Today’s episode is paid content from our feature sponsor, who helps Inside Reproductive Health to deliver information for free, to you! Here, the Advertiser has editorial control, but in the case of this episode, the Advertiser chose not to make any edits. Feature sponsorship is not an endorsement, and does not necessarily reflect the views of Inside Reproductive Health.
What’s the biggest thing happening in the IVF lab?
It might just be automation. This isn’t hypothetical. It’s operating now.
We visited Hope IVF in Mexico City to see AURA, the fully automated IVF lab created by Conceivable Life Sciences. We sat down with co-founders Joshua Abram, Dr. Alejandro Chavez-Badiola, and Alan Murray to ask the questions you submitted—and some of our own.
Tune in as the founders share:
The origin of AURA and what problems they set out to solve.
How a team of 3 embryologist technicians could run 2,000+ cycles per year.
What IVF cycles really cost (And why CFOs should pay attention)
The commercialization strategy behind automation.
How this might change costs, outcomes, and the embryologist role forever.
Get Exclusive Updates on the Future of the IVF Lab
100 patients enrolled in groundbreaking IRB-approved study
Follow Conceivable Life Sciences on LinkedIn for exclusive updates from the AURA IRB study.
Measuring AURA’s fully automated IVF lab against today’s clinical benchmarks
Designed to improve consistency, efficiency, and outcomes
Get early insights before results are widely published
Be first to see what could redefine embryology
The revolution is underway. Don’t miss the data that could change your lab forever.
Follow Conceivable Life Sciences on LinkedIn today.
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00:00:03:13 - 00:00:37:10
Joshua Abram
We are entering the digital age of IVF. I mean, if you think in the first 40 years of flight, we went from the Wright brothers to propeller planes, but we only entered the jet age after 40 years of history. We're about to enter the jet age of IVF in the best sense of the word. I don't think any of us can look at the field and not say, we are poised on a moment of remarkable innovation. The innovation that we're doing here conceivable is going to, I think, fundamentally change the field.
00:00:47:10 - 00:01:09:10
Griffin Jones
The biggest thing happening in the IVF lab. We use that title for the LinkedIn live. I think it might have to be the title for this podcast. Episode two what's bigger than end to end automation of the IVF lab? I'm here in the Bel Air of Mexico City at an IVF center called Hope IVF, where Conceivable Life Sciences has installed their automated IVF lab, Aura, and I came with questions.
00:01:09:11 - 00:03:20:10
Griffin Jones
Questions provided by you, the inside reproductive health audience. I sit down with the three co-founders of the company Joshua Abram, Dr. Alejandro Chavez-Badiola and Alan Murray. Joshua and Alan have been in the venture capital and entrepreneur space, co-founding and investing in companies together for decades. About ten years ago, IVF caught their eye, and they founded Tomorrow.
Alejandro is a founding partner of Hope IVF. He's an MD, PhD, and together they took on this challenge of automating the IVF lab. Why? We discussed the human and commercial tragedy of the fraction of the total addressable need for IVF that's currently being served.
How big should this field of medicine be? And it's supporting industry. What are the numbers behind that? We talk about the mechanics of this automated IVF lab. No more zigzagging back and forth, no more embryologist bumping into each other. They detail the steps that allow a team of three to operate a state-of-the-art IVF lab that they're hoping will perform 2000 cycles per year.
That's three embryologist technicians, a team of three. What is an IVF cycle though? I never really thought about I'll blank out of a term. IVF cycle is for the widely differing IVF work orders that are all categorized as IVF cycles. Alan Murray talks about the research they're working on with regard to the costs associated with these different work orders.
For the CFOs, listening, you need to hear this. It will give you a better understanding of your operational costs and the wide variance that happened after retrieval.
How did all this happen? What's the adjacent possible? What are all the technologies that came together to build this system? How are they going to make money off of it?
What's their commercialization strategy? Will it bring costs down? Will it improve outcomes? How? Why has there never been a better time to be an embryologist? I couldn't get enough content while I was down here. I don't have the qualification to say that the future has arrived here or conceivable, but everyone I've talked to that has visited here seems to think so.
And I did try to press on those questions that you gave me. You'll decide for yourself, but you're going to want to listen to this whole episode, because I don't think things will ever be the same.
00:03:20:10 - 00:03:42:12
Announcer
Today's episode is paid content from our feature sponsor, who helps inside reproductive health to deliver information for free to you. Here, the Advertiser has editorial control, but in the case of this episode, the Advertiser chose not to make any edits. Feature sponsorship is not an endorsement and does not necessarily reflect the views of inside reproductive health.
00:03:42:12 - 00:03:56:05
Griffin Jones
Doctor Chavez-Badiola. Hola. Mr. Abram. Mr. Murray. Alejandro, Joshua, Alan. Bienvenido, and welcome to the first ever in-person podcast episode of Inside Reproductive Health.
00:03:56:07 - 00:04:00:07
Joshua Abram
Is it not the first international podcast of Inside Reproductive Health?
00:04:00:09 - 00:04:21:10
Griffin Jones
Certainly not the first with international guests, but certainly the first where I have been abroad. All right. We've been waiting offshore. You've taken me offshore, and I am interested in exploring. Tell me, Joshua, what's the tragedy happening in IVF right now? How might you be able to fix it, be a part of fixing it?
00:04:21:12 - 00:04:47:11
Joshua Abram
Well, I think there's a tragedy, but first of all, I think there is a lot of glory to talk about. here we have a Nobel Prize winning therapy, that has the ability to cure people of a disease, that, has plagued mankind, humankind, since the beginning of recorded history and features prominently in the Bible.
00:04:47:13 - 00:05:16:22
Joshua Abram
And, in this disease strikes people uniquely in the prime of their life, curing this disease. will change the course of their life forever. And when Bob Edwards was awarded the Nobel Prize with the very fulsome, comment from the from the committee that said he had achieved a milestone in modern medicine, I think the Nobel Committee thought for good reason, done and dusted.
00:05:17:03 - 00:05:44:22
Joshua Abram
We've got this behind us, certainly the science. And it's a blessing to be involved in this field. I'm surrounded by the brilliant people who drive it. certainly the science has improved dramatically over the last 40 years. it's our our rate of innovation is stalled a little bit of late, but historically, we have improved success rates 1% year over most in four decades.
00:05:45:00 - 00:06:13:03
Joshua Abram
but the reality is that, with the awarding of the Nobel Prize, we did not in the problem, with Edwards, we had a we did not in the problem. We have a therapy that has failed to scale 95% of infertile people around the world, will never receive treatment, even in the very rich West, even in America, 80% of patients will go in treated.
00:06:13:04 - 00:06:50:20
Joshua Abram
And I don't think that any of us can or want to be satisfied, with that kind of situation. It's a ethical disaster. It's a clinical disaster. And frankly, it is a commercial disaster because this is one of those problems that if we all work together, which we will to solve it, we at once are going to have a clinical triumph and ethical triumph in terms of access to care and the commercial moment.
00:06:51:00 - 00:07:19:19
Joshua Abram
IVF will enter a renaissance there. There'll be, more opportunity for more people to do more good work and to profit by doing that work fairly. And in the history of IVF, we are entering the digital age of IVF. I mean, if you think in the first 40 years of flight, we went from the Wright brothers to propeller planes, but we only entered the jet age after 40 years of history.
00:07:19:21 - 00:07:48:11
Joshua Abram
We're about to enter the jet age of IVF in the best sense of the word. And I don't think that anyone can look at the field right now and looking at the statistics and the situation I just described, you described it as a tragedy. I agree with you. It's also an opportunity. I don't think any of us can look at the field and not say, we are poised on a moment of remarkable innovation.
