IVF Preceptorship Madrid15 -16 November 2013 - Madrid, Spain

FINAL PROGRAMME AND ABSTRACT BOOK

General information

VenueThe live educational course takes place at the:NH Eurobuilding Madrid, Spain

The clinic visits take place at the:Clínica Tambre C/ Tambre, 8. 28002 Madrid, Spain

LanguageThe official language of the live educational course is English.

Scientific secretariatSerono Symposia International FoundationSalita di San Nicola da Tolentino, 1/b00187 Rome, Italy

Associate Project Manager: Simona PantaleoniTel.: +39 (0)6 420 413 569 - Fax: +39 (0)6 420 413 677E-mail: info@seronosymposia.org

Specialist Medical Advisor: Irene ZerbettoSpecialist Medical Advisor: Angelo Marino

Serono Symposia International Foundation is a Swiss Foundation with headquarters in 14, Rue du Rhône, 1204 Geneva, Switzerland

Organising secretariatMeridiano Congress InternationalVia Sapri, 6 - 00185 Rome, ItalyProject Coordinator: Federica RussettiT +39 (0)6 88 595 209 - F +39 (0)6 88595 234E-mail: f.russetti@meridiano.it

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IVF Preceptorship Madrid

Serono Symposia International Foundation live educational course on:

IVF Preceptorship Madrid15 -16 November 2013 - Madrid, Spain

AimsLH has essential and well-established roles in both ovarian steroid synthesis and ovulation. While normal ovulation is impossiblewithout LH, the specific role of LH in folliculogenesis and oocyte maturation is less clear. Thecal cells (TC) express LH receptorsconstitutionally, and LH stimulates androgen substrate production by the TC from fetal life until after the menopause. From thephysiological and basic science, it becomes increasingly clear that some LH activity is essential for optimal maturation anddevelopment of the follicle-oocyte unit during ovulation induction treatment. It is probably also essential for optimal follicle–oocytematuration. This live educational course offers an overview on ovarian stimulation and on new laboratory technologies for in vitrofertilization cycles. This meeting is dedicated to providing new insights on these topics, with an interactive programme where eachlecture is followed by specific cases studies or working groups. The aim is to provide learners with both up-to-date knowledge andthe possibility to share their experiences with each other and with the speakers.

Learning objectivesBy attending this live educational course the learners will be able to:• Analyse the physiology of LH and its role in ovulation induction• Individualise the groups of patients that needed LH during the stimulation protocols• Identify the ovarian markers useful for tailoring the treatments and choosing the best protocol • Apply new strategies to avoid implantation failure

Target audienceThis live educational course is designed for a restricted number of expert physicians working in assisted reproductive medicine, whoare currently involved in infertility treatments.

AccreditationAn application has been made to the EACCME® for CME accreditation of the Serono Symposia International Foundation course “IVFPreceptorship Madrid” held on 15 -16 November 2013 in Madrid, Spain.

Serono Symposia International Foundation (SSIF) adheres to the principles of the Good CME Practice Group (gCMEp)

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All Serono Symposia International Foundation programmes are organized solely to promote the exchange and dissemination of scientific and medical information. Noforms of promotional activities are permitted. This programme is made possible thanks to an educational grant received from Merck Serono Middle East.

Scientific organiserRobert FischerFertility Center HamburgHamburg, Germany

Local scientific organisersMiguel Caballero CampoTambre clinicMadrid, Spain

Rocío Núñez CalongeTambre clinicMadrid, Spain

Serono Symposia International Foundation developed this course in partnership with the Tambre Clinic.

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List of faculty membersCarlo AlviggiFederico II UniversityNaples, Italy

Miguel Caballero CampoTambre clinicMadrid, Spain

Robert FischerFertility Center HamburgHamburg, Germany

Juan Antonio García-VelascoInfertility Institute of Valencia (IVI) MadridRey Juan Carlos UniversityMadrid, Spain

Peter HumaidanThe Fertility Clinic, Skive Regional HospitalSkive, DenmarkFaculty of Health, Aarhus UniversityAarhus, Denmark

Marcos MeseguerInfertility Institute of Valencia (IVI)Valencia, Spain

We value your opinion!We are continually trying to develop and improve our educational initiatives to provide you with cutting-edge learning activities.Prior and after this live educational event you will be asked to answer an online survey to help us to better tailor our futureeducational initiatives.

We thank you for participating!

