Andrew the Embryologist

Consultant Clinical Embryologist | FRCPath | FAHCS | ANSHCS | Workaholic | Coffee addict | All opinions my own 🔬🧪🧬👨‍🔬☕️

[Andrew the Embryologist @AndrewIVFSAS]

Always a pleasure team! #eshrejc

[George Liperis @GLiperis]

Thanks everyone participated in this edition of #ESHREjc 🤩

Big applause to our experts 👏🏼👌🏻🙏@AndrewIVFSAS @alteri_ale @debsmtj & Alison Campbell for their insightful contributions @ESHRE

[Andrew the Embryologist @AndrewIVFSAS]

@OmarRawi89 @ESHRE Don’t forget it could be due to the technologies used in different genetics labs. Not all genetics lab work in the same way #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

@OmarRawi89 @ESHRE You are still relying on accurate data entry. We need better EMR’s that capture datas at the source. We then go from data entry tasks to data verification #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

@SCobanMune @alteri_ale I definitely compare implantation rate between biopsy practitioners. I’m aware of a few practitioners who were so paranoid about no results, they would take very large biopsies. Consequently, there pregnancy rate was significantly lower than others #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

@debsmtj @juanjo_fraire @GLiperis @OmarRawi89 @SCobanMune @zoyaalii_ @kashish__ @BasselWattar @alteri_ale For technique, how do we decide what the best one is to standardise against? This is particularly difficult in labs where staff turnover is higher and/or you have a lot embryologists coming in with a higher skillset/were trained in different labs

[Andrew the Embryologist @AndrewIVFSAS]

@GLiperis @ProuaElina @zoyaalii_ AI might be able to detect aneuploidy in the larger chromosomes (first 13 or so) but AI algorithms weren’t really built to detect aneuploidy and they definitely don’t pick up the aneuploidy in the small chromosomes. I’ve seen so many 10 rated beautiful blastocysts with +22 gains

[Andrew the Embryologist @AndrewIVFSAS]

@GLiperis @alteri_ale @SCobanMune @kashish__ @ESHRE I have my pipette completely back filled so no bubbles and greater control #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

@zoyaalii_ Cost benefit implications will be massively skewed. Is anyone actually going to charge a patient for rebiopsy of a no result? #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

Yikes #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

#eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

Thinking on my feet. Has anyone ever published comparing PGT pregnancy rates depending on method of biopsy? *starts pondering ASRM abstracts for this year*

[Andrew the Embryologist @AndrewIVFSAS]

Thinking on my feet. Has anyone ever published comparing PGT pregnancy rates depending on method of biopsy? *starts pondering ASRM abstracts for this year*

[Alessandra Alteri @alteri_ale]

@AndrewIVFSAS On the other hand, there are still too many protocol variations in how it is performed: pulling vs flicking, assisted hatching on day 3 vs day 5-6-7, and whether to wait for the TE to extrude or biopsy directly #ESHREjc

[Andrew the Embryologist @AndrewIVFSAS]

@alteri_ale Do I dare say it’s time to revisit alternative methods of PGT? #niPGT #orjustdontdopgt #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

Whilst we can standardise protocols, we cannot standardise the actual biopsy. How many times does your method change depending on how difficult the blastocyst is to biopsy? #eshrejc

[Omar Ammar @OmarRawi89]

@alteri_ale @juanjo_fraire @GLiperis @SCobanMune @zoyaalii_ @kashish__ @BasselWattar @debsmtj @AndrewIVFSAS Also, this is more achievable than assuming everyone will standardize their protocols unless there’s a regulatory body to mandate it! #eshrejc

[Andrew the Embryologist @AndrewIVFSAS]

This is an awful percentage #eshrejc

[George Liperis @LiperisGeo81750]

@juanjo_fraire @GLiperis @OmarRawi89 @SCobanMune @zoyaalii_ @kashish__ @BasselWattar @alteri_ale @debsmtj @AndrewIVFSAS The quality of the existing literature is also a matter of concern. From the 607 records the authors identified, 570 were initially excluded with a further 28 due to not meeting study requirements, resulting to a total of 9 studies with 3 being abstracts #ESHREjc

[Andrew the Embryologist @AndrewIVFSAS]

Embryo quality here is a key one. Two biopsies of a C grade trophectoderm biopsy is a much bigger proportion of an embryo than 2 of grade A! #eshrejc

[Alessandra Alteri @alteri_ale]

@juanjo_fraire @GLiperis @OmarRawi89 @SCobanMune @zoyaalii_ @kashish__ @BasselWattar @debsmtj @AndrewIVFSAS Not all included studies adjusted for important patient-related factors (e.g., maternal age, embryo quality, prior ART outcomes), which may have influenced results #ESHREjc

[Andrew the Embryologist @AndrewIVFSAS]

Respectful? Me?! 😉🫣#eshrejc

[Omar Ammar @OmarRawi89]

Keep the conversation topic related and respectful please 👏🏼

Don’t forget to use the #ESHREjc in all your responses 🤩

[Andrew the Embryologist @AndrewIVFSAS]

Controversial but genetics provider.

We know some testing is more sensitive than others which can lead to no results. We also know labs interpret them in different ways e.g human or AI.

Not all genetics labs are created equal

[Kashish Sharma @kashish__]

#ESHREjc

Q2. Authors have found an effect on clinical outcomes when double biopsy 🧬🧬 and double ❄️❄️ was performed.

🌀What are the sources of amplification failure from a genetics🧬/embryological background❓️❓️

@ESHRE

[Andrew the Embryologist @AndrewIVFSAS]

Accurate data entry, reporting and publication is so hard to do in a single clinic never mind multiple clinics! Is there a way to make this more streamlined and efficient? #ESHREjc

[Juanjo Fraire-Zamora @juanjo_fraire]

@cimsit @GLiperis @OmarRawi89 @SCobanMune @zoyaalii_ @kashish__ @BasselWattar @alteri_ale @debsmtj @AndrewIVFSAS Yes! Standardization of lab protocols, data recording, data reporting and data publication are musts #ESHREjc 🤓

[Andrew the Embryologist @AndrewIVFSAS]

Sorry I’m late! Now to remind myself how to use twitter, I mean X! #ESHREjc

[George Liperis @GLiperis]

It gives me great pleasure to introduce our experts for this #ESHREjc

@BasselWattar
@alteri_ale
@debsmtj
@AndrewIVFSAS
Balsam Hashimi
Alison Campbell

As well as moderators
@OmarRawi89
@juanjo_fraire
@SCobanMune
@zoyaalii_
@kashish__

& authors
@RuiWangMD
Yanhe Liu

[George Liperis @GLiperis]

📣 Are you excited as we are for the 1st #ESHREjc of the year? Is it safe to perform double biopsy&double vitrification in our labs? Join the discussion this coming Friday-Saturday 17:00 CET start-stop.

👀 Amazing illustration of the paper from the talented @diana_tain90 👇🏻