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ASRM Today: Genetics - Episode Nine

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This week we are going back to the movies! In this episode, we discuss with film professor Dr. Joseph Watson the film Never Let Me Go. Our discussion goes into the problems of genetic testing and cloning while also discussing the merits of the film as a prime example of topical science fiction.

Welcome to ASRM Today, a podcast that takes a deeper dive into the current topics in reproductive medicine. I'm Jeffrey Hayes and today on the show we are going back to the movies. This is our genetics season.

I think we have picked an appropriate film that touches on genetics. It's called Never Let Me Go from 2010. It's directed by Mark Romanek.

A script by Alex Garland starring Andrew Garfield, Keira Knightley, and Kerry Mulligan. It's based on a novel. Joining me today, coming back to ASRM Today to help us, guide us through these movie discussions, is Dr. Joseph Watson, who teaches film at the University of Alabama in Huntsville.

Joey, welcome back to the show. Thank you for having me, sir. Yeah, absolutely.

You had not heard of this film when I approached you about this. This was my first experience. Yep.

This one had slipped by my radar. I'm not sure why. Maybe it's because I was getting a PhD in 2010 when this came out.

Was a little busy. I was a little busy. Yeah, yeah, yeah.

So this one slipped. Some of them are going to do that over time. But wow, what a ride this movie is.

And I guess the first thing that we need to ask is, Jeff, is this a sci-fi film? Is it a romantic drama? Is it, you know, I don't know. Break it down form plot wise, right? Okay. So we open on some really good background information, right? That scientists have finally cracked the code, we're living to 100.

There's an allusion to the genetic cloning of something, right? And we basically go from there, we're thrown like right into looking at and being around children at a school, right? And as this story develops, and I'm going to try real hard not to give too much away, but it's going to be really hard not to do it. But, you know, we follow these children, and we follow their daily routines, and we see little things in the routines, right? Like little things that are very odd, like the bracelets, and the beverage and the vitamins, and them really appreciate that. Remember the bit in the beginning about they found like three cigarettes, which was more shocking to me.

I'm kids are 11. Yeah. This is crazy.

And you might see the adults doing this, but you're not supposed to do this. You know, it's like the worst thing that you can possibly do is do this. Right, because they're reinforcing to the body as a temple.

That's right. And so as our story slowly, it develops. And by the way, this, this movie clocks in at about an hour and 45, it went by really well.

It moves. It moves. Well, yes, it really does.

Because we just what, two, three different decades almost is that three? Yeah. Yeah. And it's just it's, it's got incredibly great pacing.

And I give, you know, I can't always say that about Alex Garland. That's fair. That's fair.

Yeah, that's fair. But, uh, you know, they really paid off. Maybe maybe because this time it was based on a novel.

I don't, you know, I don't read the Ishiguro novel, but I'm familiar with Ishiguro. So yes, and all of this sort of stems from, I mean, you know, for me, the aesthetic while presenting us with kind of an alternate history, right? Yes. So it's dystopian alternate history timeline, kind of setting, but it has the feel of a Merchant/Ivory movie from the 90s.

And, you know, and I'm, you know, and this is, of course, the connection to the author of the novel, Remains of the Day, was Remains of the Day. And so that makes sense that that sort of aesthetic would sort of present itself to someone like me, right, who grew up on some of those Merchant/ Ivory films, which were often based on books and very well structured in terms of their pacing. And it was, it was Downton Abbey before there was Downton Abbey.

Absolutely. I mean, it's that same kind of... And we ate it up. I mean, those movies were very popular.

Yeah. Yeah, yeah. I think it's interesting, because you pose this question, can it be science fiction with all these elements? And I would say yes, because we have, later we have an example like Children of Men, right? And we've got dystopian realism, alternate timeline, all this stuff, right? Right.

But if you're looking for science fiction in terms of the gadgets and the computers, and the robots and all that kind of stuff, this is not your movie, right? This is more of a, much more subtle, right? We even dusted this like last season, when we talked about Gattaca, you know, that was also very realism based. There's not, you know, Robbie the robot's not running around. There's not... Right, right, right.

Do you think that the realism lends it a little more gravitas? Well, I do. I think it also privileges, you know, the production towards more romantic melodrama, right? Which is what, you know, and I mean, it fits in this particular context, because I think one of the things that the movie is definitely trying to do is explore, you know, the essence of humanity, how we can, you know, experience emotions, nature versus nurture, kind of stuff. I don't know how far I can go with this, because we certainly don't want to spoil anything for audiences who maybe haven't, you know, who are listening who haven't seen the film.

