Ep 118: The Infertility Sector and Artificial Intelligence, with Paxton Maeder York and Dr. Flisser
Fertility Forward Episode 118:
Today we are joined by two special guest speakers to discuss a very timely and engaging topic. Dr. Eric Flisser is our fellow reproductive endocrinologist and Paxton Maeder-York is the CEO and Founder of Alife Health. Alife Health is a fertility technology company that builds artificial intelligence tools to advance the IVF process. During our conversation today, we dive further into the topic of artificial intelligence and how it can impact the infertility and IVF sectors. Paxton shares the mission behind Alife Health and how AI is currently being used in the healthcare sector. He also explains how algorithms function in different settings and the importance of gathering a diverse data set to battle inequities in infertility care. To hear about the potential of AI to advance not only the IVF process but the patient experience as well, tune in now!
Rena: Hi everyone. We are Rena and Dara, and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Today we have a very interesting and engaging podcast with two guest speakers. The first you may remember, it's our fellow reproductive endocrinologist, Dr. Eric Flisser. And on top of that we have Paxton Maeder-York, who is the CEO and founder of Alife Health, a fertility technology company, building artificial intelligence tools to advance in vitro fertilization. Paxton launched his career as the first clinical engineer and leader first product manager at Auris Health, a surgical robotics company that develops integrative systems for a broad spectrum of medical interventions. Inspired by two of his grandparents who had long suffered from lung cancer, Paxton helped build surgical robots to fight the disease. His role was instrumental as part of a team that culminated in a successful Johnson and Johnson acquisition for $3.4 billion in 2019. After Auris Health, Paxon returned to Harvard University to pursue a Master's degree in both data science and business administration. He began analyzing the opportunities for machine learning to improve the medical field and began working on IVF. As someone with multiple family members who have benefited from successful infertility treatment, he knew firsthand how impactful the sector can be. Paxton founded Alife Health in 2020 with the mission of building a modern operating system for IVF, powered by artificial intelligence. Wow, Paxton. So happy to have you on today.
Paxton: Thank you very much for having me. Pleasure to be here.
Dara: And Dr. Flisser, so wonderful to have you back.
Dr. Flisser: Thank you so much.
Dara: So, so much to talk about. I'm very interested in learning all about this really interesting company, especially because I feel like AI is so the hot topic these days. So, Paxton, what is your background and why did you start this company?
Paxton: Absolutely. Well, you know, thank you for providing a little of the context of my career, but I've been passionate in medical technology for 20 years now and, as you mentioned, spent a lot of time in the surgical robotics space working on lung cancer systems. I had lost several grandparents to the disease. It was a very important mission to me. And after doing my Master's in data science, really started to become passionate for the opportunities of artificial intelligence to help patients across healthcare sectors. My little brother’s an IVF baby, and we know that, unfortunately, today, one in six couples suffer from infertility. It's very expensive, cost about $20,000 per cycle, an average of three cycles to have a successful outcome. And it's inaccessible for many today. So our goal is to use artificial intelligence and state-of-the-art software to sell, help support that to improve the experience, improve outcomes, and improve care for all.
Dara: Wow. I wanna go into this a little bit deeper, but remind us again of a life's mission.
Paxton: Absolutely. So, you know, we are really focused on building tools that help every step of the IVF process. So from the beginning of helping patients assess their chances of success with IVF, their own fertility journey, as they start the process, understanding how to manage their appointments and medications. Once they actually begin with the IVF procedure, we use AI to optimize the medications or egg retrieval, which is something we've partnered with our RMA of New York and have been working very closely with Dr. Flisser on. And then we also have a tool that helps assess embryo viability and track patient outcomes over time. So it's really a broad breadth of different technologies that in aggregate are meant to improve and ensure high quality and make this more affordable and accessible for more people. And we're the only company doing that and taking that kind of broad approach.
Dara: Oh, wow. So when did you guys start working together, Dr. Flisser and, and, and Paxton? When did you guys get connected?
Paxton: It's a great question. So we started working with RMA New York very early on in the business. And so we, the company's been around for just shy of three years and, you know, work very closely with your team to, to build the algorithms and test them out. And, and now we've made a, a version of our software available to Dr. Flisser who's been working and trying it out and, and testing it as part of a clinical study. So I'm not sure exactly how long we've been working together Dr. Flisser, but it is certainly has been a pleasure so far. I've very much enjoyed it.
