Embryology Guest Speakers

Stefan du Plessis
Stellenbosch University, South Africa

Professor Stefan du Plessis is the Head of Medical Physiology in the Faculty of Medicine and Health Sciences (Tygerberg) at Stellenbosch University where he is actively involved in undergraduate teaching and postgraduate training. He also heads up the Stellenbosch University Reproductive Research Group (SURRG) and his research interests predominantly include male infertility and sperm function with the focus on factors that can influence it (e.g. lifestyle and non-communicable diseases). He graduated with a B.Sc., BSc. Hon., M.Sc. cum laude, Hon.B., B&A, MBA and Ph.D. from Stellenbosch University and also received a certificate in Human Assisted Reproduction from the CRM at the Cleveland Clinic. To date Dr Du Plessis has published 2 books, 61 peer reviewed scientific articles and more than 20 book chapters. He serves on the editorial board of three leading international journals; act as an ad hoc reviewer for various scientific journals and funding agencies, as well as moderator and examiner to several national and international universities. Prof du Plessis is an NRF rated researcher and has received numerous awards, the most notable of which include a Fulbright Research Scholarship (2015), Lasec Award for Excellence in Physiology Research (2013) and the Dr Edmund Sabanegh Award for Excellence in Male Infertility Research (2012).


Reactive oxygen species, scavengers and reproduction
Reactive oxygen species (ROS) play an important role in male fertility. Overproduction of ROS has been associated with a variety of male fertility complications, including leukocytospermia, varicocele and idiopathic infertility. The subsequent oxidative insult to spermatozoa can manifest as insufficient energy metabolism, lipid peroxidation and DNA damage, leading to loss of motility and viability. However, various studies have demonstrated that physiological amounts of ROS play important roles in the processes of spermatozoa maturation, capacitation, hyperactivation and acrosome reaction. It is therefore crucial to realize and define the delicate redox balance in order for a better understanding of both the positive and negative effects of ROS production on fertilizing ability. This presentation will discuss the role of ROS in male reproduction and explore the impact and contribution of various lifestyle factors. Finally, possible treatment options, the latest in ROS diagnostics and reference values will be alluded to.

Kwan Mor Ko
Eppendorf Asia Pacific Regional Center, Malaysia

Mr. Kwan Mor Ko has a Master's degree in biotechnology from University of Malaya. He has experience working as an embryologist in one of the pioneer IVF centers in Malaysia. He has been with the Eppendorf Asia Pacific Regional Center based in Malaysia since March, 2005 as an applications manager for the Cell Technology range of tools, centrifuges and CO2 incubators. He has conducted and as speaker in a number of biotechnology related seminars and workshops e.g. Transgenic Animal Workshop in India, Stem Cells and Transgenic Workshop in Hong Kong, Centrifugation and its Maintenance in South Africa, Biochemistry and Technology of Cell Engineering in Indonesia, Advanced Gene Transfer Workshop in Thailand, TransTech Meeting in China, ICSI hands-on Training in Malaysia, PGD (preimplantation genetic diagnosis) Workshop in Malaysia, and Cell-based Therapy and Technology Workshop in Malaysia.


Micromanipulation: role and application in current and future ART technology
The first successful birth of a "test tube baby", Louise Brown occurred in 1978 with in vitro fertilization technique. However, conventional IVF which involves the placement of eggs into medium containing thousands of sperm is of benefit only to those with the ability to produce large numbers of highly motile and morphologically normal spermatozoa. It is not until almost a decade after the birth of Louise Brown that micromanipulation techniques were first introduced to the treatment of male-factor infertility by Palermo et al, 1992. The technique is called intracytoplasmic sperm injection (ICSI). Over a million babies have now been born as a result of ICSI technique. Ever since that, more complex invasive techniques of oocyte and embryo manipulation were introduced not only to treat human subfertility but also diagnosis of genetic disorders. In 2001, a sophisticated advancement to ICSI, intracytoplasmic morphologically selected sperm injection (IMSI) described by Bartoov et al. was introduced. Preceding studies have already demonstrated the advantage of IMSI over the conventional IVF-ICSI procedure in terms of the pregnancy rate. In my presentation I will share with you the various applications of micromanipulation technique in ART. Introduction of IMSI technique, its indication, procedure and scoring method will also be addressed.

