In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: melatonin and implantation (4:38), whole-genome screening of embryos (12:21), and bioengineering assisted reproductive technology (24:45).
Consider This: https://www.fertstert.org/news-do/can-oral-melatonin-supplementation-increase-blastocyst-implantation-success-women
F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00001-1/fulltext
F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00002-1/pdf
Fertility and Sterility On Air
Fertility and Sterility On Air - Unplugged: April 2024
Topics include: IVF in film, a rat model of fallopian tube torsion, comparing letrozole regimens for PCOS, and a review of chronic endometritis.
Fertility and Sterility On Air - TOC: April 2024
Topics this month include the use of ICSI, fertility treatments among reproductive-aged women after cancer, and more.
Fertility and Sterility On Air - Live from PCRS 2024
Fertility & Sterility on Air brings you the highlights from the 2024 Annual Meeting of the Pacific Coast Reproductive Society.
Fertility and Sterility On Air - Seminal Article: Dr. Jeremy Applebaum
Listen to this interview featuring Dr. Jeremy Applebaum, who recently published "Impact of coronavirus disease 2019 vaccination on live birth rates after IVF"ASRM Podcast Family
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ASRM Today
A podcast that takes a deeper dive into current topics in reproductive medicine. And what is in that dive? ASRM Today brings you episodes that explore reproductive medicine through personal interviews and expert discussions, keeping up with the topics that matter.
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Fertility and Sterility On Air
The podcast where you can stay current on the latest global research in the field of Reproductive Medicine. This podcast brings you an overview of the monthly F&S journal, in-depth discussion with authors, and other special features.
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SART Fertility Experts
An educational project of the Society for Assisted Reproductive Technology, this series is designed to provide up-to-date information about a variety of topics related to fertility testing and treatment such as IVF.
Topic Resources
View more on the topic of embryo
ASRM Files Amicus Brief in Texas Embryo Case
ASRM has filed an amicus curiae (friend of the court) brief in the case of Antoun v Antoun, which is pending before the Texas Supreme Court.
View the Press Release
IVF-assisted pregnancies constitute 2.5% of all births in 2022
In 2022, the number of babies born from IVF increased from 89,208 in 2021 to 91,771 in 2022. This means that 2.5% of births in the US are a result of ART.
View the Press Release
Fertility and Sterility On Air - Live from PCRS 2024
Fertility & Sterility on Air brings you the highlights from the 2024 Annual Meeting of the Pacific Coast Reproductive Society. Listen to the Episode
ASRM provides testimony to Senate Judiciary Committee on threats facing IVF
ASRM shared with the Senate Judiciary Committee the dangers to reproductive medicine nearly two years after the Dobbs decision.
View the Press Release
What's New from the Fertility and Sterility Family of Journals
Here’s a peek at this month’s issues from our family of journals! As an ASRM Member, you can access all of our journals.
Read More about the newest articles
Alabama Supreme Court Rules Frozen Embryos are “Unborn Children” and admonishes IVF’s “Wild West” treatment
Legally Speaking™ on presenting facts and reflecting on the impact and potential implications of legal developments in ART. View the Column
What's New from the Fertility and Sterility Family of Journals
Here’s a peek at this month’s issues from our family of journals! As an ASRM Member, you can access all of our journals. Not yet a member? Click here(no link) to learn more. Find More
Shipping of frozen embryos
I have some infertility coverage, under which my insurance said they will cover frozen embryo shipping/transport from one facility to another. View the Answer
Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)
This document incorporates studies about mosaic embryo transfer and provides evidence-based considerations for embryos with mosaic results on PGT-A. View the Committee Opinion
Frozen Embryo Destruction and Potential Travel Restrictions for Surrogacy Arrangements
Legally Speaking™ focuses on the impact and the potential implications of legal developments on the assisted reproductive technologies. View the Column
Journal Club Global: Transferencia de embriones frescos versus congelados: ¿Cuál es la mejor opción
Los resultados de nuevas técnicas de investigación clínica que utilizan información de bancos nacionales de vigilancia médica. View the Video
Defining embryo donation: an Ethics Committee opinion (2023)
The ethical appropriateness of patients donating embryos to other patients for family building, or for research, is well established.
View the Committee Opinion
Does the number of eggs being frozen matter?
