Clinical Embryology graduate presents research at CFAS conference
The Department of Laboratory Medicine and Pathobiology (LMP) in collaboration with the Department of Obstetrics and Gynecology (OB/GYN), launched a unique Professional Master’s graduate program in 2020, The MHSc in Laboratory Medicine. Designed to educate clinical laboratory medicine scientists as either a Pathologists’ Assistant (PA) or a Clinical Embryologist (CE), the program has a strong emphasis on critical thinking and research.
Students complete a research project in their second year called a Capstone project. Maria Perfiliev Mejia graduated from the Clinical Embryology field in 2022 and presented her results from her Capstone research project at The Canadian Fertility and Andrology Society’s (CFAS) 68th Annual Meeting in Halifax this September.
She tells us about her experience.
“The idea for my capstone project, under the mentorship of Dr. Heather Shapiro did not come in a straightforward way. In the Clinical Embryology program at U of T we are constantly encouraged, from the first semester, to develop a research hypothesis for our capstone project. The main idea of the project came from the first assignment in the advanced physiology course taught by Dr. Ted Brown where we had to choose a topic for the oral presentation.
Fascinatingly enough, I got the topic of advanced reproductive age and learned about young women entering an early menopause (<40 y/o), known as premature ovarian insufficiency (POI). It was interesting to learn about different causes for premature menopause, including genetic and gonadotoxic therapy, and the ways assisted reproductive technologies might help with their success in getting pregnant.
Elaborating and building the project was not an easy process since the theory does not always go hand in hand with the practice; particularly when talking about a retrospective study which may sometimes have incomplete data collection. Working on this project helped me to cultivate more scientific curiosity and critical thinking as well as teamwork skills. I learned the importance of defining the outcomes (clinical or ongoing pregnancy vs delivery) and limiting any potential biases and confounding factors to report the most objective information.
Presenting a poster at CFAS congress was a fantastic opportunity to learn about the ways of sharing the knowledge once we had the results. Even if the topic is interesting and well framed in the poster, presenting it requires other skills of showing confidence and developing rapport with the listeners. Although nervous at the beginning, I felt prepared and ready to share my first poster at the conference.
The Clinical Embryology program included interactive sessions with mentors where we would debate topics. Such strategies allowed us to network with fertility leaders while learning more about current assisted reproductive technologies. We also had the privilege of rotating in clinics to get the “feeling” of the daily IVF clinic workflow. Thanks to the rotations and mentors’ interactions, I had an idea of the placement I would like to work in and to further develop as an Embryologist. Currently, I am working as a Junior Embryologist, and I am looking forward to continuing growing professionally in this fascinating field”.
The research project
Our retrospective study aimed to investigate whether patients that failed previous in vitro fertilization (IVF) treatment using their own eggs, might have any occult uterine or sperm factors that may not be corrected with further treatment using donated eggs. This failed IVF cycles group was compared to patients with premature ovarian insufficiency (POI) and patients at advanced reproductive age (ARA), all undergoing IVF with donor eggs. Clinical and laboratory outcomes such as the number of successful pregnancy and delivery rates as well fertilization and number of utilizable blastocysts rates were evaluated.
We found that approximately 50% of patients achieved pregnancy on average consistent with previous studies. We found no statistically significant differences among study groups suggesting a minor role for uterine and sperm factors in the failure of the IVF cycles using autologous eggs.
What was the most interesting discovery is the number of cycles (or tries) it took to get pregnant. 75% of women with POI conceived by their 5th embryo transfer while the same proportion of failed IVF cycles group conceived after just their 2nd attempt. Although these results did not reach statistical significance and require further investigation, the results open an avenue to investigate the potential role of the endometrial receptivity in the POI patient population.