Ralf Henkel
University of Western Cape, South Africa

Ralf Henkel studied Biology and Chemistry in Marburg, Germany, and obtained his PhD in 1990. Subsequently, he was working in Andrology in Giessen and Jena, Germany. Currently, he is Senior Professor for Reproductive Biology and HOD at the Department of Medical Bioscience at UWC. He published more than 90 papers and 27 book chapters, and supervised 61 students. Ralf Henkel is member of five Editorial Boards and Co-Editor-in-Chief of Andrologia. His special research interest is on the impact of ROS on sperm functions, DNA fragmentation and fertilization, as well as the effects of Traditional Medicine on male reproductive functions.


The use of herbal medicine in Andrology
Traditional Medicine is defined by the WHO as "the knowledge, skills and practice of holistic care, recognized and accepted for its role in the maintenance of health and the treatment of diseases" and is based on indigenous believes handed down from generation to generation. Among other methods, traditional medicine mainly employs medicinal plants.
Considering that up to 80% of the population in non-industrialized countries heavily rely on traditional medicine to meet their healthcare needs and that the development of conventional "Western" medicines is becoming more expensive, interest in herbal medicine has undergone resurgence in the last twenty years. In addition, herbal remedies are believed to be without side effects and healthier than manufactured medicine. The use of herbal remedies exceeds that of conventional drugs by two to three times. Many conventional drugs including Aspirin (willow bark) or digoxin (foxglove) originated from plant sources a century ago and about 25% of all "Western" medicine prescriptions contain active ingredients derived from plants, sometimes without the physicians even knowing.
Despite biochemical characterization of some medicinal plants used for infertility treatment, very few plants with known efficacy have been investigated. In Chinese herbal medicine, over 450 published clinical trials on the efficacy of medicinal plants on various diseases exist, but the number of published trials on fertility is estimated to be only 50-60.
Among the plants investigated for their possible clinical use in Andrology Lepidium meyenni (Maca), Tribulus terrestris Basella alba, Eurycoma longifolia and Typha capensis have been used for centuries to increase sexual desire and enhance erection. Extracts of these plants have been reported to increase serum testosterone concentrations and thereby being able to treat male infertility or alleviate aging males' symptoms. Recent investigations on Eurycoma longifolia revealed possible anti-prostate cancer effects of this root extract.

Carin Huyser
University of Pretoria, South Africa

Carin Huyser received her PhD in 1996 from the University of Pretoria in Reproductive Biology where after she completed a Rockefeller foundation-sponsored postdoctoral fellowship at the Pontificia Universidad Católica de Chile. Over the past 18 years she has been an IVF Laboratory Director at the Steve Biko Academic Hospital in Gauteng South Africa and has been practicing in the field of embryology for over 25 years. She has a national research foundation rating and is an adjunct professor in the Department of Obstetrics and Gynaecology at the University of Pretoria. Areas of interest include curriculum development and training of embryologists in South Africa, economical laboratory design and risk-reduction measures; research includes semen decontamination, affordable in vitro fertilisation in a public service health care setting as well as of late, time-lapse embryo culture and selection. She partakes in the Task-force for Developing Countries and Infertility of the European Society of Human Reproduction and Embryology and Belgian-USA driven research in developing a simplified embryo culture system.


Info to follow.

Jaysen Knezovich
Genesis Genetics, South Africa

Dr Jaysen Knezovich obtained his PhD in Human Genetics from the University of the Witwatersrand, South Africa, in 2014, which was part of a split-site doctorate with the University of Cambridge, UK. Dr Knezovich's primary area of research has been investigating the effects of environmental factors on epigenetic signatures in gametes. He has published his findings in several international, peer reviewed journals. Dr Knezovich is a Medical Biological Scientist registered with the Health Professions Council of South Africa (HPCSA). Dr Knezovich also holds a Postgraduate Diploma in Management (PDM) which he obtained from Wits Business School in 2014. Dr Knezovich held a lecturing post at the University of the Witwatersrand in 2013. Dr Knezovich has supervised, and continues to supervise, a number of postgraduate degrees. In August 2013, Dr Knezovich was approached by Genesis Genetics Inc. to open a laboratory in Johannesburg, South Africa, where he is currently the Laboratory Director. Genesis Genetics is a leading global provider of Preimplantation Genetic Diagnosis (PGD) and Preimplantation Genetic Screening (PGS), providing expert laboratory services for many of the most respected in vitro fertilization (IVF) centres across the country and throughout the world. Additionally, Genesis Genetics South Africa offers prenatal genetic testing on products of conception, amniotic fluid samples, chorionic villus samples, and non-invasive prenatal testing (NIPT).


