scientific program • symposia - American Society for Reproductive ...

BETTER PCOS TREATMENT? OVARIAN STIMULATION VS.
IN VITRO MATURATION
Presented by the Asia Pacific Initiative on Reproduction
Yoshiharu Morimoto, M.D., Ph.D. (Chair)
IVF Japan, Japan
Bruno Lunenfeld, M.D., Ph.D.
Bar-Ilan University, Israel
Aisaku Fukuda, M.D., Ph.D.
IVF OSAKA Clinic, Japan
Jie Qiao, M.D., Ph.D.
Third Hospital, Beijing, China
SCIENTIFIC PROGRAM • SYMPOSIA
Wednesday, October 19, 2011 11:45 am – 1:00 pm
Symposium
Room 224 A/B
Needs Assessment and Description
In vitro maturation (IVM) has been applied worldwide in
the treatment of patients with polycystic ovary syndrome
(PCOS). However, success rates differ among centers and
the practice is not mainstream. Conventional methods of
ovarian stimulation may result in ovarian hyperstimulation
syndrome (OHSS), but this is still an effective choice for some
patients with PCOS. There is, however, limited information
comparing these two protocols. This session for physicians,
reproductive scientists and healthcare professionals involved
in assisted reproductive technologies will examine the two
methods in the treatment of patients with PCOS.
PREIMPLANTATION GENETIC SCREENING: IS THERE A
LEGITIMATE INDICATION AND METHOD?
Presented by the Society for Assisted Reproductive Technology and the
Preimplantation Genetic Diagnosis Special Interest Group
Catherine Racowsky, Ph.D. (Chair)
Brigham and Women’s Hospital
Dagan Wells, Ph.D., B.Sc.
University of Oxford
Richard T. Scott, Jr., M.D.
Reproductive Medicine Associates of New Jersey
Mark R. Hughes, M.D., Ph.D.
Genesis Genetics Institute
Needs Assessment and Description
While emerging technologies for preimplantation genetic
screening (PGS) of all chromosomes hold promise for
accurate identification of euploid embryos, controversy
exists regarding the strategies used and the patient
populations who may benefit most. Reproductive specialists
need to be updated on the technical aspects and clinical
applications of the technologies, in order to provide
appropriate patient counseling, and to consider practice
pattern changes for improved patient care.
Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Compare the different methodologies currently used for
preimplantation genetic screening.
2. Summarize the extent to which aneuploidy affects
embryo morphology.
3. Discuss the impact of biopsy at different developmental
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Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Describe basic and clinical concepts of IVM technology.
2. Assess and compare two major protocols, ovarian
stimulation and IVM, for treatment of women with PCOS.
ACGME COMPETENCY
Medical Knowledge
Patient Care
TEST QUESTION:
For patients with PCOS, after participating in this session,
I will do following in my practice:
A. Use ovarian stimulation for the first cycle and use IVM for
the second trial.
B. Not use metformin, as it is not effective with the IVM
procedure.
C. Choose IVM for patients who have experienced severe
OHSS in previous cycles.
D. Use only anti-müllerian hormone assessment prior to
treatment.
E. Use IVM for all patients, as the maturation rate of
immature oocytes in IVM is commonly 80%.
F. Not applicable to my area of practice.
Wednesday, October 19, 2011 3:45 pm – 5:45 pm
Symposium
Room 330 E
stages on the precision and safety of emerging
technologies and on the clinical outcomes achieved.
4. Describe the patient populations who may benefit most
from preimplantation genetic screening.
ACGME COMPETENCY
Medical Knowledge
Patient Care
TEST QUESTION:
A 34-year-old, G3PO, has undergone three failed IVF cycles
with her 36-year-old partner, who presents with a normal
semen analysis. She has obtained a total of 18, 16 and 22
embryos in these three failed attempts, all of which have
resulted in chemical pregnancies following transfer of 2
embryos. It is recommended that their embryos undergo
preimplantation genetic screening in their fourth IVF cycle.
The couple has read about microarray technology and
they wonder whether this should be used on their embryos.
After participating in this session, in my practice before
attempting their fourth cycle I will counsel this couple that:
A. There is no risk of decreased implantation with embryo
biopsy.
B. Preimplantation genetic screening with microarray
technology completely eliminates the risk of transferring
an aneuploid embryo.
C. SNP microarray-based 24-chromosome aneuploidy
screening provides more complete and consistent results
than FISH.
D. Only half of their embryos should be biopsied.
E. Not applicable to my area of practice.