Dr. Flisser: Thank you. Yeah, I can't say I can pinpoint when we began, but it seems like a quite a natural pairing because of our field. I mean, we, we generate a lot of data. We are always been very data driven, data focused, even in very primitive math kind of ways for, for, I think for statisticians would laugh at us often about how we went about it, but now, you know, to be able to work with someone like Paxton and his crew is super helpful because we, you know, we're sort of like, we have all this information, we don't know what to do with it, you know, and, and this is the next iteration.
Paxton: Absolutely. You know, we work with several different clinics across the country, but it is, it has become very clear to us in our, in our partnership just how data-driven RMA New York is. And that's why, you know, you and your team, Dr. Flisser, were such a wonderful partner for us to work on these different systems. I think you had already been deploying a lot of mathematical and statistical methods to help optimize and deliver precision medicine to your, your patients. What our company does is we bring data scientists, PhDs, software engineers, designers, product managers, all together to really take a lot of those insights and supercharge the clinical decision making and make it really easy to do for every patient using, using the technology. So it, it has been a real pleasure to partner with you on this,
Dara: So it's fascinating.
Dr. Flisser: So I will say, Dara, sorry to interrupt you. I was gonna say, I will say that I consider myself to be the muscle of this and Paxton to be the brains. And I guess if you know anything about my background, it's saying a lot about Paxton. So so, you know, like it's a great, it's a great pairing.
Dara: You need both, you, you need muscles, you know, braun and brain. They're both important in different ways.
Paxton: I think Dr. Flisser is being very modest. I appreciate it,
Dr. Flisser: Thank you.
Dara: So, you know, this is definitely not within my wheelhouse, so I'm just very curious, do these algorithms change depending on who you're working with?
Paxton: So the algorithms themselves are trained on a very large and diverse data set. And for our listeners who may be familiar with things like artificial intelligence and often the bias that you need to be very careful of, that's really important. You really want to aggregate data across a lot of different centers with a lot of different diversity in the types of patients that are seen. And what the algorithms basically do is they look at a bunch of patients that are similar to the ones that's coming into the clinic and finds patterns in what worked well for those historical cases. And then we provide those insights back to the doctor, such as Dr. Flisser, to be adjunctively used in their clinical decision making. And, and it's so far I think it's, it's shown pretty promising results. But yet really you wanna have an aggregate data set and, and utilize that so that you can see what worked in this patient in this one corner of the country and bring that, you know, that insight or that knowledge to the fingertips of any doc in real time as they're treating new patients.
Dara: Wow. So in some ways, like this tracking system that can give our patients the best care possible based on past experiences that may be similar.
Paxton: You got it. And over time, as the tools get used more and more and our data set continues to get larger, we continue to refine the algorithms and make them better. In addition to that, you know, working with top doctors like Dr. Flisser, you know, we gain insights as to what additional things would be interesting to look at. And we publish a lot of research as an organization. I think we've got over 18 abstracts and papers that have been published. And a lot of that is looking at these macro trends or answering big questions using very large data sets and statistical methods. And you know, I think that over time will only continue as we make the software better, be able to project farther out, deliver, you know, better features and functionalities all in the service of personalizing that care to that patient and giving them the best chances of taking home a baby at the end of the day.
Dara: Yeah, that's incredible. And I, it's great that you're building this data set and my assumption is it's important to have a, eventually, a more diverse data set. And why is, like, that so important, especially for addressing inequities in infertility care?
Paxton: So a hundred percent. It is very, very important to have a diverse data set. And we've worked really hard in that to aggregate the data and we actually have very representative data of the US population. And I would caution, you know, anyone that tries to take a very small data set just from one location or a different country or anything and try to bring it to a clinic because you really want to have the match there. We do see a lot of inequity, unfortunately, in infertility. We know that black patients, for example, are twice as likely to have infertility as their counterparts. And so we're doing a lot of really interesting research around that. We have some amazing advisors like Dr. Kim Thornton, for example, Boston IVF. So, you know, we are very serious about how can we use technology to reduce inequity, both in terms of treatment and access for every type of patient that may need this type of care.
Dara: That's remarkable. I think that's great to hear. And I think even in New York, I mean we have, you know, it's a melting pot of diversity, so I think that helps in, in many respects. Don't you agree, Dr. Flisser? We have quite a wide variety of patients.