00:07:48:13 - 00:08:16:16
Joshua Abram
The innovation that we're doing here conceivable is going to, I think, fundamentally change the field. But we're not alone. We're surrounded by innovators. There are innovations, in other parts of, AI and service delivery innovations. Again, however, that pay for this. Companies like Diya make it more affordable. And I think that there's never been a more exciting time to be involved in
00:08:16:16 - 00:08:17:18
Joshua Abram
IVF.
00:08:17:20 - 00:09:03:23
Joshua Abram
We have the demand. 12 million babies want to be born every year rather than the less than 1 million a year that we're achieving now and an equitable, just and fair world. We will reach at 1 million babies, about 12 million a year in fertility. And then once we have together innovated sufficiently to reduce the price by having to streamline service delivery, we can address Asra emphasize, as the true demand for IVF, which is 20 million babies a year, an 80 fold increase in the number of children IVF is delivered in its entire 40 year history.
00:09:04:01 - 00:09:08:20
Joshua Abram
Think of the opportunity and think of the number of people who can be helped.
00:09:08:22 - 00:09:37:02
Griffin Jones
1 million IVF babies per month is a lot more than 30,000 or so currently in the United States, or far less than that, because I'm thinking of cycles. We're talking 1 million IVF babies per month. That brings us here to hope IVF in Mexico City. Your state of the art clinic, Alejandro, where you have decided to be the first to raise your hand and install conceivable aura in your IVF lab.
00:09:37:02 - 00:09:54:16
Griffin Jones
I got to see it yesterday. What I've been hearing from people and a little straw poll when I ask, is the IVF lab ready to be automated? The majority of people and those folks that haven't been here yet, they say no. When I ask everyone who's come before me to visit here, they say, this is not a prototype.
00:09:54:19 - 00:10:27:04
Griffin Jones
This is either ready for primetime or we're talking months away, not years from from being everywhere. Tell me, what did I see yesterday? I saw a single line assembly that, it seems, goes from retrieval to transfer. the size of a small IVF lab, with where robotics takes the the egg from that face. When? When it comes from the patient all the way back to the patient.
00:10:27:04 - 00:10:35:10
Griffin Jones
So describe what I saw, because I want to try to match it to some of the footage we might be able to capture today.
00:10:35:12 - 00:11:17:19
Dr. Alejandro Chavez-Badiola
So would you had a chance to see yesterday is an end to end system that can now automate the full process of the IVF lab. From this preparation, egg finding, preparing the egg for for ICSI, preparing sperm fertilizing, going through culture with time lapse capabilities and beautification. So that is the full process. So the system was built to support with this space and and with a capacity of, 2000 cycles per year with three operators.
00:11:17:21 - 00:11:49:15
Dr. Alejandro Chavez-Badiola
So to the point of our Joshua saying this is the only way to improve access and scale IVF to be performed capacity, we know that embryology is passionate about what they do. They're passionate about getting better, doing things better because they care about patients. I don't think of any embryologist that sign up to work for 2 or 4 hours preparing a dish.
00:11:49:17 - 00:12:25:20
Dr. Alejandro Chavez-Badiola
They want to focus their attention, to work in an intellectual space that allows them to think how to get results better. So this is what the system is about. Eat is preparing dishes. It is preparing sperm. So the embryologist can work along with that and make it better and better. But that's what you saw. Of course I'm biased, but in a word, I think that what you saw is what the future of IVF is going to look like.
00:12:25:22 - 00:12:46:15
Griffin Jones
Tell me a little bit about the role of the embryologist in this system, because the first room that we walked into, there were some screens. I believe you explained to me that if for whatever reason, the embryologist needed to take control of the machine, the embryologist is right there in the control room. Tell me about that.
00:12:46:17 - 00:13:17:16
Dr. Alejandro Chavez-Badiola
So safety is priority for us. So we have very strict protocols and processes to make sure that the system is working, that we can identify when we need intervention. And we have trained people to run the proper interventions in the system like these. And I think that this is true for the foreseeable future. A human, the embryologist, the senior embryologist is the agent is responsible of what is happening.
00:13:17:18 - 00:13:47:03
Dr. Alejandro Chavez-Badiola
They are assisted throughout so they can. In any case, let's say that they don't like the sperm that was selected by the system and immobilize. They can always request for another sperm to be selected. If for any reason which is highly unlikely. and we saw the paper from Colombia showing how automated this preparation is, ten times more consistent than than humans.
00:13:47:08 - 00:14:18:04
Dr. Alejandro Chavez-Badiola
But even if this senior biologist doesn't like the dish that the system prepared, it can just as if it was if it were a junior biologist, ask it to repeat the dish. So what you were saying, we have different levels of of safety that are people that is in charge in the control room. Next to the lab, are able to overrule and take full control over the system digitally from the room next door.
00:14:18:06 - 00:14:21:14
Dr. Alejandro Chavez-Badiola
So that's the first level of safety.
00:14:21:16 - 00:14:33:14
Griffin Jones
Describe the key handler and how that works through the system and the built in. You witness thing that comes with that in the QR codes.
00:14:33:16 - 00:15:02:23
Dr. Alejandro Chavez-Badiola
So as you know, there are different ways in which embryologist identifies samples. Because I think that the one thing for which we have zero margin for error in IVF is sample misidentification. So that's been a top priority for us. So again, when you go to labs they can use different systems tags with QR codes or RFID or writing with these diamond pens.
00:15:02:23 - 00:15:35:05
Dr. Alejandro Chavez-Badiola
Then the information that is relevant to identify the samples, what we have done as part of our preparation system is that, the system automatically engraved with laser, the dish with the information that is relevant to the embryologist. And he also, imprints, QR code that is unique for that. These in such a way that the system always know where each sample is at any given time throughout the entire process.
00:15:35:07 - 00:15:58:23
Dr. Alejandro Chavez-Badiola
Once that the dish is prepared and this is moved from one station to the next, the C handler, which is a system that is moving samples from one station to the next, is making sure that the right sample is there, and then before it access any station, it reads a QR code from the station, making sure that the right sample is entering the right station for the right procedure.
00:15:59:01 - 00:16:04:14
Dr. Alejandro Chavez-Badiola
So that's top priority for us. Sample identification.
00:16:04:15 - 00:16:14:05
Griffin Jones
Elen, how the heck did this all happen? What's the concept of the adjacent possible? Maybe explain the concept for those that are unfamiliar with it. But then how is it applied here?
00:16:14:05 - 00:16:41:23
Alan Murray
sure adjacent possible for us means borrowing from other industries, standing on the shoulders of massive investment that have perfected individual things. Maybe it's better explained by looking at examples. So within the AR system, we have a many stations that use, image recognition technology, a form of the I. This did not exist ten years ago with the quality and velocity that we needed to run an IBM.
00:16:42:01 - 00:17:05:11
Alan Murray
if we think about, IVF at its most core, we're building self-driving pipe that. So we borrowed A.I. systems where hundreds of thousands of guys are. We all see it today when we use ChatGPT V and other image generators, we see image recognitions and self-driving car that are trying to isolate basketballs or baby carriage or stop signs.
00:17:05:13 - 00:17:37:21
Alan Murray
So the technology we're using to recognize cocks, eggs, embryos and position instruments around it comes directly from standing on that massive investment. when you saw the robots that were using these are industrial robots that didn't exist ten years ago. Robots that have been perfected to assemble things like an iPhone, they're cramming ever smaller components together, testing circuits that are getting smaller and smaller.
00:17:37:23 - 00:17:56:00
Alan Murray
So we're using robots that come out of, the electronics assembly, industry. They're extremely precise. Some micron precise repeatability, high reliability that have been cycled, tested way beyond the needs.
00:17:56:00 - 00:18:03:18
Griffin Jones
Of an IVF lab. When we look at that, tell me a little bit about that cycle testing. What when what went into that.
