Saudi Fertility Group 5th Annual Meeting, Jeddah, Saudi Arabia

Start Date: Saturday 26-Nov-2016

End Date: Saturday 26-Nov-2016

Dear colleagues,
It gives me great pleasure to welcome you to the 5th scientific symposium of SFG of SSOG.
The three main tasks of the meeting are:
• First, is to provide us with an opportunity to share experiences and update our knowledge for the benefit of our practices & clients.
• Second, is to keep the wheel of CME & active research running for the progress in reproduction health & medical science.
• Third, task is “social” as by meeting old friends or making new ones, the bond grows stronger among us & between generations.
Finally, I thank all speakers, chairpersons in your behalf for participating & I wish you all an enjoyable experience.

Best Regards,

PRESIDENT OF SFG
DR. HAMAD AL-SUFYAN
FRCOG

Dr. Hamad Al Sufyan
President

Dr. Nareman Al Turairi
Scientific Committee

Dr. Ahmed Amer
Executive Committee

Dr. Hanadi Baakdah
Jeddah Organizer

Mrs. Enass Abu Al Hawa
Admin & Financial Committee

Eng. Ramy Mokhtar
IT & Designs Committee

Ms. Rowida Ahmed
Media Committee

Mrs. Flerida Almora
Member

Mr. Charles Mangahas
Member

Mrs. Leah Villamor
Member

Session - 1

Prof. Hasan Jamal
Director of IVF Unit in Almashfa Hospital / Jeddah Professor and Consultant

Dr. Tawfig Gaafar
Medical Director of Maternity Hospital and Head of IVF Unit in Habib Medical Group, Olaya, Riyadh, Saudi Arabia

Session - 2

Prof. Mamdoh Eskandar
FRCSC at King Khalid University Abha, Saudi Arabia

Dr. Mazen Bishara
Consultant OB-GYN and IVF

Session - 3

Prof. Hassan Youssef
FRCOG Consultant Head of Jeddah Fertility Center Bagido / Erfan Hospital

Dr. Hamad Al Sufyan
Consultant in Reproductive Medicine and IVF (Thuriah Medical Center); Vice-President of Saudi Society of Obstetrics and Gynecology (SSOG); President of Saudi Fertility Society (SFS)

Session - 4

Dr. Osman Sindi
Consultant OB-GYN and IVF

Dr. Magdy Al Sheikh
FRCS Head ART Unit at Dr. Sulaiman Fakeeh Hospital in Jeddah, Saudi Arabia

Closing Summary

Dr. Abdalla Salih
MB BS, MMedSci, MD, FRCOG Consultant OB-GYN, Reproductive Medicine and IVF at Thuriah Medical Center, Medical Director

Session - 1

Dr. Ernesto Bosch
MD, PhD Human Reproduction Unit. Instituto Valenciano de Infertilidad. University of Valencia, Spain
Ernesto Bosch, was born in Philadelphia, USA, in 1968. He completed his Medical School in University of Valencia in 1992 and was assigned as Specialist in Obstetrics and Gynaecology by Hospital La Fe in Valencia from 1993 to 1997. He had his Training in Human Reproduction in the Hospital of the University of Pennsylvania in 1997, and completed his doctoral thesis with “cum laude” qualification about the influence of LH in oocyte quality in University of Valencia in 1999. Since January 2000, he belongs to the Human Reproduction Unit of the Instituto Valenciano de Infertilidad in Valencia, where he has participated in several clinical research projects. In 2008, he obtained the title of Master in Research on Health Sciences, by the Autonomous University of Barcelona. He has 78 publications with a total Impact Factor of 177. He has received the Scientific Program Prize Paper Award at the 2008 Annual Meeting of the American Society for Reproductive Medicine. In 2010, he was appointed as Medical Director of the Human Reproduction Unit in the Instituto Valenciano de Infertilidad in Valencia, Spain.

Dr. Naemah Mohammmed Gady
Working in King Abdul Aziz Medical City. Saudi Board Obstetrics & Gynecology 2001
Assisted Consultant KKNGH 2002- 2004. Associate Consultant KKNGH 2004 - 2005.
Fellow in assessed Reproductive Medicine in la Havre Paris 2005 - 2007. Fellow in pelvic laparoscopic surgery University Rouine Paris 2005 - 2007.
Work as Consultant Obstatric Gynecology Department. Consultant reproductive Medicean. Laparoscopic pelvic surgeon since March 2007 till present. Assessed Professor in King Saud University since 2014.

