Welcome to another Beyond the Webinar episode of the I3 Podcast, where we're joining the after party which followed the Embryo Biopsy webinar which you can view in full here. Nearly 1k people joined the webinar which focused on the practice of blastocyst biopsy with experienced biopsy practitioners. It was a fascinating conversation highlighting the practicalities when performing this delicate technique in the routine IVF lab, giving valuable advice on the methods, troubleshooting and tips. In this episode you will join the moderators Thomas Elliott and Dr. Tony Anderson along with speakers Debbie Venier, Dr. Charlene Alouf and Dr. Bec Holmes and members of the I3 team all discussing how it went 

What was discussed:

• Re-biopsy something every embryologist possibly has questions on - challenges around rebiopsing 
• TBR’s - when the embryo doesn’t seem worth it
• When TBR’s are planned according to when the lab has time  
• The impact on a lab that is short staffed. 
• Cost implications 
• Data available on rebiopsy age vs aneuploidy/ euploid
• Grading
• Read rates - spectrum and how labs vary 
• 40% of embryos tested have aneupoliody and the impact this has on implantation
• Should these test be done on all patients?
• The impact on Day 5 or Day 6 biopsy and implantation rates

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Welcome to another episode of the I3 podcast, where once again we go Beyond the Webinar to hear the discussions that followed two sessions recently shared with the I3 community. 

First up you will hear the panel's thoughts after the session called Quality Inside - discussing quality measures that are evident in IVF clinics across the globe and best practise- highlighting new technologies to help embryologists to obtain a robust quality control (QC) system for lab equipment and environment. Speakers included: Dr. Jean Popwell, Cassie Miller, Dr Mina Alikani, Dr Thomas B. (Rusty) Pool, Dr Gerardo Mendizaba Ruiz, Dr Michael Skumial and Dr. Alison Campbell and Ineabelle Collazo

Then you will hear the comments following the session titled ‘Mind the [generation] gap’ which focussed on showcasing the new demographic entering the ART workforce, the digital native, Gen Z and looked at how with an ageing workforce what will attract new talent to the profession and how best do labs work with different generations having different knowledge in terms of systems and process. 

Quality Control in the Cloud 

Watch the full session here 

What was discussed: 

• Cyber Security issues
• The impact that has in the lab & How labs can overcome the risks - guy around 7 min  
• Security within labs can be restrictive  - separate platforms have to be used for software that is being implemented. 
• How you have to think about every way software is implemented - Hacking can happen through Ultrasound machines
• What could happen if QC data is connected to patient success - how Dr Google could act against the lab with a patient seeing data and thinking something wasn’t done correctly? 
• You can anonymise systems
• Should data from an embryoscope be part of the medical record? Extra info that is discoverable could be misinterpreted. How sometimes too much information can be detrimental.
• Considerations about choosing a product that is customizable, so not everything goes to the EMR. 

Now we’re going to hear the panelists from the Mind the ‘Generation’ Gap which was hosted by Veteran senior embryologist, lab manager and mentor, Dr Kimball Pomeroy and former embryologist and current educator Huey Huynh, Panelists Savannah Palmer, Toyin Ojo and Angela Regan and Presenters: Fran Farlie Radhika Kakula-vara-pu and Chloe He

Watch the full session here 

• Discussion about obstacles affecting the LGBTQ+ community 
• Questions were raised about climate emissions from IVF and the importance of labs being sustainable. 
• Explanation of ‘Population Matters’ - Lobby group who are targeting students at Universities to think about their decision to have a family. 
• Discussions about population size issues - the world population is 8bn people, double since 1974. The rate we’re expanding is significant. 
• Discussion of how AI can help with more insight into Embryos 
• The difference in software usage amongst generations - gaps in knowledge 
• Importance of efficient databases/systems to ensure ‘user experience’ works for everyone, cross-generation. 
• Issues around finding new embryologists around the world - retractions on people practicing in different countries.
• Better funding for pipeline of talent in the UK
• Importance of awareness raising of what Embryology actually is - to attract more talent
• Lack of societal perceptions

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Welcome to another Beyond the Webinar episode, following the I3 session discussing Best Practices in Cryogovernance. The panel discussed how they are dealing with issues concerning the problems faced by clinics around the world with the increasing rising inventory of frozen specimens after IVF. The session was moderated by Senior Embryologist Dr. Mina Alikani, President of Alpha Scientists in Reproductive Medicine and British patient advocate and podcast host of The Fertility Podcast Natalie Silverman who was joined by an experienced panel consisting of a senior embryologist from Europe, Christianna Makri, lab managers from two large UK clinics Charissa Watchorn and Anastasia Mania and the vice president of clinical strategy of the TMRW group, embryologist Cynthia Hudson. 

