ASRM QBoost

Source material: Evaluation of the azoospermic male: a Practice Committee opinion Fertil Steril
2018;109:777–82
Intended audience: All (REI fellows, REI physicians, nurses, lab, urologists, mental health professionals)
Description: This question bank reviews the current methods of diagnosis and evaluation for men with azoospermia.

Source material: Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion Fertil Steril
2018;110:833–7
Intended audience: All
Description: This question bank explores the diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion. It is the responsibility of the clinician to assess for the presence of erectile dysfunction, ejaculatory dysfunction, or diminished libido 
related to hypoandrogenism among men presenting with a primary complaint of infertility. Referral to a reproductive urologist or other appropriate specialist with requisite expertise in the evaluation and treatment of such conditions is often warranted.
Sample Question: https://www.surveymonkey.com/r/9GWHTJS

Source material: Disclosure of sex when incidentallyrevealed as part of preimplantation genetic testing (PGT): an EthicsCommittee opinion Fertil Steril 2018;110:625–7
Intended audience: All
Description: This question bank is based on the Disclosure of sex when incidentally revealed as part of preimplantation genetics testing (PGT): an Ethics Committee opinion that reviews how clinics may develop a policy to disallow selecting which embryos to transfer based on sex and choose to use only embryo quality as selection criteria. Clinics may also develop a policy to use randomization to select those embryos for transfer if more embryos suitable for transfer are available than can be transferred.

Source material: Performing the embryo transfer: a Practice Committee guideline Fertil Steril
2017;107:882–96
Intended audience: All
Description: Learn the best practices in embryo transfer, work through the basic mechanics to the more challenging techniques as you encounter different case scenarios.
Sample Question: https://www.surveymonkey.com/r/NJFSSPB

Source material: Ethics in embryo research: a positionstatement by the ASRM Ethics inEmbryo Research Task Force and the ASRM Ethics Committee Fertil Steril 2020;113:270–94
Intended audience: All
Description: Ethics in Embryo Research: A question bank based on a position statement by the ASRM Ethics in Embryo Research Task Force and the ASRM Ethics Committee. Abstract: Scientific research using human embryos advances human health and offspring well-being and provides vital insights into the mechanisms for reproduction and disease. Research involving human embryos is ethically acceptable if it is likely to provide significant new knowledge that may benefit human health, well-being of the offspring, or reproduction.
Sample Question:https://www.surveymonkey.com/r/QB61520

Source material: Use of exogenous gonadotropins forovulation induction in anovulatorywomen: a committee opinion Fertil Steril 2020;113:66–70
Intended audience: All
Description: This question bank reviews gonadotropin treatment for ovulation induction in anovulatory women and the rec­ommended pretreatment evaluation, indications, treatment regimens, and complications of gonadotropin treatment.
Sample Question: https://www.surveymonkey.com/r/QBDEC20

Source material: Using Family Members as Gamete Donors or Gestational Carriers: an Ethics Committee Opinion Fertil Steril 2017;107:1136–42
Intended audience: All
Description: Analysis and counseling for intrafamilial arrangements of gamete donors and gestational surrogates can be complicated. Try this question bank to learn more.

Source material: Obesity and reproduction: a Practice Committee opinion Fertil Steril
2015;104:1116–26
Intended audience: All (also available in Spanish)
Description: This question bank provides a comprehensive report on the principles and strategies for the evaluation of couples with infertility associated with obesity.

Source material: Fertility Drugs and Cancer: a guideline Fertil Steril
2016;106:1617–26
Intended audience: All
Description: This question bank focuses on the methodological limitations in studying the association between the use of fertility drugs and cancer. Given the available literature, patients should be counseled that infertile women may be at an increased risk of invasive ovarian, endometrial, and breast cancer; however, use of fertility drugs does not appear to increase this risk.
Sample Question: https://www.surveymonkey.com/r/N9LSLWX

Source material: Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion Fertil Steril 2018;110:380–6
Intended audience: All
Description: Chemotherapy and radiation therapy often result in reduced fertility. Patients receiving gonadotoxic treatment should be informed of options for fertility preservation and future reproduction prior to such treatment. Reproduction in the context of cancer also raises a number of ethical issues related to the welfare of both patients and offspring.
Sample Question:https://www.surveymonkey.com/r/QBMay21