00:18:03:20 - 00:18:28:12
Alan Murray
So when we think about the number of cycles, the different term that IVF cycles, of course, but the number of repeated motions a robot needs to make. So when we look at industrial scale stuff, it's doing assembly of iPhone ons. And to get in an iPhone factory, these things have to be doing high repeatedly for millions and millions of cycles without failure.
00:18:28:14 - 00:18:59:07
Alan Murray
So how many cycles to failure are these things going? What environment are they being used in that if that factory gets shut down because that robot broke down, it's lots of dollars on the table. another area we've picked out is and looked deeply into is advanced optics. Today's IVF lab is using effectively the same microscopy with the same lenses, the same focusing mechanisms of 20 years ago.
00:18:59:09 - 00:19:32:16
Alan Murray
But over the last, with AI systems combined with, you hear about lidar in cars, we're using effectively light our system to find eggs. So we've looked not just to use conventional microscopy, but let's build better models based on resolution of advanced microscopy that in some cases, more than 100 times the information that we get from a kind of a two dimensional view coming out of a simple inverted microscope.
00:19:32:18 - 00:20:12:15
Joshua Abram
Data is not a good one. Allen, just said I mean, you asked about the adjacent possible, which is a theory of a of a, I named Stuart Kaufman, who's on the shortlist for the Nobel Prize. And, he, he describes adjacent as an important word in that. And it means that, innovation is only possible, when there are precedents around that empowering, Uber and Lyft were both established within 12 months of the introduction of an iPhone with a GPS and an App store.
00:20:12:17 - 00:20:28:17
Joshua Abram
that was an adjacent, hospital. Steve Jobs didn't invent anything on the iPhone. He didn't invent the MP3 player. He didn't invent the phone itself. He didn't invent GPS. What am I missing out? all the all the great, all the great features of the iPhone.
00:20:28:20 - 00:20:31:20
Griffin Jones
He didn't invent compasses. He didn't make an LCD.
00:20:31:20 - 00:20:32:17
Alan Murray
Screens.
00:20:32:19 - 00:20:33:15
Griffin Jones
And but but.
00:20:33:15 - 00:21:06:21
Joshua Abram
He did what, one and exactly what Allen would say he did with one very, very senior lab leader who came here, said Allen. Describe what we had done. He said, what you guys have done is string the pearls. You've taken the best of innovation from around the world, in industry, in science and medicine, and all proven in their own field, backed by Bill and outset, backed by billions and billions of dollars of research and practice.
00:21:06:23 - 00:21:23:10
Joshua Abram
And you strung the pearls and you may have made a beautiful necklace from things that were never contemplated to be together. But just like in the iPhone, once we assembled, everyone thought, wow, why didn't we do that before?
00:21:23:12 - 00:21:44:03
Griffin Jones
I want to come back to maintenance and and talk about that and, and talk about the schedule and the different possibilities, because that was one of the categories the audience has been most interested in. But I think they've been even more interested in how are you going to commercialize this pretty necklace? they really want to know how it's going to be implemented.
00:21:44:03 - 00:21:56:14
Griffin Jones
They want to know who's going to be buying it and, and, and how that's going to work. So I want to unpack this and get my head around it. Wants to tell me about the plan for taking the Or the market.
00:21:56:14 - 00:22:26:16
Joshua Abram
And we'll have something to say on this. But let's start with with the simple facts. we've decided as a business model to bring the technology, to market in a lab as a service model. This is nothing new to advanced medicine. So Quest Diagnostics, a great company. Roughly a third of its revenue comes from operating labs and a service basis within great hospitals.
00:22:26:18 - 00:22:55:03
Joshua Abram
and bringing the efficiency of quest experience and centralized function and all the rest. They do it better than any hospital to do it. So, lab is a service, and we are absorbing, the cost of installing the technology. it will be a collaboration between our people and, our clients people to run the the, machine in rough numbers.
00:22:55:05 - 00:23:26:10
Joshua Abram
each or, will do about 2000 cycles a year and will require three people, an engineer who will be a member of our team, senior embryology is probably initially a member of our team, but increasingly involving, our partners and maybe even involving our partners. By the way, we are very collaborative by, my nature, and find me a lab technician, who will probably be supplied by our partner.
00:23:26:11 - 00:23:47:05
Joshua Abram
So lab is a service is the first thing to understand about this. Not new. Widely used in medicine. Lots of benefits for, our clients. Reduced CapEx. We're always there to, guarantee the success. Nology on and on and on.
00:23:47:07 - 00:24:10:08
Griffin Jones
And some doctors do that. Now. They all use one person's lab. And in larger cities you might have someone that has a lab, and then you have four doctors that each use that lab, and they've got a boutique practice. And so I could see how you could really scale that lab as a service. Will you start there? Will you do you think you'll work first with some of the large fertility clinic networks that be on.
00:24:10:08 - 00:24:44:17
Joshua Abram
Premise at first? So we'll be on premise with our partners. And I think, as you started, the podcast by saying, we've been blessed to have a who's who, innovators and leaders from both the commercial side, the C-suite and the science side. The lab leaders come down, and spend time with us here often a day or two, really digging into what we're doing, the business model and the, the science and the response to that.
00:24:44:17 - 00:25:04:20
Joshua Abram
And just incredibly gratifying. I think people see the logic of what we were doing, how it's going to help them in their business. I was going to help patients, and it's how it's going to help the field. address what you described as a tragedy, what we think of as finding the missing on to demand.
00:25:04:22 - 00:25:26:11
Griffin Jones
Some of the questions have been about who's going to want to have a whole bunch of equipment and these big machines, these big, expensive machines installed in their IVF lab and have to move things around and have to incorporate all of this? Well, next to me, I have the guy that's done it.
00:25:26:13 - 00:25:53:09
Dr. Alejandro Chavez-Badiola
So me, I am the first one to do that thing that, you know, IVF doctors and biologists, we always have patients as our top priority. Patients interests are our interests and we want to make sure that we're offering the best medicine possible. So if we have a system that is consistently every cycle performing at its best, why wouldn't you want to have this system?
00:25:53:11 - 00:26:21:05
Dr. Alejandro Chavez-Badiola
So I think that. For me, the decision was very easy. I've been in this field for two decades now. This clinic has been in Mexico for 15 years. I built a reputation which is very hard to build, and I needed to make sure that the system was ready to treat patients, at least to the level that I'm used to treating patients.
00:26:21:07 - 00:26:48:09
Dr. Alejandro Chavez-Badiola
And then with the first results we have from our first IAB study, I mean, it's like, wow. I mean, the question is why was not why not is the question for me was, how soon can we get so I know that for embryology, for existing clinics, there will be a lot of questions. And how we implemented, how we adopted, how do we learn.
00:26:48:11 - 00:27:18:14
Dr. Alejandro Chavez-Badiola
And that's one of the reasons why we're operating, the, our system ourselves. We want to walk hand in hand with our partners so they can learn how to use it. We want to make sure that we keep top service, top trained people, to make sure that they want they have results that can match results from 5% of the top best clinics in the world.
00:27:18:16 - 00:27:43:06
Dr. Alejandro Chavez-Badiola
So just think about this. An embryologist, as a clinic owner, whether you are just opening a new clinic, planning to expand or planning to improve the results you're offering to patients, imagine I knock on your door and I tell you they want. I can offer you results that can compete with the top 5% clinics in the world. Would you take me on board.
00:27:43:08 - 00:27:48:00
Griffin Jones
If I saw a whole lot of evidence that said so?
00:27:48:02 - 00:28:11:08
Dr. Alejandro Chavez-Badiola
We're working on that. We are having. I mean, the first IAB study is showing that we were there. These were prototypes. And of course, with this, study that the pilot that we just launched here in Mexico City is one of the objectives that we can show that the results that we had last year can be scaled at larger, with a larger number of patients.
