Journal Club Global

Fertility and Sterility Journal Club Global is an interactive online discussion of a hot topic or seminal article from Fertility and Sterility. Our goal is to have experts in the field interact with each other, and to create an interactive experience for those who are registered to view the event.

Management of poor ovarian response

A poor ovarian response to what should otherwise be a successful stimulation cycle presents a clinical conundrum for clinicians. In the April 2022 issue of Fertility and Sterility, Dr. Marcelle Cedars and colleagues dug deeper into how to optimize success for these patients in subsequent cycles. Watch a panel discussion with Dr. Cedars, authors of the recent Views & Reviews articles, and infertility experts hosted by the Boston IVF/Beth Israel Deaconess Medical Center REI Fellowship Program.

Should everyone freeze oocytes by age 33?

Oocyte cryopreservation is one of the fastest growing areas of reproductive medicine. We have reached a stage where the outcomes are overwhelmingly positive and patients are increasingly coming back to utilize those oocytes for family building. However, there is significant debate as to when is the optimal age to cryopreserve oocytes to maximize reproductive outcomes down the road. We debate this issue live from the Society for Reproductive Endocrinology and Infertility Fellows Retreat in Park City, Utah.

Prognosis in unexplained RPL: a systematic review and quality assessment of current clinical prediction models

Recurrent pregnancy loss is one of the bigger challenges in the field of reproductive medicine. This journal club will discuss the published systematic review that identified models predicting live birth or ongoing pregnancy in couples with unexplained recurrent pregnancy loss (RPL). The manuscript evaluates the risk of bias, performance, generalizability, and applicability of these models. Finding a good model with accurate predictors would manage the expectations of couples and improve their informed decision making regarding future pregnancy attempts.

Non-Invasive Diagnosis of Endometriosis

One of the most exciting developments in the field of endometriosis is the push towards earlier and less invasive approaches to diagnosis. This webinar, in collaboration with the British Society for Gynecologic Endoscopy, explores work being done in biomarkers and advanced pelvic ultrasound as a means to shorten the delay in diagnosis for women suffering with pelvic pain.

Evidence for Immunologic Therapies in Women Undergoing ART

Reproductive immunology is perhaps one of the most controversial and promising fields within ART. With growing awareness of how the immune system may modulate implantation and early pregnancy many groups have endeavored to identify and treat patients for whom immune factors are suspected in their infertility. Join us live from the Midwest Reproductive Symposium International in Chicago, IL as our panelists discuss the evidence for the effectiveness of immunologic therapies in the ART setting.

ICSI for Non-Male Factor Infertility

While intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of male factor infertility, a significant controversy still remains regarding its ubiquitous use in all IVF cycles.

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.” Experts from Europe and the USA will discuss the article and best ART practices, including Dr. Cristophe Blockeel, Dr. Christian De Geyter, Dr. Amy Sparks, and Dr. Jim Toner.

Obesity & Reproduction: An Update on Management and Counseling

Obesity can negatively impact reproduction in various ways, including ovulatory and menstrual function, natural fertility and fecundity rates, infertility treatment success rates, infertility treatment safety, and obstetric outcomes. Given the global burden of disease, reproductive care specialists are, thus, confronted with the challenge of treating infertility in the increasingly common setting of obesity.

Should Fellows Perform Live Embryo Transfers in Fellowship?

Few things are more taboo in reproductive medicine fellowship training than allowing fellows to perform live embryo transfers. While regional and program differences exist - be it via insurance mandates, training culture, and program volume - nearly one in every five fellows graduate without performing a single live embryo transfer, with most performing under 10 during three years of subspecialty training. Is the next generation of reproductive medicine specialists being under trained in this essential skill because their outcomes are inferior to those of faculty member performed transfers?

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).

To Operate Or Not To Operate: Debating Intramural Fibroids And Fertility

Dr. Angie Beltsos, Executive Director and President of MRSi, will host the  Fertility and Sterility Journal Club Global live from the 2021 MRSi meeting. The event will debate the upcoming F&S Fertile Battle “Intramural myomas more than 3 to 4 cm should be surgically removed before IVF”.

Are We Approaching Automation in ART?

Some ART diagnostic devices are already available and offer objective tools of evaluation. However, automation of the entire spectrum of ART procedures is yet to come and can only be imagined as a platform capable of integrating all the separate technologies, successfully interconnecting them to guarantee a continued chain of custody of the gametes and embryos. The current potential for automation within the in vitro fertilization laboratory, with attention to sperm and oocyte manipulation and selection and to oocyte insemination with standard in vitro fertilization or intracytoplasmic sperm injection is unknown.

Preimplantation genetic testing for aneuploidy: Can non-invasive approaches based on spent medium analysis replace classical trophectoderm biopsy?

PGT-A by trophectoderm biopsy aims to select available euploid embryos for transfer. While the clinical efficacy of PGT-A remains debated in the scientific literature, the possibility to conduct non-invasive PGT-A (ni-PGTA) has emerged from finding that acellular DNA can be collected in the spent culture medium and through blastocele aspiration. Efforts were thus developed to determine the genetic constitution of embryos from an analysis of acellular DNA collected in the spent medium.

Accuracy of Preimplantation Genetic Testing for Aneuploidies

One of the highest aspirations in reproductive medicine is to develop a technology allowing for identification of those embryos that have true reproductive potential. The rapid proliferation of PGT-A raises some obvious questions. Does PGT-A result in the discard of embryos with significant reproductive potential? Does the trophectoderm (TE) biopsy decrease the ability of the blastocyst to implant? The answers to these questions relate to the potential for PGT-A to improve clinical outcomes, that is, improve delivery rates, reduce multiple births, and reduce spontaneous abortion.

¿Cual debe de ser la primera línea de tratamiento en parejas con infertilidad inexplicable en Latino-América?

La infertilidad inexplicable es vista entre 15% y 30% de las parejas que acuden a una clínica de fertilidad. La inseminación intrauterina (IIU) es ampliamente utilizada como una alternativa de tratamiento de bajo costo, y menos invasiva que la fertilización in Vitro (FIV) para parejas con infertilidad inexplicable. Sin embargo, en algunos países se considera que después de 2 años de manejo expectativo, FIV es el tratamiento a seguir, y no IIU con o sin inducción de la ovulación.

Recurrent Implantation Failures in ART: Myth or Reality?

Classically, implantation failures in ART were believed to result from alterations in embryo or endometrium quality. The advent of PGT-A has allowed for the transfer of only genetically normal embryos. However, not all euploid embryos implant, which leads us to question the role played by the endometrium. Several tests have been designed to assess receptivity, but none are fully validated.

Does the Endometrium Play a Major Role in Endometriosis-Associated Infertility?

This was a virtual event in the style of the "Fertile Battle" debate that took place at the 2019 SREI Fellows Symposium. The session was broadcast live to the participants of the SREI Fellows Symposium and around the world to registrants. Attendees saw and heard the interaction of the experts and asked questions. Questions were moderated by Drs. Barnhart and Hill, who relayed these questions to the experts. In-session polls were used to gauge audience opinion real-time.

Live from India: Adjuvants in IVF and IVF Add-Ons for the Endometrium

Many adjuvants have been utilized by IVF centers to improve their success rates. No high-quality randomized trial has been conducted to evaluate the effectiveness and safety of these interventions in clinical settings. Proponents of using these technologies believe that couples are losing time until evidence is collected. While opponents object to their indiscriminate use, and they believe it is unethical to use them until evidence is available. Hence, there is an urgent need to develop robust well-designed RCTs to address all aspects of these interventions.

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