- Email: [email protected]
A study of perceptions, experiences, and satisfaction with healthcare among women with polycystic ovary syndrome (PCOS)
CONCLUSION: We did not confirm a perceived benefit of faster return to fertility treatment for surgically managed patients. While medical treatment did not delay the average time, a significant number of patients suffered from retained POC and required a D&C. It is important for providers to discuss with their patients the benefits and risks associated with both treatments. Although a D&C is more likely to provide POC for karyotyping, medical management of miscarriage is a viable alternative in patients undergoing reproductive treatment.
O-21 Monday, October 25, 2010 05:30 PM A STUDY OF PERCEPTIONS, EXPERIENCES, AND SATISFACTION WITH HEALTHCARE AMONG WOMEN WITH POLYCYSTIC OVARY SYNDROME (PCOS). E. W. Sterling, T. Vincent, C. DeZarn, M. Perloe. My Fertility Plan, Marietta, GA; Georgia Reproductive Specialists, Atlanta, GA; PCOS Association, Englewood, CO. OBJECTIVE: To evaluate PCOS patients’ perceptions, experiences and satisfaction regarding healthcare in terms of the diagnosis, treatment and management of their condition. DESIGN: Using an online survey, 1,555 women with PCOS completed questions about demographics; general health; reproductive and menstrual history; healthcare; knowledge; diagnosis; symptoms; coping; and treatment. MATERIALS AND METHODS: Through descriptive analyses and Pearson chi-square tests, we described patients regarding their perceptions, experiences and satisfaction with diagnosis, treatment, and management, as well as differences among those who sought care from various healthcare providers. RESULTS: On average, it took 31.3 months to receive a PCOS diagnosis with nearly 30% visiting 4 or more doctors. Weight issues were the most important problem for seeking care. Over the past 12 months, 55.1% of patients saw an ob/gyn followed by family practitioner (35.4%), medical endocrinologist (17.3%) and RE (16.3%). Using a five-point Likert scale (with 5 being excellent), patients seeing an RE were most satisfied with their healthcare (3.7). These patients reported higher levels of satisfaction with regard to referrals made to other healthcare providers (p< .05). Medical endocrinologists received an average rating of 3.3 with patients being most satisfied with dietary counseling (p< .01) and feeling well-cared for (p< .05). Ob/gyns were rated 3.2, and patients were most satisfied with their provider’s knowledge about PCOS (p< .05). Family practitioners were rated the lowest (2.8). Patients were especially dissatisfied with the lack multiple treatment options (p< .05) and not feeling well cared for (p< .05). CONCLUSION: PCOS is a complex condition requiring a multi-disciplinary medical approach. Is important that we further investigate ways to integrate the strengths of all involved medical disciplines to develop a comprehensive standard of care that will best meet the needs of PCOS patients and effectively address the myriad of symptoms they experience.
O-22 Monday, October 25, 2010 05:45 PM EFFECT OF REMOTE ACCESS E-LEARNING MODULES ON CLINICAL OUTCOMES AND ORGANIZATIONAL EFFICIENCY. C. M. Bergh, A. McGuire, P. A. Bergh, R. T. Scott. Reproductive Medicine Associates of New Jersey, Morristown, NJ; Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ. OBJECTIVE: Pre-IVF education classes (including medication training) are an important part of the process which prepares patients for IVF. This study seeks to determine if e-Learning (EL) patient education modules may be effectively substituted for the traditional face-to-face teaching methods while maintaining the effectiveness of the teaching process. DESIGN: Retrospective. MATERIALS AND METHODS: The electronic medical record database was queried to identify all patients who cycled between January 1, 2006 and December 31, 2009. Patients undergoing their first IVF cycle were selected for further evaluation. Prior to December 2008, patients underwent preIVF education with a scheduled traditional learning (TL) education class. Thereafter, patients received medication and related pre-IVF education via an internet based e-Learning (EL) module. Primary effectiveness of the ed-
FERTILITY & STERILITYÒ
ucational processes was evaluated by comparing the time between the decision to undergo IVF and the administration of the first injectable gonadotropins. Secondary endpoints include the probability of a patient withdrawing from the planned treatment prior to initiating treatment (drop out) or subsequent cancellation rates secondary to medication errors. Two-tailed t tests with equal variances and chi square were employed for data analysis. RESULTS: 1,479 patients were selected for further study. There was no demonstrated difference in how long it took to get patients prepared and into treatment once their cycle plan was in place. Drop out rates were equivalent prior to cycle start for both groups (TL: 113 of 806, 14.0%; EL: 93 of 673,13.8%). In addition, two patients, one from each group were withdrawn due to incorrect medication administration. Patients with EL (n¼673) completed their pre-IVF learning significantly closer to their actual cycle start (p% .001, 23.74 days 21.55 days) than their peers in the TL group (n¼806) (30.29 days 25.82 days). CONCLUSION: EL and TL are equally effective and can be successfully integrated into an ART program.
