ISAR NATIONAL CONFERENCE OF. First Announcement INDIAN SOCIETY FOR ASSISTED REPRODUCTION. Conference Organizers. Dr. A.

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1 First Announcement ISAR 2012 th 17NATIONAL CONFERENCE OF INDIAN SOCIETY FOR ASSISTED REPRODUCTION to MARCH, 2012 Gharhi Chowk, City s Pride - Enlisted in Limca Book of World Record Conference Organizers Dr. A. Suresh Kumar Organizing Chairperson - ISAR 2012 & all members of Chhattisgarh Chapter of ISAR (C.G.)

2 CONTENTS Invitation Letter Organizing Committee International Faculty National Faculty Scientific Programme Call for Posters & Abstracts Venue Pre-Conference Workshops & Registration Details Hotel Accommodation Registration Form Accommodation Form In & Around Chattisgarh

3 INVITATION From the President s Desk Dear Colleagues, As the President of ISAR, It gives me immense pleasure in inviting you all for the 17th National Congress of Indian Society of Assisted Reproduction to be held in. As a policy statement in the year 2010, I had announced that we will take all possible measures to decentralize care in the field of Assisted Reproduction and make advancements known to all possible practicing Gynaecologists. As Fertility and Reproductive Medicine issues are becoming more and more important, It is essential to reach out to as many people as possible. Formation of state chapters and conducting such a big national conference in is a step towards making that dream a reality. I hope all of you attend this conference in huge numbers and make it as successful as the conferences in the past so that we can fulfill our dream of outreaching to all. Dr. Dhiraj Gada President, ISAR Dr.Mahendra Parikh Founder President Dr. Sadhana Desai Imm. Past President Dr. Manish Bankar President Elect Dr. H.D Pai, Dr.N. Malhotra Vice President Dr. Vijay Mangoli Secretary General Dr. Rishma Pai Treasurer Dr. Kamla Selvaraj Clinical Secretary Dr. Duru Shah Jt. Secretary Dr. Nimish Shelat Hon. Jt Treasurer Dr. Kanthi M Bansal Hon. Librarian MEMBERS Dr. Jaideep Malhotra Dr. Mandakini Parihar Dr. Nandita Palshetker Dr. Ameet Patki Dr. Pravin Patel Mr. Virendra Shah Dr. Prakash Trivedi Dr. Sunita Tendulwadkar Co-opted Members Dr. Korula George Dr. S.S. Vasan Dr. Sujata Kar From the Organizing Committee Greetings on behalf of Chhattisgarh Chapter of Indian Society of Assisted Reproduction. On behalf of the organizing committee of the 17th National Conference of ISAR, we take immense pleasure to announce and invite you to, the Capital of Chhattisgarh, India from 1st to 4th March city, the hub of Chhattisgarh, well known as the "Dhan ka Katora (Rice bowl of India)" is known for its rich harvest, cultural & historical heritage. It is one among the rich cities known for iron and steel market, a booming business destination, being well connected to the major metropolitan cities of India. There are so many tourist attraction points in and around Chhattisgarh state which you will be happy to explore and enjoy. The advancements both on the scientific as well as clinical fronts of infertility continue to expand rapidly. The theme of our conference is towards advances in ART & Endoscopy along with Medico legal issues in ART. This conference has been one of the most important gatherings for medical professional in the field of reproductive medicine. It aims to provide updates on the latest development in fertility treatment especially on its safety issues, way of improving its success. We promise you an academic feast by well known International and national speakers across the globe. There will be ample opportunity to interact with the expert faculty along with a colorful entertainment programme and a lavish banquet. We cordially invite all of you to join us for this event. We are eagerly waiting to welcome. Dr. A. Suresh Kumar Dr. T. Nagaria Dr. R.B. Agrawal Organising Chairperson Organising Secretaries 01