But it explores in a very realism way, right? The kinds of things that can just naturally find their way into human existence, right? Like emotions, nostalgia, memory, all of these things, you know, that can just kind of naturally occur. And this movie is definitely asking us to question the essence of humanity, what makes us human, you know, and how far the line is between, you know, science and geneticism and what the motives are, right? I think we can certainly have a very good conversation about the commodification of the human body from this movie. I don't know if it's necessarily commodification, though, because the whole country isn't on it.

Right? I mean, there's no buying and selling here going on. This is something that was agreed upon by an entire nation. It was sanctioned.

This is part of the horrific, heartbreaking aspect of it. It's like it's a creation of second class citizens, right? And just, I just couldn't let that go. Also, for some reason, I just couldn't let go of Logan's run.

Well, it certainly echoes Logan's run, for sure. And, you know, I would say, Jeff, that one of the more interesting things about what you were just saying is it's like you wondered about sort of how that system of the manufacturing of the needs that would come from the, you know, the product, so to speak, that this you're saying, like, you know, the whole country, you know, it agreed upon this, right? It's like, well, did it start out that way? Or initially, was it more of a private sort of enterprise that really relies on privilege and things like that, you know, for people to have access to that kind of stuff, right? Or even invent that kind of stuff, right? If it sort of started out that way first, and then eventually, everyone kind of politically agreed that, yes, we're okay, morally and ethically with this. So we're just going to officially sanction it for everybody, access for all.

And then that's what creates the sense of the second class citizenry. I, you know, I don't know. I mean, there's, yeah, I don't want to go too much further, because then that would be definite spoilers.

Yeah. Well, there's also the line in there, in one of the voiceovers of a really good voiceover narration, by the way, in this film. Yes.

I said something along the lines of, well, once, you know, the cat was out of the bag, you know, were we going to go back to breast cancer and lung cancer and all of these things? And the answer by the majority was no. Was no, right. Yeah, you know, so it's, you begin to wonder about, and maybe the Ishiguro novel does dig into it a little bit more, you know what I mean? Like, maybe we might get a little bit more backstory on the political motivations of the nation.

And, you know, if there was a monetary, maybe there was a privatized thing, like you're saying, and it eventually became more systemic. I mean, I'm just theorizing, but this is what good movies do, right? They generate thought and discussion that can come from, you know, the ideas being presented. I felt like the film, you know, it kind of lays, like the love story part of it, like, didn't really hit with me.

But what did hit with me from that part of the story was the, you know, just the emotional impact of nostalgia and memory, right? That it can have, and how much that it can dictate the choices that we make, you know, in life from, you know, which grocery store to go to, to who to, you know, spend the rest of your life with as a partner, right? I mean, those kinds of memories can, you know, and how, dare I say, perhaps, you know, unreliable memory is. Yeah. Yeah, well, I mean, they even admitted one point that they've, you know, why are we taking our cues from a television show, you know, about how to have a relationship or to be married or to do, you know, things of that nature.

And I thought, I thought that was a little sly commentary too, at the time, you know, about media, you know, influences our relationships. Absolutely, absolutely. And I think that it was just sort of, and it continues to play upon that kind of predetermined nature, right, that they're suggesting from the very beginning, right? I mean, these kids are told they're special, that they're special, they're not exactly, they're not exactly told why until later on.

And I was glad that, you know, and maybe this helps with the pacing as well, but I was glad that that reveal happens pretty, pretty early on in the first 45 minutes. Yeah, right. Yeah.

So after that, you're like, okay, you know, it's not going to be a 90 minute reveal. It's a 45 minutes, I mean, that, you know, the timing and the flow is really working well. But I think there's enough clues, enough gestures to where you can kind of put the pieces together, you know, in terms of, okay, there is something special about them.

But when you discover what that is, that's when the really sobering, like... I mean, like a truck hitting you, you know, it's like, well, you're in disbelief the first time you hear it, right? Because you're just like, no, that can't be right. You know, there's no, that can't be right. And then they move into the second act of the film.

And you're like, oh, no, it is real. And we're in 1985. And these kids have grown up and you're like, holy, you know, what's going on? Yeah, holy moly, what's going on? Uh, you know, and because you, you get this wonderful sequence to when they're told right where, where the cameras are just lingering on their faces, even after the news, it's like that, it's like, we, we are definitely in their shoes, right? Like, well, no, we're just, I'm right with you, Kathy, or whatever, you know, I'm just now feeling the weight of this as well.