O-23 Monday, October 25, 2010 06:00 PM THE MEN’S LOUNGE IMPROVEMENT PROJECT – DID WE GET IT RIGHT? S. Levy, B. Campbell. The Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital, Boston, MA. OBJECTIVE: To evaluate the satisfaction with changes made in the semen collection room of our IVF program in response to a prior survey. DESIGN: Prospective anonymous survey using a convenience sample of men using the room within the study time frame. MATERIALS AND METHODS: 12 question anonymous survey. 7 questions - positive statements about the room, responses on 4-point Likert scale agree 4,3 or disagree 2,1. 1 question, compare this room to other collection rooms – better 3, same 2, worse 1. Men in first cycles were asked if the new pamphlet For the Male Partner in IVF: What to Expect was satisfactory. Each question had room for comment. Demographic information: age & length of involvement in infertility treatments. February 1– April 21, 2010, on the day of their partner’s egg retrieval, men were offered the survey after using the room. They placed the surveys in a collection box. 100 surveys were collected. 48 men made 93 comments. Comments were grouped by question and overall themes. The survey was compared to the survey taken prior to the changes (100 respondents). The changes were: new chair, better sense of cleanliness, consistent media, air purifier to add white noise, and a new pamphlet. RESULTS: Demographics: 95% of men remain 30-49 years old; length of infertility fairly evenly divided: <1year (37% vs 33%), 1 year (14% vs 25%), 2 years (21% vs 17%), >2 years (28% vs 25%). Men were satisfied overall with the room (3.5 vs 3.2). 36 men rated the new pamphlet an average of 3.3. Average scores for furnishings rose from 3.0 to 3.4 and sound privacy from 2.8 to 3.3. Compared to other collection rooms, men continue to rated the room an average of 2.5. 48% vs 67% of the men made comments. There were 93 vs 173 comments; 16 of them positive vs 2. Themes from the comments targeted sound privacy and the quality of the media. CONCLUSION: This group of men expressed over all satisfaction with the room. The new Men’s pamphlet was well received. Areas of concern continue to be sound privacy and the media.
REPRODUCTIVE BIOLOGY PROFESSIONAL GROUP O-24 Monday, October 25, 2010 04:15 PM ESTABLISHMENT AND CHARACTERIZATION OF HUMAN GERM CELLS DERIVED FROM EMBRYONIC STEM CELLS (hESCs). N. D. Tran, D. Laird, M. Kissner, D. Supramanyam, M. Conti, R. Blelloch. Obstetrics and Gynecology, Center for Reproductive Sciences, University of California, San Francisco Medical Centre, San Francisco, CA. OBJECTIVE: The ability to generate germ cells from hESCs represents a potential treatment for patients with infertility as well as an essential means of studying the mechanism of germ cell differentiation. The aim of this study is to investigate the feasibility of efficient production of human primordial germ cells (PGCs) from hESCs. DESIGN: In vitro cell culture. MATERIALS AND METHODS: H9 hESCs were co-cultured with MEFs in an optimized media. Cell colonies were stained with germ
S7
O-21 Monday, October 25, 2010 05:30 PM A STUDY OF PERCEPTIONS, EXPERIENCES, AND SATISFACTION WITH HEALTHCARE AMONG WOMEN WITH POLYCYSTIC OVARY SYNDROME (PCOS). E. W. Sterling, T. Vincent, C. DeZarn, M. Perloe. My Fertility Plan, Marietta, GA; Georgia Reproductive Specialists, Atlanta, GA; PCOS Association, Englewood, CO. OBJECTIVE: To evaluate PCOS patients’ perceptions, experiences and satisfaction regarding healthcare in terms of the diagnosis, treatment and management of their condition. DESIGN: Using an online survey, 1,555 women with PCOS completed questions about demographics; general health; reproductive and menstrual history; healthcare; knowledge; diagnosis; symptoms; coping; and treatment. MATERIALS AND METHODS: Through descriptive analyses and Pearson chi-square tests, we described patients regarding their perceptions, experiences and satisfaction with diagnosis, treatment, and management, as well as differences among those who sought care from various healthcare providers. RESULTS: On average, it took 31.3 months to receive a PCOS diagnosis with nearly 30% visiting 4 or more doctors. Weight issues were the most important problem for seeking care. Over the past 12 months, 55.1% of patients saw an ob/gyn followed by family practitioner (35.4%), medical endocrinologist (17.3%) and RE (16.3%). Using a five-point Likert scale (with 5 being excellent), patients seeing an RE were most satisfied with their healthcare (3.7). These patients reported higher levels of satisfaction with regard to referrals made to other healthcare providers (p< .05). Medical endocrinologists received an average rating of 3.3 with patients being most satisfied with dietary counseling (p< .01) and feeling well-cared for (p< .05). Ob/gyns were rated 3.2, and patients were most satisfied with their provider’s knowledge about PCOS (p< .05). Family practitioners were rated the lowest (2.8). Patients were especially dissatisfied with the lack multiple treatment options (p< .05) and not feeling well cared for (p< .05). CONCLUSION: PCOS is a complex condition requiring a multi-disciplinary medical approach. Is important that we further investigate ways to integrate the strengths of all involved medical disciplines to develop a comprehensive standard of care that will best meet the needs of PCOS patients and effectively address the myriad of symptoms they experience.