4 ORGANIZING COMMITTEE 17th ISAR CONGRESS ORGANIZING COMMITTEE ASSOCIATE ORGANISING COMMITTEE MEMBERS CONFERENCE PATRON Padmashree Dr A T Dabke ORGANISING CHAIRPERSON Dr A Suresh Kumar ORGANISING SECRETARIES Dr Tripti Nagaria Dr. (Mrs.) R.B Agrawal ADVISORY COMMITTEE Dr. Abha Singh Dr. Sheela Pahlajani JOINT SECRETARIES Dr. Veronica Irene Yuel Dr. Vijaya Wakodkar Dr. Palak Gawri Dr. Neeta Kanwar Dr. Nalini Madhariya Dr. Priti Agrawal Dr. Neeraj Pahlajani Dr. Sangeeta Sinha Dr. Mamta Bansal Dr. Manoj Chellani TREASURER Dr Reema Dilawari DISTRICT COORDINATORS Dr Swati Mahobia ( City) Dr Vinita Naik (Durg District) Dr S. K Agrawal (Durg City) Dr Shubhada Kalvit (Bilaspur District) Dr Abha Verma (Bilaspur City) Dr Rohit Banchhor (Korba District) Dr P. C. Jain (Janjgir District) Dr Alpana Bansal (Jagdalpur District) Dr Rajendra Parida (Ambikapur District) Dr. Vimal Khunte (Raj Nandgaon District) Dr. Sarita Agrawal Dr. Prachi Trivedi Dr. Neerja Agrawal Dr. Aamir Husain Dr. Firoz Memon Dr. Arun Agarwalla Dr. Aravind Neral Dr. Mukti Farishta Dr. Rajni Sao Dr. Sunita Mishra Dr. Prachi Baranwal Dr. Sweta Agrawal Dr. Madhuprita Agrawal Dr. Sukirti Bansal Dr. Sameer Pahlajani Dr. Jyoti Jaiswal Dr. Rekha Ratnani Dr. Nalini Mishra Dr. Anup Verma Dr. P.K. Patra Dr.Rajesh Sharma Dr. (Major) Rakesh Sharma Dr. Ajay Mohan Sahai Dr.Preeti Saxena Dr. Lalita Singh Dr. Rashmi Upadhyay Dr. Aarti Yado Mr. Salim Umrani Dr. Asthana Anupama Dr. Sushila Jain Dr. Vinita Jain Dr. Manish Ch. Mishra Dr. Vartika Mishra Dr. Kakoli Pattnayak Dr. R.S.L.Tripathy Dr. Jyoti Wadhwa Dr. Alpana Bansal Dr. N.B. Dalla Dr. Tabssum Dalla Dr. Jyoti Dubey Dr. Jyoti Kalikoti Dr. Gurmeet Kour Dr. Anita Keshwani Dr. Subhi Naqvi 02

5 INTERNATIONAL FACULTY Siladitya Bhatacharya (UK) Rina Agrawal (UK) Peter Brinsden (UK) Jan Gerris (Belgium) Suresh Nair (Singapore) K. Jayaprakasan (UK) Roy Homburg (Israel) Martina Ribic-Puceij (Slovenia) Petra De Sutter (Belgium) Thomas Hoghe (Belgium) Ashok Agrawal (USA) T.F. Kruger (South Africa) Gulam Bahadur (UK) Mark Hamilton (UK) Silke Dyer (South Africa) Daniel R Franken (South Africa) 4 ASRM Faculty are Proposed Thomas Ebner (Austria) Jose Remohi (Spain) 03

