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They were lucky.
The gas to the incubator stopped flowing, but XiltriX caught the failure in time, no embryos were lost… and no headlines were made.
But what happens if the next failure isn’t?
In this episode, Dr. Matthew “Tex” VerMilyea of Ovation and US Fertility, and Moises Eilemberg, CEO of XiltriX North America, return to Inside Reproductive Health to ask a hard question:
What would your lab do in a crisis?
You’ll hear:
The catastrophic loss Sweden’s biobank suffered (and what you need to learn from it)
Why embryologist shortages are reshaping the IVF lab
What standardizing monitoring protocols could mean for your network
Why Tex believes monitoring as a service is the future
The steps to take after a public lab failure (and how to avoid needing them)
How XiltriX helps fertility labs gain 24/7 visibility, rapid response alerts, and peace of mind
This isn’t about tech. It’s about protecting the future of your lab, your brand, and your patients.
“Tex” Loves This System. Here’s Why...
> 23% of alarms are missed. See why Dr. Vermilyea doesn’t have that problem*
Dr. Matthew “Tex” Vermilyea gets 24/7 live assistance from XiltriX’s SafetyNet Team at his IVF labs. Request your free demo to see if your IVF lab can benefit from the same advantages;
In your free demo, you’ll receive
Tailored presentation to meet your priorities
Software demo
Real-life case studies
24/7 live support overview
*Based on product claims
Request your demo now to see how Ovation and other fertility centers are keeping their IVF labs safe!
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Tex (00:03)
Do it sooner than later. You know, this is not funny business. it's also doing it for your staff, right? Your staff needs to feel comfortable in a good system, So I'd get in touch as soon as possible, start exploring opportunities, really assess your current system, have a chat with the XiltriX team and see if they've already figured that out. I would not sit on it. I would reach out because a failure could happen tomorrow.
Griffin Jones (00:35)
Do it sooner than later. What could Tex be talking about?
Here's what we're talking about overall. Workforce crisis and burnout, particularly in the embryology lab. 24-7 operations and the financial pressure of the efficiencies that labs need to yield. Public scrutiny and risk management and what the IVF lab of the future will have that separates the best in the field from those that are run of the mill.
My guests are Dr. Matthew VerMilyea. You know him as Tex. Everybody seems to know Tex, the guy with the cowboy hat that has become the vice president of scientific advancement at Ovation and US Fertility. He oversees a lot of labs.
And Moises Eilemberg CEO of XiltriX North America, XiltriX is a monitoring solution as a service.Might be thinking I've heard that name a lot now. That's because doctors Steven Katz, Eva Shenkman, Sangita Jindal. have we've all been talking about why they use XiltriX and what they like about it. And because Tex and Moises work with so many different IVF labs. they're able to go into some detail about what labs are doing to solve for these challenges. Challenges like severe embryologist staffing shortages, standardizing protocol, the right balance of autonomy for embryologists, and the standardization of best practices when you've got a lot of labs and a lot of liability.
They talk about the hidden costs of cheap solutions, the role of monitoring as a service, standardization strategies to save cost, and head count and workflow hours. They talk about one situation that could have been really bad with an incubator, and how they caught that. They tell the story of what happened with a Swedish biobank last year that could have been prevented.
Tex shares what he would do to restore trust after a public failure like that and how to prevent it in the first place, and they talk about the essential elements for new IVF labs being built in 2026. The equipment, the setup, and the integration with new technologies and the implication that AI is going to have with all of that.
ASRM is going to be here sooner than you know it. You might just shoot XiltriX an email and set up a time to meet. You might schedule a demo or a Zoom meeting beforehand, because whether it's Dr. Jindal, Dr. VerMilyea, Dr. Shenkman, Dr. Katz, they're all saying the same things.
And when I asked Tex if he thinks that network operators and lab directors should try to get in touch with XiltriX just to at least start the conversation, just at least to see what they've got. If he thinks it's worth it, what he thinks. And he said, do it sooner than later. Of course, it helps Inside Reproductive Health, if you mention that you heard about them through us.But even if you don't want to do that, just help yourself. Find a time to meet with XiltriX at ASRM or a little bit before, and enjoy this conversation with Moises Eilemberg and Tex VerMilyea
Griffin Jones (03:49)
Mr. Eilemberg, Moises, Dr. VerMilyea Tex Welcome to the Inside Reproductive Health Podcast.
Tex (03:58)
Happy to be here
Griffin Jones (03:58)
Gotta give a shout out to Moises and his people for putting us in contact, Tex, because I feel like I've known you for a long time because we always have been in each other's periphery. This is actually the first time you've been on the show. What's the biggest challenge in the lab right now or group of challenges or what are you seeing in the lab right now?
Tex (04:18)
Yeah, great question. You know, we are currently in a time where it is a struggle to find personnel in the laboratory, not only at the bench, but just, you know, kind of supporting, you know, support teams just to help us get the job done. So I think we're really in a little bit of a crisis of trying to identify where we can find some of these usable individuals to really kind of embrace the work that we do in the laboratory and stick it out with us. ⁓
Griffin Jones (04:42)
Was this the case before the 2021 labor shortages happening everywhere? Was it bad before then, Tex? Just got worse? Or had it been okay? And then that really put the finger on the scales.
