It was a weekend of fools at the New England Fertility Society's (NEFS) 14th annual meeting, which took place on April Fools'weekend, April 1 and 2. The meeting was set amidst the gorgeous landscape of Vermont's Green Mountains in the resort town of Stowe. Yes, we had dessert catered by Ben and Jerry's Ice Cream. NEFS President, Jill Attaman, MD, thanked the roughly 170 people in attendance, and introduced the April Fool's theme, with practical jokes played throughout the weekend. Yes, there were woopie cushions. If you weren't fortunate enough to have joined us for this year's meeting, here is a brief synopsis of what you missed.
1). 2014 SART reports expected to be released this week. Brad Van Voorhis, MD, the President of the Society for Advanced Reproductive Technology (SART) discussed Big Data for Personalized Medicine and the role that SART has played over the last thirty years as the nation's first national patient health registry. Dr. Van Voorhis reports that just under 400 treatment centers report directly to SART, with only roughly 30% of that number reporting directly to the Center for Disease Control (CDC).
2). Selwyn Oskowitz has left the building. Well, sort of. Selwyn Oskowitz, MD, the founding president of NEFS (then the Boston Fertility Society), retired from his storied career at Boston IVF the day before the meeting began. His colleagues paid him an emotional homage, and he received a standing ovation from everyone in attendance. "Is this real?" Dr. Oskowitz joked, referencing the April Fool's theme. Dr. Oskowitz will be traveling to Rwanda intermittently over the next year to provide pro bono medical services to those with infertility.
3). 60% of human embryos result in pre-clinical losses. Steven Young, MD, PhD, of the University of North Carolina School of Medicine lectured on Endometrial Receptivity. Implantation abnormalities are common causes of infertility, pregnancy loss, and pregnancy complications. Dr. Young believes that the next major breakthrough for infertility therapy will come from optimizing successful embryo implantation, which may have important downstream advantages in reducing pregnancy complications.
4). Focus on fertility preservation. Clarisa Gracia, MD of Penn Fertility Care discussed Ovarian Tissue Cryopreservation. With respect to reproductive function, high-risk cancer survivors in their mid twenties have measures similar to naturally aging women in their early forties. She adds that maturing immature eggs from tissue in vitro eliminates the risk of transplanting cancer cells.
5). Cryopreservation now routinely applied to oocytes and embryos. Terry Schlenker, of the Colorado Center for Reproductive Medicine presented on the Vitrification of Oocytes and Biopsied Embryos. Ice formation is avoided by loading the cells with high concentrations of solutes to convert the water into a non-crystalline solid. Vitrification is now considered indispensable to ART.
6). May the force be with you. Judith Daar, JD, of the Whittier Law School reports that in February 2016, U.S. Secretary of Defense, Ashton Carter, announced a $150 million pilot program to fund egg and sperm freezing for all active duty military. Due to Congress's current ban on IVF, however, the frozen eggs might never be accessed once the soldier is discharged from service.
7). Stress on the rise. 44% of Americans report that their stress levels have increased over the last five years, according to a 2012 American Psychological Association study cited by Courtney Lynch, PhD, MHP, of The Ohio State University Wexner Medical Center. Though not yet conclusive, evidence is suggestive of an association between infertility and stress.
8). You're not crazy. Rachel K. Ashby, MD, of Brigham and Women's Hospital talked about the importance of validation of feelings with respect to Patient Centered Care in an Infertility Practice. "Patients are worried, 'I'm crazy, I'm not handling this well, everyone else's relationship is stronger than mine'". Dr. Ashby emphasizes the importance of validating these patient experiences as common and that distress is an appropriate reaction.
9). Triplets don't come cheap. Barbara Luke, ScD, of Michigan State University cited a 2013 American Journal of OBGYN study in her lecture on Designing Research to Assess Health Outcomes After Assisted Reproduction. The per infant cost of triplets counts at $135,733, compared with $8,327 for singletons. Media outlets often sensationalize high profile cases of multiple births but omit information regarding the highly common medical risks.
10). Politics is messy business. 132 Congressmen and Congresswomen have co-sponsored the leading federal embryo-personhood bill. Lee Rubin Collins, JD, spoke on behalf of RESOLVE on Infertility, Ideology, Patients and Politics. RESOLVE has fought legislation threatening IVF in 24 states and counting.
11). We're not the only ones. "Why would they invite a Canadian to come speak on law regarding funding for reproductive health in New England?" joked Neal Mahutte, MD, of Montreal Fertility Centre. Dr. Mahutte shared the legislative challenges to ART in Canada and in Quebec. Like the United States and virtually every nation in the world, it is very difficult for lawmakers to write consistent laws pertaining to ART. In Canada for example, clinics can import sperm from paid donors in other countries, but donor compensation within Canada is prohibited.
12). People aren't having enough sex. That was the conclusion of pretty much everyone I spoke with. Well...you heard it here first.