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VenueKipriotis Village - Congress venue
Psalidi, 85 300, Kos
Greece
www.kipriotis.gr
LanguageThe official language of this course will be English
General information
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Learning effectiveness project
The world of CME is changing with many different live and online formats, and Serono Symposia International Foundation (SSIF) is
continually trying to improve its CME activities.
With your participation in a structured series of evaluations, SSIF can provide cutting-edge learning activities designed to give you
the greatest value from the time you invest.
SSIF is running the learning effectiveness project for this meeting.
Before the conference, you were asked to complete a Pre-event questionnaire to evaluate your knowledge on the specific topics
that will be covered during the conference.
During the conference we kindly ask you to assess the program in various domains such as whether you were satisfied with the
meeting, whether it met the stated learning objectives, whether the contents were neutral and will be applicable to your daily practice.
After the event, you will be involved in two additional steps:
• Post-event: three weeks after the event we will email you a short questionnaire which will give you the opportunity to tell us how
much of what you learned has had an affect on your know-how and daily practice.
• Follow-up: three-months after the event, we will contact you with the final questionnaire.
We will collate and analyse your responses and use the results to improve and develop our ongoing programs.
Of course, we commit to maintaining the confidentiality of the information you provide and we will inform you about the results of
the process regarding the activity that you attended.
Thank you very much for participating in this project!
follow us onwww.twitter.com/SSIF_RM
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Born after ART:from the laboratory to the delivery room
Serono Symposia International Foundation conference on:
Born after ART: from the laboratory to the delivery roomKos, Kos - June 24, 2012
Aim of the conferenceIncreased longevity coupled with changes in women’s position in society have resulted in a delay in the age of childbearing and as many as
50% of patients requesting infertility treatment face the problem of reproductive ageing. This special symposium is an overview on ART
consequences, implications that can develop in managing pregnancies after ART cycles. The symposium will be especially relevant for expert
physician involved in fetal medicine and reproductive medicine who want to update in developments in these fields, as weel as all those
interested in the care of pregnant woman and their babies.
Learning objectivesParticipants of this symposium will:
• Receive a comprehensive overview of factors influencing delayed fertility
• Be updated on tools aimed at individualizing complications and clinical approaches in pregnancies after ART
• Debate challenging clinical perspectives to familiarize with different and therapeutic avenues
• Individualize the result and the complications of pregnancies after IVF treatments
Target audienceThis program is targeted to clinicians working in the specialist field of fetal medicine and assisted reproductive medicine.
All Serono Symposia International Foundation programs are organized solely to promote the exchange and dissemination of scientific and medical information. Noforms of promotional activities are permitted. All Serono Symposia International Foundation programs are made possible thanks to educational grants receivedfrom: Centre d’Esclerosi Multiple de Catalunya, ComtecMed, Congrex Sweden, Congrex Switzerland, Cryo-Save, Datanalysis, Esaote, European Society ofEndocrinology, Fondazione Humanitas, Fundación IVI, ISFP International Society for Fertility Preservation, ISMH International Society of Men’s Health, K.I.T.E.,Merck Serono, Sanofi-Aventis, University of Catania, Vall d'Hebron University Hospital.
