Fertility apps are mobile apps that promote wellness, treat and diagnose disease, aid clinical decision-making, and manage patient care from the comfort of home. Patients suffering from infertility might find these apps helpful pre-fertility treatment as they can help to manage lifestyle factors, during treatment to manage medications and calendar appointments, use message boards where they can share experiences, seek or offer peer support, track and chart medical information such as cervical fluid, basal body temperature, and fertility medications and to time intercourse. Could you guess how many fertility awareness apps there are out there? 100! And they have more than 200 million downloads!

Fertility apps are changing the field of reproductive medicine to make it more understandable and easier to manage for patients! We understand that infertility is not easy to navigate and with rapidly developing technology comes some awesome apps that will do all the navigation for you!

ART Compass

ART Compass is a fertility app! It makes the process of IVF so much easier not only for clinics but for patients as well! You are able to view images of your embryos and also view their pre-implantation genetic testing status! All your data is in one place, easily accessible to you the patient! There is no hassle in trying to communicate with your IVF clinic either when you use ART Compass! Fertility apps should all have one goal in common, to make your TTC journey less stressful and complicated and ART Compass does just that!

Natural Cycles the app and the data it’s provided

Harper et. al. looked at over half a million ovulation cycles worth of data collected via the FDA Approved Natural Cycles app to enhance our understanding of the key stages of ovulation. The results demonstrated that few women have that textbook 28-day cycle, with some experiencing very short or very long cycles. The findings show that an average cycle lasts for 29.3 days and only approximately 13% of cycles are 28 days in length! In the entire study, only 65% of women had cycles that lasted between 25 and 30 days. The Natural Cycles app claims to be useful as a hormone-free method of birth control. Some studies have demonstrated a “typical use” failure rate over 13 menstrual cycles of 8.3%.

Further Research

An additional 25 apps out of 140 reviewed (17.9%) contain information or functions specifically related to infertility or its management. High quality infertility applications were noted as allowing users to track fertility medications, symptoms  and results. Additional features include reminders of fertility doctor appointments and when to administer fertility medication, results tracking (including blood type information, sperm counts and blood levels), notes section for tracking of issues for later reference, and ability to track symptoms. Menstrual tracking applications have been consistently assessed for their  functionality and accuracy. This particular research has revealed a downside to fertility apps. In 2016, Moglia et al. scored 108 menstrual tracking  applications, and their primary criterion for ongoing inclusion was accuracy. They concluded “Most free smartphone menstrual cycle tracking apps for patient use are  inaccurate. Few cite medical literature or health professional involvement.”

Updating this analysis in 2019, Zwingerman et. al. Identified 140 menstrual tracking applications, with a low overall app quality score of 32%, and a further thirty-one apps (22.1%) with serious inaccuracies in content, tools, or both. When 218 menstrual tracking apps were assessed in 2016 for their use in preventing unintended pregnancy, over 40% were found to not mention any modern contraceptive methods at all. A systematic review by Mangone et al. found that very few fertility awareness applications have clinically relevant, evidence-based usefulness, and many of them may even increase the likelihood of unintended pregnancy due to the low effectiveness of the contraceptive methods promoted. For this reason, the American College of Obstetricians and Gynecologists only advocates the use of mobile applications to track menstrual cycles, not as a primary tool to prevent or achieve pregnancy.

Additionally, there have been major HIPAA compliance concerns with some fertility tracking apps. These applications often ask for intimate details: sexual activity, history of abortions, cervical mucus consistency, orgasm frequency, preferred sex positions. It was recently reported that the Glow (a pregnancy planning app) app was plagued by a series of security flaws, exposing sensitive  information to anyone who cared to look. It was characterized as a “Jackpot for Stalkers.” They have since added a new section to their website, inviting hackers to “research” security flaws and responsibly report them.

There are clearly many upsides and downsides to fertility apps. This is why it is crucial to choose the right one. You can do so by doing a little research by reading customer reviews for apps and understanding what specific services they provide! And of course, in today’s day and age, privacy is important! So watch out for some apps that don’t seem the most secure! All in all, fertility apps can help you navigate infertility with ease if you choose the right one.

References:

Berglund Scherwitzl, E., et al., Perfect-use and typical-use Pearl Index of a contraceptive mobile app. Contraception, 2017. 96(6): p. 420-425.

