P-735 Regional Trends in Licensing and Certification of Clinical Embryologists: Insights from a Cross-Sectional Analysis

Study question Does national licensing influence the likelihood of clinical embryologists obtaining ESHRE certification? Summary answer Licensing for embryologists in Europe is associated with a higher likelihood of pursuing ESHRE certification, a pattern not observed in regions such as Arab countries. What is known already The demand for clinical embryologists has increased due to the growing complexity of IVF cycles and staffing requirements. However, professionalism varies significantly across countries, with differences in training, recognition, and regulatory frameworks. Few studies have examined workforce regulations, with only one mapping European nations, revealing limited mandatory licensing. Since its introduction in 2008, ESHRE certification—enhanced by a proctored exam since 2021—has become the first standardized credential. Given these disparities, it is essential to assess whether national regulations influence clinical embryologists' pursuit of ESHRE certification as a means of validating expertise and enhancing professional recognition. Study design, size, duration This cross-sectional, cross-regional study examines the relationship between national licensing regulations and ESHRE certification among clinical embryologists in European and Arab countries. Primary data is collected through a survey of key informants across 17 Arab countries to assess licensing status. Secondary data includes literature-based licensing information for European countries. Both datasets are cross-matched with the number of ESHRE-certified embryologists listed on the ESHRE website up to 2024, providing a comprehensive regional comparison. Participants/materials, setting, methods Purposeful selection of key informants was employed to ensure expert sampling across 17 Arab member states. The questionnaire covered various aspects of national regulations governing clinical embryologists. For European countries, national regulatory data was extracted from the PubMed database. The number of ESHRE-certified embryologists was obtained from the ESHRE website, including those certified up to the 2024 cycle. Associations between certification and regulatory frameworks were examined within each region. Main results and the role of chance Among the 17 Arab countries analyzed, 7 have explicit national licensing frameworks for embryologists. A total of 64 ESHRE-certified embryologists were identified in this region. No statistically significant difference was found in the number of ESHRE-certified embryologists between licensed (38) and non-licensed countries (26) (Mann-Whitney U test, p = 0.959). However, licensed Arab countries had a slightly higher mean number of certified embryologists compared to non-licensed countries. Conversely, findings from 12 European countries showed an opposite trend. Among these, eight countries have established national licensing frameworks for embryologists, with a total of 753 ESHRE-certified embryologists in licensed countries. A statistically significant difference was observed between licensed (325) and non-licensed countries (428) (Mann-Whitney U test, p = 0.048), indicating a higher prevalence of certified embryologists in countries with regulatory frameworks. When analyzing ESHRE certification numbers from 2021 onward, after the transition to a proctored exam format, the same trends persisted, reinforcing the observed associations between national licensing and ESHRE certification in both regions. Limitations, reasons for caution This study is limited by self-reported data bias, small sample sizes in some groups, and reliance on secondary sources for European licensing data. Additionally, it does not account for potential confounding factors that may influence the findings. Wider implications of the findings Regulatory policies, professional mobility, career incentives, and certification accessibility warrant further investigation to better understand global disparities in the clinical embryology workforce. Trial registration number No