There is currently only one CPT code for the cryopreservation of mature oocytes and embryos. View the Answer
Reproductive Tissue Storage
What are the CPT codes for the Storage of Reproductive Cells/Tissues? View the Answer
ICSI and Embryo Biopsy
How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
Lab RVUs
Is there a list of RVUs for embryology and andrology laboratory procedures, and if so, where can it be found? View the Answer
Embryo Storage Fees For Multiple Cycles
We bill embryo storage 89342 for a year's storage. View the Answer
Embryo Biopsy
Have any new codes been introduced for the lab portion of PGT? View the Answer
Embryo Biopsy Embryologist Travel Costs
Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
Embryo Biopsy PGS Testing
What codes are appropriate for PGS testing? View the Answer
Embryo Co-culture
Can codes 89250 and 89251 be billed on different days of the same cycle? View the Answer
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Embryo Culture Less Than And More Than Four Days
When coding 89250 culture of oocytes/embryo <4 days, should that code be submitted to the insurance company for each of the days? View the Answer
Embryo Freezing/Thawing
Our question refers to the CPT code 89258 “Cryopreservation; Embryo(s)” and 89352 “Thawing of Cryopreserved; Embryo”. View the Answer
Embryo Thawing/Warming
Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? View the Answer
Gamete Thawing/Warming
Can patients be charged for each vial/straw of reproductive gametes or tissues thawed? View the Answer
D&C Under Ultrasound Guidance
What are the CPT codes and ICD-10 codes for coding a surgical case for a patient with history of Stage B adenocarcinoma of the cervix ... View the Answer
Assisted Hatching Billed With Embryo Biopsy
Do you know if both assisted hatching (89253) and embryo biopsy for PGS/PGD/CCS (89290/89291) can be billed during the same cycle? View the Answer
Assisted Zona Hatching
Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
Billing For Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? View the Answer
Embryo Transfer
A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
Colorado court balances religious and secular beliefs in frozen embryo divorce dispute
The day before the Dobbs decision, the Colorado Court of Appeals ruled on a divorcing couple’s disputed control over their frozen embryos. View the Legally Speaking
Journal Club Global: Is PGT-P cutting edge or should we cut it out?
PGT for polygenic risk scoring (PGT-P) is a novel screening strategy of embryos for polygenic conditions and traits. View the Video
Disposition of unclaimed embryos: an Ethics Committee opinion
Programs should create and enforce written policies addressing the designation, retention, and disposal of unclaimed embryos. View the Committee Opinion
A review of best practices of rapid-cooling vitrification for oocytes and embryos: a committee opinion (2021)
The focus of this paper is to review best practices for rapid-cooling cryopreservation of oocytes and embryos. View the Committee Opinion
Ethics in embryo research: a position statement by the ASRM Ethics in Embryo Research Task Force and the ASRM Ethics Committee (2020)
Scientific research using human embryos advances human health and offspring well-being and provides vital insights into the mechanisms for reproduction and disease. Research involving human embryos is ethically acceptable if it is likely to provide significant new knowledge that may benefit human health, well-being of the offspring, or reproduction. View the Committee Opinion
Guidance for Providers Caring for Women and Men Of Reproductive Age with Possible Zika Virus Exposure (Updated 2019)
This ASRM guidance specifically addresses Zika virus infection issues and concerns of individuals undergoing assisted reproductive technologies (ART). View the Guideline
Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)
The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion (2018)
Posthumous gamete (sperm or oocyte) retrieval or use for reproductive purposes is ethically justifiable if written documentation from the deceased authorizing the procedure is available. View the Committee Opinion
Disclosure of medical errors involving gametes and embryos: an Ethics Committee opinion (2016)
Medical providers have an ethical duty to disclose clinically significant errors involving gametes and embryos as soon as they are discovered. Clinics also should have written policies in place for reducing and disclosing errors. View the Committee Document
Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion (2014)
A general overview for good management practices within the endocrinology, andrology, and embryology laboratories in the United States. View the Recommendation
Informed consent and the use of gametes and embryos for research: a committee opinion (2014)
The ethical conduct of human gamete and embryo research depends upon conscientious application of principles of informed consent. View the Committee Opinion
ASRM EDGE Tool
Get the EDGE on your fellow Embryologists! As the grading of embryos varies within IVF laboratories and between laboratories, EDGE allows you to compare yourself against embryologists in the US and around the world. Learn more about the EDGE ToolTopic Resources
View more on the topic of assisted reproductive technologies
IVF-assisted pregnancies constitute 2.5% of all births in 2022
In 2022, the number of babies born from IVF increased from 89,208 in 2021 to 91,771 in 2022. This means that 2.5% of births in the US are a result of ART.
