Endometriosis, Endometrial Disorders, and Infertility: From Bench to Bedside

text Study question Which are the trends shown in data collection XXI of the European Society of Human Reproduction and Embryology (ESHRE) PGT Consortium compared with previous years? Summary answer Data collection XXI, year 2019, represents valuable data on PGT activity in (mainly) Europe and reports on the main trends observed, being the further expansion of comprehensive testing technology in PGT-SR and PGT-A. What is known already The ESHRE PGT Consortium was set up in 1997 and from that time has been collecting data on PGT and PGT-A. The PGT database comprises the world’s largest collection of PGT / PGT-A data providing a valuable resource for data mining and for following trends in PGT practice. So far, up to the year 2015, data collections were carried out in a retrospective data way, from 2016 onwards a prospective data collection was in place. Study design, size, duration As the nature of PGT/ PGT-A treatments has changed significantly over the last years and IVF cycle management and genetic analysis techniques are getting more complex, ESHRE uses an online data collection system in which data are collected prospectively from oocyte retrieval to analysis, embryo transfer and pregnancy / live birth. Data are collected cycle by cycle on a voluntary basis. Participants/materials, settings, method For the 2019 data, individual centres (31) from 19 countries directly entered the data into the PGT database through software developed by ESHRE. Data were analysed at ESHRE headquarters and include all aspects of PGT/PGT-A cycles. Main results and the role of chance The Consortium has analysed the PGT analyses (n = 2735) performed in 2019. The indications for PGT included inherited chromosomal abnormalities (n = 253 analyses), monogenic disorders (n = 1105 analyses), aneuploidy testing for infertility (n = 1111 analyses) or combinations of the above (n = 266 analyses). In addition, 662 clinical pregnancies and 216 deliveries have been analysed in detail. The methods used for biopsy were polar body (2%), cleavage stage biopsy (35%) and blastocyst biopsy (61%; comparable with data from 2018). The methodology used for diagnosis is what is evolving most over the last years, with data set XXI (2019) showing around 7% of FISH, 37% of PCR and 55% of WGA. Within WGA 90.6% of the analysis were done using NGS, in 4.4% cases SNP arrays were used and in 2.4% array-CGH was used. The overall clinical pregnancy rate is about 24% per analysis. The baby data show that it is difficult for most centres to have a detailed follow-up. Limitations, reasons for caution The findings apply to the 31 participating centres and may not represent worldwide trends in PGT. Data were collected prospectively, but details of the follow-up on PGT pregnancies and babies born were limited. Wider implications of the findings The ESHRE PGD Consortium continues its activities as an important forum for PGT practitioners to share data and exchange experiences. The information extracted from the data collections helps to monitor quality issues in PGT and survey the introduction and effectiveness of new PGT technologies and methods.

