See what you missed at ASRM 2024 with the ASRM 2024 Recorded Bundle 

Menu
Close Close Icon
ASRMed talks Logo

Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​ Part I

View more ASRMed Talks

Video

Title:  Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​ Part I

Runtime: 5 min 35 sec

Speaker: Richard J. Paulson MD

Transcript

This transcript was automatically generated.

Dr. Richard Paulson delves into the intricacies of endometrial preparation for assisted reproductive technology (ART). He discusses the historical evolution of hormonal induction of endometrial receptivity, from its early applications in egg donation to its current use in frozen embryo transfer. Dr. Paulson also explores the optimal methods of estrogen and progesterone administration, including oral, transdermal, intramuscular, and vaginal routes.

Hello, I'm Dr. Richard Paulson from the University of Southern California. I've been doing IVF and egg donation and all of these other things that we all do for a very long time. One of my areas of interest for a long time has been the question of endometrial receptivity and in particular the hormonal induction of endometrial receptivity.

Now this procedure, if you will, really was first invented in the context of egg donation because remember embryo cryopreservation wasn't very efficient. So it was when IVF first started and people saw that you could have sperm in one dish and egg in another dish that it didn't take a huge leap of the imagination to say, oh gosh, we could be donating eggs from one person to another. And of course the early recipients were all young women with premature ovarian failure.

So they had no ovarian function and the only way to induce receptivity to embryo implantation was with the progesterone. So the world's first pregnancy in an agonadal recipient took place in 1983. The patient took oral estrogen and vaginal progesterone, 50 milligrams twice a day.

Remember that, 50 milligrams twice a day. And one two-cell embryo was transferred on the second day of progesterone. Second day of progesterone, that means the progesterone started when that embryo was at the pre-nuclear stage.

So remember that, that's actually 24 hours after ovulation. The procedure, or if you will, the preparation of the endometrium was then extended to surrogacy. Same kind of idea, eggs being donated from one person to another.

And when embryo cryopreservation became more efficient, we started using it for preparation of the endometrium prior to frozen embryo transfer. And indeed, that is what it's being used for mostly nowadays. In fact, egg donation and gestational surrogacy, as most of you know, has really shifted towards frozen embryo transfer in any event.

So let's talk about how it is we prepare the endometrium. You need estrogen and you need progesterone. You don't need anything else.

People have tried, but estrogen and progesterone is all that has ever been shown to be necessary and nothing added to it has actually been shown to make a difference. So apparently, that's how that works. So how do you give somebody estrogen? So there's lots of options.

Estradiol in the circulation is relatively low quantities, and as a consequence, you don't have to give that much medication. So we can use oral estrogen. Typically, we use two milligram oral doses, maybe twice a day or three times a day.

You can use transdermal, and because transdermal is absorbed much more efficiently, the dose is lower. So estrogen patches that are used are typically 100 microgram doses. 0.1 milligram dose by a patch is equivalent to about two milligrams orally.

So two milligrams twice a day, for example, orally translates into two patches at one time, and that's how it can be used. The patches actually are more physiologic. They provide the right kind of ratio of estrone and estradiol, but I would say that the majority of cycles in the United States still use oral, and that is because we're more comfortable with it.

It's easier for the patients to take it via pill. You can also use intramuscular, or you can use vaginal administration. We won't go into depth on those.

Those do produce actually higher levels. So estrogen has to be given for some period of time to prepare the endometrium, and specifically to prepare the endometrial cells and to allow them to develop progesterone receptors, because it is progesterone that actually causes the luteinization and opens the window of implantation. So most of us give estrogen for about 10-12 days.

We look for an endometrial thickness of seven millimeters, but you should know that no one has ever correlated endometrial thickness with the presence of progesterone receptors and so on. So the thickness is not all there is to it. Let's move on to progesterone.

So progesterone is present in the body in much higher levels. Remember, we measure progesterone in nanogram quantities, nanogram per mil, and therefore the doses that are given are much higher. So intramuscular doses are typically 50 milligrams, 50 milligrams per ml.

That's a dose. Vaginal doses then typically are around 100 or 200 a day. So oral is not really a reality.

Really, we're stuck with intramuscular or vaginal. The transdermal administration for progesterone also doesn't work. First of all, you have to think about how big that patch would have to be.

