to reproductive medical outcomes. The faculty will review critically the application of ultrasonography to infertility diagnosis and treatment monitoring, early pregnancy, congenital malformations of the reproductive tract, and menopause. Participants will discuss such areas of uncertainty as three-dimensional ultrasound, the value of blood flow assessment, and ultrasonographically guided embryo transfer. Finally, the faculty will introduce the audience to the potential importance, requirements and benefits of AIUM accreditation.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Summarize the appropriate use of ultrasonography in the evaluation of infertility, ovarian follicular growth, uterine abnormalities and the pathology of the reproductive tract.
Describe the proper assessment of early pregnancy and list findings on early pregnancy assessments that are associated with poor outcomes.
Discuss new developments in ultrasonography, including its use as an aid in surgery, the importance of 3-D ultrasonography in reproductive medicine, and the importance of blood flow assessment in reproductive medicine practice.
List the requirements and benefits of a clinical practice attaining accreditation in ultrasonography.

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Course 17 (Sunday)

Robotics, Simulators And Suturing In Advanced Laparoscopic Surgery: A Hands-On Surgical Course
Developed in Cooperation with the Society of Reproductive Surgeons (SRS)

Faculty:
Camran R. Nezhat, M.D., F.A.C.O.G., F.A.C.S., Chair
Anthony A. Luciano, M.D., F.A.C.O.G., F.A.C.E., Co-Chair
Tommaso Falcone, M.D., F.R.C.S.C., F.A.C.O.G.
Javier Magrina, M.D., F.A.C.O.G., F.A.C.S.

Needs Assessment and Course Description
A surgeon’s skill and experience with endoscopic surgery and the availability of and familiarity with proper equipment can be major factors limiting implementation of minimally invasive surgery in gynecology. The learning curve for operative laparoscopy can be shortened greatly by user-friendly instrumentation and enablers such as surgical simulators and robots. The objectives of this course are to introduce gynecologic surgeons, both experienced and in training, innovate to learn new surgical robots and simulators and to demonstrate their applicability to gynecologic laparoscopy. The course will employ intensive didactics followed by hands-on demonstrations of simulators and robots. Participants will have ample opportunity to practice using the instruments.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Compare different methods of endoscopic simulation.
Describe how simulators, robots, three-dimensional vision and “third eye” vision can be introduced into modern education and practice of gynecologic surgery.
Utilize currently available simulators, robots, three-dimensional vision and “third eye” vision equipment in surgical procedures.

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Course 18 (Sunday)

Advanced Nursing Roles In Reproductive Medicine
Developed in Cooperation with the Nurses Professional Group (NPG)

Faculty:
Monica E. Moore, M.S.N., R.N.C., Co-Chair
Lisa A. Rinehart, R.N., B.S.N., J.D., Co-Chair
Sharita R. Warden, R.N.C., M.S., B.S.N.
Lisa Souza Van Dolah, R.N., B.S.N., M.B.A.

Needs Assessment and Course Description
Nurses in reproductive endocrinology (RE) settings have continuously evolving responsibilities, requiring new competencies as they advance in their clinical practice or practice management. Typically, advancement is based on ability and experience rather than on formal education. Surveys of the Nurses Professional Group have revealed a need for nursing professionals to learn more about leadership skills, human resource development and management, regulatory compliance, and communications as they move into administrative roles.

The objective of this course is to prepare nursing professionals for advanced leadership roles within assisted reproductive technologies clinical practices. The faculty will emphasize the enhancement of RE nurses’ knowledge base and management skills. Participants will learn approaches to effective public speaking and compliance with regulations of governmental and non-governmental agencies.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Identify leadership opportunities within an RE practice.
List the characteristics of an effective leader and ways to integrate these characteristics into daily practice.
Utilize effective communication skills to resolve difficult employee relations issues in a productive and mutually beneficial manner.
Develop an operational plan that satisfies regulatory requirements and integrates compliance into daily operations.

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Course 19 (Sunday)

Historical Perspectives Of ART In Human And Animal Reproduction: Who Has Benefited From Whom?
Developed in Cooperation with the Reproductive Biologists Professional Group (RBPG)

Faculty:
Mitchel C. Schiewe, Ph.D., H.C.L.D., E.L.D., Chair
Chad A. Johnson, Ph.D., H.C.L.D., Co-Chair
Robert A. Godke, Ph.D.
Marius Meintjes, Ph.D., H.C.L.D.
David E. Wildt, Ph.D.

