PCRS Update

PCRS Meeting Review

Optimizing success rates for patients was the focus, with presentations on “Improving Live Birth Rates”, videos on the importance of early embryo development, optimizing treatment protocols, and early embryo testing. There were sessions on stress reduction, discussions on single embryo transfer, healthy debates between experts, and conversations about new advances that will improve patient care.

Alice Domar, Richard Tucker, Michael Alper and Richard Scott were among the luminaries presenting at the meeting. Right alongside them was Joe Conaghan, Carolyn Givens, Lauri Black, and Paul Turek with matching skills and knowledge. All were directed at improving care for our patients.

Pacific Coast Reproductive Society is one of the important professional organizations supporting fertility care. Although they are a West Coast organization by title, Pacific Coast has developed national and international status in our field by focusing on the patients. As described on their website, “PCRS provides an outstanding forum for the exchange of information, and the advancement of the ideologies of reproductive medicine in a relaxed and collegial setting building relationships that foster the integration of current knowledge to ensure quality medical care for patients.”

Pacific Fertility Center is pleased to support Pacific Coast Reproductive Society. We are looking forward to applying these advances, and already working on the new advances we will be talking about next year!

-Philip Chenette, M.D.

Pacific Coast Reproductive Society Highlights

One of the highlights of this year’s meeting was a talk by Sheryl Kingsberg, Ph.D., a Professor in the Dept. of Reproductive Biology and the Chief of the Division of Behavioral Medicine at Case Western University. Dr. Kingsberg’s area of expertise is in Human Sexuality and sexual disorders in women. She gave an excellent synopsis of “normal” sexuality in our culture and how we have come to view and define that norm. She also provided background on the physiology of sexual excitement and sexual response in women. She spoke about the different classifications of sexual disorders, which includes Hypo-active Sexual Desire Disorder (what we know as low libido), Sexual Aversion Disorder, Female Sexual Arousal Disorder, Female Orgasmic Disorder, and the Pain Disorders: Dyspareunia (painful intercourse) and Vaginismus (localized vaginal and vulvar pain).

Dr Kingsberg also covered the topic of sexual dysfunction and sexual function. One of the most valuable things she discussed was that doctors should use a sexual function checklist. Here is the checklist she presented: Please answer the following questions about your overall sexual function in the past 3 months or more: Please answer the following questions about your overall sexual function in the past 3 months or more:

1. Are you satisfied with your sexual function?
   • Yes
   • No If no, please continue.
2. How long have you been dissatisfied with your sexual function?
3. The problem(s) with your sexual function is: (mark one or more):
   1. Problems with little or no interest in sex
   2. Problems with decreased genital sensation (feeling)
   3. Problems with decreased vaginal lubrication (dryness)
   4. Problems reaching orgasm
   5. Problems with pain during sex
   6. Other
4. Which problem is most bothersome? Circle one: 1 2 3 4 5 6
5. Would you like to talk about it with your doctor?
   • Yes
   • No

Many of us at the conference realized there is a need to identify and assist our fertility patients that also may be suffering from sexual dysfunction. We need to spend a few moments covering this topic with our patients. We will be considering how to add these types of questions to our current patient history forms. We want to identify the patients with sexual dysfunction in addition to fertility problems so we may assist them in finding the appropriate resources for treatment.

-Carolyn Givens, M.D.

Genetic Testing Breakthrough

Genetic screening techniques are a prime topic of research and dialogue in the IVF community. We continue to seek techniques that are 1) accurate, 2) have quick turnaround times for results, and are 3) versatile enough to be able to give a breadth of testing results on one embryo, as well as 4) cost effective.

One of the exciting presentations at PCRS was by a firm called Gene Security Network (GSN), whose laboratory is in Redwood City, CA. GSN has been on the forefront of providing pre-implantation embryo genetic testing which is accurate, covers all 23 pairs of chromosomes including the sex chromosomes, and provides results within 24-48 hours post embryo biopsy (therefore negating the need to freeze embryos while waiting for the genetic results, as with the CGH technique). This technique, developed by GSN, is called Parental Support.

Parental Support is a new technology for Preimplantation Genetic Diagnosis (PGD) that tests all 24 chromosomes in a single cell from an embryo (called a blastomere) for a variety of genetic abnormalities. The test reliability typically exceeds 99% and results are returned within 24 hours in time for Day 5 embryo transfer.

Single gene mutations (such as cystic fibrosis) have been traditionally tested for as one genetic test only. Dual testing, the ability to test for both single gene mutation and aneuploidy screening was not able to be done accurately or easily. GSN has been working on this challenge of dual testing, and had just announced the birth of the first baby born after such dual screening—a healthy baby girl.

This announcement was also exciting for us, since the patient who is now a proud parent of a healthy baby, was a PFC patient.

We continue to collaborate with GSN on current and upcoming clinical trials, pushing the frontiers of genetic testing of embryos, and of diagnostic testing that promotes the creation of healthiest babies possible.

-Isabelle Ryan, M.D.

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