Nigeria: Bridge Clinic Series - Role of Technology in Fertility Care

19 September 2024

Oladimeji Ajayi

Since ancient times, there has been a strong connection between medicine and technology with some notable advancements and innovations that paved the way for future developments.

Ancient cultures developed medicinal herbal remedies, which involved processing and preparing plant extracts using primitive technologies. Ancient civilizations also recorded medical knowledge in written texts, like the Edwin Smith Papyrus (circa 1600 BCE) and the Hippocratic Corpus (circa 400 BCE), which facilitated knowledge sharing and advancement.

Ancient civilizations in Egypt, China, India, Africa, Greece, Meso-America and Rome also developed simple medical instruments including scalpels, forceps, and scissors, which were often made from copper, bronze, obsidian, or iron.

Animal bones and antlers were used to make instruments like needles, awls, and surgical needles while ivory was used to make delicate instruments like surgical knives and scalpels

Wooden instruments like splints, probes, and applicators were used for various medical procedures and gold and silver were used to make decorative and ceremonial surgical instruments, as well as those used for special procedures like trephining (a form of skull surgery).

These materials were often used in conjunction with other substances like leather, cord, or wood to create functional and durable surgical instruments.

Ancient surgeons developed techniques like trephining and laparotomy (abdominal surgery), which required basic technological advancements. Ancient Egyptians and Greeks also developed simple prosthetic devices and orthotic appliances to aid mobility and function and in Central America Mayan and Aztec healers in the Pre-Columbian era developed surgical techniques, including skull surgery and dental implants.

Notable medical practitioners who developed technological advancements in ancient civilizations include Galen, the Greek philosopher and physician, (129-216 AD) who developed forceps and scalpels as surgical instruments and improved surgical techniques.

Ibn Sina (Avicenna) [980-1037 AD] the Persian polymath invented the surgical needle while the Chinese Hua Tuo (110-207 AD) developed the first general anesthetic and performed surgical operations and Sun Simiao (581-682 AD) wrote extensively on medicine, including the use of acupuncture and herbal remedies.

In Africa, Imhotep (2600 BCE), an Egyptian polymath, developed surgical instruments and techniques, and wrote medical texts and Amenhotep (1500 BCE) an Egyptian physician developed a surgical procedure for cataracts.

In India, Sushruta (600 BCE) wrote the "Sushruta Samhita," which focused on surgery and described procedures like cataract surgery and caesarean sections and Charaka (400 CE) authored the "Charaka Samhita," a foundational text on Ayurvedic medicine that described the use of herbs, minerals, and other substances for treatment.

While ancient medicine was relatively primitive compared to modern standards, these early innovations demonstrate the beginnings of a connection between medicine and technology that has continued to evolve over time.

Today, medical practitioners are heavily reliant on the application of current technology which permeates all aspects of medicine.

Examples of this connection between technological advancements and the practice of medicine in modern times include the development of Electronic Health Records (EHRs) which digitalize patient data, streamlining access and management.

Virtual consultations and remote monitoring via telemedicine expand access to healthcare, and advanced MRI, CT, and PET scans enable earlier disease detection.

Robotic surgery enables precise surgical procedures with reduced recovery time; Artificial Intelligence (AI) assists in diagnosis, drug discovery, and personalized treatment plans; and cloud computing provides secure data storage and analysis which facilitates collaborative research.

In addition, 3D Printing creates custom prosthetics, implants, and surgical models; gene editing enables precise genetic modifications; and Nanotechnology enables targeted drug delivery

Point-of-care testing devices for rapid disease diagnosis and wearable devices which track vital signs, activity, and health metrics have also been developed.

These technological advancements have transformed the healthcare landscape, enhancing patient care, streamlining clinical workflows, and driving medical innovation.

In fertility clinics, technology and Assisted Reproductive Technology (ART) have a deeply intertwined relationship, with technological developments driving innovation and advancements in ART.

Technology provides the tools and platforms for ART procedures such as IVF, ICSI, and PGD; enhances precision and accuracy in ART procedures, like embryo selection and genetic testing; and enables increased efficiency by streamlining laboratory workflows, reducing time and costs.

