IVF is Special, But It's Not Different

My pre-ASRM notes on Innovation in Reproductive Medicine

The editors of Reproductive Biomedicine Online asked me to write a piece on what IVF will look like 25 years from now.

I’m about 2900 words away from the 3000 they asked me to submit, but with the ASRM conference starting this week, I want to share my thinking.

IVF is special, but it’s not different.

Humans have been around in our present form for about 3000 centuries, but it’s only been for the most recent three or four that we have built scalable technology to solve common problems globally.

We trudged along for 299,600 years, using human and animal muscle power for most of the world’s energy needs. We grew our food on an as-needed basis, built and rebuilt our homes with whatever basic materials we could forage, shared thoughts and ideas mainly with the people within earshot, and traveled only as far as we could walk.

Fast forward to the 1600’s and beyond. We discover or invent electricity, inorganic chemistry, air flight, agricultural engineering, stainless steel, Portland cement, eyeglass lenses, semiconductors and transistors, refrigeration and air conditioning, and with each discovery we make a subpopulation of the world’s lives better.

And then the magic happens. We apply the technology playbook of standardization and automation to enable scale -- which makes an enormous percentage of the world’s lives better.

We tackle hunger, shelter, the need for intellectual and human connection. We unlock the potential of education and travel, and we scale these benefits to the world. And with each problem addressed, we have a more sophisticated tool kit with which to tackle the problems that remain.

Problems like infertility, recurrent pregnancy loss, genetic disease transmission, damage to fertility from life-saving treatments for cancer and inflammatory disease and the family building needs of our LGBTQ family and neighbors.

We’ve taken our knowledge of cell biology, microscopy, protein chemistry and pharmacology, and ultrasound scanning, combined with improvements in communication and travel and created twelve million babies that world could not have created during our first 299,055 years.

And now it’s time to scale.

IVF is modern, but not “tech modern.”

IVF is a propeller plane that can cross the Atlantic, a television with rabbit ear antennas, a standalone computer connected to a dot matrix printer, vaccines made from serum of infected patients, small molecule drugs extracted from tree bark, food refrigerated in an icebox that was literally a metal box with a big block of ice. Each of these seemingly primitive techniques made many peoples’ lives better.

These were spectacular advances in solving basic human need.

And each was a step towards meeting the challenge of scaling better-ness to everyone else.

So IVF in 25 years?

Better answers. We will engineer away the concept of “unexplained infertility.” Total geographic access. IVF comes to you, wherever you are. No needles. Eggs, sperm, and embryos will travel. Patients won’t have to. True big data (as opposed to the mini-big data we have now) -- the sum of hundreds of millions of IVF cycles, each of which measures and analyses thousands of micro-process measurements, yielding both a constant process improvement and greater understanding of human reproduction and human health.

And at some point, an IVF that is so different we don’t call it IVF at all.

I’ll be in Denver from Thursday night until early Wednesday morning. My drinks are espresso and bourbon neat. I'm buying. See you there!