Moglia, M.L., et al., Evaluation of Smartphone Menstrual Cycle Tracking Applications Using an Adapted APPLICATIONS Scoring System. Obstet Gynecol, 2016. 127(6): p. 1153-60.

Mangone, E.R., V. Lebrun, and K.E. Muessig, Mobile Phone Apps for the Prevention of Unintended Pregnancy: A Systematic Review and Content Analysis. JMIR Mhealth Uhealth, 2016. 4(1): p. e6.

Wait hold up. Isn’t a gestational carrier a surrogate? The answer to that question is yes-and-no. Both persons perform the same job: helping a couple have their miracle baby by carrying a child for them. However, a surrogate will be the biological mother of the child because she has donated her egg to make the baby she is carrying. A gestational carrier is not the biological mother of the child she is carrying. 

Image by Brodie Vissers

Who requires a gestational carrier?

There are a variety of reasons for wanting to have a gestational carrier. 

• The woman’s uterus is not able to carry a baby
• The woman may be experiencing certain disorders that hinder her ability to carry a child such as “extensive fibroids, scarring of the uterine cavity or adenomyosis” (Yale Medicine)
• The woman might have had several failed pregnancies, stillbirths, and miscarriages, which indicate another pregnancy might not yield good results.
• The woman has experienced complications while giving birth that is a cause for concern and may indicate another pregnancy could be fatal for the mother or baby.

What is the procedure for a gestational carrier?

It might differ slightly from one clinic to another. Essentially, it is the same. In this article, we will include what the process is like at Yale Medicine as described by the clinic itself! It begins with an evaluation of the gestational carrier. This evaluation is both psychological and physical. This is to ensure that the gestational carrier is ready to take on the overwhelming job of carrying another individual’s baby. The woman then undergoes a practice embryo transfer. By undergoing a practice run, the specialists are able to gain a better understanding of how the GC’s uterus will respond to the medications required to prepare the uterus for the transfer. Once the GC’s ovulation is aligned with the biological mother’s, the embryo is transferred and the hard part is essentially over! From there onwards it’s simply a regular pregnancy. 

Gestational Carriers are Growing in Popularity

As the scientific field progresses, more and more gestational carriers are being used by infertile couples. In fact, the CDC has some data that can help put it into perspective!

• During the period of 1999 to 2013, 2% of all artificial reproductive technology cycles involved a gestational carrier. This equates to 30,927 cycles.
• The couples using a GC were often older.
• GC cycles had better rates of live pregnancy when compared to the cycles which did not have a GC. 
• Multiple births were more common among GC cycles

How to Find a Gestational Carrier and Things to Keep in Mind

One of the first steps is finding a surrogacy agency. Steps after that involve choosing the GC and reviewing the abundant legal matters that surround the situation. These govern every aspect, from the extent of involvement of the intended parents during the pregnancy and whether the child will have contact with the GC when he or she grows up.

Knowing whether a GC is right for you is a conversation involving you, your partner, and your fertility doctor. People may have their own opinions about your use of a GC. They might see it as unnatural and belittle you for the choices you have made. At the end of the day, they don’t have all the information to be making claims about your fertility. Check out some of the articles we have referenced to explore more aspects of having a GC!

References:

1. “Surrogacy: Who decides to become a gestational carrier ….” 5 Mar. 2020, https://www.health.harvard.edu/blog/surrogacy-who-decides-to-become-a-gestational-carrier-2020030519052. Accessed 18 Sep. 2020.
2. “ART and Gestational Carriers | Key Findings | Assisted … – CDC.” 5 Aug. 2016, https://www.cdc.gov/art/key-findings/gestational-carriers.html. Accessed 18 Sep. 2020.

“Gestational Surrogacy > Condition at Yale Medicine.” https://www.yalemedicine.org/conditions/gestational-surrogacy/. Accessed 18 Sep. 2020.

Artificial intelligence is often not really associated with reproductive health! We always hear a lot of talk about medicine evolving and incorporating AI into its operations, as we live in a technology-filled world. I’m sure when you’ve heard this the first image that might pop into your head is robots replacing surgeons! However, Scientific American about Artificial Intelligence’s role in treating infertility? How does that work? Well, we’ve got some good news for you. Our CEO Dr. Carol Curchoe and one of our scientific advisory board members, Dr. Charles L. Bormann break it ALL down for you in a Scientific American post titled “What AI Can Do for IVF”! 

