Biomedical imaging technologies, professional and lay visions

Category: Conferences

Our Year in Review

2018 has been a busy year for the Remaking the Human Body team. We are happy to share that we have, so far, conducted observations at 5 sites and have interviewed more than 50 professionals and patients about their views on time-lapse, IVF technology, and add-ons in the UK. This year we are looking to finish data collection and are eagerly anticipating the start of our public engagement activities, generously funded by the Wellcome Trust through an additional grant.

By presenting preliminary findings at several conferences, we have incorporated useful feedback from scholars from various academic backgrounds. This, in turn, has helped us hone our questions and methods. We have greatly enjoyed presenting at conferences ranging from science communication meetings to medically-oriented meetings, such as ESHRE. Below is a short list of some of the events we have had the pleasure to attend in 2018, with presentation title in parentheses:

Science in Public 2018 Conference, Cardiff, December 17-19. (Perrotta, M., Geampana, A., Hamper, J.A. “Predicting success: visual practices and predictive algorithms in IVF.”)

European Society for the Study of Science and Technology (EASST) Annual Meeting, Lancaster, July 24-28. (Perrotta, M. & Geampana, A. “Non-invasive predictions: visual predictive tools in IVF.”)

European Society for the Study of Human Reproduction and Embryology (ESHRE) Annual Meeting, Barcelona, July 1-4. (Perrotta, M., Geampana, A., Hamper, J.A., Giraud, AS. “The ethics of commercialization: a temporal analysis of newspaper coverage of IVF add-ons in the UK.”)

Science and Technology Studies Italia Meeting, Padova, June 14-16. (Perrotta, M. & Geampana, A. “Standardising professional vision in embryo imaging.”)

Visualising Reproduction – An Interdisciplinary Inquiry, De Montfort University, Leicester, June 6. (Perrotta, M. “Remaking Embryos. Time-lapse Microscopy and the Future of Embryology.”)

British Sociological Association Human Reproduction Conference, De Montfort University, Leicester, May 24. (Perrotta, M., Geampana, A., Hamper, J.A. “The IVF add-on debate: from techno-scientific breakthroughs to unproven treatments.”)

The previous year has also been a great one to immerse ourselves in the wider world of fertility treatment and education, through attending various public events:

Progress Educational Trust conference ‘Make Do or Amend: Should We Update UK Fertility and Embryo Law? – London, December 5

Fertility Show – London, November 3-4

40 Years of IVF at the Science Museum – London, July 25

Fertility Fest – London, May 8-13

Progress Educational Trust/ British Fertility Society event ‘The Real Cost of IVF’ – London, April 11

Fertility Show – Manchester, March 24-25

In particular, the Fertility Show and Fertility Fest have provided opportunities for us to learn and reflect on how we might proceed with public engagement activities in the near future. You can read some of our previous blogs for impressions from our work and how it fits into wider conversations on fertility and IVF treatment.

We anticipate a productive rest of 2019 and look forward to keeping you posted about our activities!

Better regulations or no regulations? Thoughts on PET’s 2018 conference

The annual conference of the Progress Educational Trust (PET), ‘Make Do or Amend: Should We Update UK Fertility and Embryo Law?’ could not have been more timely. Held at the beginning of December, it shortly followed emerging reports from China that the first gene-edited babies will soon be born. While attendees did not miss the opportunity to discuss these developments, the conference provided food for thought for anyone interested in the legal aspects of fertility and reproduction.

The general sense in the room was that the law can hardly keep up with technological developments in this area. As many speakers brilliantly argued, this can lead to problems and frustrations when trying to apply old laws to current contexts. Professor Emily Jackson underlined the issues faced by UK patients as a result of the 10 year legal limit on embryo storage, while Dr Kylie Baldwin highlighted similar issues experienced by women undergoing egg freezing for social reasons. Additionally, the law can be especially restrictive for families who conceive through donation and surrogacy. Both Natalie Gamble and Natalie Smith did an excellent job of underlining changing family practices.

I was especially struck by the diversity that exists within European fertility law. Oftentimes, regulations cannot be separated from the ethical and religious context of their respective countries. This was especially evident in Professor Robert Spaczyński’s presentation on reproductive laws in Poland and Professor Christian de Geyter’s overview of assisted conception in Switzerland. Giving attendees a fascinating picture of the larger European landscape, Satu Rautakallio-Hokkanen, the Chair of Fertility Europe, walked us through many differences between legal restrictions in assisted conception and services offered in various countries across the continent.