00:28:11:10 - 00:28:13:10
Dr. Alejandro Chavez-Badiola
Yeah. We don't have the data.
00:28:13:12 - 00:28:31:17
Griffin Jones
How do you think you might counsel them on change management? What challenges did your own team have you? I think you took part of your andrology lab and part of your conventional Ed, but you still have your andrology lab and you still have your conventional lab, and you're able to fit Ora in there. What challenges did your team have?
00:28:31:17 - 00:28:40:20
Griffin Jones
How do you think you might counsel these folks that start to take on Ora in the United States in 2026, and this change management?
00:28:40:22 - 00:29:11:21
Dr. Alejandro Chavez-Badiola
So the first step that I think that made or helped make things as fluent as possible was incorporating the team stands at the Andrology team and biologists, to work with Alda before the system was installed. Then before we started running patients, we ran drills for safety. So when we had the first patient, all the lab team, then nurses that doctors were already familiar with the system.
00:29:11:23 - 00:29:39:20
Dr. Alejandro Chavez-Badiola
So this collaboration, this communication is critical, is crucial. As you were saying, yes, we had to make modifications because our lab was not. In this clinic has has been here for 11 years. I didn't even dream about the existence of this technology ten years ago. As Josh was saying, the technology was not there, not even to to imagine this.
00:29:39:22 - 00:30:09:01
Dr. Alejandro Chavez-Badiola
So it was very easy to accommodate again, because of the layout. We still have some space constraints, but again, this is the first automated lab in the world. And the idea is that we're learning a lot with intention to make the transition way more, fluent for our future partners. And the conversations that we've had so far have been very positive.
00:30:09:03 - 00:30:13:04
Dr. Alejandro Chavez-Badiola
They see this base, they have an idea about what they need.
00:30:13:06 - 00:30:46:00
Joshua Abram
And yeah, I think I mean, to your point, I look, change management is always an issue. And, addressing the concerns and the needs and the ambitions of our partners is paramount. But I think one thing is to point out, particularly to the science and biology side, that we are bringing tools to them that simply could have been dreamed of, three years ago that, our, chief science officer, abused one of their own.
00:30:46:00 - 00:31:11:04
Joshua Abram
Jack Cowan. We started talking about the Nobel Prize. was, Jack, of course, was the, person, the young man, in his lab, who Edwards had enormous confidence in and turned to Jack and said, Jack, in this science experiment, I've created you clinical medicine. Of course, Jack has been in the forefront of doing that ever since innovating.
00:31:11:06 - 00:31:53:08
Joshua Abram
throughout, associated with many of the key developments, whether it's Icsi or of education, either. Is it a mentor or the advocate practitioner? So we are automating many of the steps that Jack and other leading embryologist created, but want to make. And, what we're really doing at the end of the day is providing embryologist. The job I'd be says, is trained us to think a single cell surgeons your job lectures us and says you are not to think about the demands of this field as anything other than surgery.
00:31:53:08 - 00:32:39:20
Joshua Abram
These are single cell surgeons under enormous pressure, and they need the same tools that great surgeons have in other parts of medicine. And what the da Vinci robot, for instance, has done to, surgery, the kind or conceivable is going to do, for IBM. We are the da Vinci robot of IVF, putting the tools needed by these brilliant single cell surgeons in their hands for the first time, and relieving them of a lot of the pressure, that goes in running lab and operating the lab and letting them focus on the key decisions that now our I was started by talking about in person the loop at all times that
00:32:39:20 - 00:32:54:18
Joshua Abram
only an embryologist to make. so a lot of change management is making clear how we are empowered with the latest technology, but none of us could have dreamed of just a few years ago.
00:32:54:20 - 00:33:24:06
Dr. Alejandro Chavez-Badiola
I think that this is a very good point. any embryologist that, walk into our lab and look at the hybrid system working, they wouldn't be surprised with what the system is doing. We're not inventing new processes. We are following the processes that have been proven for decades with millions of treatments and liberties. The only thing that we have done is we have automated these steps.
00:33:24:08 - 00:34:03:14
Dr. Alejandro Chavez-Badiola
Everyone will recognize the dishes that we're using, the pipettes, the Icsi needles and the protocols that we're following. So there are no surprises there. There's no magic, which is automating and increasing the precision, the accuracy of these processes. so again, no surprises. The other thing that, I forgot to mention in taking again, the example of the of the Da Vinci problem, if you have a recently graduated ObGyn wanting to work in operate, we did the robot.
00:34:03:16 - 00:34:34:15
Dr. Alejandro Chavez-Badiola
They wouldn't be able to do it. They would be able to recognize everything the same technique, the same equipment that they would use in laparoscopy, but they would need to get special training. And after that, there is no turning back as a doctor or as a patient. And as an example, if I had a need for prosthetic surgery, I wouldn't go to a doctor that is not going to operate me with the robot just because of the precision.
00:34:34:17 - 00:34:43:04
Dr. Alejandro Chavez-Badiola
And yes, that doctor had to undergo extra training to improve the quality of of medicine that he's practicing.
00:34:43:06 - 00:34:50:22
Joshua Abram
90% of prostate surgeries in America for 90% of patients demanded doctors money.
00:34:51:00 - 00:35:14:21
Alan Murray
I was going to have the, I think 100% of our visitors who are in clinical operations are here. They're looking at ways to grow their business. They're looking at ways to grow their business. In some cases where we how do we double in the next five years? How do we provide more points of care? What is the technology and tools that need to be baked into our disruptive business models?
00:35:14:23 - 00:35:48:18
Alan Murray
So it's not been about growth and pulling costs down. Cost per maybe laboratory efficiency, ability to generate more embryos with fewer eggs. So our conversations haven't been so much about retrofitting an existing laboratory environment, but what does the future look like? How do we grow? How do we integrate increased enterprise value to our networks? How are we on the on the forefront of technology to recruit more patients?
00:35:48:20 - 00:36:15:17
Alan Murray
So it hasn't been so much about within the lab and how to change a current lab. It's been how do we grow our network aggressively? We are chasing we all agree that 80% of patients in the United States, 95% worldwide, are not getting treated. That's our opportunity. And so Josh left it off when you said that missing opportunity is also commercial opportunity.
00:36:15:19 - 00:36:43:06
Alan Murray
That's a total focus of our conversation is what's next. How did they take advantage of this new technology? Yeah I think this this conversation we're talking a lot about change management, as though our target was to retrofit current labs into an oral system. with the visitors we've had down almost all, all of them are looking at how do we grow and expand our network.
00:36:43:08 - 00:36:49:05
Alan Murray
We have aggressive growth plans. You know, smaller growth patterns is how do we double in the next five years?
00:36:49:05 - 00:37:15:00
Alan Murray
There's a huge untapped market. We're only servicing 20% of the population need in the United States. What new business models can we come up with to expand together using this new technology? We need things that are enterprise scale that can grow with us at the pace we want to grow and bring quality levels.
00:37:15:02 - 00:37:39:06
Alan Murray
how many, you know, our time to pregnancy down our success rates per cycle? all of that comes through automation. So it's been much less about change management in the existing lab, but changing the vision for the future of how IVF can be delivered to service at population scale to get more of that 80% that's unserved.
00:37:39:08 - 00:37:43:12
Alan Murray
And that's where Ora fits in as a key part of those strategies.
00:37:43:14 - 00:38:05:18
Griffin Jones
How do you do that without driving up costs? Earlier, you gave the examples of smartphones, which are among the best example of how you had a very primitive technology that broke phone that was several thousands upon thousands of dollars, couldn't be afforded by the average consumer. And now people can buy a supercomputer for a few hundred dollars. And almost everyone on the planet has worked.