Abstract to follow shortly.

Marcos Meseguer
IVI Valencia, Spain

Dr. Marcos Meseguer was born in November 1974, received his Biological Sciences Degree in 1997 from the University of Valencia in Spain. He performed a pre-doctoral fellowship in St Mary¬īs Hospital, Manchester University, United Kingdom. He received his Ph.D. Degree in Obstetrics and Gynecoloy in 2002 from the University of Valencia, Spain, and the European Doctor Degree form the same university. He has also a master degree in Research Methods; Design and Statistics from Universidad Aut√≥noma de Barcelona, Spain. Actually is Scientific Supervisor and Senior Embriologist in the IVF unit of IVI Valencia. He was Co-Director of the Andrology Laboratory at the Instituto Valenciano de Infertilidad (IVI) from 2000 to 2004.
Dr. Meseguer is a member of various scientific societies and has received the prize paper of the Society of Reproduction and Infertility (American Society of Reproductive Medicine). Three times the Lalor Foundation International Award from the American Society of Andrology and four times the reasearch award from the Spanish Society of Fertility. The primary areas of his research are embryology and male infertility.
As Principal Investigator, his work has been funded through 10 projects sponsored by the Spanish Government and the Valencian Government, including two EUREKA projects (granted to high quality technological projects) supported by the European Community. He has published over 130 articles and 55 reviews or book chapters, made more than 350 presentations at national and international congresses. He has been the Director of 8 Doctoral Thesis all qualified with "Cum Laude", and actually is directing 7 doctoral thesis. He is also currently Statistics Assessor of IVI Valencia the biggest infertility clinic in Spain and one of the most important in Europe, and Associate Professor of the Master in Biotechnology from Valencia University.


The time-lapse challenge: evidence of benefit methodologies and outcomes
Traditionally, embryo incubation and assessment daily has been under a light microscope, these observations are inevitably restricted to specific times and considering that the development of the embryo is a dynamic process, several critical stages in between observations may go unnoticed. For this reason, the new technologies, time lapse monitoring, have focused on the research for additional markers of viability to supplement current criteria for embryo selection and thus, achieve a reduction in the number of embryos transferred and so multiple pregnancies, making the selection procedure even easier for the embryologist. However, for wide adoption of time-lapse technology in IVF practice, there are two key considerations. First, validation of the time-lapse technology is needed to demonstrate its safety and effectiveness by prospectively designed clinical trials in a multiple-clinic setting . Second, time-lapse technology must be compatible with the busy workflow of any standard IVF laboratory and practical-to-use for any embryologist.

Cryopreservation prospects; fresh or frozen embryo transfer
Oocyte and embryo cryopreservation has been one of the most fascinating challenges of assisted reproduction technology and its incorporation into the clinical practice has been a goal since many years.
There are several indications of human female gamete cryo-storage including sub-fertile and fertile patients. Women at risk of losing their reproductive function caused by oncologycal treatments or premature ovarian failure could benefit greatly from this practice. In addition, oocyte and embryo cryopreservation may increase the flexibility of the options offered by current assisted reproduction technology strategies, especially in cases where the delaying in embryo transfer is mandatory due to the risk of ovarian hyperstimulation syndrome; management of low response to gonadotropins, contribution to PGS program or failure to obtain the sperm sample the day of ovum pick up.
In our experience, the developmental capability of vitrified embryos using the Cryotop method, is not affected by the vitrification procedure
The overall outcome of the embryo vitrification system is highly satisfactory. Survival rate after warming is over 95%. The potential of vitrified embryos is consistently similar than the one attained for fresh ones. All the evidences described in this lecture indicate that nowadays oocyte and embryo cryopreservation by means of vitrification is providing a highly effective tool within ART, attaining similar outcomes than those obtained with fresh oocytes-embryos, thus allowing its application into clinical practice. In this lecture we will discuss some basic and practical aspects of vitrification and show evidences on outcomes of embryo vitrification and its contribution to the improvement of efficiency in ART.

Sharon Mortimer
Oozoa Biomedical, Canada

Sharon Mortimer PhD became a Clinical Embryologist in 1985 and has served as Laboratory/Scientific Director for a number of ART clinics. She is now a consultant with Oozoa Biomedical Inc, in the areas of systems design and application in ART laboratories, and in research communications.
She co-authored Quality and Risk Management in the IVF Laboratory, as well as over 40 publications and over 100 conference presentations. She is an active member of 10 professional societies, and was a member of the committee that developed the certification standards for ART Lab professionals in Canada. She currently serves as a member of the Alpha Executive Committee, and as a Board member of Fertility Matters Canada.


