Female and Male Infertility

Introducing the APHRODITE criteria for male infertility diagnosis, prognosis and management

Continuing Medical Education (CME)

19 April 2024

Introducing the APHRODITE criteria for male infertility diagnosis, prognosis and management

Continuing Medical Education (CME)

19 April 2024

Podcast

APHRODITE, myth and fertility in ancient Greece

Infographic

MedEA elearning platform

APHRODITE Criteria: Five Groups in a Nutshell

CME Live Webinar registration

Live Session:
19 April 2024

From 13.00 to 16.00 Central European Summer Time (CEST) From 08.00 to 11.00 Brazil Time (BRT)

Live Podcast

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Infographic

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Overview

Male subfertility/infertility may be idiopathic, congenital or acquired but lifestyle, genetic, and psychological factors, and environmental stressors and pollutants, are implicated in the majority of cases. Clinicians have long recognised the need to improve the assessment and management of male infertility, especially in real-world settings.

Although many cases of male infertility can be corrected through lifestyle or clinical interventions, in the past treatment often centered on the female. As knowledge of spermatogenesis has increased, the potential role of exogenous gonadotropins in the management of selected cases of male infertility has emerged; there is a growing pool of evidence for this approach in humans. It is now essential that the clinician thoroughly investigates and accurately diagnoses the cause of male subfertility/infertility so that the patient’s prognosis is appropriately calculated and communicated. In alignment with this approach, the recent introduction of the APHRODITE criteria for male infertility management aims to improve the diagnosis, classification and management of infertile men.

This workshop and its complementary online activities have been developed by Professor Sandro Esteves, first author of the APHRODITE guideline publication [Esteves, in press 2024]. These guidelines explain recent biological and physiological knowledge relating to spermatogenesis, present the concept of the APHRODITE criteria and describe the application of these criteria in specific case-based scenarios.

Learning Objectives

After participating in both webinars, attendees will be able to:

Target Audience

The program is intended for clinicians, embryologists, andrologists, scientists, and managers working in ART who wish to update their knowledge of advanced techniques and scientific innovations and understand best practices using evidence-based models of care.

Accreditation

“The Introducing the APHRODITE criteria for male infertility diagnosis, prognosis and management, Virtual, Italy 19/04/2024 – 19/04/2024, has been accredited by the European Accreditation Council for Continuing Medical Education (EACCME©) with 2.5 European CME credits (ECMEC©s). Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity.”

“Through an agreement between the Union Européenne des Médecins Spécialistes and the American Medical Association, physicians may convert EACCME© credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME© credit to AMA credit can be found at https://edhub.ama-assn.org/pages/applications.

“Live educational activities, occurring outside of Canada, recognised by the UEMS-EACCME© for ECMEC©s are deemed to be Accredited Group Learning Activities (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.”

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Chairs

Sandro C. Esteves

Sandro C. Esteves

Androfert – Andrology and Human Reproduction Clinic
Campinas, Brazil
Peter Humaidan

Peter Humaidan

Fertility Clinic, Skive Regional Hospital
Faculty of Health, Aarhus University
Aarhus, Denmark

Faculty

Leen Antonio

Leen Antonio

Clinical and Experimental Endocrinology
Leuven, Belgium
Sandro C. Esteves

Sandro C. Esteves

Androfert – Andrology and Human Reproduction Clinic
Campinas, Brazil
Peter Humaidan

Peter Humaidan

Fertility Clinic, Skive Regional Hospital
Faculty of Health, Aarhus University
Aarhus, Denmark
Daniele Santi

Daniele Santi

University of Modena and Reggio Emilia
Department of Biomedical Metabolic and Neurosciences
Modena, Italy
Manuela Simoni

Manuela Simoni

University of Modena and Reggio Emilia
Modena, Italy

International Committee

Baris Ata

Baris Ata

ART Fertility Center
Koc University Istanbul
Dubai, United Arab Emirates
Alvaro Ceschin

Alvaro Ceschin

President of Brazilian Association of Assisted Reproduction (SBRA)
Brasilia, Brazil
Adriano Fregonesi

Adriano Fregonesi

Associate Professor Urology of State University of Campinas Brazil (UNICAMP) and Jundiai School of Medicine
Head of the Department of Urology / Andrology State University of Campinas Brazil
Delegate Sociedade Brasileira de Urologia São Paulo (SBU SP)
Joaquin Llácer

Joaquin Llácer

Ginefiv-GeneraLife
Madrid, Spain
Kevin McEleny

Kevin McEleny

Queen Elizabeth Hospital
Gateshead and the Freeman Hospital
Newcastle, UK
Habib Midassi

