IVF Revolutionized with Life Whisperer Co-Founder Michelle Perugini – #29

0:26 Charlene Lincoln: Welcome back to another episode of The Fertility Hour. Before I forget, FertilityHour.com is our website. If you go to there, it will say Free Report. I highly encourage you to download the Free Report if you have not already. It’s Restore Your Fertility and Get Pregnant Naturally. Dr. Iva Keene, my podcast partner who is brilliant, she wrote the report. It’s a 39-page free report. It’s amazing information. I highly encourage that.

And so today, I’m pretty excited. I feel like the future is now. We’re in a futuristic time and it’s to our benefit. And as much as sometimes I feel like technology, is it good, is it bad? Well, in some cases it’s pretty amazing in how it can benefit our lives and I think in this case scenario, it speaks so true of this woman and this company. So let me go ahead and introduce Michelle Perugini. Did I pronounce that correctly?

Michelle Perugini: Pe-ru-ji-ni.

1:36 CL: Pe-ru-ji-ni. Thank you.

MP: Good enough.

1:41 CL: She has a PhD in Medicine, spent the first 10 years of her career as a scientist in stem cell biology and cancer research. She founded her first business 10 years ago using artificial intelligence for predicting human behavior. ISD was acquired by Ernst & Young in 2015. She’s now co-founder and managing director of Presagen and Life Whisperer. Presagen is an artificial intelligence platform that specializes in image-based medical diagnostics. Life Whisperer uses AI and computer vision to better select healthy embryos during the IVF process. In addition to running two businesses, Michelle is also a dedicated mentor and advisory board member for many startups. And a mom, right?

MP: And a mom. And a mom to two.

2:35 CL: Oh, nice. Wow! Okay, well then that’s a very busy life. And you’re co-founder with, is it your husband? Because you’re sharing the same last name. Or it could be your brother.

MP: Correct. So in Life Whisperer, Don Perugini is my husband and also my co-founder; so we’ve worked together for many years. And also Jonathan Hall who’s a PhD in physics and computer vision.

3:01 CL: Wow. That’s great. So I was saying to you before this interview, the more that I’ve been reading about Life Whisperer, I don’t know, I’m really fascinated and as I said, this software has a potential to, I don’t know, I guess turn the IVF industry on its head. I don’t know what the better term is but, I mean, IVF sort of has low success rates in general. What is the average success rate of IVF at this point? Then you can introduce the software and how it came to be and what it can do to help this industry and help individuals. I mean, that’s kind of what you were talking about is the real goal of this.

MP: Yeah, absolutely. The success rates are very low in IVF and it depends who you talk to. It depends on the clinics you talk to and how they report on the data. But really, you’re talking about somewhere 20 to 30 percent success rates, and that’s very low, and in some age categories it’s far lower than that. So I think there’s a huge opportunity in this industry to improve outcomes for patients and that’s a real passion of ours and it’s something that we’ve kind of set out to achieve and we’ve got the technology that can potentially help do that for patients and we’re really excited about that. So what we’re actually doing at Life Whisperer is using artificial intelligence, and I can talk a little bit about that in a non-technical way.

4:39 CL: Yes, please.

MP: I think whenever you talk about things like artificial intelligence, everyone gets scared and thinks that it’s kind of a black box type approach to solving these problems, but it’s actually quite powerful in areas like imaging and medical diagnostics and I think it really has a potential to kind of change outcomes for patients. So in Life Whisperer, the high-level goal is to improve IVF outcomes by helping doctors to pick the best embryo to transfer during the IVF process. So currently that process is done manually, largely manually by a clinician or an embryologist looking down a microscope and making a visual assessment of a patient’s embryos. And it’s very hard for them to pick which embryo they think will likely succeed in that process. What we’re doing is using computer vision and we’ve developed an AI-based software that can better assess what a healthy embryo looks like or what a poor embryo looks like to inform their decision if you like.

