Activity Detail
Anniversary Lecture
Innovations in Reproductive Medicine. From the Bench to the Bedside
Carlos Simón
Infertility specialists have been primarily concerned with optimizing short-term outcome in the first trimester of pregnancy, while maternal-fetal medicine specialists focus on issues surrounding the diagnosis, treatment, and prevention of the “great obstetrical syndromes” which largely emerge in the second and third trimesters. Thus far, these disciplines have been operating in parallel, but multiple lines of evidence have now coalesced to support the concept that most complications of pregnancy, including the absence of it, emerge from disorders which have their origins in the periconceptional space, at the time of embryo implantation and placentation initiation. A major challenge in the 21st century is to consider how the recently generated knowledge and technologies can improve personalized medicine in the periconceptional care for the benefit of patients with infertility and to prevent pregnancy complications. In this presentation, I will present the biological plausibility, scientific demonstration, and clinical proof of concept of different translational lines performed at the Carlos Simon Foundation. These lines consider the human embryo at the genetics and imaging levels, the maternal endometrium reviewing the current knowledge about the endometrial microbiome and endometrial receptivity as well as emerging evidence linking a decidualization defect inducing impaired cytotrophoblast invasion as a possible cause of euploid miscarriage, preeclampsia and other obstetrical syndromes. Delivering a healthy baby—the most important battle for prospective parents—should be won before gestation is even initiated. The convergence of reproductive medicine and obstetrics in the periconceptional space has great potential to unravel the pathologies that have been always impacted women´s reproductive health.