Dr. Hanin Abduljabar
Graduated from King Abdul-Aziz medical school in Jeddah, Saudi Arabia.
Did her residency training at university of Manitoba. After that went to do the fellowship at university of western Ontario
Currently she is Consultant, Obstetrics & Gynecology, Reproductive Endocrinology and Infertility and Minimal Invasive Surgeries at King Faisal Specialist Hospital
Has Royal College Degree (FRCSC) in Obstetrics & Gynecology, Reproductive Endocrinology and Infertility & MIS
Has a paper published in Fertility and Sterility August 2011 : Presurgical management of dysmenorrhea and endometriosis in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome. Another publication is on going.

Dr. Saad Al Hassan
Is a Consultant and Head Section of Reproductive Medicine, Department of Obstetrics and Gynecology, King Faisal Specialist Hospital & Research Center (KFSHRC), Riyadh. He obtained MBBS degree from King Faisal University, Dammam. He has been trained in the British Isles and worked there for more than 14 years. Certificate of Full Registration as a Medical Practitioner was granted by General Medical Council (GMC). Initially he got the Licentiate of Midwifery (LM), The Rotunda Hospital, Dublin, Ireland. He obtained the membership (MRCOG), then the Fellowship (FRCOG) of the College of Obstetricians and Gynecologists, London, UK. He gets Certificate for Subspecialty of Reproductive Medicine, Nottingham University Research and Treatment Unit in Reproduction, U.K. In addition to the clinical works, a Master of Medical Science in Assisted Reproduction Technology (MMSci-ART) obtained from Nottingham University, Nottingham, U.K.
Postgraduate teaching is one of his interests and abilities. He has been involved in theoretical and bedside teaching for the last 30 years. He is an Examiner and an Author of Part I and II Examination for Saudi Specialty Certificate of Obstetrics and Gynecology (SSCOG) since 1999 to date.
He was the Director of Residency Training Program, then the Director Fellowship Program, Reproductive Medicine, Department of Obstetrics and Gynecology KFSHRC. He was a member in the Saudi Council for Health Specialties (SCHS), Scientific Board of Obstetrics & Gynecology.
Currently he is a Member of the Infertility Practice Regulations Committee, Ministry of Health and Chairman of Infertility Practice Evaluations subcommittee, Ministry of Health. His interest is in ethical and religious issues related to the practice in Reproductive Medicine especially in Saudi Arabia.
He was Member of the Credential Committee for Medical Certification Evaluation, Saudi Council for Health Specialties and was the chairman of RCOG Representative Committee of Saudi Arabia, Royal College of Obstetricians and Gynecologists, UK.

Session - 2

Dr. Samir Mohamed Aly Abbas, FRCOG
Al- Azhar University in Cairo, Egypt, Bachelor & Master of Obstetrics and Gynecology 1972 - 1975.
Royal College of Obstetricians and Gynecologists in London UK MRCOG 1981.
International College of Surgeons USA FICS 1994.
Royal College of Obstetricians and Gynecologists London UK FRCOG 1995.
European college of aesthetic medicine & surgery ECAMS Dublin-Ireland MCVS 2013.

Professor of obstetrics and gynecology at king Abdul-Aziz University 1981-1986.
Pioneered of infertility treatment by IVF in the Middle East in 1984.
Has a chain of IVF centers: Jeddah- Riyadh- Khobar and Madimah.
Member of the scientific committee (international Islamic FIOH academy) since 1982.
Member of review committee research at King Abdul-Aziz city for science and technology since 1998.
Founder & Co-founder of many society
Over 100 presentations national and international meetings.
Published over 50 papers & Author of 3 books
Founder of Dr. Samir Abbas Hospital

Dr. Ernesto Bosch
Ernesto Bosch, M.D., Ph.D. Human Reproduction Unit. Instituto Valenciano de Infertilidad. University of Valencia. Spain
Ernesto Bosch, born in Philadelphia, USA, in 1968 completed Medicine School in University of Valencia in 1992 and is Specialist in Obstetrics and Gynaecology by Hospital La Fe in Valencia from 1993 to1997. Training in Human Reproduction in the Hospital of the University of Pennsylvania in 1997, and completed his doctoral thesis with “cum laude” qualification about the influence of LH in oocyte quality in University of Valencia in 1999. Since January 2000 belongs to the Human Reproduction Unit of the Instituto Valenciano de Infertilidad in Valencia, where has participated in several clinical research projects. In 2008 he obtained the title of Master in Research on Health Sciences, by the Autonomous University if Barcelona. He has 78 publications with a total Impact Factor of 177. He has received the Scientific Program Prize Paper Award at the 2008 Annual Meeting of the American Society for Reproductive Medicine. In 2010 he was appointed as Medical Director of the Human Reproduction Unit in the Instituto.