How should fertility preservation in child and adolescent males receiving gonadotoxic therapies be managed? There were 44 recommendations formulated to provide guidance on all aspects of fertility preservation in prepubertal boys and adolescent males in whom it is not possible to obtain sperm by established methods including semen cryopreservation and surgical sperm extraction; the recommendations covered topics from setting up a fertility preservation program, determining who is eligible, and counselling, to the practical aspects of the testicular tissue biopsy and cryopreservation. For young males facing gonadotoxic treatment, there are limited options for fertility preservation. For those who are unable to produce sperm (children and adolescents) testicular tissue cryopreservation is being increasingly offered prior to gonadotoxic treatment for potential future clinical use to restore fertility. This Good Practice Recommendations (GPR) article was developed according to a predefined methodology for ESHRE good practice recommendations. Recommendations are supported by data from the literature, if available. ESHRE appointed a European multidisciplinary working group with expertise in paediatric oncology, paediatric endocrinology, human tissue banking, and surgery, as well as reproductive specialists and researchers, who have demonstrated leadership and expertise in fertility preservation in prepubertal boys and adolescent males. The recommendations were formulated based on the expert opinion of the working group, while taking into consideration the published data. The draft document was then open to ESHRE members for online peer review and was revised in light of the comments received. The multidisciplinary working group formulated 44 recommendations to provide guidance on all aspects of fertility preservation by testicular tissue cryopreservation, from setting up a fertility preservation program, determining who is eligible and counselling, to the practical aspects of the testicular tissue biopsy and cryopreservation. These guidelines offer valuable direction for healthcare professionals taking care of children and adolescents facing gonadotoxic treatment. Their purpose is to promote knowledge among clinicians and to enable patients to make informed decisions based on realistic expectations. This article provides not only good practice advice but also highlights the areas that need further research. This research, when well-conducted, will be key to making progress in the area of fertility preservation in children and adolescents. All costs relating to the development process, including meetings and technical support for this project, were funded by the European Society of Human Reproduction and Embryology (ESHRE). There was no external funding of the development process or manuscript production. RTM was supported by a UKRI Future Leader Fellowship. The other authors disclosed no conflicts of interest. N/A. This Good Practice Recommendations document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and are based on the scientific evidence available at the time of preparation.ESHRE GPRs should be used for information and educational purposes. They should not be interpreted as setting a standard of care or be deemed inclusive of all proper methods of care, or be exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, or variations based on locality and facility type.Furthermore, ESHRE GPRs do not constitute or imply the endorsement, or favouring, of any of the included technologies by ESHRE.

The 27th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) for the year 2011 was held in Stockholm (Sweden) between the 3rd and 6th of July. The ESHRE conference is always a great annual opportunity to connect with friends in the profession from across the world was well attended by 8361 participants. The ESHRE has grown from strength to strength since its first annual meeting in Bonn in 1985 and the meeting is now one of the most important meetings on fertility and embryology. The meetings are attended by professionals from all over the globe with very good attendance from Asia as well. As the scale of the meeting is very large, a summary to present some of the highlights is a useful tool and this article aims to do that.

Assisted reproduction and COVID-19: A joint statement of ASRM, ESHRE and IFFS

Molecular Human Reproduction made its debut in 1995, associated with Human Reproduction, and becomes a separate journal with this issue. The number and quality of submitted papers, the level of outside interest and the appointment of a distinguished Editorial Board allow this bold move to be taken with confidence. Molecular Human Reproduction produces a forum for the increasing numbers of molecular biologists working in the field of human reproduction. A journal dedicated to their work has become prerequisite, both as an avenue for publication and as a focus of information for scientists and clinicians. Volume 2 will initially include 10-12 articles per issue, fewer if large reviews or other articles are printed, and may increase in size as the year progresses. Molecular Human Reproduction will be part of a package of four journals which can be bought by members of the European Society for Human Reproduction and Embryology (ESHRE), and of some other societies, at very reduced rates. These arrangements will enable ESHRE members to purchase Molecular Human Reproduction and Human Reproduction at a discounted combined price and obtain Oxford University Press (OUP)'s Human Molecular Genetics at a greatly reduced cost (Table 1). The price of Human Reproduction Update remains constant, despite the expected increase in size of the journal (Table I). A free bound copy of Volume 1 of Molecular Human Reproduction will be sent to institutional subscribers; personal subscribers can purchase this for £20. The first issue of Volume 2 of Molecular Human Reproduction will be issued free-of-charge to all subscribers of Human Reproduction, except members of ESHRE and other societies. We wish to draw the attention to this offer especially to Institutional and Personal subscribers, since they must place an order immediately for copies of Volume 2, number 2 if they wish to maintain their continuity in receiving the journal. In 1996, Molecular Human Reproduction will continue to focus on papers devoted to studies on molecular aspects of genetics, gene expression, cell cycle control, physiology, gametogenesis, fertilization, embryonic growth and pregnancy as in Volume 1. Studies primarily focussed on the function or clinical use of molecules will be published in Human Reproduction as in past issues. For example, manuscripts describing genetic regulation, structure and activity of various paracrines or molecular and genetic aspects of the cell cycle will be published in Molecular Human Reproduction, whereas studies investigating the presence of genes and molecules in various tissues and their clinical value, or applications of knowledge on the cell cycle, will be published in Human Reproduction.

