Today’s Advertiser helped make the production and delivery of this episode possible. But the themes expressed by the guests do not necessarily reflect the views of Inside Reproductive Health, nor of the Advertiser. The Advertiser does not have editorial control over the content of this episode, nor does the Advertiser's sponsorship constitute an endorsement of the guest or their organization. The guest's appearance is not an endorsement of the Advertiser.
OB/GYNs are entering the IVF space—but what role should they play?
This debate is heating up in fertility medicine, and Dr. Stephanie Kuku, a former OB/GYN surgeon in the NHS and now Chief Knowledge Officer at Conceivable Life Sciences, offers her global, tech-forward perspective
In this episode, she talks through:
What REIs and OB/GYNs really need from each other
Where the line is on fertility care qualifications
What REI oversight could look like in different countries
How new tech may expand REI roles (not replace them)
How Conceivable is building collaborative care models (including their current 100-patient IRB study)
The field is changing. How will REIs lead the way forward?
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 automated IVF lab against today’s clinical benchmarks
Designed to improve consistency, efficiency, and outcomes
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The revolution is underway. Don’t miss the data that could change your lab forever.
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00:00:02:23 - 00:00:48:20
Dr. Stephanie Kuku
If we increase the number of cycles to meet demand of the 1 in 6 people who suffer from infertility, we we need the physician care to meet this demand. Because of course, you know, there's a laboratory element, but there is a sort of clinical care. And the current capacity in really care does not meet that. And so we need a collaborative model where Obagi is supported and supervised by RTI, is a part of the sort of fertility care model, the future fertility care model.
00:00:48:22 - 00:01:11:07
Griffin Jones
What should OB gyns be doing in fertility care? They're coming into IVF, but they're not our eyes. This debate rages on in this field, and I want to keep exploring different angles and hearing different voices. My guest, Doctor Stephanie Kuku, was a practicing ob gyn surgeon in the NHS in the UK. She's been an adviser to some 75 health tech startups.
00:01:11:09 - 00:01:38:12
Griffin Jones
Now she's the chief knowledge officer of conceivable. She's not trying to do IVF. So from my point of view, she doesn't seem to have a dog in this fight. So I ask, what do OB GYNs need from rise? What do rise need of OB GYNs? What's the oversight that you guys have over OB GYNs in other countries? What are OB GYNs qualified to do with regard to fertility care and not qualified to do without our AI training?
00:01:38:12 - 00:02:03:05
Griffin Jones
And I make Stephanie describe what in our eyes work might look like when he or she is overseeing far more cases and potentially teams of providers in apps underneath him or her doctor who thinks we'll need more areas, not less. The career opportunities will be more, not less. The livelihood they make will be greater if they embrace the necessary changes and are part of leading the way.
00:02:03:07 - 00:02:26:07
Griffin Jones
Doctor Kuku is talking about the research that OB GYNs and our allies can collaborate on, including the 100 person IRB study that conceivable Life Sciences is running right now. How will technologies like conceivable bring OB GYNs and our eyes closer together? Listen in on my conversation with Doctor Stephanie Kuku.
00:02:26:08 - 00:02:47:23
Announcer
Today's advertiser helps make the production and delivery of this episode possible for free to you, but the themes expressed by The guest do not necessarily reflect the views of inside reproductive health, nor of the Advertiser. The Advertiser does not have editorial control over the content of this episode, and the guest appearance is not an endorsement of the advertiser.
00:02:48:01 - 00:02:52:20
Griffin Jones
Doctor Kuku, Stephanie. Welcome to the home edition of the Insight Reproductive Health podcast.
00:02:52:21 - 00:02:55:02
Dr. Stephanie Kuku
Thank you Griffin, I'm so excited to be here.
00:02:55:04 - 00:03:15:21
Griffin Jones
Now, as you can see, it's like being in my living room, except if I had a camera crew with me. And the more this must be how naturally beautiful people or seemingly naturally beautiful people feel all the time. All the work that goes into the most natural setting, setting up, a couch and being very self-conscious about how I turn my jacket.
