Center of Continuing Education and Lifelong Learning
National and Kapodistrian University of Athens

Course Presentation

#Aim

The “Advanced Clinical Embryology” (ACE) Course is an Online International Postgraduate Course of Continuing Vocational Education and Professional Development in Clinical Embryology. The ACE Course is dedicated to the scientific discipline of Clinical Embryology and respective practices, aligned with the core principles of Personalized and Precision Medicine.


The aim of the ACE Course is to provide insight into the advanced cognitive objects of Clinical Embryology and Biology of Human Reproduction. Its innovative educational framework is designed to foster critical thinking, strengthen participants’ academic background, and promote an integrated comprehension of state-of-the-art scientific and technological advancements in the field.


Covering the full spectrum of Clinical Embryology and Reproductive Biology, the curriculum encompasses topics ranging from the optimal operation of embryology and andrology laboratories and the methodology employed for quality control, to the current and novel approaches on embryo culture and evaluation of the embryo’s competency. Through this holistic approach, this course covers the A to Z of Clinical Embryology and Biology or Reproduction Practices from theory to practical aspects.



#Teaching Modules

Submodules

1.1 Female Reproductive System: Physiology and Oogenesis. To be confirmed

1.2 Female Infertility: Aetiology and management strategies. Ippokratis Sarris

1.3 Male Reproductive System: Physiology and Spermatogenesis. Francesco Lotti 

1.4 Evaluation and management of male infertility. Theodora Stasinou

1.5 Ovarian stimulation in the era of personalized and precision medicine. Theodoros Kalampokas

1.6 Diminished ovarian reserve from bench to bedside. Panagiotis Drakopoulos

1.7 Embryo and Endometrium: A complex relationship. Irene Souter

1.8 Embryo Transfer: Evidence based clinical practice. Nikos Christoforidis

1.9 Recurrent Miscarriage and Recurrent Implantation Failure: How far have we come? Petros Drakakis

1.10 The role of Nutrition and Metabolic Factors on Human Reproduction and MAR. Chavarro Jorge

Submodules

2.1 Organization and management on setting up an Assisted Reproduction Unit. Despina Tzanakaki 

2.2 Organization, management, and standard operating procedures (SOPs) for the Embryology Laboratory. Giles Palmer

2.3 Organization, management, and standard operating procedures (SOPs) for the Andrology Laboratory. Evangelini Evgeni

2.4 Organization, management, and standard operating procedures (SOPs) for Cryopreservation Banks. Alexia Chatziparasidou