Many questions regarding reproductive genetic issues are at the crossroads of both the European Society of Human Genetics (ESHG) and the European Society of Human Reproduction and Embryology (ESHRE). In 2005, a workshop was held in Seville to discuss these topics. This effort has resulted in the production of an impressive background document and the formulation of professional recommendations. ESHG published both the background document and the recommendations in the May 2006 issue of the European Journal of Human Genetics (Soini et al., 2006). ESHRE published the background document as a monograph and the recommendation paper was published in Human Reproduction (ESHG and ESHRE, 2006). Since the developments in this area are very rapid, both societies felt it necessary to organize a follow-up discussion to the Seville workshop. This 2-day invitational meeting was held in Brussels on 5 and 6 March 2012.The22participants fromboth societieshaveproducedavery comprehensivepaperwith thenewdevelopments in the field,which hasbeen published in the European Journal of Human Genetics (Harper et al., 2013) and as a commentary paper in this issue ofHuman Reproduction and in full online (Harper et al., 2014). Since the first report, the line of evidence that assisted reproductive technology (ART) is most probably associated with a slightly increased risk of imprinting disorders is growing, but the causes of these defects are not that clear and are difficult to be attributed. However, absolute risks appear to be low. A meta-analysis of all published randomized controlled trials (RCTs) comparing IVF with and without preimplantation genetic screening (PGS) revealed that cleavage stagePGSusing fluorescent in situhybridization significantly lowered live-birth rates after IVF forwomenof advanced maternal age. Time and the results of RCTswill tell us if other biopsy and molecular approaches are of an advantage and, if so, for which indication groups. Novel genetic and genomic technologies are likely to further change the testing of embryos and will not only result in generic methodologies to identify and select against embryos carrying disorders, but will indirectly result in a genome-wide view of the future of the developing embryo. Human embryonic stem cells and induced pluripotent stem cells that carry a particular mutation represent promising new disease models, especially for those diseases for which no good animal models exist. In the near future the interface betweenARTand geneticswill certainly become more important by the increase in our understanding about the genetics of infertility and the ability to performmore comprehensive genetic testing. At the moment there is not yet a routine ‘diagnostic’ indication for exome/whole genome analyses in male or female infertility, i.e. beyond the research setting. Furthermore, with respect to genetic testing in relation to reproduction, major legal differences exist in Europe. More and more patients find their own way out. Some do this by making use of cross border reproductive care, as has been shown by the ESHRE Taskforce, which confirmed that one of the main reasons for going abroad were legal restrictions. In other cases it is possible to opt for direct-to-consumer genetic testing which can be defined as the advertising and sellingof genetic tests directly to consumers. These recent newdevelopments also create various newchallenges. Therefore it is to be expected that a third collaborative action of ESHG and ESHRE will be necessary in the not too distant future.

