Leaders discuss how growth, data-driven care, and new technologies are reshaping outcomes, access, and clinical workflows.
Over more than a decade of expansion, IVIRMA has scaled into one of the largest fertility networks in the country while emphasizing patient experience, data-driven decision-making, and consistent clinical standards across locations. In this conversation, East Coast Regional Medical Director Maria Costantini, MD, and Chief Medical Officer for North America Thomas Molinaro, MD, speak with Shawn Vincent, Chief Strategy Officer at GeneScreen, about how the organization approaches growth, workforce design, technology adoption, and the evolving definition of patient outcomes. The discussion also explores access-to-care challenges, telehealth adoption, and how emerging AI-driven workflows—an area where GeneScreen may support genetic counseling—are shaping the next phase of patient-centered fertility care.
With IVIRMA experiencing remarkable growth while maintaining exceptionally high standards of patient care, what key strategies or cultural values have allowed the practice to scale without losing its patient-focused foundation?
Maria:
“We appreciate this question because we feel very strongly—and very proud—of how our growth has always been anchored in a simple philosophy: patients always come first, and everything is data-driven. Every expansion decision is guided first by clinical outcomes and, equally, patient experience. By standardizing an evidence-based model of care across our network, we ensure consistency while still allowing local practices to reflect their unique strengths. We’ve invested heavily in technology—digital communication platforms, centralized quality monitoring, and patient-engagement tools—that make care more transparent and accessible. This combination of values and infrastructure has allowed us to scale without losing the intimacy of patient-focused care, from our beginnings as a small center in New Jersey to becoming a national and international enterprise.”
Tom:
“Maria said it more eloquently than I could. It really comes down to ‘patients first.’ When you do the right thing for patients and they have the best outcomes, the business thrives. As long as you keep patients at the center of everything, good things follow—for them and for the organization.”
As leaders in a rapidly expanding organization, what aspects of IVIRMA’s evolution are you most proud of? And where do you see the next major areas of development?
Tom:
“There’s so much I’m proud of from the last five years as we’ve transitioned from a local or regional practice into a national and international organization. What I’m most proud of is the growth in our physician leadership. Physicians are natural leaders—patients, staff, nurses, genetic counselors all look to us to be the quarterback of the team. But leadership comes naturally to some and less so to others, so figuring out how to inspire leadership across all physicians has been a major part of our growth. We’ve found opportunities for many physicians to share their talents across the network. One thing I learned early on is that this job is more fun when more people get pregnant. The hardest part is negative pregnancy tests and miscarriages. So optimizing outcomes has always been at the heart of IVIRMA. Now, we’re in a position to redefine what ‘patient outcomes’ really means. It’s no longer just about a positive pregnancy test. It’s about time to pregnancy, cost to achieve a baby, dropout rates.”
Maria:
“I completely agree with Tom. While we focus on outcomes, we also work hard to understand what patients are going through—the personal, emotional, physical, psychosocial, and financial aspects. We’re always asking what we can do better to improve the patient experience during their journey. Patient success has to include experience. We don’t want people to come to us just to get pregnant despite their experience—we want them to feel supported and cared for while achieving their goal.”
What operational or practice improvements have made the biggest impact on patient care?
Maria:
“We try not to view high volume as a burden, but as an advantage. A larger patient population provides richer data sets that improve predictive modeling, lab efficiency, and treatment personalization. To maintain individualized care, we’ve embedded advanced practice providers and primary nursing roles into our model. That close, personalized contact can’t be lost as we grow. Patients tell us all the time they don’t want to become a number.”
Tom:
“I’d add that practice makes perfect. Malcolm Gladwell says it takes 10,000 hours to become a master at something. Across our network, we probably have millions of hours of physician time. When we review challenging cases together, the amount of shared experience elevates the entire standard of care. Using our data and collective experience helps ensure optimal patient outcomes, and that really makes a difference.”
With access to care continuing to be a major challenge, how is IVIRMA working to expand access, particularly in underserved or historically overlooked communities?
Tom:
“Access to care is something we think about a lot. We approach it several ways. First is geography: we look at the U.S. map and identify where the greatest needs are. Second is technology. The pandemic made telehealth much more widely accepted, and it’s expanded our ability to reach patients regionally and nationally. We’re also expanding provider access and championing advanced practice providers. We’re focused on training the next generation of REIs through fellowships, and we stay very active at the legislative level as more states consider insurance mandates.”
Maria:
“Yes—making fertility care more accessible regardless of geography or socioeconomic status is very important to us. We partner with employers to expand fertility benefits, and our financial counselors help patients navigate the complexities of insurance. We also expand donor and egg bank programs to increase availability, and we offer financial assistance programs for eligible patients.”
What technologies stand out as most impactful for improving workflows, patient experience, or access to care?
Maria:
“The past decade has brought remarkable innovations—from advanced embryo culture and vitrification to improved implantation rates and more precise PGT workflows. Digital workflow systems and centralized quality monitoring have reduced variability across practices ensuring patients receive the same high standard of care no matter where they are. These technologies have raised success rates and patient confidence.”
Tom:
“Almost every company now has an AI module—and we’re no exception. Our in-house EMR, Artemis, now includes AI-enhanced workflows that are being released next week. Our patients today expect more information and faster access to their results. We’re also working on better data utilization and are excited about remote ultrasound monitoring, remote bloodwork and hormone monitoring, and lab automation.”
Shawn:
“I was on a call with your team today learning about your AI and how GeneScreen might be able to support it—especially with streamlining genetic counseling workflows.”
Maria:
“We hope so. It’s pretty cool. It’s exciting for providers, genetic counselors, and patients. But it’s also important to remember that AI is the infrastructure—providers are the soul of care.”
Genetics in Fertility Care Means More Than a Test - It Demands a Team
57% of Patients Had Missed Risks. 42% Changed Clinical Care. 19% of Donors Found Ineligible.
Genetic testing is complex - and interpreting what it means for patients and donors is even more so. Without dedicated expertise, critical family-history and variant insights are often missed.
57% of patients were found to have previously unrecognized genetic or family-history risks, and 42% of those findings changed clinical management (Thompson et al., Am J Perinatol 2020).
In donor screening, 84% of applicants shared new or clarifying health information during genetic counseling, with 19% subsequently found ineligible under ASRM or program guidelines (Varriale C, et al., J Assist Reprod Genet. 2025).
Incomplete genetic review risks care gaps, regulatory exposure, and loss of trust.
GeneScreen delivers concierge-level, comprehensive genetic counseling that integrates seamlessly with your clinical workflow - scalable, accurate, and patient-centered.