Maggie McKay (Host): When it comes to reproductive science, there's a lot of exciting news, including AI or artificial intelligence in the mix. Today we'll meet Dr. Eduardo Hariton. He's a physician and we're going to find out how his Harvard education influenced his career. We're also going to be speaking with Jackie Xu, a Medical Assistant and founder of U.S. Syncare and an HIMSS member.

Welcome to Fertile Edge, a podcast from Reproductive Science Center of the San Francisco Bay Area. I'm Maggie McKay. Thank you both for being here today. We are also going to have Jackie translating our questions and answers in Chinese. Dr. Harriton, can you share your background and how your Harvard education influenced your career in reproductive medicine?

Eduardo Hariton, MD: Xie xie, Jackie, wǒ de qiong wén bù hǎo. I'm so happy to be here. I'm originally from Venezuela, so I grew up overseas. I came to the United States when I was 15. Did some education in Florida and then moved up to Boston where I did my medical school degree, my business school degree, and my residency in obstetrics and gynecology at the Harvard hospitals.

It was a real life change to go and meet people from such diverse backgrounds that were at the top of their field. I was constantly stimulated, learning different things and learning from different people. And then I found the field of reproductive medicine a little bit serendipitously. I wanted to work in a field where I could partner with patients to change their health and improve their health.

And I realized that fertility was one of them. It was where women would be coming to you at a very vulnerable time to try to get help, to try to really partner with you to either change their course of the pregnancy, change their life by helping them have children when they couldn't. And it was a really special experience.

So it was at Harvard where I decided that that was the path that I wanted to take in my career. It's a long path. It requires seven years of training after fellowship, but I love my job and I love everything I do every day.

Host: As a former Harvard Medical School Admissions Committee Member, what advice can you offer prospective applicants who want to study there?

Eduardo Hariton, MD: I would first encourage them to dream big. You know I never in my life imagined that I would be able to get into this institution, but I worked very hard and eventually I got there. When I was there, I wanted to make sure that I supported the community and I served in the admissions committee reviewing applications and deciding which people we would accept into the medical school.

I can tell you not only your test scores and your grades are important, but also the kind of activities to do, the passion that you show, and like your distance traveled. And by that, I mean, not everybody starts with the same opportunities. And it's what you make of the opportunities that you are given, that really shows the kind of person who you are and what you can bring to the community. So Harvard looks for diversity. They look for passion. They look for commitment. They look for excellence. And I would encourage everybody who wants to grow their education and really take that next step wherever whether it is med school or business school or college; to really dream big and try and really open up your story and share a little bit more about who you are, because I can tell you it's not just the grades.

It's also the story that you share and why you want to be there that makes a difference.

Host: Your bio shows that you received a medical degree, but also an MBA at Harvard. How do you blend your medical and your business expertise to innovate in fertility services at the Reproductive Science Center?

Eduardo Hariton, MD: So I think what business school really taught me is to approach problems from a different perspective. You know, in medical school, everybody studies the same thing, and then you learn every different step of the way from the basic to the complex. In business school, you sit down and you do a case with 80, 90 people from different backgrounds, different countries, different genders, different perspective and you discuss that case and you get put into different situations. So what it brought to me is an ability to look at problems from a different perspective. You know, healthcare is very complex, but the way that we take care of patients can always get better. So the way that I use my business education is to really look at both patient care and the operations of the clinic and think about how can we do this better?

How can we take better care of patients? How can we make the process easier because people are coming from very far, from China, from South America, from Europe, to get care from us. And I want to make sure that it is as easy as it can be. This is a difficult time in their life and I want to make it easier.

The other thing that I do is that I spend a lot of time thinking about innovation and technology. I want to make sure that we're using the latest, most innovative approaches, whether it is AI or new culture media or whatever else, making sure we put the patient first, but always trying to give them the best success possible.

