Summary of que 4⃣ moderated by @DKalaitzopoulos #ESHREjc

Over the next 24h will be engaging in discussion for a very common medication and its effect in embryological outcomes #ESHREjc 👇🏻

Q4: #ESHREjc Until prospective data arrive, what’s a proportionate counseling message for TTC/IVF patients needing analgesia, what alternatives, what timing advice, and how to avoid over-restriction that drives unsafe NSAID substitution? @ESHRE

🚨Q1 #ESHREjc The study finds that APAP delays cleavage-stage divisions, while blastocysts keep total cells but show reduced ICM and DNA synthesis. What do these stage-specific vulnerabilities imply for implantation and embryo competence? @ESHRE

1/ This #ESHREjc we are discussing how a common analgesic Acetaminophen (APAP) may interfere with pre-implantation embryo development. Study in focus: https://t.co/06gl7eXX2t A tweetorial to get you up and ready for tomorrow. #ESHREjc @ESHRE

🚨 Could a common painkiller disrupt the earliest stages of human embryo development? Join us for the next #ESHREjc 🗓️ 28–29 November ⏰ 17:00 CET start 📍 on @ESHRE 🔗 https://t.co/06gl7eYuS1 🌟 @juliauraji, Thanos Papathanasiou & David Kristensen

Q3 on diagnostic pitfalls in adenomyosis and clinical outcomes in subtypes of adenomyosis #eshrejc By @GLiperis

Q4 on “ideal” setting of IVF #eshrejc By @NoemiSalme30386

Q2 on the role of diagnostic criteria of uterine anomalies By @AttilioDGM7

Q1 on control group for the role of uterine factor in RPL #eshrejc By @juanjo_fraire

Many thanks to all participants 🙌 and to @DKalaitzopoulos and his team for leading this great edition of the #ESHREjc

@GLiperis @ESHRE @CatenaUrsula Adenomyosis is a “shades of gray” rather than “black and white” condition so it is challenging to establish association vs causation and clinical relevance.

@GLiperis @AlexQuaas Should we define high-risk criteria? Yes — combining: Quantitative JZ metrics. Number of MUSA features (≥2 direct signs). Clinical phenotype (primary RPL, multiple losses). This could identify women most likely to benefit from early interventions or closer monitoring.

Q4: Moving into the “ideal” setting of IVF. ✨LBR after multiple ET reach 60–70% in women <35 years…. 🔎to what extent can the remaining failure be explained by uterine factors? could this account for the entire 30–40%? Or are we missing something else? #ESHREjc

Q3: What are the main diagnostic pitfalls in adenomyosis? How do clinical outcomes differ in subtypes of adenomyosis? Should we define specific criteria to identify those women at higher risk? #ESHREjc @CatenaUrsula @AlexQuaas

🚨Q2: Prevalence of uterine anomalies (e.g. septate uterus) shifts a lot by criteria (ESHRE/ESGE vs ASRM vs CUME). 👉🏼How does this shape practice over/under-diagnosis, over/under-treatment and interpretation of treatment outcomes? #ESHREJC

This edition’s paper is “The importance of the ‘uterine factor’ in recurrent pregnancy loss: a retrospective cohort study on women screened through 3D transvaginal ultrasound” published in our science journal Human Reproduction 👩‍🎓 🔗 https://t.co/KuAcPvHb3T #ESHREjc

@juanjo_fraire @ESHRE @CatenaUrsula @PaolaVigano3 @maclaudiaa @AlexQuaas @NoemiSalme30386 @DKalaitzopoulos @drbarisata Interesting point 👀. A control group with prior fertility, no miscarriages, and 3D US would be valuable to test the uterine factor’s causal role in RPL. 👉 The challenge is recruitment, plus heterogeneous diagnostic guidelines make causal inference tricky. #ESHREJc

Q1: To demonstrate a causal role of the uterine factor on RPL, a control group of 👭is needed with -previous fertility -no previous abortions -with a 3D transv US Is this a feasible endevour? Can causality be inferred even if diagnostic guidelines are heterogeneous? #ESHREjc

Welcome to this month's #ESHREjc moderators 🙌 Have fun! @DKalaitzopoulos @Saara_riibeiro @NoemiSalme30386 @OmarRawi89