And my empathy has exponentially grown for you, right? But I didn't feel cheated by that. I thought it was a really neat, you know, neat storytelling device that reveal right there, you know, because it really propelled into the, into that second act in 85, 1985, when you're like, what are they doing? What's going on? You know, what's Yeah, well, one of them makes a humongous decision to be a caregiver at, you know, at this point. Now, this is where it gets a little bit where I can understand where you didn't maybe feel the love story as much, because it was just like, you know, they're trying really hard to establish that this is like unrequited, you know, and that it's just, I can agree with you that I did not feel it as well.

I'm feeling more again, I'm feeling more empathy towards the situation. Yes. So that is heartbreaking.

Yes. You know, them not finding love, I found myself a little bit, you know, like, like, just kind of like that with it. Well, it's, I guess that's sort of, you know, the film has this, because of its premise in the way it sets up the story, it has this sense of questioning time, right? Like this, you know, how much time do you have? Do we really have? And of course, you know, you and I've had this conversation a lot, you know, we don't know we there's so much in life that we don't have control over.

And so I think that when when these characters get into that informed situation, wow, that's the best way I can say it without spoiling anything. You know, that sense of time, like, what are we going to have left time wise? And then how can we connect that to what experiences are out there that you know, I mean, because it's, it's finite for all of us, but for them, it's, it's very different. Yes, very different.

Yes, even and even and you can even have questions. And there are questions of quality of life after certain phases of, you know, what they end up these characters end up having to do, right? Or as they call it, what do they call it? They call it not passing, but completion. They call it completion.

Yeah, it's very, it's very, procedural, right? It's very procedural, that they move, they move on to completion at some point, right? In their in their existence and in their lives. You know, this, this film also brings up really interesting questions from from gene editing in, you know, side of the street. You know, CRISPR, I'm sure would be a great, you know, side study into this about how they how they deal with that.

But I was really fascinated. In my notes, I was thinking about this also, about like, did you notice that they must have made them sterile? Well, we weren't given any evidence to the contrary, right? I mean, it wasn't right. So I mean, I yeah, I don't know.

Did they explicitly state that in them? No, they don't. Because they're sexually active. Yeah, well, I, I assumed that at one point, there was a scene where there was big news being revealed.

And I thought, oh, you know, this one character might be pregnant. And but that's, obviously, that wasn't what it was. But I guess that would be another clue as well.

Because most logical audience members are going, okay, is there a baby on the way here? Because yeah, yeah. And that's, yeah, yeah. Well, they're teenagers.

Yeah, yeah, yeah. Teenagers and young adults. Did you, the way that they tried to introduce the idea of them considering themselves second class citizens, was that they believe that they come from less desirable people, or less just people in less desirable professions in life.

And there's a very specific scene where she finds some magazines. And, you know, initially, it's thought that, you know, she's being sexually curious, but she comes to find out that it's more than that. I mean, what did you think of that as far as as an angle, you know, as a commentary of sorts? Again, was it just, was it reinforcing that this is a danger that this road could go down, you know, that that because it's never confirmed, right? It's never confirmed about how they got there.

But it's alluded to. Yeah, so that, you know, we're sort of taking the less desirable of our society and allowing them to be the source of the procreation. And is it even participation? You know, that was another question I had, I wrote down, I said, is this participatory? Or is this, you know, forced? Yeah, you know, and there is sort of a, there is, you know, a section of the film where there is this sort of push for to sort of find the model or the inspiration, right, the source for them.

So yeah, I, you know, I don't know if I have like, I mean, I guess anyone is probably going to want to find their home source of identity, right? Their true parentage, their true genetic history, right? You know, orphans, certainly, you know, whether they get adopted or not, like, they certainly pursue that sometimes, right, like, after a certain time. So I mean, I think, isn't that just sort of a indication of the human condition, that desire to want to find the, you know, your source of origin, if it's not known to you from the beginning, right? Yes, and it's withheld. And because it's withheld from them here, this is another ethical quandary, because it's just like, you know, the child, and a lot in reproductive medicine, we talk about this in ethics is just like, you know, the child's right to know.

