The initial sessions of the Congress were dedicated to the epidemiology of malignant diseases during the reproductive age, and the effects of chemo- and radiotherapy on fertility. Hamish Wallace reviewed issues related to paediatric cancer, illustrating the distribution of different tumors in childhood, and presented data on recent improvements in treatments and outcomes, raising the issue of restoring fertility in survivors. Ovarian reserve is based on primordial follicle pool and Dror Meirow demonstrated that the end-results of chemotherapy are total loss of primordial follicle and ovarian atrophy. When menstrual cycles after chemotherapy are regular, and ovarian damage only partial, the decrease of primordial follicle reserve affects fertility and increases the risk of premature menopause. After this introduction, the speaker went into detail describing the mechanisms of ovarian tissue damage in general and in particular that of follicular cells and oocytes. During a second presentation by the same speaker on the detection of malignant cells in the reproductive organs, he concluded that advanced methodology must be employed to detect malignant cells in ovarian tissues before attempting re-transplantation to restore fertility in a cured cancer patient.
The issue of ovarian cancer risk related to the ovulation induction techniques employed in ART procedures was the topic of the second session. Liat Lerner-Geva presented results that suggest that no additional risk of ovarian cancer is related to these procedures, and that infertility in patients with normal ovulation is in itself a risk factor for ovarian cancer development. Adam Balen addressed the relationship between Polycystic Ovarian Syndrome (PCOS) and cancer, including all the possible linking factors: increased body weight, parity, insulin resistance, release of growth factors, higher levels of LH and genetics. The hypothesis of unbalance between chronic anovulation and unopposed estrogen secretion seems to increase the risk of hyperplasia as well as uterine and breast carcinoma. Curt Burger presented a comprehensive review of data on cancer incidence in children born with ART. In the past, an increased risk of cancer (such as retinoblastoma) in this population had been hypothesized, but the data presented in this lecture suggest the risk of retinoblastoma is similar in IVF to that of naturally born children, although further investigation on this issue is ongoing. Bella Kaufman reviewed the hormonal and genetic aspects of the association between breast cancer and fertility. First full term pregnancy after 35 years of age, high levels of estrogen and progesterone, and nulliparity are all fertility related factors which increase the risk of breast cancer and interact with genetic factors. This speaker also stressed the correlation between modified genes, response to DNA damage, hormonal and reproductive factors and exposure to carcinogens such as smoke. In this session Kutluk Otkay gave the first of his three lectures focusing on preservation of infertility and fertility treatment in breast cancer patients. He started with a comprehensive flow chart summarizing strategies aimed at preserving fertility in males and females. He then presented procedures of ovarian suppression and controlled ovarian stimulation for embryo and oocyte cryopreservation prior to cancer treatment including aspects of ovarian stimulation characteristic in cancer patients as well as historic and practical information on drugs used to treat breast cancer, but that also influence gonadic hormone physiology. The effect of the association between tamoxifen and FSH on hormonal trends and on follicle maturation was also discussed. The speaker addressed all the issues related to the use of anti-estrogen drugs in IVF procedures, not only in terms of efficacy and safety, but also about legal implications. After a comprehensive review of data on poor responders to IVF drugs after chemotherapy, he concluded that anomalies in children born through IVF in these kinds of patients are not increased if the procedures are performed six months to one year after the last chemotherapy session.
The next sessions were dedicated to procedures and techniques used in men and women whose fertility is threatened by malignant diseases and administered treatments. Gilad Ben-Baruch began his lecture illustrating a case of a woman with borderline malignancy cyst adenocarcinoma who underwent surgery and later had two successful pregnancies. He also summarized the experiences of the Sheba Center where 158 women with borderline malignancies were treated. Twenty-five women had a total of 38 pregnancies and 53 babies were delivered. Seven of these successful pregnancies were obtained through IVF. Amir Arav gave a provocative lecture on recent progress in oocyte vitrification and entire ovary freezing. This lecture provided basic knowledge to better understand all the modifications that occur in oocytes and within the entire ovary during freezing processes. He presented data collected both from animal studies and research on human tissues, showing interesting evidence about the relationship between dietary lipids, gametes membrane composition and injury during freezing processes. The next speaker, Seang Lin Tan, addressed the same topic from a more clinical point of view. He presented the results of oocyte, embryo and ovarian tissue vitrification, concluding that each preservation procedure has its own indications with pros and cons that need to be taken into consideration when planning a fertility preservation strategy. Sherman Silber presented ten cases of ovarian transplantation in monozygotic twins, where one of the two was effected by premature ovarian failure between the ages of 24 to 40 years. Seven out of ten have already undergone transplantation and 3 are still waiting. In the last part of the Congress, Kutluk Otkay gave another two excellent lectures addressing other topics related to fertility preservation in males and females.
A comprehensive review will soon be available on the Serono Symposia International Foundation website offering complete coverage of the contents of the Congress.
My name is Wolfram Sterry and I am Professor and Chairman of the Department of Dermatology and Allergology at the Charité University Medicine Berlin, Germany. Furthermore, I am Board Member of the International League of Dermatological Societies, the European Dermatology Forum and the International Psoriasis Council; in addition I am Editor in Chief of the Journal of the German Dermatological Society (JDDG).
How important is psoriasis within dermatology?
Without any doubt psoriasis is among the major issues in dermatology, given the fact that psoriasis is often a severe disease that can ruin lives and cause a severe burden on the affected patients given the high frequency among the general population. Lastly, psoriasis plays an important role as model disease also for other chronic inflammatory disorders as such as rheumatoid arthritis, inflammatory bowel disease and multiple sclerosis.