Tex (04:58)
Yeah, I think it feels like it's gotten worse. And I think that's just because there's a surge of volume. COVID really put a lot of patients through our laboratories post-COVID. And I think ⁓ there's a lot of burnout and trying to find ways of how we can sort of standardize processes within the laboratory to kind of improve workflow efficiencies. it's always, I feel it's always been a growing problem. More labs are popping up. Patients are demanding services. So trying to keep up with supply and demand issues.
Griffin Jones (05:24)
Do you feel like, it still getting worse like since the 2022 era? Is it sort of like leveled off and now it's just like this constant challenge?
Tex (05:35)
You know, I feel that it's a constant challenge. really do. think that there's, you know, we have individuals that are retiring and we have, you know, others that are coming into the field wanting to be in the field. And it's just a matter of having time actually to spend to train these individuals and get them up to speed. You know, there's a lot of desire and will to be an embryologist, but just trying to figure out, you know, who maintains what they have to be able to stay within the field and really do good bench work.
Griffin Jones (06:04)
We'll go into this more deeply today, but kind of as an overview, what do you see as the consequences of that labor shortage?
Tex (06:14)
Yeah, ultimately, you know, unfortunately, we just can't get cycles in the laboratory. I think in addition to having physicians ⁓ availability to see new patients, think the last thing you want to do is have the laboratory sort of be the gatekeeper as to how many patients can be cycled through. But often that happens just based on pure shortages of personnel or lack of physical space to accommodate those numbers of patients and number of embryos within the laboratory.
Griffin Jones (06:42)
Moises, you work with a lot of different labs. have a lot of different IVF labs. There are customers. They're telling you stuff. How would you describe the challenges that they're telling you about?
Moises Eilemberg (06:53)
yeah, it's actually really interesting to hear Tex's perspective. We obviously see things from our end as a partner to a lot of IVF groups. And we absolutely see the stress on the staff. Shortage of human capital is a theme that we continuously hear.
And there's a couple more that kind of come to mind. One of them is also financial pressure. There's been a lot of financial investment into the space. even though there is, as Tex was saying, a tremendous amount of demand, you can only do so much with a limit on human capital. And so
I think there's also stress from the investment that has gone into the field that is looking for a return. And so that translates into financial stress that we see and feel. And then as we all know, there's a tremendous amount of scrutiny on the industry. Unfortunately, every time something
not so good happens in the space, it becomes highly, highly publicized. So there's a lot of eyes on the industry from a regulatory perspective, from a just public perception perspective. So I think those areas are also ⁓ areas that are facing the space.
Griffin Jones (08:14)
All right. So you've got a shortage happening in the workforce and the stress that's caused from that, the burnout that comes from that. You have an additional financial stress of people that have made investments in either opening or buying labs and clinics. And they need a high efficiency because they have to return their investment. then Moises is like the external scrutiny of...
Anytime there's a lawsuit, anytime there's a bad news story, anytime that heat gets brought on to the field. Let's start with that. Let's stay with the workforce for a second. And either of you guys can tackle this one. But how are labs addressing that right now? How are they dealing with burnout and shortages?
Tex (09:03)
Yeah, I can speak to that. what I see, it's a lot of investment into personnel and trying to get them to training centers, potentially, to learn and build those skill sets. It's extremely competitive with regards to trying to identify a senior embryologist with a full set of skill sets. And at end of the day, they're very expensive. And so to accommodate their compensation requests can be difficult.
You know, we do, US Fertility does a lot of recruitment at universities, try to get students that are looking to enter the field and try to grab them when they're young and train them up accordingly. with that as well, I think we're seeing a revolution or an evolution of technology and some capabilities that will allow us to standardize some of the more repetitious processes within the laboratories.
automation into the field, we're seeing some robotics into the field that hopefully can do some of the mundane tasks within the laboratory allowing for those embryologists to really focus on their skill set for the latter part of the embryo culture process.
Griffin Jones (10:05)
Yeah, because throwing bodies at the problem only works to one, to the extent that you can get the bodies and sometimes you can't even do that. And then two, then it starts to jack up that financial stress that Moises was talking about too. So you need technology to leverage. Moises, I'm guessing that's why a lot of people are coming to you. What are they coming to you for? And what are...
What have you seen that you've been able to help them with from a standardization aspect of so that they're not just relying on having to throw bodies at the problem every time?
Moises Eilemberg (10:42)
Yeah, no, sure. That's the reality as Texas saying is you have you have the need to do more with inputs that are limited. So you have your human capital, you have financial capital, and those are not in endless supply, especially the human capital. As Texas saying, it just takes time. You can't just, you know, go to the store and purchase 10 embryologists. It takes time for
Tex (10:45)
Thank
Moises Eilemberg (11:08)
REI is to get education and train people and get up to speed. So I think really the way to go at this problem is to get more output out of the inputs that you have. And that's, I mean, that's the story of humankind, right? That's the way it is and the way.
the way we solve hard problems not only in IVF but across industries. so I think the first thing that I would recommend and that we actually help our customers with is stop using scarce and very expensive human capital to address issues that are non-core to what they're equipped to do better than anybody else.
