Thanks to all participants & experts! It was such a great discussion! 🙌🏼

See you in May 👋🏼🔜 #ESHREjc

Also a big thank you to our fantastic moderators for leading such an engaging and insightful discussion 👇

@gliperis.bsky.social
@dkalaitzopoulos.bsky.social
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Your energy and thoughtful moderation made this #ESHREjc truly outstanding 👏

A big thank you to our amazing experts for making this discussion truly outstanding 👇

@prof-lotti.bsky.social
@smdsresearch.bsky.social
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Your expertise and insights made the difference. #ESHREjc

A big thank you to everyone who joined this lively edition of the #ESHREjc! 🦋

It was a pleasure to see such engaging discussions and insightful contributions from all participants and experts.

Truly grateful to have shared this with such a fantastic community... looking forward to the next one! 🙌

Many thanks to all participants, experts and to @mr-att.bsky.social and his team for leading this lively edition of the #ESHREjc 🦋
See you next time! 🙌

💬 Q4 Summary is out!

Good counselling isn’t just prognosis.

👉 Clear steps, follow-up, and support are key to reduce patient distress.

#ESHREjc

🔬 Q3 Summary is out!

Why do controlled models show weaker male effects?

👉 Oocyte repair capacity may mask sperm damage... but only up to a point.

#ESHREjc

🧬 Q2 Summary is out!

OAT-S and NOA are not one entity.

👉 Biology, epigenetics, and confounders all interplay... how much is intrinsic vs contextual?

#ESHREjc

🧠 Q1 Summary is out!

Severe male factor may not affect neonatal outcomes... but it impacts time, cycles, and patient burden.

👉 Time-to-live-birth matters.
#ESHREjc

Looking forward for FertiShare results 👉 doi.org/10.1136/bmjo...
#ESHREjc

Agree! Research in the fertility-specific context is still needed. Despite growing attention, we lack emprical evidence on how doctor-patient communication improves patients’ decision-making process and emotional adjustment in this field #ESHREjc

Indeed, although propensity score matching was used to control for key confounders, residual confounding cannot be excluded, particularly regarding female-related factors that strongly influence IVF/ICSI outcomes, such as oocyte quality and endometrial receptivity.
#ESHREjc

Training can start as early as during graduation and continue throughout professional life to address the specificities of fertility care. While evidence in this field is limited, general studies show that communication training improves patient satisfaction and physicians' self-efficacy #ESHREjc

Every couple is different and should be approached individually, with clear expectation management.
The focus should be on strategies to improve outcomes, including antioxidant supplementation, which, although still under investigation, may improve semen parameters, particularly in OAT-S #ESHREjc

Studies show that patients often don’t retain most of the information they receive after receiving bad news. So summarizing at the end and offering a chance to revisit the topic later (such as in a follow up consultation) may be helpful #ESHREjc

Agree! Patients may need time to process information before they can ask questions or engage in the next step discussion. Having an easy way to contact their healthcare provider or scheduling a follow up consultation is important #ESHREjc

It’s normal for patients to feel distressed after receiving bad news (sometimes the concern would be if they weren’t), and they find coping mechanisms to deal with it afterward. But for patients with high levels of distress, psychological support may be needed and it should be accessible #ESHREjc

Normalizing emotions is important, but there is often a fine delicate line between normalization and undervaluation. Patients can feel misunderstood and normalization shouldn’t make them feel their experience is being minimized #ESHREjc

YES! Doctor-patient communication is key in fertility care, especially when delivering difficult news. Frameworks like SPIKES help professionals communicate empathetically, set realistic expectations, and support patients’ emotions while respecting their pace #ESHREjc

a drawing of a heart and a brain with the name william marsh on the bottom ALT: a drawing of a heart and a brain with the name william marsh on the bottom

Agree! Sometimes evidence alone isn’t enough. Information may be processed more through an emotional lens than rational thinking (so a 5% chance can feel like a certainty they’ll be in that 5%). Understanding if patients expectations are adjusted is very important #ESHREjc

Yes, agree it's important to highlight that outcomes depend on multiple factors. I would also add that we need to understand who is the patient, as they differ in their preferences: some patients want step by step info, others want to know evrything right away (from plan A to Z) #ESHREjc

ALT:

Q4: How can doctor-patient communication effectively integrate prognosis and expectation adjustment in severe male infertility (OAT-S, cryptozoospermia, NOA) without increasing couples’ emotional distress? #ESHREjc

These findings challenge the long-standing perception of ICSI as a complete equalizer of male factor infertility. Instead, they reinforce the biological relevance of sperm-derived contributions to early embryogenesis, likely reflecting underlying genomic and epigenetic integrity.
#ESHREjc

The data compellingly demonstrate that severe MF infertility—particularly severe OA (in paper OAT) and NOA—is not fully mitigated by ICSI. Rather, it remains significantly associated with impaired fertilization, reduced embryo developmental competence, and lower cumulative live birth rates.
#ESHREjc

ALT:

Q2: #ESHREjc Are poorer outcomes observed in severe OAT-S and NOA mainly driven by sperm DNA damage and epigenetic defects, or are they still partly explained by residual female and treatment-related confounding?

#ESHREjc
Hello Everyone!
One of the most persistent assumptions in ART is that ICSI has effectively overcome male infertility impact. But has it? This study addresses whether male infertility is merely a barrier to fertilization or a determinant of reproductive success across the entire ART.

Delighted to contribute to this discussion. Male fertility has remained underfunded and under-researched for decades, even though male factors contribute to around half of infertility cases. It is time to give male reproductive health the scientific attention it deserves. #ESHREjc

ALT:

Q1: If severe male-factor infertility impairs fertilization and embryo development but not neonatal outcomes among live births, how should this change clinical counselling and treatment strategy? #ESHREjc

The important role of male in treatment outcomes will be discussed in this #ESHREjc edition!

🚨Revisit the #bluettorial for the discussed paper 👇
#ESHREjc