The speakers were Dr. Michael Collins, Glenn Proctor, Dr. Steven Katz and Robert Perkinson.  We'd like to give a huge thank you to our session sponsor TMRW Life Sciences and you can watch the full session here 

What was discussed: 

• Different regulations around the world  - what they mean 
• Common worry globally worry about cryostorage amongst embryologists
• How bio-repositories in the UK are on standby for smaller clinics or partner clinics locally which have reciprocal agreements 
• What is going into cryostorage, it’s not just embryos it’s also eggs, so a 20yr old might not want them for a decade. 
• How patients are encouraged to discard or donate material because they don’t want to pay, but if there are no storage fees they might just forget about them
• How the industry needs to think about better communication, so the clinic is clear to patients about the process - roles and responsibilities. Guidelines with the paperwork about - being able to contact patients etc to help with the issue of orphaned embryos. 
• Better engagement is needed with the patient to give them the perceived value of what they have in storage 
• What protections are in place in the US and the issues that the industry faces
• Language used such as 'discarding' embryos creates issues for patients as it can be triggering and how patients can bury their heads in the sand when not knowing what to do with their frozen gametes. 
• Could there be a monthly fee, rather than the yearly storage fee?
• Coverage that clinics have for the storage and the attention that is paid to the tanks
• What can go wrong with Dewers - how problems are managed, how they are monitored.
• Warranty on Dewers
• Explanation of how TMRW storage process works  - it’s a specimen management software tool

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Welcome to another Beyond the Webinar episode of I3, where we bring you the conversation from after one of our sessions. This was a webinar looking at worldwide practices of transporting gametes and embryos, the new technological advances to keep samples safe, and the standards and regulations that should be applied. This session was kindly sponsored by Cryoport. 

The panel included moderators Giles Palmer and Jessica Bailey, panelists Victoria A. Wells, John Condon and Dr Simon Cooke and Presenters, Dr Kristen Ivani  who gave the embryologist's point of view, Deborah Mecerod who spoke about the demands of an egg bank, Bret Bollinger who explained the role of technology in IVF shipping and Dr Mark Sawicki talking about the future of cryo-transportation

You can view the whole session here 

What was discussed: 

• Is the UK being ‘blissfully’ unaware of this situation compared to the US? However, can it be compared considering the UK experience being on a smaller scale
• Lack of consistency in the notification from US centres that items have been delivered.
• Question about tank failure or tank being revalidated. 
• Tracking failure rate of shippers eg. based on structural failure 
• Critical checklist for the shipment process 
• How we don’t know what X-Rays in airports could do to samples
• There are times when it is Xrays as people aren’t paying attention to the request not to 
• Austria - open and Xray everything so some shippers try to avoid going through there
• Australia and New Zealand - bulletin on technical standards for shipping 
• Audits on the services
• Previously patients could take their own samples (which can still happen in the US) and they have to sign a waiver

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Welcome to another Beyond the Webinar episode from I3, following on from a recent webinar session of the same name called Return to Cairo which you can view here It brought together leading clinical embryologists, chemical engineers and professionals from the laboratory construction sector discussed the requirements of a modern laboratory performing IVF and ART. The prime focus of the session was on reviewing one of the most important, published paper reporting the outcomes from an international expert meeting on the recommended technical and operational requirements within modern assisted reproduction technology (ART) laboratories. The Cairo Consensus: DOI: 10.1016/j.rbmo.2018.02.005. The session was sponsored by LifeAire

In this episode, you'll hear the conversation that took place after the webinar with guest speakers: Dr. Sangita Jindal, Dr. Cihan Halicigil, Manar Hozyen, Dr. Chelsey Leisinger, Kevin D. Bomboy and Dr. Lars Johansson, Dr. Jacques Cohen and Dr. Katy Worrilow,

• Discussion about how impactful it was to see videos of other labs etc in Estonia
• Questions from the session were further discussed about VOC’s
• Smells people can smell in the lab eg. pine cones 
• Do light bulbs release VOC’s? 
• Issues around improper air ventilation 
• Use of Computational Fluid dynamics (CFD) to solve these issues 
• How VOC’s in plastics are dealt with 
• Importance of negative pressure for off gasing plasticwear 
• How negative suction is cost effective in planning 
• Optimal temperature range within labs