2.5 Quality control and crisis management in the IVF Laboratory. Chelsey Leisinger

2.6 Inspecting an IVF Laboratory. Gerry Celia

2.7 Data, data, data. The past, present and future of data management in IVF. Jaques Cohen

2.8 Designing a patient-centered MAR Unit. To be confirmed

Submodules

3.1 Standardized semen analysis: Lessons for Novice and Experts. To be confirmed

3.2 Sperm morphology assessment by strict criteria. To be confirmed

3.3 Semen analysis: Ancillary tests. George Liperis

3.4 Automated analysis of sperm diagnostics and selection for therapeutics: CASA and Beyond. Meurig Gallagher

3.5 Optimal management of ejaculate and non-ejaculate originating spermatozoa for MAR purposes. Michael Carroll

3.6 Sperm preparation techniques for diagnostic and MAR purposes. To be confirmed

3.7 Advanced semen tests. Dolores Lamb

3.8 Contributions of the Male Gamete to the Embryo and Offspring. Dolores Lamb

3.9 Latest research in andrology. Ralf Henkel

Submodules

4.1 How understanding basic cryobiology can help us improve outcomes. Kimball O. Pomeroy 

4.2 Safety in human reproductive cell cryopreservation. Lodovico Parmegiani

4.3 Cryostorage safety: validation, quality control and best practices. Kimball O. Pomeroy 

4.4 Factors affecting vitrification success. Kimball O. Pomeroy

4.5 Oocyte and Embryo cryopreservation. Laura Rienzi

4.6 Frozen Embryo Transfer: Optimizing the Outcome. Eman Elgindy

4.7 Restoration of function following ovarian tissue cryopreservation: In vivo and in vitro outcomes. David Albertini

4.8 Testicular tissue cryopreservation: Where are we today? Elena Kontogianni

Submodules

5.1 Insemination methods an Overview of IUI, IVF, ICSI and specialized equipment. Jackson Kirkman-Brown 

5.2 Micromanipulation in the era of Individualized Medicine: how to select the best sperm for ICSI Lodovico Parmegiani

5.3 Intracytoplasmic Sperm Injection (ICSI): Technique and technical aspects. Mina Alikani

5.4 Evaluation of insemination outcomes. Nikica Zaninovic

5.5 ICSI for All? Mina Alikani

5.6 How to select the best insemination method: Evidence Based Clinical Practice. Gemma Arroyo

5.7 Managing cases of extreme low oocyte yield: Which is the best insemination option? To be confirmed

5.8 Artificial oocyte activation: From basic research to clinical practice. Karl Swann

5.9 Understanding the oocyte and decoding its competence. Federica Franciosi

Submodules

6.1 Physiology and development of the preimplantation embryo. Mara Simopoulou

6.2 The pyramid of successful implantation. Laura Rienzi

6.3 Metabolism of the preimplantation embryo. Roger Sturmey

6.4 Culture media in IVF. Dean Morbeck

6.5 Embryo culture incubators. Jason E. Swain

6.6 Time-lapse imaging technology in the IVF laboratory. Marcos Meseguer 

6.7 The epigenetics of blastocyst culture. Alan Handyside

6.8 Embryo Culture: Past, present and future. David Gardner

Submodules

7.1 Embryo selection. David Gardner

7.2 The making of the blastocyst. Giovanni Coticchio

7.3 Novel approaches in oocyte and preimplantation embryo evaluation and automation in MAR. Alejandro Chavez-Badiola

7.4 Embryo identification. Irene Dimitriadis

7.5 Non-invasive selection of embryo viability: The value of the embryo’s metabolic blueprint. Denny Sakkas 

7.6 Artificial intelligence in the IVF laboratory. Charles Bormann

7.7 Morphokinetic evaluation of the preimplantation embryo: What is there to gain? Eros Nikitos

Submodules

8.1 Genetic profile, analysis of the preimplantation embryo and novel approaches. Dagan Wells

8.2 Tips and tricks for optimizing micromanipulations during biopsy for PGT. Debbie Venier

8.3 Preimplantation Genetic Testing for Structural Rearrangements (PGT-SR). Darren Griffin

8.4 Preimplantation Genetic Testing for Monogenic Disorders (PGT-M). Joanne Traeger-Synodinos

8.5 Preimplantation genetic testing for aneuploidy (PGT-A): Benefits, risks and it’s true place in MAR.  Eric Forman

8.6 Embryo ploidy status and implantation: A conundrum. Danilo Cimadomo

8.7 Physiology of the preimplantation embryo post biopsy and vitrification. Aikaterini Chatzimeletiou

8.8 Chromosomal mosaicism: Origins and clinical implications. To be confirmed

8.9 Non-Invasive Preimplantation Genetic Testing. Gary Harton

Submodules

9.1 The strategic role of the clinical embryologist as a Scientist and Innovator. Jared Robins

9.2 Novel promising concepts in clinical embryology research. Ioannis Sfontouris

9.3 Novel experimental approaches in addressing Ovarian Insufficiency. Sonia Herraiz

9.4 Novel experimental approaches: Mitochondrial Replacement Therapy. Nuno Costa-Borges

9.5 The Bioethicist's perspective on novel approaches and Add-ons offered in Assisted Reproduction. Heidi Mertes

9.6 The Clinical Psychologist’s perspective on novel approaches and Add-ons offered in Assisted Reproduction. Mariana Veloso Martins