Dr. Osama Sadeak Bajouh
MD, AFSA
Chairman; Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia, September 14, 2014 up to present.
Assistant Professor and Consultant; Reproductive Endocrinology and Infertility
Department of Obstetrics and Gynecology, King Abdulaziz University Hospital Jeddah, Saudi Arabia, 2011 up to present.
Vice President; Center of Innovation in Personalized Medicine, September 21, 2014 up to present
Certification and licensure:
AFSA in Medical Gynecology & in Reproductive Endocrinology and Infertility, University of Pierre and Marie Curie Paris 6 ,Paris, France ,Sept 2011.
Diploma in Gynecological Laparoscopy, University of Auvergne, Paris, France, Sept 2011
Fellowship in Gynecological Laparoscopy, University of Auvergne, France ,May 2010 to Sept 2011
Fellowship in Reproductive Endocrinology and Infertility, Hospital Saint Vincent De Paul Paris, France ,Jan 2009 to Sept 2011.

Session-3

Dr. Naeem Iqbal
PhD. HCLD, ELD
Dr. Naeem Iqbal is currently working as Sr. Clinical Scientist and IVF Lab Director at King Faisal Specialist Hospital and Research Center, Jeddah. Dr. Iqbal received his PhD degree in Physiology in 1993 from the University of Minnesota, USA. He is board certified by the American Board of Bioanalysis for High Complexity Clinical Laboratory Director (HCLD), and Embryology Laboratory Director (ELD). He is an active member of the American Society of Reproductive Medicine, USA and European Society for Human Reproduction and Embryology and accredited by Saudi Council for Health Specialties. Over the last 20 years he has been working as embryologist and directed ART labs at different IVF programs worldwide. Prior to joining King Faisal Hospital, he got the opportunity to establish three new IVF labs where high pregnancy rate was achieved right from the beginning. His main areas of interest are Quality Control and Quality Assurance programs, gamete physiology, embryo growth in different culture conditions and troubleshooting of problems in ART labs.

Dr. Marcos Meseguer
PhD - Scientific Supervisor and Senior Embryologist, IVI Valencia, Spain.
Dr. Marcos Meseguer received his biological sciences degree in 1997 from the University of Valencia in Spain.
He performed a pre-doctoral fellowship in St Mary’s hospital, Manchester University, United Kingdom. He received his ph.D degree in obstetrics and gynecology in 2002 from the University of Valencia, Spain, and the European doctor degree from the same university. He has also a master degree in research methods; design and statistics from Universidad autonoma de Barcelona, Spain. He was co-director of the andrology laboratory at the instituto valenciano de infertilidad (IVI) from 2000 to 2004. Actually is senior embryologist in the IVF unit of IVI Valencia.
Dr. meseguer is a member of various scientific societies and has received the prize paper of the society of reproduction and infertility (American society of reproductive medicine). Has many awards and many researches.
He has published over 75 articles and 35 reviews and book chapters, made more than 200 presentations at national and international congresses.
He is also currently statistics assessor and scientific updater of IVI Valencia, the biggest infertility clinic in Spain and one of the most important in Europe, and associate professor of the master in biotechnology from Valencia University.

Session-4

Dr. Amjad Alwaal
Urologic Surgeon, Assistant Professor of urology at King Abdulaziz University.
Andrology, Consultant, International Medical Center.
Finished MSc degree in Surgery from University of British Columbia, Canada.
Finished urology residency from McGill University, Canada.
Finished Andrology and Trauma and Reconstructive Urology fellowships from University of California San Francisco.
Over 40 publications in peer-reviewed journals.

Session-1
Lecture-1 [10:00 - 10:20]
Optimizing IVF outcome with hp-HMG
Dr. Ernesto Bosch
Highly purified (hp)-HMG provides equal activity of FSH and LH for ovarian stimulation. The LH activity is provided by hCG, which shares receptor with LH, but has a 6 fold higher biopotency.
Ovarian stimulation with recombinant (r) FSH and hp-HMG show some differences regarding follicular dynamics and hormonal profile. These differences have been well documented in two large multicentre randomized controlled trials. In the first one (Merit study), rFSH and hp-HMG were compared in the GnRH agonist long protocol, in the second one (Megaset) these two compounds were compared in the GnRH antagonist protocol.
In both studies is shown that ovarian stimulation with hp-HMG provides a better selection of follicular growth, with comparable number of mature follicles at the end of stimulation, but fewer intermediate follicles. This leads to a shorter risk of ovarian hyperstimulation syndrome.
On the other hand, ovarian stimulation with hp-HMG deserves a different hormonal profile than the one observed with r-FSH. When hpHMG is used, higher serum E2 and lower P4 are observed at the end of the follicular phase. The earliest ensures a better oocyte maturation, while the latest provides a better endometrial receptivity.
In terms of cycle outcome, cycles with hp-HMG are characterized by a shorter oocyte yield, but with more embryos of good quality available for transfer. Both the Merit and the Megaset studies prove the non inferiority of hp-HMG when compared to r-FSH. However, the largest metaanalysis published comparing r-FSH and hp-HMG show a slight but significant better result when hp-HMG is used.