Alpha Consensus on the Professional Status of the Clinical Embryologist
In 2014, Alpha hosted an international Workshop to establish consensus on the professional status of the Clinical Embryologist. A survey administered to national/regional societies before the meeting identified the current practice in 58 countries, and this information was used to frame the discussions. The Workshop participants represented 20 countries (Australia, Austria, Belgium, Brazil, Canada, China, Croatia, Finland, France, Germany, Ireland, Italy, the Netherlands, Russia, South Africa, Spain, Sweden, Turkey, UK, and USA). This report presents an overview of the Workshop, as well as the consensus points reached regarding the role of the Clinical Embryologist, educational and academic requirements, training expectations, defining and assessing competence, and continuing professional development.

The Istanbul Consensus on Embryo Assessment (Alpha and ESHRE)
The lack of a global standard in embryo morphology assessment makes it difficult to interpret studies that use embryo quality as an endpoint. Accordingly, an international consensus meeting was convened to define the minimum criteria for oocyte and embryo morphology assessment, covering oocyte scoring, timing of assessment, zygote scoring, cleavage-stage embryo scoring, and blastocyst scoring. This report presents the outcome of that meeting, including the consensus points reached to support standardized reporting of the minimum dataset required for the accurate description of embryo development.

The Alpha Consensus meeting on Cryopreservation: Key Performance Indicators (KPIs) and Benchmarks
A survey on current practice in cryopreservation administered to participants at the Alpha biennial meeting in Budapest in 2010 identified a wide range of expected outcomes, highlighting a need for global standardization of KPIs and benchmarks to support the development of best practice in cryopreservation. In response, Alpha convened an international workshop to establish consensus on KPIs for oocyte and embryo cryopreservation, as well as minimum performance and aspirational levels. This report presents the proceedings of that meeting, including the consensus KPI and benchmark values.

Melodie Slabbert
UNISA, South Africa

Melodie Slabbert obtained the degrees BA, BA (Hons), MA and DLitt from the University of Pretoria, and the degrees LLB and LLD (in medical law under the supervision of Prof SA Strauss) from the University of South Africa. She was admitted as an advocate of the High Court of South Africa in 1996. She studied as part of her doctoral research at the Max Planck Institutes in Heidelberg, Freiburg and Munich. She received various international research grants to conduct research in Finland, Germany, Australia, Spain, France, Scotland, the Netherlands and Belgium. During 2001-2002 she lectured medical law and ethics at the Adelaide University Law School in South Australia. She is presently the chairperson of the Inter-University Centre for Education Law and Policy and has served on the boards of the SAMLS and Dignity SA. She is presently an advisory board member of, amongst others, the Institute for Cellular and Molecular Medicine at UP, Bone SA (as non-executive director) and the Innocence Project SA. She has published numerous articles on medical law and other fields of law in local and international law journals and has presented many local and international conference papers. She is the author of the recent monograph on South African Medical Law for the Encyclopaedia of Law Series (Wolters Kluwer International). In 2012 she received the Chancellor's Award for Excellence in Research from the University of SA, the Women in Research Leadership Award, and the Hugo de Groot Prize. She was formerly the Director of the School of Law at the University of South Africa and is presently the Deputy Executive Dean of the College of Law, consisting of the School of Law and the School of Criminal Justice, at the same institution. She has been involved with the revision and drafting of health legislation for a number of years.


Egg donation: Legal and ethical controversies
The demand for human ova has dramatically increased over the past few years, whether for the purpose of research or treatment. This presentation will explore some pertinent legal and ethical concerns relating to gamete donation in South Africa, focusing specifically on egg donation. Some of the present concerns relate to limitations on the use of residual gametes by fertility clinics following the completion of a family from a donor; the role of egg donor agencies vis-à-vis fertility clinics; the recruitment of egg donors by foreign agencies; compensation of egg donors, number of offspring born from one donor; impact of the absence of a central national database of gamete donors, as well as informed consent challenges. Some recommendations will be made to address or remedy some of the legal lacunae identified.