Habib Midassi

Polyclinique Ibn Annafis
Sfax, Tunisia
Paula Navarro

Paula Navarro

Ribeirão Preto Medical School
University of Sao Paulo,
Sao Paulo, Brazil
Amina Oumeziane

Amina Oumeziane

Tiziri IVF Center
Algiers, Algeria
Emre Pabuçcu

Emre Pabuçcu

Ufuk University School of Medicine
Ankara, Turkey

Partnerships

Scientific Programme

Live Podcasts series

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Agenda

· Sandro C. Esteves ·

Sandro C. Esteves, MD., PhD. is a reproductive urologist who specializes in treating male infertility, particularly its connection with assisted reproductive technology (ART). He is the founder and medical director of ANDROFERT, a Fertility Center based in Campinas, Brazil, dedicated to male reproductive health. He is also a Collaborating Professor of Urology at the State University of Campinas (UNICAMP), Brazil, and an Honorary Professor of Reproductive Medicine at Aarhus University, Denmark.

He obtained his MD. degree in 1990 from the Faculty of Medical Sciences of UNICAMP, Brazil. Subsequently, he completed his Urology residency at the same institution and a postdoctoral fellowship program at the Glickman’s Urological Institute at the Cleveland Clinic Foundation in the United States. He earned a master’s in Surgery from UNICAMP and a Ph.D. in Urology from the Federal University of S o Paulo (EPM-UNIFESP). Dr. Esteves has contributed to our understanding of male infertility with over 25 years of experience in clinical and academic settings. He has emphasized the limitations of basic semen analysis, the importance of assessing sperm DNA fragmentation in male infertility evaluations, and highlighted the relevance of varicocele and its treatment in enhancing male fertility prospects. He has also published extensively on his clinical experience with microsurgical treatment of infertile men, as well as on hormonal therapy for improving sperm retrieval success of men with non-obstructive azoospermia. Dr. Esteves has helped design novel stratification systems for infertile men with testicular dysfunction, for whom fertility prospects may improve after hormonal therapy, and for low prognosis infertile women undergoing ART. Dr. Esteves is a prolific author, and his research comprises over 350 published papers, numerous book chapters, and textbooks. With a Hirsch index of 71 and a citation count of around 17K, he is ranked among the top 1% of global researchers by the Science-Wide Author Databases of Standard Citation Indicators (Elsevier). Prof. Esteves plays an active role in the scientific community as a member of the Faculty Opinions in reproductive endocrinology and infertility and as a founding member of the POSEIDON group for reproductive medicine. Additionally, he holds positions as Associate Editor/Section Editor in several journals, including Human Reproduction, Andrology, Reproductive Biomedicine Online, Frontiers in Endocrinology, and the International Brazilian Journal of Urology. He also serves on the editorial boards of many scientific journals, including Nature Reviews Urology. Dr. Esteves’ clinic has been at the forefront of implementing cleanroom technology in the ART laboratory and adhering to ISO 9001 quality standards in Brazil. The ANDROFERT team is renowned for its strict quality standards and remarkable success rates in treating couples with male factor infertility. As a seasoned speaker, Dr. Esteves delivers over 50 lectures annually in Brazil and internationally. He has received multiple research grants and awards from national and international societies and currently holds the position of head of the Department of Andrology at the Brazilian Society of Human Reproduction.

· Peter Humaidan ·

Professor Peter Humaidan is a specialist in reproductive endocrinology, professor at The Fertility Clinic Skive Regional Hospital, Aarhus University, Denmark and Honorary professor at Odense University, Denmark. During his scientific work he has primarily focused on developing individualized treatment protocols for the infertile patient. His doctoral thesis (DMSc) explored the role of LH during the follicular and luteal phases in controlled ovarian stimulation. His main fields of interest are triggering of ovulation with GnRH agonist, role of LH during the follicular and luteal phases, role of the female genital tract microbiota for reproductive outcomes, OHSS prevention, and role of sperm DNA fragmentation for spontaneous and assisted reproduction. He is the founder of the international society “The Copenhagen GnRHa Triggering Workshop Group” who introduced the GnRHa trigger in modern IVF, changing trigger policies worldwide. He is co-founder of the POSEIDON group which suggested a new stratification of the poor responder patient, and a past board member of the ESHRE SIG Endocrinology Group. Finally, he is also co-founder of the APHRODITE group which suggested a new classification of the infertile male into five sub-groups who might benefit from medical treatment in terms of spermatogenesis. He is in the Elsevier, Stanford global list of 2% top scientists, and he authored and co-authored 270 + articles (H-index 70, Google Scholar) in international peer reviewed journals as well as chapters in textbooks and the Danish guidelines for OHSS prevention. Peter Humaidan has a wide international scientific network and is frequently invited as a speaker at international conferences.