6 P R O P O S E D N A T I O N A L F A C U LT Y A. Rajasekharan A. Suresh Kumar Abha Majumdar Abhilasha Prakash Akhand Prakash Aleyama T. K. Alka Kriplani Ameet Patki Ameya Purandre Amit Chakravarty Amit Tandon Anirudh Malpani Anirudh Singh Anita Singh Anjali Malpani Anoop Gupta Anshu Jindal Anupam Gupta Archana Baser Arun Madhab Boruah Asha Baxi Asha Gangane Asha Rao Ashok Khurana Ashwini Kumar Deshmukh Ashwini Trikha Atul Ganatra B.R. Desai B.N. Chakravarty Banker Manish R. Bansal Kanthi M. Bharucha M.R. Bhalerao Gandhi Ashwini Bharati Dore Patil Bijoy Balakrishnan Bina Vasan C. Sharath Kumar C.B. Nagori C.N. Purandre Chandravati Charudutt Joshi Deepak Goenka Devika Gunasheel Dhanabagyani Dhiraj Gada Dilip P. Patel Dinesh Jain Duru Shah Evita Fernandez Falguni H. Bavishi Farma E. Irani Fessy Louis T. Firuza Parekh G.A. Ramaraju Gajendra Tomar Gaurav Majumdar Gautam N. Allahabadia Gita Khanna Goral Gandhi Hafeez Rahman Hari N. Borkataki Harpreet Sidhu Himanshu P. Bavishi Hrishikesh Pai Himanshu Patel Himanshu Roy Hrishikesh Pai Indira Flindujes Indira Hinduja Iqbal Singh Ahuja Ishwar Chandra Verma J. Krishnakumar Jaideep Malhotra Jatin Shah Jayam Kannan Jayandhi Raghavan Jayashree Bhattacharya Jaydeep D. Tank Jyoti Bali K. Jayakrishanan K.K. Gopinathan Kaberi Banerjee Kamal Gupta Kamini A. Rao Kamla Selvaraj Kanad Dev Nayak Kannaki Uthraraj Kapil Kochhar Kaushtubh Kulkarni Kavita Agarwal Kavita Mandrel Ie Kirti Dhonde Kishore Ch. Mohapatra Kishore Nadkarni Korula George Krishnan Kutty Krishnendu Gupta Kuldeep Jain Kumud Pashricha Kurian Joseph Kusum Zaveri Lakhbeer Dhaliwal Lakhvinder Singh Laxmi L. Shrikhande Mohinder Kochhar Madhu Gulati Madhu Loomba Madhu Srivastava Madhuri Patil Mahender N. Parikh Mala Arora Malathi Rao Mamta Agnihotri Mamta Deendayal Mandakini Parihar Mangala Ketkar Mangala Telang Maninder Ahuja Manish Banker Manju Jilla Meena Chimote Meenakshi Bharat Mhanlal Swarnakar Milind R. Shah M.L. Goenka Mohamde Ashraf Mohan Kamath Monesh Shah Monica Singh Monika Jain Monu Pattnaik Mridhu Bhashini Govindrajan Mukesh H. Agrawal N. Chimote N. Palaniappan N. S. Reddy Neena Malhotra Nalini Mahajan Nandita Palshetkar Narendra Gupta Narendra Malhotra Narvekar Nayna Patel Neela Beheti Neelam Bafna Neera Agrawal Neeta Singh Nimesh Shelat Nishad N. Chimote Nita Jaggi Nitin Narvekar Nozer Sheriar Nutan Jain P.C. Mahapatra Padmarekha Jirge Parul Kotdawala Parul Seghal Paul P.G. Pawan Dhir PK Sekharan Pooja Singh Poonam Loomba Prabhakar Singh Pravin M. Patel Pragnesh Shah Prakash Patil Prakash Pawar Prakash Trivedi Pramod Sharma Pranay Shah Pratap Kumar Priti Kumar Priti Trivedi Priya Kanan Purnima Nadkarni Priya Selvaraj Col. R. K. Sharma Ragini Agrawal Rajat Ray Rajeev Agrawal Rajendra Sankhpal Raju Nair Rajul Tyagi Rajvi Mehta Rakesh Sinha Rakhi Singh Ramadevi Popolu B. Ramesh Ranjana Bagchi Ranjana Mangoli Ranjeet Joshi R.B. Agrawal Renu Makwana RG Patel Rishma Dhillon Pai Rita Billiangady Roya Rozati Roza Olyai RP Soonawala Rupin Shah S Dastidar Ghosh S Dhanabhagyam S Gunasheela S Inamdar S Kant Goswamy S Krishnakumar S.S Vasan Sachin Kulkarni Sadhana Desai Sadhna Patwardhan Sam P.Abraham Sandeep Talwar Sandhya Krishnan Sangeeta Jain Sanjay Gupte Sanjay Makwana Sanjay Patil Sanjeev Khurd Sarat Battina Saroj Singh Satish Adiga Shailaja Gada Saxena Sharad Gogate Sharda jain Shashi Arora Shashi Singh Shaunak Khandwala Shefali D. Jain Shivani Sachdeva Shraddha Agrawal Shreyas Padgaonkar Shyam V. Desai Shyam V. Kulkarni Siddhartha Chatterjee Sohani Verma Sonal Panchal Sonia Kamboj Soniya Malik Sonu Talwar SPS Virk Srinivas M.S Srinivasan Vyjayanthi S.S. Chawla Sudesh Kamath Sudha Prasad Sujata Kar Sumita Prabhakar Sunita Mittal Sunita Tandulwdkar Surheeta Kareem Surveen Ghumman Sushma Deshmukh Swati Allahabadia Tarini Taneja Thankam Varma Umesh Jindal Vaishali Tandon Vandana Bansal Vandana Walvekar Vanie S. Thapar Veronica Irene Yuel Vidhu Modgil Vijay Kumar Vijay Mangoli Vijay Sing Nahata Vijayalekshmy N.P. Vineet V. Mishra Vinita Raut Vinita Salvi Virendra Shah 04