Needs Assessment and Course Description
Novel medical technologies generally are tested in animal models prior to clinical application. However, new developments in human assisted reproductive technologies (ART) sometimes precede developments in animal models. Many new biologists, physicians and support staff lack an historical perspective of such technical advances as embryo culture, cryopreservation, vitrification, micromanipulation, intracytoplasmic sperm injection, cloning and blastomere biopsy for preimplantation genetic diagnosis. Reproductive biologists and other healthcare professionals require a thorough understanding of the development of these and other procedures in order to troubleshoot laboratory problems and implement old and new techniques appropriately.

The aim of this one-day course will be to reacquaint biologists, nurses, physicians and other specialists in reproduction with the historical development and possible future applications of ART. The course faculty first will focus on the historical achievements of the pioneers in reproductive physiology and relate their contributions to current clinical practice, the domestic animal industry and conservation of endangered wildlife. In the latter part of the course, participants will discuss ways to integrate current ART applications across disciplines and technologies on the horizon to improve ART outcomes.

Learning Objectives
At the conclusion of this course, the participant should be able to:

List the fundamental discoveries in reproductive biology and medicine.
Summarize the pioneering discoveries in gamete biology, in vitro fertilization, and embryo culture, and how they led to the development and practice of clinical ART.
Educate patients effectively about current ART practice.
Propose ways that healthcare professionals might facilitate the advancement of ART beyond clinical medicine.

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Course 20 (Sunday)

A Hands-On Training Course In Office-Based Family Planning Procedures
Developed in Cooperation with the Association of Reproductive Health Professionals (ARHP) and the Contraception Special Interest Group (CSIG)

Faculty:
Jeffrey T. Jensen, M.D., M.P.H., Chair
Philip D. Darney, M.D., M.Sc.
Mark Nichols, M.D.

Needs Assessment and Course Description
Contraception is an important area of reproductive medicine for the public health and welfare. Typically, reproductive health professionals receive their training in contraceptive options and methods through industry-sponsored activities. The Contraception Special Interest Group determined
via a poll of its members that there is a need for a course designed to update clinicians on recently approved contraceptive procedures and to provide hands-on training in the insertion and use of these methods in a non-commercial venue.

This course, jointly sponsored with the Association of Reproductive Health Professionals, will train clinicians who provide contraceptive care for their patients in the skills needed to provide new family planning methods that require special office procedures. The faculty will utilize published evidence to compare new and more traditional contraceptive methods and then will provide hands-on training for participants using inanimate models. Topics to be covered will include: modern intrauterine devices, implantable contraceptives, transcervical sterilization, and the manual vacuum aspiration technique of uterine evacuation for pregnancy termination.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Describe and insert the levonorgestrel intrauterine system and CuT380A intrauterine device, and counsel patients regarding anticipated bleeding patterns with these devices.
Compare the single rod etonogestrel contraceptive implant with the first generation implant systems, counsel patients about the contraceptive benefits and bleeding patterns with this system, and demonstrate correct insertion technique.
List the advantages and disadvantages of the different methods of female surgical sterilization, and identify appropriate patients.
Demonstrate correct hysteroscopy technique and placement of the Essure® method of transcervical sterilization.
List the advantages and disadvantages of outpatient dilation and curettage, office electric vacuum suction curettage, and office manual vacuum aspiration (MVA) for pregnancy termination, and demonstrate correct uterine evacuation technique with the MVA.

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Course 21 (Sunday)

Fertility Preservation: Biological Basis, Procedures And Genetic Consequences
Developed in Cooperation with the Fertility Preservation Special Interest Group

Faculty:
Kutluk H. Oktay, M.D., F.A.C.O.G., Chair
David F. Albertini, Ph.D.
Stephan Schlatt, Ph.D.

Needs Assessment and Course Description
Advances in gonadal, gamete and stem cell biology have revealed new theoretical opportunities for preservation and regeneration of reproductive capacity. Translation from theory to practice requires a sound knowledge of the current concepts of the origin, structure, function and pathophysiology of the ovary and testis. However, few clinicians have the advanced knowledge of this rapidly changing area of reproductive biology to be able to choose between evidence-based versus unproven, anecdotal approaches for fertility preservation.