Scientific programme15-16 November 2013

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Chairs: M. Caballero Campo (Spain) - R. Fischer (Germany)

09.10 L1: Physiology of gonadotropins secretion androle of polymorphisms of FSH and LHreceptor in infertile patientsC. Alviggi (Italy)

09.35 L2: LH and ovarian stimulation: differentapproachesP. Humaidan (Denmark)

10.20 Questions time

10.40 Coffee break

11.00 WG1: Case studies on L1 and L2C. Alviggi (Italy)P. Humaidan (Denmark)

12.00 Lunch

The role of LH: from the physiology tostimulation protocolsSession I

Friday, 15 November

08.30 Registration

08.50 Serono Symposia International Foundation (SSIF) introductionR. Fischer (Germany)

09.00 Local scientific organiser welcomeM. Caballero Campo (Spain)

Chairs: M. Caballero Campo (Spain) - R. Fischer (Germany)

13.00 L3: GnRH agonist versus antagonist protocols inIVF/ICSI cycles P. Humaidan (Denmark)

13.30 L4: Individualized Controlled Ovarian Stimulation(iCOS): tools for matching patients andprotocols C. Alviggi (Italy)

13.55 Questions time

14.15 WG2: Case studies on L3 and L4C. Alviggi (Italy)P. Humaidan (Denmark)

15.15 Visit of the clinic (1st group)

End of the first day

Individualized Controlled Ovarian Stimulation(iCOS)Session II

Legend

L : Lecture; : Questions time; WG : Working Group;

Saturday, 16 November

Chairs: M. Caballero Campo (Spain) - R. Fischer (Germany)

09.00 L5: Biomarkers of gamete selection and embryoviabilityM. Meseguer (Spain)

09.25 L6: PGD and cGH array. Indications and futureprospectives M. Meseguer (Spain)

09.50 L7: Luteal phase support J.A. García-Velasco (Spain)

10.15 Coffee break

10.35 L8: The role of endometrium receptivity andRecurrent Implantation FailureJ.A. García-Velasco (Spain)

11.00 Questions time

11.20 WG3: Case studies on L7 and L8 J.A. García-Velasco (Spain)

12.20 Lunch

13.20 Visit of the clinic (2nd group)

End of the live educational course

Implantation failure: from biological aspects tolaboratory techniquesSession III

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Disclosure of faculty relationships

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Serono Symposia International Foundation adheres to guidelines of the European Accreditation Council for Continuing MedicalEducation (EACCME®) and all other professional organizations, as applicable, which state that programmes awarding continuingeducation credits must be balanced, independent, objective, and scientifically rigorous. Investigative and other uses for pharmaceuticalagents, medical devices, and other products (other than those uses indicated in approved product labeling/package insert for theproduct) may be presented in the programme (which may reflect clinical experience, the professional literature or other clinical sourcesknown to the presenter). We ask all presenters to provide participants with information about relationships with pharmaceutical ormedical equipment companies that may have relevance to their lectures. This policy is not intended to exclude faculty who haverelationships with such companies; it is only intended to inform participants of any potential conflicts so that participants may form theirown judgements, based on full disclosure of the facts. Further, all opinions and recommendations presented during the programmeand all programme-related materials neither imply an endorsement nor a recommendation on the part of Serono SymposiaInternational Foundation. All presentations represent solely the independent views of the presenters/authors.

The following faculty provided information regarding significant commercial relationships and/or discussions of investigational ornon-EMEA/FDA approved (off-label) uses of drugs:

Miguel Caballero Campo Declared no potential conflict of interest.

Robert Fischer Declared no potential conflict of interest.

Peter Humaidan Declared receipt of un-restricted research grant from MSD. Declared of honoraria for lectures from:Merk Serono, MSD, Ferring and Nordic Infucare.

Marcos Meseguer Declared otherwise benefit from a relationship with a commercial enterprise as speaker at MerkSerono symposia.

Rocío Núñez Calonge Declared no potential conflict of interest.

The following faculty have provided no information regarding significant relationship with commercial supporters and/or discussionof investigational or non-EMEA/FDA approved (off-label) uses of drugs as of 5 November 2013.

