January 14, 2025 • 20 mins
Our latest discussion dives deep into the metrics that make understanding IVF easier and more empowering. We explore how key performance indicators (KPIs) like Antral Follicle Count, fertilization rates, and embryo quality inform treatment decisions while addressing the emotional landscape of the fertility journey.
• Introduction to the importance of KPIs in IVF
• Breakdown of the IVF process and relevant KPIs
• Discussion on Antral Follicle Count (AFC) and its implications
• Insights into follicle growth during stimulation
• Evaluation of egg retrieval and fertility success rates
• Explanation of fertilization rates and pronuclei indicators
• Analysis of blastocyst development as a key marker
• Overview of embryo transfer metrics and uterine positioning
• Importance of emotional resilience and building support systems
• Future outlook on innovations in IVF technology
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:01):
Life by Dr Pat, leading innovation in fertility
excellence.
Deep dive into reproductionwith Life by Dr Pat.
Speaker 1 (00:09):
Empower the understanding of your IVF cycle
with KPI.
Speaker 2 (00:14):
Okay, get ready, because today we're going deep
into IVF.
Speaker 1 (00:19):
Diving in.
Speaker 2 (00:20):
Yeah, but specifically those KPIs that can
help everyone listening reallyunderstand what's happening
during treatment.
Lots of listeners want toreally grasp those metrics that
matter.
Speaker 1 (00:32):
Right.
Speaker 2 (00:33):
Almost like we're decoding the secret language of
a fertility journey.
Speaker 1 (00:37):
You know yeah.
Speaker 2 (00:39):
Thankfully we have an expert here with us.
Speaker 1 (00:41):
Absolutely.
Speaker 2 (00:42):
Who's going to help us break it all down?
Speaker 1 (00:44):
Absolutely.
Speaker 2 (00:44):
Now I know, KPI sounds a little like corporate
jargon, right?
Yeah, not something you'dreally expect in a fertility
clinic.
Speaker 1 (00:51):
Right.
Speaker 2 (00:52):
But think of them like guideposts, okay, helping
you and your doctor kind of seehow things are moving along.
Speaker 1 (00:58):
That's a great way to put it, yeah.
Speaker 2 (01:00):
So, before we get into specifics, can you give us
like a super quick overview oflike the IVF process?
Speaker 1 (01:06):
Of course.
So it all starts withstimulating the ovaries to
produce multiple eggs.
Then those eggs are retrievedand then fertilized in the lab,
and the resulting embryos arecultured and monitored before
one or more are transferred backto the uterus.
Speaker 2 (01:21):
Okay.
Speaker 1 (01:22):
And each step has its own KPI, helping us assess how
things are going and makeadjustments as needed.
Speaker 2 (01:28):
I actually found this visual guide in Thai.
Speaker 1 (01:31):
Okay.
Speaker 2 (01:31):
Called Nankanankanitakikakankanpapi Got
it which maps out those stepsreally clearly.
It's really helpful to just seeit visually laid out.
Speaker 1 (01:40):
Visual aids are fantastic for understanding this
journey.
Speaker 2 (01:42):
Exactly Okay, let's get into those KPIs.
Speaker 1 (01:45):
Absolutely.
Speaker 2 (01:46):
This resource lists a bunch.
Speaker 1 (01:47):
Yeah.
Speaker 2 (01:48):
Starting with antral follicle count, or AFC.
Yeah, what is that actuallymeasuring?
Speaker 1 (01:53):
So AFC is one of the first things we look at.
It's a simple ultrasound countof the tiny follicles in your
ovaries at the beginning of yourcycle.
Speaker 2 (02:01):
Okay.
Speaker 1 (02:03):
You can think of it as a snapshot of your ovarian
reserve, so the pool ofpotential eggs that you have.
Speaker 2 (02:08):
So a higher count generally means a better reserve
.
Speaker 1 (02:12):
Generally yes.
Speaker 2 (02:13):
But I'm guessing age plays a factor too.
Speaker 1 (02:16):
Absolutely.
Age is a significant factor.
As women get older, the numberof antral follicles naturally
decreases, right?
But lifestyle genetics, evenprevious medical treatments, can
impact that count as well.
So it's not a perfect predictor, but it gives us a starting
point.
Speaker 2 (02:35):
Interesting.
So it's less about hitting likesome magic number and more
about understanding, like whatyour AFC means.
Speaker 1 (02:43):
Exactly.
Speaker 2 (02:44):
In the context of your personal health history.
Speaker 1 (02:46):
Precisely.
It's about personalizedmedicine, not a one size fits
all approach.
Speaker 2 (02:49):
Okay, next up is how your follicles respond to that
stimulation medication, right?
So we're not just countingfollicles now, but we're looking
at how they grow.
Speaker 1 (02:58):
Exactly.
We're tracking the percentageof follicles that grow to a
mature size after you starttaking the medication.
It's all about seeing how wellthose follicles are nurtured and
developing those precious eggs.
Speaker 2 (03:10):
I remember reading an example in this Thai source
where one patient had a dominantfollicle that was growing super
fast, almost like it washogging all the resources.
Does that happen often?
Speaker 1 (03:23):
It does happen and it's a great illustration of why
we don't just look at the rawnumbers.
Sometimes one follicle takesoff.
It kind of skews the overallpicture.
That can be due to the timingof the medication, individual
variations, even genetics.
Speaker 2 (03:39):
Wow.
Speaker 1 (03:39):
But that's why it's so important to have open
communication with your doctor,so they can explain these
nuances to you.
Speaker 2 (03:44):
So it's like those follicles are all on their own
little race and sometimes onejust gets a head start.
Speaker 1 (03:50):
Yeah.
Speaker 2 (03:50):
But ultimately we want to see like a good
percentage reaching maturity.
Speaker 1 (03:54):
Exactly.
We're aiming for efficient,even development to maximize
your chances of retrievingmature eggs.
Speaker 2 (04:01):
So that brings us to egg retrieval.
Yes, what KPI are we looking athere?
Speaker 1 (04:06):
So this is where things get exciting.
We track the percentage ofmature eggs that are
successfully retrieved duringthe procedure.
We want to collect as many ofthose mature eggs as possible,
because those are the ones withthe potential to be fertilized.
Speaker 2 (04:20):
And it seems intuitive, right?
