Presented by TMRW Life Sciences
Imagine it’s the year 2100. Hundreds of millions of people were born thanks to the help of cutting-edge cryopreservation technology, according to RBMO Journal. Due to medical advances in the field, almost all of these births were associated with embryos and eggs that were once frozen and stored in a lab.
This is the future of fertility. Anyone can embrace the option to build a family. How did we get here?
IVF: Then and Now
Today, despite astonishing growth in this fertility option, cryo-management practices in IVF have barely evolved since IVF was founded nearly half a century ago. Clinics have had to rely on manual systems borrowed from when frozen fertility cells were originally used to breed cattle and horses!
This labor-intensive process includes labeling specimens by hand, measuring liquid nitrogen levels in tanks with yardsticks and dipsticks without the benefit of reliable electronic sensors, and tracking patient data often using paper logs. As any physician or lab technician will tell you, these tasks are time-consuming and ultimately leaves room for human error.
Tara Comonte, CEO of TMRW Life Sciences and former IVF patient, explains: “Over the last 15 years, since the introduction of vitrification (the process of freezing), the volume of frozen specimens that clinics are managing has grown exponentially. Clinics have become unintentional storage facilities managing millions of specimens, and that is certainly not how they were designed. If you go to most clinics today, you’ll find a room that’s packed, often wall to wall, with tanks full of frozen eggs and embryos. They’re bursting at the seams.”
In today’s medicine, almost all IVF cycles use eggs, sperm, and embryos that were once frozen, and often stored for long periods of time.
Every year, more families are being created through IVF and cryopreservation—the process of cooling and storing cells, tissues, or organs at cryogenic temperatures to save them for future use.
Every year, more families are being created through IVF and cryopreservation—the process of cooling and storing cells, tissues, or organs at cryogenic temperatures to save them for future use. With this method, eggs are flash-frozen by immersing them in liquid nitrogen, cooling them nearly instantly to -196 C, so they become glass-like, or vitrified. This quick-freezing process nearly eliminates the possibility of ice crystals forming inside the eggs and damaging them.
As our world rapidly shifts towards cryopreservation, on any given day, IVF clinics globally are actively managing and storing millions of frozen fertility cells, helping create families of all kinds around the world.
As our world rapidly shifts towards cryopreservation, on any given day, IVF clinics globally are actively managing and storing millions of frozen fertility cells, helping create families of all kinds around the world. This notable rise in IVF and egg freezing can be attributed to a host of factors ranging from an increase of family planning options and access, the use of IVF for family-building by LGBTQ+ communities, and parents planning to create their families later in life.
“We’re over 40 years into human IVF with remarkable advancements in medicine and science along the way. However, the tools and infrastructure within those clinics, particularly in relation to the care of frozen eggs and embryos, really hasn’t been updated in decades, until now,” says Comonte. “We need to equip our clinicians with modern-day tools, and best-in-class technology and infrastructure, so the field is set up for the growth of the next 40 years…For care providers, I think about the unsustainable volume of specimens under their care and how they can handle them safely. Unfortunately, there have been mistakes often due to simple human error or hardware failure in the labs. They haven’t had the technology and tools that they need and it is incredibly stressful for them to rely on such archaic existing infrastructure.”
Introducing TMRW Life Sciences
TMRW Life Sciences is responding to the need for a new standard of care for frozen eggs and embryos used in IVF. Comonte says that TMRW’s mission is to safeguard life’s most precious cells. The company’s platform offers a completely new realm of safety for the frozen fertility cells used for IVF by creating unique digital identification, tracking, and transparency for a patient’s specimens.
Freezing eggs or undergoing IVF can be an immensely expensive, labor-intensive, and emotional process for patients. With TMRW’s technology, they can rest assured that their specimens are protected by the most sophisticated technology available to reliably track, store, and manage their eggs and embryos.
Jessica Bailey, Chief Cryobiologist and Tissue Bank Director at Boston IVF and a TMRW user, explains: “There’s been a huge shift generationally – we’re more dependent on technology now than ever before, and we’re seeing that in all aspects of our practice. Our patients prefer an app rather than a phone call. When we add enhanced technology like TMRW to the patients’ overall experience, they become more comfortable with the process because they understand that TMRW is using best-in-class tools to manage their eggs and embryos.”
TMRW’s technology ensures that a patient’s frozen specimens are both traceable using radio frequency identification (RFID) and safely maintained at ultra-low temperatures. According to Comonte, clinics that use TMRW’s platform can track and locate frozen fertility samples instantly and via touchscreen software that’s as easy to use as an ATM. Through automating tasks prone to human error, TMRW enables more peace of mind for doctors, embryologists, and patients alike.
From my experience going through IVF myself, I found that it’s a total black hole trying to understand where your embryos are stored. Regardless of when and why you’re going through fertility treatment, using the latest technology allows for not just increased safety but also transparency for a patient.
Comonte notes, “From my experience going through IVF myself, I found that it’s a total black hole trying to understand where your embryos are stored. Regardless of when and why you’re going through fertility treatment, using the latest technology allows for not just increased safety but also transparency for a patient.
If I can check my bank balance, make a reservation, and track my pizza all on an app, how can I not yet – after spending tens of thousands of dollars on IVF – have access to technology and transparency as a consumer when it comes to my eggs or embryos? The technology hadn’t existed…until now. At a touch of a button, a clinic has immediate access and visibility to the specimens under their care in the TMRW platform.”