Carlo Alviggi

Juan Antonio García-Velasco

Biosketch

Biosketch

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Dr. Miguel Caballero Campo is Medical Director of Clinica Tambre. He is Specialist in Obstetrics and Gynaecology, subspecialist inreproductive medicine and surgery and Magister in Human Reproduction (Universidad Complutense, Madrid). He is also specialistin Intensive Care. Dr. Caballero Campo trained in Hospital Universitario Gregorio Marañon until he was appointed as specialist inreproductive medicine at the Clinica Tambre since 2010. He is also a member of Tambre Foundation since 2003. Dr. Caballero is amember of national and international learned societies including the European Society of Human Reproduction and Embriology(ESHRE) and Spanish Fertility Society (SEF).

Miguel Caballero CampoTambre clinicMadrid, Spain

Carlo Alviggi works as a Specialist in Reproductive Medicine at the Fertility Unit of the University of Naples “Federico II”. Since 2006,he has been working in the same unit as Assistant Professor. Dr Alviggi’s current research interests are the role of luteinizinghormone (LH) in folliculogenesis, the use of LH-containing drugs in patients undergoing controlled ovarian stimulation for in vitrofertilization, the pathogenesis of pelvic endometriosis, and the genetics of human reproduction. Dr Alviggi has published extensivelyand has been invited to lecture at over 40 international meetings dealing with reproductive medicine and gynaecologicalendocrinology. He has also served as ad hoc reviewer for international journals of these fields and has participated in severalnational and international (phase II-III) multicentre, prospective randomized trials.

Carlo AlviggiFederico II UniversityNaples, Italy

Robert Fischer is Founder and Medical Director of the IVF unit at the Hamburg Fertility Center, one of the largest and leadingGerman IVF centres. In July 1998 the Fertility Center of Hamburg was one of the first centres in Germany and worldwide to introducecertified quality management according to the ISO 9001. In 2002 the IVF laboratory was ISO 17025 certified. Prior to this he wasMedical Director of the first outpatient IVF unit in Hamburg. Author of numerous publications in national and international scientificjournals and books, as well as lectures at conferences worldwide, Dr Fischer is an active member of the American Society ofReproductive Medicine, founding member of the European Society of Human Reproduction and member of its advisory committeeas well as founding member of the “AG Gynäkologische Endokrinologie und Fortpflanzungsmedizin” and “BerufsverbandReproduktionsmedizinischer Zentren”, both in Germany.

Robert FischerFertility Center HamburgHamburg, Germany

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Dr Velasco is Director of IVI Madrid as well as Director of the Masters Degree in Human Reproduction, Director of the Postgraduatecourse in Nursingin Human Reproduction, and Associate Professor of Obstetrics and Gynecology, Rey Juan Carlos University inMadrid. He is the author of more than 100 scientific articles as well as 22 book chapters and abstracts on human reproduction,especially on endometriosis and both hyper- and hypo- ovarian stimulation response. He has been a Principal Investigator for theSpanish Ministries of Health and Education. Dr Velasco has served on the editorial board of Fertility and Sterility and has been amember of ESHRE’s Advisory Committee.

Juan Antonio García-VelascoInfertility Institute of Valencia (IVI) MadridRey Juan Carlos UniversityMadrid, Spain

Marcos Meseguer received his PhD (Obstetrics and Gynaecology) and MD from the University of Valencia, Spain, and a mastersdegree in Research Methods, Design and Statistics from Universidad Autónoma de Barcelona, Spain. From 2000 to 2004, DrMeseguer served as Co-Director of the Andrology Laboratory at the Instituto Valenciano de Infertilidad (IVI) and is currently a SeniorEmbryologist in the IVF unit of IVI Valencia. Dr Meseguer is a member of various scientific societies and has received the prize paperof the Society of Reproduction and Infertility (American Society of Reproductive Medicine), three times the Lalor FoundationInternational Award from the American Society of Andrology, and twice the research award from the Spanish Society of Fertility. Theprimary areas of his research are embryology, male infertility and assisted reproduction in HIV/VHC serodiscordant couples. AsPrincipal Investigator, his work has been funded through 10 projects sponsored by the Spanish Government and the ValencianGovernment, including two EUREKA projects (granted to high-quality technological projects) supported by the European Community.He is currently Statistics Assessor and Scientific Updater of IVI Valencia, and Associate Professor of the Master in Biotechnologyfrom the University of Valencia. Dr Meseguer has published over 85 articles and 40 reviews or book chapters, and made more than250 presentations at national and international congresses.

