Obstetrics and Gynecology
Walter Reed Army Medical Center
National Naval Medical Center
IVF / ICSI / GIFT
The Division of Reproductive Endocrinology of the National Capital Residency Program in
Obstetrics and Gynecology initiated an Advanced Reproductive Technology (ART) program that
began January 1996. It offers In Vitro Fertilization (IVF), Gamete Intra Fallopian Transfer
(GIFT), and Intracytoplasmic Sperm Injection (ICSI).
Our program utilizes an independent contractor to provide our embryology services. Because of
this collaboration, all patients are required to pay for the laboratory services prior to starting the
treatment. This cost is approximately $3500 to $5000.00. You may also be required to provide a
portion of your fertility medications, which may cost another $50-150. Detailed financial
information can be obtained by calling (202) 782-9244.
Not all infertility patients require IVF for their treatment. Many conditions may be treated with
simpler and less expensive modalities. If you are unsure whether you need IVF, you should
consult your local gynecologist before applying to our program.
Unfortunately, not everyone is a candidate for our program. Women who are age 42 or older
have little chance for success with conventional IVF and will not be accepted. Women who do
not have a uterus or who have no functioning ovaries also are not candidates. Significant medical
problems can be a reason for exclusion; such conditions should be evaluated by the patient’s
primary physician and /or obstetrician to determine whether their health may be worsened by
pregnancy or the IVF procedure itself. We are happy to care for you at Walter Reed Army
Medical Center during your evaluation and we sincerely hope that it will be a rewarding
experience. We also recognize that this may be an anxiety –producing time for you. Remember
that our primary purpose is to serve you. We can do a better job if you understand why we do
what we do. Some general explanations are included in this booklet that, in conjunction with
your clinic visits will answer most of your questions. There are many other resources available
such as books, magazines, support groups and the Internet. It is very important that you
understand that some of what you may read in these sources may be opinion and not entirely
based on good data. Our training is long and rigorous precisely so that we can help guide your
evaluation and treatment in the most efficient manner possible. It is very important that you are
an active participant in your care. Together, we hope to help you achieve your goal of a happy
and healthy child.
Division of Reproductive Endocrinology and Infertility
Walter Reed Army Medical Center
The Division of Reproductive Endocrinology and Infertility is the branch of the Department of
Obstetrics and Gynecology that deals with issues of infertility, repetitive pregnancy loss and
hormonal abnormalities in women. The division offers a full range of treatments, from basic
clinical evaluations through high tech assisted reproductive technologies, including in-vitro
fertilization (IVF), intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis
(PGD), and embryocrypreservation.
More than 400 assisted reproductive technology (ART) cycles are managed yearly. Cycles are
batched four times yearly in January, April, July and October. Candidates for this procedure
include couples who have either failed more conservative therapeutic approaches or those for
whom other modalities are inappropriate. The ART program primarily serves military
beneficiaries from the northeast, although anyone eligible for care anywhere in the world may
participate. Since its inception in 1995, pregnancy rates have been consistently in the top 10
percent in the nation.
The division has five board-certified or board-eligible Reproductive Endocrinologists on staff. In
addition to the assigned faculty, a very close relationship is maintained with the National
Institutes of Health (NIH). Physicians from the NIH participate in all aspects of patient care and
conferences. A vibrant program of research is maintained in conjunction with WRAMC, NNMC,
NIH and the Uniformed Services University of the Health Sciences (USUHS). A fellowship
program in Reproductive Endocrinology and Infertility, the oldest in the nation, continues to
provide training for both the military and the civilian sectors. The division also provides training
to the National Capital Area military residency in Obstetrics and Gynecology.
Since the Division is staffed by sub-specialists, we have a responsibility to teach others.
Residents are physicians who are training to become specialists in Obstetrics and Gynecology.
Given the nature of a training hospital and the multitude of responsibilities that each staff
member has within the program, Residents or staff members cannot be your personal or private
clinician. Rest assured that the professional scrutiny under which medicine is practiced in our
program is equivalent if not better than that found in any large group practice/HMO training
program found anywhere in the United States. With cutting-edge research and superb teaching,
the Division of Reproductive Endocrinology and Infertility is able to provide the best care
available anywhere to its patients.
Instructions for Semen Analysis with the Embryology Laboratory
All couples entering the IVF program are required to have a comprehensive semen analysis with
our Embryology laboratory. We cannot accept semen analysis reports from outside institutions.
