Pretreatment androgens protocol in poor responders patient: outcomes and perspectives -S.K.Sunkara, UK
A vital clinical milestone to optimising the success of IVF treatment was the introduction of controlled ovarian stimulation
(COS) regimens. However, after the introduction of COS into IVF it became evident that ovarian response varies between women.
Since its first description by García et al in 1983, the burden of poor ovarian response has been reported to be increasing
as women delay childbearing. The management of poor responders is a challenge to both clinicians and patients who often adopt
new interventions to maximise ovarian response and IVF outcome.
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Risk factors, prevention and treatment of OHSS - J.A.Garcia Velasco, Spain
Ovarian hyperstimulation , although rare, is still in the XXI century a complication during controlled ovarian hyperstimulation.
OHSS has been prevented and treated empirically over the years because its pathophysiology remained unknown. Prevention has relied
on clinical parameters such as age, BMI, antral follicle count, serum estradiol levels, or number of follicles developed.
However, the effectiveness of these preventive measures is way far from what a clinician would like
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Male subfertility: from the pharmacogenetic towards medical therapies - A. Ferlin, Italy
Male infertility represents one of the clearest examples of complex phenotype with substantial genetic basis (1, 2). Numerous male mouse models, mutation screening and association studies performed in the last few years definitively demonstrate the high prevalence of genetic causes of spermatogenic impairment. Genetic causes account for 10%-15% of severe male infertility, including chromosomal aberrations and single gene mutations. However, a large proportion of infertile males does not receive a clear diagnosis and are reported as idiopathic or unexplained, reflecting our poor understanding of the basic mechanisms regulating spermatogenesis and sperm function
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Microsurgical techniques for sperm retrieval: indications procedures and results - C.Balmori Boticario, Spain
Prior to the availability of assisted reproductive technologies, the use of donor sperm was the only option offering a realistic chance of conception for couples affected by azoospermia. The approach to azoospermic patients has changed significantly with the introduction of sperm retrieval techniques and assisted reproductive technologies, especially intracytoplasmic sperm injection (ICSI).
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Female infertility: endometriosis and surgical approach - E Somigliana, Italy
The role of surgery in the treatment of endometriosis-associated infertility is highly debated. The effectiveness of surgery has not been questioned for a long time but, during the last decade, there is growing evidence that the benefits of the intervention are less evident than previously believed. There is general rethink of the role of surgery and this is mainly consequent to the widespread diffusion of IVF.
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Video session - Laboratory topics and techniques - F.Bronet, Spain
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Vitrification and its application: ovarian tissue oocyte and embryo cryopreservation - A Cobo, Spain
Vitrification is a physical phenomenon consisting on the solidification of aqueous solutions without ice crystal formation. The achievement of the vitreous state is facilitated by the use of high cryoprotectant concentration and high cooling rates. Due to the toxicity of these substances, high CPA concentration has been a major drawback associated with vitrification. In consequence, it is necessary to reduce the CPA concentration. Nowadays, we can say that different vitrification approaches have solved these drawbacks.
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New Frontiers and applications of time-lapse - N.Basile, Spain
Time-lapse image technology is a new tool for in vitro fertilization laboratories. These advantages improve embryo selection that ultimately results in improved implantation rates. Time lapse movies may be analyzed to determine the exact timing of main embryo events such as PN formation, PN fading and cleavage to 2, 3 and 4 cells, among others. Preliminary data suggests that the timing of embryo cleavage may correlate with the viability of the embryos. This technology also aids in the observation of unusual patterns often missed with the current methods of embryo evaluation. False divisions, fusion between cells and re-absortion of fragments are some examples of these abnormal events.Basile
Select the best embryo: metabolomics and proteomics - N.Prados, Spain
Unfortunately in assisted reproduction techniques, not all the embryos we transfer implant or achieve the birth of a baby. One of the main tasks of the IVF laboratory is to choose the embryo with the higher implantation potential among the cohort. This is still usually performed by visually assessing the morphology of the embryo using an inverted microscope.
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Autoimmunity infertility and pregnancy loss - H.J.A.Carp, Israel
Autoimmune mechanisms may influence the fertility of both sexes, manifesting as infertility or pregnancy loss. There are also late obstetric complications such as intrauterine growth restriction, preeclampsia and pre-term birth. At present, it seems that three conditions responsible for infertility, premature ovarian failure, antisperm antibodies, and endometriosis, may be autoimmune in origin.
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Couples drop-out from IVF treatment - N.Garrido Puchalt, Spain
Understanding all the medical procedures devoted to solve infertility as a whole is a key factor against one of the most relevant issues preventing infertile couples to succeed: dropping-out. In this sense, the major factors involved in dropping out treatments, apart from economic burden, are related with emotional harm, but also with poor doctor-patients communication and uncertainty,
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