ESHRE

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Dr. Hans van der Slikke:  "Professor Lynn Fraser, we are at the 16th ESHRE Conference in Bologna, Italy, and you're this year's ESHRE President. Can you tell us what ESHRE is all about?"

Professor Lynn Fraser:  "ESHRE is a Society that was founded in 1985 with the specific intention of providing a forum for both clinicians and scientists working in the area of reproductive medicine and reproductive science to get together to discuss, debate, pose questions, argue, and so on. It started in the first year or two with about 200 members, and we now have over 4,000 members in the Society. Likewise, our meetings started small and they continue to grow and grow so we have over 4,000 participants at this year's meeting in Bologna."

Dr. Hans van der Slikke:  "Is this an annual meeting?"

Professor Lynn Fraser:  "Yes, it's an annual meeting held in the summertime, usually the very end of June."

Dr. Hans van der Slikke:  "Who were the founders of ESHRE?"

Professor Lynn Fraser:  "The main founding nucleus included Professor Robert Edwards who along with Patrick Steptoe was involved in producing the first so-called test tube baby and Professor Jean Cohen from France. Those were two of the main individuals involved in forming the ESHRE Society." 

Dr. Hans van der Slikke:  "How many members do you have at this moment?"

Professor Lynn Fraser:  "It's slightly over 4,000."

Dr. Hans van der Slikke:  "Is it all European members?"

Professor Lynn Fraser:  "Oh, by no means at all. The country that has the highest number of members is the United Kingdom followed by the United States of America so I think we have to redefine European."

Dr. Hans van der Slikke:  "So it's also a little bit of an American society. Do you have a special position in this fertility society's world?"

Professor Lynn Fraser:  "I think most definitely although we obviously started as a brand new society and we were an unknown quantity, I think most people would acknowledge that we are one of the two main internationally recognized societies devoted to reproductive science and medicine. Our other competitor, if you want to call it that, is the American Society for Reproductive Medicine - ASRM but of course that's only a national society whereas our name says European but in truth we are an international society."

Dr. Hans van der Slikke:  "Are the topics that you address different if you compare them with the American Society or the International Society, the IFFS?"

Professor Lynn Fraser:  "I'm not a regular attender at those meetings, I'm a basic scientist by training but I think the difference between ESHRE meetings and meetings of these other societies is that we always aim to have a balance between basic science and clinical presentations. Certainly for our invited speakers, we have a very good balance between clinical topics, basic science topics, and we have many sessions which are mixed so that one of the presentations will address the scientific element of a particular area and the other one will discuss clinical matters related, again, to that same area."

Dr. Hans van der Slikke:  "Talking about these differences with this conference, could you tell me the headlines in your opinion?"

Professor Lynn Fraser:  "It's such an exciting meeting that I'm not sure that there's any one particular set of headlines. For the second year, we have been running a press office and as a consequence we have had a number of press releases drawn up and distributed to journalists both attending the meeting as well as to various information spreading groups such as, the Associated Press, Ruters, etc. Of course we did have a press briefing on the first day which was Monday, and we decided that it would be useful to highlight the fact that we have a broad range of different areas addressed in any one of our meetings so we had a brief presentation from each of four individuals who were speaking here at the Bologna meeting. One was speaking on a clinical topic, one on a scientific topic, one on an ethical topic, and the last on a psychological topic. 

I suspect that one of those which caught a lot of attention was the one that was the basic science one where the presenter discussed preliminary studies where small pieces of frozen human ovarian tissue were grafted into mouse muscle as a means of trying to get early development of follicles and so eggs, and then using them once they got to a sufficiently large stage to put into culture to grow. It's very difficult to take very early follicles and culture them in the laboratory from the very early stages all the way through to a stage that could be fertilized. This technique might have applications for individuals who have had cancer. Before having treatment for the cancer, one would take out ovarian tissue, freeze it, treat the individual and then of course many times the treatment would actually - in this case we're talking about - make the woman sterile. So all of her eggs would have been damaged by the treatment. The difficulty of putting the piece that had been removed and frozen back into the woman is that it was taken before the woman was treated and, therefore, there might still be cancerous potential in the surrounding cells. So by using something like this very special kind of a mouse system, the eggs could be developed to a stage where they could then be matured in vitro and then only after you got the maturation of the egg and fertilization, the embryo almost certainly I think would not have cancer. So you could then put it back into the woman, you would not cause her to suffer from cancer again, and she could then hopefully have a normal pregnancy, i.e. to become fertile."

Dr. Hans van der Slikke:  "Yes, this is a very promising report, I agree with you. So this was a scientific one and then there was the intrauterine shaver from Mark Emanuel, what’s your comment about this rotating machine?"

Professor Lynn Fraser:  "I thought it was a very interesting presentation because it's an area about which I know very little but the fact that the technique that they are hoping to replace by using this shaver, that original technique is very hard to learn and it sounds as if you have to be very, very careful or else you can have serious consequences for the woman on whom the technique is being used. So the shaver looks to me to be a very good way forward in many instances, and I think it has considerable exciting promise for use."

Dr. Hans van der Slikke:  "And the ethical one, I think it's a little bit dangerous to comment about."

Professor Lynn Fraser:  "I think so."

Dr. Hans van der Slikke:  "It was provoking wasn't it?"

Professor Lynn Fraser:  "Professor Carl Wood who is giving an invited lecture was made an honorary member of ESHRE at this meeting as well and is known for taking provocative stands because I think he wants people to actually think about many of the questions that have now been raised because of the advance in the assisted reproduction technology that can be used. He raised a whole variety of provocative topics, not least of which was that if women drink a certain amount of alcohol, it increases their testosterone levels and, therefore, makes them perhaps more interested in having sexual intercourse. Actually, for people who are suffering from infertility, when you're infertile you have to have intercourse to a timetable and that's not much fun so the fun goes out of the relationship in a couple. He suggested that having a little bit of alcohol might help you bring back some fun into the relationship. So I don't know, it's always a possibility."

Dr. Hans van der Slikke:  "And you live longer."

Professor Lynn Fraser:  "And you live longer as well, as long as you don't overdo it."

Dr. Hans van der Slikke:  "So the fourth point you mentioned was the psychology item."

Professor Lynn Fraser:  "Yes, this was Dr. Kopitzke from the U.S. who gave a presentation about the emotional-psychological stresses that couples have to bear up with when they're undergoing treatment for infertility. It is very, very difficult because if you're the woman you take drugs that will make you feel sad, depressed, and unhappy. You may get emotional, you may hit your husband or your partner, and it makes life very difficult for the woman. The male partner has difficulties as well, the fact that again, you have to have intercourse to some sort of a timetable, it takes all of the spontaneous enjoyment out of a relationship that a couple may have had. I think this does have tremendous stresses and strains on some couples, and I think some of them just can't cope, particularly if they are unsuccessful after several cycles. I think it's not uncommon in at least some couples for them to actually split up because it has put such a strain on their relationship."

Dr. Hans van der Slikke:  "I think this was a very beautiful summary of the hot topics of this conference. Thank you very much."