2018年7月1-4日，國際人類生殖與胚胎醫(yī)學盛會——2018年第34屆歐洲人類生殖與胚胎學學會年會（ESHRE）在西班牙·巴塞羅那隆重召開。婦產(chǎn)科在線（www.peanutsfamily.cn）攜手益普生對本次大會進行現(xiàn)場報道。會議期間，大會主席Roy Farquharson教授接受婦產(chǎn)科在線的現(xiàn)場專訪。Roy Farquharson教授就會議學術主題安排設置和反復流產(chǎn)診治的未來前景、最新進展及ART后流產(chǎn)的處理經(jīng)驗等問題完成此次訪談。

Roy Farquharson

【專家簡介】
1975年在阿伯丁獲得醫(yī)學和外科學士學位；1986年在阿伯丁獲得醫(yī)學博士學位；1981年獲得皇家婦產(chǎn)科醫(yī)學院院士（MRCOG）稱號；1993年獲得皇家婦產(chǎn)科醫(yī)學院榮譽院士（FRCOG）稱號。

1986-2016年，他擔任利物浦婦女醫(yī)院婦產(chǎn)科顧問；1987年，他成立了流產(chǎn)診所，專注于治療婦女反復流產(chǎn)，并支持反復流產(chǎn)的調研、病因分析和管理的多學科合作研究。2006-2011年，他擔任英國早期妊娠分會協(xié)會的主席，ESHRE早期妊娠SIG的協(xié)調員。2010-2013年，他任NICE指南小組成員；2014年，擔任NICE異位妊娠和流產(chǎn)EUEG小組成員。2011-2015年，他擔任ESHRE執(zhí)行委員會成員，2015-2017年被任命為ESHRE委員會的主席。2010年，他擔任劍橋大學出版社出版的《早期妊娠》雜志的聯(lián)合編輯。2010年至今，他擔任《人類生殖醫(yī)學前沿》的副主編。

1、Good Afternoon,Mr.Farquharson.First let me wish the congress a complete success.The annual meeting of ESHER has a global influence in the field of human reproduction and embryology.As the chairman of ESHER,would you please briefly introduce the overall situation,the themes and the arrangement of the congress.
Roy Farquharson教授，下午好！首先預祝大會成功召開。ESHER 年會在生殖領域可謂是全球非常有影響力的大會，您作為ESHER的大會主席，請您介紹下本次大會情況，以及大會學術主題和內容的安排。

Pro.Farquharson  2018ESHRE年會大會主席：Thank you!As you know it is the 34th meeting of the European Society of Human Reproduction and Embryology annual meeting in Barcelona,Spain.We are looking forward to attracting probably 11,000 participants at the meeting this year.Our aims are education,training,practice and research.So this year we had a recorded number of abstracts submitted for research projects up to eighteen hundred ninety six were submitted.So of these,the best 225 for lecture presentations and about 800 posters as well,can be read online at the meeting.So overall,we are very pleased with the continuing response.And for the first time this year,we also have a festival attached the conference.But some of the quality of the studies has been very impressive.So I am very much looking forward to groundbreaking studies,new information,new insights into what we can do to improve the patients'experience of assisted Reproduction,ART,and hopefully, creating the family the desire.But we are at the beginning of the congress,full of optimism.And I'm sure that will continue for the next three days.

謝謝！這是第34屆歐洲人類生殖和胚胎學學會年會，在西班牙巴塞羅那召開。我們期待著今年或許可以吸引11000名參會者。我們的目標是教育、培訓、實踐和研究。所以今年我們收到了大量的摘要，多達1896份。所以我們從中選取了225份最好的摘要，邀請其研究者參會演講，另有約800份展出并可以在線閱讀?？偟膩碚f，很高興ESHRE年會持續(xù)被關注。今年，首次將年會和我們的節(jié)日一起舉辦。其中，一些研究的質量真是讓人印象深刻。所以我非常期待更多的開創(chuàng)性的研究、改善病人的輔助生殖體驗方面的新信息、新見解，同時，我們也期待能燃起家庭的希望?，F(xiàn)在，這次年會才剛剛開始，充滿著積極的氛圍，我相信這樣積極的氛圍將會在未來的三天持續(xù)下去。