Right. You know, do you or don't you withhold? You know, like, is there a time where it's considered okay, where this sort of thing happens? And I think that that's such an interesting sort of, again, and it's not explicitly stated in the film, it's just where my thought pattern went, you know, as I was writing my notes, and I was writing my questions down, because this is one of the great things that I love about this film is that it does raise so many questions. And as you said earlier, you know, it just, it doesn't lay out everything for you, which is a good hallmark of good, hard science fiction in my opinion.

Yeah, and Alex Garland. And Alex Garland, yes, he's very good at keeping, we still don't know, you know, many things in a film like Men, if you haven't seen Men, oh boy, buckle up. Buckle up.

Yeah. Did you have any specific questions that the film raised for you when you were watching it, like in your notes, or? Oh, wow. Well, one of the things that was interesting to me that stood out, and, you know, I don't know, it was this idea of nostalgia, you know, and something that I saw early on in the movie, you know, there's this sequence where they're bringing them, you know, boxes, and... Oh, yeah.

Right, various items. The little fair, or whatever it is, like, where they trade their stones in. Yeah, yeah, it's like the Scholastic Fair, if you had those when you were in elementary school.

The Scholastic Book Fair, yeah. If you had those, it was kind of a dystopian offshoot of that, right? Just almost more like a yard sale, but the, you know, the objects that were picked, you know, and the fact that he picked an object for her, you know, and that was sort of the spark, right, for their interest in each other, their souls, so to speak. Yeah, that was a really sweet moment, and so I kept reflecting back on that, because they were so driven, their characters were so driven by those memories, you know, and so, I guess for me, what stood out, I didn't really have any questions, but what I was surprised about was that I got more, way more invested in the romantic melodrama component than I did more of the sci-fi dystopian stuff.

That stuff sort of hit a lot harsher, because it, you know, took me out of the... Well, as you say, is that more a distraction in the end? Yeah, it was just like, this is a love story, right? This is like, you know, this is a love story, and it is in a way, right? But it's a dystopian love story at that, right? So, you know, those aren't going to end well. So, yeah, I just, I think I was surprised by that, and just had questions about just how much nostalgia triggers our behaviors, particularly from a consumer standpoint. You know, you think about collecting, and the nostalgia that drives, you know, collectors, and of all kinds of artifacts, and it's like, whoa, okay.

Yeah, yeah. Digi, I want to go back to this concept of the soul real quick, because I think it's interesting you bring that up. They raise them at peers without... I wondered if you were going to take that.

I was like, okay. I was going to take the bait on the soul. It appears that they are raised without religion.

We never see any mention of a celestial figure of any kind, or any kind of service that is given. They meet in a main hallway, you know, very hot. And they sing.

They sing, but it's more like an alma mater more than... Yeah, it's not a hymn. No, it's some kind of creepy alma mater, you know. It's like, you feel like you're in dead poet society in the first 15 minutes.

You're like, what am I watching, you know? Yeah. Yeah. Yeah, but I think, too, it's just the way that other people react around them, like from the town.

They just don't want to deal with it. You know, they're just like, these are soulless things, right? And they just always are very irritated, and, you know, just don't want to deal with it. And it's just so upsetting.

Yeah, it's like Village of the Damned, right? Oh, yeah. Yeah, yeah. Only the kids, they're not terrified of them.

They're just disgusted by them, right? In this movie, right? Yeah, yeah. But the soul, where were you going with that? Well, I mean, it's just you can't, whether you're scientifically involved or theologically involved in, you know, these debates about, what is human experience? You know, what is it to be alive? You know, is there a soul? Is there not a soul? How would we deal with, you know, what they would, and that's why I say that I consider that everyone else considers them to be soulless beings, because they can't deal with the idea that they would put some, you know what I mean? Like, that's what I get when I was watching it also, was that, like, they have to clean their hands of it. They have to look at them as objects, and not as real living thinking beings.

And that would lead me down the road, just if I'm putting A and B together to saying something like, oh, well, you believe it doesn't have a soul. Like, you know, that's why you can pick up a rock and throw it in the ocean and not feel bad about it, because you think a rock doesn't have any soul in it, so it wouldn't drown or, you know what I mean? Like, that's kind of where my thought process was when I was considering the soul. Well, and certainly it's timely, Jeff.

I mean, you know, I think we certainly, you know, that kind of detachment, that kind of sense of, like, I need to, you know, step out or step away, right? I need to disengage from society or culture, right? Because of all the things that are going on. I mean, I think that that is one of the reasons why probably the movie still is so strong, is that it's still so very timely in terms of how is it addressing several of the ways that we address the essence of humanity. And I think you're right in this soul question.