Yeah, we want as many eggs aspossible.
Speaker 1 (04:23):
Right.
Speaker 2 (04:23):
Are there ever situations where, like, that's
not the goal?
Speaker 1 (04:27):
That's a great question.
Speaker 2 (04:28):
Yeah.
Speaker 1 (04:29):
While more eggs generally offer more options,
it's not just about quantity,okay.
Quality matters too, right.
Sometimes fewer high-qualityeggs are preferable to a large
number of immature orlower-quality eggs.
It really depends on theindividual situation.
Speaker 2 (04:46):
Okay, so that makes sense.
Speaker 1 (04:47):
Yeah.
Speaker 2 (04:48):
Even here it's about looking beyond those numbers and
considering that whole picture.
Speaker 1 (04:52):
Precisely, and that's where your doctor's expertise
and personalized guidance comein.
They will help you interpretthat data and make the best
decisions for your journey.
Speaker 2 (05:00):
Okay, so we got those precious eggs retrieved, right?
What happens next?
Speaker 1 (05:04):
So next we look at egg maturity.
Not every egg that's retrievedis mature and ready for
fertilization.
Speaker 2 (05:11):
Ah, so we're looking at how many of those retrieved
eggs are actually ready to go.
Speaker 1 (05:15):
Exactly.
This KPI tells us how many eggsare truly viable for
fertilization.
It's a crucial step becauseonly mature eggs can be
successfully fertilized anddevelop into healthy embryos.
Speaker 2 (05:27):
Now I know from the steps in IVF, ICSI source that
fertilization happens in the labusing a technique called ICSI,
where a single sperm is injecteddirectly into the egg.
Speaker 1 (05:39):
Yes.
Speaker 2 (05:40):
What QAPI helps us understand how that process is
going.
Speaker 1 (05:43):
So we track the fertilization rate, which is the
percentage of mature eggs thatare successfully fertilized
after ICSI.
Okay, this KPI gives us insightinto both the egg and sperm
quality.
Speaker 2 (05:54):
Okay.
So if we're seeing like a goodfertilization rate, that's a
good sign for both partners,right?
Speaker 1 (05:58):
Absolutely.
It means the eggs are receptiveto fertilization and the sperm
is capable of penetrating theegg's outer layer and delivering
its genetic material.
Speaker 2 (06:07):
Now I remember reading about something called
pronuclei in one of the sources.
Speaker 1 (06:10):
Yes.
Speaker 2 (06:11):
How does that relate to fertilization?
Speaker 1 (06:13):
So these pronuclei are the visual confirmation that
fertilization has occurred.
They show us that the sperm andthe egg's DNA have combined,
confirming successfulfertilization.
It's like seeing the blueprintfor a new human being start to
form.
Speaker 2 (06:28):
Wow, that is incredible, but I know that
there's been cases, right?
Speaker 1 (06:31):
Right.
Speaker 2 (06:32):
Where people have a lower fertilization rate, but
they still had success.
Speaker 1 (06:36):
That's right.
A lower fertilization ratedoesn't necessarily mean failure
.
Okay, while it might indicatechallenges with egg or sperm
quality, sometimes just onehealthy embryo is all it takes.
It all comes back tounderstanding the nuances of
your individual case, and that'swhere open communication with
your doctor is so vital.
Speaker 2 (06:54):
Right, even if, like a particular key PI isn't ideal,
it doesn't automatically meanlike game over.
Speaker 1 (07:00):
Exactly.
Speaker 2 (07:01):
There might be other factors at play, and that's
where, like you said, the doctorcan really help.
Speaker 1 (07:05):
Exactly, and remember IVF technology is constantly
evolving, so even if you facechallenges in one cycle, there
might be new options oradjustments we can explore in
future cycles.
Speaker 2 (07:15):
Okay, so we've got fertilized eggs, so now we're
moving to that embryodevelopment phase right.
What KPI helps us understandhow those embryos are
progressing?
Speaker 1 (07:24):
So we track the percentage of fertilized eggs
that develop into blastocysts.
Speaker 2 (07:28):
Okay.
Speaker 1 (07:29):
A blastocyst is a more advanced stage of embryo
development with a higher chanceof implantation.
Speaker 2 (07:35):
So a good blastocyst development rate like that means
those embryos are strong andhealthy.
Speaker 1 (07:41):
Precisely.
Speaker 2 (07:42):
Ready to potentially implant.
Speaker 1 (07:43):
It tells us that those embryos have the potential
to make it to the next stage.
Speaker 2 (07:48):
What factors can affect blastocyst development?
Sure, is it all about, likethat, initial egg and sperm
quality, or are there otherthings at play?
Speaker 1 (07:57):
So egg and sperm quality are definitely
foundational, but the labenvironment plays a crucial role
too.
Temperature, humidity and eventhe air quality are carefully
controlled to create the optimalconditions for those embryos to
thrive Right.
Think of it like creating atiny perfect world for them to
grow.
Speaker 2 (08:15):
It's amazing how much goes into creating that like
ideal environment, you know.
Yeah, it really highlights thatdelicate balance of science and
nature and IVF.
Speaker 1 (08:25):
It truly is a delicate dance.
Speaker 2 (08:27):
Yeah.
Speaker 1 (08:28):
And the expertise of the embryologist is crucial in
ensuring those embryos arehandled with the utmost care and
precision.
Speaker 2 (08:34):
Well, I'm really starting to see how all these
KPIs are like puzzle pieces.
Yes, each one giving us, youknow, a little bit more
information about the overallpicture.
Speaker 1 (08:44):
You got it.
It's about connecting thosedots and understanding the story
they tell about your individualjourney.
Speaker 2 (08:50):
Okay, we've covered a lot already, but we're not done
yet.
Let's take a quick pause andwe'll be right back to explore
that next stage of IVF Soundsgood, and those KPIs that guide
us there Stay with us.
Speaker 1 (09:00):
Welcome back to our deep dive into IVF KPIs.
Speaker 2 (09:04):
Yes, we've back to our deep dive into IVF KPIs.
Yes, we've explored those KPIsthat kind of guide us from
ovarian stimulation all the wayto embryo development.
Right, but we still have areally crucial step to cover.
We do Embryo transfer.
Speaker 1 (09:16):
Absolutely.
This is where we take one ormore of those carefully nurtured
blastocysts.
