Air quality: is it that important? And if so, how to measure and control it?Sandro Esteves
Quality and Risk Management in the IVF Laboratory; Redlara Brasil, Belo Horizonte, 14-15 September 2016
Content:
1.Air quality: is it that important?
2. How to control?
3. How to measure?
Air quality: is it that important? And if so, how to measure and control it?Sandro Esteves
Quality and Risk Management in the IVF Laboratory; Redlara Brasil, Belo Horizonte, 14-15 September 2016
Content:
1.Air quality: is it that important?
2. How to control?
3. How to measure?
The Embryology laboratory should been designed to provide an environment that is as close to optimum as possible for the growth of human embryos and to provide the best resulting pregnancy rates for patients undergoing IVF cycles.
Here, we discuss what is the components of IVF laboratory.
Setting up ART ,IVF laboratory standards -Artificial Reproductive Technique b...Healthcare consultant
The primary function of an ART laboratory is to provide an optimal environment for gametes and embryos. To set up an ART laboratory, that is efficient and safe, the three key areas to focus on would be the place or location of the laboratory, the embryologists, and the protocols or procedures.
The following chapter will focus on the physical layout of the lab, the basic equipment required and consumables used in the ART lab. The responsibilities of the key people in the laboratory, the embryologists and the importance of the procedures and protocols will be elucidated.
EMBRYO QUALITY ASSESSMENT, WHICH TO SELECT? Rahul Sen
Traditional embryo evaluation systems are simple, non-invasive, cost-effective & mainstay in majority of IVF laboratories. Embryo selection based on combinations of morphology scores at different stages of embryonic development with time may be more effective
Particles smaller than one micron are most important to eliminate because they make up 99% of the number of particles in your air and can be breathed deep into the lungs and AEROCIDE can do that
National Renewable Energy Laboratory – July 1998
Self Cleaning Catalyst: Mineralization of E. Coli to Water Vapor and CO2
State of Wisconsin Hygiene Laboratory – August 2002
Performance of AiroCide® in Controlling Bacterial Spores (Anthrax-like spores)
Food & Drug Administration (FDA) – November 2002
Verification of Technology and Class II Medical Device Listing
Texas Tech University – June 2003
AiroCide® Destroys Mycotoxins from Mold Spores
Texas A&M University – June 2004
Peer Reviewed and Published Paper on AiroCide® Performance in a
Hospital Operating Room
Air Quality Sciences, Inc. – 2005 to date
Independent Air Quality Testing Lab, conducting multiple efficacy tests on
AiroCide® and RevolutionAir prototypes
The Embryology laboratory should been designed to provide an environment that is as close to optimum as possible for the growth of human embryos and to provide the best resulting pregnancy rates for patients undergoing IVF cycles.
Here, we discuss what is the components of IVF laboratory.
Setting up ART ,IVF laboratory standards -Artificial Reproductive Technique b...Healthcare consultant
The primary function of an ART laboratory is to provide an optimal environment for gametes and embryos. To set up an ART laboratory, that is efficient and safe, the three key areas to focus on would be the place or location of the laboratory, the embryologists, and the protocols or procedures.
The following chapter will focus on the physical layout of the lab, the basic equipment required and consumables used in the ART lab. The responsibilities of the key people in the laboratory, the embryologists and the importance of the procedures and protocols will be elucidated.
EMBRYO QUALITY ASSESSMENT, WHICH TO SELECT? Rahul Sen
Traditional embryo evaluation systems are simple, non-invasive, cost-effective & mainstay in majority of IVF laboratories. Embryo selection based on combinations of morphology scores at different stages of embryonic development with time may be more effective
Particles smaller than one micron are most important to eliminate because they make up 99% of the number of particles in your air and can be breathed deep into the lungs and AEROCIDE can do that
National Renewable Energy Laboratory – July 1998
Self Cleaning Catalyst: Mineralization of E. Coli to Water Vapor and CO2
State of Wisconsin Hygiene Laboratory – August 2002
Performance of AiroCide® in Controlling Bacterial Spores (Anthrax-like spores)
Food & Drug Administration (FDA) – November 2002
Verification of Technology and Class II Medical Device Listing
Texas Tech University – June 2003
AiroCide® Destroys Mycotoxins from Mold Spores
Texas A&M University – June 2004
Peer Reviewed and Published Paper on AiroCide® Performance in a
Hospital Operating Room
Air Quality Sciences, Inc. – 2005 to date
Independent Air Quality Testing Lab, conducting multiple efficacy tests on
AiroCide® and RevolutionAir prototypes
Flexible Endoscopes.pdf Risks associated with reprocessing flexible endoscopesTalal Albudayri
Reprocessing Flexible Endoscopes
Objectives
Risks associated with reprocessing flexible endoscopes
Causes of contamination and infection
Gaps in current reprocessing standards
Establish scientific rationale and evidence requirements for
enhancing safe practices
AMH JOURNALS UK Publishes STERILIZATION OF OPERATING THEATRES by Dr.T.V.Rao MD
Methods to replace fumigation By Dr.T.V.Rao MD is a Professor and Head of the Department of Microbiology at Travancore Medical College in Kollam, India
Dr T V Rao is also a content provider on Medical Microbiology and Infectious Diseases for numerous international websites.