The way it works is essentially we’ve got a very large data set of embryo images that the model gets trained on and then it knows whether those embryos have resulted in a positive or a negative pregnancy. Then the computer essentially learns or the software essentially learns from that very large history and can be predictive in terms of them understanding for a new embryo image that it sees whether it looks more like a good one or more like a bad one. So that’s the premise of what we’re doing.

6:20 CL: I was reading on your website and I forgot the exact numbers but they were comparing like a human looking at embryos and detecting the viability of that compared to the software. What were the numbers in comparing the two?

MP: Yeah. So we did a patient study in Australia of nearly 600 patients, it was 598 patients. And we showed that our software was 30 percent more accurate in terms of identifying embryo viability than world-leading embryologists, seasoned or untrained embryologists, or world-leading embryologists. And that’s no disrespect to the embryologist because they do an amazing job and they’re actually just limited by what their eyes can see down a microscope. Computers and this type of technology are able to see much finer details that are potentially not even visible to the human eye and very complex patterns within the embryo image that a computer can extract that information where we can’t as humans. So it’s fundamentally providing additional information to the clinicians to better make that decision if you like.

7:34 CL: Thirty percent is extremely a significant number. So in that 30 percent, okay, say, compared to an embryologist and then the software, was the software finding more viable embryo than the human eye could?

MP: What it does is it just better classifies them. So assuming a patient has 5 embryos to choose from at day 5 in their sort of embryo culture. The embryologist will then look at those 5 embryos and they will give each of them a score. That’s quite a subjective process at the moment and it’s very difficult for embryologists to see what a good embryo and what a poor embryo looks like. So it’s really based on just very few simple measures. What happens is with our software, we’re able to better classify and get it right more of the time when the software says this is a good one, then more of the times, 30 percent more often it gets that right; and when it says this is a bad one, you shouldn’t use it, 30 percent more often it gets that assessment right. So it’s about classifying them better and giving more information about, more surety around the health of that embryo.

9:04 CL: That’s amazing. As you can see, I have a little visitor. Hold on one second and I’m so sorry about that. Hold on one second.

Okay. So, how did the software come to be? Like, you and your husband are talking “what if we could do something to help these couples?” I mean, what was the process?

MP: It’s a really interesting story actually because it kind of happened by chance. So my background, obviously, in stem cell biology, I really had that passion for health and improving health as well as kind of research and using research outcomes. Really passionate about that. After we sold our first business, we kind of left that organization after a year and I think having been part of a large corporation, it kind of reaffirmed our passion for that deep technology and understanding kind of how the body works and trying to apply our very technical backgrounds to solve real world problems. That’s what we really enjoy doing. And at that time I was mentoring through an Australian commercialization program and one of the mentees or one of the students that was part of that program was Jonathan Hall and he had been working on computer vision techniques. I had been looking at fertility problems and trying to identify how you peak about an embryo but using things like shining different lights on the embryos and other more invasive processes. He thought there must be a way to do this in a noninvasive way to the embryo so that you’re not touching the embryo, you’re not impacting how it grows. You’re just basically assessing the embryo in its normal course of growth and helping make that assessment. So as soon as I met him and I heard the concept, I was really drawn to it.

And I think one of the important things with the type of business that we’re running is you need such a multidisciplinary skill set. You need the medical side. You need to be able to understand the embryology. You need computer vision. You need to understand how to apply these types of techniques to identify information out of the images and you also need very strong AI expertise, which we just happen to have all of those three things as well as the passion for the actual project. I think the thing that personally drew me to this is that I had a lot of trouble conceiving my first child. I now thankfully have two, which is wonderful. But I did have a lot of trouble conceiving my first child and I know the sort of expectation and the disappointment that comes with that whole process. Anything that we can do to improve that process for patients and to make it better and improve outcomes and improve the actual journey and the process itself is really important to me personally. So I just feel really drawn to this concept and it’s a solvable concept with our skill set, so we thought, “let’s go ahead and do it.”