Scientific organizersRobert Fischer
Fertility Centre Hamburg
Hamburg, Germany
Kypros Nicolaides
The Fetal Medicine Foundation
London, UK
Scientific secretariatSerono Symposia International Foundation
Salita di San Nicola da Tolentino 1/b
00187 Rome, Italy
Associate Project Manager: Chloé Xilinas
Tel.: + 39 06 420413 505 - Fax: + 39 06 420413 677
E-mail: info@seronosymposia.org
Serono Symposia International Foundation
is a Swiss Foundation with headquarters in
14, rue du Rhône, 1204 Geneva, Switzerland
Organizing secretariatTighisti Amare
The Fetal Medicine Foundation
137 Harley Street
London, W1G 6BG
United Kingdom
Tel.: + 44 (0)207 034 3070
Fax: + 44 (0)207 034 3071
fmfeducation@fetalmedicine.com
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List of faculty membersCarlos Alviggi
Federico II University
Napoli, Italy
Renato Fanchin
Hôpital A. Béclère
University Paris-Sud 11
Clamart, France
Robert Fischer
Fertility Centre Hamburg
Hamburg, Germany
Angelique J. Goverde
University Medical Centre
Utrecht, The Netherlands
Giuseppe Grimadi
Genesis - Grimaldi Medical group IVF Center
IVF/ICSI unit
Rome, Italy
Leanne Jones
Laboratory of Genetics
The Salk Institute for Biological Studies
La Jolla, USA
Neri Laufer
Hadassah University Hospital
Ein Karem, Jerusalem, Israel
Markus Montag
University of Bonn
Bonn, Germany
Kypros Nicolaides
The Fetal Medicine Foundation
London, UK
Antonio Pellicer
Instituto Valenciano de Infertilidad (IVI)
Valencia, Spain
List of faculty members
4
Carlos Simon
Instituto Valenciano de Infertilidad (IVI)
Valencia, Spain
Avi Tsafrir
IVF Unit, Department of Obstetrics and Gynaecology
Shaare-Zedek Medical Center
Hebrew University Medical School
Jerusalem, Israel
Dagan Wells
Nuffield Department of Obstetrics & Gynaecology
University of Oxford
John Radcliffe Hospital
Oxford, UK
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Scientific programSunday, June 24 - 2012
08.30 Registration
09.00 SSIF welcomeR. Fischer, Germany
09.15 Scientific Organizers’ welcomeR. Fischer, Germany; K. Nikolaides, UK
Session I Infertility and obstetric complications
Chairmen: C. Grimaldi, Italy; K. Nikolaides, UK
09.30 L1 - Biological versus chronological ovarian ageC. Alviggi, Italy
10.00 L2 - Selection of embryos to avoid multiple pregnanciesM. Montag, Germany
10.30 L3 - PCOS: infertility and obstetrical problemsA. Goverde, The Netherlands
11.00 Coffee break
11.30 L4 - Preimplantation screening and diagnosisD. Wells, UK
12.00 L5 - Implantation and obstetric complications C. Simon, Spain
12.30 L6 - Obstetrical problems in ageing patientsA. Tsafrir, Israel
13.00 Lunch
Workshops
13.50 L7 - Preimplantation screening and diagnosis D. Wells, UK
15.20 L8 - Ultrasound in ART R. Fanchin, France
16.50 Coffee break
Session II Fertility; past, present and future
Chairmen: N. Laufer, Israel; A. Pellicer, Spain
17.10 L9 - Oocyte donation A. Pellicer, Spain
17.40 L10 - Germ line stem cells ageing D.L. Jones-A., USA
18.10 L11 - Fertility preservation: oncology and social reasons N. Laufer, Israel
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Serono Symposia International Foundation adheres to guidelines of the European Accreditation Council for Continuing Medical Education
(EACCME) and all other professional organizations, as applicable, which state that programs awarding continuing education credits must
be balanced, independent, objective, and scientifically rigorous. Investigative and other uses for pharmaceutical agents, medical devices,
and other products (other than those uses indicated in approved product labeling/package insert for the product) may be presented in the
program (which may reflect clinical experience, the professional literature or other clinical sources known to the presenter). We ask all
presenters to provide participants with information about relationships with pharmaceutical or medical equipment companies that may
have relevance to their lectures. This policy is not intended to exclude faculty who have relationships with such companies; it is only intended
to inform participants of any potential conflicts so participants may form their own judgments, based on full disclosure of the facts. Further,
all opinions and recommendations presented during the program and all program-related materials neither imply an endorsement, nor a
recommendation, on the part of Serono Symposia International Foundation. All presentations solely represent the independent views of the
presenters/authors.
