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Article: Sustainability in reproductive healthcare: Considering the environment outside of the incubator

Fran Farlie 30 January 2023

In light of the recent United Nations COP27 Climate Change Conference, the environmental impact of human activity is constantly being assessed under a microscope. It is widely accepted that the climate crisis is now a health crisis, yet the medical field seems to be lagging behind in adopting sustainable practices, instead fostering a culture of excess and normalising disposability.

Why should we be looking towards more sustainable practice, especially within reproductive healthcare? 

While evidence is still preliminary (and due to the multifactorial nature of human reproduction the reports are not without their limitations), an increasing number of studies and systematic reviews are starting to find associations between factors of climate change with adverse reproductive and obstetric health outcomes.

To name just a few, air pollution and increased ambient temperatures have been suggested to increase the risk of preterm birth, low birth weight and stillbirth. Higher ambient temperatures have also been associated with increased prevalence of vector-borne diseases, and with reproduction in mind, zika and malaria would be of concern for their known severe complications with fetal development.

The abundant use of plastics is also thought to negatively impact our reproductive health due to their endocrine-disrupting chemical properties. Reports published in Environmental Research and Public Health and Environment International have detected microplastics in human tissues: testis, placenta and umbilical cord, as well as associating microplastic exposure to ovarian fibrosis and oocyte and semen quality.

Following these findings, it would be ethically irresponsible to continue as normal without any progression towards sustainability in the way we work. Arguably, without change, we would no longer be fully upholding the Hippocratic oath to 'do no harm'.

But where is the carbon footprint of healthcare coming from?

2019 report by Health Care Without Harm, reported over 70 percent of greenhouse gas emissions in healthcare are derived from the supply chain. This is because it is not only how we use and dispose of consumables, pharmaceuticals and equipment in our own clinical environments, but all the processes before that, such as sourcing the raw materials, product manufacturing and transportation. It is therefore key that we push our reproductive healthcare suppliers to act more sustainably in order to reduce our own carbon footprint.

In Australia and New Zealand, styrofoam boxes to transport media at refrigerated temperatures have been replaced with an unorthodox reusable, recyclable and biodegradable insulation alternative – sheep wool! It just shows sustainable options for packaging are available, we just need to use our purchasing power as reproductive healthcare professionals to encourage more of these changes from our suppliers.

The onus, however, is not all on manufacturers, individual clinics also need to take responsibility. Facilities need to look at optimising their use of resources across all departments, as each sustainable marginal gain collectively can help reduce their overall environmental impact. The easiest way to think about where to start is to look at key areas, such as: energy, water, transport and waste, and reflect on the waste hierarchy pyramid. This approach emphasises prevention, reducing, reusing and recycling (in that order), and deems recovery and disposal unfavourable options where alternatives are possible.

Approximately every four seconds a disposable hat is thrown away in healthcare – since there is no evidence to suggest the safe use of reusable hats has any increased risk of contamination or infection, laboratories and theatre spaces should be looking to implement this change. Virtual consultations ought to be encouraged to avoid emissions generated from patient transport while still being able to provide the same level of care. Clinics could even hold collection points for certain items, such as medication blister packets, which can then be sent on for recycling, reducing the amount of waste which would otherwise go to landfill.

Our carbon footprint can also be reduced by replacing virgin paper with recycled paper, which is 50 percent less energy consuming to produce, while also increasing digitisation both in-house and for patient communication to avoid the need for printing paper in the first place.

How can we ensure sustainability is a key feature of 'best practice' now and in the future?

I strongly believe this is where our national/international societies and governing bodies need to step up and enforce a stronger response to 'the environmental impact of reproductive healthcare. In July 2022, the Health and Care Act placed new responsibilities on the NHS in England to consider climate change, being the first country in the world to directly address its healthcare's response to climate change in national legislation. NHS England's aim is to be the world's first net zero national health service.

This law currently only applies to NHS trusts, but it shouldn't stop the private sector aspiring to reach the same targets. Just like the NHS, healthcare facilities should all be evaluating their environmental impact and generating short and long-term action plans to tackling the issues.

Ultimately, individual action is necessary to work towards a greener, more sustainable practice in reproductive healthcare, but it is only once paired with systemic change from all stakeholders: suppliers, clinics, societies, that we will be able to make the biggest impact in reducing reproductive healthcare's environmental impact.


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Course: 1 WEEK INDIVIDUAL HANDS-ON IN ART

Marc Van den Bergh 17 January 2023

DATE :  7th to 14th May 2023

LOCATION : Switzerland  ITCART

INFORMATION : [email protected]


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Webinar: EMBRYO BIOPSY-LEVEL UP!

International IVF Initiative 16 January 2023
EMBRYO BIOPSY-LEVEL UP!

