NATIONAL AND KAPODISTRIAN UNIVERSITY OF ATHENS
ΗΜΕΡΟΜΗΝΙΑ ΥΠΟΒΟΛΗΣ ΑΙΤΗΣΕΩΝ ΕΩΣ 17/9/2024
Responsible:
Mara Simopoulou B.Sc.,M.Sc.,Ph.D
Associate Professor of Physiology-Embryology
Sr. Clinical Embryologist/Geneticist
School of Medicine
National & Kapodistrian University of Athens
"Clinical Embryology and Preimplantation Embryo Genetics"
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What is the subject of the new specialization of the MSc?
''Clinical Embryology'' is a field of Biomedical Sciences that studies the physiology of gametes, as well as the formation and development of the human preimplantantion embryo. In the Clinical Embryology Laboratory, in vitro fertilization is conducted and embryos are created in the context of IVF.
The aggressive designation ''Clinical'' separates this scientific field from the general basic research disciplines of ''Embryology-Histology'' and ''Developmental Biology'', as it deepens the embodiment of basic research knowledge in Clinical Practice in the context of Medically Assisted Reproduction. It is therefore one of the most characteristic examples of Translational Research in modern Biomedical Sciences.
In particular, the Clinical Embryology Laboratory is undoubtedly the 'heart' of modern Medically Assisted Reproduction Units, as a series of specialized procedures are conducted there with the main objective of evaluating the quality and dynamic of gametes (oocytes and spermatozoa), performing in vitro fertilization and ensuring the proper development and thorough evaluation of the potential and implantation capacity of embryos.
To summarize , Clinical Embryology is defined as the clinical and laboratory science that studies the physiology of gametes, as well as the creation and development of the human embryo up to the pre-implantation stage. The protagonist of this new major of the MSc 'Molecular and Applied Physiology' is therefore the preimplantation embryo.
By looking further into the preimplantation embryo, this new focus of the MSc includes the study of 'Genetics of the Preimplantation Embryo'. In addition to 'Clinical Embryology', which focuses on the study of the Physiology and Developmental Biology of the preimplantation embryo, the field of 'Genetics of the Preimplantation Embryo' focuses on the study of the complex chromosomal and gene composition of the incipient human life. Together with Prenatal and Postnatal Testing, it is an integral part of Medical Genetics and Human Genetics and more specifically, ''Preimplantation Genetic Testing'' is the most modern and perhaps the most rapidly evolving field of Medical Genetics. ''Preimplantation Genetic Testing'' is applied to evaluate the genetic and chromosomal profile of the embryo in order to avoid the inheritance of genetic syndromes and diseases, as well as to evaluate the quality and growth dynamic of embryos in order to improve the success rates of IVF.
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What are the objectives of the new PMS qualification?
The MSc ''Molecular and Applied Physiology'' is the first and only postgraduate program in Greece and one of the few postgraduate programs in Europe that provides specialized and holistic training at theoretical and practical level in the fields of Clinical Embryology and Preimplantation Embryo Genetics together.
The aim of this new major is to provide specialised training and education to Life Scientists who wish to work in Clinical Embryology and Preimplantation Embryology and Genetics at both research and clinical-laboratory level, ensuring that they are equipped with all the necessary skills to carry out autonomous research and clinical work.
The curriculum of the new major is designed to provide trainees with an in-depth understanding of these scientific areas, in a context of providing knowledge directly applicable to day-to-day clinical and laboratory practice, which significantly strengthens their professional careers in this field.
Particular emphasis is placed in understanding the physiology of the preimplantation embryo from the molecular to the cellular level, in vitro fertilisation methods, in vitro culture systems for embryos and gametes, methods of assessing the quality and growth dynamics of embryos, methods of cryopreservation of embryos and gametes, and methods of biopsy and genetic analysis at the preimplantation stage of development. The study of the above will be carried out with emphasis on the most advanced state-of-the-art techniques and methodologies applied internationally in the most up-to-date clinical embryology laboratories in the world, always following the standards of precision and individualized medicine and in accordance with the requirements of evidence based medicine (EBM).