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Welcome to the latest episode of the I3 podcast where we are sharing the Beyond the Webinar discussion following our webinar discussion on whether people in person should be entitled to fertility treatment and fertility preservation. Should prisoners retain the right to a private or family life? Should restriction to procreation form part of their sentence? It was a fascinating conversation and do make sure you watch the main session which you can view here 

What was discussed: 

• Smuggling Sperm 
• People incarcerated with frozen eggs outside - what happens with consent? 
• Can they have a surrogate? 
• Can a man with frozen sperm who is incarcerated and his wife start fertility treatment? 
• can it happen, if the clinic gets consent? 
• How consent happens - in person or virtually
• Kits available today have made it easier for young men to freeze their sperm
• Risk of infection if a man was to try and collect his own semen in a prison environment
• How ART has made it possible for so many different scenarios
• Data says that there is less reoffending when you are given congenital visits. 
• Genetic assessment of criminality.
• Clinics declining or postponing consent
• ‘Meaningful productive parental relationship’
• The welfare of the child considerations
• Impact on a child or a prisoner
• Healthcare access in prison- where does ART fit?
• The overturning of Roe v Wade and its implications

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A special podcast about the overturning in the US of Roe v Wade and its global implications.

A joint venture with the International IVF Initiative (I3) and Doctors for Fertility- a group of reproductive endocrinology and infertility doctors with a mission to educate and inform policy on reproductive rights and to advocate and take political action for continued access to fertility treatment and preservation.

Almost half a century ago, the Roe v. Wade ruling was the basis for establishing a constitutional right to abortion. The recent decision in Dobbs v. Jackson Women’s Health Organization demonstrates the increasingly conservative direction of the court in the US and prompts questions about the implications for civil rights, embryo rights, and health policy.

What does this mean for IVF?

It has raised fears that it could have "far-reaching ramifications" on people looking to get pregnant and the clinics providing services to help them.

Will embryos created, frozen, used in fertility treatment, PGT, or discarded have rights?

Will "trigger laws"  go into effect that recognizes an embryo as a person?

This closed zoom meeting with open dialogue involving a select panel of experts will offer content to help all that are impacted by this ruling.

With examples of restrictive policies in the past and a call for action for all stakeholders, this podcast should support

everyone that needs help and will offer advice to organize individuals and communities to fight restrictive IVF legislation in vulnerable States.

Participants:

Serena H Chen MD

Giles Palmer

David Sable MD

Davina (Rudnick) Fankhauser

Dr. Vivienne Hall  

Salu Ribeiro

Lucky Sekhon MD

Lowell Ku MD

Colleen Quinn

Stephanie Gustin MD 

Declan Keane  

Jacques Cohen PhD

Lea Wilcox

Cynthia Hudson

Thomas Elliott

Mary Ann Szvetecz

Brad Zavy

see also:

Doctors for Fertility

Fertility within Reach

Bill relating to clinical laboratories

A New Challenge for Fertility Patients?

Modeling IVF Access Post Repeal of Roe v. Wade

Hippocratic Oath

The Solemn Truth About Medical Oaths

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Welcome to the latest behind-the-scenes podcast from I3, which took place after two Legacy sessions, discussing the need for embryologists globally and the changing challenges and demands of the embryologists, the demographics of the people working in an IVF laboratory, and ways to retain, train and recruit embryologists into the workforce as more of the veteran embryologist retire. Speakers during the sessions included:  Giles Palmer, Bill Venier, Andrew Thomson, and Dr. Gloria Calderon, Eva Schenkman, TJ Farnworth, Andrew Thomson, Dr. Alison Campbell, Dr. Tony Anderson:  The second part of the webinar which is also discussed in an after party here - continues on with this topic and Giles Palmer is joined by Keshav Malhotra, Dr. Tony Anderson and Eva Schenkman, Elina Roumian, and Dani Smale, Debbie Venier and Dr. Joe Conaghan. 

What was discussed: 

• Talking about filling spaces 
• Why does someone leave suddenly? If that happens you need to figure out why as any good team member will give notice eg. 1 year 
• Team having an exit strategy  - post-pandemic 
• How busy are the training centres - currently booked out until June 2023
• How the training has been reinvented with 2-3 month courses and how beneficial they are, delivering programmes in a condensed fashion enabling junior trainees to get more experience 
• People who come off the courses are hot commodities - end up being part of a bidding war as candidates have several offers
• Salaries that are 30/40/50% than 12 months ago 
• People aren’t let go - until they are comfortable with procedures such as ICSI which is different from older courses where you only got a few hours of hands-on experience 
• Helping to teach in a custom way to a network’s protocols  - signing NDA’s. 
• There is a reluctance from clinics to not have the teacher’s methods taught - instead, the clinic needs to trust 
• Consultant trainers- go into clinics to train someone who can’t travel

