Minutes from the 1st JOINT
ASRM/ESHRE/APEA MEETING
16 September 2005 in Maastricht
About 30 people were present at
the meeting chaired by Agneta Bergqvist (Coordinator
ESHRE SIG Endometriosis and Endometrium) and Robert
Taylor (Chairman ASRM SIG Endometriosis and Endometrium).
The welcome was by Agneta Bergqvist, who explained
the background for the meeting, which aimed to foster
global collaboration in the field of endometriosis.
The following items were discussed:
1.
Guideline for the diagnosis and treatment of endometriosis
(Gerard Dunselman)
The ESHRE guideline has been developed
and published in Human Reproduction in the October
issue and is now available at www.endometriosis.org/guidelines.
This has been adopted by the Dutch Society for Obstetrics
and Gynaecology, and the Royal College in the UK
will most likely do the same.
The ASRM practice committee receives
input from members, and a guideline cannot be published
unless it is approved by the practice committee
and the board of directors. Guidelines are in the
process of being developed for various aspects of
endometriosis. It was noted that there are legal
implications to guidelines in the USA.
It was agreed to evaluate what
is available at the moment and compare it to the
ESHRE guideline to determine to what extent these
can be combined.
ACTION:
Robert Taylor to review the ESHRE guideline, and
subsequently discuss with Robert Rebar, who will
send recommendations to the practice committee.
2.
Research initiatives
(Martyn Stafford Bell and Thomas
D’Hooghe)
The issue of prospective trials
where large numbers of patients are required also
require collaboration between multiple centres,
but there is always the issue of funding of these.
The type of collaboration that would be needed between
SIGs and WES in order to address this needs to be
discussed, especially in the context of funding
and structure.
ACTION:
A working party was convened to address these issues
and come up with suggestions/a report to this group
by the end of the year, resulting in a proposal
to the ESHRE SIG business meeting on 18 June 2006
in Prague. The working party consists of: Martyn
Stafford Bell, Thomas D’Hooghe, Luk Rombauts,
David Adamson, Robert Taylor, and Lone Hummelshoj.
3.
Relationship with industry
(Robert Rebar)
Industry is really only interested
in product-related research, though occasionally
there are opportunities for small funding for medical
liaisons (outside of the traditional remit of it
being product-related). It was agreed that people
around this table ideally are the ones who should
be designing studies. If studies were designed in
parallel and/or with similar structures this would
be very helpful.
It was suggested that it may be
an idea to write a protocol and get it approved
by the various scientific bodies around the world.
The NIH will fund a meeting on
Friday 20 October 2006 to achieve consensus regarding
the best way to measure pain in clinical trials,
where all stakeholders will be represented (clinicians,
scientists, patients, and industry). Regulatory
representatives (FDA, EU) should be included as
well. The meeting will be organised by Pam Stratton
(NIH) and Stephen Kennedy (University of Oxford).
With representatives from industry there it is an
opportunity to get the message across on what needs
to be done and how it needs to be done.
The challenge is that enthusiastic ideas and groups
convene, but it can be discouraging to have to wait
for funding.
It was raised that we should look
at ways in which to decrease costs – and then
go to the health authorities to ask them for funding
if we can prove that we are saving money in health
care. There may also be opportunities to follow
this approach with insurance companies.
ACTION:
Stephen Kennedy to keep everyone abreast of the
NIH meeting.
4.
Classification system for endometriosis
(Agneta Bergqvist)
There was little time for discussion,
but it was clear that the current staging system
is not working as it does not take into consideration
all the factors affecting endometriosis, including
active/inactive disease, progression, etc. It was
suggested, however, that if we keep the current
system, all that would needed to be added is symptoms
and a note on whether the disease is subtle or deep
infiltrating endometriosis.
David Adamson will be publishing
a validated and robust staging system for infertility,
which is created out of raw data.
ACTION:
David Adamson needs to circulate this to the group
once it is published, and then this issue needs
to be addressed further at future meetings.
5.
Cooperation /differentiation between WES and SIGs
(Agneta Bergqvist)
With the emergence of an alliance
between the ASRM/ESHRE SIGs it was asked whether
the WES still has a role to play. Whilst ASRM and
ESHRE are large organisations, with many members,
the benefit of the WES is that it is a global organisation.
It was agreed that mechanisms to
co-exist needs to be developed, including not organising
meetings in too close proximity to each other. Joint
meetings are also an option. Due to a lack of time,
this was not addressed further, but will be dealt
with in future meetings.
6.
Asia Pacific Endometriosis Alliance
(Susan Evans)
During this World Congress the inaugural meeting
of the Asia Pacific Endometriosis Alliance (APEA)
took place, and they were welcomed into the collaboration.
Contact
Susan Evans for more information or to join
the APEA.
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