In addition, the aims of the major include the detailed and in-depth understanding of the Principles of Operation and the Standards of Organization and Quality Control of the Clinical Embryology, Preimplantation Genetic Diagnosis and Cryopreservation Laboratories in accordance with the International Regulations to ensure the proper operation of the Laboratories of Medically Assisted Reproduction Units. This knowledge will help significantly in the immediate adaptation and harmonization of the trainees in the highly demanding working environment of the Embryology and Preimplantation Genetic Testing Laboratories and the Cryopreservation Banks of genetic material, laying the foundations for the provision of high quality clinical and research work, with the ultimate goal being upgrading health services and optimizing the methods of medically assisted reproduction.
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What will the teaching work of the new PMS specialization include?
In order to achieve the goals of this new major, thorough training will be provided both on a theoretical and practical level by recognized Academic and Clinical Scientists in the field of Clinical Embryology, Reproductive Biology and Reproductive Medicine, in order to form a strong scientific background, which in turn is a necessary condition for the provision of autonomous research and clinical work in the cognitive subjects of the new specialty. More specifically, the educational programme of the new major of the MSc focuses on:
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In Principles of Physiology and Pathophysiology of the Reproductive System: one of the first and most important points for the provision of specialized and quality Clinical Laboratory Work in the field of Clinical Embryology is an in-depth understanding of the cause of infertility, which leads to practice and decision making in the context of an individualized approach for successful and safe infertility management.
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Principles of Medically Assisted Reproduction: knowledge of the methods available, their limitations and their advantages is necessary for effective management, but also for thorough counselling in the context of infertility management
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Physiology and Developmental Biology of gametes and the preimplantation embryo: in-depth investigation of the molecular and cellular physiology of gametes and embryos, both in vivo and in vitro, is a requirement for a fuller understanding of the methods used in clinical embryology laboratories and for the continuous optimisation of clinical work. It is one of the most important and rapidly evolving fields of translational research in medically assisted reproduction, as it represents the 'bench to bedside' investigative approach.
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Principles of Cryobiology and cryopreservation of gametes, embryos, ovarian and testicular tissue: clinical embryology together with regenerative medicine are perhaps the only branches of Biomedical Sciences where cell and tissue cryopreservation is widely applied, not only at the research level, but especially at the clinical level. Especially in the field of Clinical Embryology, cryopreservation is now applied on a daily basis and therefore training in Cryobiology and Cryopreservation methods is necessary. In addition to infertility management, cryopreservation is nowadays also used to preserve the fertility of pre- and post-adolescent oncological patients who receive gonadotoxic therapies as part of cancer treatment. Therefore, the role of the Clinical Embryologist today is not only limited to the management of infertility, but is also placed in the services of modern Oncology.
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Sperm analysis and processing: one of the most important parameters for the correct diagnosis and management of infertility is the specialised and thorough analysis of the qualitative and quantitative characteristics of the sperm. In addition, an in-depth understanding of the correct methods and techniques of sperm processing and in vitro activation is particularly important for the successful outcome of an IVF cycle. For this reason, the development of skills in this area is a primary objective of the training received by any new clinical embryologist.
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In vitro fertilization methods:an understanding of in vitro fertilisation methods and techniques is an essential requirement for the successful performance of the work of a clinical embryologist. The aim is to provide specialised knowledge, not only at the practical level, but also at the level of in-depth evaluation of zygote morphokinetic characteristics, as these are strong predictors of subsequent fetal development. In addition, important insights will be provided regarding the management of cases where an unexplained increased frequency of fertilization failure is observed, delving into the molecular mechanisms of causation, as well as the available techniques to approach this phenomenon.
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Embryo and gamete culture systems: the appropriate design and implementation of embryo and gamete culture protocols is of paramount importance for the maintenance of quality and growth potential and therefore for the success of an IVF cycle. For this reason, an in-depth analysis of modern culture systems, alternative culture protocols, and available culture materials will be performed, focusing on the current developments in the field of in vitro embryo culture. Also, this module will present important information on troubleshooting, so that trainees will gain a comprehensive and global understanding of the operation of an IVF laboratory in day-to-day clinical practice.
