How quality control during human embryo culture leads to improved IVF outcomes

Quality management in IVF clinics today, focus on creating an optimal environment for embryo culture. Quality Control (QC) and Quality Assurance (QA) in clinical laboratories increase the chances of success of the IVF outcome, and embryologists play a crucial role in quality assessments to make sure highest standards are maintained.

Working to imitate the natural process of reproduction, except with more precision and certainty, an embryologist is directly involved in helping couples conceive their children – by ensuring healthier embryos, proper embryo implantation as well as assisting with In Vitro Fertilization, maintaining clinical records and running tests on eggs and embryos. That said, when it comes to quality maintenance, there are plenty of crucial decisions left to embryologists.

Goral Gandhi ( Indo Nippon IVF Clinic ) an embryologist in India who has established several training programmers for practicing embryologists and ascertained guidelines on good practice for IVF laboratories, discussed about the quality practices contributing to performance and success in the embryo laboratory.

“QC is a rigorous process that is performed in all IVF labs. The guidelines are not restricted to the clinical laboratory protocol, but cover every aspect of the process including staff, equipment and safety, quality control, and medical training. However, the onus is majorly on the team of embryologists that carry out the entire procedure. I always lay extra emphasis on good laboratory practice and train my embryologists to perform their work with utmost diligence, with the greatest of their abilities,” explained Gandhi.

Assisted Reproductive Techniques (ART) today has evolved into branches that not only help parents conceive but also treat specific hormone related illnesses. It does not only refer to IVF but also the treatments tailored to patients’ unique conditions.

Another embryologist Evelyn E. Neuber, Ph. D., HCLD (ABB), Clinical Research Coordinator at the Center for Advanced Reproductive Services at UCONN, tells us about the quality protocols followed in a clinical laboratory.
“I verify and document countless QC measurements, including the room temperature, the pH of the media used to grow the embryos, lot numbers of reagents, microscope temperature settings, and gas tank levels. Only when I am 100% certain that everything is in optimal working order do I open the IVF lab for patients,” she said.

Embryologists work dedicatedly on maximizing the chance of success of IVF and minimize risk. With a wide range of new reproductive options available to patients, the quality assurance and control has become a mandate to help achieve the desired outcome, and maintain the best of health for patients and their off springs.
“We critically work on quality parameters in terms of checks and protocols we follow in our lab when it comes to equipment, pressure modules, quality control of culture medium and disposables, handling of oocytes and spermatozoa, evaluation of results such as fertilization rates, cleavage rates, embryo quality, pregnancy rates, implantation rates, survival rate for frozen embryos, etc,” added Goral Gandhi (Indo Nippon IVF).

Performing all the core embryology techniques – eggs retrieval, ICSI, biopsies, and cryopreservation, and quality controls, the work of an embryologist, thus, determines the efficacy of the IVF process.

Dr Goral Gandhi explains process of Embryo Cryopreservation

Preserving motherhood for when you think you’re actually ready

The option of banking embryos, not just for medical reasons but for social factors too, has been a great conduit provided by modern medicine and sciences. Defying the constraints of the natural biological clock, women worldwide have been able to plan better for their pregnancy, and extend their childbearing years through ART and associated options.

The process of embryo freezing has been one such breakthrough medical option for childless parents and couples intending to conceive at later stages in life. It has given women from all walks of life the liberty to plan their motherhood through storing embryos for future pregnancies. “This option can give you peace of mind that whatever happens you may be able to have a family in the future,” says a spokesperson of the Human Fertilization and Embryology Authority (HFEA), the fertility watchdog.

With ART advancements, women are fortunate enough to deliver healthy babies whenever they want, irrespective of their physical conditions or ambitions in life. But what exactly happens during the process of embryo cryopreservation or embryo freezing?

“Embryo cryopreservation is a clinical process that requires a great degree of precision and care. It is the process of freezing and storing embryos in subzero temperatures to preserve their superlative quality. Embryos can remain frozen for a prolonged period and can be thawed to lead to viable pregnancies as and when the couple desires,” says Goral Gandhi, the Founder as well as Scientific and Laboratory Director at( Indo Nippon IVF), Mumbai, India.