Technology enables remote monitoring, telehealth and personalized care, providing an enhanced patient experience by improving patient engagement as well as expanding access to ART services, making them more widely available and affordable..

Technology provides valuable data and analytics to improve ART outcomes, predict success rates, and identify trends; and drives innovation in ART, enabling new techniques like gene editing and stem cell therapies.

The use of certain technologies, however, such as genetic selection and gene editing can raise serious ethical concerns requiring careful consideration and regulation.

This synergy between technology and ART has transformed the field of reproductive medicine, improving outcomes and expanding possibilities for people seeking to build their own families.

It is evident that technology plays a crucial role in ART, enabling various procedures that help individuals and couples conceive. Some key technological advancements in ART include: In Vitro Fertilization (IVF) where eggs are fertilized outside the body, and the resulting embryos are transferred to the uterus; Intracytoplasmic Sperm Injection (ICSI), in which a single sperm is injected into an egg to fertilize it; and Preimplantation Genetic Testing (PGT) in which embryos are tested for genetic disorders or chromosomal abnormalities.

Improved nutrients and environments support healthier embryo development and cryopreservation techniques allow for preservation of eggs and embryos for future use.

AI-assisted embryo selection and prediction models optimize IVF outcomes and robotic-assisted reproductive surgery enables minimally invasive procedures, and improves accuracy and recovery in surgeries like tubal ligation reversal.

These technological advancements in ART have significantly improved success rates, reduced complications, and expanded access to reproductive care, offering hope to individuals and couples hoping to start their families.

Bridge Clinic integrates various advanced technologies into IVF to enhance treatment outcomes for couples.

Bridge Clinic employs PGT which involves genetic screening of embryos prior to implantation and ensures only healthy embryos are used, lowering the risk of genetic disorders.

Vitrification technology is used at Bridge Clinic for the cryopreservation of eggs, sperm, and embryos, maintaining high survival rates upon thawing. This method is recommended for clients who are scheduled for cancer treatment or clients who for other reasons want to postpone having chilldren.

Bridge clinic utilizes an advanced but user-friendly medical record system. This houses the records of clients with a seamless financial element that allows payment gateway integration, data integrity and synchronization with our Customer Relationship Management System (CRM). All activities are automated to allow for a seamless engagement with our ever-increasing database.

Our financial software, ERP next, helps track all our revenue transactions making payment easy for our clients and reconciliation almost unnecessary.

Bridge Clinic utilizes specialized media that mimics the natural conditions of the human body and supports better embryo development.

By leveraging these advanced technologies, Bridge Clinic aims to boost the effectiveness and efficiency of their IVF treatments, offering patients a greater chance of achieving a successful pregnancy as well as connecting with them emotionally throughout their treatment journey.

Over the past 50 years, since Drs. Edwards and Steptoe's ground-breaking in-vitro fertilization techniques resulted in the birth of the world's first 'test tube' baby in 1978, ART practitioners have employed several emerging technologies, particularly from the field of computing, to improve service delivery. In the near future these technologies will include enhanced artificial intelligence algorithms which will be used for embryo selection, predictive analytics, and personalized treatment plans.

Quantum computing will enable high-speed processing for complex data analysis, simulations, and predictive modeling in reproductive medicine. Machine Learning (ML) models will improve IVF outcomes, detect anomalies, and optimize laboratory protocols while advanced robotic systems will ensure precise embryo handling, injection, and sorting.

Precise genetic modifications using CRISPR/Cas9 and other technologies will prevent inherited disorders; regenerative medicine utilising stem cell therapies will be deployed for reproductive tissue engineering and repair; advanced genomics and proteomics will permit individual cell analysis and personalized treatment; and nanotechnology will make targeted drug delivery possible.

Through 3D printing and biofabrication, the creation of artificial gametes, reproductive organs, and personalized prosthetics will be possible and wearable devices will facilitate remote monitoring, AI-powered fertility tracking, and virtual consultations.

These emerging technologies will transform the field of ART, improve outcomes, reduce costs, and enhance patient experiences.

*Oladimeji Ajayi is Head of Technology, Bridge Clinic.

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