Griffin Jones (11:57)
What are those specifically?
Moises Eilemberg (11:58)
Yeah, so I often use the analogy of you used to have a Microsoft Exchange email server in your server room, and that meant you need to have an IT guy that would come in and would have to maintain that server and upgrade it and fix it when it goes down.
Nowadays, you can take that server, can dump it in the trash, and you can use Gmail, or the corporate version of Gmail. And that way, you let somebody who specializes in email provision that solves all the problems for you, and you don't need to worry about having some of your own staff dedicated to managing
a problem that is not core to your practice. So for us, we're obviously in the environmental monitoring space and I am shocked at the amount of very expensive and very specialized staff time that goes into troubleshooting, maintaining systems like the ones we provide.
when we can provide a turnkey service and ⁓ free up the scarce human capital for things that are really going to move the needle for our customers.
Griffin Jones (13:20)
Tex, what does that look like in the absence of an environmental monitoring solution like that? What is it that embryologists are wasting time on or doing that they don't need to be doing?
Tex (13:31)
Yeah, so every day we kind of go through a quality control component whereby we're checking our systems in place, you know, making sure incubators are being maintained at the right temperature, making sure that our cryo storage containers are being held at the right temperature. And it can be a fairly labor intensive, you know, project or labor intensive process. So you can imagine, you know, having a senior embryologist come in the day and spending, you know, a good 30 to one hour potentially of their day.
doing this sort of monitoring ⁓ if they don't have a auto monitoring system that's you know, truly identified to where there's validation in place and that it can do the process for them. So I think if we're able to sort of remove that human element and, you know, kind of put the time back at the bench, you know, for some of our embryologists so that they can just kind of allow some of these systems to go on autopilot. But I agree, it can be
another one of these mundane tasks that doesn't necessarily require human capital to complete as long as the system is robust and trustworthy.
Griffin Jones (14:33)
What was it about XiltriX's solution that you thought was the way to go for you guys? Pretend Moises isn't here. Earmops, Moises. But I know how many people are calling on you because we work with almost everybody on the industry side at one point or another. And when you ask folks,
Who you going after? Obviously, US Fertility Ovation is at the top of a lot of people's list. Your name is mentioned specifically. So I know almost anybody that's selling anything that has to do with the lab is trying to get your attention. And there's just only so many solutions they can get picked. the fact that you pick them tells me something. What was it about their solution that you felt like
wasn't offered or as good with some other kind of solution.
Tex (15:26)
Yeah, sure. And I'll lead into that question with your previous question, like what's the main hurdle around laboratories? And yes, I agree about, I mentioned personnel, but one of them also is lack of standardization. And so we thought XiltriX offered a solution whereby we could standardize our alarming process, not only just for cryo storage, but our incubators, our VOC levels within the laboratory, our temperature, our humidity, our refrigerator door openings, all these aspects that really
We're dependent on a system that we can trust. We're also reluctant to have a system that goes back to the boy who cried wolf, right? Occasional alarms that go off, you go 4.30 in the morning, 2.30 in the morning, you go and check and it's nothing or it's a false alarm. So we were very comfortable when we first installed XiltriX that we figured out the kinks, we got this system humming just the way we wanted it.
And then based on that standardization process for one laboratory, we just rolled it out across the entire network. And with the further experience, and I can have a call with my lab directors, and we can all talk about the same system. We can go to XiltriX and say, hey, guys, can we adjust this particular parameter? And I can adjust that particular parameter for the entire network. And so we're all compliant. We're all consistent. We're all standardized. So that was a key element for us to go that route with XiltriX.
early on and had been a value.
Griffin Jones (16:47)
Why not try
it on your own? We're in an environment where every executive is faced with build or buy. You got to make that decision. Why not try it on your own?
Tex (16:58)
It's a lot. And I think we could do it well, but I think these guys do it, you know, super well. And the ability to have a third party involved in our monitoring, right? So system alarm goes off. Yes, all the lab stuff is notified, but they're also XiltriX notified. And we get a follow-up call from XiltriX saying, hey guys, there is an alarm. This is legit. You guys need to go respond to it. So having a partner on that sort of risk,
risk management sort of component of what it is that we do is super valuable. Because you have a third set of eyes. We don't want to miss something. We're busy in the laboratories. just like any other staff, especially embryologists, they like to get their sleep when they can. So if we get an alarm in the middle of the night and it's not responded to, XiltriX is there to follow up and make sure that somebody is attending to that alarm and able to give us some context. I will say back in the days, there was an alarm system
that the alarm would go off, but you would have no idea which incubator it was. You would have no idea what cryo system it was. You had no idea why it went off. Did the power go off? Was there a lightning strike? Was there a glitch in the system? Are you really out of gas and temperature? But this is able to dial down and remotely we can access to find out exactly what the issue is. And that's obviously an added benefit.
Griffin Jones (18:13)
So the alarm gets escalated to ziltrix if there's a not response. Moises, can you think of examples of how your systems have helped catch errors? Like what comes to mind?
