@prof-lotti.bsky.social
@smdsresearch.bsky.social
@drdanielmarcu.bsky.social
@mvazquezlevin.bsky.social
@drlucaboeri.bsky.social

The report from our latest ESHRE Journal Club is now live on FoR! 📄

A great opportunity to revisit the discussion on severe male factor infertility and its impact beyond fertilisation.

🔗 lnkd.in/evM7y2Kx

Huge thanks to our amazing experts for their insights and contributions🙏

#ESHREjc

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

@gliperis.bsky.social
@dkalaitzopoulos.bsky.social
@juanjo-fraire.bsky.social
@ribeirosara.bsky.social

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
@drdanielmarcu.bsky.social
@mvazquezlevin.bsky.social
@drlucaboeri.bsky.social

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! 🙌

Is anyone else blown away by the numbers treated at a single reproductive centre in this study? Nearly 15000 cycles in less than 5yrs!! 💪💪 #eshreJC
Differences seen in outcomes are unlikely to be attributable to different lab practices…

💬 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

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3/3
😏 At the same time, many of you raised important doubts about how much of this effect is truly biological versus context-dependent.
💬 A rich, nuanced discussion, thank you all for your contributions! 🙏🏻
Now we look forward to the summary slides, coming in a few hours 👀
#ESHREjc

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2/3
🤔 There’s growing agreement that male infertility is not one entity, and that severe phenotypes may impact outcomes more than we previously acknowledged, especially in terms of time and efficiency to live birth.🫨
#ESHREjc

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1/3 🚀🚀🚀 As this #ESHREjc discussion comes to a close, a few key themes are emerging 👇
We’ve questioned long-standing assumptions, particularly whether ICSI truly overcomes male factor infertility, and highlighted the gap between improving semen parameters and achieving live birth.

#ESHREjc

#ESHREjc

#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

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

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

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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

We’ve become very good at improving surrogate markers, but evidence linking these changes to live birth remains limited.🫣
🤔We need studies powered for live birth outcomes, not just semen parameters. #ESHREjc

You’re absolutely right to shift the focus from a binary success rate to Time to Live Birth. While neonatal outcomes might remain comparable once a pregnancy reaches term, the efficiency of the process is where the impact of severe male factor is most punishing. #ESHREjc

Poorer outcomes in severe OAT-S and NOA are driven by a synergistic failure of both biology and environment.While sperm DNA fragmentation and epigenetic defects provide the intrinsic ceiling often leading to late paternal effect and embryo arrest #ESHREjc

Yes, this could also be! #ESHREjc I think we have to design our clinical studies properly to answer specific questions and test specific hypothesis. Then we interpret the data we obtain objectively, without speculating or extrapolating.

Say controlled model results are underestimating the male factor (due to high-quality oocytes compensating), we may be at risk of under-counselling couples about sperm-related risks, if we are relying strongly on them for our decisions. #ESHREjc

Or, even if the controlled model is compensating and we still see a difference, it means it is an important effect to really consider in decision-making #ESHREjc

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What do you think? How can we practically integrate structured communication training into routine clinical practice, and is there evidence that it actually improves patient outcomes in fertility care? #ESHREjc