Host: It seems like you've done a lot of work in the artificial intelligence space. You mentioned it a few times earlier. In what ways do you see AI improving or optimizing reproductive cycles in the near future?

Eduardo Hariton, MD: I think artificial intelligence is a very exciting tool that we're going to be able to apply to the way that we take care of patients. I'll talk about three things that I think we can do with it. Number one is predicting outcomes better. I think it is really important to set our patient's expectations before we begin treatment as to what they might expect. And I think we can be a lot more precise if we use AI models to help them understand what the success might look like with IUI or with IVF or with donor, et cetera, so that they can pick the right treatment for them. During stimulation, I think we can make better decisions. I trained for a lot of time to do this and I like to think that I'm very good at it, but I only trained on a limited number of patients. What if I could take the data from every patient that the whole country has taken care of over the last 10 years and use that to make the right decision for each individual patient based on how old they are, how much they weigh, how many follicles they have, what they have tried before.

I think we could get a lot better because the human brain doesn't have the capacity to process that much data so quickly. And also it would remove a lot of the biases that humans have in terms of what happened last week or the patient that comes to mind in this given instance. And then lastly, we use embryologists and the way that they look at embryos to pick the one that we want to select for transfer.

I think we can use machine learning and computer vision to rather than look at an embryo and a couple characteristics, look at 2 million pixels of information to pick the best embryo so that hopefully we're prioritizing the ones that are going to get our patients pregnant faster. We're doing studies across all of these fields and trying to bring the best of it forward.

It will take a little bit of time to get that to market because we want to do so thoughtfully and carefully and always making sure we're putting the rights of the patient first.

Jackie Xu, MA: Okay. So, I know, uh, RSC has been a pioneer to utilize all kind of high tech. When I start work with RSC I believe 10 years ago, RSC already used big data, Polaris to, you know, predict for the cycle treatment protocol. So, Dr. Hariton, do you have, uh, more software, do you still use Polaris to predict?

Eduardo Hariton, MD: That's a great question. We don't use Polaris because unfortunately they took that off the market and it's not available, but we're creating our own software to be able to do the same kind of thing and answer the same questions because like you said, patients used to love it.

Doctors used to love it and we want to make sure we continue to provide that to patients. We are using big data in many other ways. So for example, our lab director is also a fan of AI and he's a very quantitative guy. So he put together a calculator that helps us think about, you know, if you look at an embryo and you look at the grade of the embryo, the day of biopsy, what is the likelihood of that succeeding?

Because it's not always clear whether you should transfer 6BB from day 6 or a 5AA from day 7. We can look at every transfer that has happened at RSC over its whole history and then see which embryo is better and we'll talk to our patients and we'll give them those very unique statistics for them and that allows them to be able to make the right decisions in concert with me and their clinical teams.

Jackie Xu, MA: Of course, Dr. Hariton, because RSC already have a huge database because 40 years practice. So, that's the software or the AI tool can tailor, for the uh prediction for the patient uh, come to RSC.

Host: You mentioned earlier that you spend a lot of time thinking about the future of fertility. So as the Managing Director of the U.S. Fertility Innovation Fund, what role do startups and innovation play when shaping the future of fertility treatments and why should that matter to patients?

Eduardo Hariton, MD: That's a great question. That's one of the hats that I wear. I see patients most of my week, but I also think about innovation and the future of fertility in my corporate role. We're a corporate parent, US Fertility. I think startups are crucial to the future of fertility because large companies get really good at doing one thing.

And there are so many people to take care of that they're not trying to think of different ways of doing things or better way. They just want to do things really good at what they're best. So get a patient, get them pregnant, deliver good care. But they're not trying to think about AIs or different software or things like that.

They rely on smaller companies with great ideas to start thinking outside the box. The beauty of my job is that I get to sit at a big company that has been around for 40 years and thinking through how do we take really good care of the patients with the tools that we have today, but also take everything coming out of the startup world, better medications, better media, better technology, better ultrasounds, AI, and put them together and see how do we plug them in at the right places so that over time we continue to raise the standard of care and make fertility treatments more equitable, more accessible, more successful, and easier to go through for our patients.

