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• What are the principal objectives?

The MSc ‘Molecular and Applied Physiology’ is one of the few postgraduate programs in Europe that provides specialized and holistic training at a theoretical and practical level in the fields of Clinical Embryology and Preimplantation Embryo Genetics. This is the first and only postgraduate program in Greece that provides an M.Sc. Degree with a specialization in ‘Clinical Embryology and Preimplantation Embryo Genetics’. The objective of this specialization is to provide rigorous and comprehensive training to scientists aspiring to pursue a career in Clinical Embryology and Preimplantation Embryo Genetics at both a research and clinical-laboratory level, ensuring that they are equipped with the necessary skills to carry out autonomous research and clinical work. The curriculum is structured to enable students to acquire an in-depth understanding of these scientific areas, within a framework that emphasizes the direct applicability of knowledge to daily clinical laboratory practice, which significantly enhances professional development. Particular emphasis is placed on the understanding of the Physiology of the Preimplantation Embryo from a molecular to a cellular level; in vitro fertilization methods; in vitro culture systems for embryos and gametes; methods for assessing embryo quality and embryo developmental dynamics; cryopreservation techniques for embryos and gametes, and biopsy and genetic analysis methods at the preimplantation stage. The study of these topics is approached with a focus on the most advanced state-of-the-art techniques and methodologies currently used in leading Clinical Embryology laboratories worldwide. The instruction of the aforementioned is aligned with the principles of precision and personalized medicine and adheres to the standards of evidence-based medicine. Furthermore, the specialization includes a detailed and rigorous understanding of the operational principles, organizational standards, and quality control protocols governing Clinical Embryology, Preimplantation Genetic Testing and Cryopreservation Banks. All in accordance with the International Regulations, which ensure the proper operation of the Laboratories of Medically Assisted Reproduction Units. significantly support the integration and compliance of trainees within the highly demanding work environment of the Clinical Embryology and Preimplantation Genetic Testing Laboratories, as well as Cryopreservation Banks. Ultimately, the specialization lays the foundations for delivering high-quality clinical and research services, with the ultimate goal of enhancing healthcare delivery and optimizing practices in Medically Assisted Reproduction.

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• What does the curriculum include?

In order to achieve its objectives, comprehensive training will be offered at both theoretical and practical levels. This instruction will be provided by distinguished academic and clinical experts in the fields of Clinical Embryology, Reproductive Biology, and Reproductive Medicine, with the aim of cultivating a robust scientific foundation. Such a foundation is essential for the independent undertaking of clinical and research activities in the disciplines encompassed by this specialization. More specifically, the curriculum focuses on the following core areas:

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1. The Principles of Physiology and Pathophysiology of the Reproductive System: A fundamental prerequisite for the provision of specialized and high-quality Clinical Laboratory services in the field of Clinical Embryology is the comprehensive understanding of the causes of infertility. This knowledge directly informs clinical practice and decision-making within an individualized approach, aimed at achieving effective and safe infertility management.

2. Principles of Medically Assisted Reproduction (MAR): A thorough understanding of the available MAR methods, their advantages and limitations, is essential for effective clinical management and comprehensive patient counselling, which is a critical component of individualized and evidence-based infertility care.

3. Physiology and Developmental Biology of Gametes and the Preimplantation Embryo: An in-depth exploration of the molecular and cellular physiology of gametes and embryos, both in vivo and in vitro, is fundamental for a comprehensive understanding of the methodologies employed in clinical embryology laboratories. It is one of the most important and rapidly evolving fields of translational research in medically assisted reproduction, embodying the 'bench to bedside' approach.

4. Principles of Cryobiology and Cryopreservation of Gametes, Embryos, Ovarian and Testicular Tissue: Clinical Embryology alongside Regenerative Medicine, is one of the few fields of Biomedical Sciences where cell and tissue cryopreservation is routinely applied, not only at a research level, but also at a clinical level. Especially in the field of Clinical Embryology, cryopreservation has become a daily practice. Training in Cryobiology and Cryopreservation Techniques is thus indispensable. 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 thereby extending the embryologist’s role into the realm of contemporary oncology.

5. Semen Analysis and Sperm Preparation: Accurate and detailed analysis of semen quality and quantity is fundamental to the correct diagnosis and managment of male-factor infertility. In addition, a deep understanding of appropriate methods for sperm preparation and in vitro activation is essential for optimizing the success of in vitro fertilization (IVF) cycles. For this reason, the acquisition of advanced skills in this area is crucial in the training of new clinical embryologists.