Marcos Meseguer Infertility Institute of Valencia (IVI)Valencia, Spain

Peter Humaidan is a Specialist in Reproductive Endocrinology, Professor and Clinical Director of The Fertility Clinic at OdenseUniversity Hospital, OUH, Denmark. He trained at the Sahlgrenska University Hospital, Gothenburg, Sweden, where he alsocompleted a speciality degree in Obstetrics and Gynaecology. His research interests include: reproductive endocrinology; thefunction of gonadotrophins; GnRH antagonists and triggering of ovulation with GnRH agonist; sperm chromatin integrity in relationto ART outcomes; and acupuncture related to infertility. He is a former board member of the Danish Fertility Society, and has co-authored some 50 papers in peer-reviewed international journals as well as chapters in textbooks.

Peter HumaidanThe Fertility Clinic, Skive Regional HospitalSkive, DenmarkFaculty of Health, Aarhus UniversityAarhus, Denmark

Abstracts

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L1. Physiology of gonadotropins secretion and role ofpolymorphisms of FSH and LH receptor in infertilepatients

Carlo AlviggiFederico II University, Naples, Italy

Abstract not in hand at the time of printing.

References:1 - Chappel SC, Howles C 1991 Reevaluation of the roles of luteinizing hormone and follicle-stimulating hormone in the ovulatory process. Human Reproduction

6 1206-1212. 2 - Filicori M, Cognigni GE, Pocognoli P et al. 2003 Current concepts and novel applications of LH activity in ovarian stimulation. Trends in Endocrinology and

Metabolism 14, 267-273.

IntroductionWith the recent development of recombinant gonadotropins (FSH and LH), it has become possible to further adjust the stimulationprotocol according to the expected needs of the patient. In this respect, the possible beneficial role of exogenous LH activitysupplementation for stimulated ART cycles has received increasing attention.According to the two-cell, two- gonadotropin theory (Fevold, 1941), both FSH and LH are required for normal folliculogenesis inhumans. LH stimulates the production of androgens in the theca cells, which in turn are aromatised to estradiol by the granulosacells under the action of FSH. However, at a follicle size of 8–10 mm in normogonadotropic women, the granulosa cell also acquiresLH receptors in addition to the FSH receptors, already present. Once LH receptors are expressed in the granulosa cell, LH is able toregulate both steroidogenesis and growth of the follicle; thus, from this moment on FSH function can to a large extent be replacedby LH activity.

MethodsDuring recent years an increasing body of scientific evidence has raised the question whether the endogenous LH level achievedafter down-regulation with either GnRHa or GnRH antagonist is really optimal for all patients, or whether sub-groups of patientsexist who might benefit from exogenous LH supplementation. Several studies have until now addressed the effect of LH activity supplementation. The results of these studies indicate that twosubgroups of normogonadotropic patients: patients > 35 years of age (Marrs et al. 2004, Humaidan et al., 2004, Bosch et al., 2008;Matorras et al., 2009) and patients with an initial sub-optimal response to FSH only preparations (Barrenatexea et al., 2000; DePlacido et al., 2004; Ferraretti et al., 2004; Ruvolo et al., 2007) seem to benefit from modifications of the stimulation protocol in termsof exogenous LH activity supplementation.Possible biological reasons for a beneficial effect of LH activity supplementation in these sub-groups will be discussed as well asmolecular, structural and functional differences between LH and hCG and the most recent meta-analyses on the subject. Finally, the importance – or not – of late follicular progesterone rise during COS will be debated.

ConclusionsAge and LH gene polymorphisms are some of the factors known until now to influence the ovarian response after COS. LHsupplementation in sub-groups seems to improve the ovarian response and the reproductive outcome. Ovarian response tostimulation with FSH is a polygenic trait and the future scenario of ART will include pharmacogenetics in order to define the specificneeds of gonadotropins to secure the most optimal ovarian response.

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L2. LH and ovarian stimulation: different approaches

Peter HumaidanThe Fertility Clinic, Skive Regional Hospital, Skive, DenmarkFaculty of Health, Aarhus University, Aarhus, Denmark

Patients undergoing IVF/ICSI experience substantial treatment burden, psychological distress, and risk. These factors often lead totreatment discontinuation if pregnancy is not achieved. One approach to reduce these negative factors is the use of the GnRHantagonist protocol. Data from the most recent clinical trials and meta-analyses show that co-treatment with GnRH antagonistduring COS is associated with similar live birth rates, reduced treatment burden and a more than 50% risk reduction inhospitalisation due to severe hyperstimulation syndrome compared with the long GnRHa down-regulation protocol. However, thegreatest advantage of GnRH antagonist co-treatment is that it allows final oocyte maturation to be triggered with a bolus of GnRHa,resulting in a significant reduction in or complete elimination of OHSS, the retrieval of more MII oocytes, and a higher patientconvenience during the luteal phase. Despite these factors, interestingly worldwide the majority of COS cycles are still performedwith GnRHa co-treatment. During this lecture it is stated that in 2013 the GnRH antagonist protocol should be the protocol of choicefor the normo-responder as well as the hyper-responder patient and a straightforward protocol for the normo-reponder patient willbe presented.