Moises Eilemberg (18:26)
Yeah, that's what we do every day, multiple times a day. It is a huge part of the value that we bring to the table because failures are going to happen. Systems are going to have glitches. Internet connections are going to go out. And to have somebody there to help you understand and diagnose what the issue is and what you need to do about it.
is a huge value added. So I was just actually listening to a phone call, because we record all the phone calls that we place out to our customers, where there was a failure with an incubator. And this was probably around 10 o'clock at night. Oftentimes, if you don't have a provider like XiltriX,
it would be up to the staff to figure out what the problem is. And in this case, the person was convinced that it was a problem with connectivity. And they very much likely would have potentially not addressed the issue right away because oftentimes you get connectivity glitches and your staff
learns to then ignore alarms. In this case, our team reached out to the person and they confirmed that it was absolutely not a technical issue. There was a problem with the incubator. That person got in their car, drove 45 minutes to the lab, and indeed the CO2 connection to the incubator was that the tank was out.
So that could have been a pretty bad event. But because there's somebody there who does this like us for lots and lots of customers, we have a much better understanding of what we're looking at. We can help diagnose an issue and prevent a huge failure from happening. It was good.
Griffin Jones (20:19)
What would have
happened if that error went unattended? If that CO2 issue with that incubator went unaddressed for the whole night, what would have happened?
Moises Eilemberg (20:30)
Well, Tex probably knows better than I do, but I think there would have been potentially a loss of some embryos in that incubator.
Tex (20:37)
Absolutely,
yep. You'd have some pH fluctuations within the culture media and then basically could lead to degeneration of the cells and ultimately loss of embryos. And that would be a hard case to fight, especially if there is indication that an alarm went off and nobody attended to it. So that's where I say, going back to this boy crying wolf, like we take...
every alarm, especially from ziltrax, we take every alarm seriously because we just trust in the system and know that we're not, you know, it's not a fluke and it's better to be safe than sorry and, you know, make the, make the way in. also, you know, you get tired of going on false alarms. And as Moisa said, kind of become a little bit, you know, not paying so much attention to some of those, but, ⁓ but yeah, it would have been devastating for the patients and ultimately for the laboratory as well.
Griffin Jones (21:31)
I think that's... To me, that seems why it's so useful having an external body too, right? It would be like... It's like fire drills at a school or fire drills in an office building, right? You take your sweet time getting out of the building because you're like, this is just another drill. It's not the real thing. And if there was... And that can cause serious issues to people if there was some sort of...
It's third party that was like, this isn't a drill. Get your ass out of the building right now. To me, it sounds like a little bit of the value that you're playing. Moises, have you seen that impact workloads in any way? So that shifting workloads more equitably, preventing burnout in some kind of way?
Moises Eilemberg (22:15)
Yeah, I was actually gonna bring it back to the point of efficiencies. Again, there's a lot of pressure on providers and on IVF providers to be more efficient. So accommodate more cycles without the luxury of being able to add more staff at will. But not all efficiencies are created equal.
There's a lot of criticism, I think, that I've read about in the industry about how with outside investment into the space, things are being forced into being more of a factory and not allowing the doctors to perform medicine. And I think, again, not all efficiencies are created equal. There's a lot of efficiencies.
that you can implement across a network that make a lot of sense and have nothing to do with patient care. You can centralize finance, can centralize accounting, you centralize marketing, and you don't need a CFO per location. So you can create a lot of efficiencies. And so I think similarly for something like what we do, if you simply ⁓ purchase a piece of technology,
and place the burden on your expensive and scarce laboratory team to manage, maintain, troubleshoot, diagnose that system, that is a huge burden. It's not just responding to alarms. know, technology sometimes has glitches and sometimes it's got to do with
and not the technology itself, know, connectivity goes down, things of that nature. And relying on the lab team to handle that certainly takes away from time on the bench and serving patients. And so for us, when we partner with a customer and we take that burden off of the shoulders of the staff, it just, it frees up time.
And it may seem a little bit more ⁓ expensive upfront, but in terms of the time that you're creating for your team, there's very few areas where I see more ROI than outsourcing things to a specialized provider, particularly when it comes to monitoring.
Griffin Jones (24:43)
text you and every other lab director, every other chief scientific officer out there, I have to make a business case to the rest of your organization to make investments like these. I think of yesterday, I go to the mechanic, mechanics telling me it's gonna be seven grand and and it needs this and that or the car is gonna fall apart and say, let me take a look. And I'm looking at like, I don't think so. I'm taking some video and and photos, sending it to my cousin who's
mechanic and he's like, dude, that's not an emergency. Yeah, it's several months to think about it. You're probably gonna buy a new car anyway. And in this case, I am analogous to the business person, the auto mechanic. It might be an embryologist who wants everything. But then there are times where it's like, no, I'm the expert here. We need this for safety. And it's being ignored.
Tex (25:17)
Thank
Yeah.
Griffin Jones (25:40)
The business person has to suss that out. They have to think, is this just one more bell and whistle that would be nice to have? Or is this something that we have to have as a business? How do you make that argument? Maybe using XiltriX as an example, but how do you show that? How do you make that business case to the business people when...
It really is a must to have and not a nice to have.