00:38:05:18 - 00:38:30:09
Griffin Jones
So that's an example of where scale has really brought costs down. But there have been other things in in education and health care where, oh, now we have online education so that you bring the cost of college tuition down. And yet college tuition skyrockets. How do you make sure that you're able to make costs go down when some doctors think there's there's nothing that will make costs go down.
00:38:30:09 - 00:38:40:06
Griffin Jones
Costs will just keep going up. And this is this might improve quality and it might improve, capacity. But but how do you make costs.
00:38:40:11 - 00:39:03:09
Alan Murray
So let's turn it let's turn it to consumer demand. And they're looking at cost per baby. So we can talk about cost per cycle, cost per lab flow. But the end point here is cost for baby. In the US we're averaging about $75,000. Is the out of pocket cost to have a baby. That's two two and a half cycles.
00:39:03:11 - 00:39:26:12
Alan Murray
And of course, you know, that varies by age and other, issues. But $75,000 is twice the take home pay of the average American. It's an impossible thing to enter the market. Biggest lever we have to pull costs down out of IVF is to pull down the number of cycles. Let's take two cycles, make it one and a half for that demographic.
00:39:26:12 - 00:39:53:13
Alan Murray
Let's take two cycles. Let's make it one cycle. And the laboratory is the key driver for that. How many eggs come in to how many usable blastocyst go out? How many shots on goal do we have a transfer? If we take and we stack up the principle of IRA and we map it toward the Vienna consensus, we are mapping to be at the very top.
00:39:53:13 - 00:40:21:13
Alan Murray
The aspirational levels of DNA consensus and continue to improve from there. The average lab in the United States is producing two usable blastocysts for every ten eggs that come into the laboratory. Can we take that from two usable blast per cycle to four usable Blast per cycle? That is our vision, and that's directly mapping to that over the coming years.
00:40:21:15 - 00:40:45:09
Joshua Abram
And that ties back into at 100 point earlier in that, with automation and what we're seeing, given our very early tests, that we can be at the very top and share with our partners a lab at day in, day out through automation is at the very top of the pyramid. Consensus. The top 5% and a lab in the top 5% performing day in and day out.
00:40:45:09 - 00:41:03:16
Joshua Abram
And that will gets us to the kinds of ratios that Allen has described. Human beings have done this on good days. It's not impossible. But what we haven't been able to do is replicate it day in and day out and just scale. That's the power of automation, and that's how we're going to reduce costs.
00:41:03:23 - 00:41:29:03
Griffin Jones
You mentioned that very rough numbers and or and do 2000 IVF cycles with three technicians, embryologist for those that might be thinking, well, that has to be more expensive than the number of embryology, I don't know if it's ten or 12 or 15 that would normally to to take to do or even more. I don't know what the number is to do 2000 cycles.
00:41:29:05 - 00:41:40:05
Griffin Jones
They think that the technology must be more expensive than that. How does the and what volume does or makes sense
00:41:40:08 - 00:42:10:12
Alan Murray
We are looking at it in large scale opportunities. or makes sense at some threshold over a thousand cycles per year. the economics and cost per embryo produced goes down the higher that throughput number is. So we can take one or line, we can amp it up. We don't have to operate eight hours a day like a normal lab, or it can operate 16 hours much easier.
00:42:10:14 - 00:42:40:15
Alan Murray
so it's easier to double shift an instrument. We talk about a team. One team can operate two or a line simultaneously. So we can increase capacity there. So we can pull labor costs down. We're pulling CapEx down. We're pulling the price of consumables down. Just like all large scale manufacturing or the higher the scale, the lower the price.
00:42:40:15 - 00:43:12:16
Dr. Alejandro Chavez-Badiola
thinking, as the owner of an IVF clinic that is expanding, that's pretty much a dream come true. I don't have to put down money to buy new equipment, which is part of the highest expenses in IVF. I don't have to worry about the leasing costs. It is conceivable is putting the machine in my lab now, we were talking about the complications or the challenges of adopting out of system.
00:43:12:17 - 00:43:44:21
Dr. Alejandro Chavez-Badiola
This is the first one, and there's a lot of redundancy, but the system is capable to stand on itself. Each unit, which some unit has all the air filtration to guarantee top quality of air, even if you are in an unprepared room. We have ups at every single station for backup. You don't need to invest in extra ups for it for your system.
00:43:44:21 - 00:44:15:20
Dr. Alejandro Chavez-Badiola
So again, I don't have to worry about that. I don't have to worry about if I if I'm planning to double the number of cycles over the next 12 months, I don't have to worry about hiring new embryologist. How many more? 1015? 20 when there are no embryologist, I don't have to worry about making sure that the results from this new expanded lab are up to the level of the results that I had yesterday.
00:44:15:20 - 00:44:29:06
Dr. Alejandro Chavez-Badiola
I know that day one I'm going to have at least the same, if not even better, results than the ones that I had yesterday. So expansion is easier in that sense.
00:44:29:08 - 00:44:39:21
Griffin Jones
How will or how might or, take the average lab from two usable blasts to 40 blasts?
00:44:39:23 - 00:45:16:04
Dr. Alejandro Chavez-Badiola
Let's start with this preparation. And I mentioned something about this earlier on. There's a paper from, Columbia showing how improved automated these preparation can improve than 11%. The number of usable blastocysts for a then next step, you need to prepare sperm. With our system, we have reduced DNA from station. We are using a system that is centrifuge free, so that in itself has a potential to improve.
00:45:16:06 - 00:45:46:17
Dr. Alejandro Chavez-Badiola
But if we take it one step further, we're not now selecting sperm based on how I feel the sperm is looking, whether I think that he's moving good or not, whether I think that the morphologies of the or not. Now we're selecting the best sperm based on a quantitative analysis and the results that we've shown. And we have the bodies, we can improve last generation by about 15% just by improving sperm selection.
00:45:46:19 - 00:46:18:20
Dr. Alejandro Chavez-Badiola
Now taking another example, PSA is not used in in Western countries because of many different reasons. The complexity of setting up the system to concerns about dumping fluid. But the papers coming out from Japan and now Australia show improved results. With the use of PSA. Fewer eggs get generated, higher rates of normal fertilization. Now, with the precision of the robots, we don't need a dumping fleet.
00:46:18:22 - 00:46:47:17
Dr. Alejandro Chavez-Badiola
We don't need specialized bipeds for PSA. We use conventional needles, and the level of precision means that we just need one PSA movement to break the axis and bring down dramatically the percentage of degenerated eggs through XY. And with this increase, the proportion of eggs that get normal fertilization. And I think the idea is at each system, each step is doing this again vitrification.
00:46:47:19 - 00:47:27:07
Dr. Alejandro Chavez-Badiola
Another example, the modifications that we've done that automated vitrification system allows to 55 up at 30 times 40 times faster than manual beautification using the same protocols, just standardizing what we're doing and including some, improvements. So if you add all these and you do these consistently, then you can easily explain how can we get from two blastocyst recycle to four again, you have an embryologist.
00:47:27:08 - 00:47:53:21
Dr. Alejandro Chavez-Badiola
Your best immunologist is not going to have the same fertilization and blast formation rates every day. It's not going to get the same places formation rates from different cycles throughout the day. We have variations within our practitioners in this clinic. I have another clinic in Valhalla. There are variations between the clinics and we have our patients month after month.
00:47:53:23 - 00:47:55:15
Dr. Alejandro Chavez-Badiola
How can we start to dissect?
00:47:55:17 - 00:48:34:10
Joshua Abram
We had one major lab. They could come here and say, look guys, I am convinced, I think you would good for results. Having heard Alejandro go through the data on improvements in each one of these steps. But then he said, it's for God's sakes, if you could just normalize within my own network performance because on some key indexes and he cited two American cities, and the, the benchmark for fertilization to be key and the, the success rate at one clinic was an 82 wedding, 3%.
