Ovarian stimulation is a cornerstone of assisted reproductive technology (ART), aiming to optimize follicular recruitment and growth, maximizing the chances of a successful outcome. However, monitoring should balance efficacy with patient comfort. This lecture, “How to monitor ovarian stimulation – Monitor Only Relevant Parameters,” emphasizes a streamlined approach to monitoring during controlled ovarian stimulation. By focusing on clinically meaningful parameters—such as follicular recruitment, follicle number, growth, and patient-specific risk factors—we can reduce unnecessary interventions, improve cost-effectiveness, and enhance patient experience without compromising success rates. The lecture will critically examine traditional versus modern monitoring protocols, highlight the limited utility of routine hormone panels in most cases, and discuss how individualized strategies can guide timely decision-making. Participants will gain practical insights into optimizing monitoring protocols in diverse patient populations, including poor and high responders, and explore the important role of ultrasound as the primary tool. Ultimately, this session advocates for a more rational, patient-centered approach to monitoring during ovarian stimulation—less is often more.
In assisted reproductive technology (ART), adequate luteal phase support is critical for successful embryo implantation and pregnancy maintenance. Progesterone plays a pivotal role in this process. Traditional administration routes, such as vaginal, intramuscular, subcutaneous and oral, have their limitations, including discomfort, variable absorption rates and differential distribution between the endometrium and serum. This presentation explores the innovative approach of rectal administration of progesterone, highlighting the pharmacokinetic, enhanced bioavailability, and improved patient compliance. Studies, which provide insights into the efficacy of rectal progesterone compared to conventional methods in Hormone Replacement Therapy Frozen Embryo Transfer (HRT-FET) cycles will be presented. These studies demonstrate that rectal administration not only supports the luteal phase effectively but also increases patient satisfaction through reduced discomfort. In addition to summarising the clinical research findings, the presentation will outline suggestions for practical guidelines for implementing rectal progesterone in HRT-FET protocols, including potential challenges, such as patient acceptance and side effects, as well as future directions for research in this field will be discussed. This presentation aims to inform and engage IVF professionals by advocating for the consideration of rectal progesterone as a viable option in ART, ultimately contributing to improved patient outcomes and experiences.
The city of Skive, located in West Jutland Denmark, is looking to develop a long term strategic urban development plan integrated with supporting climate adaptation pathways keeping Skive climate-proof for future conditions. In this study a Dynamic Adaptive Pathway Plan (DAPP) was used to investigate uncertainties with regards to future climate change and urban development. Similarly to uncertainties regarding climate change (e.g. Sea-level rise) and the associated change in risk, there is great uncertainty in the future development of the system (Skive) through a range of socio-economic variables. This will directly affect the solution space for climate adaptation. NIRAS, LYTT Architecture and Skive Municipality have developed a strategic urban development plan and investigated the implications and possibilities for climate change adaptation in Skive. It is one of the first fully developed DAPP processes in Denmark. The project illustrated the need for supporting uptake of dynamic decision making, the necessity of multi-disciplinary collaboration within the municipality, and the integration of land use considerations within the adaptation pathway development.