Lecture-2 [10:20 - 10:40]
Growth Hormone in poor responder infertility patient
Dr. Naemah Mohammmed Gady
Growth Hormone is a pleiotropic multifunction hormone secreted in the pituitary and the ovary, which plays role in steroidogenesis and gametogenesis.
It is involved in the management of infertility for poor responders for many years as co-treatment with human menopausal gonadotropin and HCG for improvement of follicular growth.
However due to the very high cost of growth hormone in the past it was rarely utilized.
There are many studies published for the use of GH, that showed benefits for poor responders in IVF cycles.
Although all of the studies that have investigated this had small sample sizes, several of them showed significantly improved IVF success rates in poor responder.
A meta-analysis for ten studies (440 subfertility couples) were included, demonstrate no difference in outcome measures and adverse events in the routine use of adjuvant growth hormone in in-vitro fertilization protocols.
However, meta-analysis demonstrated a statistically significant difference in both live birth rates and pregnancy rates favoring the use of adjuvant growth hormone in in vitro fertilization protocols in women who are considered poor responders without increasing adverse events, OR 5.39, 95% CI 1.89 to 15.35 and OR 3.28, 95% CI 1.74 to 6.20 respectively.

Lecture-3 [10:40 - 11:00]
When helping hurts
Dr. Hanin Abduljabar

What’s ovarian reserve?
Why is it measured?
How is it tested?
Effect of various gynecological on ovarian reserve.

Lecture-4 [11:00 - 11:30]
Dr. Saad Al Hassan
Transplantation of the human uterus, is the time right for the KSA?
Brännström and colleagues report the first successful birth of a child following uterus transplantation (1).
This report marks an important development that will give women with congenital or surgical absence of the uterus an opportunity to give birth to a child
However, uterus transplantation touch on fundamental issues concerning perception of procreation and parenthood as well as of medical advancements. These perceptions are not globally homogenous and the diversity in moral, religious and philosophical values in different societies will most likely render human uterus transplantation acceptable in some societies and unacceptable in others.
KSA has its own distinct religious traditions / cultural and legal beliefs that influence perceptions of human uterus transplantation.
In this presentation, I will explore some of the fundamental ethical issues raised by human uterus transplantation. The current legal status regarding human uterus transplantation in the KSA will be presented
1. Brännström M, Johannesson L, Bokström H, et al. Livebirth after uterus transplantation. Lancet 2014.

Session-2
Lecture-5 [14:00 - 14:20]
CRISPR (Clustered regularly interspaced short palindromic repeats)
DR. Samir Abbas, FRCOG
Since gene technology first emerged over 40 years ago we’ve seen a wealth of genetic advances –not least of all the decoding of the human genome in 2001.
Researchers discovered what genes do by switching them on or off, or cutting them out of the DNA in a cell entirely.
Since it appeared in 2012, CRISPR has completely transformed the process that researchers use to edit genes this way.
CRISPR not only finds the target gene and locks on, it also delivers an enzyme that cuts the DNA with unprecedented accuracy
The reason it’s to manage this precision double act is because CRISPR is made of ribonucleic acid (RNA) – a molecule that can be tailor-made to perfectly match a sequence of DNA or to be a protein.
Replacing faulty genes with healthy ones will be transmitted to offspring’s which may create ethical problems.
The CRISPR interface technique has enormous potential application, including altering the germ line of humans, animals and other organism, and modifying the genes of food crops.
CRISPR provide successful in disable the gene that cause Huntington disease and prevent muscular dystrophy and deletes 60 viruses from pig genes, paving the way for lower risk transplant of pig organs humans.

