International variation in ART practice and data collection

A recent Serono Symposium International Foundation conference in Athens has revealed considerable international differences in both the provision and practice of assisted reproduction and also considered the need for improved data collection. Arne Sunde, one of the founders of the European Society of Human Reproduction and Embryology (ESHRE) and Chairman 2003 to 2005, showed massive differences of provision of assisted reproduction throughout Europe explaining how some countries had lower provision due to religious reasons and lack of national resources. However, Professor Sunde found it difficult to explain the relatively shameful provision of assisted reproduction in the UK, calling for the UK to do better.

Prior to the symposium, participants had been engaged by online questionnaires - over 460 had been completed by respondents from over 37 countries. Real-time voting during the presentations continued this interactive theme, and uncovered astounding differences in opinion about patient management and even the meaning of the terms used in daily practice. Julian Jenkins, chairman of the ESHRE Classification of Infertility Taskforce (ECIT), explained how ESHRE was working towards a coding system to allow computer systems to collate infertility information whilst aware of the differences in opinion.

Karl Nygren, chairman of the International Committee for Monitoring Assisted Reproductive Technology (ICMART), explained the large differences in assisted reproduction data collection throughout the world and the need to improve this to build confidence in assisted reproductive technology. Anders Nyboe Andersen, coordinator of ESHRE's European Infertility Monitoring (EIM) programme, outlined the successful collaboration of 24 countries to provide invaluable data on efficacy and safety of assisted reproductive technology. However, Professor Andersen commented that currently it takes over four years to collate this data for Europe for each year, whereas we should be aiming to achieve this within two years.

James Lawford Davies, legal specialist in reproductive and genetic technologies, drew attention to the forthcoming information requirements of the European Union (EU) Human Tissue Directive and the role that ESHRE could play in meeting these. Christopher Barratt, Head of the Reproductive Medicine and Genetics Research Group at the University of Birmingham and member of the HFEA, covered further requirements of this new legislation querying whether each EU member state should 'reinvent the wheel' or whether ESHRE could play a central role. Adrianne Pope, President of the Fertility Society of Australia, explained how they had completed a similar exercise in Australia and extended the offer to collaborate with ESHRE to provide centralised advice for the EU.Re-enforcing the need for collaboration, international experts revealed major differences in both clinical and scientific assisted reproductive technology management with a clear need for further research to determine what is the best approach. Joep Geraedts, chairman elect of ESHRE and co-coordinator of the ESHRE Special Interest Group on Reproductive Genetics, provided an overview of the variation of assisted reproductive technology throughout Europe for prenatal diagnosis and genetic screening, illustrating the value of good quality data collection. Ian Cooke, Medical Education Director of the International Federation of Fertility Societies (IFFS), commented on the IFFS e-learning programme, which he hopes will extend the educational reach of the IFFS beyond international meetings. Basil Talatzis, president-elect of the IFFS, concluding the Athens symposium, was encouraged by the enthusiastic response from participants to engage in the post symposium online e-learning programme from February 2006 with multimedia lectures, interactive questions and opportunities for discussion. This is not intended to be a passive process but an opportunity to share views, debate management and even input into formulation of new terminology, for computerisation that underpins clinical practice.