· Leen Antonio ·

Prof. Dr. Leen Antonio, MD PhD, is a medical specialist in Endocrinology and Diabetes. She works as endocrinologist and andrologist at the department of Endocrinology of the University Hospitals Leuven, Belgium and as an assistant professor at the Department of Chronic Disease and Metabolism of the Faculty of Medicine, KULeuven, Belgium. As a clinician-scientist, her areas of expertise (clinical as well as research research) include andrology, reproductive endocrinology, male infertility, and steroid hormone measurements.

She holds the Clinical Andrologist Certificate from the European Academy of Andrology. She is a member of the guideline committee and male health awareness committee of the European Academy of Andrology and working group leader in COST action ANDRONET. She is associate editor for the Journal of Sexual Medicine.

· Daniele Santi ·

Dr. Daniele Santi obtained the medical doctor degree with Honors at the University of Modena and Reggio Emilia (UNIMORE) in 2008. He obtained with Honors the specialization in Endocrinology and Metabolism in 2014 and his PhD in Clinical and Experimental Medicine in 2017 from UNIMORE. Currently, Dr. Santi works as Assistant Professor at the Unit of Endocrinology of the Department of Biomedical, Metabolic and Neural Sciences of the UNIMORE. He obtained the national scientific qualification as associate professor in Endocrinology (MED/13, 06/D2), in 2020.

He has published 135 manuscripts in peer-reviewed journals (ORCID: 0000-0001-6607-7105), with 3200 citations and a H-index of 30 (Scopus).

In 2015, he obtained the ESE (European society of endocrinology) young investigator and the under-32 SIE (Italian society of endocrinology) awards. He is coordinator of the committee “Young endocrinologists” in both SIE and Italian society of medical andrology and sexual medicine (SIAMS). He is member of the executive committees of SIE and general secretary of SIAMS. He is associate editor a member of the peer-reviewed “Andrology”, “Frontiers in Endocrinology” and “Reproductive Medicine” journals. Moreover, he is the andrology section Editor for the new peer-reviewed journal “Reproductive, Female and Child Health”. He was editorial assistant of the peer-reviewed “Andrology” journal from 2018 to 2020.

· Manuela Simoni ·

Manuela Simoni trained as a clinical endocrinologist at the Endocrinology Unit of the University of Modena in Italy between 1982 and 1990, following this with training as a molecular endocrinologist at the Institute of Reproductive Medicine of the University of Münster in Germany. She was Professor for Endocrinology and Molecular Biology of Reproduction at the University of Münster from 1998 to 2008, being appointed to her current position as Professor of Endocrinology at the University of Modena and Reggio Emilia in 2008.

Professor Simoni’s research interests are in: gonadotropin and androgen action; testicular function; male infertility; and the endocrinology and pathophysiology of reproduction. She is a member of several societies, including the European Academy of Andrology (EAA) and the European Society of Endocrinology (ESE), serving as the ESE secretary until April 2018, and is active on the editorial boards of several journals in the fields of endocrinology and reproduction. She has been Co-Editor-in-Chief of Andrology, the official journal of the EAA and the American Society of Andrology (ASA), since January 2017.

· Baris Ata ·

Baris Ata graduated from the Istanbul School of Medicine in 1998. He completed residency training in Obstetrics and Gynecology in 2003. During medical school and residency training he attended courses on research methodology, assisted reproduction and gynecological endoscopy around the world. His keen interest to improve his research skills led to acquisition of a Master’s Degree in Clinical Trials from the prestigious London School of Hygiene and of Tropical Medicine. He completed a three years long clinical and research fellowship program in Reproductive Gynecological Endocrinology and Infertility at McGill University, Montreal, Canada in 2011. Upon returning to Turkey he founded and assumed the directorship of the assisted reproduction unit of the Uludağ University, a highly successful program that grew to over 500 IVF cycles per annum in less than two years. He recently moved to Koç University. He has several awards of excellence as a resident, fellow, clinician and scholar. His research is on clinical aspects of female infertility including but not limited to ultrasound imaging of female reproductive tract, luteal phase physiology and support, prevention and management of ovarian hyperstimulation syndrome and in vitro maturation. Baris has over 100 publications on various aspects of assisted reproduction. He is sitting on the editorial board of six journals including Human Reproduction, and is a regular ad hoc reviewer for leading journals in his field. He is a member of the executive board of the Turkish Society of Reproductive Medicine and the board of directors of the International Society of In Vitro Fertilization.