Speaker 2 (09:21):
Okay.
Speaker 1 (09:22):
And transfer them back into the uterus, hoping
that they will implant and leadto a pregnancy.
Speaker 2 (09:28):
I can imagine this step comes with a whole new set
of anxieties and hopes.
Speaker 1 (09:33):
It does.
Speaker 2 (09:34):
Are there KPIs here that can give us insight?
Speaker 1 (09:37):
Absolutely.
We look at factors like embryoquality and uterine lining
thickness to assess thelikelihood of implantation.
Speaker 2 (09:46):
So it's all about making sure that both the embryo
and the environment are ready,right.
Speaker 1 (09:50):
Yes.
Speaker 2 (09:50):
Like a perfectly timed meeting of the two.
Speaker 1 (09:53):
That's a great analogy.
It's about synchronicity,ensuring that everything is
aligned for optimal implantation.
Speaker 2 (09:59):
Let's talk about embryo quality first.
I remember reading about embryograding in one of the sources.
How does that work?
Speaker 1 (10:08):
So we use a grading system to assess the appearance
and development of the embryos.
Higher graded embryos generallyhave a better chance of
implantation.
It's like a quality check toselect the embryos with the
highest potential.
Speaker 2 (10:20):
So it's like choosing the strongest contenders for
the implantation race, but Iknow from the dysmorphic uterus
101 source that the uterusitself plays like a really
critical role too.
Right.
Speaker 1 (10:32):
You're absolutely right.
The uterine lining, orendometrium, needs to be
receptive for the embryo toimplant and thrive.
We use ultrasound to measurethe thickness and appearance of
the lining, making sure thatit's thick enough and has the
right characteristics to supporta pregnancy.
Speaker 2 (10:47):
So a thicker lining is a good sign.
Generally yeah, it seems likeit would offer more cushioning
and support for that embryo.
Speaker 1 (10:53):
A thicker lining generally indicates better blood
flow and more nutrients,creating a welcoming environment
for the embryo.
It's like preparing a cozy nestfor that little embryo to
settle into.
Speaker 2 (11:04):
I love that.
Yeah, it's amazing howeverything has to work together
so perfectly it is.
Are there any other KPIsrelated to the embryo transfer
itself?
Speaker 1 (11:14):
Yes, the technique used for the transfer can also
influence success rates.
We aim for a smooth, gentletransfer, placing the embryos in
the optimal spot within theuterus.
Some clinics even useultrasound guidance during the
transfer to ensure preciseplacement.
Speaker 2 (11:29):
It sounds like a really delicate procedure
requiring a lot of skill andexpertise.
Speaker 1 (11:34):
Absolutely, and the experience of the doctor
performing the transfer iscrucial.
They're not just transferringembryos, they're handling the
hopes and dreams of those hopingto become parents.
Speaker 2 (11:46):
That's a beautiful way to put it.
It's not just a medicalprocedure.
It's a moment filled withemotion, anticipation.
Speaker 1 (11:54):
Lots of it.
Speaker 2 (11:55):
After the transfer, we enter the dreaded two-week
wait.
Speaker 1 (11:59):
Yes, we do.
Speaker 2 (12:00):
Is there any KPI that can tell us if implantation has
occurred?
Speaker 1 (12:05):
Unfortunately there's no KPI that directly measures
implantation.
We have to rely on thepregnancy test a couple of weeks
later to confirm if an embryohas successfully implanted.
But even without a specific KPI, we can gather clues along the
way.
Speaker 2 (12:20):
What kind of clues?
What should someone be lookingout for during that two-week
wait?
Speaker 1 (12:24):
It's important to listen to your body.
Some women experience mildcramping or spotting around the
time of implantation, but othershave no symptoms at all.
The key is to manageexpectations and avoid reading
too much into every twinge orsensation.
That two-week wait can beemotionally challenging and it's
crucial to prioritize self-careand emotional well-being during
(12:45):
this time.
Speaker 2 (12:46):
We've talked a lot about, like the individual KPIs,
but I remember reading thatthat these numbers can sometimes
feel, you know, reallyoverwhelming.
Speaker 1 (12:55):
They can.
Speaker 2 (12:56):
How can we use these KPIs to like empower ourselves
without getting like totallylost in the data?
Speaker 1 (13:02):
That's a great point.
These KPIs are meant to betools for understanding, not
weapons of self-criticism.
It's about seeing the biggerpicture and understanding the
trends and patterns they reveal.
Speaker 2 (13:13):
So it's not about like fixating on a single number
, right, but it's more aboutseeing that overall story that
those numbers tell.
Speaker 1 (13:20):
Exactly, and that's where open communication with
your doctor is so important.
They can help you interpret thedata, explain the nuances of
your case and answer anyquestions you might have.
It's about working together asa team to make informed
decisions and navigate thisjourney with confidence.
Speaker 2 (13:36):
I remember this anecdote from the Thai source
about a patient who had 18 largefollicles before egg retrieval.
Speaker 1 (13:43):
Yeah.
Speaker 2 (13:43):
But only retrieved five eggs.
Speaker 1 (13:45):
Okay.
Speaker 2 (13:47):
And it was obviously like super disappointing for her
Right but those KPIs actuallyhelped her doctor like uncover a
potential issue.
Okay, with her response to thetrigger shot, the medication
that triggers ovulation.
Speaker 1 (14:00):
That's a perfect example of how KPIs can be
incredibly valuable.
Even when they revealchallenges, they can pinpoint
areas for improvement and leadto adjustments in future cycles.
It's about using data topersonalize your treatment plan
and maximize your chances ofsuccess.
Speaker 2 (14:16):
It seems like these KPIs aren't just about tracking
progress, but they're also aboutimproving that IVF process
itself.
Right Like learning from eachcycle, Right Refining techniques
to better support patients.
Speaker 1 (14:30):
You're absolutely right.
These KPIs are drivinginnovation and pushing the
boundaries of what's possible inreproductive medicine.
Speaker 2 (14:36):
We've talked a lot about like the specific KPIs
related to IVF.
Yeah, but I'm curious about howthey connect to like other
aspects of fertility.
Sure, for example, I wasreading about the impact of
uterine abnormalities Right Likea T-shaped uterus on IVF
outcomes.
Speaker 1 (14:53):
Yeah.