00:48:34:12 - 00:48:39:01
Joshua Abram
And at another clinic, also in the United States, it was 50.
00:48:39:03 - 00:48:40:06
Dr. Alejandro Chavez-Badiola
Just over 50.
00:48:40:06 - 00:49:08:16
Joshua Abram
So it was a 50% swing. But this is a great operator. And the same protocols, the same, technology, the same good intention, the same training. And on a month to month basis, they're just seeing these kind of swings. I mean, it's the devil in the system. And it goes back to the point that I think Clovis made that is very difficult to scale this manual, artisanal analog system.
00:49:08:18 - 00:49:16:19
Joshua Abram
This is the job of automation. And to put it at the top of the beginning, consensus every single day of the week.
00:49:16:21 - 00:49:40:22
Griffin Jones
I'm glad you had to do a question about the answer protocol two, but that was a question from our audience, from Simon Lumsden, who wanted to we wanted that question answered. So thank you for answering that. Speaking of swings, Alan, you got me thinking about swings in costs, and I know you're still doing some research into this, but you got me thinking that the the term IVF cycle is a really general blanket term.
00:49:41:01 - 00:50:01:06
Griffin Jones
You know, anything with a retrieval, any time an egg is retrieved, that's an IVF cycle. But sometimes you might retrieve it eggs, sometimes you might retrieve 21 eggs. And you could you could have big swings in the number of eggs that are retrieved and therefore the the amount of embryology work. How are you thinking about this?
00:50:01:07 - 00:50:28:08
Alan Murray
I think in helping our partners understand their cost basis. We've done something with, twin brothers. Close the paper very soon. We're in the final publication of something called an activity based costing of an IVF lab. You know, it's basic. Think about putting a stopwatch on an embryologist, looking at what they're doing, looking at what they consume. so when we talk about a cycle, we talk about some kind of a generic cycle.
00:50:28:10 - 00:50:56:13
Alan Murray
I don't know what it is anymore. what's coming into the laboratories? Our demands for an IVF are UI preparation. It's a work order coming into the laboratory. Now, their work order comes in. We're going to do egg preservation for a patient. So. And we looking throughout this roughly seven different definitions of work orders that are coming in the lab from an AI UI to prepping for an embryo transfer.
00:50:56:15 - 00:51:17:18
Alan Murray
So as in this body of research, we've looked at the cost associated with each of those work orders or procedures that are coming into a laboratory. and we start looking at swings on it, number of eggs for, call it a standard cycle in the US that might include,
00:51:17:18 - 00:51:29:07
Alan Murray
patient gametes going through an XY cycle with a biopsy and then freezing all the, resulting embryos.
00:51:29:09 - 00:51:53:22
Alan Murray
I mean, look at the cost swing if it was a lower stem or lower response, and we saw ten eggs come in a lamb versus a high responder or a high stem protocol, it's all 30 eggs coming in. The cost of a cycle varies by more than 60%, just on the number of eggs per cycle. We look at, the time of day utilization.
00:51:54:00 - 00:52:18:11
Alan Murray
How well balanced is the workload on the daily basis? Some days the embryology team is just crammed or the andrology team is quiet. Other days they've got some time to breathe and catch up, so they're not operating at peak times. We look at clinics that are large and have scale. Labor doesn't move that much. Labor overhead of supervision stays constant and can be spread.
00:52:18:11 - 00:52:49:08
Alan Murray
So there's some economies of scale on labor. They've got more purchasing authority on supplies. so defining the cost of the cycle is more complex than just thinking about the rules of thumb. we needed this work so we could understand. So we're doing simulations on the throughput capacity for an Or system, and it's really, dumbed down to say it does 2000 cycles a year.
00:52:49:09 - 00:52:56:01
Alan Murray
It's doing close to the 4000 work orders that come into a laboratory every year.
00:52:56:03 - 00:53:17:22
Dr. Alejandro Chavez-Badiola
So, I'm going to try to answer as a doctor every time. And again, I have plenty of experience every time that I face a patient. And I have to make a decision about when is the best time to trigger, whether I push a bit more to get a few more follicles to mature, and trying to get a few more eggs or not.
00:53:18:00 - 00:53:59:04
Dr. Alejandro Chavez-Badiola
I think that I am doing the best to get the best. But then how do you define the best time when we don't have the technology just want to make sure that they fertilize and that they make embryos. And that's how we assess equality. Now imagine what we can do with a system that standardizes everything, how we'll be able to learn a lot about whether one particular protocol is working better for one set of patients, whether triggering with one medication or another is better for certain group of patients because your patient endometriosis patient older patient younger patient.
00:53:59:05 - 00:54:26:18
Dr. Alejandro Chavez-Badiola
So I can start personalizing these key decisions. The other important thing is that right now, we're only as good as the quality of the gametes that we're working with. So the key in the lab is making sure that we're giving each of these gametes the best opportunity. And the bottleneck is eggs. Now, right now in the lab, because of the way in which we work, we treat eggs as batches.
00:54:26:20 - 00:54:53:00
Dr. Alejandro Chavez-Badiola
So I collect the eggs, put them in the incubator for a couple of hours, let's say. Then we go for XY. I will do need all the eggs one 1012 eggs at once. And if they were not ready. So then I will inject every year with a polar body. That doesn't mean that the cytoplasm was mature. It's an indirect measure telling me that they could be ready.
00:54:53:02 - 00:55:30:12
Dr. Alejandro Chavez-Badiola
Why then do I the new the different times? Why don't we inject at different times? Because we don't have that capacity. We can't have our embryologist occupying stations at different times and then bringing Rd. I mean, they're busy with the next case with the technology that we have implemented without anything like modern microscopy, we can actually evaluate the presence of a polar body before denuding the egg so we can stop treating eggs as batches.
00:55:30:14 - 00:55:55:05
Dr. Alejandro Chavez-Badiola
We can define which hacks can be the new now, which other eggs should keep. It should be kept in the incubator before then, using to give them a better chance for hydration. We can actually identify this. We need to decide when is the best time to inject, and those that don't show this being at the right time can be it could be injected later.
00:55:55:06 - 00:56:24:08
Dr. Alejandro Chavez-Badiola
So this level of individualization in the decision process can transform what we're doing into giving each egg the best opportunity to become an embryo, which could make the difference for a patient between having a baby or not. And these can only happen throughout the nation. Or unless you duplicate the number of embryologist and the workstations that you have on European.
00:56:24:10 - 00:56:47:13
Griffin Jones
Machines, don't have the variants that humans do. Machines can work. Double shift machines don't call in sick. Machines don't bump into each other in the lab. Crossing back and forth. But machines break. We were yesterday doing a LinkedIn live in my freaking microphone that I use for every podcast. Just doesn't work for LinkedIn live. But we did the test at home.
00:56:47:13 - 00:57:14:21
Griffin Jones
I come here with stupid microphones not working. That has been among the biggest worry that people have with any technology. And certainly here is what is maintenance look like? What happens if we have Doctor Emily Thacker ask some questions about what maintenance looks like? Of course, Steve Rooks has more very specific questions about median time to repair and median time between failure.
00:57:14:23 - 00:57:21:07
Griffin Jones
What's maintenance look like? How frequently do errors happen? What happens when they do? What are the proactive measures?
00:57:21:08 - 00:57:44:15
Dr. Alejandro Chavez-Badiola
I'll let Alan answer this one, but I just want to give an example. I think that is about that how flexible you are with mistakes. How what is your threshold? A few months ago I saw that that,
00:57:44:17 - 00:57:47:11
Dr. Alejandro Chavez-Badiola
How do you deal with pilots after their instrument?