I often like to joke that you'd have to have a progesterone jacket to wear. And still, of course, there's five alpha reductase in the skin, which metabolizes the progesterone and makes it be inactivated. So we're going to stick with intramuscular and vaginal.

So that's it for the options that we have for progesterone administration. So I've been investigating progesterone administration for a very long time, and I want to tell you more about that and particularly about the uterine first pass effect that was discovered as a consequence of measuring endometrial tissue levels rather than serum levels of progesterone. And we're going to talk about that in the next video.

ASRMed Talks

Check out more ASRMed Talks
ASRMed talks Logo

Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​ Part II

Dr. Richard Paulson discusses progesterone administration in IVF, comparing intramuscular and vaginal methods, optimal timing, and recent research findings.
ASRMed talks Logo

Genetics: Counseling Fertility Couples About Their Evaluation

Caitlin Hebert discusses fertility counseling, the importance of carrier screening, and overcoming barriers for patients while highlighting the role of genetic counseling.

ASRM Academy

ASRM Academy Teaser Image
ASRM Academy Online

Find A Course

View the ASRM Academy Course Catalog

View the Course Catalog
ASRM Academy Webinars teaser
ASRM Academy Digital

Educational Webinars

Panel discussions on topics to enhance your knowledge of all facets of reproductive medicine

View Upcoming Webinars
ASRM Academy Teaser Image
ASRM Academy Online

Certificate Courses and Training Modules

View the specially crafted certificate courses and training modules available from ASRM Academy

View the Courses/Modules
ASRM Academy Teaser Image
ASRM Academy Digital

Podcasts

The ASRM Family of Podcasts were developed with both health professionals and the layman in mind

Subscribe to the ASRM Today Podcast
ASRM Academy Teaser Image
ASRM Academy On the Go

MedTalks

Head to the highlights! Stay up to date with engaging video excerpts from webinars and courses that cover a topic in 7 minutes or less.

View the ASRMed Talks!
MAC 2021 teaser
ASRM Academy on the Go

ASRM MAC Tool 2021

The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.

View the MAC Tool
EDGE teaser
ASRM Academy on the Go

ASRM EDGE Tool

Get the EDGE on embryo identification! EDGE allows you to compare your grading of embryos against embryologists in the US and around the world.

Grade Embryos Now

Topic Resources

View more on the topic of egg donation
Videos Icon

Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​ Part I

Explore Dr. Paulson's insights on endometrial receptivity and hormonal preparation in IVF, egg donation, and surrogacy, highlighting estrogen and progesterone roles. View the ASRMed Talk Video
Coding Icon

Mental health assessment for donors and intended parents

Is it appropriate to use 96156 or 96167 for mental health professional (MHP) counseling of gamete/embryo donors and gestational carriers? View the Answer
Document Icon

Family members as gamete donors or gestational carriers: an Ethics Committee opinion (2024)

The use of adult intrafamilial gamete donors and gestational surrogates is ethically acceptable when all participants are fully informed and counseled. View the Committee Document
Coding Icon

Mandated states and egg retrieval

What name should you use to submit for reimbursement for the actual egg donor when there is benefit for the donor egg retrieval? View the Answer
Coding Icon

Reimbursement for donor egg

My wife and I are going through a fertility treatment process, and we have purchased a donor egg out-of-pocket from a donor bank.  View the Answer
Videos Icon

Modernizing Clinic Options for Directed Gamete and Embryo Donation

Explore the evolution of gamete insemination laws, ethics, and rights for donor-conceived individuals from 1884 to present-day privacy shifts. View the ASRMed Talk Video
Document Icon

Misconduct in third-party assisted reproductive technology by participants and nonmedical professionals or entities: an Ethics Committee opinion (2023)

In some instances, it is permissible for the physician to disclose information to the affected party or to decline to provide or continue to provide care. View the Committee Opinion
Coding Icon

Reimbursement for cost of donor egg

My wife and I are going through a fertility treatment process, and we have purchased a donor egg out-of-pocket from a donor bank.  View the Answer
Coding Icon

Billing egg donor’s retrieval to recipient’s insurance

How you would bill an egg donor’s retrieval to a patient’s insurance? View the Answer
Coding Icon