Speaker 2 (14:54):
How do those factors come into play?
Speaker 1 (14:55):
That's a great question.
Ivf doesn't happen in isolation.
It's part of a much largerpicture of your overall
reproductive health.
Factors like age, lifestyle,medical history and even
anatomical variations caninfluence your IVF journey.
Speaker 2 (15:11):
So it's like another layer of the puzzle right Adding
complexity, nuance tointerpreting those KPIs.
Speaker 1 (15:17):
Exactly, and that's why it's so crucial to have a
comprehensive evaluation lookingat all aspects of your
fertility, not just the IVFprocedure itself.
Speaker 2 (15:25):
In the case of like a T-shaped uterus.
Speaker 1 (15:28):
Right.
Speaker 2 (15:28):
I read that a procedure called a hysteroscopic
metroplasty can be done to kindof correct the abnormality.
Speaker 1 (15:34):
Yes.
Speaker 2 (15:36):
And improve chances of successful implantation.
Is that something that you likeoften recommend?
Speaker 1 (15:41):
It depends on the individual case, of course, but
addressing underlying anatomicalissues can definitely improve
IVF outcomes.
It's about optimizing everyaspect of the journey to give
you the best possible chance ofsuccess.
Speaker 2 (15:55):
It's amazing how how medicine is constantly advancing
.
You know it is offering likenew solutions and possibilities
for those advancing.
You know it is Offering likenew solutions and possibilities.
Yeah, for those facing, youknow, fertility challenges.
Speaker 1 (16:07):
It truly is inspiring , and the more we understand
about the intricacies offertility, the better equipped
we are to support individualsand couples on their path to
parenthood.
Speaker 2 (16:17):
Okay, we've explored, you know, all these KPIs that
guide us through that IVFprocess.
Speaker 1 (16:22):
Yeah.
Speaker 2 (16:22):
From ovarian stimulation all the way to
embryo transfer Right.
But I know there's still somuch more to discuss.
Speaker 1 (16:28):
Yeah, we do.
Speaker 2 (16:29):
We've touched on, like the emotional aspects of
this journey.
Speaker 1 (16:33):
Absolutely.
Speaker 2 (16:33):
The importance of self-care.
Speaker 1 (16:36):
Yes.
Speaker 2 (16:37):
And the power of you know that open communication
with your doctor.
Speaker 1 (16:40):
Those are essential elements of this journey, and
we'll delve deeper into them inthe next part of our deep dive.
Speaker 2 (16:46):
Welcome back to the deep dive.
We spent this whole episodeexploring IVF KPIs those data
points that can really help youunderstand the science behind
your fertility journey.
Speaker 1 (16:57):
Yeah, we've covered a lot, from antral follicle
counts to embryo grading.
But as we wrap up, I think it'simportant to remember that
these KPIs yeah, we've covered alot, from antral follicle
counts to embryo grading yeah.
But, as we wrap up, I thinkit's important to remember that
these KPIs, while valuable, theydon't tell the whole story.
Speaker 2 (17:09):
Right, they're like pieces of the puzzle, but they
don't really capture thatemotional roller coaster.
Right.
Speaker 1 (17:13):
Right.
Speaker 2 (17:14):
The hopes, the fears that come with this experience.
Speaker 1 (17:16):
Exactly.
Fertility is deeply personaland while we can analyze the
data, you know we can't quantifythe resilience and strength it
takes to go through IVF.
Speaker 2 (17:26):
It strikes me that you know, knowledge is power.
Speaker 1 (17:29):
Yes.
Speaker 2 (17:30):
But it's not the only power.
You need emotional resiliencetoo.
Speaker 1 (17:33):
Absolutely what advice do you have for people
navigating those ups and downs?
It's crucial to build a supportsystem, whether that's your
partner, friends, family or atherapist.
Sharing your feelings,anxieties and even your small
victories can make a world ofdifference.
Speaker 2 (17:48):
And are there resources specifically for
people going through IVF?
Speaker 1 (17:52):
Absolutely.
Many clinics offer supportgroups where you can connect
with others who truly understandwhat you're going through.
There are also onlinecommunities and forums that can
provide a sense of connectionand shared experience.
Speaker 2 (18:05):
It makes sense.
Sometimes just knowing you'renot alone can be, you know, the
biggest comfort.
I remember reading that thiswhole journey can really impact
relationships too.
Speaker 1 (18:13):
It can.
Speaker 2 (18:15):
Any advice for couples going through IVF
together?
Speaker 1 (18:19):
Open and honest communication is key.
Okay, it's important to checkin with each other regularly,
acknowledge each other'sfeelings and make decisions as a
team Right.
Ivf can be stressful, sofinding healthy coping
mechanisms together, whetherthat's exercise, meditation or
simply spending quality timetogether, can help strengthen
your bond.
Speaker 2 (18:38):
It's like you're both on this expedition together,
exactly Facing the challengesand celebrating the wins as a
unit.
Speaker 1 (18:45):
Precisely and remember seeking professional
guidance, whether from atherapist or a counselor
specializing in fertility, canprovide valuable tools for
navigating the emotionalcomplexities of IVF as a couple.
Speaker 2 (18:58):
So, as we kind of wrap up here, I'm wondering,
like, what's on the horizon forIVF?
Are there new technologies oradvancements that give you, you
know, hope for the future?
Speaker 1 (19:08):
Oh, it's an exciting time.
Research is constantly evolving, leading to more personalized
treatment protocols, improvedlab techniques and even
non-invasive ways to assessembryo vitability.
Speaker 2 (19:19):
It's amazing how science is, you know, is finding
ways to improve the process andincrease those chances of
success.
Yes, but amidst all theadvancements?
I think your earlier pointabout the human element really
resonated with me.
Speaker 1 (19:32):
Yeah, it's easy to get caught up in the data and
the technology, but ultimately,ivf is about people, about
families, about that deep-seateddesire to create life.
Speaker 2 (19:41):
And that desire, that hope.
It transcends all the numbers.
Speaker 1 (19:45):
Beautifully put.
I encourage everyone listeningto hold on to that hope, to be
kind to themselves and toremember that they are not alone
on this journey.
Speaker 2 (19:52):
Well, thank you so much for sharing your expertise
and insights with us today.
It's been truly enlightening.