00:03:15:23 - 00:03:27:02
Griffin Jones
I want to talk to you about the relationship between our eyes and OB GYNs. In your view, what do OB GYNs need from our eyes in order to be more involved in fertility care?
00:03:27:04 - 00:03:54:15
Dr. Stephanie Kuku
Griffin so firstly, I love to remind people, and I'm sure a lot of people know this, that our eyes are OB GYNs who have specialized in reproductive endocrinology and in fertility, hence ry ob gyns, obstetrics and gynecology doctors. We all go through an ob gyn residency program and then we subspecialties. So I, for example, chose to do a specialization in oncology.
00:03:54:21 - 00:04:23:23
Dr. Stephanie Kuku
Therefore, I am not a fertility specialist, but a gynecological cancer specialist. The area I fellowships traditionally in the U.S. and abroad, have been few and far between. So if you look at the numbers of ROE as compared to ObGyn, there are under 1500 ROE ice in the U.S and there are over 40,000. Begins the problem. And the reason we're having this conversation is that there is a supply and demand mismatch in IVF care.
00:04:23:23 - 00:04:48:13
Dr. Stephanie Kuku
In infertility treatment, 1 in 6 people suffer from infertility, yet we are not meeting the needs of over 90%. And so therefore we we are at a at an inflection point when we need to be able to increase supply, increase access to fertility care. And obviously one of the most important things there is increasing lab operations.
00:04:48:15 - 00:05:20:13
Dr. Stephanie Kuku
And that's what we're doing, we're trying to we're automating the IVF lab so that we can increase the number of cycles that we do per year. Now, if we increase the number of cycles to meet demand of the 1 in 6 people who suffer from infertility, we we need the physician care to meet this demand. Because of course, you know, there's a laboratory element, but there is the sort of clinical care and the current capacity in re care does not meet that.
00:05:20:13 - 00:06:01:07
Dr. Stephanie Kuku
And so we need a collaborative model where Obagi is supported and supervised by RTI, is a part of the sort of fertility care model, the future fertility care model. And I think what OB GYNs need is this support. And this a collaborative hybrid model where they sort of can be part of fertility care. They see the low risk patients, obviously complex cases go straight to the eyes and they have, you know, training support, virtual hybrid support with red eyes to really be the first point of care for fertility care and fertility patients.
00:06:01:09 - 00:06:23:06
Griffin Jones
I think many areas have a hard time visualizing that, because this debate's been going on for a while. I have it in person with people whenever I can stoke the fire a little bit and get people debating. And you have very eyes that say, listen, this is not that complicated. We could teach a monkey to do egg retrievals, and then you have the other camp that says it's not just about egg retrievals.
00:06:23:06 - 00:06:43:23
Griffin Jones
There's a lot more that goes into AI. And it seems to me that even the folks in that camp see your point about the need, that there's just not enough our eyes, and they'll say things like, we need to add more fellowships. It's like, well, yeah, but how many more fellowships are we going to add? And like it's a drop in the bucket compared to to what needs to happen.
00:06:44:01 - 00:07:02:10
Griffin Jones
But I think that camp has a hard time seeing what that support system looks like. It seems to me like their worry is that OB GYNs are just going to start taking over IVF without any oversight. You talked about a support system and some oversight. What does that look like?
00:07:02:12 - 00:07:28:09
Dr. Stephanie Kuku
So I think again, I think it's important to remember that obligations are trained in obstetrics and gynecology. Eyes have gone through early Gyn residency to put things in context. And I think David Sable and Eduardo Harrington published this, last year in a paper titled Meeting the Demand for Fertility Services in the U.S, OB GYNs have to perform very technical surgical procedures.
00:07:28:09 - 00:07:51:18
Dr. Stephanie Kuku
So to get signed off as a board certified ob gyn, you need to have done almost 100 hysterectomies. And so the argument that it's, you know, ObGyn unqualified, you know, you have to have training in ultrasound, you have to do hysterectomies, which are far more complex and technical. The egg retrievals doesn't really stand. I think we need to go back and think about why our eyes are cautious.
