The purpose of the study is to determine physical and mental health issues of U.S. embryologists related to their occupational characteristics, and how workplace fatigue and burnout may affect their quality of life, cynicism, interactions with patients, attention to detail, and lead to human error, the cause of the most severe IVF incidents that often make headlines and result in costly litigation. It will also correlate how the current manual workflows contribute to these health issues, and what measures can be taken to improve both working conditions and embryologists' health, and, therefore, improve patient care.

Embryologist fatigue surveys conducted in Spain and the United Kingdom reported that embryologists experience work-related mental health issues similar to surgeons in the United States (36.3% in Spanish and 27.8% in U.K. embryologists v. 34% in U.S. surgeons), as well as high rates of self-reported, work-related MSDs despite taking better care of themselves than the average population. Among prevalent mental issues, they highlighted fatigue, stress, and burnout as contributing factors to decreased efficiency, cynicism, and emotional exhaustion, which, together with having to handle the increasing cycle volume using conventional, manual protocols of cryomanagement, can lead to human error and IVF incidents. The known IVF incidents resulted in lost, damaged, or misplaced embryos and gametes, lawsuits, and reputational damage to patients and providers. In the absence of a "better than" cryopreservation storage solution, many programs just turned to buying more tanks and alarms and/or added expensive staff. The more effective solutions should focus on optimizing workflows by adopting innovation like automation and a digital chain of custody, organizational changes that will lead to a more productive, collaborative, and rewarding work environment, allowing embryologists to focus on patient care, scientific research, innovation, and career planning, and fewer incidents and lawsuits.

The purpose of this cross-sectional study using a web-based survey is to determine physical and mental health issues of U.S. embryologists related to their occupational characteristics, and how workplace fatigue and burnout may affect their quality of life, cynicism, interactions with patients, attention to detail, and lead to human error, the cause of the most severe IVF incidents that often make headlines and result in costly litigation. It will also correlate how the current manual workflows contribute to these health issues, and what measures can be taken to improve both working conditions and embryologists' health, and, therefore, improve patient care.

Inclusion Criteria:

• complete surveys from embryologists;

Exclusion Criteria:

• incomplete surveys from embryologists; complete and incomplete surveys from non-embryologists.

Embryologists are the ART/IVF/embryology laboratory personnel who provide fertility and embryology services, including but not limited to IVF procedures, pre-implantation genetic testing of embryos, freezing/vitrification of embryos and gametes, cryomanagement of frozen/vitrified embryos and gametes, and monitoring and maintenance of laboratory records and equipment. They range in age, gender, marital status, children, and relationship status, but they must have a minimum of B.A./B.S. degree, and ELS (AAB) or other professional certifications to work as an embryology laboratory technologist or supervisor, and a postgraduate degree, such as Ph.D., M.D., or D.O. to serve as the embryology laboratory director. Embryologists of all career levels work in a private, academic, government, or corporate IVF clinical/laboratory on a full-time, part-time, or per-diem basis, and with a permanent or a non-permanent contract.

TMRW and Dudley Associates (DA) will keep a master list containing personal identifiers and responses separate from data forms (paper and electronic) that have only analyzed results. The master list will be on a separate computer at DA. This form of data is considered "coded" not de-identified. Since the data can be re-linked to identifiers, it is coded. Only after the key to the code or the Master List is destroyed are the data considered de-identified. External investigators will not have access to these files

The password-protected data will be stored on TMRW's drives in addition to the PIs' computers that are backed up according to TMRW's company policies

The coded data with personally identifiable information of the survey participants will be stored as described above. The participants' personal identifiers and other data will be destroyed, and data will hence be de-identified 5 years after study completion in compliance with TMRW Data Classification and Handling Policy

The coded preliminary data will become available on April 15, 2022, and it will be available to other researchers at TMRW and external collaborators for a limited duration of time, while preparing the abstract for the conference, and writing and revising a paper for a peer-reviewed publication. Only TMRW Principal Investigators and Dudley Associates will have access to the master file and participants' personal identifiers for 5 years. The participants' personal identifiers and other data will be destroyed, and data will, therefore, be de-identified 5 years after study completion in compliance with TMRW Data Classification and Handling Policy.

All data and records generated during this survey will be kept confidential according to TMRW and Dudley Associates' policies on subject privacy and that the PIs and other TMRW personnel will not use them for any purpose other than conducting the study.

All data will be anonymized by DA, and no record with personal identifiers will be available to anyone except for DA and TMRW PIs. TMRW's collaborators will be bound by the NDA, protecting the data and scientific integrity of this study.

External collaborators will only be responsible for the data analysis, interpretation of the results, and co-authoring the abstract and a full peer-reviewed article using the coded data.

No identifiable data will be used for future study without first obtaining IRB approval or IRB determination of exemption. The investigator will obtain a data use agreement between the provider (TMRW PIs) and any recipient researchers before sharing a limited dataset.