I think it has some things to say about even what our concepts are of consciousness, right? When we are aware of our human finite existence, right? When do we become something else? Right, right, right. And so, you know, and what those, I even think the film offers us iterations or glimpses into what versions of ourselves we might be like on the pathway to finding out what happens after we die, you know? I mean, those scenes after they go through some of those phases, you know, and let me just tell you, you know, Keira Knightley is very attractive, right? And I was... She does such a great job. I was researching for the podcast today, and I read where the director said it was very, very difficult to, you know, make her look, you know, weak, you know, all of those, you know, sickly, I guess, for the better.

Yeah, because she has to be sickly for most of the bulk of the film. Yes, yes. And that they struggled to do that because, you know, she's such a good actress in terms of her physical features for the camera, right? But I thought they did a really nice job, you know, with the production design, like we were saying, from makeup to even costumes, right? I mean, it just... Yeah, you know, it's really a period piece.

It's like a Merchant/Ivory film, except this time it's the 70s and 80s, right? And that's probably why the romantic melodrama drew me in, because that's what drew you into all the other Merchant/Ivory films, right? And so the, you know, the sci-fi kind of philosophical contemplative stuff that we're pulling out of it, it's there, but I just don't think that it's just not the most prominent thing that they seem to be interested in. It just seems to be, they set up the film this way, so within this romantic melodrama sort of genre formula, they're sliding in these ways in which the context of which these characters are facing, the consequences, the inevitability of what they have to do, it makes the romantic stuff even more sort of endearing, I guess, or is supposed to. Yeah, yeah.

And also just the acceptance of fate. Yes. You know, what stoicism is shown in the acceptance of one's fate? Also, again, very heartbreaking, just to say... Yeah, well, because there is no Logan's Run moment where they run to the gates of the, and are escaping and trying to, you know, live outside of that.

There's none of that. Did you think there was going to be? I wasn't sure until we got through the second act, you know, and then I was like, okay, they're not interested in that, you know, they're telling a story. They're looking to go to completion, you know, and just that that's, do you think completion serves as their, that's what they ultimately feel will be the way out? Like, you know, they're just so beaten down, that, you know, this is the way out.

Yes. Yeah. Yeah, I... Well, I just, again, it's just so, when you think about the sacrifice that's involved by these characters, and even the tertiary character, Domhnall Gleeson's character, when we were introduced to him and the girlfriend, you know, and believing that there's another way out, you know, through relationships, in the reveal of which, you know, it wasn't really a reveal for me, I always knew that it wasn't true, you know, it's just like, but I wanted to believe, I truly wanted to believe that there was that way out.

Well, that certainly would have taken the romantic melodrama angle differently, right? It would have taken it on a different trajectory. And no, it would not have worked, it would have been, the tone of the movie would have changed, you know, dramatically, if they had gone in that direction. Since it's alluded to, I think that the whole nation is in this, like, that they are aware of all this, there is no escape, right? There is no, well, number one, you're on an island, right? You know, but there is literally no exit, you know, for them, because everybody, and I only picked that up, really, the first time I picked that up was on the back of the van door, when they were delivering and it said national so and so.

And I went, oh my God, and I even said Jill was sitting there with me and I went, oh my goodness, the whole nation's in on it. Like, before I thought it might have been isolated, you know, or like you said, maybe the rich do this, or a certain class, I was like, oh, no, this is the Commonwealth. Right.

This is, oh, like, this is even more horrifying than I anticipated. Well, it certainly adds to that realism, right? And, you know, it adds to that sense of atmosphere. You know, like I said, there's several times where I was just like, from costumes to production design, I'm like, is this like a World War Two, like, film? This is post World War Two, you know, even the cars or, you know, like, you know, just, you know, from different eras, it seems like it was weird.

I don't know. But I think Well, it's an alternate timeline. Yeah, that's I think it's the alternate timeline stuff that throws me off because then you then you start thinking, okay, well, if this didn't happen in this, you know, decade, and then what other things didn't happen? And then you start thinking about how in this historical timeline that they're proposing what other things did or did not happen.

Right. You got your Watchmen scenario going on. Yes, exactly.

Right. Thank you, comic book industry. Yes, yes.

Nixon is still president. In Futurama parlance, he's still ahead in the jar now. There you go.

Still leading the world, you know, as it is. Now, this film was not a success. This film was not popular.

People did not go see this movie in 2010. And again, I surprised you with it. I'm sure we're surprising a lot of our listeners with this film.