The following faculty provided information regarding significant commercial relationships and/or discussions of investigational or non-
EMEA/FDA approved (off-label) uses of drugs:
Carlos Alviggi
Renato Fanchin
Robert Fischer
Angelique J. Goverde
Giuseppe Grimadi
Leanne Jones
Neri Laufer
Markus Montag
Kypros Nicolaides
Antonio Pellicer
Carlos Simon
Avi Tsafrir
Dagan Wells
Disclosure of faculty relationships
AbstractsKey slides
L1 - Biological versus chronological ovarian age
Carlos AlviggiFederico II UniversityNapoli, Italy
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L2 - Selection of embryos to avoid multiple pregnancies
Markus MontagUniversity of BonnBonn, Germany
9
L3 - PCOS: infertility and obstetrical problems
Angelique J. GoverdeUniversity Medical CentreUtrecht, The Netherlands
10
L4 - Preimplantation screening and diagnosis
Dagan WellsNuffield Department of Obstetrics & Gynaecology; University of Oxford; John Radcliffe HospitalOxford, UK
11
The first challenge in life is the implantation process with maternal immune system interaction. Inadequate implantation and
placentation during the establishment of human pregnancy is thought to lead to ectopic pregnancy, biochemical pregnancy, miscarriage,
and obstetric complications such as preeclampsia, fetal growth restriction or placental acretisms. Decidualization of the human
endometrium, which involves morphological and biochemical modifications of the endometrial stromal cells, is a prerequisite for
adequate trophoblast invasion and placenta formation. During placentation, the extravillous trophoblast invades through the decidualized
endometrium to engraft and remodel uterine spiral arteries. Our group have investigated the proteome and secretome that regulates
in vitro decidualization process, and combined with published genomic information to model the human decidual interactome (1). In
this presentation we will present endometrial data supporting the preparation of the decidua during implantation and their impact on
obstetric complications.
(1) Garrido-Gómez T, Domínguez F, López JA, Camafeita E, Quiñonero A, Martínez-Conejero JÁ, Pellicer A, Conesa A, Simón C. Modeling human endometrial decidualization
from the interaction between proteome and secretome. (2011). J Clin Endocrinol Metab. 96(3):706-16
L5 - Implantation and obstetric complications
Carlos SimonInstituto Valenciano de Infertilidad (IVI)Valencia, Spain
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The rates of women giving birth at advanced maternal age (AMA, > age 40) and very advanced maternal age (VAMA, > 45) have been
rising in the last decade. This trend is related to the worldwide trend of delaying childbirth and to the increasing use of Assisted
Reproductive Techniques (ART) by older women, most importantly oocyte donation. Some complications are much more common
among pregnant women after age 40 as compared with younger women. Hypertensive disorders including preeclampsia occur in 10-
30% of women, as are the rates of diabetes in pregnancy. These complications are even more common after age 45. Reported cesarean
delivery rates are 40-80% in this group, significantly higher than in control groups of younger women. This high rate seems to be a
result of high rate of elective surgery without trial of labor, which may be related to patients or doctors' preferences in the setting of a
so-called 'precious' pregnancy. A high prevalence of multifetal pregnancies in egg donation cycles also contributes to cesarean delivery
rates. Although seldom reported, dystocia is not more prevalent in older patients as compared with younger women.
With regard to neonatal results, preterm deliveries (< 37 weeks) are slightly more common in AMA age, but the rate of very preterm
deliveries (< 32-34 weeks) as well as birth weight < 1500 gr. are comparable to control groups. Neonatal acidosis, low Apgar scores
and congenital malformation rates are comparable to control groups. Data regarding an increased risk for neonatal mortality are
conflicting. Similarly, it is difficult to draw definite conclusions whether oocyte donation pregnancies are associated with increased
risks as compared with endogenous oocyte pregnancies at same maternal age.
