Training program in Assisted Reproductive Technology (ART)Since its inception in 2003, our ART training program offers a unique opportunity to learn the latest techniques in this rapidly changing subspecialty at one of the world’s premier ART centers:

• World-class faculty• Up to date training facilities• Personalized hands-on training• Multiple comprehensive training modules• Very high trainee satisfaction rates• Trained over 187 alumni from 45 countries since 2003• Certificate of Training awarded at the end of training

This intensive, 320-hour course is available exclusively to scientists and physicians with a specific interest in reproductive endocrinology, embryology or andrology as well as other health professionals such as embryologists, reproductive biologists and technologists.

The course covers: • In vitro fertilization (IVF) • Intracytoplasmic sperm injection (ICSI) • Gamete cryopreservation • Routine and advanced tests in andrology

Referral to a Human IVF Clinic may be available to select candidates looking for clinical observation in the following areas:

• LogisticsofrunninganIVFLab• ObserveIVF/ICSIprocedures• Oocyteretrieval• Oocyteassessment• Fertilizationcheck• Embryoassessment• Intrauterineinsemination

LearnfromtheLeadersThe American Center for Reproductive MedicineCleveland Clinic’s American Center for Reproductive Medicine was established 25 years ago in 1993 with a three-fold mission: to conduct cutting-edge research into the causes of human reproductive pathologies, develop new fertility biomarkers and treatment modalities, and train physicians and scientists with a commitment to advancing the understanding of human reproduction, infertility, and fertility preservation.

Course ContentHands on Assisted Reproduction (IVF/ICSI) - Module 5A - 5C (160 hours)Learn basic and advanced techniques in:IVF Techniques•Module 5A • ICSI:Intracytoplasmicsperminjection •ClassicalIVF •Oocytehandlingandscoring •Embryohandlingandscoring •Catheterloadingforembryotransfer

•Module 5B •PreparationofICSIdishes • ICSI:injectionofthespermatozooninto the oocyte •Oocytehandling(using fresh mouse oocytes)

Laboratory Training•Equipments •Micromanipulators:components and mechanics • InstallingandaligningICSIinstruments

•Supplies & Culture Medium •Preparationofculturemediumanddishes forIVF/IVF-ICSIcases •Embryoculture •Extendedembryoculture

Advanced ART Techniques•Assistedhatching(laser and chemical [acidified Tyrode’s] method)•Embryobiopsy

Pre-Implantation Genetic Diagnosis•Blastomerebiopsy•Micromanipulatorset-up•Biopsyofmouse/hamster8-cellstageembryos•UseoflaserandacidTyrode’ssolutionfor zona drilling•Blastomereandpolarbodyaspirationand fixation techniques•Cellspreading•Fixationtechniques

Cryopreservation•Embryocryopreservation(mouse embryos)•Vitrification

Andrology•SpermpreparationforIVF/ICSI

Virtual Tour of Facilities

MODULE 5

Module 5A:IVF/ICSI/Micromanipulation(80 hours)

Module 5B:ICSI/Micromanipulation(40 hours)

Module 5C:Advanced ART Techniques (40 hours)

Module 5D*:Customizable ART Training (40 - 320 hours)

*How Module 5D Works:1) Candidates select a) the techniques they wish to learn (Modules 1-8); and b) the duration of their training (1- 8 weeks).

2) Candidates consult with the Course Director regarding their training needs and choices, and together, they will decide on the appropriate modules and duration required by the candidate

3) A personalized training schedule is created specifically for the candidate

4) Training is provided at a pace established by the candidate and is geared towards fulfilling the candidates personal needs.

ART Trainee

taking Module 5

will receive a

FREE copy of

an ART Book

and more...

Amer

ican

Center for Reproductive Medicine

Centrum Excellentiae Est.