Image by Matthew Henry

All about the post

Check out the article if you’re interested in what big-name companies have been incorporating AI into fertility treatments, and medicine in general. You can also gain some insight into what stage all of these ideas are in. Scientific progress is not an overnight feat, so it’s important to always stay updated with where discoveries are and how they are doing! As most AI ideas for fertility treatments are in the experimental phase, you might also want to look into what the accuracy rates are looking like right now. Our post covers that too! 

Scientific American

Scientific American about Artificial Intelligence’s is All. Things. Science. It is one of the best ways to stay updated about all the new scientific discoveries and endeavors in our rapid-paced world! It’s not only limited to medicine. SA covers a broad range of fields including biology, chemistry, physics, math, space, and even politics among others!

We are honored that they decided to feature our article about up-and-coming AI strategies in assisted reproduction technology (ART).

We definitely want to help play our part in keeping the scientific community updated! We also want to note, SA doesn’t only have articles and publications but they’ve got podcasts and videos if you’re more into auditory and visual learning! I know I’m more of an auditory learner myself!

The importance of staying updated

Reading the newspaper or watching the news when you can is always important! It is also crucial to do so regarding scientific news regardless of whether you pursue a career in science or not. For example, exciting discoveries in medicine might concern you if they perhaps have to do with a condition a family member is suffering from. Medicine affects every one of us! And that applies to us now more than ever during this Covid-19 pandemic. At ART Compass, we try to play our part in sharing crucial information about infertility that doesn’t really get the spotlight it deserves.

Many people suffering from infertility are misunderstood or not really paid attention to. Their struggle is seen as “dramatic” and because of that, people don’t see the need to share important facts and information about infertility. We’re here to change that. For all the infertility warriors out there-we hear you and we’ve got your back! Always check our blog because we post constantly! And check out Scientific American too while you’re at it to get the latest information on what science is up to!

Reference:

Curchoe. C, Bormann. C, “What Can AI Do for IVF” Scientific American, Jan 2018, https://blogs.scientificamerican.com/observations/what-ai-can-do-for-ivf/

Reproduction is all about women, right? How could they be forgotten? Like so much of science and medicine, discoveries and accompaniments that should be credited to women have been overlooked. Reproductive health has come a long way. Back in the day, infertility used to puzzle scientists. They simply could not understand why one couple had better chances of conceiving a child than others. This was a time when IVF did not exist and the idea of “test-tube babies” would appall someone.

I’m glad we have come a long way with regards to social stigma and scientific discoveries. But that would not have been possible without the valuable contributions of various women. Unfortunately, most of these women NEVER got the recognition they deserved unlike their male counterparts. So in this blog post, we want to highlight their scientific achievements. Share this post with others so we can help spread the word!

Miriam Menkin– The first in vitro fertilization

This is where it all started! Miriam Menkin was a laboratory technician who worked for a fertility expert named John Rock. You might have heard of Rock because he received a lot of the credit for stumbling across IVF when Menkin didn’t. Menkin was always in charge of introducing the sperm to an egg in a petri dish and monitoring it for a half an hour. This one Friday night however, she was exhausted after caring for her own eight month-old at home. She arrived at the lab to do the routine procedure and dozed off while watching the petri dish. When she woke up, an hour had passed! Unfortunately she lost track of time.

When Menkin took a look at the petri dish she couldn’t believe her eyes. The egg and sperm had fertilized! This was the first ever fertilization that had taken place outside of the body. She called for Rock immediately and once he came, he apparently turned pale. They’d finally done it! To preserve the embryo she had to keep adding droplets of liquid to it. She did this in one hand while eating a sandwich in the other. 

Unfortunately, Menkin did not receive much of the credit. Though this discovery certainly had a serendipitous nature, it should not take away from the fact that it were Menkins actions that had led to it. As a single mother, she continued to balance her work and personal life and when Menkin and Rock were flooded with letters by infertile couples about their recent feat, the both of them went off to co-author 18 papers, 2 of which were on this achievement and were published in the journal Science. 

The lack of recognition for Menkin might arise from a mix of her both being a woman and a lab technician. She did not receive the same praise as her male counterparts who were scientists or doctors. 

