Page 19 - ASPIRE AUGUST 2022 Vol 7 Issue 3

SINGAPORE
ESHRE highlights and the joys of face-to-face meetings with Adelaide beckoning in 2023
By Dr Rajesh Hemashree Country Representative
Attending the recent ESHRE meeting in Milan, Italy was such a joy and relief for people to get together again – something we had almost forgotten over the past two years of the pandemic.
Virtual meetings offer the convenience of a comfortable home base, opportunities to grasp lectures at your own pace, and the ability to listen again and again (for those of us grappling with loss of attention and the pace of science). However, such convenience is the seed of procrastination as multi- taskers have the choice of whatsapping and googling simultaneously – a temptation hard to resist.
ESHRE attendance is a ritual, however it was interesting to learn that the keynote lecture this year was chosen by the most number of downloads of an original paper in human reproduction. Naturally, semen impairment in COVID won hands down!
The second keynote lecture by Efstratios Kolibianakis on IVF treatment personalisation highlighted what most of us term as individualised stimulation. This technique should rightly be seen as a best estimation cycle. Real individualisation requires the application of solid knowledge through extensive reading, which is a challenge for full-time clinicians!
Conferences highlight unique scenarios. For example, it was news to me that once upon a time IVF was done in an early pregnancy and eggs were still retrieved.
ESHRE 2022 featured some strong practical take home messages. For example:
• premature LH surges occur in 20 per cent of IVF cycles and more so in an antagonist than an agonist cycle (16.7 per cent versus 2.6 per cent);
• Progestin cycles for LH surge prevention seem to be associated with similar IVF pregnancy and offspring outcomes compared to conventional protocols;
• gonadotropin doses higher than 300iu in poor responders did not show a better live birth rate. Long-acting FSH seemed to be a reasonable option in poor responders;
• follicles less than 12 mm and more than 24 mm had a lower chance of yielding oocytes. Fertilisation
Rajesh Hemashree
rate, cleavage rate and embryo quality per fertilised oocyte seemed to be independent of the follicle size;
• prolonging ovarian stimulation by one to two days made no difference in ongoing pregnancy rates, but the resulting high E2 and P4 could increase the risk of low birth weight; and
• in the male partner with poor sperm parameters exome panels are being tested to evaluate genetic causes.
Over the past years we have given Dr Google a chase becoming internet professionals, doing on-line consults and sprucing up on international law to take consent across borders for stranded patients.
The strange thing is that our fertility clinics were pretty full during this time. Work from home made it easier for couples to come for consults and counselling together.
Many of them moved on with IVF maximising the away from office work opportunity and while saving on transport time.
Now that we have learned to live with COVID, normal routine is almost creeping up. While the masks are staying, looking up to the next ASPIRE Congress is a ray of sunlight.
The excitement of almost forgotten leisure travel, the opportunity to factor a family holiday along with heady science, the glorious venues, the chatting over coffee discussions, and the opportunities to interact casually with the IVF greats.
Adelaide in 2023, we are longing for you!
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