Tex (26:07)
Yeah, great question. And it sometimes is a challenge, absolutely. These systems are not cheap, but I and I'll use XiltriX as an example because we're on the subject. Being able to further ⁓ vocalize that this company is actually a partner, right? It's not just a service provider. They've got skin in the game as well. Mojis has talked about you could buy an alarm system.
off the shelf, install it yourself, and then it's me as the lab director to be responsible for any upgrades, updates, et cetera, et cetera. XiltriX does all that. That's on them, right? A new probe comes into the industry and it's more accurate. They're the ones that are gonna come and put it in because A, they want their system to be the best and B, they wanna make sure that we have the right appropriate services. showing that in this business case that we have a true partner in this assessment and I'm a stickler for anything we can do to reduce risk.
in this day and age with the litigious environment, it's worth the investment. And one thing we have not spoken about at all, we're talking about monitoring and alarms and so on and so forth, the amount of data that XiltriX is able to also produce, All these systems are monitoring 24 seven, every 30 seconds, 20 seconds, and you've got actual data points that you can go back and start identifying trends before they even happen.
if you're really into the data, which we should be. So we can even predict that, this incubator's kind of been warming up and creeping up over the last week and a half. Maybe we need to take it out of use and invest in something else. So showing that, it's not just an alarming system. We have hell of a lot of data that we can look back at. When to change air-conditioned filters, because our VOC levels are rising.
versus just watching and seeing, hey, embryos are not looking so good, maybe we need to go change the filters. All these kind of additional aspects to the system that we can put in place and that I can propose and put in front of the real business decision leaders as to, this is more than just a nice to have. This is gonna potentially save our ass if there is an issue.
Griffin Jones (28:07)
jump on that for a second, Moise. Tell me not just about the data points but how they can be practically applied for a benefit.
Moises Eilemberg (28:16)
Yeah, absolutely. We create a tremendous amount of visibility as to what is actually going on in
you know temperatures and cold storage, the number of times that you open a freezer, how often the tanks, the cryotanks are open, what the gas levels are in incubators. You know all of this equipment has internal sensors but ⁓ we have our own sensors and we sort of bring a third-party
independent source of truth, if you will. So what we often find is, you know, a lab may rely on what the display in the incubator is telling you, and they will tell you that everything is at 5 % CO2 100 % of the time, but we know that's not the case. And so when we install our system,
We identify that half of the incubators are at 4 point something and half of them are at 5 point X. And so we help the lab get that visibility so they can actually get more consistency and potentially improve outcomes. And that's just one example of the type of visibility that we create. It's like putting on your glasses and all of sudden you see
a lot of things that you were not seeing before.
Tex (29:34)
Yeah. And to add to that, that's where you're able to start, you know, really getting to the nitty gritty of standardization. Especially on something like this, you know, I'm one very much of, you know, what the lab directors have some autonomy, right? We all were educated in this field. You know, we may choose a specific culture media. That's OK. But, you know, if we can standardize the alarming system, that's one less headache for everybody involved. And by having a lot of that data to be able to to churn through and better understand, you know, ultimately identify best practices and
Better patient success.
Griffin Jones (30:05)
You had also alluded to the litigation that's happened in the field and you guys are making me think of an interview I just recorded with Matt Maruca. He's the chief legal officer of Inception. I don't know if his episode will come out before after your guys. I think it comes out before. What he's talking about is litigation is on the rise in the field. And it's not just because it's not like that more incidents aren't necessarily happening. It's
A lot of it is being driven by the plaintiff's attorneys. So these law firms that make their money suing people have taken their playbook from the personal injury attorneys. can't drive 100 feet in any city without seeing a billboard for a personal injury attorney. That's happening in our field too. they know what they're going after. They know how to assemble these cases. They've got it templatized.
and they're looking for any possible thing. And I'm not a lawyer, but to me, seems like the incident that you were describing where the lab director had to drive back and address that CO2 issue with the incubator had that resulted in a loss of embryos. It's like, if I'm the lawyer, I know every single solution that's out there. all I... Is part of my case prep. I'm just sharing like...
Here's what they could have had, Your Honor. Here's what other clinics are using as the standard. And they didn't, therefore they're culpable. And I think lawyers are really good at being able to make that the case. It's why you've seen so many successful personal injury cases or settlements that are probably from frivolous cases because they've got that system buttoned down and they're doing it to us now.
How much do you think about that Tex as a scientific director in your seat? Is that something that most lab directors are thinking like, well, that's kind of an... Is it an issue that haunts lab directors like this lurking litigation landscape out there? Or is it something that you think is more that they let the C-suite worry about?
Tex (32:16)
Short answer is all the time. And unfortunately, I shouldn't have to be thinking about that all the time. I should be thinking about improving patient outcomes and doing better in the lab. it is constantly on our mind, especially as we start thinking through new technologies. The first part is, wow, this is great. This is going to advance the field. This is going to help create better blastocysts. This is going to get more patients pregnant. What if it goes wrong?