Speaker 1 (19:58):
It's been my pleasure and, to our listeners, I wish
you all the best on yourfertility journey.
Speaker 2 (20:03):
That's it for our deep dive into IVF, kpis and the
human journey that theyrepresent.
Thanks for joining us on theDeep Dive Leading Innovation
Fertility.
Speaker 1 (20:23):
Excellence.
Life by Dr Pat Leadinginnovation in fertility
excellence.
Life by Dr Pat, leading innovation in fertility
excellence.
Deep dive into reproductionwith Life by Dr Pat.
Speaker 1 (00:09):
Empower the understanding of your IVF cycle
with KPI.
Speaker 2 (00:14):
Okay, get ready, because today we're going deep
into IVF.
Speaker 1 (00:19):
Diving in.
Speaker 2 (00:20):
Yeah, but specifically those KPIs that can
help everyone listening reallyunderstand what's happening
during treatment.
Lots of listeners want toreally grasp those metrics that
matter.
Speaker 1 (00:32):
Right.
Speaker 2 (00:33):
Almost like we're decoding the secret language of
a fertility journey.
Speaker 1 (00:37):
You know yeah.
Speaker 2 (00:39):
Thankfully we have an expert here with us.
Speaker 1 (00:41):
Absolutely.
Speaker 2 (00:42):
Who's going to help us break it all down?
Speaker 1 (00:44):
Absolutely.
Speaker 2 (00:44):
Now I know, KPI sounds a little like corporate
jargon, right?
Yeah, not something you'dreally expect in a fertility
clinic.
Speaker 1 (00:51):
Right.
Speaker 2 (00:52):
But think of them like guideposts, okay, helping
you and your doctor kind of seehow things are moving along.
Speaker 1 (00:58):
That's a great way to put it, yeah.
Speaker 2 (01:00):
So, before we get into specifics, can you give us
like a super quick overview oflike the IVF process?
Speaker 1 (01:06):
Of course.
So it all starts withstimulating the ovaries to
produce multiple eggs.
Then those eggs are retrievedand then fertilized in the lab,
and the resulting embryos arecultured and monitored before
one or more are transferred backto the uterus.
Speaker 2 (01:21):
Okay.
Speaker 1 (01:22):
And each step has its own KPI, helping us assess how
things are going and makeadjustments as needed.
Speaker 2 (01:28):
I actually found this visual guide in Thai.
Speaker 1 (01:31):
Okay.
Speaker 2 (01:31):
Called Nankanankanitakikakankanpapi Got
it which maps out those stepsreally clearly.
It's really helpful to just seeit visually laid out.
Speaker 1 (01:40):
Visual aids are fantastic for understanding this
journey.
Speaker 2 (01:42):
Exactly Okay, let's get into those KPIs.
Speaker 1 (01:45):
Absolutely.
Speaker 2 (01:46):
This resource lists a bunch.
Speaker 1 (01:47):
Yeah.
Speaker 2 (01:48):
Starting with antral follicle count, or AFC.
Yeah, what is that actuallymeasuring?
Speaker 1 (01:53):
So AFC is one of the first things we look at.
It's a simple ultrasound countof the tiny follicles in your
ovaries at the beginning of yourcycle.
Speaker 2 (02:01):
Okay.
Speaker 1 (02:03):
You can think of it as a snapshot of your ovarian
reserve, so the pool ofpotential eggs that you have.
Speaker 2 (02:08):
So a higher count generally means a better reserve
.
Speaker 1 (02:12):
Generally yes.
Speaker 2 (02:13):
But I'm guessing age plays a factor too.
Speaker 1 (02:16):
Absolutely.
Age is a significant factor.
As women get older, the numberof antral follicles naturally
decreases, right?
But lifestyle genetics, evenprevious medical treatments, can
impact that count as well.
So it's not a perfect predictor, but it gives us a starting
point.
Speaker 2 (02:35):
Interesting.
So it's less about hitting likesome magic number and more
about understanding, like whatyour AFC means.
Speaker 1 (02:43):
Exactly.
Speaker 2 (02:44):
In the context of your personal health history.
Speaker 1 (02:46):
Precisely.
It's about personalizedmedicine, not a one size fits
all approach.
Speaker 2 (02:49):
Okay, next up is how your follicles respond to that
stimulation medication, right?
So we're not just countingfollicles now, but we're looking
at how they grow.
Speaker 1 (02:58):
Exactly.
We're tracking the percentageof follicles that grow to a
mature size after you starttaking the medication.
It's all about seeing how wellthose follicles are nurtured and
developing those precious eggs.
Speaker 2 (03:10):
I remember reading an example in this Thai source
where one patient had a dominantfollicle that was growing super
fast, almost like it washogging all the resources.
Does that happen often?
Speaker 1 (03:23):
It does happen and it's a great illustration of why
we don't just look at the rawnumbers.
Sometimes one follicle takesoff.
It kind of skews the overallpicture.
That can be due to the timingof the medication, individual
variations, even genetics.
Speaker 2 (03:39):
Wow.
Speaker 1 (03:39):
But that's why it's so important to have open
communication with your doctor,so they can explain these
nuances to you.
Speaker 2 (03:44):
So it's like those follicles are all on their own
little race and sometimes onejust gets a head start.
Speaker 1 (03:50):
Yeah.
Speaker 2 (03:50):
But ultimately we want to see like a good
percentage reaching maturity.
Speaker 1 (03:54):
Exactly.
We're aiming for efficient,even development to maximize
your chances of retrievingmature eggs.
Speaker 2 (04:01):
So that brings us to egg retrieval.
Yes, what KPI are we looking athere?
Speaker 1 (04:06):
So this is where things get exciting.
We track the percentage ofmature eggs that are
successfully retrieved duringthe procedure.
We want to collect as many ofthose mature eggs as possible,
because those are the ones withthe potential to be fertilized.
Speaker 2 (04:20):
And it seems intuitive, right?
Yeah, we want as many eggs aspossible.
Speaker 1 (04:23):
Right.
Speaker 2 (04:23):
Are there ever situations where, like, that's
not the goal?
Speaker 1 (04:27):
That's a great question.
Speaker 2 (04:28):
Yeah.
Speaker 1 (04:29):
While more eggs generally offer more options,
it's not just about quantity,okay.
Quality matters too, right.
