22 January 2024

Declining global fertility rates and the implications for family planning and family building: an IFFS consensus document based on a narrative review of the literature" published in HRU

Family-planning policies have focused on contraceptive approaches to avoid unintended pregnancies, postpone, or terminate pregnancies and mitigate population growth. These policies have contributed to significantly slowing world population growth. Presently, half the countries worldwide exhibit a fertility rate below replacement level. Not including the effects of migration, many countries are predicted to have a population decline of >50% from 2017 to 2100, causing demographic changes with profound societal implications. Policies that optimize chances to have a child when desired increase fertility rates and are gaining interest as a family-building method. Increasingly, countries have implemented child-friendly policies (mainly financial incentives in addition to public funding of fertility treatment in a limited number of countries) to mitigate decreasing national populations. However, the extent of public spending on child benefits varies greatly from country to country. To our knowledge, this International Federation of Fertility Societies (IFFS) consensus document represents the first attempt to describe major disparities in access to fertility care in the context of the global trend of decreasing growth in the world population, based on a narrative review of the existing literature.

Read the article in HRU >



5 January 2024

Elpida Fragouli

Elpida Fragouli

It is with great sadness that Elpida Fragouli passed away after a very short illness due to cancer at the end of December 2023. She has been a key scientist in the field of PGT for over 20 years. Her contribution to the academic and clinical literature has been of global importance.

After obtaining a BSc in Molecular Biology from the University of Surrey, and an MSc in Biochemistry (Genetic Manipulation and Molecular Biology) from the University of Sussex, in 1999 Elpida joined the UCL team led by Joyce Harper and Joy Delhanty to study the MSc in Prenatal Genetics and Fetal Medicine. She stayed on at UCL to do her PhD with the UCL PGD team where she also worked on the PGD programme until 2006.

After enjoying an internship in the USA, she went on to work briefly at University of Connecticut, Yale, and the University of Oxford before joining Reprogenetics where she worked for over 10 years as Laboratory and Scientific Director with Dagan Wells and Santiago Munne. Later, she was a key member of the team that set up Juno Genetics, which rapidly grew to become one of the largest providers of genetic testing services for fertility clinics. She finally returned to academia with Anna Mantzouratou at Bournemouth University as Lecturer and then Senior Lecturer in Biomedical Sciences, as well as serving as a Deputy Head of department.

Elpida achieved an outstanding research and clinical career, publishing over 150 scientific papers. She was responsible for the development and validation of several key PGT techniques. She also looked for biomarkers of embryo competence, identified several target genes with differential expression in cumulus cells surrounding aneuploid oocytes, and the possible role of mitochondrial DNA as a predictor of embryo implantation potential. She had several roles in ESHRE including the Basic Science Officer at ESHRE’s SIG Embryology. She was a member of the editorial boards of Human Reproduction, Fertility and Sterility and RBM Online. She won several awards including the New England Fertility Society-Pacific Coast Reproductive Society Exchange Prize for best submitted abstract (2007), Basic Science Award for oral presentation at ESHRE (2011), and the SART prize for oral presentation at ASRM, (2015).

Elpida will be missed by many of us on a personal level and leaves a huge gap in the field. She leaves behind her young son, Alexander.

Elpida’s funeral will be on 20th January, Wolvercote cemetery, OX2 8EE at 12.30pm.

* From left to right: Elpida Fragouli, Georgia Kakourou, Joyce Harper, and Mara Simopoulou.

14 September 2023

In memoriam – Ian Wilmut
Professor Sir Ian Wilmut, an honorary member of ESHRE who died on 10 September 2023

Sir Ian Wilmut‘Ask yourself if this is the most ambitious experiment you can do’ was the advice Sir Ian once said he would give to young scientists seeking a career in biomedicine.

It was this bold mindset – combined with scientific brilliance – that led this soft-spoken and understated embryologist and his team to achieve one of the most remarkable breakthroughs in modern science: the birth of Dolly the sheep in July 1996.

This world-first cloning of a mammal via adult somatic cell nuclear transfer turned the embryologist, who has died aged 79, into a household name, brought international TV crews to his lab at the Roslin Institute in Edinburgh, and created a legacy which inspires animal and human research to this day.
Such was the impact of Dolly that ESHRE members may recall toy sheep being handed out at the Annual Meeting in Edinburgh in 2012, the year Sir Ian received his honorary membership.

The ‘father of cloning’ as he became known was unable to attend the event. Instead, the then ESHRE chair Anna Veiga travelled to interview him at the Medical Research Centre for Regenerative Medicine which Sir Ian headed until 2011.