You know, what system do I have to back up? Do I have another tool in the toolbox that can show that the validation was properly done, that, you know, we've got approval on doing this, et cetera, et So it definitely causes one to pause, which is unfortunate, but now it's just part of it. know, we think full circle as to what could this get us into trouble, you know, with a lawsuit.
can't, then we really push ahead. But if there's a little bit of hesitance, like, what if the battery goes dead? Then we start thinking through, OK, well, what's the backup plan? And it's just part of the daily thought now, unfortunately. But again, if I have a system in place and a good partner that's sort of behind me, that's one last thing I need to think about. And risk mitigation, that's a common topic on a daily basis, especially in my world.
Griffin Jones (33:30)
How much does standardization help to avoid that? So is your standardizing... What is it that you really want to standardize for? And what are the risks of not standardizing where it's like every lab is just doing it their own way?
Tex (33:47)
Yeah, great question. So again, you know, I'm a true advocate for some autonomy within the laboratories. But, you know, here's the scenario. Your US fertility largest network in the US. We've got, you know, 30 labs that are on ziltrex and we have two labs that are still using Sensiphone. Heaven forbid something happened in Sensiphone, in one of the Sensiphone laboratories, and we had, you know, loss of embryos.
Imagine that court case. Well, why do you have XiltriX and all the other labs and not those two? That's negligence, right? You know it's a good system. You know you're using it. You chose it for a reason. You're on this initiative to standardize. Why did you leave out those two? was like, well, we're in the process of converting or something like that, or we just never did. So those kind of bits can save our butts in a bit of legal time. But other events of standardization with making sure that we're using
Same consumables and and allows us to identify if there's any issues that are going along But also I want to I don't want to keep all my eggs in one basket especially on some of those bits and that's where it's nice to have a little bit of diversification within the laboratories, but I think on systems that systems that can easily be implemented and that can be standardized and that can improve workflow processes within the laboratory and outside I mean to me that's a that's that's a no-brainer it just makes life a bit easier and
allows us to defend, heaven forbid, something but to go wrong.
Griffin Jones (35:09)
Moises, how do see AI playing into all this in the future for you guys more broadly? How do you think AI is going to impact monitoring?
Moises Eilemberg (35:18)
Yeah, mean, think AI, as in most other fields, it's going to allow us to do things much more efficiently and potentially do things that are very difficult to do today. I mean, for us, particularly in the monitoring space,
Oftentimes when there is a problem or a failure in any of the environments that we monitor, there are usually some symptoms of a failure potentially occurring. And so I think with using AI, we're going to get a lot better at potentially predicting and picking up on those symptoms before a failure actually occurs. ⁓
mean that's a clear area where I think there's probably a lot of low hanging fruit for us in the space.
Griffin Jones (36:02)
Tell me, was there a case study that you guys did, my sister, 12 incubator alarm case study, was that what you were referencing before?
Moises Eilemberg (36:10)
Yeah, that was the instance in which there was ⁓ a ⁓ failure of the gas input to the incubator. And there was a lot of confusion about what the actual issue was. And we were able to indicate and have the person actually pay attention to it. One of the things that I want to circle back
to and maybe emphasize is look, this is an area where almost everyone I've met are talented, smart, well-intentioned, people working for a noble cause. But when errors happen, they are costly. They're very emotionally charged. And as you said, have the plaintiff's attorneys that are
latch on to those those instances and get some pretty big judgments, so I think you know the level of scrutiny that is in the industry makes it so that You know when you talk about cost efficiencies Some short-term cost efficiencies can be very very expensive in the long run so when I see You know somebody relying on a
on a very inexpensive but potentially not very reliable piece of technology to monitor what could potentially cost the business. That doesn't seem like a great short-term cost efficiency. It's almost like canceling your health insurance. Yeah, you're going to pay less this month, but you're probably not going to have
Griffin Jones (37:37)
But you better pray you
don't get nailed.
Tex (37:39)
Yeah.
Moises Eilemberg (37:39)
⁓
So, look, we do a lot of work in the pharma and biotech space where we deal with good manufacturing practices. And the first thing that these organizations do when it comes to a GMP regime is they do a risk assessment and they figure out what's the risk of failure and what's the cost of that failure. Well, if you apply that to IVF, the cost of failure
is can be tremendous. mean, the loss of reputation besides the financial cost. And so there are that would indicate that this is an area where you really want to try to mitigate risk. you know, when it comes to critical failures, more than 20 percent of the time, those critical failures result in us getting alerted because we're always right there with our customer when it comes to alarms.
24 hours a day, seven days a week. And so 20 % of the time is a lot of the time. ⁓ It's probably more than you would want, but it makes all the difference. It makes all the difference to have somebody there to catch that alarm and then to help you, just like in the incubator case, figure out and identify that this is a real issue you need to pay attention to.
Tex (38:35)
Good.
Griffin Jones (38:50)
What happened with Swedish Biobank last year?
Moises Eilemberg (38:53)
So, yeah, so this was a highly publicized, just like there's been ⁓ others, instance of a loss of basically years and years of samples that had been collected because in this instance, I think there was an alarm going off and I believe a maintenance person silenced the alarm.
because it was annoying and nobody who really needed to know was notified and the freezer failed and you lost years and years of invaluable research that you're never going to get back. As we often see, know, the technology is great and it's helpful, but usually when something like this happens, it's usually the result of
combination of things and combination of failures, almost always one of them is human error. And so in this case, evidently somebody, a human, made an error even though the technology was there. The combination of the failure of the freezer with the human error of turning off the alarm with not notifying anybody resulted in a catastrophic loss.
