Afternoon Symposium - Gamete Reserve II - Ovary

Date:October 22, 2014

Time:3:45 pm - 5:45 pm

Location:HCC306 - Hawaii Convention Center

Presenters

Marcelle I. Cedars, M.D. (Chair), University of California San Francisco Center for Reproductive Health

Aleksander Rajkovic, M.D., University of Pittsburgh

David B. Seifer, M.D., Genesis Fertility & Reproductive Medicine

Supporters

Supported by an educational grant from Ferring Pharmaceuticals, Inc.

Needs Assessment and Description
Assessment of ovarian reserve in infertility patients has been part of infertility care and management since the late 1980s when follicle-stimulating hormone (FSH) therapy was first introduced. Since 2002-2005, antral follicle count (AFC) and antimüllerian hormone (AMH) have been increasingly utilized for this purpose. While most would agree that these markers have more specificity for response to stimulation, there is still controversy regarding exactly what they measure and how they should be utilized. This symposium will focus on the latest information regarding genetic causes of decreased ovarian reserve (particularly those that may be of special relevance to reproductively active women), factors that may impact the specific results and hence interpretation of ovarian reserve testing, and how these markers of ovarian reserve should be utilized in clinical practice. This information will be useful for all physicians in clinical practice as even those physicians who do not use assisted reproductive technology need to know when to apply these tests and how to interpret them. Most importantly will be knowledge gained in counseling patients regarding results. 

Learning Objectives
At the conclusion of this session, participants should be able to: 

  1. Identify potential genetic risks in women with low ovarian reserve. 
  2. Interpret markers of ovarian reserve. 3. Utilize markers of ovarian reserve in clinical management of women of reproductive age. 
ACGME Competency
Patient Care
 Interpersonal Skills and Counseling 

TEST QUESTION
A 32-year-old single woman comes for her annual examination. She asks you about egg freezing as she read about it in a newspaper article. She’s not sure if she really wants to proceed but is currently in graduate school, not in a serious relationship, and is taking oral contraceptive pills (OCPs). She is interested in having children as part of her life plan. You decide to order an antimüllerian hormone (AMH) level to better assess her reproductive potential. Her AMH returns at 0.25 ng/mL. After participating in this session, in my practice I will do the following as the next step:
a. Counsel her about likelihood for menopause before the age of 35.
b. Refer her immediately for egg freezing.
c. Discuss potential implications and need for her to stop the OCPs and have additional testing.
d. Request she repeat testing in 1 year.
e. Not applicable to my area of practi

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