For me, a crucial question emerged during the discussion: why is this area of medical practice as regulated as it is? Some have argued that we are talking about procedures that should not even be within the purview of the law. Others might think that we just need better laws, instead of getting rid of them altogether. It is clear, however, that for the time being, fertility and embryo law remains contentious. Consequently, we need to have these debates and conversations in order to find the best solutions. PET’s event made me reflect on bigger questions than the ones I had going in. I had no doubt that better regulations are needed. Now, I wonder, however, about legal systems’ inherent limitations and whether such institutions have the adequate means to cope with rapid changes. Should certain procedures remain unregulated? I have not yet decided on my definitive views, but I’m glad these conversations are happening.

ESHRE 2018

At the beginning of this month, I had the pleasure of attending one of the biggest conferences on reproduction, organized by the European Society for Human Reproduction and Embryology (ESHRE). The ESHRE 2018 annual meeting took place in Barcelona, so, needless to say, I was brimming with excitement not only for the tens of presentations I was going to attend, but also for the amazing location (bonus: the venue was a 10 minute walk from one of Barcelona’s amazing beaches). Sun and beaches aside, the conference was interesting, well organized, and impressive in size and breadth. As a sociologist, I have gotten used to smaller conferences, so I was in for quite the treat: ESHRE had a record attendance this year of almost 12,000! It can be easy to get overwhelmed, but I was there with a purpose: to learn more about the current uses of time-lapse and about social aspects of infertility, more generally.

Time-lapse

Without a doubt, the meeting has confirmed that time-lapse is being used for research in many ways, perhaps more than was initially anticipated by anyone. Time-lapse tools allow embryologists and researchers to study the myriad of factors that can potentially influence pregnancy outcomes. Although add-ons have been portrayed as controversial in the UK media (Most still are: see, for example, recent headlines about the endometrial scratch), it seems to me that time-lapse has nonetheless been integrated into research practices. A number of authors have used time-lapse imaging as data that can generate new knowledge about how to pick the best embryo. We can now look at factors such as fragments, vacuoles, and even type of embryo movement, categorize these phenomena and conduct fairly large studies on outcome correlation, as panels at ESHRE have shown. Of note for me was Dr. Cristina Hickman’s presentation on the multiple uses of time-lapse machines in clinics around the world. Interestingly, she stressed how different labs have integrated this technology to different degrees, showing how introducing new ways of looking at embryos (including selection algorithms) is a process that needs significant work on the part of professionals – work that, however, many say is worth doing in the end. Our own work on time-lapse was represented in the digital poster area, where I was delighted to see many scroll through our summary of preliminary findings.

Fertility Awareness and Men

On top of all the fascinating insights into time-lapse and lab practices, ESHRE 2018 also offered food for thought on fertility awareness, gamete donation, health outcomes for ICSI and IVF children, social egg freezing and many other related topics that I unfortunately have no space to list in a blog post. Taking into consideration the panels I attended and the topics that caught the public’s attention, a couple of prominent themes emerged for me. As infertility is an issue that more and more couples face, the need for fertility awareness education is becoming quite pressing. Presenters and commentators alike noted that this type of education should start early.  However, quite a few presentations stressed the absence of men from this conversation. I got a sense that health professionals are worried about this and luckily, researchers are starting to have more conversations with men about reproductive timing and infertility. However, the overwhelming sense was that more work needs to be done to get men involved.

Men’s absence was highlighted in another way: women who undergo social freezing overwhelmingly do so because they haven’t found the right partner. Prof. Marcia Inhorn delved into this subject with data from qualitative interviews conducted in the US and Israel. Interestingly, this is one of the main stories that the media picked up. We are now talking more about men’s lack of a sense of urgency when it comes to having kids. This phenomenon, however, might be problematic in light of increasing knowledge that men also undergo a fertility decline as they age.

To add to all the interesting discussions, I was very glad to see social science perspectives represented at the conference and think we need to start building more bridges with the medical community. This is something that RHB aims for in our future endeavours. We also very much look forward to our next ESHRE meeting!

