Aevitas Fertility Specialist, Dr Gerhard Hanekom and Aevitas Laboratory Director, Greg Tinney-Crook represented Aevitas at the 35th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE), Vienna Austria, 23 – 26 June 2019. Upon return from ESHRE 2019, the Fertility Expert Forum was held in Johannesburg, September 2019. The Fertility Expert Forum is a local conference. The Expert Fertility Forum is attended by lecturers from all over South Africa as well as international speakers. Topics presented were those which were recently presented at the annual ESHRE conference in Vienna. Dr Gerhard Hanekom and Greg Tinney-Crook were both invited to The Fertility Expert Forum as speakers.
Dr Gerhard Hanekom presented on: 1) The use of progesterone in the prevention of miscarriages 2) Treatment of thyroid antibodies with thyroid hormone in attempt to improve pregnancy outcomes. Furthermore, Greg Tinney Crook presenter on: 3) Sperm DNA matters: Finding the best sperm.
1. The use of progesterone in the prevention of miscarriages.
Dr Gerhard Hanekom presented the latest research on the use of progesterone in the prevention of miscarriage in women presenting with threatened miscarriage or recurrent miscarriages. This was a large international randomised controlled trial in which more than 4000 women participated. The research results showed that women who suffered multiple previous miscarriages, benefited from the use of progesterone, as it resulted in more live births and less miscarriages. This gives good evidence for the management of this very difficult clinical problem that is often faced.
2. Treatment of thyroid antibodies with thyroid hormone in attempt to improve pregnancy outcomes.
Dr Hanekom further presented on a recent trial conducted in the UK. This trial investigated women presenting with thyroid antibodies (an indicator of thyroid auto-immune disease) who were either pregnant or trying to conceive, but struggling with infertility. It is well-known that thyroid antibodies puts women at risk of having miscarriages and preterm labour. Treating thyroid antibodies are believed to affect the function of the thyroid which plays a cardinal role in all the metabolic processes in the body. The trial showed that treating women with thyroid hormone did not improve the pregnancy outcomes. It has therefore opened discussion and thought to optimal management of such cases.
3. Sperm DNA matters: Finding the best sperm.
Aevitas Laboratory Director, Greg Tinney-Crook, presented on ‘Sperm DNA matters: Finding the best sperm’ (Original speaker: Nicola Garrido Puchalt). Advanced sperm selection techniques, such as IMSI, PICSI, electrophoresis, birefringence, microfluidics, magnetic activated cell sorting and use of testicular sperm, were discussed. Although some articles and studies showed some benefit to the use of these techniques most showed that the general use for all fertility patients was not deemed necessary. There is no ‘one fits all’ sperm selection method able to significantly improve success rates. Therefore, in severe male factor cases the clinic must individualize the approach to sperm selection techniques.
Furthermore, within reproductive medicine, there is a need and a drive to find the best sperm when doing fertility treatment in attempt to improve the success of fertility treatments. The question was asked whether sperm DNA testing, which can detect DNA integrity, can assist in improving reproductive outcomes. Guidelines from two fertility societies recommended that there is insufficient evidence to recommend routine use of sperm DNA integrity tests in the evaluation and treatment of the infertile couple. Therefore, testing sperm for DNA integrity is only indicated for problems which cannot be detected through semen analysis.