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Evaluation of the quality and potential of embryo development: one of the most critical if not the most critical point for the success of an IVF cycle is the selection of a suitable embryo for embryo transfer. In this section, all those features of embryo quality assessment, as well as conventional and more modern assessment methods will be presented in detail, focusing on morphomotor data, artificial intelligence and machine learning systems, and OMICs technology.
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Pre-implantation Embryo Genetics:gametes and the pre-implantation embryo present perhaps the greatest complexity in terms of DNA architecture and the dynamic changes that occur during gamete genesis, gamete maturation and early embryonic development. For this reason, it is of paramount importance to understand the complex nature of the genetic material of gametes and embryos, not only in the context of genetics and molecular biology on a theoretical basis, but especially for the individualised management of cases resorting to assisted reproduction services for genetic reasons. In addition, the genetic identity of the preimplantation embryo on its own an important method of assessing the quality and growth potential of the preimplantation embryo and is therefore directly related to the outcome of an IVF cycle, from the achievement of pregnancy to live birth of a healthy newborn.
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Conventional and Advanced Methods of Preimplanation Genetic Testing : the correct and accurate practice for Preimplantation Genetic Testing is a complex and multidimensional process, which requires a multidisciplinary approach and therefore the collaboration of several specialties, especially Clinical Embryologists and Geneticists. This section will provide a thorough analysis of all the individual critical points for the performance of Preimplantation Genetic Testing, focusing on Genetic Counseling and Causes of Referral, Biopsy Methods, as well as the most modern Genetic and Chromosomal Analysis Methods applied in modern Preimplantation Genetic Testing.
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Design and Principles of Operation of Clinical Embryology, Andrology and Cryopreservation Laboratories: an in-depth understanding and appreciation of the Principles of Operation and Quality Control of Clinical Embryology, Andrology and Cryopreservation Laboratories is essential for the human resources of medically assisted reproduction facilities. This course will present in detail the International Guidelines and the Legal Framework of the Principles of Operation and Organisation of Laboratories, the characteristics of the human and non-human resources, the Quality Assurance Systems, the Quality Control Principles, the Key Standard Operating Procedures (SOPs) and the Key Performance Indicators (KPIs).
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New Horizons and Research Objectivies in Clinical Embryology and Medically Assisted Reproduction: Completing the educational process, we will present the new research goals that seem likely to occupy us in the coming years in Clinical Embryology and Medically Assisted Reproduction, focusing on the technology of ''OMICs'', the continuous development of Artificial Intelligence, the creation of Artificial Organs, the de novo creation of Gametes from Stem Cells and Genetic Engineering and modification of genetic material of embryos and gametes.
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What will the new specialization of the MSc internship include?
According to the curriculum of the MSc "Molecular & Applied Physiology", the internship is mandatory for obtaining the Diploma of Postgraduate Studies (M.Sc.). The internship for those who choose the major "Clinical Embryology and Preimplantation Embryo Genetics" will take place in Embryology, Andrology and Cryopreservation Laboratories and Cryopreservation Banks in collaborating private and public Medical Assisted Reproduction Units. The aim of the internship is to provide students with experiential training in a realistic clinical-laboratory environment to which they will be able to adapt. Among the collaborating laboratories where the internship will take place are the Medically Assisted Reproduction Unit of the "Genesis Athens" Clinic, the Medically Assisted Reproduction Unit "Institute of Life" of the IASO Group, the Medically Assisted Reproduction Unit "YGEIA IVF Embryogenesis", the Medically Assisted Reproduction Unit "Genema IVF", the Medically Assisted Reproduction Unit of the G. N. Maternity Hospital "Elena Venizelos" and the Assisted Reproduction Department of the Second Maternity Hospital "Elena Venizelos" and the Assisted Reproduction Department of the Second Maternity Hospital "Elena Venizelos" and the Assisted Reproduction Department of the 2nd Obstetrics and Gynaecology Clinic of the Medical School of the University of Athens at the Aretaio Hospital.