ESHRE 2023

There are 19 precongress courses scheduled for this year’s annual meeting in Copenhagen, 13 organised by ESHRE’s SIGs and three as exchange sessions with other societies. There are three additional courses, one from ESHRE’s own European IVF Monitoring Consortium (EIM) on the relevance of national registries to patients, a second from the Cochrane group on how to prepare a systematic review, and a third from the editors of the ESHRE journals which will review the ‘traditional’ features of journal publication but also look ahead to new developments likely to define the field.

As ever, this year’s PCCs are characterised by a strong thread of practicality and topicality, with presentations from experts of international acclaim. Two of the courses, from the SIG Embryology and SIG Implantation & Early Pregnancy, will complement publication of two imminent ESHRE guidelines, on add-ons in ART and on recurrent implantation failure. Both guidelines have completed their stakeholder review and will be featured specifically in the courses. Add-ons, of course, have been a hot topic for ESHRE for several years, giving rise to a far wider general discussion of how to introduce new developments into everyday practice. The latter is the theme of a dedicated course from the SIG Global & Socio-cultural Aspects of Infertility, which is likely to be provocative at least, with presentations from among others Sebastiaan Mastenbroek, Simon Fishel, Jack Wilkinson and Ben Mol. Wilkinson’s presentation has a strong practical theme on a subject which seems more usually beset by opinion - on how to introduce new technologies ‘responsibly’. Claims and counter-claims present a minefield for patients (‘help, hype and hope’), which Manuela Perrotta hopes to unravel in her presentation on informed consent.

The SIG Implantation & Early Pregnancy describes recurrent implantation failure as a ‘unique riddle’, subject to ‘different perspectives and putative solutions’. These different perspectives are largely represented in a wide-ranging course which covers male, female and embryonic factors in a condition which affects 10% of the IVF population. Susan Golombok, from the Centre for Family Research in Cambridge, whose work has done so much to underline the acceptability of the new family dynamics which ART has made possible, will consider alternative approaches to parenthood. The daily routine of managing RIF patients will be reviewed by Bettina Toth.

Time-lapse systems are now ubiquitous in the IVF lab, especially in Europe, and they too feature prominently in this year’s PCCs, either in the practicality of new introductions or as a routine ‘luxury or necessity’. The latter features in a programme of debates organised by the SIG Reproductive Endocrinology, which also includes the hot topics of freeze-all, cycle programming ahead of FET, PGT-A for embryo selection, duo-stim and managing the luteal phase.

Two courses of great topical interest feature the introduction and application of artificial intelligence in reproductive medicine. Presentations will start with ‘the basics’ and further consider how AI might help in embryo selection for transfer and endometrial receptivity. Even more topical, with the imminent revision of the EUs tissue and cell directives into a single directive, is a course organised by the SIGs Ethics & Law and Psychology & Counselling on the varying regulations in Europe on third-party gamete donation. Enhanced protection of donors is likely to be a major component of the new directive, and this PCC will consider how regulation has an impact on the practice of third-party donation.

Despite the vein of practicality running through many of these courses (indeed, the session on AI is sub-headed ‘a practical course for IVF practitioners’), basic science also figures prominently in sessions organised by the SIGs Andrology, Reproductive Genetics and Stem Cells. The theme for the course devised by the SIG Stem Cells concentrates on gametogenesis and attempts to model specific steps. Some of the technologies featured (such as IVM and the use of microfluidics) are already being applied clinically, while others are just emerging as potentially important.

Meanwhile, with the PCC schedule promising a feast of learning and attraction, news from the main programme is that a record number of abstracts had been received at ESHRE’s central office by submission deadline at end January. The total - of 2109 abstracts submitted - represents a new record and the first over 2000. The previous best was in Barcelona in the pre-covid days of 2018, when 1898 abstracts were received. After scoring and organisation into the selected oral communication sessions, the presentations will be made on the three days of the main programme, from Monday 26 June to Wednesday 28 June. The precongress courses will be held on Sunday 25 June, starting at 09.00