· Alvaro Ceschin ·

Graduated in Medicine from the Federal University of Paraná (UFPR), in 1985.

Training in Human Reproduction at the Huntington Reproductive Center in Pasadena, California/USA, in 1991.

PhD in Principles of Surgery, in the area of concentration in Molecular Biology, from UFPR, completed in 2006, with the theme: “Comparative study of the viability of ovaries cryopreserved by slow freezing and vitrification – study in rats”.

Residency in Gynecology and Obstetrics at the Santa Brígida Hospital and Maternity Hospital, in Curitiba/PR, from 1987 to 1989.

Master’s degree in Principles of Surgery from the Research Institute of Faculdade Evangéilca do Paraná in 2002, with the theme: “Indirect hormonal assessment and study of follicular preservation in autologous ovarian tissue transplanted to the inguinal region, in rats”.

· Adriano Fregonesi ·

Free professor at the surgery department at UNICAMP. Assistant to the urology discipline at UNICAMP. Coordinator of the andrology sector of the urology discipline at UNICAMP.

· Joaquín Llacer ·

Dr. Llácer has over 30 years of experience in the field of assisted reproduction. He holds a Degree in Medicine and Surgery from the University of Valencia, specializing in obstetrics and gynecology at Hospital Universitario La Fe (Valencia) and holds a PhD in Medicine from the University Miguel Hernández of Elche. During the past 26 years Dr. Llácer has been part of the team of gynecologists at Instituto Bernabéu, where he also took part in the medical direction of the group and was a member of the Board of Directors.   

Among his professional achievements it was particularly noteworthy the extraordinary doctorate award for his thesis, as well has being awarded by the British Fertility Society and the American Society for Reproductive Medicine. In addition, Dr. Llácer has combined his medical activity with academic teaching in different master’s degree at University Complutense of Madrid and University of Alicante. He has authored over 50 papers in reproductive medicine journals, both national and international, and is currently a member of the scientific committee of the Spanish Fertility Society (SEF).

· Kevin McEleny ·

Mr Kevin McEleny is a Consultant Urologist working both in Newcastle and at the Queen Elizabeth Hospital in Gateshead since 2009.

He is also Consultant Andrologist and Clinical Lead for the male factor clinic at the Newcastle Fertility Centre, located at the International Centre for Life, Times Square, Newcastle upon Tyne.

After completing his medical training and PhD at University College, Dublin, he continued his urological training in the Northern Region prior to his consultant appointment.

His main clinical interests include treating and diagnosing men with fertility problems. He organised and delivers the supra-regional Male Fertility service.

His research interests are in the field of male fertility and he is actively involved in male fertility training nationally.

· Habib Midassi ·

Assistant professor of obstetrics and gynecology,Sfax university.Tunisia.(1987)

Mr Habib has completed his higher accreditation in Obstetrics and Gynecology in 1986

He works six years  as a consultant  in the Sfax teatching hospital .in 1988 he has his private office of gynecology and obstetrics.Since 2007 he also works in the IVF  center  of the polyclinic Ibn Annafis ,Sfax.Tunisia.

He has a wide experience in treating infertile couple with the first specialized fertility consultation in Tunisia (1984) .

Besides laparoscopic  Surgery, his professional interests include ovarian reserve ,luteal phase support and medical treatement of uterine fibroids

