Pre-congress courses are increasingly popular at ESHRE annual meetings and the courses run by the the SIG Embryology attract particular interest. This year’s course was on “the multiple choices of IVF”, a title designed to reflect the multiplicity of options, and sometimes dilemmas, that embryologists must consider in order to assure high performance from the IVF lab and best possible treatment. This theme was picked up in specific and sometimes burning questions by a panel of outstanding speakers.
Arne Sunde discussed the alternative use of sequential versus single step embryo culture media. In fact, he gave an overview of a much larger question, that, irrespective of the embryo culture strategy, embryologists do not have access to adequate information on the composition of culture media, which makes their decisions more difficult. In the final analysis, he concluded that a difference in performance between sequential and single step media does not seem to exist, but nevertheless advocated the formation of a task force in order to take the culture media question further.
The task of David Edgar was to review the pros and cons of cryopreserving oocytes of embryos. Clearly, these approaches have different significance in different individual cases. However, he showed very convincingly that, with optimal methodology, oocyte and embryo (cleavage stage and blastocyst) cryopreservation can achieve comparable results. He also proposed that “there is no longer justification for creating embryos merely to ensure successful cryopreservation”, but did conclude that oocyte cryopreservation may help solve logistic and ethical problems associated with embryo cryopreservation.
In the final talk, Aisling Ahlstrom presented her view on the dilemma of morphological criteria versus genetic testing for embryo selection. She addressed this by analysing different aspects of safety, evidence, cost-effectiveness and ethics. Because no definite answers have been found yet for these questions, she concluded by asking why PGS continues to grow in use.
Giovanni Coticchio, Co-ordinator of SIG Embryology