Would you would you recommend this film? Yes. Okay. Yes.

What grounds? I mean, Oh, I think it asks some very interesting questions. And I love movies that create conversation after. And by that, I mean, conversation, not just, oh, it's great.

Yeah. Right. In the drive home, you're like, did you like it? I liked it.

It was awesome. Yeah. Love, love the part where the planes crashed, you know, or the or the, you know, the building blew up or, you know, Tom Cruise drops off a motorcycle.

I love seeing Tom Cruise run again. That's, that's, that's not the kind of, I mean, those conversations are fine, right? But you know, everyone should go to the movies and enjoy what you enjoy. But yeah, no judgment at all.

But I don't think that, you know, that it's for everyone. But if you if you want to have those conversations, you know, that that ask deeper questions, this is a movie for you, you know, and I think that's kind of why slyly makes it still science fiction as well, because I think the best science fiction is philosophical. And I think that it, you know, draws out a lot of questions or should anyway.

Yeah, I'm on the same boat. I would recommend this film. Just, just because I think you should watch films that challenge you.

Films that make you question things that, you know, if I can get from A to B with this movie, I have to assume again that, you know, I'm not that I'm not alone in this exercise, where it's just like, you got you, you lock into this movie, and then you're, you're just you've got to have questions at the end of it, just because they leave again, so much open and so much on the table. And it's just, it's just, it's not a feel good movie. But, you know, not every movie is a feel good movie.

Surprise. Yes. And, you know, the tone of this on the director of this movie.

Yeah, Mark Romanek. It was, you know, didn't do a whole lot of stuff or hasn't done a whole lot of stuff. But another film that he did was quite brilliant.

It's called One Hour Photo. Oh, Robin Williams. Yes.

And and it has a very similar tone. And so it was very interesting, sort of interesting to, to experience that, you know, this movie, Jeff, it, it has a very eerie tone to it, you know, but it'll suck you in. And, and, and, you know, just with a little bit of active viewership, you know, you don't, you don't even have to have a whole lot, but just a little bit of active viewership, you'll start to get, you know, dig in to what they're what they're offering you.

It's just not heavily explicit, you know, and it's not going to be Robbie the robot, right? I mean, it's not going to be that. Absolutely. Well, look, we're your time is valuable.

I really appreciate you coming on the show today to share with to share with our audience about this film. Never let me go check it out. It's available on every platform.

You can, you know, download it, rent it, or, or you can go to your library. I'm also a big proponent of the libraries, check it out of the library. You know, the DVDs and libraries are wonderful.

And so is the digital platforms and libraries as well. Joey, thank you again so much for being on the show today. Thanks for having me.

And for our listeners, please rate, subscribe, review the show on Apple, Google, Podbean, wherever you get your podcasting needs, you know, done, go ahead and mash that subscribe button for us. If you liked it that much. And until next time, I'm Jeffrey Hayes and this is ASRM Today.

This concludes this episode of ASRM Today. For show notes, author information and discussions, go to ASRMtoday.org. This material is copyrighted by the American Society for Reproductive Medicine and may not be reproduced or used without express consent from ASRM. ASRM Today series podcasts are supported in part by the ASRM Corporate Member Council.

The information and opinions expressed in this podcast do not necessarily reflect those of ASRM and its affiliates. These are provided as a source of general information and are not a substitute for consultation with a physician.

ASRM Today Series Podcasts are supported in part by the ASRM Corporate Member Council

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Explore ethical considerations in embryo transfer, PGTM, and genetic testing with Dr. Sigal Klipstein on ASRM Today’s genetics-focused podcast episode.
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ASRM Today: Genetics - Episode Seven

Dr. Elizabeth Ginsburg discusses PGTA, its benefits, limitations, and proper use in IVF based on age, ovarian reserve, and embryo quality on ASRM Today.

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ASRM Today

A podcast that takes a deeper dive into current topics in reproductive medicine. And what is in that dive? ASRM Today brings you episodes that explore reproductive medicine through personal interviews and expert discussions, keeping up with the topics that matter.

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Fertility and Sterility On Air

The podcast where you can stay current on the latest global research in the field of Reproductive Medicine. This podcast brings you an overview of the monthly F&S journal, in-depth discussion with authors, and other special features.

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SART Fertility Experts

An educational project of the Society for Assisted Reproductive Technology, this series is designed to provide up-to-date information about a variety of topics related to fertility testing and treatment such as IVF. 