Translated into 91 global languages for benefit many in the remote corners in the Developing countries
Dr.T.V.Rao MD
Novel concepts in male factor infertility: clinical and laboratory perspectivesSandro Esteves
Presentation Objectives:
1. Update on the WHO reference values for semen parameters, and understand the role of sperm DNA fragmentation testing to decision-making strategies;
2. Learn how to counsel azoospermic men seeking fertility, and the role of gonadotropin therapy in this infertility condition;
3. Understand the benefits of microsurgery to both sperm retrieval and varicocele treatment;
4. Appraise the role of medical and surgical interventions to infertile men undergoing ART.
Public lecture - Stem Cell and Male InfertilitySandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Public Lecture - Stem Cell and Male Infertility
Clinical management of men with nonobstructive azoospermia - Role of IVF Labo...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 5: Role of IVF Laboratory in Nonobstructive Azoospermia
Clinical management of men with nonobstructive azoospermia - Sperm Retrieval ...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 4: Sperm Retrieval Methods in Nonobstructive Azoospermia
Clinical management of men with nonobstructive azoospermia - Steps Before Spe...Sandro Esteves
Reproductive Andrology Workshop III
17-21 January 2016 - Kuwait City - KUWAIT
Organized by: Al Jahra Reproductive Medicine Unit - Ministry of Health
Lecture 3: Steps Before Sperm Retrieval in Nonobstructive Azoospermia
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
How to Give Better Lectures: Some Tips for Doctors
Air quality control in reproductive laboratories: How important it is and how to implement, measure and control
1. Air quality control in
reproductive laboratories
How important it is and how to implement,
measure and control
4th International Congress - Academy of Clinical Embryologists
18-20 September 2015, Kochi INDIA
Sandro C. Esteves, MD., PhD.
Medical & Scientific Director, ANDROFERT
Andrology & Human Reproduction Clinic
Campinas, BRAZIL
2. Outline
1. Importance of air quality in IVF
2. How to implement
3. How to measure and control
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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3. Morbeck, JARG 2015; 32(7):1019-24.
IMPORTANCE OF AIR QUALITY IN IVF
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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4. IMPORTANCE OF AIR QUALITY IN IVF
25.0%
32.7%
14.1%
43.1%
Miscarriage rate
CPR
General IVF Population (N=468)
Cleanroon IVF lab (Central HVAC with particle + VOC filtration)
Standard IVF lab equipped with portable filtration units
P=0.01
P=0.03
Esteves et al. Fertil Steril 2004
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
5. CPR
Miscarriage rate
36.9%
23.0%
47.1%
15.0%
Severe Male Factor Infertility (N=399)
Standard IVF lab equipped with portable filtration units
Cleanroon IVF lab (Central HVAC with particle + VOC filtration)
Esteves et al. Fertil Steril 2006
IMPORTANCE OF AIR QUALITY IN IVF
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
6. Van Voorhis et al. (F&S 2010)
At least 7 of 10 consistently high-performing IVF centers
in the USA used filtered laboratory air with HEPA and
chemical, solid-phase filtration for VOCs
Munch et al. (JARG 2015):
Inadvertent removal of carbon filters resulted in
significant drop of KPI
Heitmann et al. (RBM Online 2015):
Central HVAC (Particles + VOC) vs. Portable Units
Higher IR (32.4% vs. 24.3%; p<0.01)
Higher LBR (39.3% vs. 31.8%; p<0.05)
RECENT EVIDENCE
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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7. Importance of Air Quality in IVF
Summary
ANDROFERT
ü High levels of VOC in unfiltered IVF lab air
ü Mouse and human embryo development inversely
correlated with VOC levels
ü Efficient particle and VOC removal by dedicated air
filtration systems
ü Better IVF outcome (PR, IR, miscarriage) in
laboratories with air particle and VOC filtration
ü Central HVAC seems to work better than portable
systems
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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8. What regulatory agencies ask for
ANDROFERTANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
9. Social responsibility to
protect public health
from exposure to harm,
when scientific
investigation has found a
plausible risk even
though a scientific
consensus had not been
reached
PRECAUTIONARY
PRINCIPLE
*Convention on Biological Diversity, UN 1992;
Ratified by 192 countries and the EU, except
USA, Andorra and South Sudan
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10. Region
(directive)
European Union (EU directive
2004/23/EC; 2006/86/EC)
Brazil (Anvisa
RDC33/2006;
RDC23/2011)
Particle
filtration
Equivalent to GMP Grade A air
quality in the critical areas with a
background environment at least
equivalent to Grade D (exceptions
apply)
At least equivalent to
ISO class 5 (NBR/ISO
14644–1) in the critical
areas
Microbial
contamination
Microbial colony counts equivalent
to those of Grade A as defined in
the current GMC guide with a
background environment at least
equivalent to Grade D
Microbiological
monitoring required;
specifications not
defined
Volatile organic
compounds
filtration
Not required Ventilation systems
should be equipped with
filters imbedded with
activated charcoal
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ANDROFERT
Reviewed by Esteves & Bento, RBM Online 2013.
11. CONTAMINATION
Any undesirable material or
substance that may affect the
quality of final product
Contaminants are
generated by
laboratory
personnel,
processes, furniture
and equipment
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Indoor air
Personnel
Material and
Equipment
Cell, tissue
and fluids
12. 1. Airborne particles
Residues of cleaning
agents and clothing, skin
shedding; temporary
suspension; 1< µm <100
2. Microorganisms
Viruses, spores, bacteria;
constant suspension in air;
size <1 up to 8µm
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
Contamination
13. CONTAMINATION
3. Indoor Volatile Organic Compounds
Chemical compounds that evaporate and react
with indoor ozone
Result in submicronic particles and harmful by-
products (eg. toluene, benzene, alcohols, acetone,
refrigerating gases, aldehydes)
Cigarette smoke, automobile exhaust, detergents, lubricants,
dyes, furniture, rubber, plastics, resins, synthetic fibers,
nylon, particle-board, plywood
Some are genotoxic/mutagenic
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
14. VOC in REPRODUCTIVE LABORATORIES
0
1000
2000
3000
Outside Air
Indoor IVF
Lab Air
533
2769
5-fold increase
in VOC
Anderson et al. 1997
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
15. HOW TO PROTECT GAMETES AND EMBRYOS
FROM CONTAMINATION
Bacteria and other
contaminants can attach
themselves to particles, a
decrease in particles equates
to an increase in air quality Pre-Filters: >10µ
Fine dust filters: 1<10µ
HEPA filters: 0,3µ = 99,97%
Removal of air particulates by forced air
movement using positive air pressurization
through a series of filters with increased efficiency
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ANDROFERT
16. Particle size/m3 of air: ISO 14.644-1
0.3 µM
0.5 µM
1 µM
5 µM
ISO 1
ISO 2
10
4
ISO 3
102
35
8
ISO 4
1,020
352
83
IVF
lab
ISO 5
10,200
3,520
832
29
ISO 6
102,000
35,200
8,320
293
OR
ISO 7
352,000
83,200
2,930
Transfer
ISO 8
3,520,000
832,000
29,300
ISO 9
35,200,000
8,320,000
293,000
CLEAN ROOM
CLASSIFICATION
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ANDROFERT
17. VOCs are 100–1000x smaller
than the effective pore size of
HEPA filters
Spaces between the carbon
particles contain a cloud of
delocalized electrons that act as
electronic glue to chemical
contaminants
Alcohols and ketones are
oxidized and thereby
detoxified by potassium
permanganate
HOW TO PROTECT GAMETES AND EMBRYOS
FROM CONTAMINATION
Removal of VOCs by forced air movement
using positive air pressurization through a
series of filters containing activated carbon
and potassium permanganate
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
18. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
PORTABLE SYSTEMS
HEPA
filter
VOC
filter
Pre-
filter
19. Central HVAC SYSTEMS
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20. BEFORE IMPLEMENTATION
Risk assessment analysis
• New or existing facility
• Age and size of laboratory
• Equipment/furniture (low off gassing?)