Psychological Evaluation

Many REs require patients (and their spouses/partners) who are considering using donor gametes to see an infertility counselor first. View the Answer
Coding Icon

IVF Case Rates

What ICD-10 codes apply to case rates? View the Answer
Coding Icon

Donor Screening

Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code?  View the Answer
Coding Icon

Egg Culture and Fertilization: Same Gender

A same-sex male couple requested half their donor eggs be fertilized with sperm from male #1 and the other half fertilized from male #2. View the Answer
Coding Icon

Diagnosis Code For Same-Sex Egg Donation

We have a same-sex male couple with insurance coverage for IVF.  View the Answer
Coding Icon

Donor Egg Infectious Disease Lab Screening

The issue we are experiencing is outside labs billing with Z11.3 are getting denials stating improper ICD-10 for the services billed.  View the Answer
Coding Icon

Donor Egg Lot Acquisition

What is the code for egg lot acquisition? View the Answer
Coding Icon

Donor Eggs-Physical Exam

Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code?  View the Answer
Coding Icon

Donor Egg-Retrieval On Recipient's Claim

Is the donor egg retrieval included on the bill to insurance with the first IVF treatment for the recipient?  View the Answer
Coding Icon

Donor Embryos

Could you give guidance for the correct ICD-10 code(s) to use when a patient is doing an Anonymous Donor Embryo Transfer cycle? View the Answer
Coding Icon

Claim Form for Donor Egg Retrieval

What bill form is used of IVF donor egg retrieval? View the Answer
Coding Icon

Coding For Donor Egg Retrieval For Male Intended Parent

In coding a donor-egg retrieval to bill to insurance under the male intended parent, would it be appropriate to use the Z31.83?  View the Answer
Document Icon

Updated terminology for gamete and embryo donors: directed (identified) to replace ‘‘known’’ and nonidentified to replace ‘‘anonymous’’: a committee opinion (2022)

ASRM encourages all stakeholders with an interest in gamete and embryo donation to adopt directed (identified). View the Committee Opinion
Document Icon

Financial compensation of oocyte donors: an Ethics Committee opinion (2023)

Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds. View the Committee Opinion
Document Icon

Guidance regarding gamete and embryo donation (2021)

This document provides the latest recommendations for the evaluation of potential sperm, oocyte, and embryo donors as well as their recipients. View the Committee Opinion
Document Icon

Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline (2021)

A review of success rates, factors that may impact success rates, and  outcomes. View the Committee Opinion
Document Icon

Repetitive oocyte donation: a committee opinion (2020)

Donors should be advised of the number of cycles/donations that a given oocyte donor may undergo. View the Committee Opinion
Document Icon

Oocyte or embryo donation to women of advanced reproductive age: an Ethics Committee opinion (2016)

Advanced reproductive age (ARA) is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications.  View the Committee Opinion

Topic Resources

View more on the topic of in vitro fertilization (IVF)
Podcast Icon

Fertility and Sterility On Air - TOC: October 2024

Explore the latest in reproductive medicine with Fertility and Sterility On Air. Topics include ovarian tissue cryopreservation, DuoStim debates, 1PN embryos, and ART outcomes. Listen to the Episode
Videos Icon

Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​ Part I

Explore Dr. Paulson's insights on endometrial receptivity and hormonal preparation in IVF, egg donation, and surrogacy, highlighting estrogen and progesterone roles. View the ASRMed Talk Video
Videos Icon

Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​ Part II

Dr. Richard Paulson discusses progesterone administration in IVF, comparing intramuscular and vaginal methods, optimal timing, and recent research findings. View the ASRMed Talk Video
Podcast Icon

Fertility and Sterility On Air - Unplugged: October 2024

Topics include: mechanical contractions and fibroid progression, endometriosis classification and risk of infertility,  fertility coverage for military personnel and more. Listen to the Episode
PR Bulletin Icon

ASRM Releases Congressional Scorecard

Discover ASRM's first Congressional scorecard, detailing positions of the 118th Congress on key reproductive legislation to guide ASRM members in elections.

View the Press Release
PR Bulletin Icon

Fertility Care Gets Important Win in California

ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.