Known for his modesty, Sir Ian said he was delighted and flattered but that research ‘involves a team’ and accepted the honorary membership on behalf of all those who he worked with.

During their meeting, which is available on YouTube, Sir Ian recalled how he worked as a teenager on farms which first attracted him to agriculture, the subject he went on to study at the University of Nottingham.

Initially, he considered carrying out advisory work in developing countries. However, the scientist switched to animal science and wrote to laboratories asking for work experience.

The first person to offer him an internship was Chris Polge at the University of Cambridge. This led to an opportunity to stay and join Professor Polge’s team which was investigating the possibilities of freezing animal semen and embryos.

The result was the birth of Frostie, the first calf to be born from a frozen embryo.

Although this early research was pioneering, it was not related to cloning. The preparatory work towards Dolly’s creation was undertaken by Sir Ian when in 1973 he moved to a permanent post at the government-funded Animal Breeding Research Organisation, later renamed the Roslin Institute.

Here, Sir Ian said he learned much about molecular biology through a project where additional genes were added to farm animals. However, the technique was (in his own words) ‘very inefficient’. So, he began to think of other ways to change genes in these livestock.

At the Roslin Institute, the aim of his gene experiments which included Dolly was not to produce stem cells for reproductive purposes. It was to change genes in farm animals, to make them healthier, and perhaps produce organs for transplant into human patients.

No one, not even Sir Ian, could predict quite how earthshattering the impact would be when news of Dolly’s creation eventually leaked out to the wider world in February 1997.

In his interview with Dr Veiga, he recalls how ‘newspaper people’ from around the globe immediately swamped the Institute. Even the Pope had a view on the cute but controversial cloned sheep who was named after singer Dolly Parton.

The ‘Dolly effect’ lasted for weeks then years. As for Dolly herself, she was euthanized aged six after suffering a viral lung infection and is on display at the National Museum of Scotland.

For Sir Ian, the experiment made him realise scientists could change cells far more than had been thought possible.

In 2005, he switched to medical research and accepted a chair in reproductive science at the University of Edinburgh. The collaborative project which Sir Ian set up into a treatment using pluripotent stem cells has helped to advance the understanding of motor neurone disease.

The technique also led Sir Ian and colleagues to form a joint research initiative with the University of Dundee into Parkinson’s disease, another neurodegenerative condition.

This was announced on World Parkinson’s Day in 2018 when Sir Ian also revealed he had been diagnosed with the condition.

Sir Ian was only too aware that ‘human life is really quite frail’, as he said in his interview with ESHRE. He had seen friends and colleagues diagnosed with debilitating conditions such as multiple sclerosis and motor neurone disease.

But biomedical research gave him hope that others would have a better future. His research showed that opportunities now exist to develop treatments for at least some of these diseases, a prospect which gave Sir Ian encouragement.

That hope now rests in the scientists who follow in his footsteps and share his ambition to do what has not been done before.

Ian is survived by his second wife Sara, by his children, Helen, Naomi and Dean, and by five grandchildren, Daniel, Matthew, Isaac, Tonja and Tobias.



18 January 2023

In memoriam Joep Geraedts – by Karen Sermon

Professor Joep Geraedts (1948), a long-standing member and past Chair (2007-2009) of ESHRE who passed away on 25 December 2022.

Even when you know a dear friend’s death is imminent, it always comes as a blow when it happens.

I met Joep Geraedts when the PGD Consortium was set up as he was the first coordinator of the then very new SIG Reproductive Genetics and quite rightly felt that both entities needed to be closely linked. From the outset, Joep was a soothing presence in a group full of energetic young scientists and more than once helped everyone reach consensus.

In 1969, Joep obtained a BSc in general biology from the Catholic University of Nijmegen and his MSc in 1972. He received a PhD in 1975 from Leiden University where he became assistant and associate professor at the Institute of Human Genetics. In October 1982, he was appointed full professor of genetics and cell biology at Maastricht University and became the first director of the university’s Clinical Genetics Centre in January 1983. In 2003, this centre became the Department of Clinical Genetics of the University Hospital Maastricht of which he became the head until his retirement in April 2013.

During his career, Joep served as chairman of various learned societies, including the Dutch Society of Human Genetics and the Society of Dutch Clinical Genetics Centres. At ESHRE, he was co-ordinator of the Special Interest Group Reproductive Genetics, Steering Committee member of the ESHRE PGT Consortium, member of the Committee of National Representatives (the so-called “Advisory Committee”), and finally Chair-elect (from 2005 to 2007) then Chair (from 2007 to 2009).