She was a scientist, with a scientist’s mind, and a scientist’s precision, and a scientist’s belief in the importance of following protocols” – Margaret Marsh

Jean Purdy– Embryologist to the first IVF baby

If you know a bit about IVF, then you know that the first IVF baby to ever be born was Louise Brown. Jean Purdy was a nurse/embryologist who was the first person to see the first successful division of the embryo! She was outrageously left off the plaque in the hospital which Brown was born in! The people who did make the plaque were Professor Sir Robert Edwards and the surgeon Patrick Steptoe. Edward’s archives reveal that he wrote to Oldham Area Health Authority in 1980 requesting the plaques in the hospital include Purdy’s name.

It never happened.

The reason for this is because she might not have been viewed as important because she was an embryologist and nurse but not a doctor. If there is anything you should know about IVF, it is that it takes a village to raise an embryo.

Madelin Evans, an archivist, said the letters do not reveal an “explicit reason” why Purdy’s name was omitted but that “it probably had quite a bit to do with the fact she was a nurse, an embryologist and a woman I suppose”.

She died at the age of 39 in 1985, her name not on the plaque. But we will not let he be one of the forgotten women of reproduction!

Muriel Harris– IVF Nuring Pioneer

Harris was an operation theater superintendent on the team who was on the team who delivered Louise Brown. Unfortunately, when Harris went on a vacation the doctors decided to move up the birth and perform cesarean section. She missed the birth, but that was not the end of her story.

She might not have been there for that glorified moment, but what she helped do before and after the birth is JUST as important. The team closed down that facility and opened a new facility named Bourn Hall. This was the world’s first IVF clinic! She played a massive role in turning a run down location into a clinic that would grant wishes of many couples struggling with infertility. 

She was not a surgeon or physician and unfortunately that meant she did not get the recognition she deserves. 

Ruth Fowler– Made STIMS possible

Ruth Fowler might not have been directly involved in the first IVF baby’s birther, but she contributed a great deal of research to reproductive medicine in general. She was the grand-daughter of Earnest Rutherford, who himself won the Nobel Prize for chemistry in 1908, for his studies on disintegration of the elements, and the chemistry of radioactive substances. Fowler’ mother died shortly after Ruth was born and her father died when she was 13. She had a rough childhood to say the least but that did not stop her from earning her degree in biology at the University of Edinburgh and then working on her PhD on genetics there as well.

Fowler and her husband Bob Edwards wrote about ways to increase the number of synchronized eggs recoverable from adult female mice through a series of five papers (1957–1961), on the control of ovulation induced by use of exogenous hormones. This feat of hers helped debunk the common misconception that superovulation of adults was not possible.

Fowler had 5 children but she continued the hustle! She still published more papers about the growth of human embryos in the laboratory, the genetics of early human development and on the progesterone, protein composition of the uterine fluids of the rabbit and the importance in understanding the environment experienced by the preimplantation embryo.

If you thought her papers ended there… well you’re wrong! Fowler continued to write with Edwards throughout even the year the first IVF baby was born! At this time her papers focused on the dynamics and endocrinology of follicular development. It’s hard to keep up with how many topics she delved into! She poured her life and soul into discovering new things and helping reproductive medicine evolve. Her husband received the Nobel laureate while she did not. She deserves more. She was, however, called upon to receive the award when her husband was too ill.

What we need to do

Spread the word. The women in science both in history and present day need more recognition and respect for their work especially women of color. We must encourage more women of color to pursue jobs in STEM and medicine and also acknowledge those who currently in the STEM and medicine fields. 

We also must not follow in the path of the popular medical dramas that portray the wrong image of medicine. They ignore the many different people that are crucial in surgeries, procedures, patient care you name it! Healthcare is never a one man job. Nurses, lab technicians and everyone deserve equal respect. In the rapidly evolving space of science, it’s important the names of those who have contributed great amounts are not lost. 

References:

1. Martin H. Johnson, IVF: The women who helped make it happen, Reproductive Biomedicine & Society Online, Volume 8, 2019, Pages 1-6, ISSN 2405-6618,

2. “Female nurse who played crucial role in IVF ignored on plaque” by The Guardian https://www.theguardian.com/society/2019/jun/10/jean-purdy-female-nurse-who-played-crucial-role-in-ivf-ignored-on-plaque
3. “The Female Scientist Who Changes Human Fertility Forever” by BBC Future https://www.bbc.com/future/article/20200103-the-female-scientist-who-changed-human-fertility-forever
4. “Our History” by Planned Parenthood

Parents to be embarking on the surrogacy journey are often faced with the predicament of bonding with their unborn child. It might seem like forming a connection with your child growing inside another woman’s womb is difficult however, there are actually several different ways which you can enjoy feeling closer to your little precious baby.