Vanessa Steenkamp
University of Pretoria, South Africa

Prof Vanessa Steenkamp currently heads the Phytomedicine Unit in the Department of Pharmacology, University of Pretoria. Her research interest focuses on traditional herbal remedies and their effect on patients, as well as the development of methods for the detection of these active compounds in biological fluids. She is also involved in pre-clinical testing of traditional herbal remedies which includes the isolation of active compounds and development of new drugs. Prof Steenkamp is the author and co-author of 120 scientific papers and 5 book chapters. She has received a number of awards for her research both nationally and internationally, amongst which is the prestigious Friedel Sellschop award, formerly known as the University of the Witwatersrand Young Researcher and Exceptional Young Researcher of the University of Pretoria, two of the leading academic institutions in the country. She serves as reviewer for 36 international peer-reviewed journals and is on the editorial board of 6 journals. She is actively involved in scientific organizations both locally and abroad. She is President of the Federation of South African Society of Pathology, Vice-President of the Toxicology Society of South Africa and Vice President of the South African Association of Basic and Clinical Pharmacology. Internationally her activities include serving as Director of Education of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology, and chair of the Clinical Toxicology Committee in this Association. She is also a member of the Executive Committee of the International Federation of Clinical Chemistry.


Traditional remedies: Impact on fertility
Infertility is often not seen as problem in developing countries due to overpopulation problems and hyper fertility. However, lack of health care and high rates of life-threatening illnesses in developing countries result in infertility which is on the increase in sub-Saharan Africa. This problem affects both males and females of reproductive ages. Infertility in these societies often leads to social stigmatization and abandonment by spouses. Assisted reproductive technologies are usually not considered as a treatment option for many due to the expense associated with the techniques. Herbal remedies however, provide a more affordable and accessible form of treatment. Moreover, these remedies form part of the cultural and religious life of African people. Herbals have been used through the ages to treat a variety of diseases, which includes treatment of both male and female infertility. It has been documented that usage of alternative medicines by infertility patients is as high as 60%. Some of the most popular herbs used to treat sexual conditions in ancient history include anise, basil, carrot, salvia, gladiolus root, orchid bulbs, sage, sea fennel and turnips. Enhanced fertility has been achieved with the aid of fertility herbs and supplements. In this presentation traditional remedies that have been found supportive for reproductive health issues will be discussed.

Petra Thorn
Protestant University of Applied Sciences, Germany

Petra Thorn has been working as a family therapist and infertility counsellors in private practice since 1993. She is a lecturer at the Protestant University of Applied Sciences, Darmstadt, Germany and carries out education and training in various aspects of infertility and psychosocial aspects of assisted human reproduction. For many years, she has focussed on third party reproduction, recently this has also included counselling and the development of counselling trainings in the area of cross-border reproductive service.


Cross border gamete donation and recent policy developments in Europe on ART donation
"Good old Europe" is not as traditional and stable as it may be seen from the outside. Many countries have introduced legislation for ART, and thus enabled new family structures possible only with ART. In countries with restrictive legislation or medical practice, patients feel unduly limited and travel in order to access ART abroad. This has led several countries to change their legislation. As a result, there may be increasing pressure of the remaining countries to adapt their legal framework.
Cross border treatment, however, has not lost its momentum. Furthermore, more and more patients do not keep their treatment abroad a secret. They support reproductive autonomy and openly acknowledge that they have carried out treatment prohibited in their home country. This presentation will describe the opportunities and challenges for these "international" family building options and their stakeholders.

Family dynamics and counselling of donor children
Although medical treatment using donor conception (donor sperm, oocytes, embryos and surrogacy with donor gametes) is being increasingly used by individuals and couples suffering from medical and/or social infertility, talking to children about their conception remains controversial in many countries. This presentation will outline these "new" family structures and describe current knowledge regarding the development of the children and the impact of disclosure and non-disclosure. It will also provide a comprehensive overview of counselling content and strategies and finish with resources available for families and counsellors.

Marie-Lena Windt de Beer
Tygerberg Hospital, South Africa

Marie-Lena Windt de Beer received her MSc and PhD in Reproductive Biology from the University of Stellenbosch in 1989 and 2000 respectively. She pioneered the fertilization method: intracytoplasmic sperm injection - ICSI in the early 1990 at the Tygerberg Fertility Clinic which resulted in the birth of the fist ICSI baby in South Africa. Currently she is the Laboratory Director at the Tygerberg Fertility Clinic at Tygerberg Academic Hospital and has been practicing in the field of embryology for almost 30 years. Areas of interest include the development of affordable IVF strategies in South Africa and also the teaching and training of young embryologists.


Info to follow.