7 SCIENTIFIC PROGRAMME Day 01 Thursday, 1st March hrs to 1700hrs 1700hrs onwards 1800hrs to 2000hrs 2000hrs onwards Pre Congress Workshop Registration & Tea Break Public forum Inauguration of Exhibition & Reception Dinner Day 02 Friday, 2nd March hrs to 1000hrs 1000hrs to 1100hrs 1100hrs to 1130hrs 1130hrs to 1300hrs Scientific Session ISAR Oration Tea break / ISAR ELECTION VOTE COUNTING Plenary Session 1300hrs to 1400hrs 1400hrs to 1530hrs 1530hrs to 1700hrs 1700hrs to 1800hrs 1800hrs to 1900hrs 1900hrs to 2000hrs 2000hrs onwards Lunch Scientific Session Panel Discussion ISAR EXECUTIVE MEETING ISAR GENERAL BODY MEETING Inauguration Cultural programme & Gala Dinner VW CANYON (RMV) in conjunction with Agrasen Dham & Babylon Group of Hotels, * Free papers will be going on simultaneously in separate halls throughout the scientific session. Day 03 Saturday, 3rd March hrs to 1000hrs 1000hrs to 1100hrs 1100hrs to 1130hrs 1130hrs to 1300hrs 1300hrs to 1400hrs 1400hrs to 1530hrs 1530hrs to 1700hrs 1700hrs to 1800hrs Scientific Session ISAR Presidential Oration Tea break Scientific session Lunch Plenary Session DEBATE ISAR Elect Executive Meeting VW CANYON (RMV) in conjunction with Agrasen Dham & Babylon Group of Hotels, 2000hrs onwards Cultural Programme With pre Holi Theme & Banquet. * Free papers will be going on simultaneously in separate halls throughout the scientific sessions. Day 04 Sunday, 4th March hrs to 1030hrs 1030hrs to 1100hrs 1100hrs to 1230hrs 1130hrs onwards Scientific Session Tea Break Plenary Session Valedictory Session & Lunch VW CANYON (RMV) in conjunction with Agrasen Dham & Babylon Group of Hotels, 05

8 C A L L F O R P O S T E R S & A B S T R A C T S Conference Theme New in ART Endoscopy in ART Medico-legal Issues in ART Format The conference themes would be presented through following formats: Plenary lectures : to offer an overview of the conference themes by distinguished speakers. Invited lectures : to present in depth analyses of specific topics. Contributory posters : these would provide an opportunity to the participants to present their work in more informal manner with personalized interaction with other participants. Submission of abstract for oral/poster presentation AWARDS For Embryologist Dr. Asha Rao award Rs. 6000/- + medal for best oral paper. Dr. Poornima Nadkarni award Rs /- + medal for second best oral paper. Dr. Poornima Nadkarni award Rs /- + medal for best poster presentation. Dr. Asha Rao award Rs /- + medal for second best poster presentation. There will be scientific sessions on various topics identified for the conference in the form of invited lectures and poster presentations. Abstracts of unpublished researches related to one of the conference themes are invited for oral presentation as well as poster papers. Abstracts should be submitted (via online) as per the approved format in about 200 words excluding title, affiliation etc. For detailed guidelines please visit ( VW CANYON (RMV) in conjunction with Agrasen Dham & Babylon Group of Hotels, RAIPUR VENUE Venue : Venue will be VW CANYON (RMV) in conjunction with Agrasen Dham & Babylon Group of Hotels, RAIPUR which is at a distance of approximately 05 Kms from the Airport. It is with in minutes drive from any part of the city. It is connected directly to the airport. CLIMATE : The weather at at that time will be very pleasant and the temperature ranges between 15 C to 20 C. OFFICIAL LANGUAGE : The official language of the Conference is English. CURRENCY : All transactions will be in Indian Rupees. REGISTRATION: Registration includes registration kits, delegate bags, entry to inaugural function, reception dinner and lunches during the conference, ENTRY IN THE SCIENTIFIC SESSIONS : Entry into the scientific sessions is restricted to registered delegates only. Accompanying Persons are not allowed inside the conference halls. All delegates / faculty / exhibitors need to collect their badges from the registration area. Please do carry your original receipt/ acknowledgement letter for easy clearance and quick identification. All delegates/accompanying persons need to wear badges at all times inside the conference area. Badges are to be kept safe during the conference days and not to be handed over to other persons for security reason. Duplicate badges will be not issued. Delegate kits can be collected any time during the conference days after registration. IDENTITY : Conference delegates are requested to carry photo identity cards (passport voter's id, Driving License, Pan Card etc) and display upon request for security reasons. BAGGAGE : Kindly leave your excess baggage at the cloak (entrance gate) and collect at the same day while leaving the premises. DISCLAIMER : It is advised not to carry excess quantity of personal baggage to the conference area. The organizing committee is not responsible for any loss of personal belongings at the conference area. CONFERENCE VENUE : Smoking/ Drinking is strictly prohibited inside the entire conference hall. It is required not to carry any metal, liquid, and harmful or banned items into the conference area. The organizing committee requests all the conference attendees to keep the conference premises clean. Kindly contact the "May I help you desk" for any assistance. 06

