Tag: Embryology

Re.conceive + Remaking the Human Body

On 3rd September 2021

At the beginning of May we were delighted to spend an afternoon on Zoom with visual artist Sally Butcher, who is currently working on her Arts Council England funded project re.conceive. Sally approached us a while back to explore some of the synergies between our projects, which in different ways explore how reproduction, fertility and (non-)reproductive bodies are visualised or, sometimes, become invisible. Sally very generously shared some of her work-in-progress with us and we shared details about our research process and findings.

Each member of the research team was able to spend some time with Sally individually, and I include our reflections in our own words below.

Giulia: Sally’s work has inspired our conversation around reproduction in its different forms. We have especially discussed the relationship between medical knowledge, technologies and tools to visualise reproductive body parts or phenomena, and embodied experiences of them. We talked about the role of visual experiences in the construction of dominant narratives of gendered reproductive lives, and about the visibility and invisibility of specific reproductive experiences (for example infertility, miscarriages, abortion). We explored the notions of common and uncommon, known and unknown, expected and unexpected, we discussed how individual experiences relate to standardised measures and protocols and how people adjust and react to these, especially when these intersect with other medical, legal and geographical infrastructures (for example in the context of transnational reproductive travels).

Sally Butcher, ***Infertile Platitudes of Embodied Emptiness***, Sonogram 7/9, Archival Inkjet Digitised Monoprint (2020). Used here with permission from the artist.

Manuela: Among the many things we talked about, Sally and I had an interesting conversation regarding some of her work-in-progress – in my interpretation, an inspiring visualisation of the current developments in the field of embryology. Sally’s representation of sets of data embedded within an image of an embryo captured the current turn in embryology, by highlighting visually the novel and increasing use of data-driven algorithms in this field. In our research, analysing the case of Time-lapse incubators and their incorporated algorithms, we have investigated how new knowledge about embryos is generated in the complex interactions between professionals and machines. Although the use of algorithms has the potential to release unknown biological information on embryos (and therefore reveal their hidden secrets), algorithms do not simply add medical and reproductive knowledge as they require human input and therefore still rely on professional expertise.

Sally Butcher, *Human Algorithm V*, pencil and pen on paper (2021). Used here with permission from the artist.

Josie: During our conversation, Sally and I found many shared interests: for instance in how themes of absence and presence, and proximity and distance, shape ideas about reproduction as well as experiences of infertility. Being a geographer (academically and at heart!), I was drawn to how the body exterior and interior are ‘mapped’ in some of Sally’s work. We talked about the role of measurements, ordering, boundaries and boundary-making in relation to how reproductive processes are visualised and described. We also talked about the intrigue and mystery of magnifying or looking inside things.

Sally’s work also drew my attention to all the other kinds of imagery that fertility patients encounter before or during their IVF treatment. The focus of our research is on images and videos of embryos, which are exterior to the body or in vitro. But fertility patients often encounter a whole range of other visualising techniques that allow them to see inside their bodies. Ultrasound scans and dye tests, for instance, are routinely used to medically investigate female reproductive organs and check that these appear to be functioning ‘normally’. Ways of visualising bodies and embryos have (personal and political) implications for how infertility is seen and known, and therefore very real consequences for patients’ treatment experiences and trajectories.

Sally Butcher, **Sub-Maternal Exhaustion During a Pandemic**, Archival Photograph, egg, ink and hand gel (2020). Used here with permission from the artist.

Sally: My conversations with the Remaking the Human Body team have been invaluable in my research project. As a visual artist, Re.conceive was driven by the invisibility of Infertility within the new wave of maternal visual arts, where, as in society at large, infertility still remains mostly hidden and shrouded in silence. My project aims to explore and visually theorise the transformational process of ‘becoming’ a (M)Other, challenging traditional reproduction to reconceive a form of sub-maternal.

My meetings with Giulia, Josie and Manuela helped thoroughly contextualise my thinking, aiding my understanding of how infertility connects with the broader narrative of reproduction, as well as giving me greater insight into the scientific procedures within embryology and new practices with AI, and drew my focus onto patient interpretation of these new technologies. It especially moved my thinking toward the visual and verbal languages used within infertility. As a cultural researcher, I am drawn to the rhetoric of medical terminology, weighted in ‘success’ and ‘failure’, aimed at potential ‘geriatric mothers’ with ‘inhospitable uteruses’, and how this may sit alongside hidden personal testimonies, confessional spaces of the coded #TTC online community, or conversations with family and friends where it so often generates a real sense of unease. As an artist, I try to use a feminist gaze to challenge institutionalised power within visual tropes of medical and commercial imagery of infertility. These meetings enlightened me as to how much power we place in these visuals and how these become naturalised into our knowledges of reproduction, with narratives of the embryo constructed from the encounters we have with these visuals. The immediate resonances I felt between my own practice and the fantastic work being done by this team, has encouraged me to continue using this imagery, exploring its symbolism alongside the power of the maternal imagination.

