If we say the name Geri, your immediate thought might be of somebody you know (or, er, a Spice Girl). For thousands of infertile women, however, the name has a very different significance. At Genea, the fertility specialists with 18 clinics across Australia, ‘Geri’ (which stands for Genea Embryo Review Instrument) is the name of a revolutionary incubator that is providing insights into the development of embryos during IVF.
“If you’re going to grow biological cells – embryos outside the body – increasingly we realised you have to maintain the same kind of atmospheric conditions that would be inside a woman,” says Mark Bowman, Genea’s medical director. “You need heat and the right mixture of gases. You also need to replace the fluid that an embryo usually sits in, inside the fallopian tube, to make sure it has all the right goodies.”
Geri came about when scientists at Genea identified a problem with the old style of incubator: multiple people’s embryos were stored in one big compartment, which meant that when a scientist opened the lid to check on the progress of one sample, every other sample was disturbed. Imagine opening the oven door on a soufflé multiple times during the cooking process.
In contrast, the Geri incubator – developed by Genea in Australia and now exported worldwide – is split into ‘wells’, so every patient’s embryos are stored individually. “What’s really revolutionary is the use of time-lapse embryonics,” says Mark. “We have little cameras hooked up above the embryos, so our scientists can watch how they’re developing and capture moments. There’s a really interesting extension of that, too – it’s technically possible to make those images available to patients in the future.”
This is not the only way technology is being used to revolutionise reproduction. The Genea laboratory, which has helped bring over 800,000 babies into the world in the past 30 years, has also developed a machine called Gavi that automates embryo freezing. The process used to be performed by hand which, Mark says, left it at risk of human error.
And that’s just the beginning. “Currently, if we want to monitor a woman’s ovulation, she has to come into the clinic and have a needle stuck in her arm,” says Mark. “Already the technology exists – although it’s not yet in Australia – to do a fingerprint test at home, hooked up to an app on your smartphone, which sends the information off to a portal and tells you what your hormone levels are.”
Creating a new life used to be a two-person activity, but increasingly it’s a collaborative effort, with the use of big data, crowdsourcing and strategies borrowed from the sharing economy. Data analysts IBISWorld report that the fertility industry has grown by 4.6 per cent year-on-year since 2011, while the number of completed IVF cycles in Australia was on course to reach 43,400 in 2015. It’s no wonder the start-up world has been looking for ways in which technology could also be used to assist Mother Nature and lay the foundations for a new business.
Over a million users have downloaded Kindara, an app described as “the Fitbit for your period”, which allows women to track when they are most fertile so they can schedule sex accordingly. Meanwhile, Californian start-up Yono Labs recently raised over US$53,000 in a Kickstarter campaign to develop an ‘in-ear fertility tracker’, which monitors a woman’s body temperature to alert her when she’s ovulating.
While the abundance of trackers on the market is important for raising awareness of fertility and educating women about their bodies, there are risks with depending solely on track-it-yourself gadgets such as these. A study presented at the annual meeting of the American College of Obstetricians and Gynecologists in Washington, DC, tested 53 digital fertility calculators and found only four (apps Clue, My Days – Period & Ovulation and Period Tracker, and website babymed.com) accurately predicted a woman’s precise fertile window. Which is why, like in many fields that have been supposedly simplified by technology, experts are calling for a return to professionals to help women conceive.
Biotech start-up Celmatix, founded by New York entrepreneur Piraye Yurttas Beim, supplies fertility specialists with a software called Polaris, which collates the medical histories of millions of women who have undergone fertility treatment. This means that a doctor can now input a couple’s history into the system and it will match them with similar case studies, and recommend a treatment option based on previous successes.
But even the question of how to find a fertility specialist can be complicated. What clinic is right for you? Should you go public or private? Jake Anderson-Bialis, a Silicon Valley venture capitalist, faced this issue when he and his wife, Deborah, were struggling to conceive naturally. So in February 2016 they launched FertilityIQ, an online database dubbed the ‘Yelp of fertility treatments’ that ranks US fertility clinics by crowdsourcing reviews from past patients who post anonymously.
“I think a more robust marketplace – a sharing economy – for reproduction is inevitable,” says Jake. “Fertility is still a sensitive subject and, for that reason, there is often an ‘offline failure’ when it comes to communication. When we move the discussion online, patients can read the full context for each experience, before deciding whether it applies to them.”
Jake believes that since its launch, FertilityIQ has helped 25 per cent of patients in America decide on where to get care, by estimating the costs they may accrue at each clinic and the protocols they are likely to face. “We take major pains to ensure those [patients] writing in remain anonymous, but are authentic,” says Jake. “Unlike every other corridor of the sharing economy, we’re not talking about finding a faster taxi or a cheaper time-share. Lives are on the line here.”
Educating couples about their options is important. Genea’s Fertility Census Report, which questioned over 3000 Australians, found men are 79 per cent more likely than women to be embarrassed to seek medical treatment for fertility. In fact, when breastfeeding specialists Medela Australia surveyed 4000 mums about who they turned to for advice about pregnancy, ‘online communities, apps and websites’ were more popular than friends or family. However, social media is making strides to end the stigma with hashtags like #infertilityhumour, while famous faces including Mark Zuckerberg, Jimmy Fallon and Tyra Banks have been public in sharing their conception challenges. Cash-strapped couples are even using crowdfunding websites like Indiegogo to raise money to pay for fertility treatment.
“Traditionally, a lot of couples with infertility suffer in silence,” says Mark. “To have social media connectedness is very important for those women and men because they can connect in a non-confronting way. A lot of the technology we’re seeing, like apps or automated machines, are making fertility treatment more convenient. What are we all? Time-poor. Ultimately, this is what technology is looking at.”
As for the future of fertility, expect robots and artificial organs. Last year, a research team from Northwestern University in Illinois announced they had successfully printed a prosthetic ovary using a 3D printer and implanted it into a mouse to restore her hormone cycle. Meanwhile, a team from the Institute for Integrative Nanosciences in Germany is developing the ‘spermbot’ – a tiny ‘micro-motor’ that attaches to a sperm to propel it towards an egg faster.
Where do babies come from? That question just got a lot more complex.