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Reflections by Sibt-E Hassan

I attended the 13th joint Fertility meeting “Fertility 2020” at the historical city of Edinburgh between 9th and 11th January 2020. It was organised by the British Fertility Society, the Society for Reproduction and Fertility and the association of Clinical Embryologists. The theme was quiet interesting and captivating, “Reproduction in a changing world”.

The venue, Edinburgh International Conference Centre was excellent and conveniently located within the heart of the city surrounded by fabulous restaurants and shops. The organisers, Profile Productions did a marvellous job as usual and the arrangements were excellent. It was very well attended by the clinicians, scientists, embryologists, nurses and counsellors and the scientific programme was organised in a way to suit everyone’s interests.

The most striking features of the conference were: the Anne McLaren, the Patrick Steptoe and the Bob Edwards Memorial lectures along with the plenary and update sessions given by the renowned presenters in the field. They were all informative, interesting and thought provoking. Also, there were almost 250 high quality posters from within and outside the UK, presenting their excellent work for the delegates to view and interact. Pharmaceutical companies exhibited their products and arranged educational and teaching activities at their stalls which also provided socialisation and networking opportunities.

Being a clinician, I tried to attend most of the clinical sessions and I found the update session 2 on Friday, the most useful and interesting. It was about “Luteal Phase Support” and was chaired by Mr Ian Aird. The first presentation “Physiology of Corpus Luteum: the science of luteal support” by Collin Duncan mentioned about seven basic physiological principles of corpus luteum and luteal phase which clarified the whole concept. The learning point was that it is not the corpus luteum which is inadequate but it is either the bad follicle or no LH surge which is responsible for defect. LH surge is deficient in PCOS, POI and breast feeding. He also mentioned that prolonged progesterone support is associated with risk of autism in the literature. The second presentation was by Mr Mostafa Metwally on “What is new in Luteal Support” where he mentioned evidence about oral progesterone Dydrogesterone for luteal phase support. He talked about Lotus 1 & 2 randomised phase3 multicentre trial where non inferiority and safety of 30 mgs oral dydrogesterone was found. He also touched upon the impact on endometrial histology and gene profile and that the overstimulation might disturb that balance. The last talk was given by Mr Coomarasamy about “Progesterone for prevention of miscarriage” where he mentioned about PROMISE and PRISM trials findings. The PROMISE trial clearly showed that Progesterone supplements in the first trimester of pregnancy do NOT improve outcomes in women with a history of unexplained recurrent miscarriages. The PRISM trial on the other hand showed that although the treatment did not reduce the rate of miscarriage for those with no previous miscarriages, there was a small reduction in miscarriage for those with 1-2 previous miscarriages and a big reduction in miscarriage for those with 3 or more previous miscarriages. This would have huge implications for this group of patients.

Overall, I thoroughly enjoyed the whole conference and I believe it was a great success. I look forward to attend the Fertility 2021 next year.

DR SIBT-E HASSAN
MBBS, MRCOG, MSc, FCPS
Senior Fellow Repro Medicine
Manchester