Babies are in this embryonic stage until week 9 of pregnancy, after which we use the term foetus. The ability to grow embryos in a laboratory environment (outside the woman’s reproductive tract) was a huge scientific achievement. This led to the development of in vitro fertilisation (IVF) as a way of helping couples fall pregnant if they could not do so naturally.
While you can’t always see what embryologists do during your IVF journey, their care of your eggs, sperm and embryos plays a huge part in the success of your treatment. As Chief Embryologist and Scientific Director at Newlife IVF, I oversee our amazing team of embryologists and ensure our laboratory is set up according to best scientific practice. In this article, I explain a little bit about what we do ‘behind the scenes’ in order to help women and couples conceive.
The laboratory is often referred to as a fertility clinic’s ‘engine room’. This is where our embryologists manage many of the steps involved in IVF. Our role in the IVF process usually begins during the egg retrieval stage. Under a microscope, we carefully examine the fluid your doctor collects from the mature follicles inside your ovary. We identify and extract any healthy eggs we find, before placing them in a laboratory dish with a specially prepared sample of your partner’s sperm (or donor sperm, if required). We then ‘keep watch’, checking for signs of fertilisation (when egg and sperm unite to form an embryo) and monitoring the growth of any embryos that do develop. In some cases, we will inject a single sperm directly into the woman’s egg to increase the chances of fertilisation. This technique is called intracytoplasmic sperm injection (ICSI).
Embryologists are also responsible for freezing and storing embryos. A woman may need to freeze and store her embryos if she has opted for a frozen embryo transfer (rather than a fresh embryo transfer) and/or if she has multiple embryos following egg collection and insemination. Only one embryo is transferred into the womb at a time, so we freeze any extra embryos in case implantation fails and repeat embryo transfers are required in the future. We store embryos at sub-zero temperatures using a process called cryopreservation.
Beyond IVF, we also freeze and store eggs for women who choose to freeze their eggs as a way of preserving their future fertility. We can even freeze sperm. This is actually incredibly important, as it allows us to maintain a bank of donor sperm for single women and couples (including lesbian couples) who rely on sperm donation to start their families.
There are a number of measures we employ in the laboratory to ensure patients are given the best chance of having a healthy baby. First and foremost, our in-house laboratory was specially designed to reduce volatile organic compounds (VOCs) and harmful blue light, ensuring optimal conditions for embryo development. Day-to-day, we also adhere to strict quality-control protocols, which are designed to maintain ideal conditions within the laboratory environment for embryo growth.
Our embryologists also use extra lab procedures that not all fertility clinics offer. We routinely use these techniques as part of our standard practice to optimise embryo development and give your embryo the best chance of successfully implanting in the womb. This includes the use of the EmbryoScope time-lapse system, sequential media and EmbryoGlue.
In some cases, we will employ even more specialised techniques to help us assess your eggs, sperm and embryos, so that we can select the best ones to use during IVF. This includes preimplantation genetic testing (PGT) of embryos. By carefully removing a small number of cells from a developing embryo, we can determine if the embryo is carrying a genetic disease (PGT-M), has the right number of chromosomes (PGT-A) or changes in the size or arrangement of chromosomes (PGT-SR). These tests require a highly experienced embryologist with special skills, so they are not offered by every fertility clinic. While PGT is not suitable for everyone, it can help lead to successful pregnancy in certain couples, such as those with a history of recurrent miscarriage or repeated unsuccessful IVF cycles. Your fertility specialist can advise if PGT is right for you.
In the case of ICSI, our embryologists use microscopes connected to micromanipulation equipment (e.g. micropipettes) to select individual sperm and inject this directly into the woman’s egg. Sometimes, we may use another technique if necessary, called intracytoplasmic morphologically selected sperm injection (IMSI), to help us pick out a healthier sperm based on its shape. We also use polarised light microscopy to assess a structure inside the egg called a ‘spindle’. We call this ‘egg spindle visualisation’. This allows us to identify if an egg is at a certain stage of development (called metaphase II) and therefore, in optimal condition for fertilisation via ICSI.
Each of these lab processes requires exquisite attention to detail, extreme care and exhaustive consideration of multiple variables that can affect the healthy growth and development of embryos, as well as the ‘well-being’ of your eggs and sperm.
No two days are ever the same! Every case is unique — whether we are caring for sperm, eggs, embryos or patients. There are always different challenges to manage or breakthroughs to celebrate. We are constantly amazed by the potential of these tiny-celled structures. And, of course, ongoing advances in the science behind IVF means that we are also continually learning new skills and adapting to new technology as well.
Patients typically get very little exposure to what is going on behind a lab’s doors. Understandably, this can make IVF even more daunting for patients. That’s why, at Newlife IVF, our embryologists make a point of staying in close contact with patients throughout their fertility journey. We are very mindful of the fact that patients have entrusted us with their future, and that their eggs, sperm and embryos are incredibly precious to them. Our embryologists are always available to speak to patients and answer their questions. Our goal is to keep patients well informed at all times about the status of their embryos and how everything is proceeding in the lab, so that they feel reassured that their embryos are being properly cared for.
Being able to help couples achieve what they want most in the world is extremely rewarding. It’s incredible to be able to watch a life begin under the microscope and emerge months later as a healthy baby. Embryology is a fascinating field that is constantly evolving, and I feel a great sense of pride at being part of such a life-changing science.
At Newlife IVF, you can rest assured that an experienced embryologist will be part of your fertility team. You can visit our team page to read more about Dr Tiki Osianlis and some of the other embryologists at Newlife IVF. If you’re ready to take the next step in your fertility journey, you can start today by making an appointment with one of our fertility specialists — call (03) 8080 8933 or book online.