To have somebody there, a third party, that can reduce the likelihood of that human error, again, makes all the difference.
Griffin Jones (40:16)
Jax, let's say this happens at a lab that isn't one of your labs. It happens some other company and they're in a huge crisis mode, PR, public crisis. They bring you in because we need a new face and we need to show people that we're making this right. What are the first things that you're doing to restore trust?
Tex (40:37)
Yeah,
getting a new system in place. I getting a reliable system in place, something that has historical evidence of being reliant, showing that, hey, we've got the best. This is not going to happen again. And really listing the reasons why. We've got state-of-the-art technology. We have another set of eyes. We have validated the system.
I will say too, a bit of a sidestep, but having exceptional customer service to be able to work with us to identify those alarms. And every new tech is going to have a little bit of issue, but it's a matter of ironing it out and having, again, a partner to help us do that, that understands the value of making sure everything is humbling along accordingly. I think regaining trust on something of that scale is an uphill battle.
There are some systems in place that can help revitalize that process or just the ability to show that we're taking this more seriously. And we should have taken it seriously the first time by having to.
Griffin Jones (41:38)
One of
the other issues in the lab is just the space. I've been in some of these labs and there's just doers, doers, doers, and people are kind of weaving their way throughout the lab. And they can be pretty small spaces sometimes. And oftentimes putting on an addition is not an option. Moving a lab sucks. Tell us about the challenges created by space limitations in the lab.
Tex (42:05)
Yeah, I think a lot of the laboratories built previously didn't think through how frozen embryo transfers were going to take off or the evolution of cryopreservation and the ability to be able to freeze embryos in such a great stable state. Not only that, just our embryo culture techniques within the laboratories have very much improved. So we are getting more blastocysts. We are getting more embryos from a cycle. So therefore, we need to store accordingly. So I think the biggest bit is
what to do with cryo storage and either send stuff off site or keep it on site. And those cryo containers and robots are all fairly big and take up a lot of space. But also just having incubator space to be able to accommodate not only the employees working around in a safe environment and making sure there's no blind corners when you're walking around with a dish in your hand with 10 embryos, but just the ability to, our incubators have gotten smaller.
more desktop, more smaller foot space and footprint. And that's helped. But I think if we would go back and survey all the laboratories, I'm sure everybody would want a larger space. But having said that, installing an alarm system of this scale will not hamper that space. If anything, you can work around it to a point where you wouldn't even know it's there in your pre-existing space.
So I don't, if there's ever an excuse of, I can't adopt this technology because of space constraints, I would argue against that statement because there's, where there's a will, there's a way, and certainly this is not gonna be, you know.
inhibitor of spatial activity within the laboratory.
Griffin Jones (43:38)
How close or far do you guys think we are from a 24-7 operational IVF lab?
Tex (43:44)
I've got my opinion. I'll let Moises go first.
Moises Eilemberg (43:47)
Well, we may have ⁓ similar thoughts on this text. ⁓ mean, I think...
Obviously human capital and having people work 24-7, I don't think is particularly in the horizon or viable. But, you know, there's companies which I'm sure we all know about, like Conceivable, who are developing, you know, what is presumably a much more automated process.
⁓ end-to-end and so I think technology is going to help us expand the capacity of the industry. I think there's no doubt that that's going to help a lot. Love to hear what you think Tex.
Tex (44:28)
Yeah, I would agree with that. We have gone down the path with having sort of shift work within the embryology laboratories based on just the volume. So we'd have an early team to come in and do the retrievals and kind of look at embryos and get things sorted out and then an afternoon team. And that's far from 24 hours, but yet based on the demand, we're having to provide the human supply to be able to accommodate accordingly. I do feel through
no technology and if there was more of a robotic system that was truly validated and can do the stuff we do at the bench just as well, if not better, then that's gonna open up opportunities and a lot of the sort hub and spoke models whereby you've got spokes out where you do an egg retrieval, you freeze the eggs and then you send the eggs, send the sperm to the main mother lab and then you process and it becomes a bit of a
processing factory-like system. How far are we away from that? Truth be told, I think none of us really know, but there's definitely been an acceleration of that sort of thought process through the development of some of this tech as of recent years. So it could be upon us sooner than we think, potentially, if it all pans out.
Griffin Jones (45:41)
You said most lab directors probably wish they had built their labs bigger. Those building a lab in 2026 have an advantage that those that built in 1996 didn't have. You're starting brand new. I'm talking complete new lab. It's going to be high volume. You're going to do between two and 10,000 cycles. How are you building it?
Tex (45:54)
So there.
A massive embryology staff playroom is key. We're talking stadium seating, we're talking concession stands, we're talking absolutely, you gotta treat these people right. So that would be my first objective. Space for staff is super important, right?
Griffin Jones (46:09)
haha
The Nespresso machine, massage chairs.
Tex (46:27)
they've got to be able to break away a little bit from the lab and go back and sort of decompress and either check an email or look at their phone for 10 minutes before they go back in to kind of take a break. I think a lot of just an area for them to break away from the lab is super important. Then it depends on which way you want to go with cryo storage. Are you going to keep it in-house or is it better just to outsource it and sort of move that risk to a third party repository?