9 PRE-CONFERENCE WORKSHOPS & REGISTRATION DETAILS PRE - CONGRESS WORKSHOPS ON 1st MARCH (Only 60, for all categories) (first come first serve basis) CATEGORY 1 ADVANCED PRACTICAL ANDROLOGY AND CLINICAL MANAGEMENT WORKSHOP Time 0900hrs to 1700hrs [ Live Demonstration of CASA, Semen Analysis, Sperm Preparation, Sperm Cryofreezing, DFI & ROS assessment. Practical tips on Sperm selection for ICSI & IMSI ] CATEGORY 2 PURSUING EXCELLENCE IN ART INTERACTIVE PRACTICAL DEMONSTRATION Time 0900hrs to 1700hrs [ ICSI, IMSI, Assisted Laser Hatching, Embryo Freezing & Vitrification (Hands on). Quality control in IVF Lab & troubleshooting in ART Procedures.] CATEGORY 3 CATEGORY 4 CATEGORY 5 ADVANCED 3D-4D REPRODUCTIVE USG WORKSHOP, LIVE DEMO / VIDEOS Time 0900hrs to 1700hrs [ Doppler & Volume USG, Deciding Stimulation Protocol with USG, Follicular quality, Endometrial receptivity LPD assessment,interventional Procedures related to infertility ] COUNSELLING IN ART Time 1200hrs to 1700hrs Registration Fee Rs 1000 [ This ISAR course is for not only counselors but also doctors & paramedics ] * Counslling is key to Infertility management. RESEARCH METHODOLOGY & BIOSTATISTICS Time 1000hrs to 1700hrs Registration Fee Rs 1500 [ This ISAR course is for not only doctors who wants to present papers but also Professors, Ph.d & P.G. Std. ] All The Workshops will be conducted in co ordination with International Speakers. REGISTRATION FEE STRUCTURE WORKSHOP FEE PARTICULARS ISAR Member Clinician ISAR Member Embryologist UP TO 31 ST OCT UP TO 31 ST JAN ON SPOT CATEGORY 1 CATEGORY 2 CATEGORY 3 INR 5500 INR 7000 INR 8500 INR 4000 INR 4000 INR 4000 INR 4500 INR 5500 INR 6500 INR 3000 INR 3000 INR 3000 Non -ISAR Member INR 6500 INR 7500 INR 9000 INR 4500 INR 4500 INR 4500 PG s INR 4000 INR 4500 INR 5500 INR 3000 INR 3000 INR 3000 Corporate Owners INR 7000 INR 8000 INR 9500 N.A N.A N.A Accompanying Person INR 3500 INR 4000 INR 5500 N.A N.A N.A SAFOG US$ 175 US$ 200 US$ 250 US$ 175 US$ 175 US$ 175 International Delegate US$ 225 US$ 250 US$ 300 US$ 225 US$ 225 US$ 225 CATEGORY 4 CATEGORY 5 INR 1000 INR 1500 Banquet Cultural Night (with Pre- Holi Theme) on dated 3 rd March 2012 INR 1700 IMPORTANT NOTES Last date for registration for all the workshops is 31st Jan 2012 The registration fee includes Conference kits, Conference lunches, Access to Scientific sessions & Workshop Extra) The Category of PG students is applicable to students pursuing Postgraduate Courses. Post graduates letter of recommendation and identification details from the Head of the Department/Institution. Embryologist to give membership proof of their association (Embryology Committee ISAR)(iForce etc., EART) Spouse / Accompanying person Registration entitles lunches / Inaugural & Valedictory Function. Please mention your ISAR Membership number, if you are a faculty. All the workshop charges includes Lunch, Dinner and Snacks. Exhibition. (Banquet & must send/bring a Refund Policy Refund requests will be entertained only up to December 31, % of the deposited 9 money will be refunded with in 30 days after the conference. 07

