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Since the first in vitro fertilization (IVF) baby was born in 1978, more than 8 million people have been born using the technology worldwide. Although IVF success rates have improved since it was first introduced, currently, only about a third of patients have a successful live birth.
“For patients, assisted reproduction is expensive, often requires multiple attempts, is physically and emotionally difficult, and is still not covered by insurance.” Paxton Mader-Yorke, CEO and founder of Alife Health, will present.
Fair access and affordability in the fertility treatment space is leading the way for IVF. It is reported that only one in twenty-five couples in the United States have access to the prenatal care they need. An average IVF cycle costs between $15,000 and $30,000, which limits the number of people who can access quality care.
“People want fertility treatments to be accessible, affordable, effective and less stressful.” Says Meir Orcha, Fertility Specialist, Mira Medical Consultant and Medical Director at Sama Fertility. “This is where technology can be a game changer in our field.”
Consumers, clinics and care
In the clinical environment, research and development (R&D) in women’s health and infertility is historically underfunded. So recent developments have mostly come from private sector fertility clinics. However, the space has recently attracted more attention from investors and technology innovators, many of whom were inspired by their personal experiences.
“Despite the remarkable advances in assisted reproduction in the last few decades, the results are still very disappointing.” says Gary Nakuda, founder of the Canadian Olive Fertility Center. There continues to be a continuing need for the latest innovations that offer a modest improvement in success rates.
Beyond the result, the main expectation is to improve the overall patient experience during fertility treatment. Clinics face significant barriers to providing the best prenatal care possible. Successful IVF pregnancies depend on complex clinical decisions made by physicians to provide optimal care for each patient.
“Information shows that the main concerns for patients are the requirements for frequent visits to clinics, invasive tests and communication issues with the clinic staff during treatment,” says Nakhuda. Focusing on the operational aspects of care delivery is critical to reducing patient dropouts and maintaining care, says Nakhuda, “the key to continuing until a successful outcome is achieved.”
Field breeding equipment
New technologies to facilitate clinical care and improve clinical operations help move the field forward to support more patients with successful outcomes. “Today, there is no unified technology platform that can help doctors improve those decisions and improve the patient experience,” Mader-York says.
From a technology perspective, recent advances in reproductive health focus on bringing clinical data and workflows into the digital age. Electronic identification systems that use barcodes to ensure accurate tracking of sperm, eggs and embryos, robotic cryopreservation systems, and artificial intelligence (AI) devices are helping to advance reproductive health.
Today’s advanced devices build on the advances of the past decade in three main areas: embryology, home diagnostics and monitoring, and AI. The post-pandemic landscape will expand opportunities as people embrace telehealth, virtual care, and the trend toward at-home testing accelerates.
“All developments aim for the same thing – to improve the quality of care and clinic efficiency through information and software technology,” he said. says Madder-York.
Explore the limitations of current technology
IVF is still an important and relatively new area of medicine that is rapidly developing. “AI-enabled advanced analytics and optimization will have a significant impact on the continued evolution of what the process looks like for patients, says Mader-York. By integrating and interpreting data, AI can help improve fertility treatment outcomes, reduce costs, and make the entire IVF process more transparent.
“The age and limitations of human biology are the most difficult challenges,” Nakuda said. However, even with simple hormone tests like anti-Mullerian hormone (AMH), early testing can help make some fertility decisions. The hope is that emerging knowledge will help to further personalize treatment.
Advanced reproductive health technologies offer opportunities to push reproductive health forward. Moving to a patient-centered approach coupled with clinic-to-patient collaboration will result in a more supportive, holistic and positive IVF experience.
Alif Health found that, on average, clinics spend an average of three weeks per quarter managing their staff’s data and building reports. When there is an enormous amount of data, there are challenges in sorting, extracting and integrating it to turn it into actionable insights. Technologies that collect, digitize, organize and present key data in real time are making their way into clinics to bring important fertility data and trends to the fore.
