Assisted Reproductive Technologies Across a Heterogeneous Patient Population

Abstract

With individualised treatment becoming an increasingly relevant topic in reproductive medicine, this symposium discussed how new and existing evidence can support a more patient-centric approach to fertility treatment. Co-Chair Prof Filicori opened the symposium by welcoming delegates and taking a moment to reflect on some of the key milestones in fertility treatment over the past few decades, including approaches that are currently being used to facilitate an individualised approach to controlled ovarian stimulation (OS). Prof Baker continued the theme of individualisation by discussing how the use of different data sources, such as randomised controlled trials (RCT), observational studies, and prediction models, could help guide personalised care. Dr Raine-Fenning presented results from the recent MEGASET-HR trial, which compared the efficacy of highly purified human menopausal gonadotrophin (HP-hMG) versus recombinant follicle-stimulating hormone (rFSH)α in patients predicted to be high responders based on their anti-Müllerian hormone (AMH) levels. The results of this study build on the existing evidence for human chorionic gonadotrophin (hCG)-driven luteinising hormone (LH) activity (HP-hMG) and provide exciting and practical insights on tailoring treatment in this subgroup of patients at risk of ovarian hyperstimulation. Dr Wijngaard-Boom then presented new data from the follitropin delta ESTHER clinical trial programme as well as real-world experience from her own clinic in Rotterdam. The real-world data presented showed that individualised follitropin delta dosing based on the approved algorithm delivers a predictable ovarian response, which is consistent with the results from the ESTHER registration trials, thereby offering positive reassurance about the role of follitropin delta in a clinical setting. The symposium was closed by Co-Chair Prof Laven, who concluded that the approaches discussed during the symposium demonstrate how treatment can be individualised based on a patient’s characteristics, and that, if they are not already, fertility experts should be looking to individualise the treatment for each of their own patients.