00:07:51:18 - 00:08:17:03
Dr. Stephanie Kuku
I would hope that the first, the first reason is patient care. We must do everything to maintain and improve patient outcomes in IVF, and that means making sure that we are very clear about how the model will work. As I said before, it's very simple. OB GYNs do low risk cases. I think a lot of people will have, you know, a happy with OBC ones during the clinical part of care.
00:08:17:05 - 00:08:45:23
Dr. Stephanie Kuku
So they do the assessments, they do the triage, they do the holistic look, they do the follicular monitoring and medication management. I think to say that I know that you will and can't manage, follicular stimulation, ovarian stimulation, is incorrect. But the important thing there is everything will be done under supervision. What people need to understand is we need to increase supply.
00:08:45:23 - 00:09:17:00
Dr. Stephanie Kuku
We need to make IVF more accessible. And to do that, we need technology. And we're going to do that with automating the IVF lab, which means that there'll be more cycles and there'll be more work. Now, rise alone cannot meet this demand. Clinical efficiency is the goal. And with Ob-Gyn starting this process, being involved in the very low risk elements of this under supervision with strict protocols, I will say OB GYNs.
00:09:17:06 - 00:09:39:14
Dr. Stephanie Kuku
We love following protocols. It's the most litigious specialty. We are very good at sort of triaging high risk, low risk. Any ob gyn would know this is out of my remit. You know, it's time to get the right, you know, telemedicine, the sort of hybrid tech enabled, you know, model is the future we'll have. But it's not a it's not an if it will happen.
00:09:39:14 - 00:10:00:04
Dr. Stephanie Kuku
We need OB GYNs who are ready. The first point of contact for the patients. Patient first patients trust their ob gyn says continuity of care where you go to your area, you come back. The areas you know and the ob gyn is involved in this care model. And that's that's the future.
00:10:00:05 - 00:10:26:14
Griffin Jones
We want to come back to what that supervision in that caseload distribution looks like. But I want to talk about the complications that arise sometimes feel. And I had this debate going on in a, in a different dinner and one very, very high volume. I said, I've been doing this for years. I've never had a complication with internal bleeding, but another one said, you know, I've had maybe three over the course of my career.
00:10:26:14 - 00:10:42:22
Griffin Jones
So they're rare, but they can happen and it would be a really big concern. I'm going to try paraphrasing something you said yesterday. So you're going to correct me if I, if I got this wrong, but and you don't really have a dog in this fight because you're not a practicing ObGyn right now, you're not trying to do IVF.
00:10:42:22 - 00:11:01:12
Griffin Jones
But you were, you know, began surgeon. To me, it sounded like if you had a complicated organ that maybe the guy isn't the first person that you would want, to to be on the scene there. You might want, you know, a bigger surgeon. I'm paraphrasing, so clean up what I'm saying.
00:11:01:12 - 00:11:27:04
Dr. Stephanie Kuku
And of course, well, it depends on the area, but I think, you know, generally in surgical practice, they say don't do a procedure for which you can't deal with the complications. And so if you think about the fact that resources specialize in egg retrievals and that they definitely do less emergency laparoscopy and laparotomy than OB gyns, ambulatory gynecologist I by the way, I trained as a cancer surgeon.
00:11:27:09 - 00:11:50:04
Dr. Stephanie Kuku
So I can guarantee you that even though I haven't practiced for five years, I could probably deal with an acutely bleeding patient. Now, even now, better than, you know, a lot of my friends who haven't done emergency laparoscopy for years. In fact, I was speaking to, an area friend in New York. And, you know, they said if I, if I ever did have a complication, I wouldn't try and deal with it.
00:11:50:04 - 00:12:11:15
Dr. Stephanie Kuku
I'll put them in an ambulance to the nearest Guinea unit, because I think that would be best, best for the patient. And so I think this idea that OB GYNs will not be able to deal with a complication of an egg retrieval, say unique pelvic artery in the patient is bleeding, doesn't really hold because nobody wants a gynecologist.
