I'm presently in our nation's capital for the 2007 ASRM meeting, an annual event when fertility doctors and personnel from all over the world meet to share information. I had posted a notice in my office a few weeks prior to this trip preparing my patients that we would arrange for them to go to my covering colleague's office while I was gone. A lot of them of gave me a supportive farewell saying something like "OK, doctor, go learn something that will help me get pregnant faster!"
Every year, our ability to help our patients improves. I think it's fair to say that if all the infertile couples from thirty years ago who ended up completely childless had full access to the medical treatments available today, over 90% would have gotten to enjoy the blessings of parenthood. Today, the focus has shifted from simply being able to help couples have a child to being able to do it in a safer, less inconvenient, less costly manner and with better obstetric outcomes and fewer complications. We might have also in some ways become TOO good, meaning some questions arise as to which cases are there in which we should NOT necessarily create pregnancies, even if we can.
These meetings are one of the ways in which our body of knowledge is advanced. During this meeting there were about 300 oral presentations and another 800+ presentations in the form of large posters detailing information that physicians, embryologists and other specialists want to share with the world. We listen critically to the presented talks, read the posters, discuss and debate the information and then we individually decide which information we choose to believe and incorporate into our own practices. One shouldn't automatically believe everything. In fact, we can't believe everything, because the information is often conflicting. For example, after many talks espousing the benefits of acupuncture in IVF patients, a controversial presentation this year out of the University of Washington reported that under certain conditions, acupuncture actually was associated with LOWER clinical pregnancy rates.
This is a good example of how new ideas presented from past years inspire the audience to go back home and follow up with their own investigations to present in future years. Over time, a relative consensus develops to persuade us to adopt the things that do work and do away with the things that don't work. This applies to decisions regarding many choices such as different treatments, different medications and different embryology protocols. Even so, you can easily find a dozen different doctors who do things a dozen different ways, all of which work.
For me personally, I will take home some new ideas to try and incorporate into my own practice. My eyes were opened to some new complex ethical considerations that are coming into play. I've met some really nice people with whom to correspond in the future. These include not only physicians, but also experts in nutrition, infertility counseling and alternative medicine. I also picked up the usual brochures and free pens from companies who offer services to help me care for my patients. All in all, it's looking to be a very successful trip! I hope to share some interesting stuff with all of you in future posts.
By the way, the next time you visit Washington DC, I strongly recommend you check out the International Spy Museum.

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