SESSION 2: 

• IVF Olympics - challenges for senior embryologists that trainees do but with opposite hand 
• People approaching embryologists to be mentors on Linked In
• Encouraging students to use social media such as Linked In to help them find work and build connections 
• Mentors and building your network which is so important as at some point in your career you will come across a problem where you need to call someone outside your network to solve it
• Get involved with associations and communities 
• To talk to new people when you go to meetings, find people in the same boat as you to support you
• Are Embryologists introverted people?
• Importance of putting yourself out of your comfort zone to talk to other people. 
•  

Legacy Session 1 

Legacy Session 2 

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Welcome to this episode of Beyond the Webinar from the International IVF Initiative I3 podcast. Here you are going to hear two conversations that took place after session 95 and 95 - which had a tech focus, looking at how the advances in the digital world are impacting ART.  The first conversation was moderated by Dr. Charles Bormann, Dr. Irene Dimitriadis, and Olcay Ocali with panelists Lizeth Barrientos and Giles Palmer, who also participated in a round table discussion with Dr. Gerardo Mendizaba Ruiz and Alejandro Chavez Badiola. This session was sponsored by IVF 2.0. 

The second was discussing how there are now available a wealth of apps from ovulation trackers, period trackers, and fertility apps...Reproductive BioMedicine Online explored the latest tech that patients are using with Professor. Alice Doma, Alison Meyers, Dr. Ka Ying Bonnie Ng, Dr. Eri Maeda, Prof. Joyce Harper, and it was moderated by Prof. Nick Macklon and Prof. Jacky Boivin have a listen to how the participants felt the sessions went, and make sure you check out the show notes to find out details of how you can watch both sessions 95 and 96 in full as we’ve included all the links you need: 

 What was discussed: 

• Is it too soon? 
• Using it as an assistant to help introduce the concept to the scientific world and patients. 
• When is the right time to trust computers? 
• We’ve already done it, it’s just a lot of people don’t think about it.. Eg. a plane often isn’t piloted
• Saying to a patient ‘A computer is selecting your embryo’ is scary
• Lots of different options on how people feel about trusting a computer 
• AI is a constant - it needs to be tested and tested again, however as a constant factor between embryologists and doctors it is a great asset. 
• The challenge of building synthetic cycles 
• Consistency when embryologists go on holiday - AI could offer a solution 
• When decisions have to be made by humans. Computers don’t have context. 
• AI is the assistant, not the decision maker 

View the whole session here 

Before we join the afterparty of our second Beyond the Webinar session, do make sure you check out the show notes of this episode so you can find details of how to watch the full session that is being discussed. We’ll join the speakers now: 

 Session 2: 

• Expectations from apps - mean people’s expectations in clinics have changed 
• Early career researchers reflecting back 
• Difference of opinion between loss and gain between generations 
• Chief Compassion Officer  - going to be responsible for the care patients get in terms of stress and also all the stress levels of employees ( 79 clinics ) 
• Burnout of employees needs to be addressed first, people are quitting and making mistakes 
• Impact of corporatization on IVF  - means apps are crucial 
• Recommendations need to be helpful  - training physicians to behave empathetically to improve patient care 
• Paper - on how if staff is having problems in clinics how can they provide the care they want. LINK
• A squeeze of time means apps are so helpful and useful as they give you more time. 
• Discussion of conferences online and in-person - will in person survive the test of time. 
• Careers and friendships are made in person 
•  

View the whole session here 

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What was discussed:

• Kathryn talking about how she got into the world of embryology 
• Her previous work with co-culture 
• When she first saw the importance of air quality - literature to identify the relationship between air quality and the culture of the human embryo. 
• Realisation when leaving lab and saw that there of tarmac happening outside the lab and how it was linked to air quality in the lab
• Started to monitor outside activity to see the drops in cellular and clinical outcomes. 
• 2017 Cairo  Consensus -discussing clean room concepts 
• Research launched once they knew the common VOC’s to look at how they are impacting the embryo
• RBM online publication on the ‘mode’ of publication 
• Biggest threats to a lab
• Important for embryologists to understand the toxic pathogens that are outside eg. off-gas equipment 
• Improvements on the Cairo consensus? Discussion of how much we’ve learnt since then 
• Which VOC’s are most common in IVF labs and where they come from, materials which should and shouldn’t be used 
• How their engineers work  - look at ‘asbuilt drawings’ to start to find cubic volumes of air - they want to protect every molecule in that space 
• How covid impacted their business - who they could help

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