View the Press Release
ASRM reacts to Alabama legislation
We are pleased that the legislation passed into law by the Alabama General Assembly will at least allow our members in the state to care for their patients.
View the Press Release
IVF at the SOTU: Fertility care expected to be major focus at State of the Union
Protecting access to IVF care is expected to be a major theme of the State of the Union on Thursday.
View the Press Release
ASRM Responds to Proposed Alabama Legislation
We are proud of our Alabama members and their patients, who have been such incredible advocates working to motivate their legislators to protect IVF.
View the Press Release
Senate Budget Hearing is Well Timed Following Alabama IVF Ruling
ASRM statement regarding the Senate Budget Committee’s hearing entitled: No Rights to Speak of: The Economic Harms of Restricting Reproductive Freedom.
View the Press Release
ASRM Responds to Senate’s Failure to Pass Access to Family Building Act
We are disappointed by the Senate’s failure to meet the moment and pass federal legislation protecting access to in vitro fertilization (IVF).
View the Press Release
ASRM Condemns Profoundly Misguided and Dangerous Court Decision in Alabama
In LePage v Mobile Infirmary Clinic, the Alabama Supreme Court made a decision that flies in the face of medical reality and the needs of the citizens.
View the Press Release
Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)
Ovarian hyperstimulation syndrome is a serious complication associatedwith assisted reproductive technology. View the guideline
ASRM applauds introduction of Access to Family Building Act of 2024
ASRM is thrilled by the introduction of the Access to Family Building Act
View the Press Release
Guidance for coding limited or follow-up ultrasounds used during an IVF Cycle
I am a coder for a Reproductive Endocrinologist's office and am looking for some guidelines on limited or follow-up ultrasounds used during an IVF Cycle. View the Answer
Measurements to report with ultrasound codes
Are there clear guidelines as to what measurements are required in order to bill for each type of ultrasound? VIew the Answer
Billing for cryopreservation procedures on different days
I understand that if cryopreservation of oocytes is performed on two separate dates of service, each date of service was billable. View the Answer
Billing IVF lab work
We typically bill our IVF Lab work under the rendering provider who performs the VOR. Who should be the supervising provider for embryology billing? View the Answer
Estradiol Free versus Total
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
IVF coverage denied for Z31.83 diagnosis code
My wife and I have been seeking IVF treatment and coverage was added for infertility treatment (up to $25,000) but our insurer keeps denying it. View the Answer
Cycle coordination fees and 99499, S4042
I reviewed cycle coordination fees, but see that there is no specific code for cycle management. View the Answer
Supervising provider for embryology billing
We typically bill our IVF Lab work under the rendering provider who performs the VOR. Who should be the supervising provider for embryology billing? View the Answer
The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
Terms and definitions currently used infertility care, infertility and medically assisted reproduction (MAR) can have different meanings that are dependent upon the setting, their usage in research or clinical interventions, or among diverse populations.View the Committee Joint Guideline
Journal Club Global - Revisiting the STAR trial: The Fellows debate PGT-A
We are excited to host a debate covering the pros and cons of PGT-A and how new technologies should be validated before clinical implementation. View the Video
Informed consent in assisted reproduction: an Ethics Committee opinion (2023)
Informed consent is a process in which the patient is supported in developing an understanding of medical options. View the Ethics Committee Opinion
Unlisted Fertility Treatment CPT Code
Can you please refer me to an unlisted management CPT code for fertility treatment? View the Answer
Z Codes Vs. Procedure Codes For Fertility Preservation Counseling
I am trying to understand better when to use the procreative management code vs the fertility preservation counseling and procedure codes. View the Answer
Pregnancy Of Unknown Location
What is the most appropriate ICD-10 code for pregnancy of unknown location (not an ectopic pregnancy)? View the Answer
Pregnancy Ultrasound
Our practice does routine ultrasounds (sac check- 76817) at the end of an IVF cycle and bill with a diagnosis code O09.081, pregnancy resulting from ART. View the Answer
IUI Same Gender
When managing an IUI or IVF cycle for a female same sex couple or a patient that has no exposure to sperm, what ICD 10 diagnosis should be used? View the Answer
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
Limited Monitoring Ultrasound