Dr. Flisser: Yeah. I think, you know, being a large metropolitan center, we, we, you know, we, we cross all the ethnicities and languages and, you know, walks of life. But I think it's also important to see that there are little nuances from place to place that can sort of impact the outcome. And I think this is what Paxton is sort of hinting at, which is it isn't just, you know, necessarily, you know, your ethnicity, but could also even be your clinic. Right? Which plays a role in your outcomes. And so you, you can't, as he was saying, you can't just sort of extrapolate from one region to the next. If you have a good enough data set, you can really, you know, get subtle about the details of where you are, things that might not be obvious to the eye of the physician. So I think, I think that, you know, that's where the power is.
Paxton: Yeah, I think Dr. Flisser makes it a really important point, which is that you actually want a lot of heterogeneity in your dataset when building these algorithms. You wanna see what different things are being tried and what different things are working across the country. And and ultimately as, as Alife continues to work internationally, we wanna be able to bring the best practices from around the world to every clinician's fingertip and every patient's benefit. And, you know, if everyone was treating every patient the exact same way, there would be no, you know, unique insights to be able to pull out using these algorithms and these data science statistical methods. So it's the fact that people are treating patients differently, actually that is what gives these algorithms the power to, to really personalize and per, you know, make your care as precise as possible and individualize for that patient.
Dara: Yeah, you made a really good point that it's not just for the benefit of these clinics, but it's really ultimately for the benefit of the patients and their overall health. On that note, I feel like there's so much potential and there's, I'm assuming a lot of advancements coming in the coming years, but, you know, what are your insights in terms of, you know, the progress in terms of fertility health in this space?
Paxton: Well, I'll let Dr. Flisser answer as well from the clinician side. You know, I think that there is a lot of excitement around what artificial intelligence can provide across medical sectors across the economy in general. I think whenever building medical technology, you need to be very thoughtful about validating the clinical benefit that you're creating. You know, run the right studies, you know, conduct the right research, partner with the right clinicians, so that you can really provide both comfort and trust in what you're doing. And so, you know, I think there's a lot of untapped potential here for software and technology to help in the IVF sector. We know that this area is growing really fast, right? I mean, more and more patients are gonna need these services over the next 10, 15 years. Unfortunately, we have a limited number of excellent docs like Dr. Flisser and, and others in the field. And so we need technologies like what Alife is building to enable more providers to deliver high quality care. And I think, you know, this is gonna play a big role in kind of the next stage of IVF as it continues to mature as a medical sector. But, you know, in terms of specifics, I think ultimately we wanna be able to optimize every step of the process even more so than we are today. I think we're building a nice foundational layer of really valuable insights that can be provided, but my team is gonna be working tirelessly to continue on adding more functionality, adding more algorithms, adding more things that can make the care even better. And I think it's gonna range all of the way from the patient experience through the actual medication recommendations, through the embryology lab to clinic management and how they're ensuring quality across all their sites. I think it's really all of it and Alife hopes to be the technology partner to this industry to bring some of those advances, you know, kind of to, to patients in the long run. So we're very excited to do that and are very grateful to have the amazing partners we do have.
Dara: Wow. And Dr. Flisser, you know, anything to add to that of what you hope to see on your end in this space?
Dr. Flisser: Yeah, well I think what I would say is that the, the clinical aspects of it are just fantastic. The, you know, part of the, the insight AI can give us that I can't see is, you know, again, these sort of subtle changes that we might be able make in someone's protocol, in the treatment process, that things that we do which may not be necessary, things that we do that should be done or you know, that we should add in…it makes those kind of connections that we're not always going to be able to detect on our own. You know, one of the things I think is that we have in fertility-land, you know, a lot of limited tools for assessing why people have trouble getting pregnant, but they can't all, you know, 20% of couples have unexplained infertility, right? So who have, excuse me, 20% of infertile couples have unexplained infertility. And they can't all be the same unexplained problem, right? They must have different unexplained problems in that set. But I can't see that. I don't even have a tool for that cause I don't know what question to ask to disambiguate one unexplained infertility patient from another infertility, unexplained infertility patient. But the computer might be able to figure out commonalities and direct us without having the answer to that question also. And that's what's fascinating to me.
Dara: Definitely. And I find also in terms of research, I feel like there is a lot of potential, you know, in, in advancement in terms of research and, and really honing in and being able to, to research more. I'm hoping that could be something down the road that really can help everyone.
