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

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS
Monday, October 17, 2011 1:15 pm – 2:15 pm
Interactive Session
FIBROIDS AND ART OUTCOME: TO INTERFERE OR NOT TO
INTERFERE. AN INTERACTIVE DEBATE.
Joint Session presented by the Fibroid Special Interest Group and the
Society for Assisted Reproductive Technology
Ayman Al-Hendy, M.D., Ph.D. (Chair)
Meharry Medical College
James H. Segars, M.D.
Eunice Kennedy Shriver National Institute of Child Health and Human
Development
James M. Goldfarb, M.B.A., M.D.
University Hospitals Case Medical Center
Needs Assessment and Description
Uterine leiomyomata (fibroids) are the most common
pelvic tumors, and their effect on IVF outcome is not fully
understood. Leiomyoma lesions that protrude or distort
the uterine cavity have been shown to negatively affect
implantation and pregnancy rates. However, studies
addressing the effect on IVF outcome of intramural
leiomyomata and other lesions not distorting the uterine
cavity have yielded conflicting results. Debates and
disagreement in the ART community are still running high
regarding the need for myomectomy for submucosal
or intramural leiomyomata prior to IVF and other ART
procedures.
Monday, October 17, 2011 1:15 pm – 2:15 pm
Interactive Session
OVARIAN TISSUE CRYOPRESERVATION: TRANSPLANTATION VS.
IN VITRO MATURATION. AN INTERACTIVE DEBATE.
Presented by the Fertility Preservation Special Interest Group
Karine Chung, M.D. (Chair)
USC Fertility
Teresa K. Woodruff, Ph.D.
Northwestern University
Dror Meirow, M.D.
Sheba Medical Center
Needs Assessment and Description
According to the guidelines of the American Society for
Clinical Oncology, patients who are facing potentially
sterilizing cancer treatments should be counseled about
the potential for infertility and should be offered options
for fertility preservation. For female patients whose
cancer therapy cannot be delayed to allow time for
in vitro fertilization, ovarian tissue cryopreservation is an
option. Clinical experience is increasing and outcomes
are improving, but optimal strategies for utilizing the
ovarian tissue remain uncertain. There are no clinical trials
comparing and contrasting the approaches of ovarian
tissue transplantation versus in vitro follicle maturation. To
provide optimal care for patients, clinicians require up-todate
information in order to appropriately counsel patients
presenting for ovarian tissue cryopreservation as a potential
means of fertility preservation.
Room 224 E/F
Room 231 A/C
84
Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Describe the impact of the location of uterine
leiomyomata on IVF outcome.
2. Examine the role of myomectomy in patients undergoing
IVF.
3. Identify the best approach for myomectomy in patients
undergoing IVF (hysteroscopic, open, laparoscopic, or
robotics).
ACGME COMPETENCY
Medical Knowledge
Patient Care
TEST QUESTION:
A 30-year-old woman and her 34-year-old husband, who
have never achieved pregnancy, have been advised to
undergo IVF-ET. She was diagnosed to have a non-cavitydistorting
intramural fibroid.
After participating in this session, I will do the following:
A. Reassure the couple and advise them to proceed with
IVF-ET.
B. Advise the couple to have minimally invasive
myomectomy either through traditional laparoscopy or
robotic surgery.
C. Advise them to proceed with IVF first, then, if that fails,
proceed with myomectomy.
D. Not applicable to my area of practice.
Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Summarize the current status and applicability of ovarian
tissue cryopreservation for fertility preservation in female
cancer patients.
2. Discuss current methods of ovarian tissue freezing.
3. List 3 advantages and 3 disadvantages of both ovarian
tissue transplantation and in vitro follicle maturation in
patients requesting fertility preservation
ACGME COMPETENCY
Medical Knowledge
Patient Care
TEST QUESTION:
A 26-year-old recently married woman with acute
lymphoblastic leukemia is referred by her oncologist for
fertility preservation. She is scheduled to start combination
chemotherapy in less than 1 week. After participating in this
session, in my practice I will offer this patient:
A. IVF with embryo cryopreservation.
B. GnRH analogue prior to and during chemotherapy.
C. Laparoscopy with oophorectomy and ovarian tissue
freezing.
D. Not applicable to my area of practice.