Virtual Andrology Masterclass focussing on male infertility and guiding ART from a Male Patient Perspective. This provided an overview of the impact of andrological investigations on male infertility diagnosis and ultimately ART success.
As a first year STP trainee in embryology and a relatively new member of ARCS I never truly anticipated the benefits of an ARCS membership. Not long after my registration, I had the unique opportunity to attend a virtual Andrology Masterclass that focused on male infertility and guiding ART from a Male Patient Perspective where I listened to a rich variety of interesting and thought-provoking presentations. These discussions provided concise background to the latest evidence-based scientific advances that predominantly highlighted the impact of andrological investigations for male infertility diagnosis and ultimately ART success. Following each inspirational talk, all delegates – that included embryologists, obstetricians and andrologists – were separated into break out rooms where we were able to ask questions and with speakers and other delegates. To my surprise, I recall Prof Sheena Lewis, proclaiming my name during one of these break room sessions and asking me to answer how I would have dealt in a clinical setting with a particular real-life clinical dilemma. This piqued my interest as I immediately felt a rush of adrenaline trying to ensure that I answer to the best of my potential and making sure my manager, listening into the course, was pleased with my efforts.
The masterclass began with an excellent talk from Mr Jonathan Ramsay, a Consultant Urologist, discussing the importance of correct history taking and clinical examination of the infertile man and being able to distinguish between diagnostic and intervention parameters in male infertility. This was followed by a highly informative talk from Dr Jackson Kirkman-Brown who explained an appropriate way in delivering results to men by ensuring that we are aware of what the desired endpoint is for the patient and providing alternatives to an issue early. Other fascinating talks covered topics based on PICSI and the impact on miscarriage and live births, the importance of MACS and ROS testing in the lab, Y chromosome deletions and understanding what they mean for treatment, as well as the use of sperm DNA fragmentation and its impact on ART diagnosis and treatment.
I particularly enjoyed a session delivered by Prof Jason Kasraie titled ‘Patients’ understanding of unexplained infertility and failed fertilisation’. Failed fertilisation and unexplained infertility is not an uncommon event within a fertility laboratory affecting around 15-30% of in vitro couples and occurs approximately twice as often in couples with male infertility diagnosed. Jason explained that fertilisation failure during assisted reproductive technologies (ART) can occur at a number of essential mechanistic and cellular events that are directly linked to the regulation of intra-oocyte signalling cascades and oocyte maturation. These include (1) cumulus cell penetration, (2) sperm/oocyte binding, (3) sperm/oocyte fusion, (4) oocyte activation (5) sperm processing and (6) PN formation. He further described how these can be potentially tackled in an ART setting to improve clinical outcomes with treatment methods such as Intracytoplasmic Sperm Injection (ICSI) or Artificial Oocyte Activation (AOA). Although, AOA was recently a technique used in our own clinic, Jason urged caution in the way this treatment is used as it is still considered “Amber” on the HFEA website due to the concerns over the influx of Calcium and should only be used as last resort with patients being made aware of risks and consenting to treatment.
As a pre-registrant embryologist I found the whole masterclass very well balanced and covered many interesting topics in the field. It was very educational, and it provided me with a valuable learning experience that broadened my knowledge and understanding in the field. For instance, in the continuously changing field of ART, with new research and technologies that can become the next trend or threat to reproduction, ARCS Andrology Masterclass provided a great platform for this to be delivered, it also offered a great opportunity to interact and fully participate in discussions with other academics and professionals that have similar interests. Finally, I would like to take this moment and thank the course co-ordinators Dr Celine Jones and Dr Sheena Lewis for setting up this course.