· Paula Andrea Navarro ·

Associate Professor at FMRP-USP (Human Reproduction Sector, Department of Gynecology and Obstetrics), President of the Scientific Integrity and Good Practices in Research Committee at FMRP-USP, Director of the Assisted Reproduction Laboratory, Deputy Coordinator of the Human Reproduction Center , Coordinator of the Postgraduate Program in Gynecology and Obstetrics at FMRP-USP, President of the Brazilian Society of Human Reproduction (SBRH, biennium 2023 to 2025), Member of the Technical Chamber of Assisted Reproduction of the Federal Council of Medicine and Member of the National Commission Specialist (CNE) of Assisted Reproduction of the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO). Researcher at the National Institute of Sciences and Technology/CNPq – Hormones and Women’s Health, Ad Hoc consultant for FAPESP, CNPq and CAPES. Chief Editor of the Human Reproduction Archives, Associate Editor of Reproductive Sciences and the Brazilian Journal of Ginecology and Obstetrics, Member of the Editorial Board of the Journal of Assisted Reproduction and Genetics and Ad Hoc reviewer for several high-impact scientific journals. Graduated in Medicine from the Faculty of Medicine of Ribeirão Preto at the University of São Paulo (FMRP-USP; 1995), medical residency in Gynecology and Obstetrics at the Hospital das Clínicas de Ribeirão Preto (HCRP-USP; 1999); master’s degree (2000), Research Fellow in Reproductive Endocrinology and Infertility, Women and Infants Hospital, Brown University and Laboratory for Reproductive Medicine, Marine Biological Laboratory (2001-2002) and PhD (2003) in Health Sciences, Gynecology and Obstetrics, FMRP -USP. Post-doctorate at New York University (2016-2017). His main research interests include: Understanding the etiopathogenic mechanisms of endometriosis-related infertility and other infertility factors; Improving the efficiency of assisted reproduction techniques; Evaluate the efficiency and safety of new strategies (adds on) in assisted reproduction procedures; Improvement of fertility preservation strategies, especially oocyte freezing; Improving access to infertility treatment

· Amina Oumeziane ·

Dr Oumeziane has a Medical Degree from Medicine’s Faculty, Algiers in 1989 and Post Graduate Degree-Specialty in gynecology obstetrics from medicine’s faculty, Algiers in 1994.
Completed her training in reproductive medicine at Cochin hospital Assistance Publique Hôpitaux , Paris.
In 2000, received Academic Diploma of Investigation and Management of Infertility from Medicine’s Faculty Rene Descartes Paris, France in 2007 and Diploma in Basic of Reproductive Medicine and Embryology from International School of Medicine Kiel, Munich in 2012.
Head of Tiziri ivf center in Algiers since 2004.
Founder of of subspeciality certificate in infertility in 2019.
Amina Oumeziane is the founder of the Algerian Society of Reproductive Medicine (SAMERE), served as its First president from 2013 to 2016 and Scientific Director from 2016-until now.

Member of the American Society of Reproductive Medicine (ASRM) and European Society of Human reproduction and Embryology (ESHRE), Reviewer in global reproductive health IFFS journal, RBMO and MEFS journals Amina’s major interest areas: Luteal phase, Agonist triggering, Frozen strategy, poor responders .

· Emre Pabuçcu ·

Emre Göksan Pabuçcu was born in Ankara in 1981. After graduating from TED Ankara Private High School, he started his medical education in Ankara University Faculty of Medicine. He completed his residency program in the Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine. He has been working at Ufuk University, Department of Obstetrics and Gynecology since 2013 where he received his Associated Professorship in 2017. He has worked at Houston Fertility Specialists Clinic and Texas Woman’s Hospital, Texas (2016) as an observer in the field of preimplantation genetic testing and minimal invasive surgery. He has also been working at Centrum Clinic Private IVF Center, Ankara/Turkey since 2012. He is actively interested in Reproductive Endocrinology and Reproductive Endoscopic procedures.  He is a former board member of International Society of Gynecologic Endoscopy (ISGE). Dr. Pabuçcu is currently a reviewer of several local and international journals about Reproductive Medicine, Endocrinology and Endoscopy. He has published more than 70 papers in peer reviewed journals. 

· Martin O. Savage ·

Martin Savage is Emeritus Professor of Paediatric Endocrinology at William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary, University of London. He was head of the Paediatric Endocrine Unit at Barts and the London School of Medicine from 1982 to 2007. He has interests in growth disorders, specifically those with abnormalities in the GH-IGF-1 axis and in phenotype-genotype relationships of GH-IGF-1 axis defects, notably GH resistance. He published the first human case of an IGF-1 gene defect in the New England Journal of Medicine in 1996.  His other interests are Cushing’s syndrome and growth in chronic inflammatory diseases. He was General Secretary of the European Society for Paediatric Endocrinology (ESPE) from 1997 to 2004. He has lectured in 60 countries and has published 482 original articles, reviews, textbook chapters and books. In 2007, he was awarded the ESPE Andrea Prader Prize for contributions to paediatric endocrinology and in 2018 he received a Visionary Award from the American Human Growth Foundation. In 2022, he received a Research Excellence Award from the Dr Sulaiman Al Habib Medical Journal in Riyadh, and the British Society of Paediatric Endocrinology & Diabetes James M. Tanner Lifetime Achievement Award. He continues to lecture nationally and internationally.