10 HOTEL ACCOMMODATION List of Hotels Accommodation has been booked at various hotels especially for the conference delegates at very special discounted rates. Participants can book their accommodation online through the conference website or write to the conference managers at the below mentioned address As demand for s is very high in the city, it is advisable to secure your accommodation at the earliest to avoid any disappointment and inconvenience at the time of the conference. S.No Name of Hotel Location category Rate for Single Rate for Double Approximate distance from Airport Approximate distance from Venue 1 2 Hotel Golden Tulip Hotel Babylon International VIP Road, (Soldout) VIP Road, (Soldout) Package tariff applicable which includes registration fee, banquet, 03 night hotel accommodation including breakfast, 01 Workshop, airport transfers, Daily shuttle service Package tariff applicable which includes registration fee, banquet, 03 night hotel accommodation including breakfast, 01 Workshop, airport transfers, Daily shuttle service 3 Hotel Babylon Inn Jail Road, Package tariff applicable which includes registration fee, banquet, 03 night hotel accommodation including breakfast, 01 Workshop, airport transfers, Daily shuttle service Hotel V W Canyon Hotel Celebration Hotel Florence 7 Corbiz Tower Hotel Shamrock Hotel Simran Heritage Hotel Simran Hotel Punjab Palace Hotel Mayura Hotel Grand International Royal Ambience Near Airport (Soldout) Jail Road, Vip Road (C,G,) Aurobindo Enclave, Pachpedi, Opposite New Bus Stand Behind, Jaihind Hosiery Market,, Station Road, Station Road, Kutchery Chowk, Jail Road Near Raj Talkies, G.E. Road Behind Gurudwara, Station Road Guru Gobin Singh Chock, Fafadih, Package tariff applicable which includes registration fee, banquet, 03 night hotel accommodation including breakfast, 01 Workshop, airport transfers, Daily shuttle service Executive Executive Kms 9 Kms Superior Executive deluxe Super Executive Executive Standard Executive Standard Standard 08 Kms 5 Kms Kms. 7 Kms Kms. 7 Kms 14 Kms 9 Kms 14 Kms 9 Kms Kms. 7 Kms Kms 9 Kms Kms 9 Kms Kms 9 Kms 08

11 HOTEL ACCOMMODATION 15 Hotel Ishika Hotel Venkatesh Hotel Puneet Hotel Ganpati (New Wing) Station Road, Phool Chowk, Opp. Bank of Baroda, Cloth Market Pandri. Standard Super Royal Super deluxe Kms 9 Kms Kms 9 Kms Kms. 7 Kms Pandri raipur Standard Kms. 7 Kms Hotel Aditya KK Road, Standard Lal Baag 21 Royal castle 22 Hotel Octopus Telibandha, Vidhansabha Road, raipur Telibandha Royal Royal Suite Super 14 Kms 9 Kms 9 Kms 5 Kms Kms 9 Kms Kms 5 Kms Remarks : rates are subject to availability of the mentioned category. Terms and Conditions All Rates given above are per per night basis Rates include, Breakfast and Taxes, unless specified. Incase of any changes in tax structure by the Government, the revised tax amount will be applicable and will be payable by the Delegate/Guest. s will be allotted on a first come first serve basis and are subject to availability. All payment should reach the Official Travel Agent within five days of submitting the Hotel Accommodation Form or else the same will be treated as a dummy booking and cancelled thereby. Accommodation through Official Travel Agent will be provided only to registered delegates. If the hotel of your first choice is not available, shall be confirmed from the next available preferred hotel. Refund, if any, will be made 30 days after the completion of the congress. 2.5% Bank Charges will be applicable incase payment made by credit card / international wire transfer. Queries and Bookings contact Mr. Vipin Tyagi / Mr. Abhishek Verma on the below details: Plan it! by Creative Travel Creative Plaza, Nanakpura, Moti Bagh, New Delhi , INDIA Tel: , / 58 / 59 Fax: / vipintyagi@travel2india.com OR abhishekverma@travel2india.com Cancellation Policy Cancellations received before 90 days prior to check in date Cancellations received between days prior to check in date Cancellations received between days prior to check in date Cancellations received less than 30 days prior to check in date No cancellation charges One night charge for s Minimum 01 night or 25% of the total billing, whichever is higher, will be charged as retention Full retention 09

