Focus on Reproduction ESHRE May 2011


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Focus on Reproduction ESHRE May 2011

  1. 1. Focus onREPRODUCTIONEuropean Society of Human Reproduction and Embryology // MAY 2010 // Crisis? What crisis? ESHRE’s role in Europe’s politics of population ESHRE news Papers which changed the world of ART Meet ESHRE’s next chairman
  2. 2. EXECUTIVE COMMITTEE Chairman Focus on Luca Gianaroli (IT) Chairman Elect Anna Veiga (ES) Members REPRODUCTION Ursula Eichenlaub-Ritter (DE) Jean-François Guerin (FR) Chairman’s introduction Timur Gürgan (TR) Antonis Makrigiannakis (GR) Carlos Plancha (PT) In my introduction to the January issue of Focus on Françoise Shenfield (GB) Reproduction I stated that 2010 was likely to be a Miodrag Stojkovic (RS) hectic year for ESHRE. Four months later, I can confirm Anne-Maria Suikkari (FI) Etienne Van den Abbeel (BE) that this is proving particularly true. Heidi Van Ranst (BE) Traditionally, ESHRE has always given its first Veljko Vlaisavljevic (SL) priority to education, but this year we have made even Ex-officio members extra efforts in this direction. The budget for Joep Geraedts (Past Chairman) Søren Ziebe (SIG Sub- educational activities has been increased by more than committee) 30% over the previous year and 27 Campus symposia and workshops have joined the annual meeting and FOCUS ON REPRODUCTION precongress courses to enrich the ESHRE calendar. EDITORIAL COMMITTEE So far, we have had extremely positive feed-back from all the activities that Paul Devroey Bruno Van den Eede have already taken place this year. Our Campus meeting on the ‘Prevention Hans Evers and treatment of infertility in modern society’, held in Istanbul in February Joep Geraedts and reported in detail on page 28, formally inaugurated the public activities of Luca Gianaroli the Task Force Reproduction and Society, and created much interest. Hanna Hanssen Anna Veiga Another important event was the Campus consensus meeting on poor Søren Ziebe ovarian response held in Bologna in March. This was the first ever activity to Simon Brown (Editor) be organised through a collaboration of all ESHRE’s SIGs. The meeting Focus on Reproduction culminated with the development of common definition of poor ovarian is published by response, an issue that has so far has been the subject of much debate in the The European Society of Human Reproduction and Embryology scientific community. Meerstraat 60 There is also encouraging news to report from the embryology certification Grimbergen, Belgium committee, which will shortly introduce a process of certification renewal through a scoring system similar to the CME scheme already in place in many European countries. All rights reserved. The opinions expressed in this As far as international relationships are concerned, a letter of intent has magazine are those of the been recently signed by ESHRE and the Chinese Society for Reproductive authors and/or persons interviewed and do not necessarily reflect the Medicine to promote grants and exchanges between researchers from Europe views of ESHRE. and China. We are hopeful that this collaboration will lead to significant results in the future. MAY 2010 The organisation of the annual meeting in Rome is now progressing in the Cover picture: best possible way, and ESHRE 2010 will be another outstanding assembly of Getty Images/Hulton Archive clinicians, scientists and paramedics from all over the world. So I look forward to seeing you all in Rome! Luca Gianaroli ESHRE Chairman 2009-11 CONTENTS NEWS FEATURES 4 Scientific programme Rome 28 Europe’s demographic crisis 8 Honorary members 2010 Simon Brown on ESHRE’s role in Europe’s politics of population 9 This year’s AGM agenda 32 Papers which changed the world 10 Rome to celebrate 20 years of PGD of assisted reproduction 13 From the Paramedical Group Hans Evers with a commentary on 14 Fertility Europe some of the landmark papers in the history of ART 15 From the Special Interest Groups 36 Meet Anna Veiga 20 Sperm banking Campus report ESHRE’s Chairman Elect 24 Consensus in poor ovarian response talks about her career and 26 From the Task Forces ambitions for the SocietyFocus on Reproduction May 2010 3
  3. 3. ANNUAL MEETING 2010 Abstracts go through the roofSubmissions up by anunprecedented 33% The final programme for our annual meting in Rome is All abstracts were submitted to our standard review now confirmed, and this year the International Scientific procedure, which comprises a screening and a scoring Committee (ISC) has been faced with an unprecedented process. The aim of the screening is: increase in the number of abstracts submitted. The to ensure that abstracts are generally designated to the committee has received a remarkable 33% more abstracts correct topic category this year than last, a rise from 1154 in 2009 to 1539 in to eliminate all abstracts of obviously poor quality 2010. It is also clear that there is a wealth of new to eliminate abstracts that deal with topics or subject developments now scheduled for the free communications, matters unrelated to the meeting either as oral or poster presentations. A total of 138 abstracts were rejected following the The submitted abstracts were arranged in the following screening process. In addition, there were five withdrawals. categories before review: This means that 1396 abstracts underwent the complete review procedure. Of these, there were: Category Total 359 abstracts submitted for poster presentation only Andrology 208 1037 abstracts submitted for oral/poster presentation Cross-border reproductive care 17 And from this latter total no more than 239 have now been Demography, epidemiology, registries, selected for oral presentation and 590 for poster. This and health economy 54 selection was done solely on the basis of the scores from Early pregnancy 71 three reviewers scoring blinded abstracts. The 239 free Embryology (embryo selection) 184 communications have now been divided into 45 sessions, Endometriosis, endometrium, implantation 144 which each contains between four and seven oral Ethics and law 21 presentations. Fertility preservation 105 Others 202 Poster presentations Paramedical (nursing, laboratory) 30 With such a substantial increase in the number of abstracts Psychology and counselling 47 submitted, the ISC agreed to admit a higher percentage of Reproductive endocrinology 217 poster presentations than last year, with 590 authors now Reproductive genetics 68 invited to present their posters electronically. Furthermore, Reproductive surgery 35 each presenter this year will be offered the additonal Safety & Quality 112 opportunity of a paper poster. These traditional posters will Stem cells 24 be presented in the ‘Poster Village’, according to subject, as Grand total 1539 was done last year. The number of posters in each category4 Focus on Reproduction May 2010
  4. 4. Human ReproductionTopic (total posters) Poster discussion Poster Village keynote lecture, in honour of the best paper from our mainAndrology (91) Tuesday Wednesday journal. The first presenter,Cross-border reproductive care (9) Monday Gayle Jones, has beenDemography, epidemiology, registries and health economy (17) Monday selected on the basis of theEarly pregnancy (23) Tuesday paper ‘Novel strategy withEmbryology (103) Tuesday potential to identifyEndometriosis, endometrium, implantation (64) Monday Tuesday developmentally competentEthics and Law (4) Monday IVF blastocysts’, which wasFertility preservation (49) Wednesday Monday published in 2008. Gayle willParamedical (6) Tuesday begin her presentation withPsychology & counselling (14) Tuesday the published work and thenReproductive endocrinology (97) Monday go on to deal with moreReproductive genetics (27) Monday recent developments. TheReproductive surgery (11) Wednesday second keynote lecture is bySafety & quality (63) Tuesday Wybo Dondorp, who willStem cells (12) Wednesday discuss the risks and responsibilities associated as well as the days on which they will be presented in the with innovative reproductive technologies. Poster Village are indicated in the box above. In addition, Monday morning will also feature a PGD/PGS session each day of the meeting will feature a more formal poster during which the latest annual data from the PGD discussion, also as indicated in the table above. The time Consortium will be presented as well as the first results allocated to each presenting author will be restricted to from the PGS pilot study staged by ESHRE’s Task Force on two minutes only and thereafter three minutes will be PGS. available for discussion. In recent years our debate sessions have been well Continued over page Geographical distribution As ever, abstracts were received from all over the world. This year, no fewer than 65 countries (last year 60) will be represented. The ten most prolific countries are shown below: Total Selected Selected abstracts for oral for poster Spain 157 19 65 Italy 128 10 48 United Kingdom 114 29 39 USA 86 18 44 Netherlands 81 23 35 Japan 76 8 39 France 73 16 34 China 63 7 19 Where from? Selected oral presentations 2010. South Korea 60 3 22 Brazil 60 9 19 It is interesting to note that Belgium, which is not on this list, submitted 40 abstracts, of which 14 were selected for oral and 19 for poster presentation. As always, the main scientific meeting begins on the Monday morning (28th June). Before that, however, no fewer than 12 precongress courses will be held on the Sunday. The topics vary from ‘Patient-centred fertility care’, hosted by Fertility Europe, to ‘Fertility preservation in cancer’, organised by our Task Force on Fertility Preservation in Severe Diseases. Monday starts as usual with a keynote lecture session. This year, for the first time, one of the presentations is the Where from? Selected poster presentations 2010.Focus on Reproduction May 2010 5
  5. 5. ANNUAL MEETING 2010 All aboard! Take the bus, the train or the Metro in Rome The congress venue in Rome, the Nuova Fiera di Roma, is Shuttle buses located outside the city centre, between the city and Hotels officially booked by ESHRE and its agent, Fiumicino airport, which means that all participants this Meridiano Congress International, will be served by a fleet year - even those staying in hotels near the congress centre of shuttle buses running between the hotels and the - will need transportation. congress centre. The journey time from the city centre There are three public transport systems available: hotels will be around 45 minutes, so delegates planning an Scientific programme, Rome Continued from previous page received, and this year there will be at least one a day. This again combining the awards ceremony with summaries of year’s topics include natural cycle IVF vs. stimulation, the award-winning presentations and the closing ceremony. selection of male vs. female gametes and alternative All in all, this has been an unprecedented year in terms medicine. of interest and abstract submission, and there’s little doubt On Tuesday our historical lecture is topically devoted to where most investigators want to be at the end of June. We ‘Catholicism and human reproduction’ and will be in the ISC are looking forward to a very interesting and delivered by Norman Ford. rewarding programme, which we feel confident will deliver The number of invited sessions totals 25, and almost presentations of the highest quality. every one of ESHRE’s SIGs is represented. There are also Joep Geraedts, company symposia, our traditional live surgery session, Chairman International Scientific Committee and sessions covering themes related to ESHRE activities. There is more graphic information on the geographical And as last year - since it proved such a success - we are distribution of abstracts on the ESHRE website.6 Focus on Reproduction May 2010
  6. 6. early start at the congress will need to be on their way by 7.00! First results from ESHRE’s PGS pilot Metro + Laurentina shuttle Rome’s Metro system is inexpensive study to be reported in Rome and easy to use, with just two lines First results from the amplification protocol crossing the city. These two lines - line PGS pilot study staged and the 24sure A and line B - cross at the Termini by ESHRE’s PGS Task microarray technology station. Those without access to Force will be presented provided by BlueGnome official hotel shuttle buses may take in Rome in a Monday of Cambridge, UK. The the line B Metro to Laurentina station morning session which images have been scored (at the end of the line), where a further also includes new data from the by two independent observers in fleet of shuttle buses will run to and ESHRE PGD Consortium. each centre. To estimate the from the congress centre. More than This PGS proof of principle (PoP) concordance of data between the 2000 seats a day will be available on study, which was first announced in polar bodies and corresponding the Laurentina shuttles. Amsterdam last year, began about a oocytes, there will be a blind analysis Direct on the FR1 railway month later than originally planned. of those oocytes which are deemed Fiera di Roma has its own stop on the However, recruitment of patients aneuploid according to the result of FRI (Trenitalia) train line between the went successfully and the technical the polar body analysis. city and Fiumicino airport. You can part of the project will be completed The study began in September pick up the train at stations Termini, soon. A sufficient number of polar 2009 and it is expected that the Tuscolana, Trastevere or Ostiense in bodies have been biopsied by the two acquisition of the data will be the direction of Fiumicino and get off pilot centres in Bonn and Bologna. completed in May. At the moment all at Fiera di Roma. Departures are every First and second polar bodies have data are in the process of evaluation 15 minutes. been separately processed for by an independent data analysis team We also understand that some of our chromosomal analysis, which has at the University of Amsterdam. sponsoring companies with large hotel been performed at each of the two Joep Geraedts allocations will be providing their own centres using the SurePlex Co-ordinator PGS Task Force transport between hotels and the congress site. Our agents in Rome, Meridiano, have now devised a bus timetable, European Court declares Austria’s ban with schedules divided according to on gamete donation unjustified three clusters of hotels - ‘city centre’, ‘congress area’ and ‘residential area’. The European Court of Human gametes from the treated infertile The timetables are available on the Rights has ruled in favour of two couple. Legal restrictions had been ESHRE website. All buses will carry infertile Austrian couples who put in place to protect children from the ESHRE logo, and each will have a complained to the Court that ‘unusual family relationships’ and representative of Meridiano on board. Austria’s ban on sperm and egg the exploitation of donors. Filippo Maria Ubaldi donation in ART violated their right ‘It’s early to say what this means Chairman Local Organising Committee to respect for family life and that for other countries where gamete the difference in treatment available donation in IVF is banned,’ says to them (needing gamete donation) ESHRE’s Chairman Luca Gianaroli. and to other couples using ART ‘But this ruling appears to set a (without gamete donation) was precedent that any restriction on discriminatory. On this latter gamete donation in IVF is a violation complaint, the Court - while noting of two articles of the European that among EU member states there Convention on Human Rights - on was ‘no uniform approach’ to ART rights to family life and to non- nor any ‘obligation to allow it’ - discriminatory treatment. As in Italy, ruled by a majority of six to one that the challenge to restrictive the difference in treatment at issue legislation in ART has once again was not justified. come from patients.’ According to a 1st April press The Austrian government now has release from the Court, Austrian law three months in which to decide allows ART only with ‘homologous’ whether to appeal the judgement.Focus on Reproduction May 2010 7
  7. 7. ANNUAL MEETING 2010 // HONORARY MEMBERS // Meet ESHRE’s 2010 honorary members Honorary memberships have been awarded annually to two luminaries from reproductive science and medicine at each of ESHRE journals: ESHRE’s annual meeting since 1985, one of them from the HR progresses ‘in host country. This year’s ‘local’ honorary membership will be awarded to the Italian gynaecologist Ettore Cittadini, who the right direction’ since the late 1950s has worked clinically and in research in The publisher’s report to gynaecological endoscopy, infertility and family planning at ESHRE’s journal sub- several hospitals in Italy and abroad, including the Hopital committee for 2009 shows that Broca in Paris and the O&G Clinic of Palermo. Professor the indices of performance for Cittadini was a member of ESHRE’s first temporary Human Reproduction ‘have all committee, which Robert Edwards formed in 1984 to steer moved in the right direction’. the fledgling society, and of ESHRE’s first Advisory The number of new Committee set up soon after. submissions was maintained ESHRE’s second honorary membership will be awarded to or increased, the time to a the French biologist Professor Luc Montagnier, who in 1983 first decision decreased, the led the group which first isolated the human acceptance rate declined, the immunodeficiency virus (HIV1) and identified it as the response times from associate causative agent of AIDS. In 1985 he isolated the second AIDS editors reduced, and the virus, HIV2, from West African patients. His laboratory in impact factor increased. Paris at the Institut Pasteur was also the first to show that a During the six-month period large fraction of white blood cells of HIV-infected patients of July-December 2009, the ESHRE’s two honorary were prone to die by apoptosis, a process of programmed cell journal received a total of 851 members for 2010: death attributed to oxidative stress in patients, possibly manuscripts, the vast majority above, Italian associated with infections. Besides his involvement in the original articles. The 9% gynaecologist Ettore design of new types of HIV vaccines, his current studies are acceptance rate for 2009 Cittadini, and below, French biologist aimed at microbial and viral factors associated with cancers, suggests that the decline Luc Montagnier. neurodegenerative and articular diseases. observed over the previous In 1987 Professor Montagnier was one of four guest four years (19, 15, 12 and lecturers at ESHRE’s third annual meeting, which Edwards 11%) may now be stabilising. organised in Cambridge, UK. Continuing education for ESHRE-certified embryologists ESHREs programme for the certification of embryologists improved, with different parts of the curriculum being is now in its third year, and this years exams will be held linked to relevant syllabi from ESHRE workshops. in Rome on Saturday 26th June at 16.30. With the A questionnaire regarding the certification procedure, numbers of certified embryologists - and scientific and what ESHRE-certified embryologists have gained after developments - ever increasing, ESHRE will this year obtaining their certification, was sent out at the beginning introduce a Continuous Embryology Education (CEE) of the year. The results are currently being analysed, and system in which ESHRE-certified embryologists will be able will be presented shortly. to upgrade their certification on-line. This can be done The website also contains detailed instructions about the through examination in Rome - as well as details for aspiring attending meetings, courses and workshops examinees of eligibity and logbook submission for next publishing abstracts and articles year’s exam in Stockholm. The rules for certification of presentations at meetings embryologists state that the applicant must be a member The embryology certification pages on the ESHRE website of ESHRE at the time of applying for certification. will shortly contain full information. Kersti Lundin The curriculum information on the website will also be EmCC Steering Group Co-ordinator8 Focus on Reproduction May 2010
  8. 8. // ANNUAL GENERAL MEETING // Balance sheet shifts towards higher expenditure ESHRE’s financial report to be presented at the General Assembly of Members (AGM) in Rome will Income show - for the first time in many years - a small budget deficit for 2010. With income continuing to rise, the shortfall in Expenditure finances will be accounted for by a greater commitment to the activities of the SIGs and Task Forces, which in 2009 are set to represent 19% of Balance ESHRE’s total expenditure. The organisation of Campus events, for example, of which 27 have been scheduled for 2010, cost ESHRE 382,584 euro in 2008, but 418,567 euro in 2009, an increase of 8.6%. Currently, SIG and Task Force activities represent around 19% of the Society’s total 2008 2009 Budget 2009 Budget 2010 expenditure, but generate only around 7% of total Income 5,612,051 5,943,762 5,161,495 6,259,708 income. Attendance costs of Campus events are kept Expenditure 4,795,813 5,945,504 5,120,231 6,379,951 to a minimum to encourage participation from +816,238 -1,742 +41,263 -120,243 Balance students and young members. The annual meeting remains ESHRE’s greatest Financial results 2008-9; Budget 2009-10 (euro) source of income (67%) and greatest expenditure (50%). Publications represent 16% of the Society’s 1. Minutes of the last meeting income, and membership fees 7%. However, ESHRE 2. Future activities of the Society remains financially strong - despite the economic 3. Ratification of the honorary members for 2011: circumstances - and committed to its training nominees are Alan Trounson and Lars Hamberger programme and specialist groups. 4. Paramedical Group This year’s General Assembly of Members will take 5. Financial report place on Tuesday 29th June at 18.00 at the Fiera 6. Membership of the Society Roma (Hall 10, Room I), Rome; the agenda is as 7. Any other business summarised in the box opposite: 8. Date of the next General Assembly of Members Make the most of Special Interest Group membership There are 11 Special Interest Groups (SIGs) in ESHRE members (deputies), including a junior representative and all members are asked to indicate which is their and the recent past co-ordinator. The role of the SIG primary and secondary interest. Of course, this does not committee is to take suggestions for Campus events restrict you to participating only in the activities of your and PCCs and organise these activities, which may special interests, but will enable you to receive special often be combined as a joint course with other SIGs. alerts relating to topics of interest and forthcoming There are 25-30 workshops each year, across a range of Campus events and precongress courses (PCCs). The subjects and in different European countries. These SIGs are listed on the ESHRE website under the serve to provide both training and state-of-the-art heading ‘Speciality Groups’. In addition, there is the updates. Lecture notes are available on the ESHRE Paramedical Group, which was established to assemble website. The SIGs also hold a business meeting at each nurses, lab technicians and other support personnel annual meeting, which is open to all members. Here active in the field of reproductive medicine and you may make suggestions for future activities. science. The PMG also organises Campus workshops If you are not a member of a SIG (or two), please and has dedicated sessions at the annual meeting. contact ESHRE and express your interest. Each SIG has a co-ordinator, who is nominated from Adam Balen the SIG committee, which usually comprises three other Co-ordinator SIG Reproductive EndocrinologyFocus on Reproduction May 2010 9
  9. 9. ANNUAL MEETING 2010 // PGD CONSORTIUM // Twenty years of PGD for celebratory post-congress course in Rome ESHRE’s PGD Consortium and SIG Reproductive Genetics are this year organising a post-congress course to celebrate 20 years of PGD. The event will take place on 1st July in Rome. The first clinical PGD cases were performed at the Hammersmith Hospital in London in 1989, and, although the first couple treated did not get pregnant at this first attempt, they did deliver twins in 1990 at their second try. However, more than 20 years before that, the first PGD had been performed by Richard Gardner and Robert Presentations from many Edwards - in 1967. They biopsied a small portion of the of the central figures in PGD trophectoderm from rabbit blastocysts, sexed the embryos The celebration of 20 years of PGD will be held as an by identifying sex chromatin to identify females, and ESHRE post-congress course on Thursday 1st July in replaced the biopsied blastocysts back into recipient Rome and includes contributions from many of the key females. The offspring in these experiments were found to players in PGD. These include include Alan Handyside, be of the predicted sex.1,2 Joep Geraedts, Karen Sermon, Joyce Harper, Gary The first human PGD cases were performed at the Harton, Darren Griffin, Marilyn Monk, Montse Boada, Hammersmith Hospital in 1989, using cleavage stage Mark Hughes, Dagan Wells, Edith Coonen, Santiago biopsy for embryo sexing by PCR.3 Female embryos were Munné, Cristina Magli, Luca Gianaroli, Joe Leigh selectively transferred in five couples at risk of X-linked Simpson, Alison Lashwood, Inge Liebaers, Francesco disease resulting in two twin and one singleton pregnancy. Fiorentino, Stéphane Viville, Guido de Wert, Leeanda A total of 21 cycles were performed in two series and Wilton and Anver Kuliev (who will also pay tribute to included the above successes as well as one misdiagnosis. the late Yury Verslinsky). The programme is divided into At that time little was known about the pitfalls of single three sessions: The past, present and future of PGD; cell amplification, particularly allele dropout, cumulus cell PGD from the patients perspective (which will include contamination or amplification failure from single cells. talks by two families who have benefitted from PGD In the USA several teams were also developing PGD in and saviour sibling HLA matching); and Embryology the late 1980s. Yury Verlinsky did his first cases in and ethics as they relate to PGD. 1988/89.4 His team used the first polar body to detect a maternally transmitted alpha 1 antitrypsin deletion in one patient. Eight eggs were collected, seven polar bodies were PGD, with four in the USA. A total of 83 cycles were aspirated, six embryos fertilised, and PCR was successful in reported of sex selection for patients carrying X-linked five cases. Two embryos were transferred but the patient disease using PCR or FISH and 51 cycles of PGD for did not become pregnant. In the same year Yury’s team monogenic disorders, including cystic fibrosis. Three reported on preconception diagnosis for cystic fibrosis.5 centres dominated the field: the Hammersmith/UCL By 1994 there were eight centres worldwide performing group, the team at Cornell University Medical College in Joyce Harper,Chair of the PGD Consortium, demonstrating embryo biopsy during a 1993 workshop organised by Leeanda Wilton Gary Harton, right, Deputy Chair of the PGD Consortium, with in Melbourne. Alan Handyside at the Genetics & IVF Institute, Fairfax, in 1995. 10 Focus on Reproduction May 2010
  10. 10. Accreditation the way to quality assurance in the PGD lab According to an internationally recognised standard accreditation bodies for each country have been (ISO), accreditation is increasingly acknowledged as established, which will streamline the accreditation the most effective route to appropriate laboratory process. quality assurance, and most diagnostic and IVF At this year’s workshop 15 invited speakers provided laboratories are now moving towards accreditation. a detailed overview of current best clinical/laboratory ESHRE’s PGD Consortium, and some regulatory experience in quality management for PGD. This bodies including the HFEA in the UK, recommend that included training of PGD staff, auditing PGD activities, all PGD laboratories should be accredited according to external quality assessment, key quality indicators in ISO 15189, Medical laboratories - Particular PGD, emerging technologies in PGD and the role of the requirements for quality and competence. The PGD PGD Consortium. Since the first workshop of 2008, Consortium working-group on accreditation has recently several centres have become accredited and many described each point of the ISO and how it relates to others are working towards accreditation. PGD.1 Accreditation is an ongoing issue and the Consortium In order to help centres understand the benefits, and EuroGentest are developing further workshops. The advantages and profitability of being accredited, the Consortium will be conducting annual questionnaires of PGD Consortium, SIG Reproductive Genetics and its members to monitor the centres who have been EuroGentest organised a second Campus workshop on successful in accreditation. Successful centres will be accreditation for PGD in London in March, two years noted in the quarterly Consortium newsletter. after the first on accreditation in Brno, Czech Republic, Katerina Vesela, Chairman Accreditation working group in 2008. Since that time the conditions, availability Joyce Harper, Chair PGD Consortium and legislation across Europe have developed at a fast 1. Harper JC, Sengupta S, Vesela K, et al. Accreditation of the pace. From January this year clearly defined national PGD laboratory. Hum Reprod 2010; 25: 1051-1065. Participants in the Campus workshop on accreditation for PGD held in London in March. New York run by Jacques Cohen and Santiago Munné, and 2. Gardner RL, Edwards RG. Control of the sex ratio at full term the Reproductive Genetics Institute in Chicago run by Yury in the rabbit by transferring sexed blastocysts. Nature 1968; 218: 346-349. Verlinsky. The other centres were the University Hospital, 3. Handyside AH, Kontogianni EH, Hardy K, Winston RM. Ontario, Free Univeristy Hospital Brussels (VUB), the Jones Pregnancies from biopsied human preimplantation embryos sexed Institute, Norfolk, USA, the Genetics & IVF Institute, by Y-specific DNA amplification. Nature 1990; 344:768-770. Fairfax, USA, and GIEPH, Barcelona. 4. Verlinsky Y, Ginsberg N, Lifchez A, et al. Analysis of the first Joyce Harper and Gary Harton polar body: preconception genetic diagnosis. Hum Reprod 1990; 5: 826-829. Chair and Deputy Chair 5. Strom CM, Verlinsky Y, Milayeva S, et al. Preconception genetic ESHRE PGD Consortium diagnosis of cystic fibrosis. Lancet 1990; 336: 306-307. * For more details about the history of PGD see Preimplantation 1. Edwards RG, Gardner RL. Sexing of live rabbit blastocysts. Genetic Diagnosis, Ed Harper. JC, Cambridge University Press, Nature 1967; 214: 576-577. 2009.Focus on Reproduction May 2010 11
  11. 11. ESHRE 2012 heads to Istanbul ‘. . . as far East as we can go’ ESHRE’s 2012 annual meeting - the medicine, but also its location as a limited number of cities in Europe Society’s 28th in total - will take place bridge between East and West. ‘It will able to provide what ESHRE now in Istanbul, and for the first time in provide a great opportunity for our expects - sufficient high quality Turkey, a country which is now well members in the Middle East, Asia and conference and exhibition space, represented in ESHRE’s membership. Australia,’ says ESHRE’s managing convenient transport connections and The local chairman will be Timur director Bruno Van den Eede, ‘and plentiful accommodation in all price Gürgan, who has been a member of make the 2012 meeting a little more ranges. Istanbul meets those criteria, ESHRE’s Executive Committee for the convenient. It’s another move in the with the annual meeting set to be past three years. right direction, but geographically it’s staged at the Istanbul Convention & The choice of Istanbul not only as far East as we can go.’ Exhibition Centre, a state-of-the-art reflects Turkey’s substantial With congress planning now having venue whose main auditorium can membership in ESHRE and its to consider 10,000 participants (in seat more than 2000 ‘in armchair prominent role in reproductive theory if not actually), there are a comfort’. Ten years of ESHRE IVF monitoring to be marked by celebration meeting The unique and far-reaching data collection of ESHRE’s European multiple rates below 20% for the first time. European IVF Monitoring (EIM) consortium is now in its However, the most striking trend in ten years of EIM 12th year and on 11th September in Munich the group data has been the proportional increase in the use of will celebrate the ten-year anniversary of its first ICSI, which is now double that of IVF in European publication. Ten-year trends reported by the EIM have practice. This is a complete reversal in trend from what shown a continuing increase in ART pregnancy rates, was apparent a decade ago - from 65% IVF and 35% despite the transfer of fewer and fewer embryos in each ICSI in 1997, to 37% IVF and 63% ICSI in 2005. cycle: from 26% to 30% for IVF and ICSI, and from 15% The September meeting programme has been put to 19% for frozen embryo cycles. And although the together by the present chairman of the EIM steering number of egg donation cycles remains low, pregnancy group, Jacques de Mouzon, and will feature the impact of rates have increased from 27% to 42%. ART databases over the past decade and experience from The data also showed a ten-year decline in multiple many of the local registries on which the annual EIM delivery rates, from 29.5% when records began to 20.5% reports are based. There will also be round-table sessions in 2005. Last year in Amsterdam, the EIM report noted on the practicalities of gathering and presenting EIM data.12 Focus on Reproduction May 2010
  12. 12. NEWS // PARAMEDICAL GROUP // Paramedic members encouraged to pursue their own research and submit abstracts A two-day Campus workshop on ‘Research - theory and practice’ was staged by the Paramedical Group on 4/5th March in Brussels. The course, which attracted 55 participants, aimed to increase the number and the quality of abstracts submitted by paramedics, who today include nurses and laboratory technicians, counsellors, junior scientists and junior medics. Both the editors of Human Reproduction, André Van Steirteghem, and Human Reproduction Update, John The first textbook designed for nurses in reproduction The past decade has seen the professional role of the specialist nurse evolve, through the development of More than 50 members of the Paramedical Group took part in a evidence-based protocols and a greater involvement in Campus workshop on the theory and presentation of research in reproduction. The course was designed to encourage research and research. The continuing education of nurses is increase the number and quality of abstracts and papers important to maintain this momentum and improve submitted to congresses and journals by paramedics. standards of care. As happened with our medical colleagues, more and Collins, took part, the latter describing the skills needed to more nurses are now specialising in just one field of write a meeting abstract, and the former a full manuscript. medicine, and in such cases a basic nursing education An introduction to descriptive statistics was given by is not enough to support the development of care in a Olivier Mairaisse, whose presentation covered specialty such as reproductive health. distributions, quantiles, measures of central tendency and In the Netherlands, under the lead of two nurses, variation and standard scores. Metty Spelt and Nicolette de Haan, several Van Steirteghem opened the second day with the professionals have now filled a gap in the education of selection of papers: how abstracts are reviewed and how nurses in reproduction with the development of a papers are chosen for publication. He noted that the textbook, the first to be written for nurses working in chances for acceptance of a congress abstract or a paper reproductive health. The book provides an overview of for publication might be better if potential researchers all the important issues - and junior doctors and lab know which standard should be met and what quality is technicians have also found it invaluable. expected. Herman Tournaye from the VUB in Brussels However, a lack of formal education and training for described the art of presenting data and making effective paramedics working in reproduction is not just an issue use of PowerPoint. in the Netherlands. Many countries in Europe are Facilitators for the afternoon workshops were actively unable to provide specific training - which is why involved in one type of research and proposed one of their ESHRE’s Paramedical Group has developed its basic own research projects. There were specific workshops on training course as a model suitable for members nursing research (presented by Valerie Peddie) and research throughout Europe. The next step in the support of in midwifery (covered by Mette Juhl). these training efforts was a translation of the textbook The objective of the course was to help participants into other languages. And we are pleased to report that understand the different approaches to research and to the textbook is now being translated into English and apply this knowledge in their own fields of practice. The will be ready for the annual meeting in Rome. ESHRE Paramedical Board hopes that those attending will feel has generoulsy agreed that every paramedical member more confident about their own research ideas and to will receive a free copy of the book. submit their abstracts to ESHRE Jolieneke Schoonenberg-Pomper Patricia Baetens and Heidi Van Ranst PMG Chair elect Paramedical BoardFocus on Reproduction May 2010 13
  13. 13. ‘Patient-friendly’ treatment from the patient point of view Fertility Europe will organise this year’s Patient Session in the scientific programme for Rome under the title ‘How Fertility Europe’s association with ESHRE patient-friendly is patient-friendly?’ The session, with four Why should FE and ESHRE work together? We are speakers, aims to present the patient’s view of what they experts in our own fields and complement each other. consider ‘patient friendly’ treatment to be. The perspective Patients and professionals should work in partnership is global, and, by presenting that view from East and and we both have relevant skills and experience. Western Europe as well as from a developing country, will We have now grown from seven members to 25 consider strategies to improve the friendliness of the whole thanks to ESHRE’s support. journey that patients take in their clinical and holistic care. FE is now the official partner patient organisation The first paper, presented by Guido Pennings from with ESHRE - something we are very proud of and ESHRE’s SIG Ethics & Law, will introduce an ethical take very seriously. approach to patient-friendly treatment in terms of the Statistics we have from just 11 member patient and society. Three other papers will be presented, organisations show that we reach 229,400 unique by Italian psychotherapist Vincenza Zambaldi on a holistic visitors each month via our websites and 382,000 in approach to treatment, Denisa Priadková, chair of the civil terms of total visitors per month. A fantastic reach. association Stork (Bocian) in Slovakia and vice chair of It’s important that our patient organisations across Fertility Europe, on how the rapid route to IVF is not Europe have reporting space in Focus on Reproduction always in the patient’s best interest, and Gamal Serour to bring our activities to everyone’s attention. from Egypt (and President of FIGO) on what patient- Our precongress course in Rome will represent the friendly treatment means in developing countries. patient view on treatment - a fantastic opportunity for Fertility Europe will have a booth in the main exhibition FE to inform those working in the field about patient area in Rome, so we hope all ESHRE members will pass experience and views - exactly the sort of thing the by and find out a little more about us. Our own annual collaboration with ESHRE was aiming for. meeting will be held in Rome on Monday 28th June. And I should here express our appreciation to ESHRE for allowing our delegates entry to the congress and exhibition (Onskebarn), Poland (Nasz Bocian), Slovakia (Obcianske - something none of us would be able to afford without zdruzenie Bocian), Switzerland (Verein Kinderwunsch), and the generosity of ESHRE. Patient organisations too can UK (Infertility Network UK), with candidate members learn an awful lot from the scientific sessions at the annual present from Austria (Wunschkind-Kinderwunsch), meeting and contribute to them. Bulgaria (Iskambebe and Sdruzhenie Zachatie), France Our latest FE meeting in March saw a very active (Association Maia), Greece (Kiveli), Latvia (Fertilitas), attendance from representatives of full-member patient Romania (SOS Infertilitatea), Sweden (IRIS), and Spain groups in Belgium (De Verdwaalde Ooievaar Netwerk (Genera). Fertiliteit), Czech Republic (Nadace Materska nadeje), It was striking to hear, from the presentations of each, Finland (Lapsettomien yhdistys Simpukka ry), Israel how inequalities exist between East and West Europe, and (Chen), Italy (FIAPI), Netherlands (Freya), Norway how too their issues and priorities are different. One vital role for Fertility Europe is to help beneficiary organisations share best practices, including information on fertility and infertility, prevention, fundraising, increasing membership and attracting volunteers. Among Fertility Europe’s plans for 2010 is the launch of our ‘Special Families’ campaign in which ‘virtual’ greeting cards become real cards with real hope. These messages will be displayed in a central point in Rome as a reflection of the variety and importance of fertility treatment today.Patient groups in East and West Europe Clare Lewis-Jonesare now represented in Fertility Europe Chair Fertility Europe14 Focus on Reproduction May 2010
  14. 14. SPECIAL INTEREST GROUPS // EMBRYOLOGY // Oocyte and embryo scoring The design of a common system from ESHRE and ALPHA embryologists The continuous exchange of morphological features as possible scientific and technical data Officers in relation to the time of among embryology laboratories is Cristina Magli (IT), Co-ordinator development, and to establish often hampered by the diversity of Rachel Levy (FR), Deputy Co-ordinator eventual correlations with viability experimental conditions and terms Kersti Lundin (SE), Deputy Co-ordinator and implantation potential, was of reference. The scoring of Josephine Lemmen (DK), Junior Deputy emphasised. This approach would oocytes and embryos is one such Etienne Van den Abbeel (BE), Past Co-ordinator make it possible to identify those example. Of course, there are Takashi Hiiragi (DE), Basic scientist aspects of morphology with many similarities in aspects and biological significance and for parameters of grading in each setting, but with large which systematic evaluation is critically relevant. differences of nomenclature. It is quite clear that a more The group met for two days in February in Istanbul at a uniform classification system would greatly help the meeting hosted by Basak Balaban, the current chair of integration of data for a better understanding of early ALPHA. A consensus document was drafted and is embryogenesis. currently being edited in its final version. The document With this concept in mind, the board of the SIG will be presented to the next ESHRE Executive Committee Embryology has been working towards the introduction of meeting and, after approval, published as an a comprehensive system for oocyte and embryo ESHRE/ALPHA document to be used as a common oocyte classification which could be shared throughout the and embryo grading system. scientific community. Our strategy was based on the idea of identifying those scoring criteria which could 2. The Atlas of Embryology unequivocally describe the morphological aspect of A new Atlas of Embryology was considered the best way oocytes, pronuclear stage and embryos and thereby reach to promote the new scoring system and illustrate the common definitions with a common language. We thus criteria for assessment. Working groups have now been planned to define an ESHRE scoring system to be shared organised to address the different chapters: oocytes, by all clinical embryologists - which might be realised in pronuclear stage, embryos and blastocysts. Gayle Jones has two steps: first, the compilation of evidence-based been appointed by the board of the SIG Embryology as co- evaluation data to formulate a common scoring system; ordinator of the working groups. and next, the dissemination of this new system through the During the SIGE’s business meeting in Rome there will be Atlas of Embryology. an update on the consensus document and 1. Consensus on the status of the The first step of the project. project was to gather a This initiative is the group of experts who result of a close could produce a collaboration between consensus document two embryology societies representing an evidence- and we both hope that the based guide to the proposed scoring system evaluation of oocytes, will soon become widely The SIG Embryology and ALPHA consensus development group, with pronuclear stage and all accepted, reinforcing the left to right, Alan Thornhill, Joe Conaghan, Aycan Isiklar, Lynette Scott, stages of embryo Jonathan Van Blerkom, Basak Balaban, Lisa Cowan, Kersti Lundin, idea that joint efforts can assessment. The Thorir Hardarsson, Etienne Van Den Abbeel, Cristina Magli, be very fruitful. importance of verifying Johan Smitz, Jim Catt, Dominique Royere, Sharon Mortimer and Cristina Magli the physiological David Mortimer. Not pictured are Santiago Munné, Thomas Ebner, Co-ordinator significance of as many Gloria Calderon and Daniel Brison SIG EmbryologyFocus on Reproduction May 2010 15
  15. 15. SPECIAL INTEREST GROUPS // EARLY PREGNANCY // Clarifying the evidence in recurring miscarriage Annual meeting Rome and comparative genomic Our precongress course in Rome has Officers hybridisation (CGH) array, this been creatively constructed around Roy Farquharson (GB), Co-ordinator improved accuracy of chromosomal the theme of debate and audience Mariette Goddijn (NL), Deputy Co-ordinator abnormality detection has heralded interaction. In the field of recurring Ole Christiansen (DK), Deputy Co-ordinator a new era. With a wide spectrum of miscarriage there is a dearth of Eric Jauniaux (GB), Past Co-ordinator treatment interventions now used in evidence-based practice with no clear Marcin Rajewski (PL), Junior Deputy recurring miscarriage this session systematic review to guide and provides an ideal opportunity to inform best clinical practice (Level 1 question whether treatment failure evidence). As a result, this lack of remains a valid concept in the clarity allows considerable scope for absence of cytogenetic testing. In opinion to fill the vacuum. The particular, it suggests a new purpose of our precongress activity is standard for future RCT design to clarify existing evidence and allow when pregnancy loss occurs. These a more focused approach to emerge. topics are hot topics, and would The themes are currently hot topics allow the promotion of high impact in recurring miscarriage. areas of translational research and The SIGEP committee was clinical innovation. attracted to the debate forum (a fine SIG EP co-ordinators, left to right, Roy A plenary session during the Roman tradition) and invited a host Farquharson, Mariette Goddijn, scientific programme of the meeting of world class speakers to present a Ole Christiansen and Marcin Rajewski. on Monday 28th June at 17.00 will case for and against two distinct address the prevention of maternal themes. The first theme of heparin use in pregnancy will be death in early pregnancy. This session will feature two presented by Lesley Regan (London, GB) and Carl Laskin internationally recognised experts, James Neilson on (Canada). This subject continues to attract a good deal of maternal death from miscarriage and ectopic pregnancy, opinion, especially as a treatment intervention in and Michael Greaves on thromboembolism and early preventing early pregnancy loss in recurring miscarriage pregnancy. patients. There is emerging evidence based on RCT findings assessing the role of heparin, with recent Notes for your diary publication in 2010. In addition, the indications for ESHRE joint SIG meeting Dubrovnik maternal thromboprophylaxis have recently been updated. On 24-25th September 2010 a joint SIG meeting with SIGs which in turn moves the debate wider. Reproductive Surgery and Reproductive Endocrinology The second theme of selective karyotyping will be will take place in in Dubrovnik. A full two-day debated by two similarly world-renowned speakers in programme has now been developed. Mary Stephenson (Chicago, USA) and Mariette Goddijn ESHRE joint SIG meeting Valencia (Amsterdam, NL). Historically, the investigation of early On 2-3rd December 2010 a joint SIG meeting with SIGs pregnancy loss relied on parental chromosome testing and, Endometriosis and Endometrium and Stem Cells - on the more pertinently, failed pregnancy testing. Conventional ‘maternal embryonic interface’ - has been developed. Full cell culture techniques exhibited a high rate of maternal programme details will be available in shortly. cell contamination from failed pregnancy. With the Roy Farquharson appearance of innovative cytogenetic techniques, such as Co-ordinator SIG Early Pregnancy extended fluorescent in situ hybridisation (FISH), spectrum roy.farquharson@lwh.nhs.uk16 Focus on Reproduction May 2010
  16. 16. // ENDOMETRIOSIS AND ENDOMETRIUM // A high profile for endometriosis in Rome Annual meeting Rome poor responders. It is We hope to see as many of Officers accepted, he said, that in you as possible at this Hilary Critchley (GB), Co-ordinator over-responders, the very year’s precongress course. Anneli Stavreus-Evers (SE), Deputy Co-ordinator Endometrium high E2 levels (>20,000 Juan Garcia Velasco (ES) Gerard Dunselman (NL), Deputy Co-ordinator Endometriosis pmol/l) adversely affect and Paola Vigano (IT) have Annemiek Nap (NL), Junior Deputy endometrial development prepared an excellent Thomas D’Hooghe (BE), Past Co-ordinator and function and reduce programme on the theme of implantation rate. In ‘Endometriosis: How new technologies may help’. The normal responders, the moderately high E2 levels seem to course will provide participants with an understanding of affect endometrial morphology but do not have any major not only the pathogenesis of endometriosis but the detrimental effect on implantation rate (usually around importance of diagnosis and non-surgical approaches to 30%). In poor responders, however, E2 levels are lower management. We encourage all those involved in the care than normal responders but are still higher than those in of patients with endometriosis - and particularly those natural cycles - yet the implantation rate is reduced with needs of fertility and pain management - to attend. (~10%). Professor Li noted that there are no good quality We hope to see all SIG members there. data on endometrial function in poor responders, but It is splendid that the scientific programme of the annual nevertheless proposed that their reduced implantation rate meeting will provide a platform for presentations on topics is more likely a consequence of poor oocyte quality, endometriosis/endometrium, with oral contributions in because these same women usually have good implantation four sessions and a significant number of posters. Well rates when they have oocyte donation. done all for submitting your work! The Poster Village will have representation from our SIG on Tuesday lunchtime, Future activities and we’ll also be involved in an interactive poster A tripartite meeting of the SIGEE, SIG Early Pregnancy discussion on Monday lunchtime. and Stem Cells in Valencia is now scheduled for 2-3rd December. This exciting event should have wide appeal Endometriosis guidelines and provide a platform for state-of-the-art discussion on Revised ESHRE guidelines for the diagnosis and treatment complementary topics of implantation, stem cell biology of endometriosis were presented and interactively discussed and endometriosis. during a Campus course in Budapest in February. The We are also exploring a joint Campus meeting with the course was organised by Attila Bokor and Thomas SIG Reproductive Surgery on the subject of ‘Deeply D’Hooghe, who also spoke at the meeting, together with infiltrative endometriosis’; more details will follow in a other members of the Endometriosis Guideline future edition of Focus on Reproduction. Another Development Group - including Stephen Kennedy (GB), proposed Campus initiative will be on the topic of Daniela Hornung (DE), Robert Greb (DE), Ertan ‘Scarring and adhesion formation in the female Saridogan (GB), Charles Chapron (F) and Lone reproductive tract’. We hope to hold this meeting in Hummelshoj (DK). The course was attended by about 65 Edinburgh in late 2011/ early 2012. participants and rated as very good or excellent by the majority with respect to organisation, general information, Raising awareness of endometriosis educational value, and individual lectures by the invited Endometriosis support organisations across Europe drew speakers. This was the first time we had organised an much public attention to the disease during this year’s educational activity in Central/Eastern Europe, and we feel Endometriosis Awareness Week (8-14th March). MEP and that this format was interesting and can be repeated vice-president of the European Parliament, Diana Wallis, elsewhere upon request. called for more investment in research into endometriosis. Lone Hummelshoj continues to press the European Poor ovarian respsonse Parliament and Commission to acknowledge the need for The first inter-SIG Campus meeting considered poor investment in benign female diseases, especially those, such ovarian response and the contribution from the SIGEE was as endometriosis, which affect women during the prime delivered by Professor TC Li, from Hallam University, years of their lives. Sheffield, who reported that, while the implantation rate Hilary Critchley in normal responders is ~30%, it is reduced to ~10% in Co-ordinator SIG Endometriosis and EndometriumFocus on Reproduction May 2010 17
  17. 17. SPECIAL INTEREST GROUPS // REPRODUCTIVE ENDOCRINOLOGY // Old and new hormones reviewed in Budapest Professor Janos Urbancsek proved the adrenal in health and disease, a tremendous host for our Campus Officers and current management of types workshop, ‘Old and new Adam Balen (GB), Co-ordinator 1 and 2 diabetes. The Leeds hormones’, held at Semmelweis Richard Anderson (GB), Deputy Co-ordinator contribution was completed by University, Budapest, in December Juan Garcia Velasco (ES), Deputy Co-ordinator myself on hyperandrogenism in last year. We had just over 80 Georg Griesinger (DE), Junior Deputy women - diagnosis and registrants from 22 different Nick Macklon (NL), Past Co-ordinator management - and not only in countries, with a very good PCOS! Thyroid physiology and representation from the host country Hungary. Every talk dysfunction were covered by George Griesinger (DE), was of the highest standard and the meeting provided a before we moved on to new data on the link between gut superb overview and update of recent advances and and adipose hormones and reproduction by Waljit Dhilo potential future research. (GB). Among a range of elegant and comprehensive reviews Our host, Professor Urbancsek, gave an elegant overview were presentations on: of the role of inhibins during the menstrual cycle and Current understanding of the hypothalamic-pituitary- during ovarian stimulation for IVF and shared many years gonadal axis (John Marshall, USA), with comment on of carefully collected data. His key message was that recently derived pathways and neuropeptides such as measurement of inhibin B may indeed predict ovarian kisspeptin, GPR 54 and neurokinin B. response and pregnancy, whilst measurement of the other Determinants of normal puberty (David Dunger, GB) on members of the inhibin/activin family does not warrant secular changes, epidemiology and the influence of routine assessment in clinical practice. The meeting birthweight and early infant growth on puberty and concluded with the latest endocrine marker for ovarian longer-term health. reserve, AMH, delivered by Frank Broekmans (NL). Control of ovulation (Steve Hillier, GB), including the Whilst more data is still required, it appears that AMH is role of IL-1 and its regulation of enzymes such as not only the best predictor of ovarian response and 11betaHSD1 in controlling the conversion of cortisone to potentially oocyte quality but also, when measured at cortisol and the regulation of matrix metalloproteinases on intervals, may in future provide a better insight into the ovarian surface epithelium. declining ovarian reserve with age than other tests such as Hormonal control of spermatogenesis and the antral follicle count. hypogonadal male (Richard Anderson, GB) on the action of androgens in the testis and their control by the HPT Future events axis. Our precongress course for Rome is on ‘The lost ART of Hypothalamic disorders and their management (Pierre OI’. Many of us feel that the pathway to IVF is too swift Bouloux, GB) on the more and that a preferable aim is common and very rare causes to treat the underlying of Kallmann’s syndrome and causes of infertility. Special hypogonadotrophic skills are required when hypogonadism. performing ovulation Pituitary tumours and the induction for anovulatory management of hyper- infertility, which require a prolactinaemia, in which degree of subtlety not Didier Dewailly (FR) needed for ‘controlled’ dispelled any notion of an ovarian hyperstimulation association with PCOS. for IVF. This course will Among other presenters cover the causes of were Philippe Bouchard (FR) anovulation and deal in turn with a fine update on FSH with management protocols, and LH receptor Speakers at our Campus workshop in Budapest. Seated are SIG predictors for response and polymorphisms, Eleanor Co-ordinator Adam Balen (left) and local host Janos Urbancsek, algorithms for treatment. Scott (GB) with two flanked by Ine Van Wassenhove and Veerle De Rijbel from Further ahead we have a endocrinological reviews of ESHRE’s Central Office. joint Campus with the Early18 Focus on Reproduction May 2010
  18. 18. // PSYCHOLOGY AND COUNSELLING // Collaborations with other SIGs prove valuable The SIG Psychology and 22). In April, she introduced Counselling has a challenging Officers infertility counselling to junior precongress course planned for Petra Thorn (DE), Co-ordinator doctors, paramedicals and Rome with topics covering Christianne Verhaak (NL), Deputy Co-ordinator embryologists in Kiev, Ukraine. current developments in ART and Jan Norré (BE), Deputy Co-ordinator This is clearly a valuable their impact on counselling. The Patricia Baetens (BE) Past Co-ordinator contribition to clinical meetings morning sessions will tackle Uschi Van den Broeck (BE), Junior Deputy and we hope to see more ethical dilemmas arising from collaboration with other SIGs. We recent advances, such as providing ART for HIV-affected can all benefit from a multidisciplinary approach. men and women, egg freezing and PGD. Afternoon Our second Campus workshop in Amsterdam on sessions will feature clinical issues such as counselling the December 3-4th will be a two-day course designed to infertile man, mourning rituals for couples remaining increase knowledge and competence in psychosocial care childless, internet-based support for infertility and finally by outlining the different perspectives of infertility discussion on whether interactive personal health records counselling and acquiring basic communication skills in can empower patients. The course will be chaired by SIG specific situations through in-depth case work. The course Co-ordinator Petra Thorn and Deputy Chris Verhaak. is aimed at all professionals involved in the psychosocial The SIG business meeting which follows welcomes care of people with infertility: psychologists, counsellors, members to join in the discussion. Topics this year will doctors, nurses, administrative personnel and other medical include collaboration on the update of guidelines as well as staff. The first day will focus on more theoretical issues in an overview of the first Campus workshop held in Basel the psychology of infertility, medical treatment from a last year and the upcoming event in Amsterdam later this patient-centered perspective, infertility counselling from a year. The annual dinner in conjunction with the cognitive-behavioural and systemic perspective, third party International Infertility Counsellors Organisation (IICO) reproduction and the difference between infertility will complete the day’s events in Rome. Participants counselling and psychotherapy. The second day will interested in joining the dinner can contact Jan Norré for provide discussion targeted towards medical and more information. administrative staff on the one hand and psychosocial staff We have been well represented by Petra Thorn, our Co- on the other. In-depth case work will guide the much more ordinator, in the past few months in other Campus events. hands-on discussion and promote interactive participation. In March Petra described the psychological perspectives of Uschi Van den Broek women diagnosed with poor ovarian response (see page Junior Deputy Co-ordinator 24) and counselling concepts for donor insemination (page SIG Psychology and Counselling Pregnancy and Reproductive Surgery SIGs, entitled consensus workshop on ‘Medical problems associated with ‘Healthy start - The determinants of a successful PCOS’. The first consensus in Rotterdam, in 2003 pregnancy’. This will take place in Dubrovnic, Croatia, in provided definitions for PCOS which resulted in one of the September (on 24/25th). The meeting will start with the most cited publications in our field. The Thessaloniki diagnosis of congenital anomalies of the lower genital tract consensus on the management of infertility in PCOS also and evidence for surgical approaches (whether cervical produced a highly cited joint publication in Human cerclage should be vaginal or abdominal). We will move on Reproduction and Fertility and Sterility, so we anticipate to the problems of obesity and early pregnancy, the effects that this third consensus will be equally stimulating and of obesity on natural conception and fertility treatment, important in its outcome. and the topical issue of medical and surgical approaches to Towards the end of the year we will be running a the management of obesity. Pregnancy in the older woman Campus course in Madrid (3-4th December) on ‘GnRH will cover how we can best predict fertility, what we agonists for triggering of final oocyte maturation-time for a should do about fibroids and endometriosis, and how the paradigm shift’, so please mark this date in your diaries older mother is best managed. too. The third joint ESHRE/ASRM PCOS consensus meeting Adam Balen will take place in Amsterdam, beginning on 18th Co-ordinator SIG Reproductive Endocrinology November with an open meeting followed by a two-day on Reproduction May 2010 19