1. Focus on
REPRODUCTION
European 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

3. 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
info@eshre.eu
www.eshre.eu 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 Society
Focus on Reproduction May 2010 3

4. ANNUAL MEETING 2010
Abstracts
go through
the roof
Submissions up by an
unprecedented 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 category
4 Focus on Reproduction May 2010

5. Human Reproduction
Topic (total posters) Poster discussion Poster Village
keynote lecture, in honour of
the best paper from our main
Andrology (91) Tuesday Wednesday
journal. The first presenter,
Cross-border reproductive care (9) Monday
Gayle Jones, has been
Demography, epidemiology, registries and health economy (17) Monday
selected on the basis of the
Early pregnancy (23) Tuesday
paper ‘Novel strategy with
Embryology (103) Tuesday
potential to identify
Endometriosis, endometrium, implantation (64) Monday Tuesday
developmentally competent
Ethics and Law (4) Monday
IVF blastocysts’, which was
Fertility preservation (49) Wednesday Monday
published in 2008. Gayle will
Paramedical (6) Tuesday
begin her presentation with
Psychology & counselling (14) Tuesday
the published work and then
Reproductive endocrinology (97) Monday
go on to deal with more
Reproductive genetics (27) Monday
recent developments. The
Reproductive surgery (11) Wednesday
second keynote lecture is by
Safety & quality (63) Tuesday
Wybo Dondorp, who will
Stem 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

6. 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

7. 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

8. 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
ESHRE's programme for the certification of embryologists improved, with different parts of the curriculum being
is now in its third year, and this year's 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-ordinator
8 Focus on Reproduction May 2010

9. // 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 Endocrinology
Focus on Reproduction May 2010 9

10. 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 patient's 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

11. 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

12. 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

13. 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 Board
Focus on Reproduction May 2010 13

14. ‘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-Jones
are now represented in Fertility Europe Chair Fertility Europe
14 Focus on Reproduction May 2010

15. 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 Embryology
Focus on Reproduction May 2010 15

16. 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.uk
16 Focus on Reproduction May 2010

17. // 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 Endometrium
Focus on Reproduction May 2010 17

18. 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 Early
18 Focus on Reproduction May 2010

19. // 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 adam.balen@leedsth.nhs.uk.
Focus on Reproduction May 2010 19

20. SPECIAL INTEREST GROUPS
// ANDROLOGY //
At last, the fifth WHO manual for semen
analysis has finally arrived
The fifth edition of the long
awaited WHO laboratory manual Officers
for the examination and Roelof Menkveld (ZA), Co-ordinator
processing of human semen was Jose Antonio Castilla (ES), Deputy Co-ordinator
finally published on line in Sheena Lewis (GB), Deputy Co-ordinator
March.1 Jessica Tu (SE), Junior Deputy
The manual was originally
expected in 2008, but one of the reasons for its delay may morphology. The new
have been that the semen parameter ‘reference’ values, edition has been
previously known as ‘normal’ values, had to be subject to considerably extended
peer review in a journal. This finally happened at the end of and contains much in detailed
2009, when the report was published on line.2 procedures and notes on the different aspects of
However, as with the past issues, the new reference values the whole process of the semen analysis.
are likely to prove controversial, especially the very low As one of the main focuses of the SIG Andrology is to
value of 4% morphological normal spermatozoa for sperm promote the performance of semen analyses to a high and
// REPRODUCTIVE SURGERY //
Repeats this year and next for our popular endoscopy course
Our precongress course in Rome is determinants of a successful
on NOTES (natural orifice Officers pregnancy’, will take place in
transluminal endoscopic surgery) Marco Gergolet (IT), Co-ordinator Dubrovnik, Croatia, on 24-25th of
and single access surgery. Interest Vasilios Tanos (CY), Deputy Co-ordinator September this year, followed by a
in the course is growing following Rudi Campo (BE), Deputy Co-ordinator joint meeting with the SIG
the revolution in endoscopic Stephan Gordts (BE), Past Co-ordinator Andrology in Treviso on 8-9th
surgical access. There have been Pietro Gambadauro (IT), Junior Deputy October.
criticisms of this pioneering Next year an interesting course
surgery, but not unlike the criticism 20 years ago on on ‘Reproduction and the management of fibroids’ will
laparoscopic surgery. The live surgery session in Rome be organised in Larnaca, Cyprus, on 15-16th April
will take place on 29th June. 2011, followed in May (6-7th) by a workshop on ‘How
Our course on ‘Endoscopy in reproductive surgery’ in surgery can increase the success rate in ART’. This
February in Leuven was a great success! As usual, it was meeting will be held in Grado, Italy, an attractive island
fully booked and participants came from 13 countries, in the northern Adriatic connected by a short bridge to
from Czech Republic to Turkey, from Philippines to the mainland. Grado is also known as the ‘sunny island’
Kuwait. The hands-on suturing sessions with the pelvic and has been appreciated for its beautiful beaches since
trainer were performed on chicken legs, pig bowel and the country was ruled by the Habsburg Empire. Its
pig bladder. For the first time the location of the course intricate history is linked to the history of Aquileia from
was at the new building of he European Academy of the time of the first barbarian invasions, and to the
Gynaecological Surgery. The course will be repeated in Republic of Venice.
November (24-26th) and twice in 2011 (23-25th Our precongress course in Stockholm in 2011 will be
February and 23-25th November). on the prevention and management of adhesions.
A joint meeting of SIGs Reproductive Surgery, Early Marco Gergolet
Pregnancy and Endocrinology, ‘Healthy start - the Co-ordinator SIG Reproductive Surgery
20 Focus on Reproduction May 2010