12 R E G I S T R A T I O N F O R M ISAR 2012 March 1st 4th, 2012 Agrasen Dham Convention Center in conjunction with RMV Resorts & Babylon Group of Hotels, (Chhattisgarh) ISAR Membership No. (Mandatory for faculty) Pre-Congress Course on 1st March Main Conference on 2nd 4th March Title: Dr./Prof./Mr./Ms. First Name Last Name ISAR Member Clinician ISAR Member Embryologist Non ISAR Member/Embryologist PG s Corporate Owners SAFOG Member Gender: Male International Delegate Female Institution/Organisation Address City Postal Code State Country Telephone Mobile Fax no (mandatory) Passport Details (Only for NRI and International Delegates ) Passport No. Date of Issue Date of Expiry Place of Issue Date of Birth Name of Accompanying Persons :( If Any) Registration Category (Please tick as applicable ) All The Workshops will be conducted in co ordination with our International Speakers. REGISTRATION FEE STRUCTURE WORKSHOP FEE PARTICULARS ISAR Member Clinician ISAR Member Embryologist UP TO 31 ST OCT UP TO 31 ST JAN ON SPOT CATEGORY 1 CATEGORY 2 CATEGORY 3 INR 5500 [ ] INR 7000 [ ] INR 8500 [ ] INR 4000 [ ] INR 4000 [ ] INR 4000 [ ] INR 4500 [ ] INR 5500 [ ] INR 6500 [ ] INR 3000 [ ] INR 3000 [ ] INR 3000 [ ] Non -ISAR Member INR 6500 [ ] INR 7500 [ ] INR 9000 [ ] INR 4500 [ ] INR 4500 [ ] INR 4500 [ ] PG s INR 4000 [ ] INR 4500 [ ] INR 5500 [ ] INR 3000 [ ] INR 3000 [ ] INR 3000 [ ] Corporate Owners INR 7000 [ ] INR 8000 [ ] INR 9500 [ ] N.A N.A N.A Accompanying Person INR 3500 [ ] INR 4000 [ ] INR 5500 [ ] N.A N.A N.A SAFOG US$ 175 [ ] US$ 200 [ ] US$ 250 [ ] US$ 175 [ ] US$ 175 [ ] US$ 175 [ ] International Delegate US$ 225 [ ] US$ 250 [ ] US$ 300 [ ] US$ 225 [ ] US$ 225 [ ] US$ 225 [ ] Banquet Cultural Night (with Pre- Holi Theme) on dated 3 rd March 2012 INR 1700 [ ] CATEGORY 4 INR 1000 [ ] CATEGORY 5 INR 1500 [ ] In house package Single Double Hotel Babylon International Per Person Per Person Hotel Golden Tulip Per Person Per Person Package Includes : 03 Night / 04 Days accommodation, Registration Fees, Workshop, Banquet, Airport/Station transfer, Daily buffet breakfast, All Taxes only these two hotels will have shuttle service.

13 Pre Conference Workshops on 1 st March 2012 [Please tick only one] (Limited seats for each workshop are 60) [ ] Category 1. Advanced Practical Andrology and Clinical Management Workshop [Time: 0900 hrs to 1700 hrs] [ ] Category 2. Pursuing Excellence in ART Live demonstration & Handson [Time: 0900 hrs to 1700 hrs] [ ] Category 3. Advanced 3D-4D Reproductive USG Workshop with Live Demo & Videos [Time: 0900 hrs to 1700 hrs] [ ] Category 4. Counselling in Art [Time: 1200 hrs to 1700 hrs] [ ] Category 5. Research Methodology & Biostatistics [Time: 1000 hrs to 1700 hrs] Admission to all Congress Sessions, Poster & Exhibition Area, Inaugural and Valedictory Ceremonies. Lunch and two time tea / coffee on all days of the Congress, Kitbag including Scientific Program, Congress Badges And Lunch Coupons (Banquet and Workshop Extra) Payment Details: Option A: Demand Draft Demand Draft in favour of Chhattisgarh Chapter of ISAR payable at and to be sent at Conference Secretariat. Draft No. Dated Drawn on For INR Option B: Bank Transfer Remit to: Account no: Swift no: PUNB IN BBRPM Bank Name: Punjab National Bank Address: Anupam Nagar Branch, (C.G), India Note: Please note that all bank charges are to be borne by the sender Date Signature Mailing Address : (Please send Registration Form with payment to the following Address) Registration / In-house Pre-Congress Workshop Accompanying Person Banquet Total Secretariat Address CG Chapter of ISAR Office, 2nd Floor, Ashoka Super Speciality Women Hospital & ICSI Test Tube Baby Centre, Ashok Vihar Colony, Opp. Mandi Gate, Pandri, (C.G.) Pin Phone No / / , Fax: E -mail : secretariat@isar2012raipur.com / isarcgchapter@gmail.com / isar2012@gmail.com Website : Important Note: PG students should submit the bonafide certificate from Head of the Department. Embryologist to give membership proof of their association (Embryology Committee ISAR) (iforce etc.). Cancellation Policy: Cancellation must be notified to the secretariat in writing by to secretariat@isar2012raipur.com isarcgchapter@gmail.com. isar2012@gmail.com Refund requests will be entertained only up to December 31, % of the deposited money will be refunded with in 30 days after the conference. Official Conference Manager (ISAR 2012) Mr. Vikas Sharma / Ms. Pooja Aswani Plan it! by Creative Travel Pvt. Ltd. Creative Plaza, Nanakpura, Moti Bagh, New Delhi Tel: /58/59, Fax: , isarcgchapter@gmail.com / secretariat@isar2012raipur.com Website:

14 A C C O M M O D A T I O N F O R M Please return this form not later than 31 January 2012 to Creative Travel Pvt. Ltd. Creative Plaza, Nanakpura, Moti Bagh, New Delhi , India. Fax: / DELEGATE DETAILS: Title: Dr./Prof./Mr./Ms. First Name Last Name Institution/Organisation Address City Postal Code State Country Telephone Mobile Fax no (*mandatory) HOTEL DETAILS: (Please indicate choice in order of preference, subject to availability on first come, first served basis.) Hotel Choice: Type of required (per ): Single Double Twin Number of occupants Check-in date Check-out date Total nights: Special requests (If any) PAYMENT DETAILS: (Please type or print all information clearly, please avoid errors due to illegible data). Total Amount Indian Rupee MODE OF PAYMENT: If paying by Demand Draft: Demand Draft in favor of CREATIVE TRAVEL PVT LTD. Payable at New Delhi of Rs. DD No. Dated: Drawn on: Terms and Conditions 1. All Rates given above are per per night basis 2. Rates include, Breakfast and Taxes, unless specified. 3. Incase of any changes in tax structure by the Government, the revised tax amount will be applicable and will be payable by the Delegate/Guest. 4. s will be allotted on a first come first serve basis and are subject to availability. 5. All payment should reach the Official Travel Agent within five days of submitting the Hotel Accommodation Form or else the same will be treated as a dummy booking and cancelled thereby. 6. Accommodation through Official Travel Agent will be provided only to registered delegates. 7. If the hotel of your first choice is not available, shall be confirmed from the next available preferred hotel. 8. Refund, if any, will be made 30 days after the completion of the congress % Bank Charges will be applicable incase payment made by credit card / international wire transfer. Cancellation Policy Cancellations received before 90 days prior to check in date Cancellations received between days prior to check in date Cancellations received between days prior to check in date Cancellations received less than 30 days prior to check in date No cancellation charges One night charge for s Minimum 01 night or 25% of the total billing, whichever is higher, will be charged as retention Full retention Queries and Bookings: contact Mr. Vipin Tyagi / Mr. Abhishek Verma on the below details: Plan it! by Creative Travel Creative Plaza, Nanakpura, Moti Bagh, New Delhi , INDIA Tel: , / 58 / 59; Fax: / vipintyagi@travel2india.com OR abhishekverma@travel2india.com

15 I N & A R O U N D C H H A T T I S G A R H Madhya Pradesh Jharkhand Orissa Maharashtra Andhra Pradesh

16 I N & A R O U N D C H H A T T I S G A R H Doodhadhari Math Math Maa Maa Bamleshwari (Dongargarh) Kanha Kanha National Park Park (150( kms Madhya from Pradesh) ) Khajuraho Bhoramdeo (Kawardha) Manipat Konark Sun Sun Temple Hirakud Dam Dam (90 kms from ) (300 kms from ) (220 kms from (Orissa) ) Mahamaya Temple (Ratnapur) Kunkuri (Jaspur) Hazaribagh Lodh Lodh Falls Falls (110 kms from ) Khiragarh Barsoor (Dantewada) Deekshabhoomi (85 kms from ) (280 kms from ) (170 kms (Nagpur) from ) Tekdi Tekdi Ganapati Temple Amarkantak Barnawapara Sanctuary (110 kms from () ) Simachalam (18 kms from the (Vizag) city of Vizag) Visakhapatnam Champaran Chitrakote Waterfall (Jagdalpur) Sirpur Sirpur Kapildhara (Amarkantak)

17 Bharat Serum Proposed Sponsors and many more... Conference Organizers DR. A. SURESH KUMAR Organizing Chairperson & all members of C.G. Chapter of ISAR, (C.G.) Conference Secretariat CG Chapter of ISAR Off ice, 2nd Floor, Ashoka Super Speciality Women Hospital & ICSI Test Tube Baby Centre, Ashok Vihar Colony, Opp. Mandi Gate, Pandri, (C.G.) Pin Tel: Fax: Website : Conference Managers Planit! By Creative Travel Creative Plaza, Nanakpura, Moti Bagh, New Delhi , India Tel : /58/59 Fax: /9764 Website: