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

SCIENTIFIC PROGRAM • INTERACTIVE SESSIONS
Tuesday, October 18, 2011 1:15 pm – 2:15 pm
Interactive Session
TO ICSI OR NOT TO ICSI ALL? THAT IS THE QUESTION.
AN INTERACTIVE DEBATE.
Presented by the Society of Reproductive Biologists and Technologists
Kathryn J. Go, Ph.D. (Chair)
The Reproductive Science Center of New England
J. Michael Wilson, Ph.D.
E.L.C. LLC
Douglas T. Carrell, Ph.D.
University of Utah School of Medicine
Needs Assessment and Description
Intracytoplasmic sperm injection (ICSI) represents the most
aggressive method for achieving fertilization and a way
of avoiding idiopathic fertilization failure. Recent SART/
CDC reports (2006-2008) reflect that ICSI has been applied
in over 60% of ART treatment cycles in which both male
factor and non-male factor existed. This high utilization
merits the consideration that ICSI could be proposed as the
routine, global method for fertilization in vitro, supplanting
conventional insemination entirely, but the added
manipulation and risk may be barriers to this paradigm. A
debate on the advantages of each of these approaches,
specifically the universal versus selective use of ICSI, offers
the opportunity to gain an informed perspective for clinical
practice.
Room 224 G/H
90
Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Identify and contrast the reasons and objectives for ICSIall-eggs
versus using ICSI only when specific clinical
factors warrant its inclusion in the IVF treatment, e.g., male
factor, history of failed fertilization (selective ICSI).
2. Appraise the merits and disadvantages of an ICSI-all-eggs
vs. selective ICSI policy.
3. Support the selection of ICSI-all vs. selective-ICSI for one’s
practice.
ACGME COMPETENCY
Medical Knowledge
Patient Care
Tuesday, October 18, 2011 1:15 pm – 2:15 pm
Interactive Session
SRS DEBATE: ENDOMETRIOMAS: TREATMENT OR NO TREATMENT
FOR FERTILITY
Presented by the Society of Reproductive Surgeons
Steven F. Palter, B.A., M.D. (Chair)
Gold Coast IVF, New York
Juan A. Garcia Velasco, M.D.
IVI Madrid
Antonio R. Gargiulo, M.D.
Brigham and Women’s Hospital
Needs Assessment and Description
Endometriosis is a major cause of infertility, yet one that
is potentially treatable with multiple different therapies
including medications, surgery, and ART. Considerable
controversy exists regarding the optimal management of
those patients with infertility found to have endometriomas.
The literature contains conflicting recommendations
regarding the optimal use and risks of surgery and ART in
this population. This session will compare and contrast
the reasons for treating or not treating endometriomas in
patients desiring fertility.
Room 224 E/F
TEST QUESTION:
After participating in this session, in my practice I will advise
patients that:
A. There is no difference between ICSI and conventional
insemination.
B. ICSI is an unproven methodology without clinical merit.
C. ICSI improves in vitro maturation as well as fertilization
rates.
D. There are rationales for both using ICSI globally and using
it selectively.
E. All IVF centers have the same views and perspectives on
using ICSI.
F. Not applicable to my area of practice.
Learning Objectives
At the conclusion of this session, participants should be able
to:
1. Identify the potential benefits and risks of treating
endometriomas in patients seeking fertility treatment.
2. Select the best treatment for endometriomas in patients
with infertility.
ACGME COMPETENCY
Medical Knowledge
Patient Care
TEST QUESTION:
After participating in this session, for a 38-year-old patient
with a 5 cm endometrioma who plans IVF, in my practice I
will recommend the following:
A. Incision and fulguration of the cyst wall is optimal surgical
therapy.
B. Surgery should not be attempted before IVF is completed.
C. Stripping of the cyst wall is the optimal approach if
surgery is chosen.
D. Pregnancy rates are significantly improved if the patient
has had 2 previous failed IVF cycles despite the transfer
of high grade blastocysts.