00:57:47:11 - 00:57:48:14
Joshua Abram
Cockpit? Dashboard? Cockpit?
00:57:48:14 - 00:58:24:09
Dr. Alejandro Chavez-Badiola
Yes. And I haven't seen these for decades. I remember when I was a kid and these were open or were analog instruments. This time, for the first time ever, 100% digital. When I flight transatlantic our flights, I know that the pilots are not behind the wheel. During the 12 hour flight, I know that is how the pilot. It's just that the aeronautic industry has practically zero margin for error.
00:58:24:11 - 00:58:49:15
Dr. Alejandro Chavez-Badiola
So where are we? And that's the key. And we're dead and in. And I will be able to tell you more about the team that we have dedicated to quality control and quality assurance and to my maintenance and all these. But that's the key. What's how tolerance for error. And we know that in medicine is or should be zero.
00:58:49:17 - 00:59:15:14
Alan Murray
Yeah. Look up. and I think we begin with culture and we totally recognize the need for high reliability laboratory that is you know, it's it's table stakes for us. So from culture led to our recruiting philosophy. We have a team of incredible engineers and we can think of roughly half of them are come from an R&D world.
00:59:15:16 - 00:59:50:19
Alan Murray
Experimental mechatronics, experimental optical physics, coders, AI people all very experimental. Move fast. Let's get things done. Other half of the team comes out of the automotive industry. The quality control programs in automobile component manufacturer are so far beyond anything we've ever seen. Close to the IVF community. So the guys we brought in out of suppliers to the automotive industry, who were responsible for bringing products to market that drive cars.
00:59:50:21 - 00:59:52:10
Joshua Abram
Autonomous driving.
00:59:52:12 - 01:00:23:01
Alan Murray
Including autonomous driving, the guys that are making the lidar systems that have to work every time that are doing the controllers. For power, speed, engine management, all of these things. And in that culture, it has to work. They are supplying to BMW, Chrysler, Ford, Hyundai, big wide. These corporations are putting out millions of cars that are that have passengers inside of them.
01:00:23:03 - 01:00:57:00
Alan Murray
Anything goes wrong. There's a huge problem. So we've got recalls which bankrupt companies. So what we come from is a culture of validation, verification, design, organizational flow that goes all the way through testing. And you mentioned Steve Brooks. Meantime, the failure testing for a component going into a car is 100 million times or more. So before they release full production, they do a limited run and run.
01:00:57:00 - 01:01:31:05
Alan Murray
These things. So that's the culture of our team that transcends down to then what do our suppliers are doing? Are they under this rigorous quality program? so we've looked at our supply chain training and we're looking for quality suppliers. So when I mentioned our robots came out of electronics manufacturing, we're going to robot manufacturer that are making a thousand a month or 100,000 a year robotic components and selling them into lines that are doing assembly of electronics.
01:01:31:05 - 01:02:02:16
Alan Murray
And that line goes down. They're losing million dollars a minute. So it's not the human cost, but there's an economic cost. So have looked for rigid quality control suppliers and everything from our optical movement to our optical component to our robots, to our linear motion devices, to our micro robots, to our anti vibration tables that are all being sold at scale into environments that are 100 to 1000 times more demanding every day.
01:02:02:18 - 01:02:05:06
Alan Murray
Than running 12 human cycles through a lab.
01:02:05:06 - 01:02:15:15
Griffin Jones
mentioned, it can vary so much between clinics. What will it be for it? Will there be remote monitoring? And will someone come on site to inspect every three months, or what will routine.
01:02:15:15 - 01:02:22:06
Alan Murray
You know, so we're starting it ourselves. So we have an on staff engineer. behind that engineer is a team.
01:02:22:11 - 01:02:23:14
Joshua Abram
Every hour of operation.
01:02:23:17 - 01:02:26:14
Alan Murray
Every hour of operation. And this is a,
01:02:27:17 - 01:03:05:11
Alan Murray
Embryo engineer cross-trained in embryology. They know our systems. They know how to swap out robots or robotic components. They know the service and maintenance schedules. We've got a QMS department that's actively, developing very detailed maintenance, whether it's, daily, weekly, monthly program or annual program for each component. so the systems are coming live today that, both predictive maintenance, because we know from our optics whether a robot is is hitting as precision every time.
01:03:05:13 - 01:03:15:11
Alan Murray
So we've got early indicators, through the digital components. And then we have, of course, very rigid schedule maintenance procedures.
01:03:15:13 - 01:03:45:00
Griffin Jones
We talked about how increasing the number of usable blasts and decreasing the cost for manpower, they reduce the cost for IVF and certainly cost for baby. so I think we answered most of Mark Evans question, but he wondered about a regression model that correlates to to price in the patient adoption of IVF. So I wondered, do you have any way of how will you be thinking about this a year or two from now to see, did we actually bring cost down?
01:03:45:04 - 01:04:19:15
Joshua Abram
I would start with a landmark paper by David Adamson, through his organization, A command, which was published a couple of years ago. it's the only, W.H.O. affiliated NGO, econometrics, economists involved, the paper physicians involved in the paper. And they documented that for every, point reduction, in cost against disposable income, it was a 3.2, 3.3 increase in utility of the service.
01:04:19:17 - 01:04:55:21
Joshua Abram
So we've actually mapped this out. But and I would not scope the figures here, but I'm happy to supply the data, which was interesting that as the cost of IVF begins to drop, there is more leverage in pricing than in almost any other field that we have seen. I mean, this is a credibly price I field field and the big opportunities over time in the future, we think with providing high quality IVF at scale and undoubtedly many innovators are going to choose models that are less expensive.
01:04:55:21 - 01:05:13:05
Joshua Abram
I mean, it's just inevitable our innovation will beget other innovations. so I think there's a very, very fair path between, automation, the ability to innovate across the field, but particularly on price. If that's what you want to do.
01:05:13:07 - 01:05:26:23
Griffin Jones
People will be thinking, good luck getting FDA approval, but you've gone a route where they have everything that touches the embryo is already FDA approved. Tell me why that's important. Tell me more about that.
01:05:27:01 - 01:05:52:02
Alan Murray
So let me jump in. I mean, it's, our governing body, as we come into the US, will actually they'll be doing inspections here as cap college American pathologist. So we've engaged with them. They've been down here, started looking at our systems. And how do we make protocols or clear lab protocols here. And using their international program, which is a mirror of the US program.
01:05:52:04 - 01:05:56:02
Alan Murray
we're working with Cap, which is the gold standard of laboratory.
01:05:56:02 - 01:06:07:14
Alan Murray
certification and inspection. we have components which are going to go through an FDA 510 K if that's a piece of it. So we have a few elements that will be going through an FDA 510 K.
01:06:07:14 - 01:06:36:07
Alan Murray
And then as you started the conversation, we have built for a version one to use petri dishes coming out of IVF, general suppliers. So they've gone to FDA. We're using media produced and commonly used throughout U.S labs. Our micro tools. We've adapted the robots to use existing micro tools to everything that's happening within the dish, or 1 or 2 degrees away from a cell.
01:06:36:08 - 01:06:39:11
Alan Murray
Are FDA cleared components.
01:06:39:13 - 01:07:17:03
Dr. Alejandro Chavez-Badiola
Imagine you hire me as a consultant. You wouldn't because I am a doctor, not an embryologist. Can you imagine? You hire me as a consultant to design and equip your new IVF lab. I will choose the equipment that I think that is the best. I will lay the equipment down based on whatever I think is most efficient. And nobody's going to come and assess the equipment that I have that I selected, or the layout.
01:07:17:05 - 01:07:51:00
Dr. Alejandro Chavez-Badiola
Would, cap is going to come into maturity is that everything is working according to protocols and all the things that we're meeting. So what we're doing is that we're equipping, designing, equipping IVF labs with 21st century technology. And the protocols, again, are the same protocols that have been that have demonstrated safety and results with media inside of libraries.