9.7 Introducing new technology into the IVF lab: Past and Future. Joyce Harper

9.8 Advanced Maternal Age: Challenges and Solutions. Martha Luna

9.9 Novel approaches for studying early embryo-maternal interface. To be confirmed

9.10 Digital transformation of the IVF unit. Achilleas Papatheodorou

9.11 Concerns and Considerations in IVF practices. David Albertini                        

Submodules

10.1 The evolution of research in female reproduction: Milestones and future goals. George Mastorakos

10.2 Type of studies in research. Theodoros Sergentanis

10.3 Research and statistics. Kimball Pomeroy 

10.4 Basic statistical principles for practicing physicians and embryologists. Theodoros Sergentanis

10.5 The value of Systematic Reviews and Meta-Analyses in MAR. Efstratios Kolibianakis

10.6 Evidence Based Medicine. Charalampos Siristatidis

10.7 Evidence Based Clinical Embryology: it is not that simple. Jaques Cohen

10.8 IVF add-ons: Proper Research Methodology and Execution. Mara Simopoulou

Submodules

11.1 Critical analysis skills assessment

11.2 Round Table I ‘’Do's and Dont's of How to Successfully Run an IVF Laboratory’’

11.3 Round Table II ‘’Outliers: handling unusual events in the IVF laboratory’’

Moderator: Gerry Celia

Andrology-The challenge of handling different specimens. Liesl Nel-Themaat

Handling unusual patients-Things to watch out. Bryan Kloos  

Oocyte freezing and thawing: What to watch out for. Wayne Caswell

Culture conditions-blastocyst problems: What do we need to know. Arthur Chang

PGT-A: The perspective and responsibility of the geneticist. Gary Harton

11.4 Round Table III “The JARG’s Round Table: Insights in publishing in Reproductive Medicine”

Moderator: David Albertini

The Editor’s perspective: A view from the top 2 decades of change and where we are going. David Albertini

What are the characteristics of a publishable manuscript. Pierre Comizzoli

From the trenches: Managing the process of reviewing. Arthur Chang

From data analysis to clinical relevance. Alex Quass

11.5 Round Table IV “Training Management and Development in Clinical Embryology"

Moderator:Giles Palmer

Training and Management. Giles Palmer

Staff Recruitment /Worldwide Embryologists Status. Joe Conaghan

Responsibilities/Occupational Demands. Kathryn Go

Conflict resolution. Andrew Thompson

Continuing professional development and how to navigate your career as a Clinical Embryologist. Julia Holland

Wellbeing and Burn-out in the IVF Laboratory. Shaista Sadruddin



#Learning Outcomes

Knowledge

Following completion of the ACE Course participants should be able to define and clearly describe:

1. Recall the fundamental principles of the physiology and pathophysiology of the reproductive system 

2. Summarize the causes of infertility and present contemporary methods and strategies for its management 

3. Evaluate different methods and approaches to ovarian stimulation within the framework of personalized medicine 

4. Outline the principles of embryo transfer, with emphasis on the complex interaction between the embryo and the endometrium

5. Describe recent advances in the diagnosis and management of complex clinical cases, including diminished ovarian reserve, recurrent miscarriage, and recurrent implantation failure 

6. Outline the protocols for the organization and management of medically assisted reproduction units, including embryology and andrology laboratories, cryopreservation facilities, and preimplantation genetic testing laboratories 

7. Outline the principles of quality control and quality assurance, as well as crisis management strategies, within the IVF laboratory environment 

8. Define the criteria assessed during inspection procedures in medically assisted reproduction units 

9. Evaluate key performance indicators and apply effective data management strategies in the design of patient-centered medically assisted reproduction units 

10. Define the laboratory methods employed in semen analysis and the evaluation of semen quality for diagnostic and clinical purposes 

