Our Scientific Director at ESHRE

08 August 2016

ESHRE meeting Early in July I had the opportunity to attend the European conference in Human Reproduction held in Helsinki Finland. Helsinki is a beautiful city especially in the summer when the markets are full of Raspberries and Strawberries – my vices.  ESHRE is a very large meeting (10,000 delegates) that attracts people from all over the world. It is a huge melting pot of cultures and ideas motivated in their pursuit in helping to create families and enables us to learn and share latest developments in reproductive medicine.  The meeting covers all the areas of Reproductive Medicine and, being an embryologist, my interests are primarily in the area of embryos, oocytes and seeing how we compare with the rest of the world. Over the last decade there has been a concerted effort in developing methods that help scientists in trying to choose the right embryos. These range from high tech incubators using time lapse observation to analyse embryo development, to looking at embryo metabolism from spent culture media. Many labs and companies claim their system is the answer but often they are inconsistent or the evidence is not significant.  The general conclusions that are being made on many of these techniques is that they are still very unreliable in choosing the best embryo but are excellent in identifying those embryo that are not going to make a baby.  I find it discouraging so much energy goes into trying to work out which is the best embryo rather than looking closely at improving systems to make better embryos every time. There was some discussion on how to improve the oocytes from advance maternal aged patients (>40). This is centered on improving / replacing the mitochondria in the oocyte.  Mitochondria are what gives the oocyte/ embryo energy and the idea is that in older oocytes this functionality is reduced. This is a very topical area but may but hold some success in the future. Pre implantation diagnosis of embryos is always a hot topic at these meetings. This is when a small sample of the embryo is taken and tested for the right number of chromosomes or a genetic condition. The usefulness of this technique still remains unconvincing as a routine application and that it benefits can only be seen in a select cohort of patients with infertility. Lastly, how is Fertility SA stacking up against the rest of the world? We are excellent, and for that matter so are most Australian clinics. We have high pregnancy rates with extremely low multiple rates. Most of the world are still routinely transferring two or more embryo, with some countries reporting a twin rate as high as 40%. Also not to be overlooked is the much bandied phrase of the “networking” benefit of these conference. This is very much a cliché but the best information learnt is over diner time conversations and bumping into old colleagues in the exhibition room hall. Michael Barry Scientific Director
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