Talk to them

It’s as simple as that. If you reside in the same city or country as your surrogate, you can plan visits to get some exclusive time to talk to your baby, so that they identify with your voice from early on. However, in many instances, Intended Parents are geographically miles apart from the surrogate and their baby, in which case it’s still fairly easy to converse with you child. Thanks to good technology, you can send plenty of voice notes to the surro-mama for relaying to the baby, including your favorite songs, bedtime stories, poems or lullabies. Listening to you repeatedly will help them familiarize themselves with your voice.

Baby’s preferences

Pregnant women often talk about their babies being most active at night when they lay down. Studies reveal that is probably because while you’re walking around or doing house chores, the movement lulls the baby to sleep. And when you’re sitting or lying down, the baby wakes up due to the lack of movement. This explains why newborns want to be “rocked” to sleep. Experiencing tiny things like these during your surrogacy journey might seem like a challenge but small steps and tips can really make you feel better connected.
Ask your surrogate about your baby’s preferences and activity times. Babies also respond to certain flavors favorably while inside. Ask the surro-mama what kind of cravings is the baby inducing? Does she crave sweets or more savory foods? That’s a good clue to finding out what your little one’s taste-buds (developed at week 13-15 already) enjoy more.

Decorate the nursery

Assemble difficult nursery furniture and pick out shades for the accent wall to foster a sense of anticipation and excitement for the new addition, arriving soon! Utilize this time proactively and get the nursery ready for the arrival of the stork and your little bundle of joy. Once the baby comes home, he/she might not be able to acknowledge your efforts right away as he/she makes messes on the spotless white rug you picked for the room, but trust me, it’s all the worth the effort.

Baby Registry

The importance of this cannot be emphasized enough. List down all the essential items you will need once the baby is here, which might seem like the entire inventory of BuyBuyBaby, however talk to your friends and family and discuss what items you’d need absolutely ready before the grand arrival. Picking out stuff you love and coordinating it with everything you’ve learned about the baby can help you feel even more emotionally connected.

Baby’s sense of smell

Your baby’s 5 senses begin developing inside the womb somewhere between weeks 16 to 21. Intended Parents can ask the surro-mama to start keeping a teddy-bear next to her during this timeframe to help the baby take in and familiarize himself/herself with some scents. Once the baby is born, the stuffed toy can travel to the IP’s home with them, serving as a transitional connection for the baby.

Birth of baby

When the moment you’ve been impatiently waiting for, for far more than 9 months finally arrives, try and let the baby confirm their senses as he/she struggles to touch the surro-mama’s face or hands. In all fairness, it’s what they’re most easily able to recognize so make sure to allow some time for the baby and surro-mama to spend together in physical contact just so the baby can ease into the life outside the womb. Be wary of whether your surrogate is emotionally ready to hold the baby or not and plan your post-birth activities accordingly.

Skin-to-skin contact

Spend lots of skin-to-skin time together. There’s nothing stronger than the power of touch while you hold your tiny miracle in your arms. Make sure to cradle and caress the baby abundantly, helping him/her acknowledge and recognize your touch.

Final Thoughts

Surrogacy is definitely not an easy journey, for either the Intended Parents or the Surrogate however employing certain behaviors and techniques can aid your and the baby’s transition from the womb to your home.

If you’ve decided to go the surrogacy path, we are here to help make the process as easy and stress-free for you as possible. Patriot Conceptions is one of LA’s leading surrogacy facilities with a vast pool of dedicated, loving and compassionate surrogates, and we are proud to partner with them in helping make surrogacy a blissful reality for you.

Does Blastocyst Grading Matter?⁠

Blastocyst grading is not an exact science, but it is a tool that providers use in addition to other factors to determine which embryos may be fit for transferring. ⁠Despite forty years of research and clinical application, the average success rate of IVF today has been reported to be as low as 20-40%. Selection of the best embryo is key to the success of IVF cycles.

Blastocysts are embryos that have advanced to the 5 or 6 day stage.