1993

Ranked One of America’s Top 2 Hospitals

American Center for Reproductive MedicineHands on Training in Assisted Reproductive Technology

1 | Cleveland Clinic American Center for Reproductive Medicine LearnmoreaboutourARTTrainingProgram

Clinical Didactics by a Male Infertility Specialist&REI

1)Evaluationandmanagementof male infertility2)Lecturesonclinicalaspectsand latest strategies for controlled ovarian hyperstimulation 3)Oocytepickup&Embryotransfer: Clinical inputs

ART Training

2 | Cleveland Clinic American Center for Reproductive Medicine LearnmoreaboutourART Training Program

Edmund Sabanegh, MDChairman, Department of UrologyHead, Section of Male InfertilityProfessor,LernerCollegeofMedicine

Sajal Gupta, MS, MD, TS (ABB) (MS in Reproductive Clinical Science, Jones Institute)Reproductive SpecialistSupervisor, Andrology CenterAssistantProfessor,LernerCollegeofMedicine

Rakesh Sharma, PhDResearch Coordinator,American Center for Reproductive MedicineAssociateProfessor,LernerCollegeofMedicine

Ashok Agarwal, PhD, HCLDDirector, Andrology CenterDirector, American Center forReproductive MedicineProfessor,LernerCollegeofMedicine

Christina Anagnostopoulou, MSDirectorandClinicalEmbryologistIVFClinic“EmbryoART”Athens, GreeceTestimonial

Israel Maldonado Rosas, MScDirectorandClinicalEmbryologistCitmer IVF ClinicMexico City, MexicoTestimonial

Semenology - Modules 1A (8 hours) and 1B (16 hours)Gain proficiency in:

Module 1A: • Collection and delivery of semen sample • Routine semen analysis • Computer assisted semen analysis (CASA) • Review quality control methods for semen analysis • Proficiency survey for semen analysis

Module 1B: • SpermmorphologyassessmentsbyWHOandKruger’sstrictcriteria(WHO4th and 5thEd.) • Differences between the two morphology classification systems • Semen smear preparation and practice staining techniques • Quality control measures

ART Sperm Preparation - Module 3 (16 hours)Develop skills in sperm preparation for ART: • Preparation of ejaculated sperm for ART: Sperm wash Double density gradient technique Swim-up protocol • Method of retrieval of sperm from retrograde ejaculate (demonstration only) • Sperm retrieval and preparation of testicular biopsy specimens (using rat or mouse specimens)

Advanced Andrology Techniques - Module 2A (40 hours) and 2B (80 Hours)Gain proficiency in these advanced techniques:

Module 2A (40 hours) •Measurement of sperm DNA fragmentationbyTUNELassayusing FACS* Flow Cytometry •MeasurementofOxidationReduction Potential(ORP)insemensamples •MeasurementofReactiveOxygen Species(ROS)levelsinsemensamples • Measurement of lipid peroxidation in semen samples • Measurement of Total Antioxidant Capacity (TAC) in seminal plasma • Selection of non-apoptotic spermatozoa using MACS** technique

Module 2B (80 hours) • Measurement of sperm DNA fragmentationbyTUNELassayusing FACS*BDAccuriC6Benchtop Flow Cytometer •MeasurementofOxidationReduction Potential(ORP)insemensamples •MeasurementofReactiveOxygen Species(ROS)levelsinsemen samples • Measurement of lipid peroxidation in semen samples • Measurement of Total Antioxidant Capacity (TAC) in seminal plasma • Selection of non-apoptotic spermatozoa using MACS** technique

*Fluorescence-activated cell sorting**Magnetic-activated cell sorting

Cryopreservation - Module 4 (8 hours)Learn the proper procedures for freezing human spermatozoa: • Freezing of ejaculated human spermatozoa •Cryopreservation of epididymal and vas deferens aspirates* • Isolation and cryopreservation of sperm from testicular biopsy specimens* •Protocol for cryopreservation of ovarian tissue from cancer patients**demonstration only