Sometimes fewer high-qualityeggs are preferable to a large
number of immature orlower-quality eggs.
It really depends on theindividual situation.
Speaker 2 (04:46):
Okay, so that makes sense.
Speaker 1 (04:47):
Yeah.
Speaker 2 (04:48):
Even here it's about looking beyond those numbers and
considering that whole picture.
Speaker 1 (04:52):
Precisely, and that's where your doctor's expertise
and personalized guidance comein.
They will help you interpretthat data and make the best
decisions for your journey.
Speaker 2 (05:00):
Okay, so we got those precious eggs retrieved, right?
What happens next?
Speaker 1 (05:04):
So next we look at egg maturity.
Not every egg that's retrievedis mature and ready for
fertilization.
Speaker 2 (05:11):
Ah, so we're looking at how many of those retrieved
eggs are actually ready to go.
Speaker 1 (05:15):
Exactly.
This KPI tells us how many eggsare truly viable for
fertilization.
It's a crucial step becauseonly mature eggs can be
successfully fertilized anddevelop into healthy embryos.
Speaker 2 (05:27):
Now I know from the steps in IVF, ICSI source that
fertilization happens in the labusing a technique called ICSI,
where a single sperm is injecteddirectly into the egg.
Speaker 1 (05:39):
Yes.
Speaker 2 (05:40):
What QAPI helps us understand how that process is
going.
Speaker 1 (05:43):
So we track the fertilization rate, which is the
percentage of mature eggs thatare successfully fertilized
after ICSI.
Okay, this KPI gives us insightinto both the egg and sperm
quality.
Speaker 2 (05:54):
Okay.
So if we're seeing like a goodfertilization rate, that's a
good sign for both partners,right?
Speaker 1 (05:58):
Absolutely.
It means the eggs are receptiveto fertilization and the sperm
is capable of penetrating theegg's outer layer and delivering
its genetic material.
Speaker 2 (06:07):
Now I remember reading about something called
pronuclei in one of the sources.
Speaker 1 (06:10):
Yes.
Speaker 2 (06:11):
How does that relate to fertilization?
Speaker 1 (06:13):
So these pronuclei are the visual confirmation that
fertilization has occurred.
They show us that the sperm andthe egg's DNA have combined,
confirming successfulfertilization.
It's like seeing the blueprintfor a new human being start to
form.
Speaker 2 (06:28):
Wow, that is incredible, but I know that
there's been cases, right?
Speaker 1 (06:31):
Right.
Speaker 2 (06:32):
Where people have a lower fertilization rate, but
they still had success.
Speaker 1 (06:36):
That's right.
A lower fertilization ratedoesn't necessarily mean failure
.
Okay, while it might indicatechallenges with egg or sperm
quality, sometimes just onehealthy embryo is all it takes.
It all comes back tounderstanding the nuances of
your individual case, and that'swhere open communication with
your doctor is so vital.
Speaker 2 (06:54):
Right, even if, like a particular key PI isn't ideal,
it doesn't automatically meanlike game over.
Speaker 1 (07:00):
Exactly.
Speaker 2 (07:01):
There might be other factors at play, and that's
where, like you said, the doctorcan really help.
Speaker 1 (07:05):
Exactly, and remember IVF technology is constantly
evolving, so even if you facechallenges in one cycle, there
might be new options oradjustments we can explore in
future cycles.
Speaker 2 (07:15):
Okay, so we've got fertilized eggs, so now we're
moving to that embryodevelopment phase right.
What KPI helps us understandhow those embryos are
progressing?
Speaker 1 (07:24):
So we track the percentage of fertilized eggs
that develop into blastocysts.
Speaker 2 (07:28):
Okay.
Speaker 1 (07:29):
A blastocyst is a more advanced stage of embryo
development with a higher chanceof implantation.
Speaker 2 (07:35):
So a good blastocyst development rate like that means
those embryos are strong andhealthy.
Speaker 1 (07:41):
Precisely.
Speaker 2 (07:42):
Ready to potentially implant.
Speaker 1 (07:43):
It tells us that those embryos have the potential
to make it to the next stage.
Speaker 2 (07:48):
What factors can affect blastocyst development?
Sure, is it all about, likethat, initial egg and sperm
quality, or are there otherthings at play?
Speaker 1 (07:57):
So egg and sperm quality are definitely
foundational, but the labenvironment plays a crucial role
too.
Temperature, humidity and eventhe air quality are carefully
controlled to create the optimalconditions for those embryos to
thrive Right.
Think of it like creating atiny perfect world for them to
grow.
Speaker 2 (08:15):
It's amazing how much goes into creating that like
ideal environment, you know.
Yeah, it really highlights thatdelicate balance of science and
nature and IVF.
Speaker 1 (08:25):
It truly is a delicate dance.
Speaker 2 (08:27):
Yeah.
Speaker 1 (08:28):
And the expertise of the embryologist is crucial in
ensuring those embryos arehandled with the utmost care and
precision.
Speaker 2 (08:34):
Well, I'm really starting to see how all these
KPIs are like puzzle pieces.
Yes, each one giving us, youknow, a little bit more
information about the overallpicture.
Speaker 1 (08:44):
You got it.
It's about connecting thosedots and understanding the story
they tell about your individualjourney.
Speaker 2 (08:50):
Okay, we've covered a lot already, but we're not done
yet.
Let's take a quick pause andwe'll be right back to explore
that next stage of IVF Soundsgood, and those KPIs that guide
us there Stay with us.
Speaker 1 (09:00):
Welcome back to our deep dive into IVF KPIs.
Speaker 2 (09:04):
Yes, we've back to our deep dive into IVF KPIs.
Yes, we've explored those KPIsthat kind of guide us from
ovarian stimulation all the wayto embryo development.
Right, but we still have areally crucial step to cover.
We do Embryo transfer.
Speaker 1 (09:16):
Absolutely.
This is where we take one ormore of those carefully nurtured
blastocysts.
Speaker 2 (09:21):
Okay.
Speaker 1 (09:22):
And transfer them back into the uterus, hoping
that they will implant and leadto a pregnancy.
Speaker 2 (09:28):
I can imagine this step comes with a whole new set
of anxieties and hopes.
Speaker 1 (09:33):
It does.
Speaker 2 (09:34):
Are there KPIs here that can give us insight?
