ACTIVITY NUMBER: RBP002

ACTIVITY TITLE: Developmental Anomalies of the Urogenital Tract

ACCREDITATION STATEMENT

The American Society for Reproductive Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Release Date:  October 1, 2012

Reviewed: 2015, August 2022, September 2025

Expiration Date: March 31, 2029

Estimated Time to Complete Activity: 1.0 hour

NEEDS ASSESSMENT and IDENTIFICATION OF PRACTICE GAP

Developmental abnormalities of the female reproductive tract are common and occur as consequences of genetic errors or teratogenic events during embryonic development.  Abnormalities range from minor external manifestations to major organ and endocrine involvement that severely impacts menstrual and reproductive functions. The incidence of Müllerian anomalies is 1% to 3%.  Abnormalities may be evident at birth, or may not manifest until puberty, the onset of menstruation or with pregnancy.  Depending on the lifestage, such anomalies can have profound psychological effects on parents, the child or adolescent, or a couple desiring to have children.  Physicians must be able to accurately diagnosis and treat these disorders and be skilled in patient communication and education because of the long-term implications. In a 2008 survey of practicing reproductive care physicians, fewer than 5% could correctly identify the optimal treatment for complete androgen insensitivity syndrome; they also could not correctly identify the roles for reproductive endocrinologists in collaborative care of children affected by developmental sex disorders.  Thus, this educational content is even more needed for resident physicians in training.

This educational activity is designed to address the Unit 5 Reproductive Endocrinology educational objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG) on this topic.

EDUCATIONAL OBJECTIVES

At the conclusion of the educational activity, participants should be able to:

1.       Describe the major developmental anomalies

2.       Understand the implications of various anomalies on sexual function, menstruation, fertility, and reproductive outcome.

3.       Discuss the genetic components of müllerian development.

4.       Describe and list the features of a patient’s history suggestive of a developmental anomaly of the urogenital tract.

5.       Interpret tests to confirm the diagnosis of a developmental anomaly, its etiology, and its potential clinical implications.

6.       Describe appropriate medical and surgical treatments for patients with developmental anomalies by classification.

TARGET AUDIENCE

This activity is designed to meet the educational needs of resident physicians in obstetrics and gynecology and other related specialties.

ACGME COMPETENCIES

Medical Knowledge

Patient Care

Interpersonal and Communication Skills

SUCCESSFUL COMPLETION REQUIREMENTS

Successful completion of this educational activity requires the learner to:

·         View a course overview page, containing all CME and disclosure information, including acknowledgement of commercial support and disclosure of unlabeled use, prior to the start of each module.

·         Complete a 10-question pre-exam prior to the module. Learners should note any pre-exam questions answered incorrectly for clarification during module study.  

·         Be given the option of downloading a printed syllabus containing the presentation and narrative.

·         Participate in the interactive activity: Audio narration is synchronized with PowerPoint presentation that can be advanced, stopped or reversed as desired.

·         Complete a 10-question post-exam, with feedback of correct/incorrect answers, scoring a minimum of 70% in two attempts.

·         Complete the evaluation survey.

·         Print certificate of completion.

DISCLOSURE STATEMENT

It is the policy of ASRM to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty/speakers participating in this activity are required to disclose any relationships they may have with companies whose products or services could be mentioned, allowing participants to determine the objectivity of the presentations. The content and views presented in this activity are those of the faculty/speakers and do not necessarily reflect those of ASRM. Any discussion of the off-label, experimental, or investigational use of drugs or devices is not allowed. The disclosure statements were reviewed by the CME Subcommittee and the Executive Program Committee of ASRM, and any perceived conflicts of interest were resolved in accordance with the ACCME’s policies and Standards of Integrity and Independence in Accredited Continuing Education.