Source material: Fertility treatment when theprognosis is very poor or futile: an Ethics Committee opinion Fertil Steril 2019;111:659–63
Intended audience: All
Description: This question bank explores the Ethics Committee's recommendations on the development of evidence-based policies that are patient-centered for each in vitro fertilization (IVF) center. In most cases, the provision of futile therapies is not ethically justifiable. For those treatments with very poor success rates, clinicians must be vigilant in their presentation of risks, benefits, and alternatives.
Sample Question: https://www.surveymonkey.com/r/QB0721

Source material: Infertility Workup for the Women’s Health Specialist Obstet Gynecol 2019;133:e377–84
Intended audience: All
Description: Infertility, defined as failure to achieve pregnancy within 12 months of unprotected intercourse or therapeutic donor insemination in women younger than 35 years or within 6 months in women older than 35 years, affects up to 15% of couples. This question bank explores the essential components of an initial workup, which include a review of the medical history, physical examination, and additional tests as indicated. This question bank is based on the Infertility workup for the woman’s health specialist: ACOG committee opinion.

Source material: Informing offspring of theirconception by gamete or embryodonation: an EthicsCommittee opinion Fertility and Sterility 2018; 109(4): 601-605.
Intended audience: All 
Description: The question bank explores the discussion of the ethical implications of informing offspring about their conception using gamete or embryo donation. It replaces the 2013 ASRM Ethics Committee document of the same name.

Source material: Interests, obligations, and rights ingamete and embryo donation: an Ethics Committee opinion Fertil Steril 2019;111:664–70
Intended audience: All
Description: This question bank reviews the interests, obligations, and rights of all parties involved in gamete and embryo donation: both males and females who choose to provide gametes or embryos for use by others, recipients of donated gametes and embryos, individuals born as a result of gamete or embryo donation, and the programs that provide donated gametes and embryos to patients.
Sample Question: https://www.surveymonkey.com/r/QBapr21

Source material: Interpretation of clinical trial results:a committee opinion Fertil Steril 2020;113:295–304
Intended audience: All
Description: This question bank reviews the guidance, background, and tips on how to recognize quality trials and focuses on evaluating the validity, importance, and relevance of clinical trial results.
Sample Question:https://www.surveymonkey.com/r/QBNOV20

Source material: Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a Practice Committee guideline Fertil Steril
2018;109:993–9
Intended audience: All
Description: This is a short 7-question bank that evaluates pregnancy and live-birth rates in patients expected to be poor responders using mild ovarian stimulation and natural-cycle protocols vs conventional IVF.
Sample Question: https://www.surveymonkey.com/r/NCFF27W

Source material: Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline Fertil Steril
2016;106:1634–47
Intended audience: All
Description: Ovarian hyperstimulation syndrome (OHSS) is an uncommon but serious complication associated with assisted reproductive technology (ART). This question bank explores the systematic review that aims to identify who is at high risk, how to prevent OHSS, and the treatment for existing OHSS.
Sample Question: https://www.surveymonkey.com/r/XBYXCTG

• Optimizing natural fertility: a committee opinion Fertil Steril 2017;107:52–8
• Current recommendations for vaccines for female infertility patients: a committee opinion Fertil Steril
  2018;110:838–41

Source material: Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome FertilSteril 2018;110:364–79
Intended audience: All
Description: This question bank explores the comprehensive evidence-based guideline that builds on prior high-quality guidelines and culminates from a rigorous, Appraisal of Guidelines for Research and Evaluation-II (AGREEII)-compliant, evidence-based guideline development process. It provides a single source of international evidence-based recommendations to guide clinical practice with the opportunity for adaptation in relevant health systems.
Sample Question: https://www.surveymonkey.com/r/NKYCQ2Y

Source material: Planned oocyte cryopreservation for women seeking to preserve future reproductive potential: an Ethics Committee opinion.
Webinar: Planned Oocyte Cryopreservation: Medical, Ethical and Social Considerations Fertil Steril 2018;110:1022–8
Intended audience: All 
Description: This question bank addresses an emerging but ethically permissible procedure that may help women avoid future infertility. Because planned OC is new and evolving, it is essential that women who are considering using it be informed about the uncertainties regarding its efficacy and long-term effects.
Sample Question: https://www.surveymonkey.com/r/NY6HP6P