View the Press Release
Podcast Icon

ASRM Today: Equity, Access, and Innovation, Episode Five: Policy Matters

This episode covers ballot measures on reproductive rights, ASRM advocacy efforts, and Vot-ER’s push for civic engagement among healthcare workers ahead of elections. Listen to the Episode
PR Bulletin Icon

Nation’s Leading Professional Group for Fertility Care Professionals Calls for Passage of Right to IVF Act

ASRM applauds Majority Leader Schumer’s decision to seek reconsideration of the Right to IVF Act.

View the Press Release
Podcast Icon

ASRM Today: Equity, Access, and Innovation, Episode Three: Innovation

Explore innovation in reproductive health with ASRM Today. Discover how AI, robotics, and new technologies are transforming fertility care and improving patient outcomes. Listen to the Episode
Podcast Icon

Fertility and Sterility On Air - Live from ESHRE 2024: Part 1

Discover the impact of embryo expansion post-biopsy and freezing time standardization on live births in this episode from ESHRE 2024.  Listen to the Episode
Podcast Icon

Fertility and Sterility On Air - Live from ESHRE 2024: Part 2

Explore fresh embryo transfers, progesterone elevation, and day-seven embryo utility from experts at ESHRE 2024. Cutting-edge fertility insights await! Listen to the Episode
Podcast Icon

Fertility and Sterility On Air - ANZSREI 2024 Journal Club Global: "Should Unexplained infertility Go Straight to IVF?"

Join "Fertility and Sterility On Air" for insights from the ANXSREI conference on unexplained infertility, IVF, and expert debates. Listen now at ASRM.org. Listen to the Episode
Document Icon

The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)

PGT-A use in the U.S. is rising, but its value as a routine IVF screening test is unclear, with mixed results from various studies. View the Committee Opinion
PR Bulletin Icon

Trump Calls for IVF Coverage, California Legislature Sends IVF Mandate Bill to Governor

The California General Assembly approved a bill mandating most private health insurance plans to provide coverage for In Vitro Fertilization (IVF). 

View the Press Release
Videos Icon

Journal Club Global from ANZSREI 2024: Debate Unexplained infertility; Straight to IVF?

ANZSREI 2024 debate: Should unexplained infertility go straight to IVF? Experts discuss pros, cons, and alternative treatments. No clear consensus reached. View the Video
PR Bulletin Icon

Get Vot-ER Ready This National Patient Advocacy Day!

Celebrate National Patient Advocacy Day by boosting civic engagement! Order your free Vot-ER badge to help patients register to vote and promote healthy communities.

View the Press Release
Coding Icon

Performing MD is not the Doctor of Record

Currently we are billing the performing provider as the service provider and the Doctor of Record as the billing provider. View the Answer
Coding Icon

Who to bill for gestational carrier services if intended parents have insurance?

I wanted to inquire about guidelines for billing services to a surrogate’s insurance company if intended parents purchased the insurance coverage.  View the Answer
PR Bulletin Icon

ASRM marks World IVF Day by doing what we do best – advocating for access to reproductive health care by calling for a House floor vote on the Right to IVF Act

ASRM observed World IVF Day, the day marking the birth of the world’s first IVF baby in 1978, by continuing its advocacy for improvements in IVF policy.

View the Press Release
Videos Icon

Journal Club Global: Oral Progestin For Ovulation Suppression During IVF

Live broadcast from the 2024 Midwest Reproductive Symposium
International in Chicago, IL View the Video
PR Bulletin Icon

Order your FREE Vot-ER badge to encourage patients and colleagues to vote!

ASRM) is pleased to announce our partnership with Vot-ER, a grassroots organization dedicated to driving civic engagement among healthcare professionals.

View the Press Release
Podcast Icon

Fertility and Sterility On Air - Seminal Article: Ernest Ng and Zhi Chen

June issue Seminal Contribution: a randomized controlled trial studying the use of progestins for ovulation supression in predicted high responders.  Listen to the Episode
PR Bulletin Icon

ASRM Responds to Senate Vote on IVF Bill

ASRM is disappointed that a filibuster prevented the passage of the Right to IVF Act.

View the Press Release
PR Bulletin Icon

ASRM Calls for Passage of Family Building Bill

It would increase access to IVF treatments for all Americans, including active-duty service members, veterans, and federal employees.