12:28CL:  So right now it’s not available in IVF clinics, right? We were talking about that. They’re running clinical trials in a clinic that was mentioned. I mean, what’s the timeline on it?

MP: The process we’re at at the moment, so we finished our clinical study in Australia at the end of last year. The important thing for this type of technology is to make sure that it’s robust and that it works in different environments. Clinics all have different clinical environments and different ways of culturing embryos. They have different embryologists and they’re in different countries. So there’s different demographic characteristics.

So what we’re in the process of doing now is engaging clinics to gather a large and diverse data set of embryo images to underpin the final model that we’ll take to market. That’s really critically important to make sure that our software is robust and scalable and works in every situation. So we’re currently working with a set of US clinics in California and in Austin, Texas and we’ve got another clinic in Malaysia that we’re starting to work with and we’ve got others interested in a whole range of countries like the UK, China, Canada. So we’re working through that process now and that will likely take us a couple of months. But we anticipate that this will be out to the first set of markets at the end of this year. So it’s actually an incredibly quick time frame. We have the software product essentially built. It’s more about testing and ensuring that the algorithms are robust and can work in different environments.

14:11 CL: You must be so excited. I’m excited. Yeah, I’m excited. Obviously so many couples are dealing with fertility challenges these days. A large percent will go the IVF route for one reason or another and to be able to increase the success of it because, I mean, it’s physically, emotionally, and financially taxing for you to be able to. I mean, anything to sway the needle towards your benefit. And it’s amazing.

MP: Correct. I think there’s a few reasons why. So firstly, infertility is increasing globally. That’s a fact. There’s a number of reasons for that including women having children later in life. There’s some issues in countries like China where they’ve had the “one child” policy and they’ve got an extremely aging population that are now trying to have a second child now that that policy has been relieved. But I think the other thing is that in countries like America and Australia, very well-developed countries, there’s other techniques like genetic screening that can be used. But those techniques are not available worldwide and they’re quite invasive and they cost patients a lot of money. They require removing a part of a developing embryo and I think if you can kind of come in with a solution that’s completely noninvasive, that’s scalable, it’s very easy for the clinic to provide to patients. It’s very low cost. We actually believe that that will increase the demand for IVF generally because one of the reasons or two of the reasons that people don’t do IVF currently and why there’s not more infertile people undergoing IVF is because of those low success rates and high cost. It’s really unattainable for a lot of people and I think that’s really sad because it is a life decision and it’s something that can impact you and your family’s life forever if you either can’t have children or you can’t afford to go through the process. So I think that’s kind of our core goal is to change that for patients.

16:37 CL: I know this is probably a difficult question to answer, but what do you think that the numbers will look like if they’re able to screen the embryo using the software? You were saying, whatever, 20-something percent is the average success rate right now. I mean, do you know?

MP: It’s hard to say because what we’re not doing is we’re not improving embryo quality. We’re helping select the best embryos. Obviously, for any given patient if they don’t have high quality embryos then we can’t manufacture good pregnancy outcome. But what we’re trying to do is prevent the selection of an embryo that’s not likely to succeed and having the patients go through that process, that costly and timely process and then have it not succeed at the end and have them try one, two, three, four times to get to that outcome. We’re trying to kind of reduce that time frame and also give them realistic expectations around the likelihood of success because I know with me, and I know a lot of people who have gone through the full IVF process and I think part of the issue there is everyone goes into it thinking, “Oh well, okay. It didn’t happen naturally but now I’m going through IVF and that surely will, you know, give a positive outcome. And it’s just so often not the case and I think their expectation is just really terrible for patients especially when it doesn’t turn out and they kind of come to that realization that they may never able to have children and that’s a terrible, terrible thing to kind of arrive at. So if we can give them more information about that and tell them, “Look, you’ve got two embryos. Both of them have a low chance of success,” maybe we decide to put both of them in or one of them has a fantastic chance of success, let’s put that one in, let’s screen the other one or let’s freeze the other one. It just is providing really critical information that can help guide the clinician in their treatment of you during that IVF process.