Comonte is already at work on additional advanced tracking technology for patients. She says: “We’re developing a patient app that allows them to see where the specimens are located and how they’re doing. This provides emotional and technological connectivity, visibility, and transparency for patients for the first time. We want to provide that emotional and tangible connection, that visibility, and assurance to all hopeful parents going through the process.”
Listen to “The Future of Fertility” pregnantish podcast episode featuring TMRW Life Sciences:
An Update on Fresh vs. Frozen Eggs
As technological capability in fertility medicine has improved since the origins of IVF, one heavily discussed topic lies in the decision to use fresh or frozen eggs.
The main difference between using fresh or frozen eggs has to do with the timing of the egg fertilization process. Fresh eggs are fertilized within hours of being retrieved and are then cultured in an IVF lab for five days. At this point, they are frozen until the intended parent (IP) is ready for an embryo transfer. In contrast, frozen eggs are not fertilized immediately but are cryopreserved within hours of being retrieved. When the IP is ready for a transfer, usually six or more eggs are thawed, then fertilized, and cultured for embryo transfer (or embryo freezing).
In terms of which option is “better,” it’s important to acknowledge that the choice to use fresh or frozen eggs depends on the circumstances and needs of each IP. Of course, intended parents should consult with their healthcare providers. Considerations include: timeline to TTC, socioeconomic status, whether an egg donor is being used, physician recommendations, and more.
Bailey says: “We’re seeing a downward trend in fresh eggs. The technology, medicine, and testing involved in using frozen eggs is allowing us to optimize opportunities for the most successful transfers for our patients. Now we have a better chance of creating both an embryo and uterine environment that will lead to a successful pregnancy. For example, many patients will freeze their eggs and return for transfer at the right time when their uterus is at its most ideal environment for embryo acceptance. This is easiest to control and safest when using frozen, as the risk for ovarian hyperstimulation post-retrieval is far lower. Patients are also increasingly conducting genetic testing these days, which can take a few weeks, so we’ll often need to freeze the embryos and wait for results to come back before transfer anyway, making the use of frozen far more common.”
For IPs using an egg donor, some prefer the option of fresh eggs because they are entitled to all eggs retrieved in a given cycle. This sometimes results in a greater number of embryos to work with and increases the likelihood of having embryos to freeze and possibly use later for a full genetic sibling.
On the other hand, when participating in a fresh egg donor cycle, there are certain aspects of the process that simply cannot be predicted. Like any medical procedure, there can be unforeseen circumstances that may delay or prevent a cycle from happening. Agencies and fertility clinics, of course, try to mitigate these circumstances and do their best to keep cycles on track.
Additionally, while a cycle using fresh eggs can take about three or more months, a cycle with frozen eggs can be administered far more quickly. If using a donor, there’s no need to sync cycles as needed with a fresh cycle, so the clinic can base all medical protocol off the IP and get to transfer faster.
Regarding cost, for IPs using an egg donor, IVF cycles with frozen eggs tend to be less expensive than fresh eggs, largely because costs are split among multiple recipients.
Regardless of whether intended parents are planning to use fresh or frozen eggs or embryos, it is especially important to research and choose the clinic and care team carefully and find the right fit for their needs.
Fertility of Tomorrow
So much is changing in the world of fertility, and more than just technology. Culturally, conversations around fertility have increased as younger generations gain greater access to information and resources, empowering them with options as they consider family planning.
Companies and nonprofits have been successful in providing communities with the information and power to learn about fertility possibilities. More celebrities and people in powerful positions are publicly discussing their lived experiences of assisted reproductive technology and modern family planning. This amplifies and normalizes the conversation on multiple levels, bringing these important, emotional experiences to dinner table conversations, internet exchanges, podcasts, media, television, and more. Today, intended parents can access support groups, join online forums, see representation in media, and even attend conferences to share resources and feel solidarity with others TTC with the help of assisted reproductive technology.
Comonte says, “When I went through IVF eight years ago, I didn’t have any of these patient sites or online communities available to me, let alone an app that you could check where your embryos were. Technology is going to play a huge role in patient education, patient awareness, and transparency versus a previously opaque process. Anything we can do to provide greater peace of mind and the feeling of more control to patients is a good thing.”
It’s an exciting, evolving world, and this cultural shift is in part thanks to technological advances, like those offered by TMRW, helping to ensure that the process of creating a family is as safe as possible.
“Whether it’s AI, computer-vision, machine-learning, or robotics… technology is going to play a huge role in the standardization of fertility care and has the potential to remove a significant amount of variability that exists in the system today,” says Comonte. “New tools and technology will help clinics scale and meet increasing patient demand, ultimately enabling care for more people in need. We’re seeing significant growth in the field with waiting for patients regularly months long. As technology and automation become the norm, this will help drive costs down while also increasing precision, and in the process also create transparency for both clinics and patients alike. We have a long way to go, and this is just the beginning.”
Whether people proactively store embryos to help safeguard and create their future family, cancer patients preserve their fertility prior to treatment, single parents seek a donor, or LGBTQ couples aim to start a family, the future of fertility options to treatments, cryopreservation, and access to necessary care is opening up for more people than ever to build their families with the help of assisted reproductive technology.
This article is presented by TMRW, whose mission is to safeguard the world’s most precious cells for life and to provide clinics with the right tools and technology for their IVF labs. Learn more by visiting TMRW.ORG.
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