Paxton: For sure. You know, we, we've been doing a lot of research in conjunction with all of our partners and we recently published a paper with Johns Hopkins on answering the question and SART - are more eggs better? Is it better to try to shoot for more eggs? And it's a really interesting question that has been debated I think, in the field for a while now. And different folks even internationally have different perspectives on that question. And it was really cool to kind of look at a huge dataset and answer that at scale. But, you know, I think there's so much that will continue to be evolved with, you know, kind of the support and help and insight, you know, of, you know, folks like Dr. Flisser and, and our other partners. And then there's a lot of stuff we can do also on the patient experience side. So, you know, we know that this can be a very overwhelming process for patients and it's difficult to manage. And so, you know, one of the additional things we're doing is we're building a patient app that's recently launched and you know, this can help people navigate their journey from end to end. You know, keep track of all the paperwork, the medication alarms, the appointments, educational information. So, you know, it's, we're really trying to hit it from both sides, both the clinical-improvement side as well as, as the patient experience side. And if patients are interested, they're welcome to download the app. It's available in the app store today.
Dara: Is it Alife? Is that the…I mean, that's really fascinating. I think having this one stop place where you can really customize your own experience and really, you know, help optimize and organize your overall experience at a fertility clinic is pretty remarkable.
Paxton: Well that's certainly the hope. And you know, we were talking before we started the podcast about nutrition and nutrition's role in all of this, and we haven't even started down that road, but there's I'm sure enormous amount of opportunity for how technology can help with meal plans or nutritional information and education resources as well as maybe we can apply some, you know, large statistical methods and, and try to supercharge what we're doing on that side of this. So it's, our goal at Alife is really to bring all the pieces of the puzzle together and try to be, try to be partners with everyone so that we can have one simple place that, you know, has all the data and, you know, enables a patient to more easily navigate what we know is a very challenging experience. Wow,
Dara: Wow. That is so…
Dr. Flisser: Will we finally be able to answer the question as to whether pineapple is an important aspect of fertility?
Paxton: I think that's gonna be our next, next paper. Dr. Flisser. We'll make sure you've got lead author on that one!
Dara: Yeah. Still have lots of people over consuming pineapple core. Yes. But I think, yeah, it's great to see that there's so much potential and, and I love to hear that, you know, hopefully expanding and adding in a nutrition slash lifestyle component that could also be part of, of their care, I think is, is really great. So much to be excited about with your company. Congratulations. I'm so excited to see where it goes. And would love to have you back on down the road when you know you've added more. We would, I'm sure our listeners would love to hear all about it.
Paxton: Absolutely. Well, thank you so much for having me on at this point, and we're gonna keep at it. And it's been a pleasure speaking with you. And, and of course, Dr. Flisser, thank you for all of your help along the way.
Dr. Flisser: Of course. Thank you so much. It's been a great experience so far and we look forward to continuing into the future.
Dara: So to learn more about Alife Health, visit www.alifehealth.com. That's a-l-i-f-e-h-e-a-l-t-h .com. And again, make sure to download the Alife mobile app today on the app store. And how we like to end our podcast is with words of gratitude. So, Paxton, what are you grateful for at this very moment?
Paxton: I am very grateful to have such an amazing team at Alife that I get to work with every day. And I would also like to show appreciation to all of the clinicians and doctors who have suspended disbelief as we continue to build this cutting edge technology partnered with us and helped us design this, these systems to ultimately always have the best patients outcomes in mind. So thank you to all.
Dara: That was so nice. Dr. Flisser?
Dr. Flisser: Yeah, I guess I would say that I'm, I'm grateful or thankful for being able to live a meaningful life here. To be able to contribute to patient health and, you know, patient care. To be able to work with Alife, and Paxton, and his team to improve upon that. I mean, I think it's one of the, you know, being in healthcare I think, think is one of the greatest activities you can undertake. And it, it's real satisfaction to pair up with other like-minded people.
Dara: How beautiful. On that note, I was speaking to Dr. Flisser before we were recording, and I'm actually grateful for Dr. Flisser because he was there when I got pregnant via IVF at RMA and that's 13 years ago. So I'm very grateful to you. I cannot believe I have an almost 13 year old, I'm celebrating her, her bat mitzvah in a couple weeks.
Dr. Flisser: Mazel tov!
Dara: And who would've thought that, like my resident IVF baby is, is, you know, becoming a young woman. So I'm definitely grateful for that. So thank you both so much and everyone have a wonderful day.
Thank you so much for listening today and always remember: practice gratitude, give a little love to someone else and yourself, and remember, you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.