Source material: LAB108: Preimplantation Genetic Testing (online course)
Intended audience: All
Description: Differentiation between the use of testing described as PGT-M, PGT-SR versus PGT-A and the application of each. A review of the different methodologies used in testing the embryo, with risks and benefits. Enroll to learn more.
Sample Question: https://www.surveymonkey.com/r/NQZ7KW8

Source material: Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline Fertil Steril
2017;108:416–25
Intended audience: All
Description: This question bank reviews the impact of uterine myomas and the likelihood of pregnancy and pregnancy loss, and if myomectomy influences pregnancy outcomes in asymptomatic women.
Sample question: https://www.surveymonkey.com/r/QB0321

Source material: Role of metformin for ovulation induction in infertile patients with polycystic ovary syndrome (PCOS): a Practice Committee guideline Fertil Steril
2017;108:426–41
Intended audience: All
Description: Does metformin alone compared with placebo increase the ovulation rate in women with PCOS? Are oral ovulation induction agents alone much more effective in increasing ovulation, pregnancy, and live-birth rates in women with PCOS? Enroll in this question bank to take a deeper dive.

Source material: Smoking and infertility: a Practice Committee opinion Fertil Steril
2018;110:611–8
Intended audience: All
Description: This question bank explores the reviews on the potential deleterious effects of smoking on conception and substantial harmful effects of cigarette smoke on fecundity and reproduction.
Sample Question: https://www.surveymonkey.com/r/NYYCLW2

Source material: Transferring embryos with genetic anomalies detected in preimplantation testing: an Ethics Committee Opinion Fertil Steril 2017;107:1130–5
Intended audience: All
Description: Patient requests for transfer of embryos with genetic anomalies linked to serious health-affecting disorders detected in preimplantation testing are rare but do exist. This Opinion sets out the possible rationales for a provider's decision to assist or decline to assist in such transfers. The Committee concludes in most clinical cases it is ethically permissible to assist or decline to assist in transferring such embryos. In circumstances in which a child is highly likely to be born with a life-threatening condition that causes severe and early debility with no possibility of reasonable function, provider transfer of such embryos is ethically problematic and highly discouraged.

Source material: Uterine Septum: a guideline Fertil Steril
2016;106:530–40
Intended audience: All
Description: The Uterine Septum guideline reviews the literature regarding septate uterus and determines optimal indications and methods of treatment for it.
Sample Question: https://www.surveymonkey.com/r/XFQW7ZT

Source material: Diagnosis and treatment of infertility in men
Target audience:Nurse Practitioners
Description: a. This question bank explores updated, evidence-based recommendations regarding evaluation of male infertility as well as the association of male infertility with other important health conditions, according to the diagnosis and treatment of infertility in Men: AUA/ASRM Guidelines and briefly examines recurrent pregnancy loss, DNA fragmentation and other genetic issues.
Author: Elizabeth Sanderman, RN

• Clinical Management of mosaic results from preimplantation genetic testing for aneuploidy (PGT-A) of blastocysts: a committee opinion (2020). F&S 114(2): 246-254.
• ASRM Ethics Committee Opinion: Transferring embryos with genetic anomalies detected in preimplantation testing (2017); F&S 107(5): 1130-1135.

Source material: Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion
Target audience: All
Description: This question bank reviews the counseling process regarding available options for fertility preservation for iatrogenic infertility for patients preparing to undergo gonadotoxic medical therapy, radiation therapy, or gonadectomy.
Author: Rebecca Brodie, RN

Source material: Carrier Screening for Genetic Conditions
Target audience: Nurse Practitioners
Description: This question bank reviews the recommendations and conclusions provided by The American College of Obstetricians and Gynecologists (the College) regarding carrier screening for genetic conditions.
Author: Svetlana Izrailevsky, RN

Source material: Resident Education Module RES000: Pediatric Gynecology
Target audience:All
Description:The most common pediatric gynecologic problem is vulvovaginitis. This condition is an inflammation of the vulvar and vaginal tissue, and accounts for as many as 50% of outpatient pediatric gynecologic visits. This question bank is based on RES000 Pediatric Gynecology course.
Link to QBoost Bank: https://asrm.qstream.com/courses/35954.