Joep was also author, co-author, or editor of more than 300 articles and served on the editorial boards of various scientific journals. Since his retirement, he was also an advisor to various projects in the field of reproductive genetics.

I got to know Joep better when our PGT team at the University Hospital Brussels formed BruMa with his team at Maastricht University, and we organised 6-monthly meetings to discuss PGT-related topics. Still in existence, this group was renamed BruMaStra when Stéphane Viville and Céline Moutou from Strasbourg joined us.

I remember the warm welcome we always received in Maastricht, with lots of “Limburgse vlaaien” (fruit pies) and convivial dinners in the evening, and I am sure Joep looked benevolently upon his team getting ready to receive the notoriously critical (when it comes to food and drink) Belgians.

I also recall Joep’s involvement in the ESHRE PGT Consortium. We were both part of the large group of people who, for several years, aimed to build a bridge between ESHRE and the European Society of Human Genetics of which Joep was also a proud member.

My most precious memory of Joep at ESHRE was during the Annual Meeting in Amsterdam, when the Speakers’ Dinner was in a deconsecrated church, and he gave a speech from the pulpit with much glee and chuckling.

When Joep decided to start an RCT within ESHRE on PGT on polar bodies (the well-known ESTEEM study), I did not get involved at the outset, but little did I know ESTEEM would catch up with me. During that time, Joep and I coordinated the redaction of two papers in Molecular Human Reproduction (Geraedts and Sermon, 2016 and Sermon et al., 2016) which are still highly cited and continue to be a resource if you want to know the different points of view on PGT.

I received the message that Joep had left us the morning after Christmas Day, and it was only then that I realised he had been a quiet mentor for me. Without pontificating, or taking the moral high ground, Joep led the way by example. The most important thing he taught me was the need for communication, and that one phone call could solve things much quicker than endless emails. Remember, this was before the pandemic and before we had Teams and Zoom. He also taught me that those who talk most during meetings do not always get most attention. Sometimes Joep would fall completely silent during a meeting, leaving those who did not know him well to think he had dozed off, only for him to suddenly open his eyes and say something that would help transform an endless discussion into a firm conclusion.

Although a practicing Catholic, Joep had a progressive view on reproductive rights and the right of all of us to self-determination. This broadminded attitude made him a frequent speaker on the topic of PGT in, for instance, the German parliament. He would often tell me, when we were abroad, that he had visited a church and burned a candle there, showing no apprehension in sharing his devotion with a staunch atheist, and feeling (correctly) I would understand his way of expressing his spirituality. Our views on religion could not have been further apart, but we always respected and understood each other’s stance in life. I would like to believe his faith gave him the fortitude to carry the burden of his illness to the end.

Joep will always be remembered as an amiable man with a bone-dry sense of humour. His stories were always about simple things happening to simple people, but made hilarious by the absurdity of the situation, or people not quite behaving as they were expected to. He would tell us during a Teams meeting that not being allowed to drink beer made him sorry in the evening, but happy in the morning, adding that Belgian alcohol-free beer was “passable”. He will live on forever in our hearts and minds, and later, when time has done its healing work, we will chuckle at his jokes.

Joep leaves his loving wife José, his son and daughter and 4 grandchildren.



4 January 2023

The updated 5th edition of the Guide to the quality and safety of tissues and cells for human application has been published by the EDQM

The European Directorate for the Quality of Medicines and HealthCare (EDQM) of the Council of Europe released their 5th edition of the Guide to the quality and safety of tissues and cells for human application in December 2022.

The Guide contains technical information and guidance for professionals working in tissue establishments, inspectors auditing these establishments, and Health Authorities responsible for tissues and cells for human application. It collates the most up-to-date information to provide a comprehensive overview of the most recent advances in the field, with the aim to support professionals at a practical level and contribute to improving the rate of successful and safe clinical application of tissues and cells of human origin.

Two chapters in the Guide are specific for Medically assisted reproduction (Chapter 29) and Fertility preservation (Chapter 30) and have been written with the collaboration of ESHRE. General requirements for all tissues and cells are written in the general Chapters (Part A of the Guide).

We greatly appreciate that ESHRE was actively involved in the elaboration of the EDQM Guide, and that a number of our experts could share their valuable experience and knowledge within this important project. We strongly encourage you all to read it.

Find out about how to download the updated EDQM Guide (5th ed.) on this page.