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Topic Resources

View more on the topic of genetic screening/testing
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Fertility and Sterility On Air - Live from the PCRS 2025 Annual Meeting

Explore cutting-edge fertility research from PCRS 2025—PGT-A, embryo screening, cost-effective protocols, and gamete storage breakthroughs. Listen to the Episode
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ASRM Today: Genetics Bonus Episode - Inclusive Family History Project

Explore how inclusive family histories improve healthcare for donor-conceived and adopted individuals with new EHR standards and provider education tools. Listen to the Episode
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Fertility and Sterility On Air - TOC: June 2025

Stay updated on global reproductive medicine with Fertility & Sterility On Air—insights, debates, and journal highlights hosted by leading experts. Listen to the Episode
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ASRM Today: Genetics - Episode Nine

Explore ethics, identity, and humanity in a dystopian love story as ASRM Today discusses Never Let Me Go through the lens of genetics and reproduction. Listen to the Episode
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ASRM Today: Genetics - Episode Eight

Explore ethical considerations in embryo transfer, PGTM, and genetic testing with Dr. Sigal Klipstein on ASRM Today’s genetics-focused podcast episode. Listen to the Episode
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ASRM Today: Genetics - Episode Seven

Dr. Elizabeth Ginsburg discusses PGTA, its benefits, limitations, and proper use in IVF based on age, ovarian reserve, and embryo quality on ASRM Today. Listen to the Episode
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ASRM Today: Genetics - Episode Six

Explore how genetics may unlock the secrets to longevity, reverse aging, and extend life through telomeres, gene therapy, and cellular reprogramming. Listen to the Episode
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Fertility and Sterility On Air - TOC: May 2025

Explore new fertility research on IVF triggers, thyroid autoimmunity, prednisone use, and genetic impacts in this expert-led review of May 2025’s F&S journal. Listen to the Episode
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ASRM Today: Genetics - Episode Five

Explore how personalized medicine is transforming reproductive healthcare, from IVF optimization to ethical issues in genetic testing and AI-driven care. Listen to the Episode
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Fertility and Sterility On Air - Best of ASRM and ESHRE 2025

Experts explore recurrent pregnancy loss, embryo testing, IVF mental health, and stem cell banking at ASRM–ESHRE 2025. Insights from leading fertility voices. Listen to the Episode
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ASRM Today: Genetics - Episode Four

Explore how genetics shapes agriculture and reproductive medicine, from GMOs to CRISPR and lab-grown meat, in this ASRM Today podcast episode. Listen to the Episode
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Transfer of embryos affected by monogenic conditions: an Ethics Committee Opinion (2025)

Patient requests to transfer embryos with serious monogenic disorders detected in preimplantation testing are rare; this opinion discusses physician responses. View the Committee Opinion
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ASRM Today: Genetics - Episode Three

Explore how genetic mutations cause disease, and discover breakthroughs in gene therapy like CRISPR offering hope for treating conditions like cystic fibrosis. Listen to the Episode
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ASRM Today: Genetics - Episode Two

Explore the nature vs. nurture debate, epigenetics, and how genetics and environment shape behavior, personality, and modern precision medicine. Listen to the Episode
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Fertility and Sterility On Air - TOC: Jan 2025

This episode of Fertility and Sterility On Air covers groundbreaking research on reproductive medicine, including PGTA in donor eggs, BMI effects, and ovarian transplantation. Listen to the Episode
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Fertility and Sterility On Air - TOC: Dec 2024

Podcast episode discussing reproductive medicine highlights, including ASRM 2024 insights, meta-analysis integrity, donor ethics, and IVF communication challenges. Listen to the Episode
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Journal Club Global: Embriões mosaicos ao Teste Genético Pré-Implantacional para Aneuploidia (PGT-A): o que fazer?

Discutiremos embriões mosaicos ao teste genético pré-implantacional para aneuploidia (PGT-A) View the Video
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Journal Global Club From TSRM 2024: Preimplantation genetic testing for aneuploidy in unexplained recurrent pregnancy loss: A systematic review and meta-analysis

Explore the effectiveness of PGT-A in managing unexplained recurrent pregnancy loss, featuring systematic review findings, insights on miscarriage risks, and live birth rates. View the Video
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Genetics: Counseling Fertility Couples About Their Evaluation

Caitlin Hebert discusses fertility counseling, the importance of carrier screening, and overcoming barriers for patients while highlighting the role of genetic counseling. View the ASRMed Talk Video
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Use of preimplantation genetic testing for monogenic adult-onset conditions: an Ethics Committee opinion (2024)

