Kalaitzopoulos Dimitrios Rafail

WESINAR: Discover key insights and themes from ESHRE 2025,. 23 Feb 2026 | 10:00am PST | 7:00pm CET Moderator: Dimitrios Kalaitzopoulos Speakers: Connie Rees, Anna Stepniewska, Laura Benaglia 👉 Register: tinyurl.com/pshk6xvm #WESinar #Endometriosis @DKalaitzopoulos

Summary of que 4⃣ moderated by @DKalaitzopoulos #ESHREjc

@juanjo_fraire @catiamalinina @Kristensen8511 @OmarRawi89 @ESHRE @juliauraji @AttilioDGM7 @GLiperis @Saara_riibeiro @NoemiSalme30386 I believe that, from a design perspective, it should not be difficult to conduct a retrospective clinical study examining the effect of paracetamol exposure during ovarian stimulation or embryo transfer, in order to obtain clinical evidence.

@catiamalinina @Kristensen8511 @OmarRawi89 @ESHRE @juliauraji @AttilioDGM7 @GLiperis @DKalaitzopoulos @Saara_riibeiro @NoemiSalme30386 I think it means that we shouldn’t overuse acetaminophen and while more research is available, take the decision on dose or alternatives with your doctor #ESHREjc

Q2: #ESHREjc Nielsen et al, showed the molecular effect of APAP 💊 on early embryogenesis. However, we cannot exclude its systemic effect. Could APAP also affect endometrial tissue during implantation? Would its effects extend beyond the peri-implantation period? @ESHRE

@GLiperis @ESHRE @OmarRawi89 @juanjo_fraire @NoemiSalme30386 @juliauraji @AttilioDGM7 @FabrizzioHorta I totally agree with you @GLiperis. The problem is that the alternatives do not appear to be less harmful than paracetamol. I think the main rule for paracetamole should be "use the lowest effective dose in the shorter time" and for sure not prophylactic #ESHREjc

@DKalaitzopoulos @ESHRE @OmarRawi89 @juanjo_fraire @NoemiSalme30386 @juliauraji @AttilioDGM7 @FabrizzioHorta I would think it’s important to avoid a blanket “no paracetamol ever” rule as it can push pts to unsafe substitutes. A suggestion would be to offer clear timing advice (avoid around trigger, implantation), but ok outside that window unless contra-indicated. #ESHREjc

Q4: #ESHREjc Until prospective data arrive, what’s a proportionate counseling message for TTC/IVF patients needing analgesia, what alternatives, what timing advice, and how to avoid over-restriction that drives unsafe NSAID substitution? @ESHRE

Over the next 24h will be engaging in discussion for a very common medication and its effect in embryological outcomes #ESHREjc 👇🏻

🚨Q1 #ESHREjc The study finds that APAP delays cleavage-stage divisions, while blastocysts keep total cells but show reduced ICM and DNA synthesis. What do these stage-specific vulnerabilities imply for implantation and embryo competence? @ESHRE

1/ This #ESHREjc we are discussing how a common analgesic Acetaminophen (APAP) may interfere with pre-implantation embryo development. Study in focus: doi.org/10.1093/humrep… A tweetorial to get you up and ready for tomorrow. #ESHREjc @ESHRE

🚨 Could a common painkiller disrupt the earliest stages of human embryo development? Join us for the next #ESHREjc 🗓️ 28–29 November ⏰ 17:00 CET start 📍 on @ESHRE 🔗 doi.org/10.1093/humrep… 🌟 @juliauraji, Thanos Papathanasiou & David Kristensen

Q3 on diagnostic pitfalls in adenomyosis and clinical outcomes in subtypes of adenomyosis #eshrejc By @GLiperis

Q4 on “ideal” setting of IVF #eshrejc By @NoemiSalme30386

Q2 on the role of diagnostic criteria of uterine anomalies By @AttilioDGM7

Q1 on control group for the role of uterine factor in RPL #eshrejc By @juanjo_fraire

Many thanks to all participants 🙌 and to @DKalaitzopoulos and his team for leading this great edition of the #ESHREjc

@GLiperis @ESHRE @CatenaUrsula Adenomyosis is a “shades of gray” rather than “black and white” condition so it is challenging to establish association vs causation and clinical relevance.

@GLiperis @AlexQuaas Should we define high-risk criteria? Yes — combining: Quantitative JZ metrics. Number of MUSA features (≥2 direct signs). Clinical phenotype (primary RPL, multiple losses). This could identify women most likely to benefit from early interventions or closer monitoring.

@NoemiSalme30386 According to this systematic review the prevalence of uterine factor infertility varies between 2.1 to 16.7%🤔 Studies are extremely heterogeneous More questions less answers #Eshrejc mdpi.com/2077-0383/11/1…

Q4: Moving into the “ideal” setting of IVF. ✨LBR after multiple ET reach 60–70% in women <35 years…. 🔎to what extent can the remaining failure be explained by uterine factors? could this account for the entire 30–40%? Or are we missing something else? #ESHREjc

@GLiperis @CatenaUrsula @AlexQuaas Usually Adenomyosis also co-exists with other entities. pubmed.ncbi.nlm.nih.gov/38103882/ #eshrejc @AlexQuaas

@GLiperis @CatenaUrsula @AlexQuaas Not every Uterus with Adenomyosis is the same This is also the reason for high heterogeneity between Studies on Adenomyosis associated infertility. A classification is needed!

Q3: What are the main diagnostic pitfalls in adenomyosis? How do clinical outcomes differ in subtypes of adenomyosis? Should we define specific criteria to identify those women at higher risk? #ESHREjc @CatenaUrsula @AlexQuaas