Highlights from the ASRM 2003, and plans for the future

The importance of safety and efficacy

Hugo Verhoeven, MD and Robert Rebar, MD, PhD
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Hugo Verhoeven, MD: Good morning everybody. My name is Hugo Verhoeven, from the Centre for Reproductive Medicine in Düsseldorf, Germany. I am on the Editorial Board of OBGYN.net and am reporting from the ASRM meeting in San Antonio, Texas. It is an exceptional honour for me to talk this morning to Dr. Robert Rebar, who is the Executive Director of the ASRM, and who is in charge of this fantastic and beautiful meeting.

You told me before this interview that you wanted to have a successful meeting where everybody could have the information they wanted. The diversity of the meeting is very important to you and I think you succeeded. But let us talk about your thoughts before you started to organise this meeting. What did you want, what were your goals, and how did you get to those goals?

Robert Rebar, MD, PhD: This year’s president, Dr. Sandra Carson, and the executive committee, wanted to emphasise that what we were really trying do was strengthen our diversity. That was the theme of this year’s meeting. 

So, if one takes a look at the plenary speakers that we brought in, we tried to cover the breadth of reproductive medicine; from the problems of the male, to problems of the female with regard to fertility, to problems with ageing, to problems of interactions between patients and their physicians. We attempted, really, to span the breadth of reproductive medicine.

At the same time we wanted to put it in the context of introducing our new journal, “Sexuality, Reproduction and Menopause” - SRM. And that we did at this meeting as well. 

Hugo Verhoeven, MD: The meeting will go on a few hours more and then will be ended. What were, for you, the highlights of this meeting? 

Robert Rebar, MD, PhD: Since this is my first meeting as Executive Director, I can tell you that the highlight to me was seeing everything go forward without too many difficulties. And I think that the warts probably didn’t show for all of the people here. 

I think there were some really interesting advances in the area of in vitro fertilisation, with regard to pre-implantation genetic diagnosis. I think that we saw that there really is progress being made in the areas of osteoporosis and menopause. I think we see that there really are, really because of genetics, advances being made in problems related to male reproduction as well. 

When I take a look and think back over the past few years, the past several years, I realize the tremendous advances that we have made in general. And, in fact, that is an obvious lead in, if you’ll pardon my saying so, to next year’s meeting in Philadelphia, because next year is our 60th anniversary, and we’re calling next year’s meeting, 60 Years of Progress.

It’s kind of fitting that it should be in Philadelphia, the home of Benjamin Franklin, central to our country but at the same time, forward looking. And so I think that we will be recalling all of the progress that’s been made in the last 60 years.

Think about it: it was in the 1960s that we first developed the ability to measure hormones, let alone to treat patients. It’s really been in the last 20 years that we have the ability to offer more routinely in vitro fertilisation to couples. It’s really been in the last few years that we’re now beginning to use the genetic information we’ve acquired to treat difficult problems. These are tremendous advances over the last several years. 

Hugo Verhoeven, MD: Maybe it would be interesting to talk also about the differences between different countries. In Europe you know that we are much more concerned about allowing PGD. Many techniques deadlocked in the last few months in the country where I’m working. I am Belgian, but I’m working in Germany. Belgium is a very liberal country; everything is allowed like in the US as we have an ethical committee there. While in Germany, practically everything that we heard new in this meeting is already now forbidden. 

That means that in Germany, reproductive medicine came to a stop two or three years ago. If the law does not change, we are going to be treating our patients in the same way in five or ten years from now as we did two years ago. That will be a reason for the patients to go to those countries where the treatment possibilities are available for what they want. People will not stop having a treatment because of the views of the politicians. What is your opinion on that?

Robert Rebar, MD, PhD: Our Society has always stood for responsibility. Clearly, two of our mottos, if you will, two of our tenets, are that nothing should happen that is not safe, and nothing should happen that is not efficacious. So safety and efficacy are very important, and we encourage debate and discussion, we encourage responsible progress. No paper is allowed to be submitted if it involves human investigation that is not approved by an accredited investigational review board. 

Now, to be sure, there always, in any field, may well be people who try to stretch the envelope all the time. But as a Society, we’re committed to responsible, and efficacious, and safe investigation and care of patients. 

Hugo Verhoeven, MD: We were just talking about the meeting in Philadelphia. There are, of course, some new techniques that will be deadlocked in the near future. Do you have any, how shall I say, wishes? What should be new on the market? In what direction should research go?

Robert Rebar, MD, PhD: I don’t know that you and I can sit here and predict what ways that research could go. But I’ll predict for you that we’ll be talking about stem cells next year in Philadelphia. In fact I know that’s true, and I know that we will address the issue of what is the role of stem cell research in the whole area of reproduction. It’s very clear that when you take a look at IVF on the one hand, and genetics on the other, that where these come together is with stem cell research.

Hugo Verhoeven, MD: That’s exactly what I wanted to hear, because at this meeting, I couldn’t go, of course, to all sessions. There was not that much on cloning, or stem cells. I don’t know why?

Robert Rebar, MD, PhD: I think again, as you know, research in this area is limited in this country. But if one takes a look at those areas that involved that kind of research, certainly I saw a lot of people present at the sessions, and I think that is true. But I can assure you that will be an area that we address at next year’s meeting.

Sixty years of progress, progress continues, that clearly is a most important field for the future.

Hugo Verhoeven, MD: There will be no other way.

Robert Rebar, MD, PhD: That is correct.

Hugo Verhoeven, MD: Well, thank you very much for a very interesting talk. And I wish you all the best for the rest of this meeting.

Robert Rebar, MD, PhD: Thank you very much.