O-22 Monday, October 25, 2010 05:45 PM EFFECT OF REMOTE ACCESS E-LEARNING MODULES ON CLINICAL OUTCOMES AND ORGANIZATIONAL EFFICIENCY. C. M. Bergh, A. McGuire, P. A. Bergh, R. T. Scott. Reproductive Medicine Associates of New Jersey, Morristown, NJ; Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ. OBJECTIVE: Pre-IVF education classes (including medication training) are an important part of the process which prepares patients for IVF. This study seeks to determine if e-Learning (EL) patient education modules may be effectively substituted for the traditional face-to-face teaching methods while maintaining the effectiveness of the teaching process. DESIGN: Retrospective. MATERIALS AND METHODS: The electronic medical record database was queried to identify all patients who cycled between January 1, 2006 and December 31, 2009. Patients undergoing their first IVF cycle were selected for further evaluation. Prior to December 2008, patients underwent preIVF education with a scheduled traditional learning (TL) education class. Thereafter, patients received medication and related pre-IVF education via an internet based e-Learning (EL) module. Primary effectiveness of the ed-
FERTILITY & STERILITYÒ
ucational processes was evaluated by comparing the time between the decision to undergo IVF and the administration of the first injectable gonadotropins. Secondary endpoints include the probability of a patient withdrawing from the planned treatment prior to initiating treatment (drop out) or subsequent cancellation rates secondary to medication errors. Two-tailed t tests with equal variances and chi square were employed for data analysis. RESULTS: 1,479 patients were selected for further study. There was no demonstrated difference in how long it took to get patients prepared and into treatment once their cycle plan was in place. Drop out rates were equivalent prior to cycle start for both groups (TL: 113 of 806, 14.0%; EL: 93 of 673,13.8%). In addition, two patients, one from each group were withdrawn due to incorrect medication administration. Patients with EL (n¼673) completed their pre-IVF learning significantly closer to their actual cycle start (p% .001, 23.74 days 21.55 days) than their peers in the TL group (n¼806) (30.29 days 25.82 days). CONCLUSION: EL and TL are equally effective and can be successfully integrated into an ART program.
O-23 Monday, October 25, 2010 06:00 PM THE MEN’S LOUNGE IMPROVEMENT PROJECT – DID WE GET IT RIGHT? S. Levy, B. Campbell. The Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital, Boston, MA. OBJECTIVE: To evaluate the satisfaction with changes made in the semen collection room of our IVF program in response to a prior survey. DESIGN: Prospective anonymous survey using a convenience sample of men using the room within the study time frame. MATERIALS AND METHODS: 12 question anonymous survey. 7 questions - positive statements about the room, responses on 4-point Likert scale agree 4,3 or disagree 2,1. 1 question, compare this room to other collection rooms – better 3, same 2, worse 1. Men in first cycles were asked if the new pamphlet For the Male Partner in IVF: What to Expect was satisfactory. Each question had room for comment. Demographic information: age & length of involvement in infertility treatments. February 1– April 21, 2010, on the day of their partner’s egg retrieval, men were offered the survey after using the room. They placed the surveys in a collection box. 100 surveys were collected. 48 men made 93 comments. Comments were grouped by question and overall themes. The survey was compared to the survey taken prior to the changes (100 respondents). The changes were: new chair, better sense of cleanliness, consistent media, air purifier to add white noise, and a new pamphlet. RESULTS: Demographics: 95% of men remain 30-49 years old; length of infertility fairly evenly divided: <1year (37% vs 33%), 1 year (14% vs 25%), 2 years (21% vs 17%), >2 years (28% vs 25%). Men were satisfied overall with the room (3.5 vs 3.2). 36 men rated the new pamphlet an average of 3.3. Average scores for furnishings rose from 3.0 to 3.4 and sound privacy from 2.8 to 3.3. Compared to other collection rooms, men continue to rated the room an average of 2.5. 48% vs 67% of the men made comments. There were 93 vs 173 comments; 16 of them positive vs 2. Themes from the comments targeted sound privacy and the quality of the media. CONCLUSION: This group of men expressed over all satisfaction with the room. The new Men’s pamphlet was well received. Areas of concern continue to be sound privacy and the media.
REPRODUCTIVE BIOLOGY PROFESSIONAL GROUP O-24 Monday, October 25, 2010 04:15 PM ESTABLISHMENT AND CHARACTERIZATION OF HUMAN GERM CELLS DERIVED FROM EMBRYONIC STEM CELLS (hESCs). N. D. Tran, D. Laird, M. Kissner, D. Supramanyam, M. Conti, R. Blelloch. Obstetrics and Gynecology, Center for Reproductive Sciences, University of California, San Francisco Medical Centre, San Francisco, CA. OBJECTIVE: The ability to generate germ cells from hESCs represents a potential treatment for patients with infertility as well as an essential means of studying the mechanism of germ cell differentiation. The aim of this study is to investigate the feasibility of efficient production of human primordial germ cells (PGCs) from hESCs. DESIGN: In vitro cell culture. MATERIALS AND METHODS: H9 hESCs were co-cultured with MEFs in an optimized media. Cell colonies were stained with germ
S7