ESHRE 2025 in Paris: Innovations in infertility treatment

The ESHRE 2025 annual meeting, held in Paris, was a true source of inspiration for reproductive medicine specialists. It was practical, modern, and rich in innovations aimed at improving the outcomes of in vitro fertilization (IVF). During numerous sessions, experts shared their experiences, presented research results, and discussed clinical cases in detail, making participation particularly enriching for practicing physicians.

PPOS + IUI — a modern alternative to traditional stimulation

PPOS is considered a promising stimulation protocol without the use of antagonists injections. Instead of daily injections, it uses progesterone tablets, which significantly improves patient comfort. Among the advantages of this method are:

• a reduced number of injections,
• convenience and safety,
• high efficacy in programs of oocyte or embryo cryopreservation.

This protocol is especially valuable for women planning a later embryo transfer or in complex clinical cases. When combined with artificial intelligence (AI) tools, this strategy enables personalized stimulation and minimizes interventions. It was emphasized that new digital solutions help physicians better predict ovarian response and reduce the risk of complications.

PERFORM — a study on the optimal hormone combination

Special attention was given to the European PERFORM study, which examined the correct dosing of FSH and LH hormones during ovarian stimulation. It was demonstrated that this combination helps increase the number of oocytes, improve embryo quality, and enhance pregnancy chances. It is particularly beneficial for patients with low ovarian reserve and women over 35 years old. It was also discussed that using such a protocol requires careful monitoring and flexible dose adjustments for each patient, made possible by modern data analysis algorithms.

Luteal phase support

Data presented at the conference highlighted the key role of progesterone support. It was shown that a progesterone level ≥ 9.2 ng/ml on the day of embryo transfer is associated with a 53% pregnancy rate versus 32% for lower levels. Therefore, monitoring progesterone levels before transfer and individually adjusting luteal phase support is recommended, especially if the level is below 9.2 ng/ml. The standardization of laboratory measurement methods was also discussed to eliminate variability between clinics and improve predictive accuracy.

Lifestyle factors: BMI and harmful habits

A body mass index (BMI) ≥ 25 is associated with lower progesterone levels, even at the same dose of luteal support, reducing implantation chances. Smoking and alcohol consumption cause oxidative stress that directly affects embryo quality. Furthermore, the importance of physical activity and a balanced diet was emphasized, as these factors are directly linked to hormonal metabolism and the overall preparation of a woman's body for pregnancy.

Strategy for thin endometrium

When endometrial thickness is less than 7 mm, ESHRE recommends:

• optimizing estrogen support (by oral or transdermal route);
• considering the addition of PRP or growth factors (G-CSF) for circulation (although data is still limited);
• using hysteroscopy in cases of suspected adhesions and to exclude chronic endometritis.

Promising regenerative medicine methods were also discussed, such as the use of stem cells and biomaterials to improve endometrial quality. Although research is still in early stages, these approaches are drawing increasing interest.

Artificial intelligence in prediction

Developments from the Carlos Simon fund, recognized for their use of AI models to predict implantation and preeclampsia, deserve particular attention. These tools significantly reduce uncertainty and improve treatment personalization. Physicians highlighted that AI implementation not only aids in making predictions but also helps manage large clinical datasets, facilitating decision-making and reducing treatment initiation time.

Practical conclusions of the conference

• Personalization using Pergoveris (r-hFSH: LH ≥ 150 UI) increases the number of oocytes and treatment efficacy.
• PPOS + AI allows reducing the number of injections and improving patient comfort.
• Monitoring progesterone and individual dosing of luteal support increase success rates
• In cases of thin endometrium, optimized estrogen therapy combined with PRP/G-CSF and hysteroscopy yields good results.
• The use of PRP with DuoStim increases blastocyst maturity and quality.
• Controlling BMI and quitting harmful habits remain fundamental for successful IVF.

Main conclusions

ESHRE 2025 demonstrated that modern reproductive medicine is moving towards personalization, integration of innovative technologies, and a focus on individual patient factors. The conference was not only a scientific exchange but also a reflection of the sincere commitment of specialists to their profession. It emphasized the value of collaborative work among doctors, embryologists, and researchers who strive to unite efforts to increase the chances of successful motherhood. Emphasis was also placed on interdisciplinary approaches and continuous training, enabling the practical application of all new discoveries. The event's atmosphere was inspiring, reminding us that developments in reproductive medicine are not only about technology but also about attentiveness, empathy, and respect for each woman and couple seeking help. The specialists at NatuVitro fertility clinic follow all innovations, participate in symposiums and exhibitions to implement best practices for their patients. Thanks to this, patients can rely on access to the most advanced techniques, and the clinic itself strengthens its position as one of the leaders in assisted reproduction technologies.