A Great Grey Rhino in the Room: The Human Capital Conundrum in ART
In the USA, the IVF industry is experiencing a pressing problem. An estimated 5% of the existing embryology workforce is beyond retirement age (65-67 years old) and an additional 20-40% will reach retirement age within the next 7 years.  Clinical laboratories are feeling the impact of the aging workforce, as experienced professionals who had delayed retirement due to economic uncertainties are now retiring, or planning to retire in the next five years, in great numbers. For the 17 laboratory departments identified in the 2016-2017 ASCP vacancy survey, the average expected five-year overall retirement rate for all departments was 19.4%.
This brain drain will have immense consequences for IVF labs and patient care.
Embryologists are the core of the IVF supply chain, and a shocking “grey” rhino (an obvious yet ignored threat) has entered the room. You can listen to my discussion with Griffin Jones at Fertility Bridge on this subject.
By all predictions, the IVF industry is on track to grow exponentially over the next ten years driven by millennials who have put off childbearing for career as they begin to seek age-related infertility care, as well as LGBTQ+ family friendly policies, rising infertility rates, and the availability of genetic testing.
The question looms – How do we attract new embryologists to the field, ensure a high level of training to advance our profession, and meet the needs of the individuals who need IVF? Every day I field at least one email from a junior embryologist struggling in their career path, due to haphazard training progressions and lack of mentorship and skill- building training.
Just think of the IVF lab directors and embryologists you know. If they are in their late 50’s or early 60’s, they will probably retire in the next 5+ years. Many of them likely direct numerous “offsite” laboratories, which means that the impact from each retirement will be exponential. Are enough new HCLD certificates being granted to ensure that IVF labs can continue to function at the highest level of quality and patient care within the reality of a looming tsunami of retirements?
In the USA, there are only a few “embryologist” education, training, or placement programs. The bulk of new embryologist training falls on senior embryologists. However, embryology is a profession that is characterized by skills and knowledge, acquired through prolonged courses of study and advanced specialized intellectual instruction.
As a result of the current human capital conundrum, it has become critical that IVF clinics ensure knowledge transfer, retention, and upskilling. Campbell et al. note that “Knowledge sharing is vital among an IVF laboratory team to build on the knowledge base and enable succession and development. Clinical case review, journal-based learning, and research opportunities all facilitate such sharing and knowledge building.” Many embryologists are struggling to simply complete the clinical laboratory work of the day and they are experiencing “burnout” in record numbers. They may not be able to reach these lofty ideals, as well as train and supervise junior team members without additional support, particularly for the clinical workload. Advanced technologies, such as artificial intelligence, promise to ease stress and burnout by shouldering some of the highly repetitive and mundane tasks, freeing up time and energy to commit to the important work of mentorship and training.
One possible path for the embryology field could be a standardized, digital education, training and competency management platform , such as Choucair et al  proposed, including; “A robust roadmap to modernize knowledge transfer that includes multiple digital methods; online self-assessment programs, digital technology integration through blogs, podcasts, and influential videos, an online platform education management platform to report training logbooks, including a knowledge assessment passport,” among other items.
“Digital first” training and education could help to attract Gen Y and Z, and it is the natural progression following the recent pandemic. These generations, are the most diverse and educated in history, highly collaborative digital natives, and want to feel that they are doing mission driven work. Setting up immersive virtual reality environments with real -world simulations, with highly engaging and personalized training, as well as the ability to prioritize skills and on – the job training with real-life apprenticeship opportunities might grab the attention of students looking to make an impact on society and the world.
What else do you think will need to change to attract and nurture the next generation of IVF lab leaders and scientists to the embryology profession?
- Edna C. Garcia, M., M. Iman Kundu, and P. and Melissa A. Kelly, Clinical Laboratory Workforce: Understanding the Challenges to Meeting Current and Future Needs. 2021.
- Campbell, A., et al., The in vitro fertilization laboratory: teamwork and teaming. Fertil Steril, 2022. 117(1): p. 27-32.
- Curchoe CL, Bormann C, Hammond E, Salter S, Timlin C, Williams LB, Gilboa D, Seidman D, Campbell A, Morbeck D. Assuring quality in assisted reproduction laboratories: assessing the performance of ART Compass – a digital art staff management platform. J Assist Reprod Genet. 2023 Jan 13. doi: 10.1007/s10815-023-02713-2. Epub ahead of print. PMID: 36637586.
- Choucair, F., N. Younis, and A. Hourani, The value of the modern embryologist to a successful IVF system: revisiting an age-old question. Middle East Fertility Society Journal, 2021. 26(1): p. 15.