00:12:11:16 - 00:12:16:19
Dr. Stephanie Kuku
We do more gynecological surgery on a day to day basis than our eyes do.
00:12:16:19 - 00:12:19:19
Griffin Jones
OB GYNs do retrievals in the UK and.
00:12:19:19 - 00:12:30:12
Dr. Stephanie Kuku
Europe and UK, some obese ones who've had additional so who have a specialist interest in fertility can have had some additional training. Absolutely, yes.
00:12:30:14 - 00:12:46:05
Griffin Jones
What does that training typically look like? Because a fellowship in this case tends to be more of an American context, right. You've got a three year area fellowship training in the US, two year fellowship area training in Canada. But does that exist in the UK in that form or in Europe?
00:12:46:07 - 00:13:07:16
Dr. Stephanie Kuku
Do we have a subspecialty training program for fertility, for oncology? But within Europe, in the UK you have what we call clinical fellows. So you all you don't go through a three year training program, but you have a sort of truncated training program where you are a gynecologist with a special interest, you are under supervision of an area.
00:13:07:16 - 00:13:31:07
Dr. Stephanie Kuku
You go through sort of years of practice and training and practice. You do lots of cases supervised by NRI. And yes, there are a lot of gynecologists in Europe and UK who are already involved in egg retrievals. I don't advocate that. Gynecologists you do embryo transfers. I think the most important part, if you if you think about.
00:13:31:09 - 00:13:34:13
Griffin Jones
When I was the difference between transfer and retrieval, in that sense.
00:13:34:15 - 00:14:05:18
Dr. Stephanie Kuku
I think that the transfer, denotes, the, the embryo transfer is comes in sort of under the infertility, the fertility care, embryology laboratory services. I think that we must separate what is clinical gynecology and what is sort of embryology laboratory and IVF. And I and I really believe that the best person for a job should do the job.
00:14:05:18 - 00:14:31:03
Dr. Stephanie Kuku
So if we are thinking about embryo transfers, we should leave that to the eyes, because at that point you're trying to return the embryo. I think as a patient, I would be very comfortable with my re with my gynecologist dealing with my initial fertility care, managing my stimulation. You know, my gynecologist is brilliant, is scanning. She's a PhD in ultrasound.
00:14:31:05 - 00:14:54:12
Dr. Stephanie Kuku
But I would want my re doing everything from the point to which my eggs are retrieved and the embryos transferred, just that separation. And then, of course, I'd want to go back to my ObGyn. I, I think that it's we must have and I don't know who's going to set it just very clear protocol. So nobody's stepping on anyone's toes and accountability can be very clear.
00:14:54:14 - 00:15:16:10
Dr. Stephanie Kuku
And I don't want to go into how that model is going to look like because there are lots of debates. But I think that, collaborative model also has to have very clear delineations. And we want to make it very clear what gynecologists should be involved in and where their role is, which is the patient care, the assessment, anything that can be done.
00:15:16:10 - 00:15:38:10
Dr. Stephanie Kuku
If you think of patients who live an hour from the fertility center, anything that can be done without you having to travel an hour to the fertility center, for example, ultrasounds, follicle monitoring, and then all you have to do is go to your fertility center for egg retrievals and embryo transfer. I think that that's how the model in reality is going to work in the future.
00:15:38:16 - 00:16:03:23
Griffin Jones
I think that travel is such a big piece that we don't talk about. So I took the number of IVF labs in the US and from the CDC report from the latest data, which is 2022, there's 450 something like 470 something like that. And I told ChatGPT to look up what county, what number of U.S counties or county equivalents each of them are in.
00:16:04:05 - 00:16:17:00
Griffin Jones
And then I told ChatGPT, look up how many counties there are in the United States. Guess what percentage to take a wild guess what percentage of U.S counties have an IVF lab?
00:16:17:01 - 00:16:19:03
Dr. Stephanie Kuku
Probably less than ten.