What is the appropriate code to use for a limited follow-up follicular transvaginal ultrasound? View the Answer
Limited Transvaginal Ultrasound
One of our clients received information that a repeat limited transvaginal ultrasound should be billed with a limited pelvic ultrasound code (76857). View the Answer
Monitoring E&M
Our group would like to know if others are billing an evaluation and management code for ultrasound and blood draw visits? View the Answer
Monitoring FET
What is the correct diagnosis code to use on the follicle ultrasound (76857) for a patient who is undergoing frozen embryo transfer (FET)? View the Answer
Monitoring Ovulation Induction By Nurses
We are considering the use of CPT code 99211 for encounters during cycle management as part of ovulation induction. View the Answer
Non-REI Board Certified MD Performing REI Procedures
My boss has a few follow up questions about a non-REI board certified MD performing REI procedures. View the Answer
In Vitro Maturation
Have CPT codes been established for maturation in vitro? View the Answer
Embryo Storage Fees For Multiple Cycles
We bill embryo storage 89342 for a year's storage. View the Answer
Endometrial Receptivity Analysis
Our physicians are going to start doing an Endometrial Receptivity Analysis. Do you know the appropriate CPT code that should be used?View the Answer
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? View the Answer
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. View the Answer
Donor Embryos
Could you give guidance for the correct ICD-10 code(s) to use when a patient is doing an Anonymous Donor Embryo Transfer cycle? View the Answer
Billing at an Outside Clinic for Lab Services
One of my physicians uses an outside facility to perform the retrievals and transfers. View the Answer
Board Certified Vs. Non-Board Certified Billing
Is coding/billing any different when a non-board certified or non-REI provider submits for REI procedure? View the Answer
Coding For Placement Of A Cervical Stitch
Physicians at our practice are placing a stitch and dilating the cervix after egg retrievals for those patients that have cervical stenosis. View the Answer
Assisted Hatching Billed With Embryo Biopsy
Do you know if both assisted hatching (89253) and embryo biopsy for PGS/PGD/CCS (89290/89291) can be billed during the same cycle? View the Answer
Mental-health Services During Assisted Reproduction
A summary of codes for Mental-health Services During Assisted Reproduction compiled by the ASRM Coding Committee. View the Coding Summary
Laboratory Procedures during ART Cycles
A listing of codes, compiled for a fresh ART cycle, transfer, biopsy, cryopreservation of embryos and oocytes, storage, and thawing. View the Coding Summary
Journal Club Global: Evidence for Immunologic Therapies in Women Undergoing ART
Reproductive immunology is perhaps one of the most controversial and promising fields within ART. View the Video
Comprehensive guidance for human embryology, andrology, and endocrinology laboratories: management and operations: a committee opinion (2022)
ASRM has published guidance and minimum standards for embryology and andrology laboratories. View the Committee Opinion
Journal Club Global - Best Practices of High Performing ART Clinics
This Fertility and Sterility Journal Club Global discusses February’s seminal article, “Common practices among consistently high-performing in vitro fertilization programs in the United States: a 10 year update.” View the Video
Journal Club Global - Fertilization rate as a novel indicator in ART results
This Journal Club Global discusses a provocative article recently published in Fertility and Sterility, discussing the results of a multicenter retrospective cohort study with the objective to appraise the fertilization rate as a predictive factor for cumulative live birth rate (CLBR). View the Video
Journal Club Global - Are We Approaching Automation in ART?
Some ART diagnostic devices are already available and offer objective tools of evaluation. View the Video
Guidance on the limits to the number of embryos to transfer: a committee opinion (2021)
ASRM's guidelines for the limits on the number of embryos to be transferred during IVF cycles have been further refined ... View the Committee Opinion
Role of tubal surgery in the era of assisted reproductive technology: a committee opinion (2021)
This document reviews surgical options for reparative tubal surgery and the factors that must be considered when deciding between surgical repair and IVF.View the Committee Opinion
Minimum standards for practices offering assisted reproductive technologies: a committee opinion (2021)
A framework for assisted reproductive technology (ART) programs that meet or exceed the requirements suggested by the Centers for Disease Control View the Committee Opinion
Journal Club Global - Recurrent Implantation Failures in ART: Myth or Reality?
Classically, implantation failures in ART were believed to result from alterations in embryo or endometrium quality.