Which research topics in the area of infertility should be prioritized in the allocation of research resources? Twelve research priorities were formulated, spanning the following areas: preventing infertility and preserving fertility, gynaecological diseases, male infertility, optimizing fertility treatments, optimizing psychosocial support and deepening knowledge on preimplantation development and early pregnancy. Many research gaps related to infertility and its management remain understudied and underfunded, making it important to set priorities to ensure appropriate allocation of research resources. The European Society of Human Reproduction and Embryology (ESHRE) appointed a multidisciplinary working group, including a patient representative, to develop a list of research priorities related to infertility, which are relevant to researchers and institutions that fund research. A list of research topics was collated based on the recommendations for future research formulated in ESHRE's evidence-based guidelines and suggestions submitted by ESHRE's Special Interest Groups as call topics for the ESHRE research grants. A scoring tool was developed to assess the expected impact of research on each topic on individuals, society and scientific advancement. Topics were scored independently by the working group members and the 12 topics with the highest scores were selected for presentation in this paper. Using our newly developed scoring tool, we have identified 12 research priorities that broadly fall under six areas. These are preventing infertility and preserving fertility, gynaecological diseases, male infertility, optimizing fertility treatments (two priorities per area selected), optimizing psychosocial support (one priority selected) and deepening knowledge on preimplantation development and early pregnancy (three priorities selected). The impact scoring tool would benefit from further testing and refinement in future projects. The scoring of some impact indicators is heavily based on the judgment and expertise of the scorers, which was accounted for by ensuring representation of knowledge and experience from all relevant disciplines and subject areas as well as the patient perspective within the working group. This paper may serve to stimulate further thought and discussion within the infertility research community on the potential impact of proposed and ongoing research. It will furthermore inform and encourage policy makers involved in research funding allocation and contribute to a more efficient and purposeful allocation of research resources towards infertility research. The technical support for this project was provided by ESHRE. A.C. reports employment at Juno Genetics. Y.C. reports a grant from Guerbet and honoraria from Ferring, Merck, Abbot, Nordic Pharma and Organon. G.C. reports consulting fees from Gedeon Richter and honoraria from Cooper Surgical. S.G. reports the development of www.myjourney.pt licensed under a CC BY-NC-SA 4.0 licence. J.K.-B. reports grants from the NIHR Evaluation and Studies Coordinating Centre, the Gates Foundation, the Economic and Social Research Council, BAYER Consumer Health and MRC Confidence in Concept; honoraria from Ferring and Cooper Surgical; travel support from Ferring, Cooper Surgical, Congressworks LLP, Deutsche Gesellschaft für Andrologie e. V., BAYER, University of Munster and ESHRE; a patent for microchannel sperm cell preparation; and a leadership or fiduciary role in the Association of Clinical and Reproductive Scientists. A.P. reports grants (to her institution) and consulting fees from Gedeon Richter, Ferring, Merck A/S and Cryos; honoraria from Gedeon Richter, Ferring, Merck A/S and Organon; and travel support (to her institution) from Gedeon Richter. H.S.N. reports grants from Freya Biosciences ApS, Ferring Pharmaceuticals, BioInnovation Institute, Ministry of Education, Novo Nordic Foundation, Augustinus Fonden, Oda og Hans Svenningsens Fond, Demant Fonden, Ole Kirks Fond and the Independent Research Fund Denmark; speaker's fees from Ferring, Merck A/S, Astra Zeneca, Cook Medical, Gedeon Richter, Ibsa Nordic, Novo Nordisk A/S; co-development of an app with the Maternity Foundation; and co-founding a project with Lulu Health. The remaining authors (J.T., A.A., I.D., C.F., M.G., A.S.L., M.M.-R., V.N., A.O., N.R., M.S.-L., P.T., N.V., S.V. and K.S.) have nothing to declare. N/A.

Towards the global coverage of a unified registry of IVF outcomes.

Reply of the Authors

In January 2023, European Society of Human Reproduction and Embryology (ESHRE) has released updated recommendations on recurrent pregnancy loss to replace the previous 2017 version. All changes and addendum to the recommendations in the guidelines were formulated after evaluating the most qualitative and relevant evidence that appeared in the literature and their discussion by an expert group. The authors of this article have analyzed the main points of the updated ESHRE recommendations. The article discusses whether new tactics have appeared in the patient management with recurrent pregnancy loss, whether they should be adopted by a practicing physician, and whether they differ from the recommendations of the Russian Society of Obstetricians and Gynecologists regulating the actions of Russian medical specialists during the work with female patients having the appropriate diagnosis. Based on the analysis, the authors concluded that the expert groups that compiled clinical recommendations on recurrent pregnancy loss are mostly in solidarity on fundamental issues. On the one hand, the Russian recommendations look more reasonable in some issues, but on the other, the recommendations are likely to be revised taking into account new data. KEYWORDS: recurrent pregnancy loss, habitual abortion, pregnancy, ESHRE, clinical recommendations, RSOG, assisted reproductive technologies. FOR CITATION: Dobrokhotova Yu.E., Kuznetsov P.A., Dzhokhadze L.S. Current discourse on recurrent pregnancy loss (ESHRE Protocol 2023, National Clinical Guidelines "Recurrent Pregnancy Loss" 2021, materials of the World Congress of ESHRE 2023). Russian Journal of Woman and Child Health. 2023;6(3):219–225 (in Russ.). DOI: 10.32364/2618-8430-2023-6-3-1.