Blastocysts possess an inner cell mass which will become the baby. The outer layer of cells of the blastocyst are called the trophoblast. The trophoblast will become the placenta.This layer surrounds the inner cell mass and a fluid-filled cavity known as the blastocoel. Blastocysts are qualified by their inner cell mass and trophoblast.
⁠
Rating blastocysts follows a three-part system of grading, however there are many systems of grading.

The three parts are always: ⁠
-The degree of the expansion of the embryo’s cavity.⁠
-The inner cell mass (the baby-making part) quality.⁠
-The trophectoderm quality (the cell layer that makes the placenta and the membranes surrounding the baby).⁠
⁠
The number and quality of blastocysts available is a key determinant for a patient’s chance of success with ART, thus blastocyst development rate is an important measure of an IVF clinic’s performance. ⁠ While morphological evaluation is widely accepted and implemented in most IVF clinics worldwide, the exact morphologic parameters used to score embryos are highly variable between clinics, and the assessment process is strikingly subjective even between embryologists at the same clinic. Embryo grading is not the end all and be all though- every embryologist has stories of remarkable transfer outcomes with poor quality embryos!

However, most human embryos do not have the genetic potential to develop normally to the blastocyst stage, hatch from their shells, implant, and continue normal embryonic development in order to result in a live birth.

As couples navigate through their fertility journey, you will meet with your physician and begin the process for IVF that includes preparation, stimulation, and monitoring.

In the background is the functioning of the IVF laboratory, where what is actually occurring can be a bit of a mystery. It is after all an almost literal black box! A windowless lab that is under strict lock and key and is often a dark, warm humid atmosphere, just like a human fallopian tube which is the site of fertilization inside the body. 

The scientist who combines the sperm and egg and helps the resulting embryos to grow in a controlled environment is called an embryologist. Access to the laboratory or embryologists in most clinics is limited. 

An embryologist is a fertility specialist that helps to create embryos to either be used in IVF right away or to be frozen for later use. Embryologists aren’t MDs, but we are highly trained medical professionals, usually holding a Masters’s degree or a Ph.D. due to the specialized nature of our work. Here are ten things we want you to know about IVF!

1. What is a blastocyst and why is embryo grading important?

   
   A blastocyst describes an embryo stage reached usually after about five days of development post-fertilization. It has about 50-150 cells and has started to develop specific regions with different cellular destinies. The blastocyst is working hard; pumping fluids towards its center, creating a fluid-filled center and expanding like a water filled balloon. Embryo grading is when embryologists grade embryos based on their potential to successfully implant and result in a pregnancy. The criteria varies from clinic to clinic but the goal is always the same-transfer the best embryo! Embryologists have lots of training in grading embryos and make the best decision they can for you and your embryos. New technologies like AiVF‘s artificial intelligence system EMA are replacing the subjective human analysis of blastocysts with data-driven decision making, while bringing automation and full transparency to the process, which can make IVF efficient, accurate, and easy.

2. Why are there so many unknowns about “IVF Add-Ons like EmbryoGlue, PGT-A, Assisted Hatching etc?

   
   In my opinion, this is the result of thirty years of political turmoil in the US. research on embryos and IVF has largely been driven out of the public sphere and into the private sector, entirely supported by commercial interests and individual clinics.

3. A lot of embryos look amazing on Day 3, but do not go on to form blastocysts. Why?

   
   Embryonic gene activation (EGA) is the process by which an embryo begins to transcribe its newly formed genome. Sperm play an essential role in embryonic genome activation and embryonic progression to blastocyst. Embryos often “arrest” at this stage.

