O-174 Marginal gains: can small actions in the ART lab improve the environmental impact of medically assisted reproduction?
Authors: Farlie F 
Published: July 2024

Abstract

Marginal gains
can small actions in the ART laboratory improve the environmental impact of medically assisted reproduction? (Invitation)

Study question
Is it possible to reduce the environmental impact of assisted reproductive technology (ART) laboratories while maintaining quality and safety?

Summary answer
While individual interventions may yield modest results, their cumulative effect on a wider scale can lead to substantial reductions in resource consumption and emissions over time without compromising treatment outcomes or patient/staff safety.

What is known already
According to the World Health Organisation (WHO) the change in global climate is one of the gravest threats facing humanity, with pregnant women, new-born and child health considered highly vulnerable. In recent years growing evidence has linked climate change, air pollution, pollutant exposure and microplastics to compromised male and female reproductive health and even spontaneous and in vitro fertilisation (IVF) outcomes.
Ironically, the healthcare industry is a major contributor of greenhouse gas emissions, and the rapidly increasing utilisation of ART has raised concerns regarding its environmental footprint. A field primarily driven by highly specialised, energy-intensive laboratory processes, continuous monitoring of hormone testing, single-use consumables and large amounts of waste; the quest for bringing awareness to sustainable practices within ART laboratories is critical, not just for the planet, but for our patients and future generations.

Study design, size, duration
Alongside a comprehensive review of existing literature, a panel of international professionals and enthusiasts within reproductive medicine, law and environmental science convened in a green conferencing format to discuss key environmental challenges associated with ART and explored potential avenues for enhancing sustainability in the laboratory. A survey and interviews with stakeholders also took place to understand current attitudes and provide real-time social, economic and environmental examples of sustainability in ART laboratories.

Main Results
I will present a roadmap for sustainability in the IVF laboratory so far. A selection of actions which result in marginal gains within the ART laboratory include but are not limited to:
Participate in a ‘green certification’ programme specifically tailored to the IVF laboratory and consider forming a ‘green team’
Aim for energy efficiency, renewable energy, preventive maintenance and consider plug load of non-essential equipment for cost savings.
Consider widening operating ranges for temperature and humidity, air circulation changes and HVAC design where possible for energy savings of 15–30%
Correct waste management can result in &gt; 30% reduction in clinical waste alongside €11,600 annual savings, with focus on prevention of unnecessary consumables (dishes, media), reducing use of plastics and other single-use items to the extent that is possible and safe, and reusing where appropriate (e.g., training vitrification straws).
Adopt electronic platforms for consents/laboratory paperwork; avoiding the use of &gt; 40 pages per cycle in the UK.
Reuse packaging materials (cold gel packs, bubble wrap) or form partnerships with local businesses who can reuse.
Manage inventory carefully, asking for products with longer expiry dates, and consolidate purchase order to minimise frequency.
Minimise liquid nitrogen loss during routine activities and consider batching samples for cryo-transport to minimise frequency of shipments.

Limitations
Every country, region and laboratory is different and will have their own myriad of regulatory constraints and industry standards to adhere to. This may present barriers to the adoption of certain sustainability measures in ART laboratories and is therefore imperative to seek local guidance first.

Wider implications of the findings
The carbon footprint of ART extends beyond the laboratory and into the supply chain, encompassing transportation, pharmaceutical production, and waste disposal processes. In this way a holistic approach is necessary, with the need for partnerships between fertility clinics, manufacturers, and regulatory bodies continuously working together to drive the development and adoption of sustainable practices and technologies across the entire ART field.