6. In Vitro Fertilization Methods: A comprehensive understanding of in vitro fertilization methods and techniques is a fundamental requirement for the effective practice of Clinical Embryology. This module aims to provide specialized knowledge, not only at the practical level, but also at the level of critical evaluation of zygote morphokinetic characteristics, as these are key predictors of subsequent embryonic development. The module also address unexplained fertilization failure, delving into the molecular mechanisms involved and strategies for overcoming such challenges.

7. Embryo and Gamete Culture Systems: The design and implementation of embryo and gamete culture protocols are critical for maintaining gamete and embryo quality and developmental potential, thereby influencing the success of IVF cycles. Accordingly, this module includes an in-depth exploration of contemporary culture systems, alternative protocols, and available culture materials will be performed, focusing on the current developments in the field of in vitro embryo culture. In addition, practical instruction in troubleshooting common laboratory challenges will be provided, offering trainees a comprehensive view of the operational dynamics of IVF laboratories.

8. Evaluation of Embryo Quality and Developmental Potential: Among the most critical determinants of IVF success is the selection of embryos for embryo transfer. In this module, a comprehensive overview of traditional and emerging methods for assessing embryo quality will be presented in detail, focusing on morphokinetic data, artificial intelligence, machine learning systems, and OMICs technology.

9. Preimplantation Embryo Genetics: The genetic architecture of gametes and the preimplantation embryo is characterized by extraordinary complexity and dynamic change during gametogenesis, maturation, and early embryonic development. Therefore, it is of paramount importance to understand the complex nature of gamete and embryo genetics, not only in the context of a theoretical basis, but especially for the individualized management of cases resorting to medically assisted reproduction services due to the couple’s genetic basis. In addition, the genetic identity of the preimplantation embryo represents an important factor in the assessment of the quality and developmental potential of the preimplantation embryo and is therefore directly related to the outcome of an IVF cycle-from the achievement of pregnancy to the live birth of a healthy infant.

10. Conventional and Advanced Methods of Preimplantation Genetic Testing: The effective and accurate practice of Preimplantation Genetic Testing is a complex and multidimensional process, which necessitates a multidisciplinary approach-the collaboration of several specialties, primarily Clinical Embryologists and Geneticists. This module will explore genetic counseling, indications for referral, biopsy techniques, and cutting-edge methods of genetic and chromosomal analysis currently used in PGT.

11. Design and Principles of Operation of Clinical Embryology, Andrology and Cryopreservation Laboratories: A thorough understanding and appreciation of the Principles of Operation and Quality Control of Clinical Embryology, Andrology and Cryopreservation Laboratories is fundamental for professionals working within Medically Assisted Reproduction Units. This module offers a detailed introduction to the International Guidelines and the Legal Framework of the Principles of Operation and Organization of Laboratories, the characteristics of 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).

12. Emerging Horizons and Research Objectives in Clinical Embryology and Medically Assisted Reproduction: The educational process concludes by highlighting future directions in research and innovation, focusing on OMICs technologies, advances in artificial intelligence applications, development of organoids, de novo gametogenesis from stem cells, and the application of genetic engineering to gametes and embryos.

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• What does the specialization provide in terms of practical training?

According to the curriculum of the MSc ‘Molecular & Applied Physiology’, practical training is a compulsory component for the completion of the Master Programme. The practical training for those who opt for the specialization ‘Clinical Embryology and Preimplantation Embryo Genetics’ is conducted in Clinical Embryology, and Andrology Laboratories as well as in Cryopreservation Banks, in collaboration with affiliated private and public Medical Assisted Reproduction Units. The aim of this practical training is to provide students with experiential training in a realistic clinical-laboratory setting, to which they will be actively integrated. Affiliated institutions include 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 ‘Gennima IVF’, the Medically Assisted Reproduction Unit ‘Eugonia’, the Medically Assisted Reproduction Unit of the General Maternity Hospital ‘Elena Venizelos’, the Medically Assisted Reproduction Unit of the Naval Hospital of Athens and the Medically Assisted Reproduction Unit of the Second Department of Obstetrics and Gynaecology of the Medical School of the National and Kapodistrian University of Athens in Aretaieio University Hospital. In addition, the specialization offers the opportunity to undertake an internship at Medically Assisted Reproduction Units in European Union countries through the Erasmus+ program.