00:16:19:05 - 00:16:20:17
Griffin Jones
To 8%. Yeah.
00:16:20:19 - 00:16:22:03
Dr. Stephanie Kuku
Pretty good.
00:16:22:05 - 00:16:43:21
Griffin Jones
8% of US counties or county equivalents have an IVF lab. So that means that there are people in in large parts of this country that are traveling hours to, to, to get IVF and that it turns out there might not even be an IVF lab in Alaska, that previously there had been people doing remote monitoring. And then you've got to fly to Seattle to get IVF treatment.
00:16:43:23 - 00:17:11:14
Griffin Jones
So there's this there's this big access problem. There's far more OB organs to the tune of 40,000 in the UK, in Europe, for those ObGyn that are doing retrievals under the supervision of an RTI, is the ROI in the room physically or is is there a number of OB gyns doing a retreat retrievals? And in RTI, is there a case manager that's always on site?
00:17:11:14 - 00:17:12:09
Griffin Jones
How does that work?
00:17:12:11 - 00:17:38:14
Dr. Stephanie Kuku
I think it's safe to say that majority of retrievals. So I know you we we're back to each of the retrievals are done by our eyes. There is a percentage which I'd say is under 50% that are done by gynecologists with a special interest in fertility who have had additional training, especially in places like Spain and in that there's always an ROI in, in the unit.
00:17:38:14 - 00:18:25:17
Dr. Stephanie Kuku
Absolutely. Who is accountable? But of course, you know, I think that, again, you know, we keep coming back to the sort of the retrievals. I don't think that the retrievals are where we should be focusing on. I think it's the point of care for patients. We talked about these fertility deserts, underserved areas. How do we get this sort of streamline to get patients through faster pathways, increased clinical efficiency, the waiting times from being referred from your gynecologist and ROI without having these for ObGyn led fertility hubs, where essentially where begins a starting the process of trials, the assessment, then making sure that they know which patients are high risk and low risk, they
00:18:25:17 - 00:18:49:02
Dr. Stephanie Kuku
send the high risks on straight off to the ice is less waiting times. So imagine a world where we have automated the IVF lab and we are seeing, you know, thousands of cycles more so than the current rise in the US and globally and globally can, you know, can manage. And so we need the ObGyn as the first point of quarter A must start.
00:18:49:02 - 00:19:09:04
Dr. Stephanie Kuku
The first part, the clinical care, the ovarian stimulation and then patients travel again just for those sort of lab operations as a way to centralize, you know, send centralized IVF centers powered by technology, so that we can meet this demand with more cycles.
00:19:09:04 - 00:19:19:21
Griffin Jones
Sorry. Guys are seeing complicated cases. They're doing the transfers. Who's setting the protocol? So in Spain are the OB gyns tending to set protocols? Are they choosing from a menu?
00:19:20:00 - 00:19:49:15
Dr. Stephanie Kuku
Absolutely not. You know, infertility care will always be led by re eyes. I think that much is clear. Reset protocols. Yeah. The specialists but non ry professionals who are have adequate training follow safe protocols to be involved in part of this fertility Catholic care. I think we have to be very you know doctors especially the big ones are very good at following protocols.
00:19:49:21 - 00:20:23:11
Dr. Stephanie Kuku
So we must make sure that we don't get into the you know, I think the debate over fertility can arise is sort of losing focus. We need to bring it back to patient care, care delivery, collaborative models, setting clear boundaries and making sure we can meet the demand and meet the need of patients. I think that patients want that for their OB GYNs involved because they're the first point of care, but I think they also wanted their rise to be leading this care.
00:20:23:13 - 00:20:44:12
Dr. Stephanie Kuku
And so nobody's saying that our eyes are going to take over. And I think that that's where we're not making progress, because it's always about what Aria should do. It's it's that the debate has turned into the sort of turf war, but it shouldn't be. It's it's a collaborative model to increase clinical efficiency. OPG wins over big wins and rallies, especially.
