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Laurel Stadtmauer

Laurel Stadtmauer

Eastern Virginia Medical School, USA

Title: Controversies in PCOS management and fertility treatment

Biography

Laurel Stadtmauer joined the Jones Institute for Reproductive Medicine faculty in April of 2001 and is an active member of the IVF group as well as the medical director of the program for SART. She is director of the female reproductive endocrinology and infertility course for the Distance On-line Masters in Clinical Embryology and Andrology. She is board certifi ed in obstetrics and gynecology and reproductive endocrinology and infertility. She also is certifi ed in advanced laparoscopic hysteroscopy and robotic surgery. Dr. Stadtmauer completed her associate degree in chemistry at Harvard University in 1980. She achieved her M.D. degree and a Ph.D. in molecular pharmacology from Albert Einstein College of Medicine in New York and completed her internship in internal medicine at Bellevue Hospital in New York City. She specialized in obstetrics and gynecology and completed her residency training at Mount Sinai Hospital in New York. She then pursued subspecialty training in reproductive endocrinology and infertility and completed her postdoctoral training at Columbia Presbyterian Hospital. She also served as director of reproductive endocrinology and infertility at Harlem Hospital in New York City. Prior to joining the Jones Institute, she worked in a private practice infertility treatment clinic in North Carolina. She is a fellow of the American College of Obstetricians and Gynecologists and a member of the American Society for Reproductive Medicine where she has Chaired the postgraduate courses in Ultrasound in Reproductive Medicine for the last 3 years, Society for Assisted Reproductive Technology, Society of Reproductive Endocrinology, American Association of Gynecologic Laparoscopists, and the South Atlantic Obstetrics and Gynecology Society. She is also the Course Director for the 15 week course in Reproductive Endocrinology and Infertility for the fi rst distance (on-line) Masters in Clinical Endocrinology and Andrology Program at EVMS. She is the primary or contributing author of more than 75 articles published in major peer-reviewed journals, such as Fertility and Sterility, wrote more than 10 chapters in books. She is currently an Editor of “Ultrasound in Reproductive Medicine and ART” which will be published in the near future. She also has been an Investigator in more than 15 funded research and training grants. Her primary interests are in vitro fertilization, 3-D ultrasound, polycystic ovarian disease ( PCOS ), endometriosis, and uterine fi broids and has lectured at meetings all over the world in these areas.

Abstract

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder that aff ects reproductive age women and is characterized by hyperandrogenism, oligomenorrhea, insulin resistance, obesity and polycystic ovaries on ultrasound. Th ese patients have associated infertility due to chronic anovulation and increased medical problems related to obesity. Although the syndrome was first reported over 50 years ago, there are still controversial areas in the diagnosis and management of this syndrome. Th e talk will review the controversial areas, mainly related to the areas of infertility treatment based on published evidence by this author and other prominent authors. Th e relationship between neuroendocrine abnormalities, insulin resistance and PCOS will be discussed as well as the ultrasound defi nition. Ovulation induction with letrazole may become fi rst line treatment to replace clomiphene citrate. Progesterone withdrawal may not be recommended. Th ere is a benefi t of the GnRH antagonist in conjunction with gonadotropins for both OI and IVF stimulation to decrease the risks of ovarian hyperstimulation and increase pregnancy chances. Finally the role of metformin in ovulation induction and pregnancy will be discussed as there have been changes in the opinion of its benefi t in PCOS.

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