Preimplantation genetic testing for adult-onset monogenic diseases is ethically allowed when fully penetrant or conferring disease predisposition. View the Committee Opinion
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Codes for Embryo Biopsy

When doing a preimplantation genetic test (PGT) biopsy, can you bill for each day a biopsy is performed or can you only bill once for the cycle? View the Answer
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The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)

PGT-A use in the U.S. is rising, but its value as a routine IVF screening test is unclear, with mixed results from various studies. View the Committee Opinion
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Journal Club Global: Recent clinical trials in Fertility and Sterility from the Asia Pacific region

Join ASPIRE 2024 for a Journal Club Global on PGT-A and IVF. Learn from top experts discussing recent clinical trial data and pregnancy outcomes View the Video
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Coding for an endometrial biopsy/Mock cycle

We had patients request us to bill their insurance for the two monitoring visits and the Endo BX and change the diagnosis code to something that is payable.  View the Answer
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Journal Club Global: Cost effectiveness analyses of PGT-A

Infertility treatments can be financially burdensome, often without insurance coverage, making understanding the cost effectiveness of PGT-A crucial. View the Video
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Coding PGT requisitions to the PGT lab

Do you have any recommended codes to use for PGT requisitions to the PGT lab?   View the Answer
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Genetics: Is Expanded Carrier Screening the Standard of Care?

Hannah Green, a genetic counselor at NYU, discusses the benefits and limitations of expanded carrier screening, highlighting its impact on clinical practice and patient care. View the ASRMed Talk Video
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Genetics - Extra Testing, Passthrough or Money Maker?

Danielle Soltesz of RMA New York discusses the complex economics and ethical considerations of genetic testing in reproductive medicine, exploring costs, patient care, and sustainability. View the ASRMed Talk Video
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Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)

This document incorporates studies about mosaic embryo transfer and provides evidence-based considerations for embryos with mosaic results on PGT-A. View the Committee Opinion
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Journal Club Global - Revisiting the STAR trial: The Fellows debate PGT-A

We are excited to host a debate covering the pros and cons of PGT-A and how new technologies should be validated before clinical implementation. View the Video
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Indications and management of preimplantation genetic testing for monogenic conditions: a committee opinion (2023)

ASRM has updated its opinion on PGT for monogenic conditions, providing guidance on clinical and technical complexities. View the Committee Opinion
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Results Review

What CPT code is most appropriate to submit for Physician Time to review CCS/PGS/PGD results? View the Answer
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Sperm DNA Fragmentation

Is there a CPT code for HALO DNA Fragmentation for sperm? View the Answer
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ICSI and Embryo Biopsy

How to bill for ICSI or embryo biopsies that occur in different days?  View the Answer
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Embryo Biopsy

Have any new codes been introduced for the lab portion of PGT? View the Answer
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Embryo Biopsy Embryologist Travel Costs

Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
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Embryo Biopsy PGS Testing

What codes are appropriate for PGS testing? View the Answer
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Genetic Counseling

Does ASRM have any guidance for how to bill for genetic counseling services provided by a genetic counselor?
View the Answer
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Assisted Zona Hatching

Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
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Journal Club Global - PGT-A - Can non-invasive approaches based on spent medium analysis

PGT-A by trophectoderm biopsy aims to select available euploid embryos for transfer. View the Video
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ASRM müllerian anomalies classification 2021

The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability. View the Committee Opinion
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Journal Club Global - Accuracy of Preimplantation Genetic Testing for Aneuploidies

One of the highest aspirations in reproductive medicine is to develop a technology allowing for ID of embryos that have true reproductive potential.
View the Video
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Reproductive and hormonal considerations in women at increased risk for hereditary gynecologic cancers: Society of Gynecologic Oncology and American Society for Reproductive Medicine Evidence-Based Review (2019)

Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions. View the Joint Statement
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Disclosure of sex when incidentally revealed as part of preimplantation genetic testing (PGT): an Ethics Committee opinion (2018)

Clinics may develop a policy to disallow selecting which embryos to transfer based on sex and choose to use only embryo quality as selection criteria. View the Committee Opinion
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Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)

ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint Guideline
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Preimplantation Genetic Testing Special Interest Group (PGTSIG)

The ASRM PGTSIG coordinates research, education, and training in preimplantation genetic diagnosis (PGT). Learn more about the PGTSIG