Management of IVF and Andrology Laboratories - Module 7 (16 hours)Gain proficiency in: • Implementation of a Total Quality Management Program •Regulation, licensing and accreditation •Quality Control and Quality Assurance •Proficiency Testing •Quality management tools •Troubleshooting

Vitrification - Module 6 (8 hours)Acquire competency and knowledge of vitrification: • Fundamentals of vitrification •Vitrification for routine use in an embryology laboratory •Hands on training in set-up vitrification of oocytes and embryos using techniques such as: open and closed vitrification system, warming of cryopreserved oocytes and embryos, oocyte and blastocyst vitrification, cleavage stage embryo vitrification

Preparing for CAP Accreditation and FDA Inspection - Module 8 (16 hours)Learn how to prepare your laboratory or tissue bank for accreditation by the Collegeof American Pathologists (CAP) Reproductive Laboratory Inspection Program •LearnhowtoprepareyourreproductivelaboratoryforaccreditationbytheCollegeof American Pathologists (CAP) inspection program or your tissue bank for the United States: Food and Drug Administration (FDA) inspection. •What to do: Pre-inspection, during inspection and post inspection •Inspection Techniques •Quality Management (pre-analytic, analytic, and post-analytic processes) •Critical indicators for all three processes •LaboratoryGeneralChecklist •ReproductiveLaboratoryChecklist(EmbryologyandAndrology) •TeamLeaderassessment •FDA Compliance

Training Faculty

AccreditationAccredited for 320 AMA PRA Category 1 CreditsTM

ParticipantsclaimingCMEcreditfromthisactivitymay submit the credit hours to the American OsteopathicAssociationCouncilonContinuingMedicalEducationforCategory2credit.Accredited by the AmericanCollegeofEmbryology

Learn MoreFor complete information, application instructions and course fees, visit www.clevelandclinic/org/reproductiveresearchcenter/arttraining.html

Virtual tour of the American Center for Reproductive Medicine

Training Methodology:1.Trainingprovidedbycertified,practicingClinicalEmbryologists

2.TrainersincludeAndrologists,ReproductiveEndocrinologistsandother experts in ART

3. Fully hands-on, one-on-one laboratory training sessions under the direct guidanceofClinicalEmbryologists • Training is done using animal models (frozen hamster oocyte and mouse embryos) (Module 5)

4.Eachtrainingsessioniscustomizedtothetrainee’s • Professional background •Levelofskillandcompetence • Specific training needs • Desired outcomes from attending the ART training course

5. Interactive discussion and teaching sessions

6.Livelecturesandmultimediapresentationsinsmallgroupsessions

7. Four state-of-the-art micromanipulators dedicated solely for training purposes(IVF/ICSI)

Note:• Training is offered in a dedicated ART training suite inside a non-clinical research laboratory• There is no patient contact

Trainee Evaluations:EachTraineeistestedattheendoftheirtrainingfor:

1. Knowledge/Theoretical Component (30%): Multiple choice questions on lab techniques linked to each course module

2. Practical Skills (50%): Tested on specific lab techniques taught during the training

3. Verbal Communication & Comprehension Skills/Integrative Component (20%):

• The performance of the candidate throughout the course will be reflected in a Grading Report.

• Candidates who meet the training requirements and successfully complete the course work will be awarded a Training Certificate

Registered Trainees Will Receive…1.CourseSyllabuswithReadingMaterialandLabProtocols

2.FreeAccesstotheClevelandClinicAlumniLibrary

3.FreeTextBookon“Practical Manual of In Vitro Fertilization: Advanced Methods and Novel Devices” edited by Dr. Peter Nagy et al, Springer (only for Modules 5A-5D)4.FreeE-Booktitled“Andrological Evaluation of Male Infertility: A Laboratory Guide” edited by Dr. Ashok Agarwal et al, Springer (only for Modules 1-4) (on Flash Drive)

5.WHOLaboratoryManualfortheExaminationofHumanSemenand Sperm-CervicalMucusInteraction:FifthEdition(onFlashDrive)