This course will update reproductive biologists, reproductive endocrinologists, reproductive surgeons and oncologists with the most current knowledge of ovarian and testicular biology, stem cells, and mechanisms of gonadal failure. The faculty will review the current biological basis for and concerns about a spectrum of methods to preserve fertility. Participants will formulate potential evidence-based approaches to fertility preservation.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Describe the differentiation and development of the ovary and testis and their respective germ cells.
Summarize the pathophysiology and diagnosis of gonadal failure.
Formulate mechanistic, evidence-based approaches to fertility preservation.

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Course 22 (Sunday)

Puberty And Beyond, It’s Worse Than You Think: When The Hormones Are Raging (And When They Are Not)
Developed in Cooperation with the Pediatric and Adolescent Gynecology Special Interest Group (PAGSIG) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG)

Faculty:
Samantha M. Pfeifer, M.D., Chair
Frank M. Biro, M.D.
Valerie S. Ratts, M.D.

Needs Assessment and Course Description
Adolescence is a turbulent time –- many changes occur driven by the hormonal progression associated with puberty. While things can be difficult for the adolescent in whom all progresses normally, the adolescent who has any perturbations in pubertal and adolescent events can be
affected both physically and emotionally. The overall objectives of this course are to provide an overview of important endocrinopathies and hormonally driven gynecologic problems that are encountered in young females, and to describe current approaches to diagnosis and treatment
of these disorders.

This course is designed for practicing clinicians, residents and fellows in obstetrics and gynecology and reproductive endocrinology seeking to expand their knowledge in the field of adolescent gynecology. The faculty, comprised of experts in adolescent medicine, adolescent gynecology and reproductive endocrinology, will employ lectures and case studies to present current information about key clinical topics, highlight newer treatment strategies, and discuss long-term health concerns. Topics will include: factors affecting the possible earlier timing of puberty, primary
amenorrhea, female athlete triad, disordered eating, bone health, conditions causing dysmenorrhea and pelvic pain, polycystic ovary syndrome, and obesity and the metabolic syndrome.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Define the factors affecting earlier pubertal progression and precocious puberty.
Describe the hallmarks of polycystic ovary syndrome, obesity and metabolic syndrome during adolescence and the current treatment strategies.
Formulate diagnostic and therapeutic algorithms for primary amenorrhea, dysmenorrhea and pelvic pain in the adolescent.
Assess and treat adolescent women presenting with the female athletic triad of disordered eating, menstrual dysfunction and osteoporosis.

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Course 23 (Sunday)

Controversies In Recurrent Pregnancy Loss
Developed in Cooperation with the Reproductive Immunology Special Interest Group (RISIG)

Faculty:
Dan I. Lebovic, M.D., M.A., Chair
William H. Kutteh, M.D., Ph.D., H.C.L.D.
Raj S. Rai, M.D.
Danny J. Schust, M.D.

Needs Assessment and Course Description
Human pregnancy is an inefficient process that is repeatedly unsuccessful in some couples. The pathophysiology and medical management of recurrent pregnancy loss (RPL) are complex and controversial. ASRM members frequently request educational activities dealing with this topic in needs assessment surveys and course evaluations.

This one-day course is designed to address the need for specialists in reproductive medicine to utilize the highest level of evidence when evaluating and treating those experiencing recurrent miscarriages. Topics will include: (1) genetic evaluation of the parent and progeny, (2) progestins and pregnancy maintenance, (3) thrombophilia and when and how to treat, (4) uterine pathology, and (5) the role of preimplantation genetic diagnosis (PGD) in avoiding recurrent loss. The faculty will critique the latest systematic reviews and randomized controlled trials of diagnostic and treatment strategies in order to acquaint participants with possible future approaches to preventing RPL.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Describe the role of genetic analyses, including parental, fetal and preimplantation screening, in predicting recurrent pregnancy loss.
Critically assess the utility and risks of progestin supplementation in preventing RPL.
Summarize the evidence pertaining to the immunologic basis of RPL and the efficacy of immunotherapeutic options.
Discuss the evidence pertaining to the association of certain thrombophilias with RPL.

