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Thursday, April 18, 2024

This Doctor Uses Machine Learning to Identify Overlooked Causes of Infertility


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Dr. Andrea Vidali is a reproductive endocrinologist, reproductive immunologist, and endometriosis surgeon who is using AI to help families detect overlooked causes of infertility. He sat down with Jessica Abo to discuss his new company, Pregmune, and why he’s on a mission to help patients better understand their fertility journey.

Jessica Abo: Can you start by giving us an overview of your work?

Dr. Andrea Vidali: The baby is what we call a semi-allograft because it contains 50 percent of the genetics of the other parent. And therefore there is a tendency for rejection. Many pregnancy complications, when they happen, are due to this type of phenomenon. Studying this is the whole field of reproductive immunology. But reproductive immunology is complex, and a lot of doctors, although they are aware of reproductive immunology, are aware that many pregnancy complications are related to the immunological aspect of pregnancy, they do not know how to evaluate and address immunological problems in pregnancy. And this is common. This is normal because the way medicine is, it’s very compartmentalized. The knowledge is compartmentalized. So, there’s a number of cognitive biases where doctors only apply the knowledge that they know.

Why did you start this company?

Vidali: The reason why I wanted to start this company was specifically this, to allow doctors who are aware of immunological complications in pregnancy, such as recurrent pregnancy loss, infertility, implantation failure in IVF, to evaluate and learn about the reproductive immunological component of it. And therefore give them a tool, which in our case is our report, to assess these patients and hopefully provide both insight as well as treatment.

How does the company work?

Vidali: What we provide is a very detailed assessment, a snapshot of what’s happening with a patient’s immune system. Now, whenever you’re looking at the immunology of pregnancy, you have to look at multiple aspects. You have to look at compatibility between the couple. You have to look at the inflammatory component of the person who’s carrying as well as the other parent. So, all of these components are usually analyzed via laboratory work.

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And this laboratory work is very complex. It includes genetic evaluation because of course genetics is very important because it looks both at the genetics of the HLA system, which is what our bodies, our inflammatory cells look at for compatibility. You have to look at the tendency toward our immunity, that’s also genetics and there’s familiarity there. Then you have to look at the blood to look at inflammatory components and you also have to look at the blood when it comes to nutrition and hormones. So what we do at Pregmune, we take all of these different elements together. We put it through an artificial intelligence engine and we give both a prediction of risk based on immunological data, and we also give recommendations on how to correct potential immunological problems.

Where is this available?

Vidali: This is actually available all over the United States. Patients can order the report, either their doctor can order or by calling a number and using a doctor in our network. And they will then go to a national-level lab to get the blood work worked on, these labs come together and they get analyzed in an automated way. Ultimately, of course, a set of human eyes has put them on the reports to make sure that everything is okay. And then the report gets handed out to the doctor and the patient as well, with both the recommendations and also the full analysis in a very sophisticated graphical form.

Given you’re a practicing physician, how did you find the time to create this company and take it nationwide?

Vidali: We had always thought about how we have a very successful medical practice and we are leaders in our field. How do we create something that has a bigger, a broader reach? We realized that the value of what we did was actually in the data analysis, in the ability to actually look at the data that we already had. At that point, the plan was ready. And at that point it is just team-building, hiring the right people, right? You have to have a COO, who’s actually a doer. Somebody who’s organized and gets things done. You need to have the right science behind you. And I did have a scientific group that I expanded. And then lastly, you have to have the technology.

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How much does this test cost and how long does it take to get results?

Vidali: The blood work goes off to people’s individual’s insurance. And of course, as you know, insurances are sometimes inconsistent with the way they cover the labs, but overall, most of the labs are covered. The price for the report itself, which is what we charge for, is $2,000. But of course, now we’re launching it at a discounted price of $900. The timeline can be long. We tell people anywhere between four to six weeks to get results back.

What do you want to say to other physicians out there who have a business idea?

Vidali: My recommendation to any doctor is, the first thing you have to do is believe in yourself and believe in an idea. You have to be ready to go for it. You’re not a kid going to a VC and throwing them an idea and they give you like whatever, $40,000 at a valuation of $8 million and you go. You’re not that person. You are a more mature individual, and if you have that idea, you have to put your energy behind it, and take the risks that come from developing that idea.

October is Pregnancy and Infant Loss Awareness Month. What do you want to say to people who are experiencing a loss?

Vidali: Not enough can be said about the pain and the suffering that comes from either a miscarriage or multiple IVF failures. So much pain that people have to endure, and most of this pain is suffered, unfortunately, in silence. What I like to tell people is, first of all, that your suffering is indeed acknowledged, at least by me, at least by us. And the second thing I like to tell people is to never accept unexplained fertility as an answer. Never expect we don’t know, or bad luck as an answer, because I think that physicians are obliged to look for an answer to your problem. They’re obliged to look for an answer. And I think that the physician will automatically tell somebody, there is no answer, it’s unexplained. They probably haven’t looked hard enough, because there’s got to be an answer for at least most problems.

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One of the most important things in medicine is that knowledge is ever-evolving. And the field of reproductive immunology is one of those fields that, although it’s not new, has not fully permeated the reproductive world yet. And I think that that makes it even more exciting for me, as an opportunity. And I think that because it’s something that when you have the depth of knowledge and you’ve seen the experience, and you’ve seen it, but somebody else, or many other doctors have not seen it. You’re not just an entrepreneur or a doctor, you’re also an evangelist. You’re an educator. Because you have knowledge that very few people have. And I think that’s something that I value a lot. And as an entrepreneur, it’s something that gives me the strength to go ahead every day and wake up and say, what are we going to do today?

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