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The coronavirus disease 2019 (COVID-19) pandemic created a significant impact on medically assisted reproduction (MAR) services. ESHRE decided to mobilize resources in order to collect, analyse, monitor, prepare and disseminate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) knowledge specifically related to ART and early pregnancy. This article presents the impact of the SARS-CoV-2 pandemic focusing on reproductive healthcare. It details the rationale behind the guidance prepared to support MAR services in organizing and managing the re-start of treatments or in case of any future wave of COVID-19 disease. The guidance includes information on patient selection and informed consent, staff and patient triage and testing, adaptation of ART services, treatment planning and code of conduct. The initiatives detailed in this article are not necessarily COVID-specific and such action plans could be applied effectively to manage similar emergency situations in different areas of medicine, in the future.

Study question: Is it possible to define a set of performance indicators (PIs) for clinical work in ART, which can create competency profiles for clinicians and for specific clinical process steps? Summary answer: The current paper recommends six PIs to be used for monitoring clinical work in ovarian stimulation for ART, embryo transfer, and pregnancy achievement: cycle cancellation rate (before oocyte pick-up (OPU)) (%CCR), rate of cycles with moderate/severe ovarian hyperstimulation syndrome (OHSS) (%mosOHSS), the proportion of mature (MII) oocytes at ICSI (%MII), complication rate after OPU (%CoOPU), clinical pregnancy rate (%CPR), and multiple pregnancy rate (%MPR). What is known already: PIs are objective measures for evaluating critical healthcare domains. In 2017, ART laboratory key PIs (KPIs) were defined. Study design, size, duration: A list of possible indicators was defined by a working group. The value and limitations of each indicator were confirmed through assessing published data and acceptability was evaluated through an online survey among members of ESHRE, mostly clinicians, of the special interest group Reproductive Endocrinology. Participants/materials, setting, methods: The online survey was open for 5 weeks and 222 replies were received. Statements (indicators, indicator definitions, or general statements) were considered accepted when ≥70% of the responders agreed (agreed or strongly agreed). There was only one round to seek levels of agreement between the stakeholders. Indicators that were accepted by the survey responders were included in the final list of indicators. Statements reaching less than 70% were not included in the final list but were discussed in the paper. Main results and the role of chance: Cycle cancellation rate (before OPU) and the rate of cycles with moderate/severe OHSS, calculated on the number of started cycles, were defined as relevant PIs for monitoring ovarian stimulation. For monitoring ovarian response, trigger and OPU, the proportion of MII oocytes at ICSI and complication rate after OPU were listed as PIs: the latter PI was defined as the number of complications (any) that require an (additional) medical intervention or hospital admission (apart from OHSS) over the number of OPUs performed. Finally, clinical pregnancy rate and multiple pregnancy rate were considered relevant PIs for embryo transfer and pregnancy. The defined PIs should be calculated every 6 months or per 100 cycles, whichever comes first. Clinical pregnancy rate and multiple pregnancy rate should be monitored more frequently (every 3 months or per 50 cycles). Live birth rate (LBR) is a generally accepted and an important parameter for measuring ART success. However, LBR is affected by many factors, even apart from ART, and it cannot be adequately used to monitor clinical practice. In addition to monitoring performance in general, PIs are essential for managing the performance of staff over time, and more specifically the gap between expected performance and actual performance measured. Individual clinics should determine which indicators are key to the success in their organisation based on their patient population, protocols, and procedures, and as such, which are their KPIs. Limitations, reasons for caution: The consensus values are based on data found in the literature and suggestions of experts. When calculated and compared to the competence/benchmark limits, prudent interpretation is necessary taking into account the specific clinical practice of each individual centre. Wider implications of the findings: The defined PIs complement the earlier defined indicators for the ART laboratory. Together, both sets of indicators aim to enhance the overall quality of the ART practice and are an essential part of the total quality management. PIs are important for education and can be applied during clinical subspecialty. Study funding/competing interest(s): This paper was developed and funded by ESHRE, covering expenses associated with meetings, literature searches, and dissemination. The writing group members did not receive payment. Dr G.G. reports personal fees from Merck, MSD, Ferring, Theramex, Finox, Gedeon-Richter, Abbott, Biosilu, ReprodWissen, Obseva, PregLem, and Guerbet, outside the submitted work. Dr A.D. reports personal fees from Cook, outside the submitted work; Dr S.A. reports starting a new employment in May 2020 at Vitrolife. Previously, she has been part of the Nordic Embryology Academic Team, with meetings were sponsored by Gedeon Richter. The other authors have no conflicts of interest to declare. Disclaimer: This document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgment to each individual presentation, nor variations based on locality and facility type. Furthermore, ESHREs recommendations do not constitute or imply the endorsement, recommendation, or favouring of any of the included technologies by ESHRE.