And I think that comes into play with a lot of it. Are we gonna have benches that are relatively higher that we can roll these doers or cryo-micro-nitrogen storage doers underneath? What about the footprint of technology coming through? We've seen some robots already. It was just an S-ray and they're pushing a dish-making robot. So what does that footprint look like? Is that gonna be the size of a Flowhood? Therefore we need to accommodate. ⁓
find some space for that. And then obviously, what's the next evolution? Are we going to continue to do invasive ⁓ embryo biopsy? So do we need micro manipulation setups across the laboratory? Or is technology going to beat us where we're doing non-invasive? We're looking at cell-free DNA and culture drops. Therefore, we need to put more of an emphasis on incubator space and maybe larger incubators to accommodate single embryo culture so we can assess that spin culture media.
Yeah, it's just keeping your fingers on the tab with where the tech's coming up. But I honestly say, priority number one is a good safe space ⁓ for our very dear embryology staff.
Griffin Jones (47:59)
Anything you'd add to that, Moises?
Moises Eilemberg (48:01)
No, think everything that Tex brought up sounds right on point. The one thing I would maybe add is you asked about how technology and better use of space can help alleviate some of the stress and some of the constraints and challenges that we're facing.
And I think technology is a huge part of it. In our world, we call it internally here, it's like the, it's a technology paradox because when it comes to doing something like what we do, environmental monitoring, usually more monitoring leads to more alarms and more alarms typically leads to alarm fatigue and alarm fatigue leads to...
more risk. So you started trying to address risk with technology and you ended up with more risk. And so when I think about the application of technology to alleviate some of these things, think they're going back to where we started partnering with specialized providers that can
make sure that that technology doesn't add to the burden but instead reduces the workload and the burden is the critical difference here. And I think that probably applies to a lot of the things that Tex mentioned earlier.
Griffin Jones (49:12)
What do you guys think will separate the really, really successful IVF labs from the rest of the pack in the next 10 years?
Tex (49:22)
think being open to some of new technology coming down the pipeline. A lot of it still needs to be properly validated. The IVF and ART is one of those fields that just constantly evolving. And you don't want to be left in the dust, but you also don't want to adopt a new tech that hasn't proven its worth. I think there's also a more genuine focus on specialized patient care.
and really treating each patient as an individual patient versus grouping them into our SART age groups, you know. And I think we're going to get to more of a precision offerings within the laboratory and clinically that is more catered to that individual patient as itself. And I think artificial intelligence is really going to allow us to dig through that data that we already have, you know, from
the millions and thousands of cycles that we've already performed, how can we start identifying where those best practices are and applying them to specialized, personalized care for the patients.
Griffin Jones (50:19)
What do you think, while you work with lot of labs, not just IVF labs, what do you think is going to be the standard bearer in the next 10 years?
Moises Eilemberg (50:28)
Well, I mean, I think when it comes to what's going to drive the most success right now, it seems like a little bit of a longer term thinking makes a big difference because I think some of the pressures that we were talking about are leading to some short term focus. And I think that's that's risky. I think.
you know, focusing on the factors that techs brought up, the long-term success of a particular practice, focusing on patient care, making sure that your staff is not overworked and burnt out and overburdened with non-core activities, and really investing for the long-term. I think it's gonna make a difference because any blip,
as a result of short-term thinking usually has a pretty ⁓ negative outcome.
Griffin Jones (51:18)
This episode will probably come out like two months, six weeks, something like that before. As around this point, a lot of the people that are listening now, they've heard, well, Ava Shankman seems to really like XiltriX and Sangita Jindal really liked XiltriX and Steve Katz seems to think that it's a lot better for my insurance and for my legal liability in Texas and why he likes them.
They sound pretty cool. I've got 900 other things to do. For somebody that's thinking, yeah, maybe I should get in touch with these guys and maybe I should schedule a Zoom or a demo before ASRM or at a bare minimum, find a time to meet with these guys at ASRM. What would you advise to somebody thinking like that, Tex?
Tex (52:06)
Do it sooner than later. You know, this is not funny business. mean, you've got to make sure that... And, you know, it's also doing it for your staff, right? Your staff needs to feel comfortable in a good system, you know, and most likely some of them are going to be, you know, having to attend to some of these alarms. So I'd get in touch as soon as possible, start exploring opportunities, you know, really assess your current system.
and think, wow, this really sucks about this system. I wish this could be improved. And yeah, have a chat with the XiltriX team and see if they've already figured that out. These guys are always been open to suggestions of improvement. And that's been very, very helpful with us, especially as we standardize things across our laboratory and say, hey, can you do this? And can we do a blanket launch across the entire network? And ⁓ that's been amazing. But yeah, I would not sit on it. I would reach out because a failure could happen tomorrow.
Griffin Jones (52:56)
Moises, thank you both very much for joining me on the Inside Reproductive Health Podcast.
Moises Eilemberg (53:01)
Thank you, Griffin, and thank you, Tex. I learned a lot today. Appreciate it.
Tex (53:05)
Same here, my pleasure.