What are the European trends and developments in ART and IUI in 2014 as compared to previous years? The 18th ESHRE report on ART shows a continuing expansion of both treatment numbers in Europe and more variability in treatment modalities resulting in a rising contribution to the birth rates in most participating countries. Since 1997, ART data generated by national registries have been collected, analysed by the European IVF-monitoring (EIM) Consortium and reported in 17 manuscripts published in Human Reproduction. Continuous collection of European data by the EIM for ESHRE. The data for treatments performed in 2014 between 1 January and 31 December in 39 European countries were provided by national registries or on a voluntary basis by clinics or professional societies. From 39 countries and 1279 institutions offering ART services, a total of 776 556 treatment cycles, involving 146 148 with IVF, 362 285 with ICSI, 192 027 with frozen embryo replacement (FER), 15 894 with PGT, 56 516 with egg donation (ED), 292 with IVM and 3404 with frozen oocyte replacement (FOR) were reported. European data on IUI using husband/partner's semen (IUI-H) and donor semen (IUI-D) were reported from 1364 institutions offering IUI in 26 countries and 21 countries, respectively. A total of 120 789 treatments with IUI-H and 49 163 treatments with IUI-D were included. In 14 countries (17 in 2013), where all institutions contributed to their respective national registers, a total of 291 235 treatment cycles were performed in a population of ~208 million inhabitants, corresponding to 1925 cycles per million inhabitants (range: 423-2978 per million inhabitants). After treatment with IVF the clinical pregnancy rates (PR) per aspiration and per transfer were marginally higher in 2014 than in 2013, at 29.9 and 35.8% versus 29.6 and 34.5%, respectively. After treatment with ICSI the PR per aspiration and per transfer were also higher than those achieved in 2013 (28.4 and 35.0% versus 27.8 and 32.9%, respectively). After FER with own embryos the PR continued to rise, from 27.0% in 2013 to 27.6% in 2014. After ED a similar trend was observed with PR reaching 50.3% per fresh transfer (49.8% in 2013) and 48.7% for FOR (46.4% in 2013). The delivery rates (DR) after IUI remained stable at 8.5% after IUI-H (8.6% in 2013) and at 11.6% after IUI-D (11.1% in 2013). In IVF and ICSI together, 1, 2, 3 and ≥4 embryos were transferred in 34.9, 54.5, 9.9 and in 0.7% of all treatments, respectively (corresponding to 31.4%, 56.3, 11.5% and 1% in 2013). This evolution in embryo transfer strategy in both IVF and ICSI resulted in a singleton, twin and triplet DR of 82.5, 17.0 and 0.5%, respectively (compared to 82.0, 17.5 and 0.5%, respectively, in 2013). Treatments with FER in 2014 resulted in a twin and triplet DR of 12.4 and 0.3%, respectively (versus 12.5 and 0.3% in 2013). Twin and triplet DR after IUI were 9.5 and 0.3%, respectively, after IUI-H (in 2013:9.5 and 0.6%) and 7.7 and 0.3% after IUI-D (in 2013: 7.5 and 0.3%). The method of data collection and reporting varies among European countries. The EIM receives aggregated data from various countries with variable levels of completeness. Registries from a number of countries have failed to provide adequate data about the number of initiated cycles and deliveries. As long as incomplete data are provided, the results should be interpreted with caution. The 18th ESHRE report on ART shows a continuing expansion of treatment numbers in Europe. The number of treatments reported, the variability in treatment modalities and the rising contribution to the birth rates in most participating countries point towards the increasing impact of ART on reproduction in Europe. Being the largest data collection on ART, the report gives detailed information about ongoing developments in the field. The study has no external funding and all costs are covered by ESHRE. There are no competing interests.