The purpose of this analysis is to look at the semen parameters and to determine whether
fertilization should be attempted with standard in vitro fertilization or with intracytoplasmic
sperm injection. It also helps to ascertain if men are unable to produce a sample on Ward 43.
Appointments for semen analysis for the IVF program are made through the administrative
office only. All appointments are Monday through Thursday and run from 9:00 to 13:00.
Appointments are generally scheduled the month prior to the beginning of your cycle.
Men should abstain from ejaculation for 48-72 hours prior to their appointment. Shorter
abstinence periods will reduce the volume and count of the sample and longer period s will
reduce the motility and numbers of viable sperm, in both instances leading to an inaccurate
No lubricants can be used except those that are provided by the laboratory. No condoms can be
used since they contain spermicides and will kill the sperm. Even non-lubricated over-the-
counter condoms will kill sperm. Sexual intercourse with withdrawal is not encouraged since
premature ejaculation can occur with resulting sperm loss. It can also lead to contamination of
the sperm sample, which is detrimental for the eggs.
Ideally the sample should be collected by masturbation using the laboratory provided sterile
Men should report to ward 43 at the time of their appointment. Facilities for sample collection
are provided. The men will be required to fill in certain paper work. After the analysis a report
will be generated and placed in the patient file with the IVF nurses. If there are any problems
with the sample the men will be contacted by the laboratory staff.
Men with adequate semen analysis will be designated for IVF. Those with sub-optimal analysis
will be designated for ICSI. On the day of the woman’s oocyte (egg) retrieval this may be
changed if there is a major change in the semen parameters.
Men who have no sperm in their ejaculate will need to have an aspiration (MESA or TESA). In
order to schedule this and assure that a urologist is available, the patient must make an
appointment with the urology clinic. Contact the IVF nurse who will assist you in making
arrangements for scheduling the male retrieval.
If the men anticipate a problem with collection or their sample they must talk to the laboratory
staff as soon as they come on the ward.
Clomiphene citrate challenge test (CCCT)
This test is used to screen out patients who may have inadequate egg production (what we term
"diminished ovarian reserve") and therefore may require a donor egg. The test is completed by:
1. A day 3 follicle stimulating hormone (FSH),LH, and Estradiol is drawn. Day 1 is the first
day of bleeding during the menstrual cycle.
2. 100 mg (two tablets) of Clomid are taken daily on days 5 through 9 of your menstrual
3. Another FSH, LH, Estradiol is drawn on day 10 of the menstrual cycle.
The results of the test will be discussed with you either by one of the IVF nurses or by one of our
Laparoscopy is a surgical procedure done under general anesthesia. A small cylindrical telescope
is passed into the abdominal cavity through a tiny incision at the "belly button". A second
instrument is usually introduced through a puncture at the pubic hair line. Through fiberoptic
lenses and lights, the physician is able to view directly the outside of the uterus, the tubes, the
fimbriated ends, the ovaries and the pelvic cavity in which they lie. Laparoscopy may establish
the need for medical or surgical treatment by identifying tumors, cysts, endometriosis, infection
and/or scar tissue. If any abnormalities are found, they can generally be fixed at the time they are
The incisions are closed with several stitches which will absorb in several weeks. The surgery is
scheduled before ovulation and usually is done as same day surgery. A sore throat, shoulder pain,
bloated or swollen-feeling abdomen and generalized stiffness and soreness are commonly
experienced for a day or more, but normal work activities can soon be resumed.
A companion must come with you because you may be drowsy from the anesthesia, so you will
need someone to drive you home. You will not be allowed to drive after the procedure.
If indicated, transvaginal visualization of the uterine cavity, searching for tumors, adhesions
(scar tissue) or congenital abnormalities may be performed. This may be performed at the same
time as a laparoscopy or as a procedure by itself. The device used contains lenses and a light
source in order to clearly visualize the uterine cavity. If any abnormalities are found, they can
generally be fixed at the time they are found.
The OB-GYN Department and Reproductive Endocrinology and Infertility Division operate on
an appointment system. If you cannot keep your appointment, please call and cancel within 24
hours if possible.
