Afternoon Symposium - NPG Symposium - Freeze All Cycles—Eggs and Embryos

Date:October 22, 2014

Time:11:15 am - 1:00 pm

Location:HCC318 - Hawaii Convention Center

Presenters

Carolyn Collins, B.S.N., R.N. (Chair), Reproductive Medicine Associates on New Jersey

G. David Ball, Ph.D., Seattle Reproductive Medicine

Wen-Hui Shen, M.D., Ph.D., Kaiser Permanente Center for Reproductive Health

Needs Assessment and Description
Freeze-all cycles are becoming increasingly more common in assisted reproductive technology (ART) due to improvements in oocyte and embryo cryopreservation techniques. Freeze-all oocyte cycles provide patients with the option of fertility preservation. As such, it is an appropriate option for patients who wish to delay reproduction for elective purposes, those who are experiencing fertility-threatening illness (such as cancer), as well as those who may be unable to freeze embryos for legal, medical, or social reasons. In addition, freeze-all embryo cycles are useful in ART and especially benefit patients with ovarian hyperstimulation syndrome (OHSS) and uterine dyssynchrony. This live course for nurses and other allied health professionals will discuss current and future trends in the management of freeze-all cycles used to optimize patient outcomes. 

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

  1. Describe current options to preserve fertility and emerging techniques targeted at improving oocyte cryopreservation. 
  2. Discuss indications for freeze-all embryo cycles as a means to optimize patient outcomes. 
  3. Counsel patients regarding implications of freeze-all cycles. 
ACGME Competency
Patient Care 

TEST QUESTION
A 27-year-old woman with polycystic ovary syndrome (PCOS) has an antimüllerian hormone (AMH) level of 19 ng/mL and a basal antral follicle count (AFC) of 42. The patient is undergoing an in vitro fertilization (IVF) cycle with an antagonist protocol and presents on cycle day 12 with a serum estradiol level of 6,300 pg/mL. The physician performing the day-12 ultrasound determines that the patient is ready to be triggered for her oocyte retrieval (OR). After participating in this session, in my practice I will recommend the following:
a. Administer a gonadotropin-releasing hormone antagonist (GnRHa).
b. Convert the patient to a freeze-all cycle due to her risk of ovarian hyperstimulation syndrome (OHSS).
c. Trigger the patient with 10,000 units of human chorionic gonadotropin (hCG) and proceed with a double-embryo transfer (DET).
d. Prevent spontaneous ovulation by withholding the trigger dose and cancel the cycle.
e. Not applicable to my area of practice

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