4. Why did I get so many abnormal embryos by PGT?

   
   Aneuploidy (abnormal or incorrect chromosome number) is common in humans and is the leading cause of all human birth defects as well as miscarriage. For those new to the terminology, PGT is a genetic test that takes place before embryo transfer, designed to tell you if each embryo is chromosomally healthy. An embryo that is euploid (normal) has 23 pairs of chromosomes and has a better chance at leading to a successful live-birth than an abnormal (aneuploid) embryo. Aneuploid embryos have missing or extra chromosomes and will typically fail to implant, result in a miscarriage, or lead to the birth of a child with a chromosomal disease. ⁠Aneuploidy (abnormal or incorrect chromosome number) is common in humans and is the leading cause of all human birth defects as well as miscarriage. ⁠We can perform up to three types of preimplantation genetic testing on embryos during the IVF process. Those include:⁠ ⁠ PGT-A, which screens for an abnormal number of chromosomes.⁠ PGT–M is the test for individual, or monogenic, diseases.⁠ PGT-SR tests for abnormal chromosomal structural rearrangements, like translocation or inversion.⁠ ⁠ ⁠PGT begins with a biopsy of an embryo in the blastocyst stage of development, usually on day 5 or 6 of embryo development. The biopsy removes 3 to 10 cells from the trophectoderm, which is the outer layer of cells that will become the placenta as the embryo develops. The biopsy does not remove any cells from the inner cell mass, which develops into the fetus.⁠ ⁠ After these cells are removed, the blastocyst is frozen and stored in the lab.⁠ ⁠ The biopsied cells are sent for laboratory testing. Results are typically returned in a week to 10 days following the biopsy.⁠ ⁠ Besides the two possible PGT results we’ve already talked about– euploid and aneuploid– there are also two others: mosaic and inconclusive. A mosaic embryo consists of both euploid and aneuploid cells. While mosaicism has existed all along, PGT has only been able to recognize mosaicism in embryos within the past three years, so there is still a lot of research ongoing about their potential. What we know now is that about 10-15% of all embryos are mosaic.⁠ Embryo biopsy can also yield an “inconclusive’ or “No result”. That means that the trophectoderm biopsy sample was insufficient to be used for PGT or that it did not meet the quality control standards for analysis.⁠ ⁠ A study by Cimadomo et al. (2018) showed that inconclusive results occur about 1.5-5% of the time because the cell sample is not loaded properly and the tube is actually empty, or that the sample was degraded. ⁠ ⁠ Inconclusive or no result embryos have a good chance of being “normal”. A large study (Demko et al., 2016) found for women <35 there is about a 60% chance of a blastocyst being euploid (normal) to 30% by age 41. The chance of getting NO euploid (normal) embryos was about 10% for <35 and about 50% by 43.⁠

5. I am disappointed that I didn’t have more eggs.

   
   15 is the optimal number of eggs to retrieve without putting you at risk for #OHSS. More eggs often means lower quality and higher estrogen levels, which can impair implantation in fresh IVF Cycles.

6. IVF has a 100% success rate.

   
   The success rate of IVF is about 40% in couples below the age of 35. Also, the success rate of IVF depends on factors such as age, cause of #infertility, and biological and hormonal conditions. One of the reasons for this, is that although many blastocysts may LOOK morphologically normal, their behavior can differ in surprising and clinically relevant ways. For example, during development, the blastocyst pushes against the surrounding zona pellucida to expand. Some embryos do this with no trouble, while others struggle and go through a series of contractions and expansions. AiVF’s computer vision analysis of time-lapse videos of embryos has shown that blastocyst pumping events have a high negative predictive value for subsequent failed implantation. AiVF’s AI-based digital embryology management platform was able to shed light on this complex question, by showing that contractions and expansions greater than 8 microns in diameter were associated with poor implantation rates independent of other morphokinetic features.

7. IVF is the same thing no matter which clinic you go to.

   
   NOPE! Not all fertility clinics are created equal, so it’s important to do your research to help you make an informed decision. In addition to looking for a clinic with high-qualified #fertilitydoctors, it’s critical to choose a clinic with a superior IVF lab. You can check out a clinic’s success rates at Society of Assisted Reproductive Technology or the Centers for Disease Control and Prevention website.

8. Infertility is a female problem.

   
   Most of the practical and emotional infertility support out there is aimed at women. Maybe because we are the ones being stimmed and undergoing the surgeries. But we need to get the men more involved! It’s a common misconception that women are most affected by infertility. In some cultures “male infertility” is literally unheard of, like culturally it does not exist. In fact, men and women are equally affected. In heterosexual couples, 1/3 of infertility cases are attributed to men, 1/3 to women, and 1/3 are unknown. With regard to our healthcare, often we will be the first to approach an infertility doctor, who will then prescribe a standard work up of invasive tests that have become the norm for women who experience problems conceiving: that includes multiple appointments, multiple hormone tests, internal, transvaginal scans to check your womb for fibroids, and an HSG test, where dye is pushed into your fallopian tubes to see if they were blocked. Only then, does the male partner typically obtain a semen analysis. Sometimes, men may need to modify their lifestyle habits quite a bit, but this is often brought up late, if at all. Some providers argue that assessing lifestyle factors and history, or for physical problems like varicocele, is even more important than the traditional semen analysis. Raising awareness male infertility will help us to get more funding, resources, research, and even donations made by male donors.