18:51 CL: Okay. I wasn’t even thinking of it in that way because — I mean, that’s a hard decision, right? A lot of people, they implant multiple and sometimes people have triplets. Whatever the case. It could be successful but I mean that’s an important piece of information. I wasn’t thinking of it in that regard that you could make those decisions at that point. “Oh, this is a very viable embryo. Let’s implant just this one and see what happens.” Right.

MP: Yeah, correct.

19:23 CL: Because I was thinking, “gosh.” And some people who really want a child, they’re like, “I would love to have twins and triplets,” and for other people that would be a lot. I mean, I’d be willing to take that risk but that would be a lot on my family to take care of multiple children/babies at once. Oh my gosh.

MP: I think globally there’s a trend toward single embryo transfer because it’s actually despite the fact that a lot of people get healthy, twins or triplets, after multiple birth, there are a lot of health complications that come from multiple births so it’s certainly not ideal from a medical or health perspective. And you get a lot of countries like China and India who are quite under developed in terms of their technology for IVF and they’re not doing single embryo transfers, and I think the government is trying to shift them towards that. Because if you could say upfront you’ve got four embryos, two of them have a very high chance of success, let’s put one of those in, let’s freeze the other one. If you want a second child, let’s pull that other one out and go for it again. It just gives you that extra layer of information that you wouldn’t have otherwise had. You’re kind of flying blind otherwise and really trial and error and it’s not the sort of process that you really want to do by trial and error because it is so traumatic for the patients going through it. So yeah, it’s very important to have that additional information.

21:06 CL: Well, I can’t wait. I mean, I’m really excited. I think it’s amazing and just you and your husband are just total brainiacs for thinking of this and having this background. I would think that any IVF clinic, why wouldn’t they want to implement this, you know? I mean, for their own selfish reasons but obviously for their clients, for clinical outcomes. This is really what the IVF industry sort of needs at this point. Yeah.

MP: We’ve had a hugely positive response from most of the clinics that we’ve spoken to in different kind of global locations. I think IVF clinicians, they genuinely want positive outcomes for their patients and I think they’re really driven towards that and I think they’re kind of getting more accepting of technology to help them do that because they realize that there are limitations. An embryologist’s role is far broader than just selecting that embryo but it’s a really critical piece of information that kind of drives the success of the whole process. So I think for embryologists it’s critically important for them to be able to firm up to patients and for the treating doctor to be able to firm up to patients and say, “You know what, we’re using the most advanced technology available to us to help us make the best decisions for you during this process,” and hopefully over time it will prove that there is a significant success rate increase on the basis of using this type of technology because it has the ability to fundamentally disrupt the whole fertility sector. I truly believe that. I think there’s far more things that we can also do beyond this one part of the process, but I think this is just a really critical point in the process. If we can improve it, it will definitely improve outcomes.

23:24 CL: Where can we find out more about Life Whisperer?

MP: So we have a website. It’s www.lifewhisperer.co. So you can head to our website. You can also feel free to email us directly at info@lifewhisperer.co and we can provide you info. We’re happy to receive emails with requests or questions. Also happy for, obviously, for us at the moment is about getting visibility at clinics and getting clinics onboard with the whole process. So if you’re going through IVF, talk to your clinics about us if they haven’t already heard and have them contact us so that we can give them information about this new kind of technology that’s coming onboard that they should be considering for their patients.

24:19 CL: Okay. Thank you so much.

MP: Thank you so much.

24:23 CL: I’m really excited. Thank you for the work that you do. It’s amazing.

MP: Thank you, Charlene. Thanks for the opportunity. I’ve really enjoyed it.

24:30 CL: You’re welcome. Alright. I’ll contact you in a couple of weeks when this episode goes live.

MP: Perfect.

24:37 CL: Alright. Thank you.

MP: Sounds good. Thank you so much, Charlene.

24:40 CL: Alright. Bye-bye

MP: Bye.