To schedule appointments relating to an upcoming IVF cycle or if you have any general
questions regarding IVF, call the ART Institute's administrative staff at 202-782-6198. T
Change of address, telephone number or name
There may be times that we need to get in touch with you urgently and at those times we need an
accurate phone number or address. Therefore it is crucial that you update your registration
information. You may easily do this at WRAMC by calling (202) 782-6160.
Important Phone Numbers
Reproductive Endocrinology / Infertility office 202-782-3360
GYN appointments 202-782-6114/5/6
In vitro Fertilization 202-782-6198/3600
Obstetrics Service NNMC 301-295-4400/1
WRAMC ER 202-782-1199
NNMC ER 301-295-4810
NNMC OB-GYN Urgent Care 301-295-1438
REI Division and IVF FAX 202-782-3492
WEB SITE ADDRESS WWW.WRAMC.AMEDD.ARMY.MIL
The laboratory contractor is committed to providing you the best quality service available. This
service begins with information about our services as well as any medical treatments available.
The information process starts with this booklet and continues through your consultation with the
physician, and the orientation where you will be given more specific information about your
upcoming cycle. Just as treatments vary from patient to patient, your information may vary to
make it more specific to your case. Risks and benefits will be discussed in relation to your
treatment. A contracted company will provide your laboratory and nursing services. Please feel
free to ask questions at any time during your treatment.
Please read this booklet in full. Prior to beginning an IVF treatment cycle, you will be required to
attend an orientation at Walter Reed Army Medical Center. The purpose of the orientation is to
familiarize yourself with our program, to meet and discuss the financial issues regarding your
upcoming cycle. Before you can attend this orientation (which is by appointment only), you need
to have completed all blood tests requested by us on your checklist. If you have questions that
arise while reading this handbook, please write them down so you may ask a staff member at you
The fees charged are the sole responsibility of the couple receiving the services. The physician’s
service, plus clinical lab services are provided for you by the military healthcare system. Again,
the fees charged are for the Embryology lab, and staff. We do not accept or bill insurance. We
can however, provide you with a statement of services received.
As with your other medical care, medical ethics mandates that the care you as a couple receive
through Walter Reed Army Medical Center is confidential except where written authorization is
received to release the information. Such is the case when we report our statistics to SART
(Society for Assisted Reproductive Technologies). In keeping with Federal regulations our data
is sent to this national registry which is supervised by the American Society for Reproductive
Medicine. This data is collected from all IVF centers and provides couples as well as other
centers info by which they can determine their overall success. Should you wish to look into this
registry more closely you can access it via www.ASRM.com.
The aim of our program as well as ART in general, is to help you as a couple achieve a normal
pregnancy. The following information will serve to acquaint you with all the possible variations
of assisted reproductive technologies. Some measures are used to address female infertility
causes, i.e. IVF, GIFT, Assisted Hatching, whereas ICSI is designed to deal primarily with male
InVitro Fertilization ( IVF)
In vitro fertilization constitutes the placement of both egg and sperm within the same space, a
petri dish outside the body. This is where fertilization occurs. This was first begun as means to
bypass the female fallopian tubes for normal fertilization and passage of the subsequent embryo
into the uterine cavity. As time passed it has increased in scope to include treatment for
endometriosis, for donor egg, donor embryos and gestational surrogates.
During IVF, a woman is given specific medications to stimulate her ovaries to produce multiple
eggs. These eggs are then harvested and placed in the embryology laboratory. Three to 4 hours
later sperm is placed with the eggs and allowed to fertilize the egg overnight. The following
morning they assessed for fertilization. Fertilized zygotes are grown in special culture media for
a further 3 or 5 days. Following this period of growth, the resulting embryos are transferred into
the wife’s uterus, generally on day 3 or day 5 following retrieval. IVF may provide significant
information about the cause of infertility by giving direct visualization of female eggs, male
sperm, and their subsequent interaction.
INTRACYTOPLASMIC SPERM INJECTION (ICSI)
Intracytoplasmic sperm injection is a specialized form of IVF developed and used to overcome
male factor infertility. In this procedure each egg is injected with only one sperm, thereby
bypassing the need for the sperm to penetrate the "shell" of the egg to achieve fertilization. ICSI
is considered by most to be a safe procedure. However, there are studies showing small but
significant increases in non-lethal genetic abnormalities but no increase in birth defects or
congenital abnormalities associated with babies conceived via the ICSI procedure. If there is
definite evidence of genetic factors being the cause of male factor infertility the ICSI procedure
may permit the transfer of these factors. Some of these include the genes that cause the condition
known as cystic fibrosis or micro-deletions of the Y chromosome. If this is the case then genetic
counseling should be pursued prior to doing ICSI. If the male is carrying the cystic fibrosis genes
his wife must also be tested prior to any procedures since the likelihood of having an affected
child if both partners are carrying the genes is very high. Affected children do not live long.