View the Video
The role of immunotherapy in in vitro fertilization: a guideline (2018)
Adjuvant immunotherapy treatments in in vitro fertilization (IVF) aim to improve the outcome of assisted reproductive technology (ART) in both the general ART population as well as subgroups such as patients with recurrent miscarriage or implantation failure. View the Committee Opinion
Using family members as gamete donors or gestational carriers (2017)
The use of adult intrafamilial gamete donors and gestational surrogates is generally ethically acceptable when all participants are fully informed. View the Committee Document
Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2016)
Financial ‘‘risk-sharing’’ fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. View the Committee Document
Correct coding for laboratory procedures during assisted reproductive technology cycles
This document provides updated coding information for services related to assisted reproductive technology procedures. View the Coding Committee Document
Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion (2014)
A general overview for good management practices within the endocrinology, andrology, and embryology laboratories in the United States. View the Recommendation
Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint GuidelineTopic Resources
View more on the topic of genetic screening/testing
Journal Club Global: Cost effectiveness analyses of PGT-A
Infertility treatments can be financially burdensome, often without insurance coverage, making understanding the cost effectiveness of PGT-A crucial. View the Video
Fertility and Sterility On Air - TOC: February 2024
Topics this month include the optimial AMH level in oocyte donors, the role of mean number of DNA breakpoints (MDB) in sperm DNA integrity, and more. Listen to the Episode
ASRM Today: Genetic Counseling Complexities with Katherine Hornberger
Katherine Hornberger stops by to talk about some of the complexities that can come with genetic counseling in areas such as carrier screenings and more. Listen to the Episode
Coding PGT requisitions to the PGT lab
Do you have any recommended codes to use for PGT requisitions to the PGT lab? View the Answer
Fertility and Sterility On Air - TOC: December 2023
Topics this month include: the growing role of private equity in fertility care, ART outcomes after fertility-sparing treatment for endometrial neoplasia, and more. Listen to the Episode
Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)
This document incorporates studies about mosaic embryo transfer and provides evidence-based considerations for embryos with mosaic results on PGT-A. View the Committee Opinion
Journal Club Global - Revisiting the STAR trial: The Fellows debate PGT-A
We are excited to host a debate covering the pros and cons of PGT-A and how new technologies should be validated before clinical implementation. View the Video
Sperm DNA Fragmentation
Is there a CPT code for HALO DNA Fragmentation for sperm? View the Answer
Results Review
What CPT code is most appropriate to submit for Physician Time to review CCS/PGS/PGD results? View the Answer
ICSI and Embryo Biopsy
How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
Genetic Counseling
Does ASRM have any guidance for how to bill for genetic counseling services provided by a genetic counselor?View the Answer
Embryo Biopsy
Have any new codes been introduced for the lab portion of PGT? View the Answer
Embryo Biopsy Embryologist Travel Costs
Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
Embryo Biopsy PGS Testing
What codes are appropriate for PGS testing? View the Answer
Assisted Zona Hatching
Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
Indications and management of preimplantation genetic testing for monogenic conditions: a committee opinion (2023)
ASRM has updated its opinion on PGT for monogenic conditions, providing guidance on clinical and technical complexities. View the Committee Opinion
Journal Club Global - PGT-A - Can non-invasive approaches based on spent medium analysis
PGT-A by trophectoderm biopsy aims to select available euploid embryos for transfer. View the Video
ASRM müllerian anomalies classification 2021
The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability. View the Committee Opinion
Journal Club Global - Accuracy of Preimplantation Genetic Testing for Aneuploidies
One of the highest aspirations in reproductive medicine is to develop a technology allowing for ID of embryos that have true reproductive potential.
View the Video
Reproductive and hormonal considerations in women at increased risk for hereditary gynecologic cancers: Society of Gynecologic Oncology and American Society for Reproductive Medicine Evidence-Based Review (2019)
Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions. View the Joint Statement
Disclosure of sex when incidentally revealed as part of preimplantation genetic testing (PGT): an Ethics Committee opinion (2018)
Clinics may develop a policy to disallow selecting which embryos to transfer based on sex and choose to use only embryo quality as selection criteria. View the Committee Opinion
Use of preimplantation genetic testing for monogenic defects (PGT-M) for adult-onset conditions: an Ethics Committee opinion (2018)
Preimplantation genetic testing for monogenic diseases for adult-onset conditions is ethically permissible for a range of conditions including when the condition is serious and no safe, effective interventions are available. View the Committee Document
Transferring embryos with genetic anomalies detected in preimplantation testing: an Ethics Committee Opinion (2018)
Patient requests for transfer of embryos with genetic anomalies linked to serious health-affecting disorders detected in preimplantation testing are rare but do exist. View the Committee Document
Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint Guideline