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L3. GnRH agonist versus antagonist protocols in IVF/ICSIcycles

Peter HumaidanThe Fertility Clinic, Skive Regional Hospital, Skive, DenmarkFaculty of Health, Aarhus University, Aarhus, Denmark

Abstract not in hand at the time of printing.

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L4. Individualized Controlled Ovarian Stimulation (iCOS):tools for matching patients and protocols

Carlo AlviggiFederico II University, Naples, Italy

Evaluation of gametes and embryos in vitro has improved greatly over the past 20 years. Classical assessment has beensupplemented by evaluation of several additional morphological characteristics that allow prediction of the developmental potentialof an oocyte or an embryo and the probability of achieving pregnancy for an infertile couple. Time-lapse observation presents anopportunity for optimising this embryo selection based on morphological grading as well as providing novel kinetic parameters,which may further improve accurate selection of viable embryos. The technological advances in hi-tech research have enabled alsonon-invasive determination of proteomic and metabolic status of the embryo. Oxygen consumption measurements from oocytes andembryos could be applied routinely in the clinical embryology laboratory in order to assess quality, complementing the classicalmicroscope-based methods to select embryos.

In this lecture, we present a unique clinical study which combines oxygen consumption measurements with time-lapse imaging ofembryo development for human embryos. The study presents - to our knowledge - the largest set of transferred embryos after time-lapse analysis and thus a novel opportunity to correlate morphokinetic parameters to implantation and ongoing pregnancy. We havegenerated and evaluated a tool for the selection of viable embryos based on the exact timing of embryo development events togetherwith morphological patterns by using an automatic time-lapse system to monitor embryo development.

The parameters studied have been postulated as new markers of oocyte quality and embryo implantation but also we have observedvariations in these markers depending on stimulation protocols and procedures:

1. Oocyte oxygen consumption is being affected by stimulation protocols.

2. The type of protocol used for controlled ovarian stimulation influences embryonic developmental kinetics, but these differencesare not reflected in embryo quality, assessed on the basis of cleavage timings.

3. No significant differences in embryo developmental kinetics for any of the gonadotropin regimens evaluated have been observed.An optimal range of gonadotropin dosage and steroid concentrations within embryos can be described, showing relevantdifferences in developmental dynamics. Time-lapse video system allows us to establish kinetic variations depending on the typeand total doses of gonadotropins used for controlled ovarian stimulation. The choice and the total dose of gonadotropin impactserum levels of estradiol and progesterone which influence embryo kinetics.

The efforts aimed at improving pregnancy rates have focused on the search for additional markers of viability to supplement currentcriteria for embryo selection.

Time-lapse technology represents a powerful tool in assisted reproduction techniques evaluating embryos from a dynamic point ofview. Standard methods of embryo assessment are based on subjective morphology evaluation at discrete time points, limiting theinformation for selecting embryos. Time-lapse is based on especially designed instruments which take images of the embryos every10-15 min automatically, without removing the embryos from the incubator to minimise manipulation. This also provides additionalinformation to the embryologist, who is able to evaluate embryos from a dynamic point of view and study the exact timings of someimportant parameters of embryo development. We are presenting the largest set of transferred embryos after time-lapse analysisand thus a novel opportunity to correlate morphokinetic parameters to implantation and ongoing pregnancy. We have been able toanalyse how chromosomal abnormalities may condition embryo morphokinetics too.

Nowadays, a hypothesis has been developed in an attempt to elucidate whether time-lapse monitoring system together with embryoselection by morphokinetics is able to improve reproductive outcome.

This presentation details what is known about time-lapse imaging, providing an overview of the advantages and applications of thistechnology as well as reviewing some of the most important studies published by our group in this field.