Remaking Reproduction in Cambridge

A big event on the conference calendar this year was the ‘Remaking Reproduction’ conference organised by ReproSoc (Reproductive Sociology) at Cambridge University. With great enthusiasm, all three members of the research team attended three days between June 27-29, and Manuela Perrotta presented some initial work from the project in the stream entitled ‘Mediated Reproduction’. Her paper examined how time-lapse imaging tools are involved in creating or reconfiguring knowledge about embryo development and what constitutes ‘the best embryos’ in the context of IVF treatment.

Reproduction in Law and Art

The early summer conference season has been quite eventful for us. We had the pleasure of presenting some of our initial findings at two events: the British Sociological Association’s (BSA) Human Reproduction Study Group Annual Conference on May 24 and Visualising Reproduction on June 4. Although both took place in Leicester at De Montfort University, they each took a unique and innovative angle on issues emerging in reproduction studies. I here reflect not only on our project’s fit within larger conversations on assisted reproduction, but also on the impressive breadth of topics covered at these two conferences.

Reproduction and the Law  

With a very timely choice of topic, the BSA event highlighted critical intersections between reproduction and the law. Coupled with the anticipation of the Irish referendum, I was reminded that the law plays a crucial role in determining our reproductive choices. As someone who has only recently moved to the UK, Professor Emily Jackson’s plenary talk was particularly eye-opening with regards to the legal work that still needs to be done here in order to improve women’s choices. Of course, improvements are necessary everywhere, but the UK has its peculiarities and unique challenges. Most notably, the country has a 10 year storage limit on eggs frozen for social reasons, thus not always allowing women sufficient time to use them to conceive. (An online petition you can sign to change this is in place at https://petition.parliament.uk/petitions/218313) I was also intrigued to find about the various barriers women face as a result of the 1967 Abortion Act. Unquestionably, it is time to change regulations to improve access. Professor Jackson’s talk was an important reminder that we can and should push further.

The presentations I attended throughout the day allowed me to reflect on how we might best regulate gamete donation, surrogacy, and egg freezing, to name just a few topics that came up. The range of global contexts (including North America, Europe and Asia) that presenters explored was impressive and highlighted how ethical challenges are influenced by national policies. In particular, economic inequalities have affected assisted reproduction practices, as governments often fail to keep up with such the changing landscape of assisted reproductive technologies. The regulations required to protect those who are vulnerable, such as surrogates and gamete donors who are based in lower-income countries, are either flawed or non-existent. The BSA event provided a vital space for discussions on how we might proceed. Even though many of us are unsure of the best course of action, starting these conversations is definitely a promising start.

Presenting on Time-lapse

The use of imaging technologies in IVF has been itself caught up in larger debates on commercialisation and best course of treatment. I tried to capture the contentious place that such technologies occupy today in the world of IVF during our presentation at the BSA event. Views on time-lapse have changed tremendously even during the course of our research.

The two conferences we attended perfectly capture the debates/conversations that time-lapse is part of. On one hand, it is a contested technology that potentially calls for more regulatory action in the UK. On the other hand, it captures imaginations with its ability to give us unprecedented insights into the life of embryos. This second aspect brings me to the visual of reproduction and how this was explored during the Visualising Reproduction event.

Visualising Reproduction

With topics ranging from the history of embryo illustrations to menstruation in the visual arts to holographic visualisations of the clitoris, Visualizing Reproduction was fascinating, unique, and much-needed conference that showcased the significance of reproductive imagery. Listening to the invited speakers (including our very own Manuela Perrotta), I realised that many topics we study in the social sciences are intricately related to art and visualisation. In particular, the conference highlighted collaborations between artists and academics. This stood out me as interdisciplinarity at its best. For example, Isabel Davis from Birkbeck and artist Anna Burel talked about the Experimental Conception Hospital imagined by Robert Lyall, a 19th century physician. Anna’s illustrations of pregnant women and art pieces made Lyall’s imagined institution come to life. Another example of amazing work from artists was Liv Pennington’s exploration of pregnancy tests – a technology so mundane yet at the same time so mysterious. Thinking about such work, it strikes me that the visual has the power to break down taboos and barriers, as also exemplified in representations of menstruation in the arts – a topic that Camilla Røstvik brilliantly covered in her presentation.

Visual Representations has taught us that fruitful collaborations between artists and academics might be able to provide a better-rounded picture of the topic studied. It has also taught us that we need to further emphasize the visual in our project’s exploration of time-lapse and its uses.

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