Meeting Committee  

Marina Gvakharia, M.D., Ph.D., HCLD/ELD(ABB), MT(AAB)

Greetings peers,

Now that CRB 2015 is behind us, the meeting committee can finally collectively exhale and start bragging about how awesome is was. Because it was.

Thanks to our speakers, workshop leaders, AAB folks, and attendee’s participation and enthusiasm, this meeting morphed into an amazing venue for learning, networking and, importantly, fun! Lots of fun.

We started on Tuesday, May 12, with two one-day workshops on the hot topic of time-lapse microscopy in human IVF, which were coordinated by Susie Oliver, Mason Israel, and yours truly. The first half of each day was designated to theoretical instruction on the subject. Lectures were presented by Niels Birger Ramsing, Brett Glazar, and Shehua Shen. After lunch, participants were divided into three groups that were rotated between three time-lapse instruments – Embryoscope, Primo Vision, and the Eeva System. Participants were given a chance to practice loading time-lapse culture dishes with mouse embryos and initiate time-lapse runs with each machine. They had plenty of time to interact with their instructors and to view and discuss real life human embryo recordings. Overall, this combination of in-depth theoretical instruction with extensive hands-on training was pretty intense and, quite honestly, we were all exhausted at the end. Nevertheless, we received an overwhelmingly positive feedback from our participants, who left equipped with pretty much everything one has to know about time-lapse in today’s IVF.

By bright and early on Thursday, May 14, we were joined by the rest of the conference registrants (240 attendees overall) and started with the symposium program.

Dr. Thomas (Rusty) Pool gave the opening lecture on the history of clinical IVF. This talk was very well researched and covered, in detail, scientific breakthroughs and human interest stories from the inception of our field to the present time. Our youngsters were justifiably impressed and we “oldies but goodies” couldn’t help but feel very proud of being part of this amazing story.

Jason Swain took the torch from his mentor and gave an extremely detailed review of laboratory design and quality control. This talk included important subjects of laboratory layout, workflow, equipment, HVAC, VOCs, lighting, incubators, and other cool issues that keep us up at night.

Also on Thursday, Drs. Richard Scott and Barry Behr gave two lectures each. Richard’s talks were dedicated to various stimulation protocols and review of the state of PGS/PGD and freeze-all approach. As always, Dr. Scott presented an amazing amount of evidence and left us very excited about the state of art in today’s ART. As laboratorians, we always appreciate a good review of stimulation regimens, so we can better understand the treatments our patients are receiving. And this was an excellent review indeed. On the subject of PGS, Dr. Scott’s message was this: “There is no value in transferring an aneuploid embryo. Therefore, our collective efforts should be focused on reducing the burden (financial and otherwise) of aneuploidy testing, so every patient can have every embryo tested." 

In preparation for this meeting, Dr. Barry Behr reluctantly caved under pressure to speak about a topic outside of the laboratory and prepared a talk with the provocative title: “Myths and Truths About Success Rates – Do They Truly Reflect Quality of Care?”, as well as a talk about IVF children. We were so glad he did. Barry is one of the most original thinkers in our field and, as usual, he didn’t disappoint. He really made us think about perceived success vs. real success vs. success rates. Do statistics reflect quality of care? Can individual outcomes be predicted based on statistics? Is SART data useful? What do we really know about the long term health of IVF children? How does the Barker hypothesis translate to ART babies? These and many other interesting questions were asked and discussed in much detail. We had fun!

After this very busy and productive academic exercise, we all headed to the welcoming reception, which is always fun at this meeting. We ate, we drank, we laughed, we spoke about science, we gossiped, and we gambled. We stayed up really late. Jealous? You should be. Don’t miss CRB 2016!

The next morning started with Jason Swain’s lecture about the latest and greatest in embryo culture. Nothing cures hangovers better than a healthy dose of culture media. Must be its optimal pH. After this excellent review of sequential vs. uninterrupted culture media, oxygen pressure, protein supplementation, oil, and other culture related issues, we all felt as good as new, and ready for our keynote speaker.

Dr. Shoukhrat Mitalipov from Oregon Health and Science University gave a keynote lecture titled: “Is Three a Crowd? An Update on Nuclear Transfer, Cloning and Other Exciting Stories.” I am a huge fan of Shoukhrat’s research, which I follow meticulously. Imagine my excitement when he accepted the invitation to speak at our meeting. We were presented with a detailed review of his cutting edge research, including the newest advances in nuclear transfer as cell therapy for mitochondrial diseases. I felt like I gained 20-30 extra IQ points after this talk. Let’s hope they are here to stay.

After lunch, in compliance with the Casablanca theme offered by Rusty Pool, we rounded up the usual suspects and returned for his lecture on time-lapse titled “Here’s Looking at You Kid – Time-lapse in the Clinical Embryology Laboratory.” Rusty gave us a really good overview of the time-lapse instruments available on the market, published evidence, and potential benefits of the use of time-lapse technology in IVF.

Atul Gawande’s The Checklist Manifesto is one of the coolest books written on the subject of error reduction in medicine. Our meeting committee felt that the issue of error prevention and risk management is very important in our everyday practices and IVF deserves its own Manifesto. Kim Pomeroy graciously agreed to undertake this task and presented CRB 2015 with a comprehensive study of using checklists in order to keep our extremely complex work processes flow smoothly and error-free.

Kim’s talk was followed by two hours of oral abstracts chaired by CRB President Stanley Harris. Abstracts were presented on a variety of topics, including embryo culture, andrology, cryopreservation, PGS, and time-lapse. We were impressed and happy with the quality of the abstracts presented and with the interesting discussions that followed.

After this very busy and productive academic exercise, we all headed to reception #2, which is always fun at this meeting. We ate, we drank, we laughed, we spoke about science, we gossiped, and we gambled. We stayed up really late. Jealous yet? You should be. Don’t miss CRB 2016!

The next morning started with Dr. Ajay Nangia’s lectures about semen analysis and genetic and age-related issues with male gamete. Nothing cures hangovers better than a healthy dose of sperm talk. Has to do with the acrosome reaction or something. So after this excellent review of WHO 5 manual, useful and not-so-useful andrology tests, genetic concerns, paternal age issues and other guy stuff, we were ready for our next speaker. Oh, wait. Am I repeating myself a bit? I guess the IQ points didn’t take… Anyway, can’t you see how much fun this was? Don’t miss CRB 2016!

Our last lecture was just as stimulating as the rest of the presentations: Melissa Brisman, Esq., presented her talk titled: “The Ethical, Psychological and Legal Aspects of Sex Selection.” Gender selection is one of the many ethical and legal controversies that we and our patients face daily and Melissa’s sensitive, thoughtful, and expertly presented state of the affairs in this area was very much appreciated. This talk left us with better understanding of cultural, psychological, medical, and other reasons that drive the demand for gender selection.

Melissa’s talk concluded our very busy meeting, and we reluctantly said “until next time” to each other and to beautiful Red Rock Resort.

Hope I was able to drive my point home. But just in case, once again: This was a lot of fun. Don’t miss CRB 2016!

Yours truly,

Marina Gvakharia