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L5. Biomarkers of gamete selection and embryo viability

Marcos MeseguerInfertility Institute of Valencia (IVI), Valencia, Spain

Preimplantation genetic diagnosis (PGD) is offered in many IVF centres to improve the reproductive outcome of specific groups ofpatients. PGD is used to discard affected embryos in carriers of monogenic diseases and structural chromosome anomalies.Preimplantation genetic screening (PGS) is a variant of PGD applied to the screening of numerical chromosome anomalies incouples with normal karyotype, but with infertility problems. Current indications for PGS are: advanced maternal age (AMA),recurrent miscarriage (RM), repetitive implantation failure (RIF), and severe male factor infertility (SMF). In PGS programmes, thetechnique most widely employed for the cytogenetic analysis of blastomeres has been fluorescence in situ hybridisation (FISH) fora selected panel of chromosomes. The chromosomes most commonly tested are: 13, 15, 16, 17, 18, 21, 22, X and Y, allowing thedetection of 85% of embryo aneuploidies. Using FISH protocols, an improvement in implantation and pregnancy rates has beendescribed in retrospective studies in AMA, SMF and RM patients, whereas their benefit in RIF couples has been more controversial.In recent years, prospective randomised trials (RCT) concluded that PGS should not be recommended in AMA patients. Otherauthors have argued that there are some important methodological pitfalls in the published RCTs, such us patient inclusion criteria,the embryo biopsy procedure, embryo culture conditions as well as the type of genetic analysis performed. It has been proposed thatgreater benefits would be achieved if the whole set of chromosomes could be tested. Comparative Genomic Hybridization (CGH) isthe option closer to karyotyping, and although it has been applied to clinical practice, the time required for the analysis must bereduced. The best approximation seems to be array-CGH, which would offer the most complete analysis of the embryo, givinginformation about all 24 chromosomes and extra information that can be customised. At present, aneuploidy screening introphectoderm biopsies using array analysis for 24-chromosome analysis is offering high pregnancy and implantation rates and theusefulness of PGS is being revisited. In this lecture, we will present current data with a CGH analysis for different indications.

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L6. PGD and cGH array. Indications and futureprospectives

Marcos Meseguer and Carmen Rubio IVIOMICS and IVI-Valencia, Valencia, Spain

Luteal phase support is one of the most empirical phases of infertility treatment. Basically, there is little understanding about howthe luteal phase may differ in a stimulated cycle vs a natural cycle. Thus, it is not clear if luteal phase support is needed in all typeof treatments from insemination to IVF, beyond those where no ovarian function is present such as egg donation. And when the lutealphase is supplemented, very little evidence is available on how it shoud be done, what steroids are needed (only progesterone,estrogens as well) what are the ideal doses, when to start and when to stop. The most recent evidence will be presented to concludewith a practical protocol for different infertility treatments.

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L7. Luteal phase support

Juan Antonio García-VelascoInfertility Institute of Valencia (IVI) Madrid, Rey Juan Carlos University, Madrid, Spain

The restricted time-related period when the uterus is receptive to blastocyst implantation is known as endometrial receptivity. Thewindow of implantation temporally frames this period of receptivity, and it requires an exquisite synchrony between embryo andendometrium. The spatial and temporal changes that the endometrium undergoes these days are crucial for a successfulpregnancy, as embryos only attach under optimal conditions. It seems that only estrogens and progesterone are required to induceendometrial receptivity, but no clear preference exists on ideal dose, route of administration or duration. On top of this, in the currentera of personalised medicine, and very specially in reproductive medicine where we carefully customised protocols for our patientsbased on different predictors (i.e. age, BMI, AMH) or the number of embryos to be transferred based on their quality or availability,endometrial status at the time of embryo transfer is treated equally. Perhaps due to the lack of knowledge, a customised approachis neglected. However, new technology is helping us to improve the accuracy, reproducibility and especially clinical utility of previoustest to evaluate the endometrium from the 50s based on immunohistochemistry. Transcriptomics is helping us to understand whichgenes are actively expressed at any given time within a specific cell population or tissue. Based on this technology, the EndometrialReceptivity Assay (ERA) test has been developed. This customised microarray of 238 genes has been recently validated to customisethe embryo transfer timing. Data will be presented to show the reproducibility and clinical usefulness of the ERA test in reproductivemedicine.

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L8. The role of endometrium receptivity and RecurrentImplantation Failure

Juan Antonio García-VelascoInfertility Institute of Valencia (IVI) Madrid, Rey Juan Carlos University, Madrid, Spain

NOTES

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