00:20:44:12 - 00:21:14:11
Dr. Stephanie Kuku
So how can they do what they already doing, which is assessing fertility patients, deciding who needs go straight to fertility care, deciding who can, you know, be tested on simple of ovulation induction protocols, hybrid models of care whereby, you know, you have RTI college, you colleague who says, you know, if you can manage the stimulation and then you can send, send the patient to us for, you know, egg retrieval and transfer.
00:21:14:13 - 00:21:26:08
Dr. Stephanie Kuku
That's what's happening in Europe. So I think, again, you know, we need to be clear that GYNs, OB GYNs will have their role, but our eyes will always lead fertility care.
00:21:26:08 - 00:21:29:15
Griffin Jones
Talk about the research you've been working on the last year or so.
00:21:29:15 - 00:21:51:17
Dr. Stephanie Kuku
So what we're doing conceivable and obviously, you know, we've we started this conversation talking about Ob-Gyn sun rise and this sort of the future collaborative model of care. But I think it's important to remember that in order to meet this demand, lots of things have to happen. So first and foremost, everything happens in the lab. The miracle happens in the lab.
00:21:51:17 - 00:22:22:06
Dr. Stephanie Kuku
And that's why conceivable we are automate automating the IVF labs so we can increase the demand. The goal to increasing access of courses, reducing cost, improving outcomes, and making sure that we can meet the demand for everyone in the U.S and globally. And so what we are doing is trying to show that we have the real world evidence to prove that automating the IVF lab is safe and effective.
00:22:22:08 - 00:23:09:20
Dr. Stephanie Kuku
And even, our hypothesis is that we can improve outcomes from the current standard. We have started with, you know, pre-clinical testing and have gone through very, very rigorous effort, evidence generation steps. And a lot of our work will soon start to be published. We started with, you know, mouse, animal gametes, donor samples. We went into an IRB proof of concept study, where we, you know, we have 12 life births, 41 patients from our experimental, which shows that our prototypes, which have automated sperm, egg and Icsi, sperm preparation, egg preparation and Icsi, using one of those prototypes or in combination can get the outcomes that we desire.
00:23:09:20 - 00:23:36:09
Dr. Stephanie Kuku
And, and we've had a 51%, pregnancy rate, which is comparable to, you know, the best clinics in the world. We've now started, this hundred patient validation study, IRB to go to take patients through, line up of automation. So aura is a full, complete, automated lab workstation. And our goal is to show the world that it's safe.
00:23:36:11 - 00:23:42:01
Dr. Stephanie Kuku
It's, you know, and it can improve outcomes. And that's the that's the sort of the study we're doing now.
00:23:42:01 - 00:23:48:05
Griffin Jones
How far are we into that study of those 100 patients? Have some of them cycled or all of them somewhere?
00:23:48:05 - 00:24:04:07
Dr. Stephanie Kuku
So we just started we have 33 of the 100 patients already recruited, and we just started treating our first patients. So, you know, we have six months to go. But you know, we're hoping that we have some really exciting, data to show by the end of this year.
00:24:04:09 - 00:24:05:23
Griffin Jones
By the end of 2025.
00:24:05:23 - 00:24:08:06
Dr. Stephanie Kuku
Yeah, absolutely. That's the goal.
00:24:08:08 - 00:24:20:09
Griffin Jones
That's the goal. Some data to share. What else do you hope to research in the future? If you had your druthers, what would you if if funding wasn't an object, what would you like to see more data?
00:24:20:11 - 00:24:48:01
Dr. Stephanie Kuku
I think that there is so much potential. I think one of the most important things to accept is that especially when you implement new technology, you never stop reaching to continue to improve outcomes. So one of the beauties of our technology, we have a cloud system that records over 100 data points that we are going to have world class data that no one has on all the confounders.
00:24:48:03 - 00:24:56:11
Dr. Stephanie Kuku
And so that we can take this data and look and continuously try to improve on the outcomes of IVF. And I think that that is key.
00:24:56:11 - 00:25:04:09
Griffin Jones
How do you see collaborating with other OB GYNs or areas who might want that data or involving them in future studies?