11. Evaluate different sperm preparation methods and strategies for the management of ejaculated and surgically retrieved spermatozoa in the era of personalized medicine 

12. Compare conventional and advanced methods for sperm diagnostics and selection for therapeutic applications in IVF 

13. Outline the role of the male gamete in embryo development and offspring health 

14. Outline the principles of cryobiology, cryostorage safety, quality control, and best practices in cryopreservation 

15. Define the factors affecting vitrification success, evaluate strategies for optimizing frozen embryo transfer outcomes, and assess methods for enhancing clinical efficiency 

16. Describe novel techniques and approaches in gamete and embryo cryopreservation, as well as testicular and ovarian tissue preservation 

17. Compare different insemination methods and apply criteria for selecting the optimal insemination strategy in the era of personalized and precision medicine 

18. Outline available methods, approaches, and strategies for improving insemination outcomes 

19. Evaluate the clinical validity of novel approaches for managing complex cases associated with insemination failure 

20. Recall the principles of preimplantation embryo physiology and outline the factors contributing to successful implantation 

21. Outline the influence of culture media on embryo metabolism and development 

22. Compare different types of culture media, as well as various methods and approaches to embryo culture 

23. Evaluate the advantages and disadvantages of different incubator systems used in modern IVF laboratories 

24. Apply strategies for improving embryo culture conditions 

25. Compare different methods, strategies, and approaches for embryo quality assessment 

26. Outline the advantages and limitations of novel approaches in gamete and preimplantation embryo evaluation in the era of automation and artificial intelligence 

27. Recall the principles and applications of preimplantation genetic testing within the context of personalized medicine 

28. Apply strategies for improving micromanipulation techniques during embryo biopsy 

29. Apply current guidelines and recommendations for best practices in preimplantation genetic testing 

30. Outline the relationship between embryo ploidy status and implantation potential 

31. Compare conventional and advanced methods of preimplantation genetic testing, with emphasis on analytical reliability and their impact on embryo developmental potential 

32. Outline emerging concepts and experimental approaches in medically assisted reproduction 

33. Explain the implementation of innovative experimental therapeutic approaches currently at the forefront of research in medically assisted reproduction 

34. Outline the importance of bioethics and clinical psychology in both research and clinical practice in medically assisted reproduction 

35. Outline the core principles of research methodology and evidence-based medicine 

36. Compare different study designs and define fundamental statistical concepts in medical research 

37. Apply methods for the analysis and interpretation of statistical data and develop skills in scientific writing and peer review 

38. Outline the challenges associated with integrating evidence-based practices into clinical embryology 

39. Outline the importance of clinical experience-based learning in the management of complex clinical cases and the optimization of laboratory practices and applied techniques 

40. Define the principles of staff recruitment, conflict resolution, professional responsibility, wellbeing, and burnout management within the IVF laboratory environment


Skills (Psychomotor)

Following the completion of the Course participants should be able to:

1. Correlate complex underlying causes of infertility with appropriate management approaches and apply established management protocols in medically assisted reproduction 

2. Organize, manage, monitor, and optimize the quality and reliability of services through quality control and quality assurance procedures within clinical embryology and andrology laboratories, as well as cryopreservation facilities 

3. Describe and select optimal protocols for the analysis and preparation of semen samples within the framework of personalized medicine 

4. Describe and select optimal cryopreservation protocols for gametes, embryos, ovarian tissue, and testicular tissue in order to optimize clinical outcomes 

5. Evaluate, select, and optimize insemination methods according to the specific requirements of each clinical case and the underlying causes of infertility, in accordance with the principles of personalized and precision medicine 

6. Select and optimize embryo culture conditions by applying appropriate protocols based on available laboratory equipment and the specific requirements of each clinical case 

7. Describe and select methods for evaluating the quality and developmental potential of preimplantation embryos according to current evidence and published guidelines 