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Course 24 (Sunday)

Impact Of Body Weight And Lifestyle On Reproductive Function
Postgraduate Program Chair Selection

Faculty:
Kathleen M. Hoeger, M.D., Chair
Sarah L. Berga, M.D.
Elisabet Stener-Victorin, Ph.D.

Needs Assessment and Course Description
Reproductive function is affected by weight and stress. Obesity, which is increasing at an alarming rate worldwide, can cause reproductive dysfunction; and reduced body weight, excessive exercise and psychological stress likewise can disrupt reproductive function. Polycystic ovary syndrome (PCOS) frequently is associated with obesity, and lifestyle modification and weight reduction can improve reproductive function in women with PCOS. Recent evidence suggests that modifications of lifestyle with dietary changes and exercise and stress reduction can provide effective alternatives, or adjuvant therapy, to expensive and risky medications for improving ovulation in women suffering from ovulatory dysfunction.

The objective of this one-day course is to provide a comprehensive review of the impact of weight and stress on reproductive dysfunction and provide reproductive endocrinologists, obstetrician/gynecologists and other members of the healthcare team with a framework for helping
patients implement lifestyle change. Faculty will discuss the implications of stress and body weight on reproductive function, the mechanisms behind stress-induced amenorrhea, and the benefits of psychotherapy. Treatments with exercise and complementary therapy such as acupuncture, will be reviewed along with the role of lifestyle modification in obesity and PCOS in the management of reproductive dysfunction.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Explain the contributions of increased body weight, reduced body weight and stress on reproductive function and the benefits of lifestyle modification on ovulation.
Summarize the evidence for the role of cognitive behavioral therapy on restoration of ovulation.
Describe the benefits of exercise and complementary therapies on ovulatory dysfunction in PCOS.
Develop successful strategies to help patients implement changes in lifestyle that maximize reproductive function.

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Course 25 (Sunday)

Reproductive Medicine And Law: Special One-Day CME Workshop
Developed Jointly in Cooperation with the Association of American Law Schools (AALS)

Supported in part by National Institutes of Health Grant Number R13HD056978 from the National Institute of Child Health and Human Development and the Office of Research on Women's Health.

Faculty:
Robert G. Brzyski, M.D., Ph.D.
Ronald Chester, J.D., M.I.A.
Judith F. Daar, J.D.
Mark I. Evans, M.D.
Leslie P. Francis, J.D., Ph.D.
Andrew R. La Barbera, Ph.D., H.C.L.D.
Cynthia R. Mabry, J.D., LL.M.
Lorna A. Marshall, M.D.
Nancy D. Polikoff, J.D.
John A. Robertson, J.D.
Peter N. Schlegel, M.D., F.A.C.S.
Ellen Wright Clayton, M.D., J.D.

Needs Assessment and Course Description
Infertility affects approximately 13-14% of couples of reproductive age in the United States. The advent of IVF for treatment of infertility and the ability to produce a live baby using spermatozoa, oocytes, embryos and gestational carriers from heterologous sources has led to a myriad of complicating legal issues pertaining to embryos, children, parents, families and reproductive rights. Patients and their physicians often are confused by seemingly contradictory state laws and state and federal judicial rulings pertaining to rights and responsibilities of infertility patients and healthcare providers. There is an urgent public health need in the United States for medical and legal scholars and professionals to develop enlightened and coherent approaches to jurisprudence in the area of reproductive medicine so that this increasing segment of the population is able to maximize its reproductive potential.

The workshop will bring together medical and legal professionals to review jointly the current status of assisted reproductive technologies and the body of federal, state and local laws and judicial decisions pertaining to gametes, embryos, parenting, and reproductive rights and responsibilities. Anyone who is interested in questions of the family, what it means to be a parent, choice in a multicultural/religiously diverse/increasingly global world, or debates about the goals of medicine will benefit from participation. Invited speakers will delineate the issues and lead interactive discussions of the following issues: patient and physician autonomy in ART; donors, surrogacy and child-rearing rights; the status of constitutional state law with regard to creation of embryos and their disposition, discard, donation and use in research; and posthumous reproduction.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Summarize the legal ramifications of advances in assisted reproductive technologies.
Review the current status of the body of federal, state and local laws and judicial decisions pertaining to gametes, embryos, parenting, and reproductive rights and responsibilities.
Compare novel legal strategies to govern the rapidly changing variations in approaches to family building.
Develop scholarly expert guidance that increases knowledge and informs public policy in the realm of reproductive medicine and the law.