9. IVF is only used for individuals/couples struggling with #infertility.

   
   Families with a history of genetic disorders can do IVF with pre-implantation genetic testing to screen their embryos for single gene disorders and to prevent the genetic condition from being passed onto their children. Even fertile couples use IVF to have more control over their family building, such as being able to chose the order of the sex of their children or for optimal timing for their lives and careers. Also, IVF is used by moms and dads who are single by choice and for LGBTQ couples to build their families.

10. Eggs, Sperm and Embryo Myths!

    
    We cannot tell “female” (X- bearing) sperm from male (Y-bearing) sperm. There is a persistent myth that X or Y bearing sperm look different from each other or swim at different rates. These myths are not based on good, solid science! Every egg, sperm and the resulting combination of the two are different. That makes every attempt at IVF using different gametes a different experience. From the embryologist’s point of view, each egg looks different, but we can’t see the DNA with a microscope to select the “good” eggs. Embryologists will care and nurture your gametes, but cannot repair or make an embryo better by culturing it in the laboratory. Some embryos don’t freeze well or survive the thaw, and are just indicators that there is probably something flawed about them or something we don’t yet understand scientifically speaking. Additionally, each embryo is as different as any child resulting from that embryo would be, but we can’t treat each embryo differently. Adhering strictly to IVF lab culture protocols is what elevated assistant reproductive technologies from being an art into being a reproducible science.

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ART Compass — The world’s first mobile IVF laboratory information management system (LIMS)

For immediate release: ART Compass Partners with WHO— The world’s first mobile IVF laboratory information management system (LIMS) powered by artificial intelligence, announced today that it is partnering with the World Health Organization to deliver educational content for Andrology competency assessments using high definition images from the planned 6th Edition Laboratory manual for the examination and processing of human semen.

“We are thrilled to be bringing our user’s high definition, high-quality andrology images from the World Health Organization’s 6th Edition. Semen analysis is of paramount importance to study potential male fertility and a couple’s infertility. It is was very important for us to deliver educational and competency assessment content in Andrology from the world’s foremost authority.” ART Compass Founder, Dr. Carol Lynn Curchoe says.

“2/3RDS OF IVF CLINICS ARE STILL USING A PAPER REPORTING SYSTEM.

THERE IS NO INDUSTRY-STANDARD QUALITY CONTROL. HOW CAN PATIENTS AND CLINICS BE CONFIDENT IN THEIR RESULTS?“

About ART Compass:

The IVF industry has a CAGR of 10.2%, resulting in a technology explosion, but a major lag in Quality Control Infrastructure; despite having the highest levels of documentation and reporting required for local, state, and national compliance, of any medical field. These failures cost the industry millions annually, but most important, destroy the dreams of couples desperate to make a family. ART Compass is the world’s first industry QA/QC platform powered by artificial intelligence that puts physicians, administrators, and lab staff on the “same page” as their patients. ART Compass documents IVF staff’s clinical decision making streamlines reporting, automates data analysis, and makes critical information available to all stakeholders.

About the WHO manual:

ART Compass Partners with WHO The sixth edition of the WHO manual will update the information provided in the fifth edition on sperm preparation for clinical use or specialized assays and on cryopreservation, quality control in the semen analysis laboratory, and evidence-based reference ranges and reference limits for various semen characteristics. The methods described are intended to improve the quality of semen analysis and the comparability of results from different laboratories.

Semen analysis may be useful in both clinical and research settings, for investigating male fertility status as well as monitoring spermatogenesis during and following male fertility regulation and other interventions. This manual provides updated, standardized, evidence-based procedures and recommendations for laboratory managers, scientists and technicians to follow in examining human semen in a clinical or research setting. Detailed protocols for routine, optional and research tests are elaborated.

American Society for Reproductive Medicine – ASRM Celebrating 75 Years of History and Innovation in Philadelphia, October 12-16

Exclusive continuing education content will be made available for American Society for Reproductive Medicine – ASRM 2019 attendees. The hands-on training opportunities offered by EmbryoDirector are complemented by the ART Compass competency assessment and continuing education mobile app platform. 

How does your clinical decision making or subject test knowledge compare to senior IVF industry professionals? Grab a friend or come make new ones, as you sharpen your content knowledge at our interactive exhibit.