In general, obstetrical outcome of this group of women are favorable, and the vast majority will deliver a healthy baby at term. Patient
attempting to conceive at advanced age should receive proper counseling and preparation, including assessment of diabetes and
hypertension.
L6 - Obstetrical problems in ageing patients
Avi TsafrirIVF Unit, Department of Obstetrics and Gynaecology; Shaare-Zedek Medical Center; Hebrew University Medical SchoolJerusalem, Israel
13
L7 - Preimplantation screening and diagnosis
Dagan WellsNuffield Department of Obstetrics & Gynaecology; University of Oxford; John Radcliffe HospitalOxford, UK
14
L8 - Ultrasound in ART
Renato FanchinHôpital A. Béclère; University Paris-Sud 11Clamart, France
15
Oocyte donation (OD) has become one of the most successful alternatives in assisted reproduction (AR) because it is applied to women
in whom the possibilities with their own oocytes are seriously impaired because of age due to the social changes that have delayed
childbearing. It was initially introduced as an alternative method to treat premature ovarian failure in the 80’s, but it became widely
extended and its indications include repetitive implantation failure in AR, low responders, severe endometriosis, hereditary diseases,
numerical or structural chromosomal abnormalities, recurrent miscarriage, and established menopause.
We have analyzed the outcome of OD in several publications over the years. Recently, we measured the success of OD according to
cumulative newborn rates (CNBR) per number of embryos required to achieve at least one newborn (EmbR), considering also the
relevance of age and infertility etiology. Survival curves and Kaplan-Meier methods were employed to analyze CNBR with respect to the
number of EmbR in a retrospective cohort of OD subjects.
CNBR increase rapidly (up to 64.8%) between one and five EmbR, moderately (85.2%) between five and fifteen, and slowly thereafter,
reaching a plateau at 15 embryos (92.4%) and peaking after 25 EmbR (96.8%), demonstrating that the chances of success vary as failed
attempts accumulate. Patient age was not a negative factor for receiving donated oocytes, and indication for OD was also irrelevant to
outcome. Data gave an overall mean number of 2.6 (CI 2.5-2.6) embryo transfers and 5.8 transferred embryos per newborn (CI 5.8-5.8).
Due to some difficulties in the management of donors and recipients, we developed a very strong vitrification program. In a randomized
prospective trial, we included 600 recipients based on a computer randomization list in vitrification (N=300) or fresh groups (N=300).
Vitrification was performed by the Cryotop method. The primary end point was the ongoing pregnancy rate (OPR) per randomized
patient The OPR was 43.7% and 41.7% in the vitrification and fresh groups respectively. Thus, vitrification is considered today a very
helpful tool in our OD program for several reasons. First, synchronization between donor and recipient is not a problem anymore;
Second, there is no waiting list or bleeding in our foreign patients because the patient gets started once the oocytes have been vitrified;
Third, we can apply the same safety measures that for sperm, namely we are able to check the infectious status of the donor 6 months
after the retrieval of the eggs. This is very reassuring for our patients; Last, but not least, the success of our OD program has not been
hampered by vitrification.
L9 - Oocyte Donation
Antonio PellicerInstituto Valenciano de Infertilidad (IVI)Valencia, Spain
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L10 - Germ line stem cells ageing
Leanne JonesLaboratory of Genetics; The Salk Institute for Biological StudiesLa Jolla, USA
17
L11 - Fertility preservation: oncology and social reasons
Neri LauferHadassah University HospitalEin Karem, Jerusalem, Israel
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Notes
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Notes
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Serono Symposia International Foundation Representative officeSalita di San Nicola da Tolentino 1/B 00187 Rome, Italy.T +39.06.420.413, F +39.06.420.413.677
Headquarters14, Rue du Rhone, 1204 Geneva, Switzerland
Copyright © Serono Symposia International Foundation, 2012. All rights reserved
Improving the patient’s life through medical educationwww.seronosymposia.org
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oundationnational F
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education
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