View the Press Release
Coding Icon

Billing for assisted hatching at biopsy and transfer

We would also like to know if you can bill assisted hatching with biopsy and then assisted hatching again during the transfer cycle. View the Answer
Document Icon

Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2023)

Financial ‘‘risk-sharing’’ fee structures in programs charge patients a higher initial fee but provide reduced fees for subsequent cycles. View the Committee Document
Legal Icon

Alabama Supreme Court Rules Frozen Embryos are “Unborn Children” and admonishes IVF’s “Wild West” treatment

Legally Speaking™ on presenting facts and reflecting on the impact and potential implications of  legal developments in ART. View the Column
Document Icon

Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)

Ovarian hyperstimulation syndrome is a serious complication associated with assisted reproductive technology. View the guideline
Coding Icon

Billing IVF lab work

We typically bill our IVF Lab work under the rendering provider who performs the VOR. Who should be the supervising provider for embryology billing? View the Answer
Videos Icon

IVF Lab Automation

Automation in IVF labs is progressing, focusing on cryopreservation, dish prep, and data integration. Challenges remain in standardizing processes and material safety. View the ASRMed Talk Video
Videos Icon

Journal Club Global: IVM in Clinical Practice: An Idea Whose Time Has Come?

In vitro maturation (IVM) has the potential to make IVF cheaper, safer, and more widely accessible to patients with infertility. View the Video
Document Icon

Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline (2018)

Mild-stimulation protocols with in vitro fertilization (IVF) generally aim to use less medication than conventional IVF. View the Guideline
Coding Icon

IVF cycle management and facility fees, an overview

How should IVF Cycle Management be coded?  View the Answer
Coding Icon

Limited ultrasound performed by RN

Would it be appropriate to bill a 99211 when an RN is doing a limited ultrasound and documenting findings during an IUI or IVF treatment cycle? View the Answer
Coding Icon

CPT 89253 and 89254 for Assisted hatching

Can I bill CPT codes 89253 and 89254 together? If yes, do I need a modifier on any of the codes? View the Answer
Videos Icon

Journal Club Global - What is the optimal number of oocytes to reach a live-birth following IVF?

The optimal number of oocytes necessary to expect a live birth following in vitro fertilization remains unclear. View the Video
Coding Icon

Patient Education

What is the correct way to bill for the patient education sessions performed by registered nurses to individual patients prior to their IVF cycle? View the Answer
Coding Icon

Pregnancy Ultrasound

Our practice does routine ultrasounds (sac check- 76817) at the end of an IVF cycle and bill with a diagnosis code O09.081, pregnancy resulting from ART.  View the Answer
Coding Icon

IV Fluids During Egg Retrieval

Is it appropriate to bill the insurance company for CPT 96360, Under Hydration Infusion when being used in conjunction with IVF retrieval? View the Answer
Coding Icon

IUI or IVF

Should other ovarian dysfunction (diagnosis code E28.8) or unspecified ovarian dysfunction (diagnosis code E28.9) can be used for an IUI or an IVF cycle View the Answer
Coding Icon

IVF Case Rates

What ICD-10 codes apply to case rates? View the Answer
Coding Icon

IVF Consent Counseling

When a patient is scheduled to undergo IVF and the provider schedules the patient for a 30-minute consultation is this visit billable? View the Answer
Coding Icon

Ovulation Induction Monitoring for IUI

We would like to clarify the correct ICD 10 diagnosis code for monitoring of an IUI cycle.  View the Answer
Coding Icon

In Vitro Maturation

Have CPT codes been established for maturation in vitro? View the Answer
Coding Icon

IVF Billing Forms

I am seeking information on IVF insurance billing guidelines.  View the Answer
Coding Icon

IVF Billing Globally

Am I correct in assuming that it is duplicate billing for both the ambulatory center and embryology laboratory to bill globally? View the Answer
Coding Icon

IVF Billing of Professional Charges

Are we allowed to bill professional charges under the physician for the embryologist who performs the IVF laboratory services? View the Answer
Coding Icon

Lab Case Rates

What ICD-10 codes apply to case rates? View the Answer
Coding Icon

Oocyte Denudation

Is there is a separate code for denudation of oocytes?  View the Answer
Coding Icon