Досліджуване питання: якою є оптимальна тактика лікування жінок з ендометріозом, виходячи з найкращих наявних доказів, представлених у літературних джерелах?Резюмуюча відповідь: за допомогою структурованої методології Інструкції для розробки гайдлайнів ESHRE, були сформульовані 83 рекомендації, які відповіли на 22 ключових запитання щодо оптимальної тактики ведення жінок з ендометріозом.Що вже було відомо: упродовж багатьох років орієнтиром для клінічної допомоги при ендометріозі було керівництво ESHRE з діагностики та лікування ендометріозу (2005), але це керівництво потребувало оновлення.Дизайн дослідження, розмір, тривалість: керівництво було розроблене групою фахівців у даній області з використанням методології Інструкції для розробки гайдлайнів ESHRE, зокрема шляхом ретельного систематичного пошуку літературних даних, оцінки якості включених даних за період до січня 2012 року і висновки з усіх рекомендацій.Основні результати і роль випадку: керівництво надає 83 рекомендації щодо діагностики ендометріозу і лікуванню пов’язаних з ендометріозом болю і безпліддя, та менеджменту жінок, у яких хвороба виявлена випадково (без болю або безпліддя), з профілактики рецидивів захворювання та/або больових симптомів, лікуванню симптомів менопаузи у хворих з анамнезом ендометріозу і про можливий зв’язок ендометріозу та злоякісних новоутворень.Обмеження: ми визначили кілька областей допомоги жінкам з ендометріозом, для яких не достатньо надійних доказів. Ці області були оцінені як належна клінічна практика (GPP), що грунтується на експертних думках учасників групи з розробки керівництва.Широкі наслідки висновків: 32 із 83 рекомендацій з менеджменту жінок з ендометріозом не засновані на доказах високого рівня, і тому були віднесені до GPP, робоча група сформулювала дослідницькі рекомендації для майбутніх досліджень з метою підвищення рівня доказів.Фінансування дослідження/конкуруючий інтерес (и): керівництво розроблене та фінансується ESHRE. Участь членів робочої групи не оплачувалася.Всі учасники робочої групи вказали відповідні конфлікти інтересів, Study question: What is the optimal management of women with endometriosis based on the best available evidence in the literature?Summary answer: Using the structured methodology of the Manual for ESHRE Guideline Development, 83 recommendations were formulated that answered the 22 key questions on optimal management of women with endometriosis.What is known already: The European Society of Human Reproduction and Embryology (ESHRE) guideline for the diagnosis and treatment of endometriosis (2005) has been a reference point for best clinical care in endometriosis for years, but this guideline was in need of updating.Study design, size, duration: This guideline was produced by a group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to January 2012 and consensus within the guideline group on all recommendations.Main results and the role of chance: The guideline provides 83 recommendations on diagnosis of endometriosis and on the treatment of endometriosis-associated pain and infertility, on the management of women in whom the disease is found incidentally (without pain or infertility), on prevention of recurrence of disease and/or painful symptoms, on treatment of menopausal symptoms in patients with a history of endometriosis and on the possible association of endometriosis and malignancy.Limitations: We identified several areas in care of women with endometriosis for which robust evidence is lacking. These areas were addressed by formulating good practice points (GPP), based on the expert opinion of the guideline group members.Wider implications of the findings: Since 32 out of the 83 recommendations for the management of women with endometriosis could not be based on high level evidence and therefore were GPP, the guideline group formulated research recommendations to guide future research with the aim of increasing the body of evidence.Study funding/competing interest(s): The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the implementation of the guideline. The guideline group members did not receive payment. All guideline group members disclosed any relevant conflicts of interest.

The life sciences are at loggerheads with society and neither much trusts the other. To unleash the full potential of molecular life science, a new contract with society and more organized ways of doing research are needed.

Background: We recently started developing evidence-based guidelines within the field of human reproduction. The process, as described in a manual, is executed by 10–15 expert-volunteers, supported by a research specialist for literature evaluations. Objectives: After one year, we evaluated[for full text, please go to the a.m. URL], G-I-N Conference 2012

We report on the spectroscopic quadrupole moment measurement of the 7/2(1)(-) isomeric state in S-43(16)27 [E* = 320.5(5) keV, T-1/2 = 415(3) ns], using the time dependent perturbed angular distribution technique at the RIKEN RIBF facility. Our value, vertical bar Q(s) vertical bar = 23(3) efm(2), is larger than that expected for a single-particle state. Shell model calculations using the modern SDPF-U interaction for this mass region reproduce remarkably well the measured vertical bar Q(s) vertical bar, and show that non-negligible correlations drive the isomeric state away from a purely spherical shape. ispartof: Physical Review Letters vol:108 issue:16 ispartof: location:United States status: published

Background: No consensus exists on handling conflicts of interest in guideline development. As a European guideline development program, our policy is not to exclude experts with COI, but to exclude members from elaborating certain key questions and/or participating in parts of the discussion. [for full text, please go to the a.m. URL], G-I-N Conference 2012

We report on the spectroscopic quadrupole moment measurement of the 7/2(1)(-) isomeric state in S-43(16)27 [E* = 320.5(5) keV, T-1/2 = 415(3) ns], using the time dependent perturbed angular distribution technique at the RIKEN RIBF facility. Our value, vertical bar Q(s) vertical bar = 23(3) efm(2), is larger than that expected for a single-particle state. Shell model calculations using the modern SDPF-U interaction for this mass region reproduce remarkably well the measured vertical bar Q(s) vertical bar, and show that non-negligible correlations drive the isomeric state away from a purely spherical shape.