PRIOR CONTRIBUTORS AND REVIEWERS

Ruben J.  Alvero, MD – Nothing to Disclose

Alicia Y. Armstrong, MD  – Nothing to Disclose

Valerie Baker, MD  – Institutional Support from IBSA

Nancy A. Bowers, BSN, RN, MPH  – Nothing to Disclose

Bruce R. Carr, MD – Research support from Wyeth, Neurocrine, Boehringer Ingelheim; Consultant for Novo Nordisk 

Marcelle I. Cedars, MD  – Nothing to Disclose

Marc Goldstein, MD – Advisory Board: Theralogix

Elizabeth A. Grill, PsyD – Nothing to Disclose

Andrew R. La Barbera, PhD, HCLD  – Nothing to Disclose

Lawrence C. Layman, MD – Nothing to Disclose

Meredith Loveless, MD – Nothing to Disclose

Janet McLaren, MD – Nothing to Disclose

Patricia M. McShane, MD – Nothing to Disclose

Shona C. Murray, MD - Nothing to Disclose

Steven T.  Nakajima, MD –Consultant, research support, speaker’s bureau for Warner Chilcott; Stockholder for IntegraMed

Staci E. Pollack, MD – Nothing to Disclose

Randal D. Robinson, MD - Speaker’s bureau for Merck and Teva

Richard H. Reindollar, MD – Nothing to Disclose

Nanette Santoro, MD – Consultant for QuatRx

James H. Segars, MD – Nothing to Disclose

Mary D. Stephenson, MD, MSc –  Consultant for NoraTherapeutics

Kim L. Thornton, MD – Consultant for Parexel

James P. Toner, M.D., Ph.D. -  Research support from Columbia Laboratories

Mark Trolice, MD – Cryos International – Paid Consultant (Self); Alto Pharmacy – Direct Stockholder (Self)

Ellen Wilson, MD – Nothing to Disclose

Bo Yu, MD – Nothing to Disclose

2025 CONTENT DEVELOPERS

Heather Burks – Pacific Coast Reproductive Society – Board of Directors (Self)

LaTasha Craig — Ferring Pharmaceuticals – Paid Consultant (Self)

Rani Fritz, MD – Cradle Genomics – Medical Advisory Board (Self)

Ryan Heitmann –  Nothing to Disclose

Sarah Hmaidan – Nothing to Disclose

Bradley S. Hurst, MD – Nothing to Disclose

Patricia Jiminez, MD – Society for Reproductive Investigation – Member of DEI, Early Career, and CME committee*

Molly Kornfield – Nothing to Disclose

Dab Lebovic – Ferring Pharmaceutical – Paid Consultant (Self)

Nora Miller, MD – Nothing to Disclose

Ariya Mobaraki, MD – Nothing to Disclose

Amalia Namath, MD – Nothing to Disclose

Chioma Ogbejesi – Nothing to Disclose

Pamela Parker, MD – Nothing to Disclose

Jensen Reckhow, MD – Nothing to Disclose

2025 COURSE REVIEWERS (* beta-test participant reviewer; not responsible for content)

Heather Hipp, MD – Nothing to Disclose

Paul Lin, MD – Nothing to Disclose

Winifred Mak, MD – Nothing to Disclose *

Pamela Parker, MD – Nothing to Disclose

Julie Rios, MD – Nothing to Disclose *

Divah Shah, MD – Nothing to Disclose

Mark Trolice, MD – Cryos Internation – Paid Consultant (Self); Alto Pharmacy – Direct Stockholder (Self)

David Walker – Nothing to Disclose

ADDITIONAL PRESENTERS AND RESOURCES

David Lee, MD – Nothing to Disclose

ASRM STAFF PLANNERS AND DEVELOPERS

Deidra Cain, DrPH, EdD – (former staff)

Michelle Landrum, EdD – (former staff)

Chevis Shannon, DrPH, MBA – Nothing to Disclose

Harriet Smith, M.Ed - Nothing to Disclose

STATEMENT OF SUPPORT

No commercial support has been provided for this activity.