To easily understand the concept of assisted hatching one must first think of the human
egg/embryo as that of a chicken egg, including the "shell". The shell surrounding the embryo is
thought to open while in the uterus and allow the embryo to implant in the uterine wall. In
assisted hatching, part of this "shell" is opened or removed prior to embryo transfer thereby
assisting the embryo in it’s ability to implant and ultimately produce a pregnancy. However, this
procedure is not necessary for all patients. Data indicates that assisted hatching is most likely to
help in those cases where the "outer shell" of the embryo is thickened.
Any procedures where handling of embryos is involved have associated risks. Embryo damage
may occur in spite of meticulous care by our embryology staff. As assisted hatching is one of
these procedures, there are risks. For some couples however the benefits of pregnancy may
outweigh these risks. Talk to your doctor if you have questions about this procedure.
GAMETE INTRAFALLOPIAN TRANSFER (GIFT)
This procedure most closely resembles natural fertilization as the egg and sperm are both placed
within the confines of the woman’s fallopian tubes. This procedure is therefore limited to those
couples where the diagnosis remains "unknown" following complete evaluation of both partners.
GIFT is not possible in cases of tubal factor or male factor. The female undergoing GIFT will
have general anesthesia for the procedure as a laparoscopy will be performed to access the
fallopian tubes. The pre-surgery preparation for retrieval is the same as for IVF or ICSI, where
the woman will take medications to promote multiple egg production on her ovaries. Sperm
evaluation is done approximately one hour prior to the woman’s surgery. Retrieval and transfer
are accomplished all in one day.
Occasionally GIFT may not be performed due to unforeseen circumstances. It may become
apparent only upon direct visualization that the tubes are in some way abnormal and unable to be
used for transfer. In these circumstances the resulting eggs from the retrieval and the male sperm
would then be placed in a petri dish for IVF fertilization and either transfer or cryopreservation
of the resulting embryos.
GIFT may not be advisable for those couples for whom fertilization is a question as the
fertilization cannot be observed. In this case IVF would provide much more information.
CRYOPRESERVATION (Freezing) of EMBRYOS
Cryopreservation of embryos is a viable alternative to discarding "extra" embryos not used in a
fresh IVF cycle. In this way we can maximize the stimulation of the woman’s ovaries and
eliminate the incidence of transferring too many embryos, resulting in a high-order multiple
Cryopreservation of embryos has been available for many years, with the first birth resulting
from a thawed embryo in Australia in 1985. Since 1990 there have been increased numbers of
these resulting pregnancies, though there is still limited information on long-term effects of
cryopreservation. There is no data available to support any increased risks of birth defects
resulting from the transfer of cryopreserved embryos. In animal models the use of cryopreserved
embryos for over 20 years has not resulted any in birth defects.
During a woman’s natural menstrual cycle only one egg is generally produced each month. With
IVF stimulation, the ovaries may produce upwards of 10-20 eggs and with fertilization may
result in many more embryos than can be safely returned to her uterus. The use of
cryopreservation then affords the couple another opportunity of achieving pregnancy without
having the woman undergo the stimulation portion of a cycle. It should be noted that all embryos
frozen may not survive the thawing process. As a general rule of thumb, a 50% survival rate may
be expected. The more developed the embryo is prior to freezing, the greater its chances are of
surviving the thaw. The decision to have embryos cryopreserved requires informed consent. The
decision is made by the laboratory staff which embryos are suitable for cryopreservation. Only
embryos deemed suitable for freezing and thawing can be cryopreserved. Not all "spare"
embryos will meet these criteria.
Laws dealing with cryopreserved embryos are still in their infancy. Our policies with regard to
frozen embryos are no different than those in most centers. The frozen embryos are the joint
property of the man and woman and any disposition regarding these embryos requires the
consent of both parties. Since they are the property of the couple, the couple is free to move them
to another site if they desire. Any expenses incurred in the shipment of embryos must be borne
by the couple. The embryology lab cannot guarantee the shipment or resultant handling of
embryos once they leave this facility.