2、We know you are an expert in recurrent abortion,would you please share your experience in diagnosing and treating spontaneous abortion?
您長期致力于反復流產(chǎn)方面的研究，能否請您分享一下您在反復自然流產(chǎn)診斷與治療策略方面的經(jīng)驗？

Pro.Farquharson  2018ESHRE年會大會主席：Yes,I'm very happy to share it.It's been a subject of study for our pregnancy group for the ESHER for many years.Recurrent pregnancy loss is very distressing condition for the couple.There are many units dedicated clinic to the recurrent pregnancy loss and the most recent ESHER guidelines this year is on recurrent pregnancy loss,give a very excellent evidence based on the analysis of the management and treatment for recurrent pregnancy loss.So I think for any couple with recurrent pregnancy loss,there are clear indications of the path ahead.And closes for optimism.It's not that you can cure every case,but the outlook for recurrent pregnancy loss is much better,much better than anticipated for the couple.

我很高興和你們分享。反復流產(chǎn)這個話題一直是ESHRE的主要課題。反復流產(chǎn)對于一對夫婦而言是非常痛苦的。現(xiàn)在有很多單位、診所專注于治療反復流產(chǎn)并在反復流產(chǎn)的管理和治療方面給出了非常棒的循證分析。所以我認為，對于反復流產(chǎn)夫婦而言，未來的道路是有跡可尋的，前景比較樂觀。這并不是說每種案例都能治愈，而是反復流產(chǎn)的前景會變好，會比預期的更好。

3、Have you met the cases of spontaneous abortion after got pregnant with the help of ART?Or have you studied the ART-related spontaneous abortion?
臨床中經(jīng)ART技術獲得妊娠后發(fā)生的自然流產(chǎn)的患者也有存在，您是否遇到過這類患者？或開展過ART技術與反復流產(chǎn)的相關研究？

Pro.Farquharson  2018ESHRE年會大會主席：Oh,my goodness,yes,a in my career,in liverpool UK women's hospital,you see about 300-400 new cases of recurrent pregnancy loss all over the UK every year.So it was a matter of making sure that we got to know the patient and her partner,and we would instigate investigation scheme,which is comprehensive.And following that,we would see them back to discuss the results.And following that,we will ask them to consider achieving a pregnancy.As soon as the new repregnant with a positive pregnancy test,they will report to the clinic and we will see them every two weeks until they were at least twelve weeks.The good news is that at least 70% of couples with recurrent pregnancy loss will be successful in the subsequence pregnancy after they've had a full scheme and appropriate management.

That ART pregnancies are just as prone pregnancy loss as Spontaneous conception.And I think the biggest cause is spontaneous chromosome abnormalities.And of course,this release,obviously,within the ART two regarding implementation failure because we think of the government plantation that is to school of thought.One school of thought thinks it's all to do with the uterus.And it's about endometriosis activity that might be different or abnormal.But as the other school of thought thing is all to do with the embryo that because of persisting or spontaneous films about this,the fertilized egg cannot implant a prolific.

So the two schools of thought are right.And they're not right,because it's the interaction between the embryo and the individual interface that we don't understand completely.But we want to know more.The only problem for us,of course,is that spontaneous chromosome abnormalities in the fertilized egg cannot be corrected.And the university little vast majority of the.So there's not enough what we can do about that.Some centers of the world would like to manipulate the embryo by selecting only those embers with a normal chromosome to replace as a mere transfer in ART.But of course,the results so far,not sure that it's any better than doing nothing at all.Because,as I say,seventy percent of couples with recurrent pregnancy loss will achieve success.whether they have this intervention or not. So obviously mother nature is looking after us and securing a baby for the majority of couples in the future with recurrent pregnancy loss.

是的,在我的職業(yè)生涯中，在英國利物浦婦女醫(yī)院每年你可以看到大約300 - 400反復流產(chǎn)的新增病例。這要求我們做到了解患者及其伴侶并且能為他們制定全面的計劃。在那兒之后，我們需要再次見他們討論檢查結果。之后，我們將請他們考慮懷孕。一旦懷孕，他們需要定期向診所匯報情況直到懷孕12周后。值得高興的事，至少有70%的反復流產(chǎn)的夫婦按照上述步驟做完后，成功懷孕。

