Embryo stage of IVF is initiated when germ cells are retrieved from the couple involved in the program (donor oocytes and sperm are an option). First, laboratory experts work with woman’s follicular fluid that was retrieved through the follicular puncture procedure. Using a binocular microscope, embryologist selects the oocytes, conducts the assessment of cells’ maturity and transfers them into culture media containing nutrients in order for the fertilization to take place. Semen is prepared for fertilization by removing inactive cells and seminal fluid, the best sperm cells are selected at this stage. In two to three hours eggs adjust to the environment of the media, and it is time for the fertilization process.
In our Center fertilization is conducted in several ways:
- Classic IVF. Semen is added to the media with eggs, subsequently, a sperm cell fuses with an oocyte and fertilizes it. The process goes just the same as it would in a female body.
- IVF with ICSI. With the use of a microscope embryologist selects living, morphologically normal sperm cells. Through the use of a needle, one sperm cell is injected directly through the egg’s cytoplasm. This guarantees that the best sperm cell gets into the oocyte.
- IVF with PICSI. Physiological intracytoplasmic sperm injection is a procedure that might support the ICSI method. It consists in a more thorough sperm selection by placing them in the PICSI dish containing samples of hyaluronan hydrogel.
The fertilized eggs are passed to an incubator where conditions are maintained close to the temperature, oxygen and carbon dioxide levels of a female body. But doctors’ work isn’t finished yet. From the second and through the fifth day since getting the embryos specialists judge their growth daily. If considered necessary, they conduct extra micromanipulation that is called assisted hatching (if the outer shell of the embryo is too thick, it is artificially weakened so that blastocyst could tear through it by itself).
Based on the morphological scoring system laboratory scientists decide whether the embryos are suitable to be transferred to the uterus and/or be cryopreserved through vitrification.
Execution of embryological studies and manipulations in the course of fertility treatment programs is a complex sequence of microoperations on biological material. A good result cannot be reached without a proper professional level of employees and technologically advanced modern equipment. Implementing standards and state-of-the-art quality assurance systems have a significant role to play as well.
The team of embryologists of LifeLine Reproduction center
Internationally standardized work is a rule to which LifeLine center stands firm on. Qualifications of our embryologists comply with them as well. Our team has medical specialists whose expertise is confirmed by their membership in ESHRE (European Society of Human Reproduction and Embryology) and its certificates.
Our therapists recurrently take part in conferences, seminars and workshops of nationwide and international scale, improve their qualification based on leading foreign clinics and combine their medical practice with scientific activities and teaching in universities.
The specialists of LifeLine Reproduction center have the knowledge of all the up-to-date methods of embryological work that are used in the fertility treatment programs:
- IVF, ICSI, PICSI;
- germ cells and embryos cultivation;
- cryopreservation and vitrification;
- assisted hatching;
- embryo biopsy for further preimplantation genetic diagnosis.
Embryologists of the center work in tandem with reproductologists and geneticists. A multifaceted approach to each couple significantly increases in the chances of our patients for pregnancy as the result of IVF.
Embryological equipment and material
In vitro fertilization is a technologically advanced method and just high expertise of the therapists is not enough for its effective application. The quality of laboratory equipment and materials is another factor impacting the percentage of successful IVF procedures. In this matter, embryological laboratory of the center is as good as European ones and better than many of those located in Moscow.
- The laboratory is equipped with new-generation benchtop incubators that, as a result of low oxygen content, most closely mimic the natural environment of a female body. Foreign research shows that utilization of incubators with 5% oxygen concentration level significantly improves the embryo survival rate and the rate of their successful implantation.
- Our laboratory is equipped with the innovative system Primo Vision that captures the embryo development in continuous burst mode and allows to track the cultivation cycle in full. Having all the accurate information allows to pick the best embryos for transfer. There are only few Primo Vision cameras in Russia.
- Ultra high-resolution microscopes enable our lab specialists to see the tiniest defects of germ cells and embryos.
The standards and the quality assurance system
The work of center’s embryology laboratory complies with the world quality standards in every way. In 2016 it was confirmed by an external audit carried out by A/Prof Cecilia Sjoblom (Australia) who is an auditor of IVF laboratories on the international level. For LifeLine center this accreditation became the dress rehearsal before ISO certification.
Laboratory performance complies with strict internal standards and prescriptive instructions. Every micromanipulation and every step of the research is thoroughly controlled. Moreover, the embryology laboratory has a double quality assurance system.
Guidelines and rules of work facilitation in the embryology laboratory of LifeLine clinic
- The laboratory always has two embryologists on duty. Every procedure is carried out in accordance with the instructions.
- Occasional check-ups of whether the procedures carried out comply with the instructions. An adjustment to the existing instructions is made only after it is approved by the general meeting of the embryologists and according to the “one adjustment at a time” rule.
- To estimate of temperature in the incubators, in the room and in the fridges is carried out daily. If the temperature value deviates from the prescribed one, it is calibrated.
- Dishes and test tubes containing gametal cells or embryos are labelled with the patient’s surname and a unique medical card number. Any transfers of gametal cells or embryos between dishes is carried out in the presence of the other embryologist controlling the agreement of the surnames and unique card numbers.
- The temperature of the heating surfaces of the laminal box, of microscope stage, paracentesis test tubes holder are regularly measured and calibrated.
- We keep track of the use of all the consumable material, there is a record of all the consumable material lots used for every case.
- Plastic and all the media uses are preliminary checked for being embryotoxic.
- The main basis for any manipulation with gametal cells and embryos is informed consent for the procedure signed by the patient. If there is no signed consent, no manipulations take place.
The rate of successful first tries of IVF in LifeLine Reproductive care center is almost 10% higher than the average rate in Russia. This achievement is mostly based on the work of our embryo laboratory, the area where day and night a magic process of new life origination is taking place.