• Constructing materials
• Atmospheric air pollution
• Disposable materials (storage location)
• Human activity
No. per workspace,
Use of protective clothing
Cosmetics, etc.
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ANDROFERT
22. AIR-HANDLING VENTILATION SYSTEM
(with carbon + KMnO4 filtration)
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ANDROFERT
24. ISO 5 Cleanroom IVF lab + Chemical filtration
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
25. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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2015
ANDROFERT
ISO 5 Cleanroom IVF lab + Chemical filtration
26. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
27. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
28. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
29. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
30. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
31. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
32. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
33. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
34. LAYOUT AND
CONSTRUCTION
In situ wet construction
Low off-gassing materials
Surfaces and Coatings
Lighting fixtures
Flush-mounted and sealed
Coved junctures
Stainless steel & aluminum
Furniture, doors, windows,
air vents, workstations
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
35. 0
50
100
before after
% TQE
0
20
40
before after
% miscarriage
0
50
before after
% LBR2.3
3.2
Average No. Top Quality Embryos ET
Conventional lab (with portable
filters)
Cleanroom lab (Central HVAC with
particle & VOC filtration)
P=0.01
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
N=2,315
cycles
36. Cumulative live birth rates
40.4% 48.0%
ANDROFERT, Referral Center for Male Reproduction
ET #3
(FET) 49
ET #2 (FET)
239
ET #1 (fresh)
822
50.5%
+18.8%
+25.0%Female
Age
≤38
ANDROFERT
332/822 63/239 17/49
37. HOW TO MEASURE AND CONTROL
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
38. TEST EQUIPMENT
Air volume flow rate Termoanemometer
Air exchange rate Termoanemometer
Air and room
pressure differential
Microanemometer and
balometer
HEPA-filter integrity
leak
Aerosol generator
Airborne particle
counts
Electronic particle counter
Recovery
performance
Smoke generator
Lighting level Luxmeter
Noise level Decibelmeter
Temperature and
humidity
Thermometer and
hygrometer
Third-part certification company (CCL, Brazil); semi-annually
IEST 006.2 standards
ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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ANDROFERT
39. TEST
Air volume flow rate
Air exchange rate
Air and room
pressure differential
HEPA-filter integrity
leak
Airborne particle
counts
Recovery
performance
Lighting level
Noise level
Temperature and
humidity
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40. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION
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41. Settle plates
Mold and blood-agar Petri dishes
Surface sampling
Swabs and contact plates
Five-finger glove printing
Incubators, workstations, air, floor, wall
Limits Colony Forming Unites (CFU)
Settle plates
(90mm
diameter)
CFU/4 hours
Contact
plates
(55mm
diameter)
CFU/plate
Glove
print
CFU/
glove
<3 <3 <3
Microbiological
Monitoring
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42. VOC Monitoring
1. Activated-carbon life-time
estimates
Carbon tetrachloride activity method
2. Active air sampling on Tenax TA
sorbent and 2,4 dinitrophenyl
hydrazine
Summa canisters; Thermal desorption
Gas chromatography (Limits <2 mcg/m3 TVOC)
3. Direct reading
Snapshot reading using VOC probes
Photo ionization detector
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43. Esteves & Bento. RBM Online 2013
ü APPROVED
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44. Key messages
1. Air quality (particulate matter and VOC)
associated to in vitro embryo development in
animal and human studies
2. Regulatory agencies have issued Directives
with specific requirements for air quality in IVF
labs based on precautionary principle
3. Air cleanness in IVF should integrate both
particulate matter and VOC filtration
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45. Key messages (2)
4. Risk assessment analysis needed before
implementing air quality control to IVF units
5. Validation “in operational state” after
AQC implementation
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6. Ideally, measure and control should be
guided by third-part certification
companies
46. Thank you
This presentation is available at
http://www.slideshare.net/
sandroesteves
4th International Congress - Academy of Clinical Embryologists
18-20 September 2015, Kochi INDIA