The 38th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) took place in Milan, Italy, and online between 3rd and 6th July 2022. During the opening ceremony, Giovanni Coticchio, Immediate Past Chairman of the Special Interest Group (SIG) Committee, highlighted the important role Italy has played in ESHRE history, having contributed three society chairs as well as hosting three previous annual meetings.

Ovarian endometriosis and infertility: in vitro fertilization (IVF) or surgery as the first approach?

Study question What is the value of training nurses and midwives (N&M) working in reproductive medicine (RM) in non-diagnostic pelvic ultrasound? Summary answer N&M working in RM can enhance the patient experience through continuity of care, extensive knowledge of reproductive anatomy and provision of safe, evidence-based practice. What is known already The United Kingdom Royal College of Nursing (RCN) supports nurses in career progression; non-diagnostic pelvic ultrasound being one of the recommended development skills (RCN, 2024a). Whilst the RCN attributes performing pelvic ultrasound as an advanced practice skill, their recommendation is that ‘diagnostic’ pelvic ultrasound is performed by clinicians specifically trained in this imaging modality (RCN, 2024b). Whilst registered nurses and midwives can train in sonography, no pathway exists for sonographers to train as nurses, despite the parallels between the two professions. Nevertheless, the literature is limited on the value N&M working in RM training in advanced practice ultrasound. Study design, size, duration The Nurses and Midwives Certification Committee (NMCC) of the European Society of Human Reproduction and Embryology (ESHRE) surveyed the membership (clinicians, nurses and midwives) to gauge interest in the provision of a training course in pelvic ultrasound. The survey, which consisted of 11 questions and formed the basis of this study, was circulated during August 2024, with a two-week deadline to complete. Participants/materials, setting, methods In total, 4811 ESHRE members (clinicians, nurses, midwives, and sonographers) met the inclusion criteria, with 19.5% (n = 241) response rate. Since the survey did not request country of practice, the national representatives of ESHRE were contacted via email retrospectively, with a request to provide information on specific country policy in the context of training N&M working in RM in pelvic ultrasound. Main results and the role of chance Of the respondents, 71% were clinicians (n = 169), 18% nurses (n = 44), 9% midwives (n = 22), and 2% sonographers (n = 4). Overall, 31% worked in public centres with 69% in private practice. Seventy-nine percent of clinicians were more likely to perform diagnostics, with only 4% nurses, 2% midwives, and 15% sonographers. Similar results were returned for performing early pregnancy ultrasound: 78% clinicians, 7% nurses, 5% midwives, and 10% sonographers. During ovarian stimulation, 12% of pelvic ultrasound was performed by nurses, 6% by midwives and 5% by sonographers. The main reasons cited for N&M not performing pelvic ultrasound ranged from lack of specific training (62%) and national recommendation (38%). Seventy-six percent of clinicians would support training of nurses/midwives in pelvic ultrasound, with 24% opposing support; opinion largely relating to policy/legislation. Of the nurse/midwife respondents, 36% followed a recognised training course, 82% citing interest in completing specific ESHRE training; with 87% perceiving support of their clinical lead. With regards to specific country policy/legislation, retrospective national representative communication confirmed Ireland, the United Kingdom, Netherlands and Sweden support training N&M in pelvic ultrasound. Yet, this is not permitted in Germany, Bulgaria and the Czech Republic. Limitations, reasons for caution Limitations of this study are, the small number of sonographers completing the survey, and lack of country-specific information. Missing data restricts our ability to analyse potential regional differences, which may impact the generalisability of findings across different geographical contexts. In response to this limitation, ESHRE national representatives were contacted retrospectively. Wider implications of the findings Membership interest in training N&M working in RM in pelvic ultrasound clearly exists. Nevertheless, the authors advocate the importance of developing a clear competency framework separating diagnostic from ‘monitoring’ pelvic ultrasound during fertility treatment. Accredited training, supervision, and competency assessment are essential in maintaining standards of advanced professional practice. Trial registration number No

