How technology and embryologists together can advance the future of fertility care

How technology and embryologists together can advance the future of fertility care

An interview with Laura Francesca Rienzi, Scientific Director of GeneraLife IVF network

The introduction of novel technologies into fertility clinics is helping to advance the scope of IVF treatments available to infertile patients. Consequently, the role of the clinical embryologist in the IVF laboratory has become an evolving profession. We spoke with Dr. Rienzi about the additional challenges embryologists face in their daily laboratory practices and how emerging technologies present an opportunity for embryologists to redefine their crucial role in the lab.

Dr. Laura Rienzi started her career in embryology in Paris in 1994 as a research fellow at the Centre for Reproductive Medicine, Hôpital Necker. In 2008, Dr. Rienzi co-founded the GENERA centers for Reproductive Medicine in Italy, where she held a Laboratory Director position at 4 IVF centers. Today, she is Scientific Director of GeneraLife IVF network and Adjunct Professor of Biotechnology in Assisted Reproduction at the Faculty of Biology, University of Urbino, Italy.

How is the role of the embryologist changing in fertility labs?

Currently, embryology is seen more as routine work. We use the term “artisans of life”, which is very important, but an artisan is someone only working with their hands. In the fertility laboratory, new technologies are creating more opportunities for embryologists to examine different perspectives and discover new scientific possibilities. I believe this will change the direction of the embryologist’s role in the lab back towards a more scientific position, using technology to create advancements in fertility care and improve the quality of treatments.

The main challenge for embryologists will be implementing and mastering all the novel technologies entering our field. The most exciting one is artificial intelligence and all its expressions, including the automation of vitrification, biopsy and witnessing procedures and machine learning applied to innovative embryo selection tools. The utilization of electronic medical records also has incredible potential because, with a large database, we can generate Big Data with a lot of possibilities.

“Data utilization can play a big role in the standardization of treatments and increased confidence in the lab, building trust between professionals and patients.”

Can you talk more about the utilization of Big Data in fertility clinics?

Today, we base our findings on a limited number of confounders that we can collect mostly from manual medical records. Imagine a large database with a wealth of information that we can combine with medical records. We could assess the impact not only on female age, which is the most important confounder currently used, but also on many more confounders that might help us predict pregnancy. Some of them might also be actionable, like BMI, nutrition and lifestyle. We are really missing a lot of information about our patient population.

We could start adopting pre-conception and preimplantation genetics to either predict a reproductive issue or to personalize each treatment according to a couple’s intrinsic features. For pre-conception or cryo-screening, we can define the best treatment based on a specific patient issue, and with preimplantation genetic testing, we can avoid transferring embryos affected by aneuploidies or other types of genetic abnormalities.

Today, IVF results vary greatly across clinics. A minimum standard should be guaranteed everywhere, grounded in knowledge supported by evidence and data. Data utilization can play a big role in the standardization of treatments and increased confidence in the lab, building trust between professionals and patients. Trust is indeed what clinicians and nurses must convey when outlining the probabilities of success to patients.

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How do you see the move of the embryologist from a technician to a more scientific role?

First of all, scientific progress should never scare us. If you sit on your chair in the lab and always do the same procedure, you are more like a technician than a scientist, and embryologists are scientists. This means we must be proactive and make the most from the potential each new technology has. Of course, we must be trained to accommodate these changes and be more focused on genetics and bioengineering, etc. In this regard, our industry will need to invest more in the embryologist’s knowledge and technical capability.

You might ask, how can an already busy embryologist find time for more training? But the real question is, why are embryologists so busy today? It is because they are hands-on practitioners. It’s time to introduce new tools and change the vision of embryology, to free up more time for embryologists to generate scientific developments. Some embryologists will still be hands-on practitioners, but others can be engaged in more specialized R&D projects, which I think is a very exciting prospect for the field of embryology.

“If we invest in our labs and fill the gaps of knowledge, embryologists can embrace their scientific role in the lab and lead the way in fertility advancements.”

What do you see for the future of embryologists?

Five years and beyond is when I think we’ll start seeing real change in the fertility care industry. To ensure embryologists are prepared for the advancements being introduced, we must continue to provide education and training activities to support all new products, tools, and devices introduced into clinics.

I think that companies like CooperSurgical can gain valuable insights by seeking feedback from embryologists. Through collaboration, there’s an opportunity to educate both sides and I think this will motivate embryologists to see their role as a crucial position within the lab.

For instance, to face future developments, our group is setting up a master’s course together with the University of Pavia to educate what we call “Embryologist 2.0.” The program will include bioengineers, statisticians, and representatives of companies developing new IVF technologies. I think that this form of education should be promoted because people are more likely to accept new technology if they have the opportunity to see it with their own eyes, use it with their own hands and actively contribute to its optimization.

I also believe managers of IVF clinics have a vital role in getting their clinics ready for the upcoming changes. I think it’s very important to invest more financially in technology and training. If we invest in our labs and fill the gaps of knowledge, embryologists can embrace their scientific role in the lab and lead the way in fertility advancements.

About the author

Laura Rienzi studied at Rome and Padua Universities, obtaining a biological’s degree magna cum laude and a Master’s degree in Reproductive Medicine. Since 2020 she is Scientific Director of GeneraLife an International Reproductive Medicine network. She is currently Adjunct Professor of Biotechnology in Assisted Reproduction at the Faculty of Biology at the University of Urbino, in Italy.

In 2008, she has founded the GENERA centers for Reproductive Medicine in Italy where she held a Laboratory Director position in 4 IVF centers. She is author and co-author of about 200 articles, reviews and book chapters (Scopus H-Index 50). Her current areas of interest include in vitro fertilization, ICSI, studies of human gamete, zygote and embryo morphology in relation to their developmental ability, and chromosomal constitution (PGD, PGS), as well as the cryopreservation of embryos and oocytes.

Adjunct Professor Laura Rienzi

Adjunct Professor of Biotechnology in Assisted Reproduction, University of Urbino Senior Clinical Embryologist, Scientific Director GENERALIFE

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