40 years of IVF celebrated at the Science Museum

By Josie Hamper

On 3rd September 2018

In Events

On 25 July I went along to a special event hosted by the Science Museum in London to celebrate the 40^th birthday of Louise Brown, the first ever IVF baby to be born. Brown shared the stage with Professor Roger Gosden, who is an expert in female infertility and former doctoral student of the IVF pioneer Robert Edwards, and their conversation was chaired by Roger Highfield from the museum. Together the three meandered through decades of IVF history as well as reflections on what the future of IVF might hold.

After the talk and a grand finale happy birthday singalong, all guests were led through to a pop-up fertility fair in the museum’s flight gallery. Embryologists from London fertility clinics talked visitors through the basics of modern IVF, including (of particular interest to me) how they use time-lapse imaging tools to inform the embryo selection process. The embryologists narrated clips of developing embryos to explain in detail what IVF is and does, as well as what it can’t do. Given the focus of the ‘Remaking the Human Body’ project on visual tools in IVF, it was exciting to encounter embryo imagery in a semi-public, non-clinical setting – the enlarged films of dividing cells were employed very effectively to demonstrate the spectacle of IVF and capture people’s interest.

In line with the theme of the evening, following the fair I visited a new Science Museum exhibition entitled ‘IVF: 6 Million Babies Later’. This exhibition, which will run until November 2018, traces IVF from its initial development right through to the present day.

Controversial treatment

The exhibition included a variety of medical equipment that is routinely used in fertility treatment, such as pipettes, petri dishes, needles and the numerous medicine vials required by patients going through an IVF cycle. It also displayed some of the original laboratory and clinical tools used in IVF during the 1970s – the time at which Edwards, along with Patrick Steptoe and Jean Purdy, were developing the technique. There was a desiccator, which is a large glass jar that was used to incubate embryos ‘in vitro’ (literally ‘in glass’), and early versions of surgical tools used to diagnose fertility problems.

Steptoe, I learnt, led the way in advancing laparoscopy, which is a surgical technique that enables surgeons to see the reproductive organs and retrieve eggs without making major incisions through the body. Gosden explained that this technique was initially feared by the public and critiqued by physicians for being an unsafe, unethical and experimental procedure. While the early advancement of laparoscopy was not without risks, it paved the way for what has since become a central procedure in IVF treatment and gynaecology more broadly.

The widespread public opposition to and panic around IVF at the time of Brown’s birth in 1978 was emphasised throughout Gosden and Brown’s conversation. Brown recollected how she had gradually come to realise the extent to which her parents had shielded her from the public controversies and protests that surrounded her birth as the first ‘test-tube baby’. Gosden described social anxieties about the consequences of ‘tampering’ with the ‘natural’ reproductive process and how this permeated the media coverage of IVF pioneers Edwards, Steptoe and Purdy, who were portrayed as ‘crazy scientists’ attempting the absurd.

Patient pioneers

The exhibition also offered a glimpse into the early life of IVF through original research notebooks belonging to IVF laboratories. Some of these contain handwritten clinical data for 282 women from all over the UK who volunteered to participate in hundreds of egg collections across the 1960s and 70s. While the successful birth of Brown was a ground-breaking and celebrated moment in IVF history, Gosden also drew attention to the decade of experimentation that preceded Brown’s birth and the hundreds of women who underwent invasive procedures without getting the baby they intensely wished for.

During the early years of IVF, the treatments offered were hugely unsuccessful and it was not uncommon for clinics to have success rates of zero. Within this context of unlikely success, the fact that women were undergoing procedures that were supported by very limited evidence offered a testament to what they were willing to undertake for a tiny chance of having a baby. These women and men are the IVF pioneers that we do not often hear about, and Gosden highlighted how their commitment and hope laid the foundation for developing safe and effective fertility treatments for future infertility patients.

Most pertinently for me, the evening as a whole offered a unique opportunity to reflect on the current state of IVF in light of the personal life stories of people who were intimately involved in the earliest stages of its development. The strength of the exhibition specifically, lies in how it portrays and gives a voice to the complex embodied experiences of people who have undergone fertility treatment.

Click here to see more articles on IVF from the Science Museum.

ESHRE 2018

By Alina Geampana

On 25th July 2018

In Conferences

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!