FOCUS ON REPRODUCTION

Asked to name the three most revolutionary events in reproductive medicine many of us would no doubt nominate the first successful IVF, the introduction of ICSI for male infertility, and the adoption of vitrification into routine ART programmes. The first two were central to the history of ESHRE, first in the Society’s founding by Robert Edwards after that first IVF birth, and second in follow-up to the first reports from Brussels of live births following ICSI; after that initial announcement in The Lancet in 1992, all subsequent ICSI reports appeared in Human Reproduction, with hands-on training often featuring in Campus workshops.

Vitrification would be a less emblematic development than IVF or ICSI, and its acceleration - in Europe at least - emerged from Italy in its response to the introduction of the infamous Law 40 of 2004, which outlawed embryo selection and embryo cryopreservation. Vitrification offered Italy an alternative in its potential for oocyte freezing, and studies (from Italy and Spain) would quickly show that the viability of vitrified donor eggs was just as great as that of fresh.(1) The irrevocable place of cryopreservation in today’s IVF programmes was recently put in perspective by David Adamson in his presentation of global ART data at this year’s annual meeting in Copenhagen, noting that FETs now outstrip fresh transfers by around 60% to 40%.(2)

Vitrification would be the cover story of the first issue of Focus on Reproduction under my editorship (‘the slow revolution of rapid freezing’) in May 2007 and thereafter the print edition would appear three times a year (January, May and September) usually carrying as its cover story an expert-written news feature of emerging clinical interest. Alongside the vitrification feature - from the Lubeck group of Al-Hasani - was a review from Juan Garcia Velasco on egg donation in Spain and a report from the second ESHRE-ASRM consensus meeting on PCOS, this time on infertility treatment, following a marathon meeting in Thessaloniki.(3) Alongside these main features were many news stories, both from ESHRE’s own activities and from the journals.

Among the many milestones recorded by FoR were the first ’25 years of ESHRE’ (in May 2009) and ‘thirty years of IVF’ (May 2008). There were always substantial reports from ESHRE’s two consortia (PGT and EIM) and from each of the annual meetings, which usually made the cover story for all September issues. FoR also followed ongoing discussions - ICSI vs IVF, US vs Europe, mild IVF - but the greatest controversy, today seemingly as ever, has always been PGT-A. As editor of FoR, I received my greatest complaint - with some justification - for a report (written by me) on the STAR trial. The complaint was a reminder of our need, before and after, to remain detached in our clinical reports. Indeed, I have always edited FoR as a news service from ESHRE, and not as an opinion vehicle for the Society. Any comment, of course, as in all journalism, should always be attributed. From my detached perspective as editor, the big debate in PGT-A (‘PGT-A for all?’) has somewhat receded in favour of more precise indications (advanced maternal age, previous miscarriage) and less obsession with improving LBRs generally.

This emphasis on FoR’s objectivity and reliability is today underscored by a vigilant editorial committee, without whose oversight and approval copy cannot progress to publication. At this point I should thank the present committee for their accuracy and judgement. The enthusiasm of Laurentiu Craciunas, Sofia Makieva, George Liperis and Mina Mincheva has been central to FoR’s progress - as evident too in ESHRE’s thriving online journal club. I should add here my gratitude to fellow journalist Sophie Goodchild, whose reporting reliability and nose for a story have been equally welcome. All our important reports on developments in stem cells - ethical and scientific - have come from the ever-enthusiastic hands of Mina Popovic and Susana Chuva de Sousa Lopes from ESHRE’s SIG Stem Cells.

It was in response to changing patterns in readership and budget demands that FoR moved from print to online production at the end of 2013. Loss of the magazine format saw some casualties, notably in short reports, illustrations, and ESHRE news. Copy became more extended and concentrated, with ‘news’ now derived more from the journals than from ESHRE itself. It is a hope that the new editorial structure of FoR can remedy that imbalance and place the Society more at the heart of reports than the wider fertility sector.

From September, I will be replaced by a new editor with a new editorial team, and I wish them every success. FoR has been central to my working life since that first print issue of 2007, both in terms of enjoyment and interest. And I am indeed grateful to ESHRE for the opportunity to edit FoR, and hope that the publication continues to thrive.



1. Rienzi L, Cobo C, Paffoni A, et al. Consistent and predictable delivery rates after oocyte vitrification: an observational longitudinal cohort multicentric study. Hum Reprod 2012; 27: 1606-1612.
doi.org/10.1093/humrep/des088
2. See https://www.focusonreproduction.eu/article/ESHRE-News-COP23_adamson
3. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008; 23: 462-477. doi.org/10.1093/humrep/dem426