Host: Dr. Hariton, how does your cultural background, being Venezuelan with a Taiwanese wife, influence your approach to patient care?

Eduardo Hariton, MD: So, I have family all over the world. A lot of them in East Asia, Singapore, Taipei, Venezuela, Latin America. And I have a family myself, so I think I try to bring a broad cultural perspective to the way that I take care of patients. I try to understand their cultural background, their preferences, and bring them into care, because it's really important not just to take care of the clinical situation, but to take care of the whole patient.

I also think being a father and a husband makes me appreciate how important it is for people to build a family. I get home every night to my children and it makes me proud every day that I'm able to give that to my patients as well and change their life in not just the one instance, but for the rest of their lives.

So I think that diversity and culture and experience, having lived in multiple countries and being married to someone from a different culture really helps me look at the whole holistic patient, not just at a clinical problem.

Host: Dr. Hariton, how is your Mandarin?

Eduardo Hariton, MD: 我的中文正在進步 My Mandarin is improving, but slowly. I try.

Host: Jackie, how does SYNCARE complement RSC's fertility treatment as it relates to patients coming from China?

Jackie Xu, MA: SYNCARE has been working with RCA, I believe, over 10 years. We do two things, help Chinese patients. Number one is recruit, number two is facilitate. Recruit means before cycle starts, we help send information, expose each other. So, overcome language barrier, healthcare system, culture different, like Dr. Hariton mentioned, geopolitical reason. Because, we want Chinese patient to find best fit IVF clinic for them when they're in China. So we have a office in China. We have bilingual team, to help patient to register and get to the system. The number two we do facilitating. Once patients start to cycle, we, uh, as a team of myself is a trained, certified, medical assistant, and my other team members are certified bilingual Chinese medical translator.

So, we understand and plus, we have in the past 10 plus years, we work with patients shoulder by shoulder, I believe a, hundred cycles. So we know as every aspect of the uh, procedure along the way. So that's we do for facilitating. And with our headquarter in Silicon Valley, we like RSC, blind technology to this part facilitation part.

We use uh bilingual Chinese education material, include, like radio, we can, make to Chinese, like today we're doing right now, to profile a doctor, to and during this cycle, patient cycle, we have uh MOOC radio to let patient to visualize what the procedure like, actually what looks like, what do we expect, who are you going to talk with?

So it's like use technology and our specialty trained by bilingual medical assistant work in the uh, clinic along with the process on the way.

Host: I think you mentioned it, but how long have you been working with RSC to provide concierge services?

Jackie Xu, MA: Oh, I believe, 10 more years. When we start, I was, very impressive about how I believe 10 years ago when I, I was translating, for a Chinese IVF clinic from a region, one of the, uh, IVF clinic, one of five. Their cycle is over 10,000 a year.

That's the one of five, in the country. That's IVF group. It's of course in China. This kind of IVF group is state owned, so it's like official delegation group, they come to U.S. And then, I believe HHS or CDC or ASRM organization send them to RSC to visit, to have a tour.

So I was, uh, uh, translating on them. Then I know, uh, how RSC is practice, how is a team, how advanced into apply for high tech knowledge to apply for the IVF treatment.

Host: Thank you both so much for making the time to be here today. We appreciate it. And that was fascinating hearing about what you do.

Jackie Xu, MA: Thank you.

Eduardo Hariton, MD: Thank you so much for having us.

Host: That's Dr. Eduardo Hariton, Physician, and Jackie Xu, founder of U.S. Syncare and Medical Assistant. To find out more, please visit rscbayarea.com/about-Chinese. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.

I'm Maggie McKay. This is Fertile Edge, a podcast presented by Reproductive Science Center of the San Francisco Bay Area. Thanks for listening.