00:25:04:09 - 00:25:32:22
Dr. Stephanie Kuku
I mean, we are speaking to so many partners at the moment from big, IVF groups to ObGyn small practices who are super excited about partnering with us, but also excited about the possibility of improving outcomes for their patients. One with automation too. With the data that we can use to harness to continue to improve outcomes. But three with, you know, making sure that we can try and get, you know, couples babies on their first IVF cycle.
00:25:32:22 - 00:25:34:09
Dr. Stephanie Kuku
Not that third.
00:25:34:11 - 00:26:02:09
Griffin Jones
Do you think I'm sort of picturing in the future this sort of minority report, if everybody remembers that movie, but we had this giant screen movie, Matt Damon, Tom cruise, it's pretty similar, though. You're you're thinking of The Bourne Identity. It's it's it's pretty similar. Action 2000. Never a juristic technology. The protagonist overcomes adversity to show us how humanity and technology can come together.
00:26:02:11 - 00:26:28:06
Griffin Jones
And he's got this big screen and he moves things around. And I'm sort of picturing the eye of the future looking at multiple cases for different ObGyn and maybe advanced practice providers, folks that are doing retrievals or that are seeing patients. Do you think it could be to the tune as technology advances to to dozens of patients at a time, hundreds of cases that, in our eyes, overseeing?
00:26:28:06 - 00:26:32:07
Griffin Jones
Do you think it's too soon to be able to picture that?
00:26:32:09 - 00:26:59:12
Dr. Stephanie Kuku
I think that if you look at history and trying to implement technology in medicine, from laparoscopic surgery to AI diagnostics and decision support tools, we have now, the cycle is the same, whereby, you know, we start with a kind of skepticism, you know, cautious exploration. Then we have the forward thinkers and the early adopters has started testing to evaluate.
00:26:59:13 - 00:27:23:13
Dr. Stephanie Kuku
Then we get the real world evidence, you know, building like we're doing with a study now, and then you eventually get implementation whereby people have seen the data and the naysayers are suddenly like, great, this, this can improve outcomes. It's not a, an if I think it's a when that automation of the IVF lab will become the standard of care.
00:27:23:13 - 00:27:26:09
Dr. Stephanie Kuku
I mean, look at the Da Vinci robot. It's the same. So tell me about.
00:27:26:09 - 00:27:27:10
Griffin Jones
Your experience with that.
00:27:27:12 - 00:27:44:14
Dr. Stephanie Kuku
Well, you know, I trained on the Da Vinci Robot. I think it's such a great analogy because, you know, when I was in training and you'd say to you, just as you said, this futuristic world in an IVF lab where we have 100 data points, our eyes are overseeing thousands of cycles meeting the current demand. We have lots of data.
00:27:44:14 - 00:28:11:04
Dr. Stephanie Kuku
We can use to select patients. It will happen. And in the end, you know, the early 2000s when it was, you know, surgeons were saying, oh, we can do robotic surgery. Most people said, come on, that's ridiculous. You know, who wants to do robotic surgery? And of course, you know, there were the early adopters. People started to see that, especially urologists, that you could reduce blood loss, you could reduce hospital stay, you could improve patient experience.
00:28:11:04 - 00:28:58:00
Dr. Stephanie Kuku
And those same naysayers and skeptics became, you know, the proponents of robotic surgery, more so now, you know, they say, come to our hospital, they use robotic, services to market their hospitals. We we offer robotic surgery. And so I think that it will be it's the same cycle where we will see this futuristic area, who's got an, a conceivable powered or a lab who's got tons of data points and screens, who has, you know, 24,000 cycles a year and who has a collaborative kind of fertility care delivery team that has the OPG and the nurse practitioners and areas being able to meet this demand.
00:28:58:02 - 00:29:18:07
Dr. Stephanie Kuku
Yeah. I think, you know, the, the, the sort of implementation and the sort of cycle of implementation of the, of the da Vinci robot is sort of it's a great analogy. Now, it's standard of care for urologists, gynecologists because it's better precision, better outcomes. Cardiothoracic surgeons use the robotic surgery now.
