ISMAAR Congress London – January 2015

11 Feb 2015

Friday 30th January saw a meeting of minds as practitioners, scientists and policy makers from around the world met to discuss the future of assisted reproduction technologies at this year’s ISMAAR conference.

Designed to promote education, training and research into women’s reproductive health and particularly into mild reproductive technologies, ISMAAR brings together leaders in the field of assisted reproduction. This conference exemplified that ethos, with members of the scientific community coming together to talk through a number of pertinent issues in assisted reproduction.

The day covered all aspects of the mild approach to reproductive technology, including scientific breakthroughs in the field, the role of the private and public sectors in providing treatment, the importance of ultrasound and the common myths in IVF.

The day started off with scientific lecture-style talks, where scientists from around the world shared details of their ground-breaking research in delayed implantation and personalised embryo transfer. It then moved on to talks about minor differences in patient management that can have a big effect on treatment (e.g. thyroid hormone levels and lifestyle changes); these talks gave the practitioners in the room an opportunity to think about how best to treat their patients. The afternoon sessions had a more workshop feel, and were broken down into related topics that formed the basis for discussion: the roles of the public and private sectors in IVF, egg freezing and the ‘right’ to have a baby and the role of ultrasound and common myths in IVF. This provided an opportunity for plenty of discussion, with a healthy amount of disagreement over some of the issues raised.

Overall the day provided an interesting space for some of the people at the forefront of IVF to get together and share ideas, which will hopefully lead to the progression of the field. It was above all an opportunity to learn more about the key issues and advancements in mild reproductive technologies today.

5 things I learned from the conference:

  • 1. The importance of the thyroid– The role of the thyroid has often been overlooked in fertility treatment, but as Professor Phillipe Bouchard demonstrated in his illuminating talk, thyroid hormones are crucial in ovulation, preventing miscarriage and the development of the foetal brain. It was advised that thyroid levels should be kept below 2.5 when trying to conceive.
  • 2. Delayed implantation might be possible in humans– Delayed implantation has been found in many other species of animal for environmental reasons, and researchers are now looking into the possibility of replicating this in humans. A possible metabolic pathway has been found, which could be developed so that there would be no need to freeze embryos between egg collection and embryo transfer, which could improve their survival.
  • 3. Embryo transfer should be more personalised– There is a window of opportunity for implantation where the uterus is receptive to implantation of about 4-5 days. This is usually judged by the LH surge, but there is evidence that this is not precise enough, as ovulation can occur before or after the LH surge. The endometrial receptivity assay (ERA) can be used to look at the genes in the womb lining to see if the ones that should be switched on for implantation to occur are switched on at the right time.
  • 4. The private sector can be good for the future of IVF– The private sector is often vilified for exploiting vulnerable patients or driving up prices, but it could have an important part to play in the development of new technologies. If clinics embrace innovation as a way to drive business then it could mean that better technologies and experiences are available for IVF patients.
  • 5. Ultrasound scanning is very important – Many clinics do not put much of an emphasis on ultrasound scanning, but it can be very important in the diagnosis and treatment of patients. Good scanning machines can assess ovarian reserve and see how the ovary will respond to treatment. It can also determine the quality of follicles and tell the difference between follicles and cysts.

By Anna Byrne-Smith