通過輔助生殖技術受孕一樣容易發(fā)生自發(fā)性流產(chǎn)。我認為最大的原因是自發(fā)染色體異常。當然，這顯然存在于輔助生殖技術常見的兩個失敗原因之中，因為我們通常將其歸咎于不同的想法。其中一派認為失敗是和子宮有關，可能是子宮內膜異常。而另一學派認為失敗就是胚胎導致的，因為當我們持續(xù)拍攝可以看到,受精卵通常無法多次植入。

所以這兩個學派的思想是正確的。而他們又不正確，因為這是胚胎和個體之間的交互作用，對此我們還不能完全理解。但是我們想知道更多。當然，唯一的問題是自發(fā)的異常染色體在受精卵時不能糾正，情況大多是這樣。所以我們能做的還不足夠。世界上的一些生殖中心可能會想通過選擇擁有正常染色體的胚胎來操縱改變胚胎染色體異常的情況。當然，到目前為止，這種做法的結果還不確定，但這也比什么都不做強。因為,就像我說的70%患反復流產(chǎn)的夫婦會取得成功，無論他們是否使用這種干預。顯然大自然母親是照顧我們、保護大多數(shù)反復流產(chǎn)患者的嬰兒。

4、Is there any move-on or update in the study of recurrent abortion? Will you share the progress with us?
您們近期在反復流產(chǎn)方面有沒有新的研究？您們的研究進展或結論能否分享一下？

Pro.Farquharson  2018ESHRE年會大會主席：There is.There are various studies.In fact,the ESHRE meeting this week in barcelona, we have some groundbreaking randomized control trials that are trying out this compound that might modulate the immunology of the pregnancy,now immunimodulation and recurrent pregnancy loss has been linked together for many years.There are,for instance,two or three lectures in ESHRE this week,they will try and tell us that maybe it can be improved.But I think at the end of the day,we might be a little further forward,but that's not going to be an enormous breakthrough until we understand the whole fertilization process between experiment and egg much better.It is a lot of the causes are miserable or so we need to be aware and understand more.So the basic science of our understanding that will be presented this week will also increase our knowledge and understanding what might go wrong as well as what goes right.

有的。這方面的研究有很多。事實上，本屆巴塞羅那的會議中，我們有一些開創(chuàng)性的隨機對照試驗，嘗試該化合物會在孕期進行免疫學調節(jié)。免疫調節(jié)和反復流產(chǎn)的聯(lián)系由來已久。例如，這周有兩到三個ESHRE的講座就是講這方面，他們將試圖告訴我們，情況也許可以改善。但我認為可能在結束一天的會議后，我們也僅有一點點進步。這不會是一個巨大的突破，直到我們可以理解整個受精過程和受精卵。我們需要注意和了解更多原因。所以本周我們理解的基礎科學將讓我們對正確與錯誤有更深刻的理解。

5、In the past decade,China has made progress in the reproduction field. And we know,there are many Chinese physicians attending the congress.Do you have something to share with the Chinese Physicians?
近年來，中國的生殖醫(yī)學技術也在不斷進步，也有很多突出貢獻的專家、學者，本次大會也來了很多的中國醫(yī)生， 最后您可以和中國生殖領域醫(yī)生們 分享一些什么嗎？

Pro.Farquharson  2018ESHRE年會大會主席：Definitely!First of all,we welcome our Chinese delegates.We love the fact that you come all the way to Europe to attend the meeting.But we see with ESHRE and all the e-source is collaboration.We see that collaboration is the gateway to the future.And to welcome delegates,doctors,scientists in china.This is very good because it allows us to contribute in both directions.And ESHRE is a team to set up more educational collaboration projects with China.And already today,we had interviews with various members of the Chinese medical community and Chinese ART community to find out how we can improve our educational links between Europe and China.So we're optimistic there for the future too.
當然！首先，我們非常歡迎中國代表。你們不遠千里來到歐洲參加會議讓我們非常感動。我們可以看出ESHRE及其所有的電子資源的本質都是協(xié)作。合作是通往未來的途徑。我們歡迎中國的代表們、醫(yī)生和科學家。這點非常好，因為它使我們能夠進行雙向貢獻。ESHRE這個團隊和中國有著許多的教育合作項目。今天我們剛剛和中國生殖學會數(shù)位專家探討商談如何尋求中歐合作的契機來改善我們的教育紐帶。對此，我們對未來持樂觀態(tài)度。

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