The experience of the Orlando meeting:
The American Society of Reproductive Medicine had their meeting in Orlando this year.  I signed up for it and hoped to have a poster although my experience is that a poster is of little value unless you hustle around a lot asking people to look at it.  It is even more helpful to have a team, which I have done, but still nothing came of it except that I learned from others.

I got no chance for a poster, but since it was my first meeting they arranged to have mentor who would see that I got to the places I needed to in order to get the most I could of out the meeting.  My mentor and I planned to meet when he came it; I would pick him up at the airport and run him to his hotel and I thought this would be a good chance to show him what I knew and what I wanted.  My notes were posted as “Orlando Meeting” a couple of days ago. 

I was actually sitting in baggage claim waiting when I noticed I had missed a call.  It was my mentor.  Unforeseeable things had prevented his making the conference, so I was on my own.  At least I had done my homework, so it pretty much worked out well.  The specific questions I had were addressed or I found I could run them down later.

What I really missed was a chance to spend a few minutes with one of the top experts and my notes and get some high end feedback. 

Meanwhile I noticed three things:

1. By and large the people I could actually corner were not totally comfortable with the field of fertility.  I have lost track of the number of times I mentioned pre-zygotic and post-zygotic infertility and got a blank look.  Of course the zygote is the egg-sperm combination, and anything that causes infertility by preventing it is pre-zygotic.  If you look back at the notes you will see that sperm in some species can recognize kindred sperm.  If, as I suspect, they also recognize kindred eggs, and avoid anything else, that would be pre-zygotic.  Anything that causes infertility after the zygote forms is post-zygotic.  For instance sperm counts have been falling the world over for many years.  Yet there is no sperm count crisis.  As it turns out, periodically the UN does a survey and decides what the range of normal is and publishes it.  Not everybody is totally happy, but nobody seemed to put their finger on the long term trend.  Every time the sperm count falls, they just redefine normal.  Anyway, pre and post zygotic are pretty basic concepts if you want to talk about fertility.  Since my contacts were puzzled by the terms I am pretty sure nobody is looking at the basics.
2. At the top of the food chain, it was clear that there were many highly intelligent and caring people who were simply too busy to attend to me.  I shall be writing to a number of them.  At least they were generous enough to agree to look at the notes when I sent them.  We shall see if anything comes of it.
3. At the low end of the food chain not everybody was polite.  In fact I got my ears boxed pretty regularly.  This I had expected and could discount.  But the idea that a person could be fertile with one partner and not with another simply was not on the table.  Hour after hour, day after day the details and paradoxes of assisting reproduction were discussed.  Sometimes they would give data showing that this factor or that just didn’t matter.  For instance there is sperm count, which is a poor predictor of fertility; men with excellent sperm counts are often infertile.  I would think that would scream, “Wrong mate!” but it does not.  On the other hand, whether the sperm looks good, is shaped properly, means even less.  Get this: a sperm can be so degraded that 70% of it’s DNA is fragmented and still be fully fertile.  The egg goes through the DNA, sorts it out and puts it together.  I am thinking, “Right mate!” but that does not come up for discussion.  And the presentations were so good, the amount of science so impressive and the speakers so candid that I began to think they could not possibly be far from the truth.  I began to doubt my own interpretation of the facts.  That was a rather spooky experience.  And it made me feel dreadful.  If others are as troubled as I was getting to be, no wonder they don’t want to talk about it.  But I couldn’t give up.  I had my notes.  The facts were all laid out.  They never changed.

So it was quite the experience.  Among other things, of course, I bought a textbook which includes a section on fertility.  When it arrives I shall be better able to orient to what others are thinking.  For instance one step in fertilization is when the sperm sticks to the egg.  Exactly what is the mechanism?  How to they bind?  I have an idea, but I need to see the party line.

Update: The book says nothing about how the sperm sticks to the egg. I sent out about a half dozen messages to eperts, half of whom I had spoken with and recieved promises of reply. So far nothing. We plug away.

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