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Page 1 of 6

Chicago Embryo Biopsy Workshop Application August 2022

Contact Details

First Name(*)

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Last Name(*)

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Title(*)

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Email(*)

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Street Address(*)

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City(*)

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State(*)

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Zip/Postal Code(*)

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Country(*)

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Telephone(*)

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IVF Cycle Questions

How many IVF cycles does your practice perform annually?(*)

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Of total cycles, what is the percentage of fresh cycles your practice performs annually?(*)

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Of total cycles, what is the percentage of frozen cycles your practice performs annually?(*)

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Of total cycles, what percentage of PGS does your practice perform annually?(*)

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Experience Questions

How many years have you worked in a clinical IVF practice and/or laboratory?(*)

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What is your experience level with vitrification?(*)

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What is your level of experience with ICSI?(*)

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Please explain your experience level with laser-assisted embryo biopsy (Day 3 and/or Day 5).(*)

Please explain your level of laser-assisted biopsy experience

Please explain your level of experience with time-lapse imaging and systems used (if any).(*)

Please explain your experience with time-lapse imaging

Do you consider undisturbed embryo culture to be important for optimal embryo development?(*)

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Would undisturbed embryo culture plus continuous monitoring of embryo development be of interest to you?(*)

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Equipment Questions

What type of microscope, micromanipulator and laser do you use?(*)

Please list your workstation equipment

Which optical contrasts do you use on your inverted microscopes? (Use CTRL or SHIFT key to Select All that Apply)(*)

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If you checked more than one, please specify which contrast you use for which task.

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Do you use any type of electronic witnessing in your lab? (*)

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If yes, what system?

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Do you feel electronic witnessing is important for the laboratory?(*)

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What type of incubators do you currently use (e.g., big box, benchtop, etc.)?(*)

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PGS Questions

Do you currently work with a PGS reference lab? (*)

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If yes, please list the name of the lab.

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If no, clarify where PGS testing is performed for your clinic.

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What type of technology is utilized?

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If Other, please explain:

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What is the most valuable thing you want to learn from this workshop?(*)

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Please enter any other comments or questions regarding this workshop.

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Have you attended a Hamilton Thorne Workshop in the past?(*)

YesNo

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I am Human(*)

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