01:07:51:02 - 01:08:02:16
Dr. Alejandro Chavez-Badiola
So this is where we are. The other thing again is it makes a difference, is that we are not selling the equipment we own and operate, that we're assisting.
01:08:02:18 - 01:08:12:12
Griffin Jones
I'd like each of your thoughts on this, but you said there's never been a better time to be an embryologist. Would you be better at.
01:08:12:14 - 01:08:43:15
Joshua Abram
look, I think the market demand is extraordinary. as we said before, if you take the sort of boring banker, analysis of demand by 2034, we're going to be doing globally 6.5 million cycles. if you, take the SRM approach, and think about what represents, true consumer demand, 12 million, babies are waiting to be born annually just for fertility.
01:08:43:17 - 01:09:15:16
Joshua Abram
20 million. If we include things like, making miscarriage and other valuable uses for IVF, that's if they don't happen. It's too expensive and too hard to access. So I think be hard to find whether you are a clinician of any kind or a businessperson of any kind. Involvement. Yeah. I think it'd be hard to imagine a more golden moment to be involved in the field, but, people at the front lines are better remain, and biologists are treasure single cell surgeons.
01:09:15:18 - 01:09:46:00
Joshua Abram
And, we are going to give them as many, intervention robots as they need to meet this demand. And I think together, we've got to march into a future where, you know, we're not giving birth to 1 million children, per year or 10 million to over 40 years. We're doing, providing meeting to demand for 10 to 12 million children every single year.
01:09:46:02 - 01:10:28:21
Joshua Abram
I mean, it's just self-evident that there's never been a better time to be an embryologist. It's not. Is it more, is going to eliminate the need for embryologist. We are embracing embryology. So we're going to need embryologist involved in every single station. I think the only thing embryologist, should be worried about. and I don't know any Brighton biologist you feel this way is, what happens if I don't train, if I don't change, if I don't embrace innovation, what happens if I'm the person in my office who said no, lambs and chat GTP and having them integrated into my business life is not for me.
01:10:29:02 - 01:10:53:05
Joshua Abram
I'll leave it to all the rest of my colleagues and see what happens. Well, that person I worry about, I worry about that we. But I don't think that is true of many people in the field. Should be not many of the leaders in the field and people at the front lines doing very vital work every day. So never a better time with coming technologies coming, stress is going to be relieved.
01:10:53:07 - 01:11:14:13
Joshua Abram
Opportunities are going to grow. And I don't know of a single embryologist who doesn't want to help as many people as they can. They've chosen to be in a helping profession and to go from one field. So to, a year to 12 million, that's a lot more people to help. So we're going to do this together.
01:11:14:15 - 01:11:16:01
Griffin Jones
What do you see?
01:11:16:03 - 01:11:37:00
Alan Murray
you know, it's hard to add much to that. from the embryologist perspective who embraces change, is curious, is intellectually curious, who takes advantage and learns about AI system and understands robotics and that intersection with the evolving embryology lab.
01:11:37:01 - 01:11:40:06
Joshua Abram
And we're going to help in that education process.
01:11:40:08 - 01:11:59:19
Alan Murray
It's a fantastic and it's a growing population need. We're going to need more and more embryologist. I think it's great time, man in the field. If you're curious, if you embrace technology. And I think that's broadly, you know, every job in America almost fits into that category.
01:11:59:21 - 01:12:07:16
Griffin Jones
What do you still value now that you have this automation? What do you still value from your human embryologist? As a clinician?
01:12:07:18 - 01:12:19:22
Dr. Alejandro Chavez-Badiola
Exactly the same that I value today. From my perspective, embryologist are scientists. They're not human. Roberts is down by 15. Or they they are scientists.
01:12:20:00 - 01:12:50:22
Dr. Alejandro Chavez-Badiola
I still value the same. I want people that want, that I can just or discipline who put patients care is top priority or diligent. It's exactly the same values that I use. And it branches today are the ones that I'm looking for in the biologists of the future. Now, I'll just add to your previous question. And biologists are scientists.
01:12:50:22 - 01:13:32:07
Dr. Alejandro Chavez-Badiola
That's what they are. If I think about Edwards and Jack Coleman, he was a fantastic time to be an embryologist. Anything. Everything that you did was new. You were discovering. Today, I think that most embryologist are overwhelmed by administrative chores and manual are additional steps that leave very, very little room for their imaginations to run wild and create and test what they can do to improve patient's results.
01:13:32:07 - 01:13:39:23
Joshua Abram
30% of their time is spent on paperwork. I mean, who wants to do that? And something robots do very well, I think.
01:13:39:23 - 01:14:07:17
Dr. Alejandro Chavez-Badiola
I don't know if it's going to happen ten, 50 or 100 years, but imagine the time when 99.9 to 100% of the patients get pregnant. That's a very important time to be an embryologist. But right now, as Joshua was saying, we're entering digital era in in the IVF lab right now, we have the toys, we have the technology so we can become scientists again and start improving.
01:14:07:23 - 01:14:37:21
Dr. Alejandro Chavez-Badiola
And with this system, without a system, without a nation, now, you don't have to spend that much time, hopefully zero time with administrative chores and these additional steps. Now you have time to create, to imagine, to become a scientist again, and then to apply that those improving patients results and getting to these 100% when becoming an allergist will be more.
01:14:38:03 - 01:15:15:17
Joshua Abram
Than doubling on our description of embryologist as scientists, scientists do research. And one of the things that every senior scientist embryologist has struck by coming down here is that, we are going to unleash a entirely new era of science and scientific innovation in IVF, because one of the things that automation does is removes the hungry hundreds of confounders involved in creating a sperm, an egg into an embryo.
01:15:15:19 - 01:15:40:16
Joshua Abram
Each of these individual steps, which are hard to account for and hard to do with exacting precision to maintain the control. And so everything will be standardized. And then and this was the comment of, Mitch Rosen, who came down here and he was not alone in saying this. Mitch Rosen, who he spoke to in HDL day, and in Ari, I one of the few, be immersed in California, San Francisco.
01:15:40:16 - 01:16:04:05
Joshua Abram
He was down here, I guess, ten days ago. And Mitch said, you guys don't understand just how important this is going to be for science, because it is isn't obviously an academic institution. This was hardest, you were going to take noise out of IVF research. You're going to take the noise out and allow me to listen to one variable at a time.
01:16:04:07 - 01:16:30:05
Joshua Abram
And if I can have that environment, I and my colleagues can make progress. It's going to make the world's head spin in the best possible way. So, you know, we've actually talked about promoting x percent of the time on the robotics to research projects. We're absolutely fascinated by this. We are committed to it. It's it's something that we want is part of our legacy.
01:16:30:06 - 01:16:37:13
Joshua Abram
And we are looking, to our embryology scientist partners, to help us move this forward.
01:16:37:15 - 01:16:59:22
Griffin Jones
I'm not a clinician or a scientist. I'm not the validate. I'm not the one to validate everything that you've done here. But what I can do is come and see everything working harmoniously, and I can see the team and how invested they are in this. And when you were taking me through or yesterday, does your embryologist and your technicians, how much pride they had in explaining to me, you can see that something is working here.
01:17:00:01 - 01:17:23:08
Griffin Jones
And the other thing that I can do is talk to all of the people that have come down thus far, and I've talked to Ari Ice, talk to the business folks, I've talked to the lab folks. They're all blown away. You should be very proud of what you've done thus far. I'm impressed. And thanks to your and Watson and her team for making this first in-person podcast episode possibility. It's been a pleasure.
01:17:23:10 - 01:17:24:16
Joshua Abram
Thank you so much for being here.
01:17:24:16 - 01:17:46:18
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