Dr. Goral Gandhi (Indo Nippon IVF Clinic) a leading embryologist has actively worked towards the science of ART and IVF in India, helping numerous women in their journey towards parenthood. Training more than 300 embryologists, she has educated doctors, scientists and embryologists in various aspects of IVF, embryology, and emphasizes on quality care and management in clinical laboratories.

In cases when a person may wish to freeze their eggs or use them to plan their later pregnancies, the doctor may recommend In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). The process of embryo freezing initiates when the patient intakes hormones to ensure on-time ovulation. Fertility medications also stimulate egg production, which is then left in the laboratory with sperm, produces to commence the process of natural fertilization. The fertilized egg- called an embryo is then monitored by an embryologist, who is vested with the decision to choose a suitable embryo for implantation.

For when it comes to embryos, the credibility and accuracy of grading affects the outcome of the pregnancy, therefore, an embryologist plays a crucial role in deciding which embryo(s) to go further with, explains Goral Gandhi, who has done pioneering research work on quality control in laboratories.

“If you’re at all considering starting a family and are not necessarily exactly where you want to be for any reason, it’s a good idea to come in and talk to a fertility specialist about freezing embryos, or about other options. So I think knowledge is power and there are a lot of options,” says Kathryn Calhoun, a female infertility specialist at the Atlanta Center for Reproductive Medicine.

Embryo cryopreservation has been an effective way for couples who want to welcome pregnancy at later stages of life, or for women who want to preserve motherhood for when they think they are ready to take on the roles of nurturing mothers.

This World Embryologist Day, let’s celebrate the Scientists who bring life into the world

Doctors and Scientists save lives, but their role goes far beyond than just being healers and life savers. They are the ultimate life-givers, making miracles happen the form of healthy babies to couples that have otherwise lost hope at conceiving.

25th July has been marked as an exceptional date in the history of humankind, with the birth of Louise Brown, the first IVF baby, through the successful intervention of scientists in matters related to infertility. Bringing hope to thousands of other childless couples, more than 8 million IVF healthy babies have been brought into this world through the living field of ART since then.

Elucidating on how fulfilling their jobs have proved to be, some of the renowned embryologists talk about how they have helped couples realize their dream of becoming parents.  Goral Gandhi (Indo Nippon IVF Clinic) a pioneering name in ART and IVF in India, says, “Embryologists are not just doctors merely following a protocol. It takes a certain dedication and passion for the work that we do, whether it is the QC measures that we so vehemently follow or making the best use of patient material to produce successful chance at pregnancy.”

Dr Goral Gandhi   (Indo Nippon IVF ) has successfully taught embryology to more than 300 students, who share her passion for constantly looking for new ways to help patients through better treatment practices and awareness. Talking about the empowering effect of information and awareness, Goral Gandhi says, “Childless couples who are preparing to bring a child into this world but are affected by infertility related barriers might find great comfort in knowing that they have a medical team of embryologist by their side, to help them experience the joy of parenthood.”

The work of an embryologist is mostly behind closed laboratories, where they foster healthy growth of embryos and their eventual culmination into future babies. It is not a typical 9-5 job, rather requires relentless hours of hard work and dedication, but is one of the most unique and fulfilling careers in existence, says Liesl Nel-Themaat, the IVF Lab Director of the University of Colorado Advanced Reproductive Medicine program.

With such dedicated scientists each individual’s contribution brings new breakthroughs in approaching infertility. The boundaries of what is possible with IVF and fertility treatment are continually being expanded by these doctors.

Crediting the pivotal role of embryologists in bringing assisted reproduction to what it is today, Lareina F. Welch, a leading embryologist, congratulates the doctor worldwide for creating and supporting life. “This honor wouldn’t be possible without the tireless work of pioneer embryologist and the continued efforts of current day embryologists. To all my colleagues and pioneers in our field, I thank you for your dedication and passion. I wish everyone 100% fertilization on World Embryologist’s Day!” she says.