8. Critically assess the strengths and limitations of emerging technologies, including artificial intelligence for embryo selection 

9. Determine indications for preimplantation genetic testing 

10. Evaluate and select the optimal preimplantation genetic testing strategy based on the specific characteristics of each clinical case and current clinical guidelines 

11. Recall the principles underlying the application of advanced methods in preimplantation genetic testing, with emphasis on their advantages and limitations 

12. Assess the potential impact of biopsy protocols on preimplantation embryo development and dynamics 

13. Highlight the significance of genetic profiling of the preimplantation embryo and evaluate the clinical implications of mosaicism in the context of preimplantation genetic testing application 

14. Critically assess innovative and experimental approaches emerging in the field of medically assisted reproduction 

15. Accurately interpret research data, evaluate the validity of scientific studies, optimize clinical practice through evidence-based medicine 

16. Apply the fundamental principles of research protocol design, and critically analyze the role of adjunctive interventions (addons) in clinical practice

Abilities (Social/Emotional)

Following the completion of the Course participants should be able to:

1. Critically examine and communicate fundamental and advanced concepts across the broad spectrum of medically assisted reproduction and IVF practice, while evaluating the clinical validity of emerging strategies and experimental approaches 

2. Apply the principles of personalized medicine, precision medicine, and evidence-based medicine in contemporary clinical practice 

3. Develop advanced interpersonal, cross-cultural communication, organizational, and management skills applicable to clinical practice 

4. Enhance emotional intelligence and empathy, particularly in relation to patient-centered care, multidisciplinary team dynamics, and bioethical considerations, while addressing ethical dilemmas arising in daily clinical practice and research 

5. Strengthen leadership, adaptability, and conflict-resolution skills in demanding clinical environments, while maintaining a balance between scientific rigor, compassion, and patient-centered care

#Educational Process

TThe “Advanced Clinical Embryology (ACE) Course” is an online, distance learning Course conducted on an annual basis with a total duration of 12 months, commencing in early October and concluded at the end of September of the following year.


The official language of the ACE Course is English.

Online live lectures take place every Wednesday starting at 17:00 p.m. EET [Eastern European Time, Athens, Greece]. Lectures are provided via the Zoom platform. A day prior to each lecture participants receive the link for the Zoom meeting. It should be noted that access to the meeting is only available for those who have successfully completed the registration to the Course.


The ACE Course features a hybrid (mixed) form, enabling both synchronous and asynchronous education. This means that there is access to the recorded lectures and additional educational material on the online learning platform (e-class).


Following completion of registration, each participant also receives a unique personalized username and password in order to be able to sign in on the online learning platform (e-class) platform. Via the e-class platform participants have access to the entirety of the educational material. 


The curriculum provides:


•    Full coverage on the subject of Clinical Embryology and Biology of Human Reproduction


•  11 Teaching Modules and “Clinical Experience Based Learning” focusing on issues of paramount importance during the complex daily routine in medically assisted reproduction units


•    Education provided by world-wide leaders in Clinical Embryology and Assisted Reproduction and globally acknowledged instructors


For the successful completion of the ACE Course participants should:


1. Pass two online written exams in the format of multiple-choice questions (MCQs)

The first examination takes place upon completion of the 5th Teaching Module, while the second examination takes place upon completion of the 11th Teaching Module. Each online examination session includes 50 MCQs, with a total duration of 70 minutes. In order to successfully complete and pass each examination session, participants are required to achieve a minimum score of 50%.


2. Pass a Critical Analysis Skills Assessment

Following the completion of the 10th Teaching Module, participants answer a series of three open-ended questions (marking scheme: pass mark 50%; merit 60–79%; distinction ≥ 80%).


Successful completion of the ACE Course will lead to the award of a Certificate of Specialized Training in “Advanced Clinical Embryology” awarded by the Medical School as well as by the Center of Continuing Education and Lifelong Learning of the National and Kapodistrian University of Athens.

Educational Process