Dropped after pressure from current IVF lab directors
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BY: RON SHINKMAN
The American Society for Reproductive Medicine (ASRM) and two of its affiliates proposed last year to eliminate the longstanding doctoral degree requirement for embryology laboratory directors, but withdrew it earlier this month after it came under criticism from current lab directors.
The proposal from the ASRM, the Society for Assisted Reproductive Technology (SART) and the Society of Reproductive Biologists Technologists (SRBT) was first submitted to the American Board of Bioanalysis (ABB) last April, according to followup correspondence the groups sent to ABB last September. The proposal was to reinstate an examination and certification pathway for non-doctoral technical supervisors to become embryology laboratory directors. The ABB oversees the certification of laboratory professionals in the United States.
A doctoral degree has been required for embryology lab directors since 1999. That’s when the federal Clinical Laboratory Improvement Amendments (CLIA) regulating labs in the U.S. were expanded to include embryology laboratories. The CLIA regulations also classified embryology labs as conducting “high complexity” testing. All labs with such a designation require physician or doctoral-holding directors. Non-doctoral embryology lab directors at the time were exempted from the new rule, and a small number still hold such jobs, according to Eva Schenkman, an embryology lab director and consultant based in Rocky Mount, N.C.
The September letter to the ABB mentioned “extreme staffing shortages” cited by the SRBT president at the time, Brad Milette. He referenced numerous job openings on the ASRM jobsite, LinkedIn and other sites. However, the letter does not clarify if the shortage includes embryology lab directors.
Milette, a laboratory supervisor and embryologist for the Women & Infants Fertility Center in Providence, R.I., did not respond to phone calls seeking comment.
Also signatory to the letter was past SART president Sangita Jindal. The letter noted that half of current embryology laboratory directors direct more than one lab, although she did not delve further into the average number of laboratories they supervise. Under CLIA, a single individual may direct as many as five high complexity laboratories simultaneously.
Jindal did not respond to emails seeking comment.
The third signatory to the letter was ASRM Chief Executive Officer Jared Robins, M.D. Neither he nor an ASRM spokesperson responded to emails seeking comment. ABB did not respond to a query sent through its website.
Current embryology lab directors believe there was an ulterior motive for the proposal: a concerted cost-cutting campaign among the owners of reproductive medicine practices.
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“There are people who are working for big venture capital and private equity firms (in the fertility business),” and I don’t think they want to pay for PhDs,” said Marlane Angle, director of the laboratory at the Caperton Fertility Institute in Albuquerque, N.M.
Schenkman concurred. She suggested that along with the presence of private equity, inflation and deteriorating margins may be pressuring practice owners to cut costs.
Another laboratory director who asked not to be identified said that the salary differential between someone in a supervisorial position with a doctorate degree and without could be as much as $60,000 per year. A recent salary survey conducted by ASRM and SRBT concluded that the large majority of experienced lab directors with doctorates working at private assisted reproductive technology labs received base salaries between $175,000 and $275,000 per year. But among those lacking a doctoral degree, the majority reported salaries of between $100,000 and $225,000.
“It’s just insane,” Schenkman said of the possibility that someone with a bachelor’s degree and a few years experience could direct an embryology lab.
When Schenkman discovered the proposal had been submitted, she launched a petition to have the proposal withdrawn. The multi-page petition also questioned the jobs data cited in the September letter to the ABB. It stated that the number of embryology lab director positions being posted were perhaps one or two per month. It also noted data from the Centers for Disease Control and Prevention of a 35% increase in cycles using assisted reproductive technology since 2018. Meanwhile, lab growth has been static; the petition also cited CDC data indicating that there are three fewer embryology labs operating in the U.S. now compared to 2018.
“This data aligns with the notion that the rise in cases, unaccompanied by a proportional increase in clinics, underscores a shortage of embryologists rather than laboratory directors,” the petition stated.
The campaign orchestrated by Schenkman appears to have had its impact: more than 400 individuals have signed the petition to date. And on Feb. 2., ASRM, SBRT and SART sent a joint email to ASRM members stating that it had withdrawn the proposal.
“We regret that this process has not been as transparent and inclusive as it should have been and has clearly caused polarized discussions among our SRBT members. Based on the number of comments from our members, we realize that this request was clearly premature and may not be representative of the broad SRBT membership,” read the email, which was signed by ASRM President Paula Amato, M.D., SART President Steven Spandorfer, M.D. and SRBT President Marina Gvakharia, M.D.
In addition to withdrawing the proposal, the email said it would conduct a survey of SART-affiliated laboratories regarding “the current status and future needs of lab directors.” It also planned to conduct a survey of SRBT members on the embryology lab director requirements, and “conduct a series of town hall meetings to present these findings and to listen to our members’ perspectives on addressing workforce challenges.”
The content and themes expressed within the article are that of the news. The advertisers do not have editorial control over the content of this article, and Inside Reproductive Health maintains full editorial independence. The views and opinions expressed in this article do not represent the views of the advertisers or of Inside Reproductive Health.
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This News Digest Brought to You by
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