00:29:18:07 - 00:29:21:12
Griffin Jones
So it's all the all the surgeons are trained on da Vinci.
00:29:21:12 - 00:29:44:08
Dr. Stephanie Kuku
Now not all surgeons are trained. Again, this is you know, if you think of how many studies around the world, but not, you know, well, we we when technology is implemented, the cost is high. And as you start to get, you know, you prove the business case, you get competition in the market economies of scale. You know, we now have the Medtronic's Hugo.
00:29:44:09 - 00:30:03:07
Dr. Stephanie Kuku
We have CMS versus versus. And so essentially what you have is as the cost also come down, more and more hospitals can afford to buy. Da Vinci wrote of of well, da Vinci, the other competitors, the robot and then also it's expensive, but it's pretty much standard of care for certain surgeries.
00:30:03:07 - 00:30:10:03
Griffin Jones
To people go back. So if surgeons get good at using da Vinci, do they say, I'm going to go back to the old way?
00:30:10:03 - 00:30:32:12
Dr. Stephanie Kuku
Or I think, I think the use case is always going to be there. So for example, not, you know, the robotic surgery is not appropriate for all surgeries. But you know, IVF, Icsi in a lab is quite standard. You know, and that's why it's such a beauty to automate standardize eggs preparation, sperm preparation, Icsi vitrification is pretty straightforward.
00:30:32:12 - 00:30:37:13
Dr. Stephanie Kuku
It's almost easier than, you know, implementing robotics into surgery.
00:30:37:15 - 00:30:56:13
Griffin Jones
I just don't see a world where the AI goes away. I think there I think many of the people who are opposed to OB gyns having more involvement in fertility care, they just can't visualize what they're going to be doing. And I think OPG wins or running away with it, or they think, oh, you OB GYNs are going to make all the money on these easy cases.
00:30:56:13 - 00:31:10:19
Griffin Jones
We're going to be stuck handling a few of the complicated cases. But to me, it seems like there's so much for them to be able to do. There's still a major upside to the career they're going to be overseeing. Many more people.
00:31:10:21 - 00:31:36:12
Dr. Stephanie Kuku
Are. The eyes will never go away. We don't we don't want our eyes to go away. We need to train watery eyes because we're going to have demand that needs more eyes. And a number of OB GYNs who are supporting this demand. And I think, again, we are approaching this all wrong because of course, everybody's scared about changing, change their existing practices and making less money.
00:31:36:12 - 00:32:03:19
Dr. Stephanie Kuku
But we need to go back to the to the to the ultimate problem. We need to scale. IVF technology can do that. If we scale IVF and we have an additional 12 million cycles, we need more people to do this work and nobody's going to make less money. What we need to do, though, is make it cheaper for patients so that more people can.
00:32:03:19 - 00:32:40:16
Dr. Stephanie Kuku
You seen the work of David Adamson? Cost goes down, utilization goes up. The demand is there. We know that the data is out there. Not just in fertility. The increasing need for family building in LGBTQ communities for co miscarriage, over 3% of people, genetic diseases. The fear and I think, you know, innovation breeds fear initially. And I think that this fear in our eyes is as soon as we automate the IVF lab to increase demand, I think that will be a real domino effect.
00:32:40:16 - 00:32:50:07
Dr. Stephanie Kuku
And everyone will see that there's nothing to worry about, there's enough work to go around, and nobody's going to make less money because let's face it, I think that's what a lot of people are worried about.
00:32:50:09 - 00:33:02:09
Griffin Jones
Doctor Stephanie Kuku. You know the famous Mexican expression Alejandro's oficina a su casa. Welcome to thank you for coming on the living room edition of Inside Reproductive Health. I've had a great time talking to you.
00:33:02:13 - 00:33:04:17
Dr. Stephanie Kuku
Thank you. So nice to be here. Thanks.
00:33:04:19 - 00:33:28:18
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