In the Brand study, researchers reported that using a machine learning model to select follicle-stimulating hormone (FSH) initiation resulted in better laboratory results and reduced initial and total FSH doses used.
In addition, embryologists have a manual process for reporting on embryo quality. When they look at embryos under a microscope, they transcribe and report data into their electronic medical record (EMR) system. Fetal imaging systems simplify the imaging, storage and organization of fetal images and improve the efficiency of the scoring process by synchronizing with the EMR.
Development of reproductive health
Digital-first care delivery is a priority. However, unlike pure digital health platforms for functions such as prescriptions, maternity care treatments must be tied to a physical brick-and-mortar facility, says Nakhuda. Innovative platforms allow for remote monitoring, monitoring and decentralization of many patient care burden relief processes.
During IVF, health care professionals, including doctors, laboratory technicians, and embryologists, are tasked with making many decisions to improve the patient’s chances of success. “IVF is not a single treatment for infertility, but a complex series of procedures.” says Madder-York.
In designing its AI-guided fertility tools, Alif Health wants to help doctors and fertility specialists improve the IVF process for patients, deliver better outcomes throughout treatment, and reduce the overall cost of treatment to make it accessible to more people.
In March 2022, Alif Health received a $22 million investment. Since then, the AI-driven brand has moved from the R&D stage to early traction and commercialization, with the goal of creating a complete operating system for next-generation IVF care delivery. Alife Health plans to launch two patient products in 2023 that focus on providing health equity in the IVF space, regardless of where people seek treatment.
Following the trend of remote monitoring at home, the Mira device allows for the quantitative measurement of hormones in urine, as opposed to the traditional blood sampling approach, which is inconvenient and painful. Collaboration between reproductive technology and clinics is one way to improve patient reproductive health outcomes and the landscape. The Fertility Tech brand has partnered with fertility clinics in the US, Canada and Australia to make fertility care more accessible by reducing the number of patient visits and the cost of testing.
A Canadian fertility clinic, Olive Fertility Center, recently completed a trial with IVF patients in collaboration with Mira. The trial showed that the variability of urine estrogen measured with the device was comparable to serum estrogen, indicating that urine monitoring at home could be a useful alternative to blood testing for patients undergoing IVF.
Future fertility treatment
“It’s early days,” Nakhuda said, adding that advanced technologies like AI seem to be of great use in fertility, from choosing the best treatment options to drug protocols, interpreting imaging results, and predicting gamete and embryo quality.
As healthcare broadly recognizes its value, we can expect more patients to use these new technologies and support wider adoption.
“There is no reason to believe that human decisions, which are always subject to bias and noise, will not pass, or at least improve.” says Nakuda. Automated laboratory techniques, therefore, are on the horizon. Implementing these innovations will improve outcomes and expand access to care, thus overcoming the shortage of trained providers and scientists needed for these complex tasks.
The possibility of ultrasonography at home can be managed by the patient himself and interpreted remotely by the doctor. “It’s a big step toward making hormone monitoring during fertility treatment more patient-friendly, convenient, and less invasive,” says Nakuda.
Soon, patients will no longer need to wait months for a diagnosis, leave their homes and travel far to get the best medical care. “This is an era where patients can be diagnosed sooner and get better treatment as access improves,” says Orcha.
Personalized fertility treatment is the next area for discovery. Describe it as a “quantum leap”. Continuing in genomics, Nakhuda explained that it will affect fertility care, allowing personalized medicine, diagnosis of reproductive risk factors and selection of healthy embryos.
Growing awareness of infertility and awareness of fertility preservation methods such as oocyte and embryo vitrification are at the forefront of development. Reproductive health experts also hope it will help reduce the pesky biological limitations that Nakuda says “we haven’t overcome yet.”
As new technologies are developed, both in the laboratory and with patients, we need to ensure that tests are validated and effective. “We need to make sure that at-home testing technologies are at least as accurate, if not more accurate, than the gold standard tests currently in use,” says Orcha.
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