MALE FACTOR INFERTILITY OPTIONS
If a diagnosis of male factor infertility has been given, there are several options open to the
couple. Depending on the causative factor, it is possible that the ICSI procedure would be all that
is necessary. In certain males, it may be necessary to have the sperm extracted surgically with a
procedure known as MESA or TESA. Because there is a small but real chance of not finding any
sperm at the time of the male retrieval, we require that men who need a MESA or TESA undergo
their procedure (and freeze sperm that is obtained for use later) before entry into the IVF
program. If no sperm is found, you will need to make an appointment to discuss your
In certain circumstances the male partner may be sterile. In these cases, we do provide donor
sperm services. While we do not maintain our own sperm bank, we do have the names of several
sperm banks that you can contact if this is necessary. You and your spouse should discuss the use
of donor sperm with your doctor.
The participating sperm bank carefully screens donor sperm. Detailed descriptions of the donors
are available by mail or on the internet. The descriptions are meant to help you make an
informed choice. It is the couple’s responsibility to order and pre-pay for any sperm specimens
shipped to Walter Reed for use in the IVF procedure. It is important that you contact us before
you have donor sperm specimens shipped to us so that we can make sure that we are available
when it is delivered. Please call 202-782-5090/5424 to make these arrangements. We will assist
you in any way we can.
Abortion (threatened): symptoms such as vaginal bleeding which may end a pregnancy
Abortion (habitual/recurrent): a pattern of 3 consecutive miscarriages
Adhesion: an abnormal attachment of scar tissue, usually inside the peritoneal cavity which may
interfere with normal fertilization. Often caused by surgery or infection.
Amenorrhea: the absence of menstruation
Anovulation: Total absence of ovulation.
Anovulatory bleeding: The type of menstruation associated with the failure to ovulate. May be
scanty and short or heavy with an irregular pattern.
Anti-sperm antibodies: A protective protein that exists naturally which causes agglutination of
sperm, thus preventing or inhibiting fertilization of the egg.
Artificial insemination by donor: The instillation of donor sperm into a woman’s uterus for the
purpose of conception.
Artificial insemination by husband: The instillation of a husband’s sperm into the wife’s
uterus for the purpose of conception.
Assisted Reproductive Technologies (ART): Techniques and procedures which are available to
help infertile couples achieve pregnancy after other surgical and hormonal methods have failed.
These include IVF and GIFT.
Azoospermia: The absence of sperm in the ejaculate of the male.
Corpus luteum: The special gland that forms in the ovary at the site of released egg. This gland
produces the hormone progesterone during the second half of the normal menstrual cycle.
Dysmenorrhea: Painful menstruation.
Dyspaerunia: Painful intercourse for either the woman or the man.
Ectopic pregnancy: A pregnancy in which the fertilized egg implants anywhere but in the
uterine cavity (usually the fallopian tube, the ovary or the abdominal cavity).
Ejaculation: The male orgasm during which approximately two to 6 milliliters of semen are
ejected from the penis.
Embryo: The term used to describe the early stages of fetal growth, from conception to the
eighth week of pregnancy.
Embryo transfer: Introduction of an embryo into a woman’s uterus after in vitro fertilization.
Endometrium: The membrane lining the uterus.
Endometrial biopsy: The extraction of a small sample of tissue from the uterus for examination.
Usually done to show evidence of ovulation or to diagnose endometrial hyperplasia.
Endometriosis: The presence of endometrial tissue (the normal uterine lining) in abnormal
locations such as the tubes, ovaries and peritoneal cavity, often causing painful menstruation and
Estradiol (E2): A hormone released by the developing follicles in the ovary. Plasma estradiol
levels are used to help determine progressive growth of the follicle during ovulation induction.
Fallopian tubes: A pair of narrow tubes that carry the ovum (egg) from the ovary to the body of
Fibroid tumor (Leiomyoma): A benign tumor of fibrous tissue that may occur in the uterine
wall. May be totally without symptoms or may cause abnormal menstrual patterns or infertility.
Fimbriated ends: The fringed and flaring outer ends of the fallopian tubes which capture the
egg after it is released from the ovary.
Follicle: The structure in the ovary that has nurtured the ripening egg and from which the egg is
Follicle stimulating hormone (FSH): A hormone produced in the anterior pituitary that
stimulates the ovary to ripen a follicle for ovulation.
