How embryos are treated at ReproART
About 186 million people around the world are suffering from infertility. Needless to say, obstetricians/gynecologists, fertility doctors, andrologists, and nurses are professionals who engage in infertility treatment in the first place. There are, however, other specialists who work with patients indirectly and yet play a crucial role in achieving pregnancy and live birth. Among such experts, embryologists are unique.
Being an embryologist is a stressful job combining responsibility with a busy schedule and an abundance of emotions. Along with doctors and nurses, embryologists are part of the team effort resulting in the birth of numerous healthy children in our center. What are the responsibilities of an Embryologist at ReproART?
Bingo, we have an egg!
Embryologists begin by finding an egg. At first, they examine follicular fluids extracted from women’s ovaries and look for eggs. Should eggs be discovered, the embryologist’s jubilant exclamation marking initial success can be heard at ReproART: “We have an egg!” This joy doubles if more than one egg is identified. Of course, one may be enough to achieve pregnancy, but the more eggs are available, the greater the chances of pregnancy and healthy childbirth are. At the same time, quantity alone is not enough, because the quality of each egg is equally important.
To measure the quality of maturity, ReproART’s embryologist removes the cells surrounding it—and examines it for readiness under a high-tech microscope. Identifying a mature egg is yet another step toward the goal.
Next, it is the spermatozoon’s turn, which must be prepared for fertilization, following by insemination (addition of many sperm to the medium surrounding the egg) or using ICSI (injection of one sperm directly into the egg), all of which marks one of the most responsible moments in any embryologist’s work. ICSI (Intracytoplasmic Sperm Injection) was introduced in Georgia by Lika Chkonia, ReproART’s founder and director. Consequently, the first babies conceived using this technique were born Georgia and a new effective approach to male infertility treatment became available in Georgia.
The most responsible moment…
At such moments, embryologists use a fine glass needle to pick up one spermatozoon under the microscope and to inject it into the interior of one egg. Given the complexity and significance of this most responsible process, the embryologist’s professionalism, attention and focus, and emotional state are of utmost importance. The embryologist’s brain focuses up to the extreme, with both hands working intensively, yet fulfilling totally different tasks. At moments like this, one wrong move may kill an egg which is otherwise mature enough for fertilization. Trembling hands are something embryologists cannot afford. It is imperative that they remain maximally focused and emotionally balanced when performing this procedure.
Successfully placing a spermatozoon into an egg does not necessarily guarantee fertilization, because it is the spermatozoon’s job itself to “ensure” fertilization, which largely depends on the quality of the egg and the spermatozoon. This is exactly why embryologists cannot wait for the results of fertilization the day following the procedure. They feel especially anxious for patients with only one egg, often staying up all night and wondering whether or not the only egg will be fertilized to turn the patient’s hope into reality.
The ICSI (Intracytoplasmic Sperm Injection) fertilization rate at ReproART is 80%, which is why the day following the procedure, in most cases, brings about yet another exclamation: “Hooray! It’s fertilized! We have an embryo!” This moment marks the beginning of looking after the embryo or embryos as they develop and reach a particular stage in development, which is why embryologists are nearly doting over them, keeping them in a 37-degree incubator (at the same temperature as Fallopian tubes and the uterine cavity). In addition, the incubator consists of several compartments, which means that the embryos of different patients are isolated from one another, so embryologists can check on any one of them without disrupting conditions for the others.
Importantly, our center uses a quality control computer program developed by David McCulloh, ReproART’s Director of Clinical Science. Thanks to this application, the center’s equipment, temperature, and environment are constantly monitored, protecting the embryos, which are stored in the incubator or frozen, from unexpected occurrences. ReproART’s embryologists are actively involved in this process as well.
5-6 days after fertilization, the embryos are ready for transfer. In line with ReproART’s practice, one or two embryos at most are transferred into a patient’s uterus to avoid multiple pregnancy–related risks. The remaining embryos are frozen and stored for future attempts of pregnancy. Again, embryologists are active participants of embryo transfer. They are the ones who select the embryo(s) for transfer, introduce them into a catheter and hand it to the doctor to transfer it into the uterus. Afterward, embryologists make sure that the embryo is actually within the uterus and that the “unruly child” is not hiding in the catheter. The humorous term “unruly children” is used at ReproART to refer to embryos that are, despite their stubbornness, eventually transferred into the uterus. This stage signals that the embryologist’s long day is nearing its end, though it is not the finish line yet.
Next are two weeks of waiting. This time, embryologists anticipate the most important emotion: two weeks later, a pregnancy test is administered, and its positive result equals their greatest success. Then they resume their tireless labors to make sure that more and more parents experience the joy of healthy childbirth.