Tuesday, 24th January (3 pm EST / 8 pm UK / 9 pm CET)

Please join us for the first I3 webinar of the year. We'll be discussing Embryo biopsy best practice, techniques and practicalities!

Moderators:
Thomas Elliott and Dr. Tony Anderson with Dr. Peter Nagy and Mariana Cadavid 

Presenters:
Debbie Venier “Embryo biopsy techniques”

Dr. Charlene Alouf “Biopsy or re-biopsy following vitrification – a chilling circumstance”

Dr. Bec Holmes " “Opportunities for errors" in the embryo biopsy procedure”
A talk sponsored by IMT Matcher

VIEW HERE


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News: Just four percent of sperm donor applicants become donors

Ana Vasconcelos 16 January 2023

Fewer than one in 20 men who applied to become sperm donors in the USA and Denmark in 2018 and 2019, were accepted by a sperm bank, a recent study has shown.

The number of sperm-donor-conceived children born in the UK has tripled in the past 13 years in the UK, meaning demand for sperm donors outstrips supply. Recent figures from the Human Fertilisation and Embryology Authority show half of donor sperm used in the UK is imported, often from Denmark. In a study published in Human Reproduction of over 11,000 men who applied to be sperm donors to the sperm and egg bank Cryos in the USA and Denmark, researchers looked at the points in the application process men dropped out or were rejected by the clinic. They also looked at the impact of being asked to waive anonymity on willingness to donate and acceptance.

Lead author – and Progress Educational Trust (PET) trustee – Professor Allan Pacey from the University of Sheffield, pointed out that although sperm donors can choose to retain their anonymity in the USA and Denmark (though not the UK since 2006), over a quarter of donors shifted from an initial decision to remain anonymous, to be identifiable, over the course of the donation process. He said: 'What's particularly fascinating is that more donors, who initially wanted to remain anonymous, were willing to be identifiable as the screening and donation process continued. This is particularly good news for patients in the UK undergoing fertility treatment, as it is a legal requirement for sperm donors to be identifiable to any children born from their donations.'

Around half of applicants dropped out or were rejected before being invited to provide a sperm sample, for the second stage of the application process, researchers found. Of the men who provided a sample 21 percent did not have a high enough quality semen, according to the clinic. Of men accepted after semen analysis and invited to complete a medical questionnaire, just 18 percent continued to the next stage.

A report published by PET in June 2022 Fertility, Genomics and Embryo Research: Public Attitudes and Understanding showed that 64 percent of the UK public would consider sperm or egg donation with identity release.

Professor Pacey said: 'In the UK you can only become a donor if you agreed to be identifiable and there simply aren't enough guys in the UK that are willing to do that, or we haven't managed to tempt them enough, because we haven't got an advertising system that targets them.'

He went on: 'The study with Cryos highlights how hard it is to become a sperm donor. It's not like blood donation where once it's done you can have a cup of tea and go home. Sperm donation is a regular commitment with lots of screening and regular testing as well as life-long implications for the donor if any children are born from their sample.'

Sources and References


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: 7th IUI Symposium & Hands-on Workshop 2023, Kuala Lumpur, Malaysia

Zamri Ahmad Yusof 04 January 2023
7th IUI Symposium & Hands-on Workshop 2023, Kuala Lumpur, Malaysia

OBJECTIVES

  • To learn about selection of patients & preliminary work up for IUI
  • To understand on factors affecting male fertility
  • Introduction to different techniques and factors determining the outcome of IUI
  • To understand basic principles of semen processing & analysis for IUI
  • Hands-on pratice for semen processing, density gradient & swim-up methods
  • To learn and understand about setting up of an IUI laboratory

 

TARGET AUDIENCE

  • Reproductive medicine specialist & trainees
  • Obstetricians and Gynaecologists
  • O&G trainees, registrars and medical officers
  • Family medicine specialist, primary care physicians, trainees, registrars and medical officers
  • General practitioners
  • Embryologist, scientific officer, medical laboratory technologist
  • Nurses and allied health care professionals

 


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News: ART & Embryology training program

Chennai Fertility Center and Research Institute 02 January 2023
ART & Embryology training program

Feburary 2023 Training Batch Schedule - 6th Feb To 20th Feb 2023

The International School of Embryology was established to offer training for  Clinicians in advanced Reproductive Technologies. Our skill and precision to all aspirants help them to know in-depth knowledge and experience. The members of our teaching faculty aim to bring doctors and embryologists to the highest level of knowledge about reproductive techniques and practical capability in the field.

Our courses cover basics in Andrology, embryology, ICSI, and cryosciences (Hands-on).

Limited Seats. For admission Contact  9003111598 / 8428278218


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Announcement: CLINICAL COURSES IN ART

Dr Yogitha Rao 12 December 2022
CLINICAL COURSES IN ART

 

CLINICAL COURSES IN ART

Santasa IVF &Endosurgery Institute is a forefront healthcare organization with a goal to render progressive healthcare service to every childless couples.