Lecture-6 [14:20 - 14:40]
Individualization of ovarian stimulation for IVF
Dr. Ernesto Bosch
Since the first successful In vitro Fertilization (IVF) treatment, the number of procedures performed every year increase exponentially across the world. The reasons behind this growth are the improvement on its efficiency, and the widening of the type of patients treated. It is also well established that these differences have a significant impact on the chances of success, such as age, ovarian reserve, body mass index or presence of ovarian dis-functions. However, it is much less clear if considering these features at the time of indicating a particular clinical strategy has a real impact on the probability of success.
Those advocating for a standardized practice, claim to inter-cycle variability and to the tremendous influence of Evidence Based Medicine (EBM) to support their position. On the top of that, this type of approach usually involves lower costs per procedure, as less monitorization and time consuming is needed. On the other hand, defenders of an individualized practice are based on Patient Centered Medicine (PCM).
IVF practice is full of examples of PCM: From the use of different doses and types of gonadotropins to the diverse options of pituitary suppression. Moreover, several co-treatments have been also purposed, according to certain patients’ conditions. Unfortunately, most of these strategies are applied in a trial and error basis, far away of what should be proper clinical research. Although some great advances have been done in terms of patients’ qualification, especially regarding ovarian reserve evaluation, our field is still lacking of studies on genetic predisposition to treatment response, when compared to others.
In summary, despite its clear and crucial benefits, the way to personalized medicine and customized therapy in Reproductive Medicine is still very large, with several barriers to overpass. The integration between clinical research and medical care should define the way to optimize the benefits of IVF for future patients.

Lecture-7 [14:40 - 15:00]
How to improve our success rate
Dr. Osama Sadeak Bajouh
TBA

Session-3
Lecture-8 [15:40 - 16:00]
Has the time come to replace fresh embryo transfers by frozen-thawed embryo transfers in IVF cycles?
Dr. Naeem Iqbal
Controlled ovarian hyperstimulation (COH) with exogenous FSH promotes development of multiple ovarian follicles. However, it has been suggested that COH adversely affect endometrium receptivity (ER) during ART cycles. This interaction is mediated by the supraphysiologic levels of estradiol (E2) and progesterone (P) during follicular phase, leading to morphologic and biochemical endometrial alterations and a more advanced endometrium than in natural cycles. Following COH, the endometrium is “histologically advanced, biochemically different, and genomically dysregulated.”Ultimately, these abnormal changes may affect the success rates of the IVF treatments.
In ART, the highest pregnancy rates are obtained in fresh oocyte donation cycles where endometrium is artificially primed and the embryos are therefore transferred to an environment that had not suffered the effects of the supraphysiologic hormonal levels that occur during COH. Similarly, higher pregnancy rates are achieved with the transfer of frozen-thawed embryos because endometrial priming is achieved with the use of E2 and P, and the endometrial development can be controlled more precisely than in the cycles of COH with gonadotropins. Some studies have shown good results with the cryopreservation of all embryos and subsequent FET in patient with an increased risk of ovarian hyperstimulation syndrome. Therefore, if the best-quality embryos are selected for FET and the ER can be improved in these cycles, one can expect to obtain higher implantation rates, thus improving overall ART success.
In this presentation, the findings of a systematic review and meta-analysis (Matheus Roque et al., 2013) will be discussed. The authors have suggested that IVF outcomes may be improved by performing FET compared with fresh embryo transfer. This could be explained by a better embryo-endometrium synchrony achieved with endometrium preparation cycles.

Lecture-9 [16:00 - 16:20]
Subjectivity to Objectivity in embryology and andrology lab
Mr. Marcos Meseguer
We will discuss the relevance of sperm molecular markers available to develop tools that allow the objective and evidence-based selection of the sperm with the best molecular and physiological profile to be employed in ART. We will also focus on the research for additional markers of viability to supplement current criteria for embryo selection, making the procedure even easier for the embryologist.

Session-4
Lecture-10 [16:40 - 17:00]
Yield of testicular vs. ejaculate sperm in cryptozoospermia
Dr. Amjad Alwaal
Compare the ICSI outcome of testicular vs. ejaculate sperms in cryptozoospermia.
Define the subset of patients who would benefit the most from testicular sperms in cryptozoospermia.
Preferable method of testicular sperm extraction in those patients.

Lecture-11 [17:00 - 17:20]
Current Practice of cryopreservation in ART
Mr. Marcos Meseguer
Oocyte and embryo cryopreservation has been one of the most fascinating challenges of assisted reproduction technology and its incorporation into the clinical practice has been a goal since many years. we will discuss some basic and practical aspects of vitrification and show evidences on outcomes of oocytes and embryo vitrification and its contribution to the improvement of efficiency in ART.
compared with fresh embryo transfer. This could be explained by a better embryo-endometrium synchrony achieved with endometrium preparation cycles.

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saudi fertility group 5th annual meeting, jeddah, saudi arabia

Saudi Fertility Group 5th Annual Meeting, Jeddah, Saudi Arabia

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