Folate: Controversies and Update
Dr. Mary Davenport presents on folate and folic acid. Learn about the role of MTHFR genetic variants, clinical supplementation guidelines, and the impact of folate on reproductive health and patient care.
Participation of general practitioners and therapeutic patient education in the care of infertile couples
This study from Bernot G, Lallemand L, Le Menager C, and Ecochard R. presents the work of 66 instructors and 15 doctors to help 551 couples conceive, 37% of whom conceived during the study, and reinforces the role of fertility instructors as part of the multi-disciplinary care team.
A Focused Practice in Restorative Reproductive Medicine
Dr. Nick Kongoasa presents a sustainable and replicable clinical model for Restorative Reproductive Medicine (RRM), highlighting the role of advanced practitioners in leading care, and innovative approaches to RRM education, research, and collaborative partnerships that support the advancement of RRM practices.
Ovulation and Implantation: concert of hormones and cells
Dr. Christian Gnoth presents an in-depth exploration of the evaluation and application of luteinizing hormone (LH), human chorionic gonadotropin (hCG), and uterine natural killer (uNK) cells throughout the ovarian cycle. This talk will highlight the hormonal dynamics that influence fertility and pregnancy, as well as the role of hCG in modulating uNK cell populations in the uterus.
Research Updates: Surgical Management of Endometriosis
Dr. Patrick Yeung Jr. presents updates on surgical management of Endometriosis and results of their new paper, a prospective cohort study aimed to evaluate the effectiveness of optimal excision surgery for endometriosis in reducing repeat surgery rates compared to historical data from ablation procedures, with the cohort of patients showing a notably low repeat surgery rate of 2.5% (15 out of 620 patients) following optimal excision, contrasting with suggested historical rates of 40-60% for ablation (Bozdağ 2015). The team also looked at the relationship between hormonal suppression use before surgery and the stage of endometriosis, finding no significant correlation, suggesting that hormonal suppression may not prevent disease progression.
Factors Associated with Spontaneous Conception Leading to Live Birth in Infertility Patients
Dr. Nugen will review data from his retrospective cohort study looking at outcomes of endometriosis surgery for infertility, suggesting that excisional surgery with MIGS training was more successful (higher rate of live births) than standard surgery that included ablation. He also reviews other literature and bleeding at excisional sites, and adhesion formation. Learning Outcomes: Faculty Disclosure: None declared. Please log in below - or join IIRRM to access live and self-paced free CME as well as other member benefits. For support or questions please contact info@iirrm.org. Username Password Remember Me Forgot Password
The Latency Phase of the Menstrual Cycle Deserves More Attention
Explore the intricate hormonal dynamics of the early menstrual cycle and their impact on the timing of the fertile window. Published in Human Reproduction Journal in October 2024, René Écochard, MD, PhD, presents the team's research, "Early menstrual cycle impacts of oestrogen and progesterone on the timing of the fertile window"
Recurrent Miscarriage and Restorative Reproductive Medicine: RCOG Guidelines, RRM Insights, and Case Analysis
Dr. Phil Boyle reviews the 2023 Royal College of Obstetricians and Gynaecologists guidelines for recurrent miscarriage and discusses how these guidelines compare with RRM approaches. An RRM-managed patient case report is reviewed. What guidelines would be changed or added in the development of RRM clinical practice guidelines compared with these or other practice guidelines for recurrent miscarriage?
Utilizing at-home fertility monitoring with RRM in a case of infertility
This session will introduce how home urine hormone metabolite testing may correlate with traditional serum testing, noting more research is needed. Dr. Kimberly Barrows reviews a case report and discusses who to integrate this technology as part of an RRM workup for infertility for application to clinical care. Additionally, discover resources to integrate at-home monitoring into your practice or support patients already using this platform.
Histamine Intolerance Management and Myo-Inositol: A Novel Approach in RRM
Based on clinical experience, Dr. Victoria Mena provides a practical and simple guide to identify, diagnose, and treat excess histamine, and suggests wider use of myo-inositol in non-PCOS patients—especially in combination with diamine-oxidase—as a novel approach for those with histamine intolerance.
Background:Histamine is a mediator of multiple functions in the body. Histamine intolerance is a condition that disturbs up to 1/5 to 1/3 of patients, with different symptoms and a potential dis-regulation of cortisol, but it is usually overlooked. Myo-inositol is used frequently in patients with PCOS, with clear effects on hormonal regulation and cycle balancing, but it is not used in other groups of patients with infertility or cycle defects.
Sperm DNA Integrity and Male Health
Since 1992 Dr. Preben Christensen has been researching sperm quality and reduced fertility, which in 2006 led to the founding of SPZ Lab - which offers an examination of sperm cell DNA integrity (SDI-testing) and offers testing to many European fertility clinics and childless couples. As a result of his diagnostic work, he has developed a keen research interest in exploring male fertility as a marker for a man’s general health with reduced fertility increasing the likelihood of the man developing future diseases as well as having possible negative implications for the health of any future children.
Investigating Endometriosis and PCOS as Diametric Conditions
This webinar explores the concept that endometriosis and PCOS represent opposite outcomes of variation in HPG axis development, with endometriosis linked to low prenatal and postnatal testosterone, while PCOS is associated with high prenatal testosterone. Endometriosis and PCOS could be considered as reflecting maladaptive extremes of female fitness-related adaptations, which has direct implications for therapy and fertility restoration in women with endometriosis or PCOS.
Involved in a number of research areas, Prof. Crespi also studies the evolutionary biology of risks for endometriosis and PCOS, from fetal programming to life histories.
Credit Statement: The AAFP has reviewed Investigating Endometriosis and PCOS as Diametric Conditions and deemed it acceptable for up to 1.5 Enduring Materials, Self-Study AAFP Prescribed credit. Term of Approval is from 1/12/2023 to 1/12/2024. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Low Dose Naltrexone (LDN) and RRM
Dr. Phil Boyle who has used low-dose naltrexone (LDN) in his practice for over 20 years, runs through the history of naltrexone, its mechanism of action, clinical indications of use, and application to reproductive medicine, including a number of complex case examples from which saw benefit from treatment with LDN.
Upon completion of this CME activity, you should be able to:
1. Summarize the history of naltrexone and low-dose naltrexone (LDN) 2. Describe the mechanism of action and clinical indications of LDN use (When should LDN be considered in my patient?) 3. Assess when LDN may be useful to consider in reproductive medicine 4. Evaluate potential adverse reactions and drug interactions before prescribing LDN Additional downloads and references are posted below the lesson discussed during this presentation.
DHEA Treatment for Recurrent Miscarriage: Case Report
This case presents a multi-factorial assessment and approach with DHEA treatment, of a couple who sought treatment with NeoFertility after years of "unexplained" infertility, and history of 1 live birth and 6 pregnancies.