Study questionHow was the Logbook for the Nurses and Midwives Certification programme of the European Society of Human Reproduction and Embryology (ESHRE) developed?Summary answerThe Logbook for the ESHRE Nurses and Midwives Certification programme, which questions 56 roles, was developed based on an extensive literature review and expert opinion.What is known alreadyThe ESHRE Executive Committee established the Nurses and Midwives Certification Committee (NMCC) in 2012. Since inception (2015), the certification programme has been delivered annually, with the exception of 2020 because of SARS-CoV-2. One-hundred-fourteen nurses/midwives have obtained ESHRE certification (passing rate=72%) and the programme is now accessible to nurses/midwives globally. The Certification program aims (i) to recognise the extended role of nurses/midwives delivering fertility care and (ii) to expand their theoretical background. The pre-requisites for certification are (i) being educated to a bachelor level of education and (ii) completing a practice based Logbook to demonstrate supervision of professional experience. Study design, size, durationBetween 2012 and 2014, the NMCC completed a systematic literature search for papers relating to clinical, non-clinical and extended roles of nurses and midwives in fertility settings. In addition, the NMCC invited a larger expert panel of European senior nurses and midwives to a meeting to discuss their needs and preferences regarding the certification programme and to survey the diverse roles performed by nurses and midwives in their country.Participants/materials, setting, methodsThe NMCC comprised four nurses/midwives, one clinical embryologist, and one medical doctor (both in advisory capacity). The Medline database was searched by entering a search string in PubMed combining (MeSH) terms related to reproductive medicine and nursing or midwifery. Opinion and empirical papers relating to roles of nurses/midwives in fertility settings were included. The surveyed expert panel included twelve nurses/midwives, representing Belgium, Denmark, Finland, France, Norway, Slovenia, Sweden, Turkey, Ukraine, and the United Kingdom.Main results and the role of chanceA total of 49 papers, of which 24 empirical papers, were identified with the search string (n = 47) and snowball strategy (n = 2). The papers originated from 13 countries spread across Asia, Oceania, Europe, and North America. All twelve European senior nurses and midwives responded to the survey. Finally, 56 different roles were included in the Logbook. Forty-four roles were performed by nurses/midwives working in fertility settings according to the surveyed expert panel (n = 18), the literature (n = 8), or both the surveyed expert panel and literature (n = 18). An additional twelve observations of laboratory procedures were added by the NMCC. Substantial variation in roles and responsibilities existed across the countries from which the evidence originated. Whereas a considerate proportion of roles were performed in at least five countries (n = 16/56), a minority of roles were only performed by nurses/midwives in some countries (n = 7/56). Eight specialist roles (e.g. embryo transfer) were performed independently by nurses/midwives in some countries, whilst in other countries, nurses/midwives merely had an assisting role. In addition to completing the Logbook, participants were expected to write two ethical cases according to a guideline, testifying to their ability to reflect as a senior nurse/midwife. From 2015, the content of the Logbook was further developed.Limitations, reasons for cautionThis abstract relates to the development and content of the Logbook and not the curriculum/educational material required for the theoretical exam of the Nurses and Midwives Certification programme. The NMCC continuously improves the Logbook and elements have been added and removed since its creation.Wider implications of the findingsThe review and survey illustrated the variation in roles and responsibilities of nurses/midwives across the studied countries, further highlighting the opportunity for professional development within fertility care. Further research is required to elicit the experience of certified nurses/midwives with the programme and its impact on their professional and personal development.Trial registration numberNot applicable