Follicular phase: The first half of the menstrual cycle when ovarian follicle development takes
Gonadotropin: A hormone capable of stimulating the testicles or the ovaries to produce sperm
or an egg, respectively.
Human chorionic gonadotropin (hCG): A hormone secreted by the placenta and extracted
from the urine of pregnant females. hCG stimulates the ovarian secretion of estrogen and
progesterone and maintains the corpus luteum. This hormone accounts for pregnancy tests being
positive. It may be administered therapeutically to males who have undescended testes and as an
aid to trigger ovulation in women.
Human menopausal gonadotropin (hMG): An injectable medication obtained from the urine
of postmenopausal women. It is used in the treatment of both male and female infertility and to
stimulate the development of multiple follicles in ovulatory patients participating in an IVF
Hysterosalpingogram (HSG): An x-ray study in which a contrast dye is injected into the uterus
to show the delineation of the body of the uterus and the patency of the fallopian tubes.
Idiopathic (unexplained) infertility: When no reason can be found to explain the cause of a
Implantation: The embedding of the embryo in the endometrium of the uterus.
Infertility: The inability of a couple to achieve a pregnancy after one year of regular unprotected
sexual relations or the inability of the woman to carry a pregnancy to live birth.
In vitro fertilization (IVF): A procedure in which an egg is removed from a ripe follicle and
fertilized by a sperm cell outside the human body. The fertilized egg is allowed to divide in a
protected environment for 2-5 days and then is inserted back into the uterus of the woman who
produced the egg. Also called "test tube baby" and "test tube fertilization".
Laparoscopy: The direct visualization of the ovaries and the exterior of the fallopian tubes and
uterus by means of inserting a surgical instrument through a small incision below the naval.
Luteal phase: The days of the menstrual cycle following ovulation and ending the menses
during which progesterone is produced.
Luteinizing hormone (LH): A hormone secreted by the anterior lobe of the pituitary throughout
the menstrual cycle. Secretion of LH increase in the middle of the cycle to induce the release of
Oligo-ovulation: Infrequent ovulation, usually less than six ovulation cycles per year.
Oligospermia: An abnormally low number of sperm in the ejaculate of the male.
Oocyte: The egg.
Oocyte retrieval: A surgical procedure, usually under deep sedation anesthesia, to collect the
eggs contained within the ovarian follicles. A needle is inserted into the follicle and its fluid and
egg are aspirated and then placed in a media-containing dish in the laboratory.
Ovarian failure: The inability of the ovary to respond to gonadotropic stimulation, usually due
to the absence of eggs.
Pelvic inflammatory disease: Inflammatory disease of the pelvis, often caused by infection.
Progesterone: A hormone secreted by the corpus luteum of the ovary after ovulation has
occurred. Also produced by the placenta during pregnancy
Secondary infertility: The inability to conceive or carry a pregnancy after having successfully
conceived and carried one or more pregnancies.
Semen: The sperm and seminal secretions ejaculated during a male’s orgasm.
Semen analysis: The study of fresh ejaculated under the microscope to count the number of
million sperm per milliliter (density), to check the shape and size of the sperm (morphology) and
to note their ability to move (motility).
Sperm: The male reproductive cell that has measurable characteristics such as motility,
morphology, density and viability (whether the sperm is alive or dead).
Testicle: The male sexual glands of which there are two. Contained in the scrotum, they produce
the male hormone testosterone and produce the male reproductive cells, the sperm.
Tuboplasty: The surgical repair of fallopian tubes.
Uterus: The hollow, muscular organ in the woman that holds and nourishes the fetus until the
time of birth.
Vagina: The birth canal opening in the woman extending from the vulva to the cervix of the
RESOLVE has provided help to thousands of people experiencing the crisis of infertility.
RESOLVE’s mission is to provide timely, compassionate support and information to individuals
who are experiencing infertility and to help them recognize that they are not alone.
The National Infertility Association Since 1974
Somerville, MA 02144
The American Society for Reproductive Medicine (ASRM) is an organization devoted to
advancing knowledge and expertise in reproductive medicine and biology. Established in 1944,
the Society has since achieved national and international recognition as the foremost
organization in promoting the study of reproduction and reproductive disorders. The ASRM is a
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The American Society for Reproductive Medicine