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One-Day Non-CME Courses Sunday, October 14th

Course 26 (Sunday)

One-Day Reproductive Managers Continuing Education Course: Integrating Medicine And Management Into The Fertility Practice
Developed in Cooperation with the Association of Reproductive Managers (ARM)

Note: No credits will be given for Course #26.

Faculty:
Robin T. Mangieri, M.A., Chair
Nancy Ledy-Gurren
Ronald P. Jones, C.P.A., C.M.P.E.
Dwight Ryan
Kate D. Schoyer, M.D.

Needs Assessment and Course Description
Recent data suggest that the volume of infertility patients in the United States has stabilized. In response to competitive market pressures, managers of reproductive endocrinology and infertility (REI) practices must be able to introduce new technologies and therapies into their clinical armamentarium as they become available. These include psychological services or “mind/body programs” that offer patients the support they need to withstand the stress of infertility.

By nature, the REI practice is fraught with clinical and legal risk. Managers must understand their practices’ current exposure to risk, as well as any new risks associated with the implementation of new technologies, therapies or business models. This course will address the management skills needed to design and implement a successful strategic business plan, which should include thoughtful consideration of strengths, weaknesses, revenue opportunities and risk management threats.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Identify clinical benefits and new business centers that can be created with the addition of novel therapies.
Summarize recent research concerning methods to enhance the overall practice of REI and identify a practice’s ability to offer new or improved services.
Assess elements of risk in an REI practice and implement potential solutions.
List the components of a strategic plan for the REI practice.

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Course 27 (Sunday)

CAP Reproductive Laboratory Accreditation Program Inspector Training Seminar

Note: ASRM will not be giving credits for Course #27. Credits will be awarded by CAP.

To register for this course, please contact the CAP Education Division at 800-323-4040 ext. 7525 or education@cap.org.

Faculty:
R. Bruce Williams, M.D., F.C.A.P., Chair
Erica J. Behnke, Ph.D., H.C.L.D.
M. Iqbal Khan, Ph.D.
Lyn Wielgos, M.T. (A.S.C.P.)

Needs Assessment and Course Description
In collaboration with ASRM, the College of American Pathologists (CAP) has developed an accreditation program specifically designed for the unique needs of reproductive laboratories. This program was created with the primary objective of improving the quality of laboratory services
through voluntary participation, professional peer review, education and compliance with established performance standards. Due to recent changes in accreditation inspection requirements, additional laboratorians may be involved in the inspection process.

Experience has shown that laboratorians already possess the technical knowledge regarding good laboratory practices. The purpose of this seminar is to demonstrate effective inspecting techniques so that inspectors will be more confident and comfortable performing inspection. The morning sessions focus on the overall inspection process including team preparation, resources and practical “how to” tips of conducting the inspection. The afternoon consists of sessions highlighting the accreditation requirements unique to embryology, andrology and cryobiology testing. Sessions include PowerPoint presentations, small and large group discussions regarding inspection scenarios, and hands-on document reviews. This seminar fulfills both the team leader and team member training requirements.

Learning Objectives
At the conclusion of this course, the participant should be able to:

Prepare and perform an inspection using CAP resources.
Use generally accepted techniques to produce consistent inspection findings.
Identify deficiencies and recommendations and appropriately document findings.
Identify compliance requirements unique to embryology, andrology, and cryobiology.

CME/CE Information
The College of American Pathologists (CAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Category 1: The CAP designates this educational activity for a maximum of 7.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CE (Continuing Education for non-physicians): The CAP designates this educational activity for a maximum of 7.0 credits/hours of continuing education. Each participant should only claim those credits/hours he/she spent in the educational activity.

This activity is acceptable to meet the continuing education requirements for the ASCP Board of Registry Continuing Competence Recognition Program. This activity is approved for continuing education credit in the states of California and Florida.

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ASRM 2007 Annual Meeting Preliminary Program

Postgraduate Program

ASRM 2007 Annual Meeting
Preliminary Program