After a series of blogs focusing on trends, technology and future of healthcare IT, I thought of focusing on a barely talked about entity that is backstage and absolutely the backbone of an IVF centre – the embryologist.
Typically a couple seeking fertility treatments is referred to a specialist by the primary physician or a gynaecologist. In some cases the fertility support seeker may drop in to the clinic suggested by another couple who may probably have had a successful cycle with the same doctor. In the former case the trust and in the latter case the result translating to hope, plays the major role in making a choice of the IVF centre. Only in cases where the couple decides to shop amongst the centres through Internet or other media, they have to evaluate and carefully consider the deciding factors.
A lay man whereby I mean a computer literate would look for reviews and will most likely step in to a clinic with projected high IVF success rate. I was associated with an IVF centre for about a year but never came across a patient conversation wherein the seeker enquired about the Embryologist or the Laboratory for that matter. I wonder if many of them would even know who is an embryologist.
Embryologists are scientists who work with the sperm, oocyte and the embryos. They play a vital role in an IVF cycle and are involved from the beginning till the end of the cycle.
- During the egg retrieval procedure, embryologists search the egg in the fluid under a microscope.
- They are responsible for fertilizing the eggs with sperm by conventional insemination method where sperms are placed in the dish with the eggs after the sperm preparation or by Intracytoplasmic sperm injection (ICSI). ICSI is a complicated procedure that involves micro manipulation using microscopic instruments; an individual sperm is injected into each egg. The embryologist’s skill at performing micromanipulation procedures on embryos can play a vital role in the success of IVF.
- The embryologist checks for fertilization by examining each egg under the microscope.
- The embryologist changes the culture media as needing during the 3 to 5 days before the embryo is transferred.
- Embryologists also perform embryo biopsy procedures on embryos at day 3 or day 5.
- During the embryo biopsy procedure, an embryologist relies on experience to remove a single cell from an embryo while minimizing the risk of damage to the embryo.
- The embryologist works with the laboratory performing the genetic test.
Using micro-surgical techniques, embryologists may also perform assisted hatching on embryos. During this procedure, microscopic tools are used to thin the outer shell of embryos and make a hole in the zona pellucida to facilitate the hatching process.
- The embryologist assesses the quality of the embryos and identifies the best quality ones and shares that information with the IVF doctor. When the best quality embryos are identified, the embryologists will load the embryos into the transfer catheter and work with the doctor to perform the embryo transfer procedure. The job is not yet over, any remaining embryos that are not transferred and appear to have the capability of making a pregnancy, are frozen for later use. The embryologist is responsible for the cryopreservation of extra embryos during the IVF process.
- Last but not the least embryology lab is one of the major responsibilities owned by the embryologist. Optimal conditions in the laboratory will allow the zygote to progress to the cell division stage. An incubator where the zygote becomes an embryo is regulated to control gas mixture, temperature, and several other conditions.
So you see, the embryologist’s responsibility is not only to do IVF but handle the gametes and embryos all across the treatment, use micro tools on the specimens and look after the laboratory quality. Regardless of the training background of an embryologist, a hands-on experience is one of the most critical factors in an IVF lab.
Since the IVF success so much depends on the Embryologist, the couples seeking IVF should add the profile of the Embryologist and the quality of the Embryology laboratory of the IVF Centre as additional factors for evaluating the IVF clinics.
Dr. Priyanka Gore
Business Analyst – Palash IVF