Endometrial Biopsy/Scratch

What CPT code should be used for a “scratch test”?  View the Answer
Coding Icon

Endometriosis and Infertility

For treatment like IVF would we bill with N97.x first or an endometriosis diagnosis? View the Answer
Coding Icon

Follicle Monitoring For Diminished Ovarian Reserve

If a patient has decreased ovarian reserve (ICD-10 E28.8) and patient is undergoing follicle tracking to undergo either an IUI cycle or IVF cycle... View the Answer
Coding Icon

Global Billing Vs Billing Under Provider

For an IVF cycle (that is not being billed global to an insurance plan) is it appropriate to bill the charges under one “global” provider? View the Answer
Coding Icon

Diagnosis of Infertility for IVF Procedure

How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures?  View the Answer
Coding Icon

Egg Culture and Fertilization

We are billing for the technical component of 89250 and would like to also bill a professional component of the 89250. View the Answer
Coding Icon

Egg Culture and Fertilization: Same Gender

A same-sex male couple requested half their donor eggs be fertilized with sperm from male #1 and the other half fertilized from male #2. View the Answer
Coding Icon

Donor Embryos

Could you give guidance for the correct ICD-10 code(s) to use when a patient is doing an Anonymous Donor Embryo Transfer cycle? View the Answer
Videos Icon

Journal Club Global: Natural versus Programmed FET Cycles

A significant portion of IVF cycles now utilize frozen embryo transfer.
View the Video
Document Icon

Role of assisted hatching in in vitro fertilization: a guideline (2022)

There is moderate evidence that assisted hatching does not significantly improve live birth rates in fresh assisted reproductive technology cycles View the Committee Opinion
Videos Icon

Journal Club Global - Best Practices of High Performing ART Clinics

This Fertility and Sterility Journal Club Global discusses February’s seminal article, “Common practices among consistently high-performing in vitro fertilization programs in the United States: a 10 year update.” View the Video
Videos Icon

Journal Club Global Live from India - Adjuvants in IVF and IVF Add-Ons for the Endometrium

Many adjuvants have been utilized by IVF centers to improve their success rates. View the Video
Document Icon

Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline (2021)

A review of success rates, factors that may impact success rates, and  outcomes. View the Committee Opinion
Document Icon

Development of an emergency plan for in vitro fertilization programs: a committee opinion (2021)

All IVF programs and clinics should have a plan to protect fresh and cryopreserved human specimens (embryos, oocytes, sperm). View the Committee Opinion
Document Icon

In vitro maturation: a committee opinion (2021)

The results of in vitro maturation (IVM) investigations suggest the potential for wider clinical application.  View the Committee Opinion
Document Icon

Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion (2019)

The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment.  View the Committee Opinion
Document Icon

Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)

The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
Document Icon

The role of immunotherapy in in vitro fertilization: a guideline (2018)

Adjuvant immunotherapy treatments in in vitro fertilization (IVF) aim to improve the outcome of assisted reproductive technology (ART) in both the general ART population as well as subgroups such as patients with recurrent miscarriage or implantation failure. View the Committee Opinion
Document Icon

Performing the embryo transfer: a guideline (2017)

A systematic review of the literature was conducted which examined each of the major steps of embryo transfer. Recommendations made for improving pregnancy rates are based on interventions demonstrated to be either beneficial or not beneficial. (Fertil Steril® 2017;107:882–96. ©2017 by American Society for Reproductive Medicine.) View the Committee Guideline
Document Icon

Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)

ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint Guideline
Membership Icon

In Vitro Maturation Special Interest Group (IVMSIG)

IVMSIG strives to define the best strategies to optimize IVM outcomes. Learn more about IVMSIG
Advocacy Icon

What support for IVF looks like

Bipartisan support for IVF, that is responsible for the birth of over 2% of all babies born in the USA each year, will ensure that families continue to grow. View the advocacy resource
Advocacy Icon

It takes more than one

Why IVF patients often need multiple embryos to have a baby View the advocacy resource
Advocacy Icon

Oversight of IVF in the US

In the US, medical care is regulated by a complex and comprehensive network of federal and state regulations and professional oversight. View the advocacy resource
Advocacy Icon

Advocacy Resources

ASRM has prepared resources to help explain and advocate for reproductive rights and the continuation of in vitro fertilization and other fertility treatments. View the advocacy resources