Santasa has been in the process of training future ART and OBG clinicians to develop their technical skills and knowledge in the field of reproductive medicine.

Clinical courses offered:

  • IUI Protocols
  • Mastering Follicular Scans (TVS).
  • Basic infertility course.
  • Advanced ART Course.
  • Setting Up IVF Laboratory.
  • Setting Up Andrology Lab.
  • Embryo loading techniques.
  • Optimizing embryo transfer.

In addition to the above short courses, santasa offers  Fellowship in reproductive medicine affiliated to RGUHS which is of 18 months duration.

For queries contact,

Dial: 8904253475

Whatsapp : 9845688608

Mail :[email protected]


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News: HANDS-ON TRAINING PROGRAMME IN EMBRYOLOGY & ANDROLOGY

Dr Yogitha Rao 12 December 2022
HANDS-ON TRAINING PROGRAMME IN EMBRYOLOGY & ANDROLOGY

HANDS-ON TRAINING PROGRAMME IN EMBRYOLOGY & ANDROLOGY

Santasa IVF &Endosurgery Institute established in 2008, is a pioneering health care organization with a mission to provide advanced healthcare affordable to every woman.  Its main domain of care includes fertility specialists, Embryologists & Andrology lab technicians.

Laboratory training offered at santasa imparts solid knowledge of basics as well as intricate technologies. The course also helps in getting updated with the new ART regulations.

Laboratory courses:

  • Optimizing semen analysis & DNA fragmentation
  • Semen preparation methods for different procedures (IVF/IUI/ICSI)
  • Sperm function tests
  • Quality control & documentation in IVF & Andrology laboratory
  • Optimizing disposables and consumables in IVF & Andrology lab
  • Tips and tricks in cryopreservation
  • Embryo loading techniques

For queries contact,

Dial: 8904253475

Whatsapp : 9845688608

Mail :[email protected]


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Webinar: HIGHLIGHTS OF THE 13TH BIENNIAL ALPHA CONGRESS: IN CASE YOU MISSED IT!

International IIVF Initiative 06 December 2022
HIGHLIGHTS OF THE 13TH BIENNIAL ALPHA CONGRESS: IN CASE YOU MISSED IT!

6th Dec 2022, 3pm EST LIVE, 8pm UK, 9pm CET

Moderators:
Mina Alikani, Alison Campbell, Sharon Mortimer, Dean Morbeck and Christophe Blockeel

Introduction by Sharon Mortimer

Presenting:
Alessandra Alteri – Winner Best Free Communication
"The effect of laser assisted hatching on vitrified-warmed blastocysts: a multicentric randomized controlled trial"

Ainhoa Larreategui – Winner Best Poster Presentation
"Centrosome failure and peri-centrosome fragmentation in the first cell division of non-rodent mammalian zygotes"

Anja Pinborg – Most critically important invited lecture
"FET offspring health"

Closing Remarks by Mina Alikani and Dean Morbeck introducing the Alpha Forum!

REGISTER HERE


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News: 30-year-old embryos result in live birth

David O'Rourke 05 December 2022

Twins have been born from embryos that had been frozen for 30 years, the longest any embryo has been frozen before leading to a live birth to date.

The embryos were created for an anonymous married couple using IVF in 1992. The man was in his 50s and the couple reportedly relied on a 34-year-old egg donor. The embryos were kept at a fertility lab on the West Coast until 2007, when the couple who created them donated them to the National Embryo Donation Centre (NEDC) in Knoxville, Tennessee, hoping that another couple might choose them.

They were selected by couple Philip and Rachel Ridgeway who had requested that the non-profit Christian NEDC provide embryos that had 'special consideration', meaning they had proved difficult to place with couples who wished to use a 'donated' embryo. 'We weren't looking to get the embryos that have been frozen the longest in the world,' Philip Ridgeway said. 'We just wanted the ones that had been waiting the longest.'

Two of the five thawed embryos were nonviable. Of the three that were transferred, two successfully implanted 29 years and ten months after they were frozen, resulting in the live birth of Lydia and Timothy Ridgeway on 31 October'. The couple considers the twins to be their 'oldest children' even though they are less than a month old: they already had four naturally-conceived children aged eight, six, three and one.

Theoretically, embryos can remain in cryostorage in liquid nitrogen at a temperature of -196C indefinitely. The birth of Lydia and Timothy is further evidence of this theory. On 1 July 2022, the rules on how long you can store eggs, sperm or embryos in the UK changed. Before this date, people in the UK could usually only store their embryos for up to ten years (though there were a few medical exceptions allowing for 55 years).

The law now permits storage of embryos for use in treatment for up to a maximum of 55 years from the date the embryos are first placed in storage.

Sources and References


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