In this ASPIRE webinar “mythbuster” session, our invited leading experts will address important technical and managerial topics in the ART labs, and have a live interactive Q&A to answer your questions!

This webinar is supported with an unrestricted education grant from Fujifilm Irvine Scientific.

In our daily laboratory work, we often wonder what types of latest technologies and different ways of practice are evidence-based and effective on outcomes: How to implement new generation of incubators and other equipment? What are the key factors to grow more good quality embryos through Day 7, as well as maintain consistent vitrification and warming outcomes? How to evaluate our technical competency and utilize KPIs to improve success rates? How to establish a successful PGT program, and troubleshoot critical steps in the PGT workflow? How to choose between efficacy and efficiency when performing laboratory procedures? And the big question — what works and what doesn’t?

Our four speakers will share their extensive knowledge and experience in various topics, discuss common myths behind many debated laboratory procedures and issues, and proven strategies to improve outcomes.

Please join us for this exciting “mythbuster” webinar! We look forward to chatting with you very soon!

Lecture 1: Dry vs Humidified Incubator: Maintain Stable Temperature, pH and Osmolality

Speaker: Professor Yasuyuki Mio (Yonago, Japan) [click to view speaker’s bio]

Although humidified (wet) incubators have been widely used for culturing human embryos in recent years, many laboratories have started using non-humidified (dry) bench-top incubators equipped with a time-lapse imaging system instead, due to their smaller size and lower risk of fungal contamination. However, in vitro culture conditions are thought to be unstable and far from physiologically well-controlled, compared to in vivo culture conditions. Recently, we found that the osmotic pressure in dry incubators increased much more rapidly and dramatically than those in wet incubators within a 5-day period. Therefore, according to the type of incubator (dry or wet), we need to take effective measures to minimize changing culture conditions.

In this lecture, I will talk about the differences in maintaining temperature, pH level, and the osmotic pressure between “dry” and “wet” incubators.

Lecture 2: Day 5-7 Blastocyst Culture and Vitrification: How to make More and Better Blastocysts?

Speaker: Dr. Keshav Malhotra (Agra, India) [click to view speaker’s bio]

Blastocyst culture is now a norm in ivf Laboratories. Most units prefer to culture blastocysts till Day 6, choosing to replace them in a frozen embryo replacement cycle. A recent survey suggests the apprehensions of embryologists not choosing to opt for extended blastocyst culture (Day 7), varies from their fear of high aneuploidy rates in such embryos, poor developmental potential and poor morphology on Day 7. Day 7 blastocysts make up only 5% of usable blastocysts, those which are suitable for cryopreservation or biopsy are clinically significant according to recent publications, and post biopsy outcomes of these embryos show a lot of promise. Optimised culture conditions can significantly contribute to overall blastocyst development and quality. Major factors affecting blastulation can be sectioned into four groups – Gamete Quality, Culture conditions, Lab Conditions and the Skill of the embryologists. New advances in the field especially pertaining to culture conditions seem to be promising, though the role of GM-CSF containing media in improving outcomes has been recently questioned in the latest Cochrane review, culture media supplemented with antioxidants could improve Blastulation and even cryo-survival. All in all extended blastocyst culture seems to be a new potential area of interest in this ever advancing field of embryology.

Lecture 3: A Successful PGT Program: Key factors from Embryo Biopsy to Outcome Interpretation

Speaker: Dr. Alpesh Doshi (London, United Kingdom) [click to view speaker’s bio]

Preimplantation genetic testing (PGT) has become one of the fastest growing and utilized areas in clinical assisted reproduction. Like many other techniques in ART, various methods and approaches in PGT have evolved throughout the years, and today’s laboratories often perform procedures differently from one another — some evidence-based and some by experience. In this webinar session, Dr. Doshi will discuss successful strategies in PGT program development and common myths, and bring concise and practical guidance for laboratory scientists, clinicians, and managers to systematically analyze and improve daily workflow. Key topics will include: embryo biopsy, sample tubing and analysis, mosaic embryo determination and utilization, logistics in the IVF laboratory performing biopsy, pros and cons of universal PGT-A, troubleshooting on key steps of PGT workflow, technician proficiency, as well as communication among the IVF laboratory, genetic laboratory, clinician and managers on data interpretation and reporting.

Lecture 4: KPIs in the ART Labs: Select Meaningful Indicators and Set Actionable Targets

Speaker: Dr. Haroon Latif (Lahore, Pakistan) [click to view speaker’s bio]

The World Health Organisation has estimated one in five couples to be affected by sub-fertility, worldwide. As the ART industry grows on an exponential scale, maintaining an efficient quality management system (QMS) in the ART lab is more vital than ever to provide safe and effective treatment. A good QMS constitutes of two main components; quality control and quality assurance. These include appropriate indicators to evaluate all aspects of the clinic; Reference indicators (RI), performance indicators (PI), and key performance indicators (KPI). KPIs are a set of quantifiable measurements used to review the overall performance of the clinic. The Vienna Consensus, published in 2017, established a series of minimum performance (competence) levels and aspirational (benchmark) values, to monitor both laboratory and clinical aspects of ART. KPIs must be established for each step of the ART cycle; fertilization rate, cleavage rate, implantation rate, fetal heart rate etc. Moreover, it was recommended that attainable benchmarks must be set according to the specifics of the laboratory; infrastructure, organisation etc. Given the distinct and complex nature of ART, there is an unavoidable struggle of constant troubleshooting to ensure KPIs match up to the set targets and prevent adverse events. Nonetheless, this is critical to ensure high quality care for the welfare of both the patients and the offspring.

This webinar is supported with an unrestricted education grant by FUJIFILM Irvine Scientific

LIVE WEBINAR

Watch our webinar session which was held on Saturday, 31 October 2020 at 5pm (GMT+8).

Moderator: Professor Arthur Chang (San Antonio, USA)

Panellists: Professor Yasuyuki Mio (Yonago, Japan), Dr. Keshav Malhotra (Agra, India), Dr. Alpesh Doshi (London, United Kingdom) and Dr Haroon Latif (Lahore, Pakistan)