Source material: CREOG Unit 5, Reproductive Endocrinology, Section IV: Infertility, Subsection A: Infertility Evaluation
Target audience: ObGyn Residents
Description: This question bank reviews the OBGyn Resident course work on Infertility Evaluation - Part I

• Describe the classification and principal causes of infertility.
• Elicit a pertinent history and list the components of a focused physical examination to evaluate infertility.
• Select and interpret diagnostic tests to determine the most likely cause of infertility.
• Describe appropriate treatment for infertile patients who have irregular ovulation with nongonadotropin therapy.
• Describe appropriate surgical procedures to correct anatomic conditions that cause infertility.
• Counsel patients about the prognosis for their condition and alternatives to childbearing such as adoption, donor gametes, and use of a surrogate or gestational carrier.
• Describe the indications for referral to a subspecialist for treatment.

Source material: CREOG Unit 5, Reproductive Endocrinology, Section IV: Infertility, Subsection A: Infertility Evaluation
Target audience: ObGyn Residents
Description: This question bank reviews the OBGyn Resident course work on Infertility Evaluation - Part II

• Describe the classification and principal causes of infertility.
• Elicit a pertinent history and list the components of a focused physical examination to evaluate infertility.
• Select and interpret diagnostic tests to determine the most likely cause of infertility.
• Describe appropriate treatment for infertile patients who have irregular ovulation with nongonadotropin therapy.
• Describe appropriate surgical procedures to correct anatomic conditions that cause infertility.
• Counsel patients about the prognosis for their condition and alternatives to childbearing such as adoption, donor gametes, and use of a surrogate or gestational carrier.
• Describe the indications for referral to a subspecialist for treatment.

STEP 1: To get started, you will need to login into your ASRM membership account. Click on the ‘Sign up/ Sign in for ASRM QBoost’ tab at the top of this page or click on ‘Access your account’ tab on the right side of this page.

STEP 2: On the QStream page, to sign up as a first-time user, enter your email address (use a personal one like a Gmail or Yahoo), enter your password and confirm, your first and last name. Click Sign in to create an account on the question bank platform, QStream.

Click on the “Complete Registration” link provided to you by email. To keep it simple, you may want to enter the same password you use for the ASRM website. We also recommend that you bookmark the QStream link for easy access.

There are a few extra steps to enroll in a question bank:

Step 1: On the left panel on the QStream page click ‘Browse the QStream directory’, this will open a page with question banks, to see the full suite of banks available, click ‘Browse all QStreams’.

Place your mouse over each bank and hover over them to read a snapshot of the question bank and if its intended for you (some are resident question banks).

Click on a question bank of your choice, click ‘Enroll now for FREE’, on the next page you’ll review your notification options, and click ‘Enroll’ (at the bottom of the page).

Remember to enroll in ONE question bank at a time to avoid being deluged by multiple email/ app notifications.

Please contact Sarah Ramaiah at sramaiah@asrm.org for any issues with login, password reset or problems enrolling in a new bank.

There are 3 steps before you download the APP:

Step 1: Register – sign up for ASRM QBoost
Step 2: Enroll in a question bank
Step 3: Go to the APP STORE/ PLAY STORE
Search QSTREAM
Click GET/ DOWNLOAD

To activate or deactivate email/ app notification, you can log into your QStream account and click on ‘Update notification settings.’ Here you can choose the appropriate option.

If at any time, you want to turn off push notifications, you can do so from your device settings. However, if you only want to suspend questions on the weekend or while on vacation, it is recommended that you log in to your QStream account online, click on My Dashboard, and then Account Settings. Here you can opt in or out of weekend notifications or click the Update Notification Settings button to schedule a vacation hold. Taking this step allows you suspend push notifications without permanently turning them off.

When you set up the app for the first time, you’ll be asked if you want to allow push notifications. A push notification alerts you when questions in your question bank are available to answer by displaying them on your home screen. We recommend allowing push notifications because the only action you need to take is swiping the question and marking your response.

Push notifications tell you when you have new questions. If your push notification disappears, don’t worry. You can still answer questions by opening the QStream app, tapping the menu icon, and looking under Today’s Questions.

To view the detailed QStream report, log into your QStream account, click on ‘My Dashboard’ and on the right under your progress section click on ‘View detailed report’ which provides a detailed description of the questions you have answered, the answer status, result and date/ time of taking the questions.