ACTIVITY TITLE: Nurse Certificate Course in Reproductive Endocrinology and Infertility

Nurses comprise a large and integral part of the REI medical team, yet no standardized course of study is available to train new nurses or further the education of experienced nurses in the field.  In a survey of REI nurses in 2005 by the Nurses' Professional Group (NPG) of ASRM, 80 percent of nurses reported that on-the-job training best described their preparation as a new nurse in the field. Further, they reported that the majority of their continuing education training was via pharmaceutical company-provided education.  

The REI nurse role requires structured orientation to the clinical setting and demonstrated competence in the specialty through education, emotional preparation, support and mentoring.   This content of the 16 modules contained in the Nurse Certificate Course provides core theoretical and practical knowledge specific to the clinical area of REI practice, addresses minimum competency needs, and provides evidence-based training for new and experienced nurses in the field.  This evidence-based content will assist nurses to function in their roles safely and proficiently, ultimately contributing to improved quality of care and patient outcomes.

Course Outline:

1. Female Reproductive Anatomy and Physiology

2. Causes of Female Infertility

3. Male Reproductive Anatomy and Physiology

4. Causes of Male Infertility

5. Female Infertility Workup and Testing

6. Male Infertility Workup and Testing

7. Female Infertility Pharmacotherapy                               

8. Female Stimulation Protocols                                            

9. Male Infertility Treatment                                                   

10. ART Treatments and Procedures                                     

11. Additional ART Treatments and Procedures                

12. Management of Early Pregnancy                                       

13. Genetics                                                                                       

14. Gamete and Embryo Donation and Gestational Carrier Use            

15. Psychological Issues and Counseling of Third Party Reproduction       

16. Ethical and Legal Issues in Infertility Treatment

EDUCATIONAL OBJECTIVES

At the conclusion of this presentation, participants should be able to:

1. Describe female and male reproductive anatomy and physiology, with emphasis on the hormonal and functional changes involved in gamete production, fertilization, and implantation.
2. Identify the causes of female and male infertility and describe appropriate workup, testing and treatment.
3. Identify the pharmacologic agents used in hormonal and infertility treatment of females and males and explain their mechanisms of action.
4. Select the appropriate pharmacotherapy protocols for ovulation induction and controlled ovarian stimulation cycles based on patient response.
5. Discuss assisted reproductive technologies, including IVF and embryo transfer, intracytoplasmic sperm injection, sperm preparation techniques, and embryo cryopreservation, as well as indications and protocols for these procedures.
6. Describe the physiology of first trimester embryo and fetal development, monitoring of infertility therapy-conceived pregnancies, components of patient education and counseling, issues related to multiple gestation, and management of early pregnancy loss.
7. Identify patients at increased risk of genetic disorders, and common indications and techniques for genetic screening, testing and counseling.
8. Define third party reproduction and identify appropriate screening, informed consent and counseling, compensation and cycle synchronization for gamete and embryo donation and surrogacy.
9. Summarize principles of bioethics, and discuss ethical dilemmas, legal issues, and religious traditions as they apply to infertility treatment.

INTENDED AUDIENCE

This educational activity is designed for nurses and nurse practitioners in reproductive endocrinology and infertility who meet the following criteria: hold a current, active nursing license in a state or territory of the United States or the professional, legally recognized equivalent in another country, and have a minimum of 2000 hours of experience as a registered professional nurse and a minimum of 1000 hours in women's health.  

SUCCESSFUL COMPLETION REQUIREMENTS

Successful completion of the Reproductive Endocrinology and Infertility Nurse Certificate Course requires the learner to:

• Meet the stated criteria of holding a current, active nursing license in a state or territory of the United States or the professional, legally recognized equivalent in another country, and having a minimum of 2000 hours of experience as a registered professional nurse and a minimum of 1000 hours in women's health.  
• Complete the entire series of 16 modules.
• Read the course overview page containing all CE and disclosure information, including acknowledgement of commercial support prior to the start of each activity.
• Download and print, if desired, a syllabus containing the presentation, narrative, and exam questions.
• Complete a 10-question pre-exam prior to each module.
• Participate in the interactive activity by listening to the audio narration that is synchronized with the PowerPoint presentation; this can be stopped, reversed, or advanced as desired.
• Complete a post-exam after each lesson with feedback of correct/incorrect answers, with a minimum score of 70 percent correct in two attempts.
• Complete the evaluation survey.
• Print certificate of completion.