6.Certificate of Training (issued upon successful assessment by the instructor)

7. Daily Meal Tickets

This certificate is presented to:

RAKESH SHARMA, Ph.D. Associate Professor, Department of Urology Coordinator of Research American Center for Reproductive Medicine

SAJAL GUPTA, M.D.Assistant Professor, Department of Urology Assistant Research Coordinator American Center for Reproductive Medicine

American Center for Reproductive Medicine The Cleveland Clinic

ASHOK AGARWAL, Ph.D. Professor & DirectorDepartment of Urology American Center for Reproductive Medicine

has receivedHands on Training in Human Assisted Reproduction

(Module 5A: IVF/ICSI, Micromanipulation, Embryo Biopsy, Assisted Hatching and PGD) for 80 hours offered by the

American Center for Reproductive Medicine, Cleveland Clinic September 18 - September 29, 2017

Janelle Simon, BSMemorial Sloan Kettering Cancer Center, New York, USA

Scholarship in Teaching AwardTraining Program in Advanced Reproductive Techniques

The Case Western Reserve School of Medicine Scholarship in Teaching Awards is an annual program designed to recognize faculty contribution to education from the preceding year and promote undergraduate, graduate, and continuing medical education teaching as a scholarly activity.

Teaching approaches considered scholarly are characterized by • purposeful planning • systematic implementation and • reflection and assessment for improvement.

The result should be an academic product that is actively shared and that will support the development of a community of teaching scholars.

ThisawardwasgivenoutattheCaseMedicalSchoolEducationRetreatonMarch12,2015. ACRM’s hands-on ART training program has previously been twice-recognized with this prestigious Scholarship in Teaching Award, in 2013 and again in 2014.

Certificate of Training Awarded Upon the Successful Completion

of the Hands on ART Training

This certificate is presented to:

RAKESH SHARMA, Ph.D. Associate Professor, Department of Urology Coordinator of Research American Center for Reproductive Medicine

SAJAL GUPTA, M.D.Assistant Professor, Department of Urology Assistant Research Coordinator American Center for Reproductive Medicine

American Center for Reproductive Medicine The Cleveland Clinic

ASHOK AGARWAL, Ph.D. Professor & DirectorDepartment of Urology American Center for Reproductive Medicine

has receivedHands on Training in Human Assisted Reproduction

(Module 5D: Customized ART Training: IVF/ICSI, Micromanipulation, Embryo Biopsy, Assisted Hatching and PGD; Module 3: Sperm Preparation and Module 6: Vitrification)

for 120 hours offered by the American Center for Reproductive Medicine, Cleveland Clinic September 5 - September 25, 2017

Noopur Chhasatia, MBBS, MDSurat, India

American Center for ReproductiveMedicine ART Training

This document reflects the performance of the candidate during the 2017 ART Training Session: (Module 5A: IVF/ICSI, Micromanipulation,

Embryo Biopsy, Assisted Hatching and PGD )This is to attest that the trainee,

Andrea Fatima Vargas Torres, BS, MSchas successfully completed the course work prescribed by the Cleveland Clinic’s

American Center for Reproductive Medicine and is therefore recommended for the award of

the ART Training Certificate

Grading Report

Grading Scale: A+ (>96%), A (91-95%), A- (86-90%), B+ (81-85%), B (76-80%), B- (71-75%), C (<70% is Fail)

Theoretical Component; MCQ (30%)

Total Marks Marks Obtained Contribution (30%)

30 86 (100%) 26

Practical Component; Skill Test (50%)

50 100 (100%) 50

Integrative Component (20%)Presentation and Viva Voce

20 19 (20%) 19

FINAL GRADE 95%

RAKESH SHARMA, Ph.D.Trainer, ART Training

SAJAL GUPTA, M.D.Trainer, ART Training

October 27th, 2017Date ASHOK AGARWAL, Ph.D

Program Director