Can you please explain the impact biologicals have had in the treatment of psoriasis?
With the advent of biologics the possibilities for systemic treatment of psoriasis have dramatically increased and we have welcomed a number of new agents with high power for treatment of psoriasis. Furthermore, the general interest among dermatologists in systemic treatment has become much higher, and the aim to achieve a long term control for psoriasis has become reality for many patients.
What common difficulties can be found between the management of psoriasis and other chronic diseases?
Among the common difficulties in all chronic inflammatory diseases are the high disease burden imposed by these disorders, the requirement for long term treatment with simultaneous lack of a cure of such disorders, and finally issues of reimbursement since chronic long term treatments always tend to induce high costs.
What will pharmacogenomics add to the current treatment paradigms of severe diseases?
Pharmacogenomics will allow to finally identify patients that will benefit from certain treatments as well as to identify those patients who are at risk to develop side effects. Therefore, individualized treatment not only addresses questions of severity, site, extent, family planning, profession and other factors that will have to be integrated into treatment decisions but also pharmacogenomic data predicting the responder/non responder status as well as the probability to develop certain side effects.
Thank you very much.
Reproduction and Malignant Disease; September 15-16, 2006; Barcelona, Spain
Click here for final program and abstracts!
Implantation - The Hidden Frontier; October 22, 2006; Sydney, Australia
Click here for final program and abstracts!
Click here for final program and abstracts!
The Multiple Sclerosis Advanced Course is one of the classic Serono Symposia International Foundation workshops now in its sixth edition. Created to encourage the dissemination of scientific knowledge in the field of MS and to stress the benefits of new diagnostic tools for defining the natural history of MS and disease activity monitoring, it is always appreciated by participants for the high scientific quality. As a matter of fact one comment we were able to capture was that the ECTRIMS annual meeting that followed was rather a let down after the very high scientific level of MS Academia!
Click here for final program and abstracts!
MS Nurse is an educational program created to encourage the dissemination of scientific knowledge among nurses from all over the world in the field of MS. This is considered to be an excellent opportunity for nurses to learn and to share thoughts as well as interactions that, together with the highly level of the speakers, ensure a broadening of knowledge on how to manage patients with MS. The participants particularly appreciated the cognitive fatigue presentation because there is such a shortage of information on this topic.
Click here for final program and abstracts!
The aim of this conference is to review and discuss current approaches in ovulation induction, as well as to look at various emerging techniques such as in vitro maturation to understand the applicability to current practices. Several areas where unanswered questions remain, such as implantation difficulties, will be elaborated whilst other areas, such as the usage of antagonist regimes where practices differ by country, will be discussed to share accumulated experience to-date.
This symposium has as objective to provide participants with an insight into updated infertility management and a glimpse into the future. Participants will be provided with information on epidemiology of infertility in Asia and its impact on society and infertility service provided.
A closer look at the area of fertility preservation in those with malignant disease is the aim of this congress. The program is designed to benefit clinicians, scientists and paramedical staff involved in the treatment of reproductive and oncological disorders.
An indepth analysis of the diverse surgical techniques used to treat sterility will be addressed here. Also under discussion will be the ongoing debate regarding whether there is an effective need to undergo surgery for purely reproductive purposes as an alternative, or in association, to the current pharmacological therapies to treat infertility. The conference will offer a live session on endoscopic surgery, and also renowned national and international experts will confront their respective experiences on gynecological problematics which still have not reached a consensus on the best therapeutic approach in order to explore the universe of reproductive medicine where many questions still remain to be clarified.
This conference aims to produce a highly scientific and interesting programme covering the principal aspects in the management of Multiple Sclerosis: criteria for diagnosis and early treatment approach. The analysis of these crucial aspects will update participants on current and future strategies for treatment of MS.
MS Nurse is an annual workshop created to encourage the dissemination of scientific knowledge among nurses from all over the world in the field of Multiple Sclerosis. Presentations will provide the latest information in MS in the following areas: Advanced Disease Management, Problem Symptoms and Psychosocial & Cognitive Aspects. In addition to didactic presentations, group workshops will allow nurses to discuss these topics in relation to their own practice.
This is an educational programme created to encourage the dissemination of scientific knowledge in the field of MS. It will stress the benefits of new diagnostic tools for defining the natural history of MS and disease activity monitoring. Current diagnostic criteria for MS will also be reviewed in the light of new medical evidence. A review of recent clinical trials and treatment optimisation guidelines will also be presented.
The objective of this conference is to discuss the most recent advancements of the basic and clinical aspects in sex differenciation in order to allow participants to get familiar with the identification and the most accurate treatment of patients with congenital anomalies of sex differentiation.
Please note: The official language of the conference will be Spanish. Simultaneous Translation English-Spanish, Spanish-English will be available.
Psoriasis is a chronic life-ruining disease with significant unmet clinical needs in the management of patients. Traditional therapeutic approaches such as PUVA, cyclosporine or methotrexate are problematic for long-term use because of inconvenience, organ toxicity, broad-band immunosuppression, drug interactions and a loss of efficacy over time. Hence, there has been a demand for new therapeutic approaches that are more convenient, effective, safe, and immunologically selective. This symposia will aim to bring all the current knowledge together and provide the audience with a state-of-the-art view on how to improve management of patients with psoriasis.