Sometime last year, I was having a chat with a fertility doctor, who revealed that there had been a teeny tiny mix up in their lab, which the embryologist appropriately informed the doctor. The doctor, as a matter of ethics, had to call all the patients whose embryos were affected, to tell them that there had been an issue in their lab. Even though it was a minor one, but with the delicate nature of the gametes, it could very well lead to failure of the cycles.
The calls made were made but one of the patients chose to go ahead with her cycle, and today, that woman is a proud mother of twin girls. This was after several years of trying and multiple cycles at the clinic, not to mention other clinics.
That goes to show you the kind of power that the embryologist wields in a fertility clinic. If you have ever been through the IVF process, then you must have met one or two embryologists, chatted with them about your embryos, or waited for a call that will bring results from the embryologist. There are quite a number of professionals involved in the IVF process, with the doctor as the front, the embryologist is one of the most important professionals in the line-up.
For clarification, the embryologist is the scientist who combines the sperm and egg and helps the resulting embryos to grow in a controlled environment. Embryologists are the ones who the collect eggs, assess and prepare sperm samples from partners, and inject eggs with sperm. They also do very detailed procedure where a single sperm is selected to fertilise an egg. Eggs are harvested and inseminated on the same day, and the following day, the embryologist starts looking for signs of fertilisation.
Access to the laboratory or embryologists in most clinics is limited, hence it is not all the time patients can get to have a one-on-one chat with the embryologist, or to ask questions. To bridge the gap, here are some things your embryologist would like you to know.
Every embryo is unique:
Just like no two persons’ DNA are the same, not even that of identical twins, each resulting embryo from a fertilisation process is unique. That means every egg, sperm and the resulting combination of the two are different.
While most patients assume that human gametes look the same, the reality is quite different, especially for the human eggs.
While there is a range of ideal follicular size, what is ideal for each individual is very different for every human being.
Same way not every sperm will fertilise the egg, is the same way not every egg is meant to make a baby. This dynamic ensures that each embryo has a different personality.
That personality will determine whether some will fertilise, whether the embryo will grow into blastocyst, whether it will freeze well or even survive the thaw. This personality also serves as indicators that there is probably something flawed about the embryos…unfortunately the embryologist does not understand everything just yet.
What works for one woman may not work for another:
Quite a lot of TTC moms like to compare their results with that of other TTC moms. It is a good and a bad thing. It is good because in the sea of uncertainty that is the TTC world, a fellow TTC mom’s testimony is worth its weight in gold. And it is bad because the reality is that what works for Mrs A may not work for Mrs B.
Which is why it is important to keep in mind that everyone’s IVF journey and outcomes are different. Comparing your experience to the experiences of others may not truly be as beneficial as it may seem on the surface.
Undergoing IVF is emotional and painful and it is alright to reach out to fellow TTC moms for support but be prepared for the uniqueness of your own cycle.
Embryologists can’t repair eggs:
Like I pointed out earlier, there is a limit to what embryologists understand about the embryos, and therefore can do for the embryos.
Embryologists will care and nurture gametes, but cannot repair or make an embryo better by culturing it in the laboratory. Scientists reveal that the number of eggs a female will have in her lifetime is made in utero around 18-20 weeks gestation.
Therefore, eggs are the same age as the woman’s biological age, and nothing much can be done about that.
Sadly, embryologists say there is nothing that can be done to boost egg quality (which is still in doubt), but a glimmer of hope is seen in the fact that there is evidence that the follicular environment and the health of the gamete provider during the stimulation process can affect an outcome.
Thus lifestyle factors like maintaining a healthy body mass index, avoiding narcotics and smoking, limiting alcohol consumption all have been proven beneficial to the success of IVF.
While women are born with all their eggs, most men make sperm daily and sperm on average are only 3 months old. Their daily health and choices can affect ejaculate 60 to 90 days later. At the end of the day, daily choices of both the male and female affect outcomes of the IVF cycle later.
There are no magic numbers and grade doesn’t guarantee success:
Embryo culture is a process designed to gather information about each individual embryo’s growth pattern and quality in order to effectively evaluate embryos’ implantation potential. The best embryo is usually picked for transfer.
Now, the embryologist can’t do anything about the grade of your embryos, whether it is Grade A, B or C, except pray and wish that implantation happens. Also the number of embryos transferred is not a guarantee for success, even though the higher the number of embryos, the higher the odds of success.
At the end of the day, what happens in the IVF lab is technical and in some ways mysterious, because there is no true recipe for success. You and the embryologist can only hope for the best.
Knowledge is power.
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