Speaker 1 (09:37):
Absolutely.
We look at factors like embryoquality and uterine lining
thickness to assess thelikelihood of implantation.
Speaker 2 (09:46):
So it's all about making sure that both the embryo
and the environment are ready,right.
Speaker 1 (09:50):
Yes.
Speaker 2 (09:50):
Like a perfectly timed meeting of the two.
Speaker 1 (09:53):
That's a great analogy.
It's about synchronicity,ensuring that everything is
aligned for optimal implantation.
Speaker 2 (09:59):
Let's talk about embryo quality first.
I remember reading about embryograding in one of the sources.
How does that work?
Speaker 1 (10:08):
So we use a grading system to assess the appearance
and development of the embryos.
Higher graded embryos generallyhave a better chance of
implantation.
It's like a quality check toselect the embryos with the
highest potential.
Speaker 2 (10:20):
So it's like choosing the strongest contenders for
the implantation race, but Iknow from the dysmorphic uterus
101 source that the uterusitself plays like a really
critical role too.
Right.
Speaker 1 (10:32):
You're absolutely right.
The uterine lining, orendometrium, needs to be
receptive for the embryo toimplant and thrive.
We use ultrasound to measurethe thickness and appearance of
the lining, making sure thatit's thick enough and has the
right characteristics to supporta pregnancy.
Speaker 2 (10:47):
So a thicker lining is a good sign.
Generally yeah, it seems likeit would offer more cushioning
and support for that embryo.
Speaker 1 (10:53):
A thicker lining generally indicates better blood
flow and more nutrients,creating a welcoming environment
for the embryo.
It's like preparing a cozy nestfor that little embryo to
settle into.
Speaker 2 (11:04):
I love that.
Yeah, it's amazing howeverything has to work together
so perfectly it is.
Are there any other KPIsrelated to the embryo transfer
itself?
Speaker 1 (11:14):
Yes, the technique used for the transfer can also
influence success rates.
We aim for a smooth, gentletransfer, placing the embryos in
the optimal spot within theuterus.
Some clinics even useultrasound guidance during the
transfer to ensure preciseplacement.
Speaker 2 (11:29):
It sounds like a really delicate procedure
requiring a lot of skill andexpertise.
Speaker 1 (11:34):
Absolutely, and the experience of the doctor
performing the transfer iscrucial.
They're not just transferringembryos, they're handling the
hopes and dreams of those hopingto become parents.
Speaker 2 (11:46):
That's a beautiful way to put it.
It's not just a medicalprocedure.
It's a moment filled withemotion, anticipation.
Speaker 1 (11:54):
Lots of it.
Speaker 2 (11:55):
After the transfer, we enter the dreaded two-week
wait.
Speaker 1 (11:59):
Yes, we do.
Speaker 2 (12:00):
Is there any KPI that can tell us if implantation has
occurred?
Speaker 1 (12:05):
Unfortunately there's no KPI that directly measures
implantation.
We have to rely on thepregnancy test a couple of weeks
later to confirm if an embryohas successfully implanted.
But even without a specific KPI, we can gather clues along the
way.
Speaker 2 (12:20):
What kind of clues?
What should someone be lookingout for during that two-week
wait?
Speaker 1 (12:24):
It's important to listen to your body.
Some women experience mildcramping or spotting around the
time of implantation, but othershave no symptoms at all.
The key is to manageexpectations and avoid reading
too much into every twinge orsensation.
That two-week wait can beemotionally challenging and it's
crucial to prioritize self-careand emotional well-being during
(12:45):
this time.
Speaker 2 (12:46):
We've talked a lot about, like the individual KPIs,
but I remember reading thatthat these numbers can sometimes
feel, you know, reallyoverwhelming.
Speaker 1 (12:55):
They can.
Speaker 2 (12:56):
How can we use these KPIs to like empower ourselves
without getting like totallylost in the data?
Speaker 1 (13:02):
That's a great point.
These KPIs are meant to betools for understanding, not
weapons of self-criticism.
It's about seeing the biggerpicture and understanding the
trends and patterns they reveal.
Speaker 2 (13:13):
So it's not about like fixating on a single number
, right, but it's more aboutseeing that overall story that
those numbers tell.
Speaker 1 (13:20):
Exactly, and that's where open communication with
your doctor is so important.
They can help you interpret thedata, explain the nuances of
your case and answer anyquestions you might have.
It's about working together asa team to make informed
decisions and navigate thisjourney with confidence.
Speaker 2 (13:36):
I remember this anecdote from the Thai source
about a patient who had 18 largefollicles before egg retrieval.
Speaker 1 (13:43):
Yeah.
Speaker 2 (13:43):
But only retrieved five eggs.
Speaker 1 (13:45):
Okay.
Speaker 2 (13:47):
And it was obviously like super disappointing for her
Right but those KPIs actuallyhelped her doctor like uncover a
potential issue.
Okay, with her response to thetrigger shot, the medication
that triggers ovulation.
Speaker 1 (14:00):
That's a perfect example of how KPIs can be
incredibly valuable.
Even when they revealchallenges, they can pinpoint
areas for improvement and leadto adjustments in future cycles.
It's about using data topersonalize your treatment plan
and maximize your chances ofsuccess.
Speaker 2 (14:16):
It seems like these KPIs aren't just about tracking
progress, but they're also aboutimproving that IVF process
itself.
Right Like learning from eachcycle, Right Refining techniques
to better support patients.
Speaker 1 (14:30):
You're absolutely right.
These KPIs are drivinginnovation and pushing the
boundaries of what's possible inreproductive medicine.
Speaker 2 (14:36):
We've talked a lot about like the specific KPIs
related to IVF.
Yeah, but I'm curious about howthey connect to like other
aspects of fertility.
Sure, for example, I wasreading about the impact of
uterine abnormalities Right Likea T-shaped uterus on IVF
outcomes.
Speaker 1 (14:53):
Yeah.
Speaker 2 (14:54):
How do those factors come into play?
Speaker 1 (14:55):
That's a great question.
Ivf doesn't happen in isolation.
It's part of a much largerpicture of your overall
reproductive health.
Factors like age, lifestyle,medical history and even
anatomical variations caninfluence your IVF journey.
Speaker 2 (15:11):
So it's like another layer of the puzzle right Adding
complexity, nuance tointerpreting those KPIs.