DISCLOSURES FOR PLANNERS AND FACULTY:

Planners

Nancy Bowers, B.S.N.,M.P.H.,R.N. - Nothing to Disclose
Maria Jackson, R.N. - Consultant for Walgreens
Andrew La Barbera, Ph.D. - Nothing to Disclose
Robert Rebar, M.D. - Nothing to Disclose
Angela Smith, B.S.,Ed.D.,M.A.,N.P. - Nursing Advisory Board of Schering-Plough

Content Development and Review

·        Ruben Alvero, MD - Consultant: Cooper Surgical

·        Jodie L. Asher – Employee: Integrated Genetics

·        Valerie L. Baker – Institutional Support from IBSA

·        Samantha Butts, MD - Nothing to Disclose

·        Bruce Carr, MD – Grant/Research: Evofem, Abbott, Medicines360, Merck

·        Charles C. Coddington, MD -  Ownership/Stock: Gilead, Proctor and Gamble, Merck

·        William Catherino, MD – Research/Speaker for EMD Serono; Grant/Research for Bayer and Schering Pharma

·        Owen K. Davis, MD – Nothing to Disclose

·        Michael Eisenberg, MD – Consultant: Sandstone Diagnostics, Reprovantage, Galapagos, Abbvie

·        Leslie Francis, JD, PhD –  Independent Contractor and Advisory Board for Amgen

·        Elizabeth Grill, PsyD - Nothing to Disclose

·        Clarisa Gracia, MD  - Nothing to Disclose

·        Emily Jungheim, MD – Consultant: Abbvie, Genentech, Spectrum Pharmaceuticals, Celgene

·        Sigal Klipstein, MD – Nothing to Disclose

·        Sacha Krieg M.D.,Ph.D. – Nothing to Disclose

·        Benjamin Lannon, MD - Stock ownership: Dyax Corporation

·        Mark Licht, MD - Nothing to Disclose

·        Janet McLaren Bouknight, MD - Nothing to Disclose

·        Samantha M. Pfeifer, MD – Consultant: Best Doctors

·        Thomas Price, MD – Grant/Research: Bayer Pharmaceutical, Vivere Health; Consultant: GuidePoint, MedaCorp, Gerson Lehman Group, Best Doctors Consultant

·        Gail S. Prins, PhD, HCLD - Nothing to Disclose

·        Elizabeth Puscheck, MD  -  Research Grants for Wyeth and Ethicon

·        Richard H. Reindollar, MD – Nothing to Disclose

·        Ginny L. Ryan, MD, MA - Nothing to Disclose

·        Jay Sandlow, MD - Nothing to Disclose

·        David Shin, MD - Speaker's Bureau: Endo Pharmaceutical

·        James F. Smith, MD - Nothing to Disclose

·        Steven J. Sondheimer, MD – Speakers Bureau: Schering-Plough/Merck, Bayer

·        Laurel Stadtmauer, MD – Speakers Bureau: Watson Pharmaceuticals

·        Helen Tempest, PhD – Nothing to Disclose

·        Michael A. Thomas, MD – Consultant for Watson Pharmaceuticals; Grant/research:  Ferring, Medicines 360, Berlex, EvoFem

·        Thomas Toth, MD – Consultant: Good Start Genetics

·        Angela Trepanier, MS, CGC – Nothing to Disclose

·        Carin Yates, MS, CGC - Nothing to Disclose

·        Eric Widra, MD – Stock Ownership – SG Patent Holdings, LLC; Consultant: Natera, Counsyl

DISCLOSURE OF UNLABELED USE

This presentation may contain discussion of unlabeled uses of a commercial product or an investigative use of a product not yet approved by the FDA for this purpose.

Disclaimer Information
The content and views presented in this educational activity are those of the faculty/authors and do not necessarily reflect those of the American Society for Reproductive Medicine. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity to make clinical decisions about individual patients.

Commercial Support Acknowledgement
This program is supported by an educational grant from Schering Corporation, a subsidiary of Merck & Co., Inc.