Speaker 1 (15:17):
Exactly, and that's why it's so crucial to have a
comprehensive evaluation lookingat all aspects of your
fertility, not just the IVFprocedure itself.
Speaker 2 (15:25):
In the case of like a T-shaped uterus.
Speaker 1 (15:28):
Right.
Speaker 2 (15:28):
I read that a procedure called a hysteroscopic
metroplasty can be done to kindof correct the abnormality.
Speaker 1 (15:34):
Yes.
Speaker 2 (15:36):
And improve chances of successful implantation.
Is that something that you likeoften recommend?
Speaker 1 (15:41):
It depends on the individual case, of course, but
addressing underlying anatomicalissues can definitely improve
IVF outcomes.
It's about optimizing everyaspect of the journey to give
you the best possible chance ofsuccess.
Speaker 2 (15:55):
It's amazing how how medicine is constantly advancing
.
You know it is offering likenew solutions and possibilities
for those advancing.
You know it is Offering likenew solutions and possibilities.
Yeah, for those facing, youknow, fertility challenges.
Speaker 1 (16:07):
It truly is inspiring , and the more we understand
about the intricacies offertility, the better equipped
we are to support individualsand couples on their path to
parenthood.
Speaker 2 (16:17):
Okay, we've explored, you know, all these KPIs that
guide us through that IVFprocess.
Speaker 1 (16:22):
Yeah.
Speaker 2 (16:22):
From ovarian stimulation all the way to
embryo transfer Right.
But I know there's still somuch more to discuss.
Speaker 1 (16:28):
Yeah, we do.
Speaker 2 (16:29):
We've touched on, like the emotional aspects of
this journey.
Speaker 1 (16:33):
Absolutely.
Speaker 2 (16:33):
The importance of self-care.
Speaker 1 (16:36):
Yes.
Speaker 2 (16:37):
And the power of you know that open communication
with your doctor.
Speaker 1 (16:40):
Those are essential elements of this journey, and
we'll delve deeper into them inthe next part of our deep dive.
Speaker 2 (16:46):
Welcome back to the deep dive.
We spent this whole episodeexploring IVF KPIs those data
points that can really help youunderstand the science behind
your fertility journey.
Speaker 1 (16:57):
Yeah, we've covered a lot, from antral follicle
counts to embryo grading.
But as we wrap up, I think it'simportant to remember that
these KPIs yeah, we've covered alot, from antral follicle
counts to embryo grading yeah.
But, as we wrap up, I thinkit's important to remember that
these KPIs, while valuable, theydon't tell the whole story.
Speaker 2 (17:09):
Right, they're like pieces of the puzzle, but they
don't really capture thatemotional roller coaster.
Right.
Speaker 1 (17:13):
Right.
Speaker 2 (17:14):
The hopes, the fears that come with this experience.
Speaker 1 (17:16):
Exactly.
Fertility is deeply personaland while we can analyze the
data, you know we can't quantifythe resilience and strength it
takes to go through IVF.
Speaker 2 (17:26):
It strikes me that you know, knowledge is power.
Speaker 1 (17:29):
Yes.
Speaker 2 (17:30):
But it's not the only power.
You need emotional resiliencetoo.
Speaker 1 (17:33):
Absolutely what advice do you have for people
navigating those ups and downs?
It's crucial to build a supportsystem, whether that's your
partner, friends, family or atherapist.
Sharing your feelings,anxieties and even your small
victories can make a world ofdifference.
Speaker 2 (17:48):
And are there resources specifically for
people going through IVF?
Speaker 1 (17:52):
Absolutely.
Many clinics offer supportgroups where you can connect
with others who truly understandwhat you're going through.
There are also onlinecommunities and forums that can
provide a sense of connectionand shared experience.
Speaker 2 (18:05):
It makes sense.
Sometimes just knowing you'renot alone can be, you know, the
biggest comfort.
I remember reading that thiswhole journey can really impact
relationships too.
Speaker 1 (18:13):
It can.
Speaker 2 (18:15):
Any advice for couples going through IVF
together?
Speaker 1 (18:19):
Open and honest communication is key.
Okay, it's important to checkin with each other regularly,
acknowledge each other'sfeelings and make decisions as a
team Right.
Ivf can be stressful, sofinding healthy coping
mechanisms together, whetherthat's exercise, meditation or
simply spending quality timetogether, can help strengthen
your bond.
Speaker 2 (18:38):
It's like you're both on this expedition together,
exactly Facing the challengesand celebrating the wins as a
unit.
Speaker 1 (18:45):
Precisely and remember seeking professional
guidance, whether from atherapist or a counselor
specializing in fertility, canprovide valuable tools for
navigating the emotionalcomplexities of IVF as a couple.
Speaker 2 (18:58):
So, as we kind of wrap up here, I'm wondering,
like, what's on the horizon forIVF?
Are there new technologies oradvancements that give you, you
know, hope for the future?
Speaker 1 (19:08):
Oh, it's an exciting time.
Research is constantly evolving, leading to more personalized
treatment protocols, improvedlab techniques and even
non-invasive ways to assessembryo vitability.
Speaker 2 (19:19):
It's amazing how science is, you know, is finding
ways to improve the process andincrease those chances of
success.
Yes, but amidst all theadvancements?
I think your earlier pointabout the human element really
resonated with me.
Speaker 1 (19:32):
Yeah, it's easy to get caught up in the data and
the technology, but ultimately,ivf is about people, about
families, about that deep-seateddesire to create life.
Speaker 2 (19:41):
And that desire, that hope.
It transcends all the numbers.
Speaker 1 (19:45):
Beautifully put.
I encourage everyone listeningto hold on to that hope, to be
kind to themselves and toremember that they are not alone
on this journey.
Speaker 2 (19:52):
Well, thank you so much for sharing your expertise
and insights with us today.
It's been truly enlightening.
Speaker 1 (19:58):
It's been my pleasure and, to our listeners, I wish
you all the best on yourfertility journey.
Speaker 2 (20:03):
That's it for our deep dive into IVF, kpis and the
human journey that theyrepresent.
Thanks for joining us on theDeep Dive Leading Innovation
Fertility.
Speaker 1 (20:23):
Excellence.
Life by Dr Pat Leadinginnovation in fertility
excellence.
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