Crucial role of an embryologist in ensuring an ethical fertility treatment

Embryologists are indeed the unsung heroes working behind the scenes and play a pivotal role in the success of each and every fertility treatment. They possess the expertise and skills necessary to handle and care for delicate embryos.

Infertility is a growing matter of concern worldwide, with about 17.5 per cent of the adult population, roughly 1 in 6 people, battling fertility issues, according to WHO. The remarkable progress in science and technology has brought us to a stage where we can overcome intricate fertility challenges and achieve the extraordinary feat of creating life outside our bodies. With the help of ART treatments such as IVF, ICSE and IUI, it has become feasible to fulfil the parenthood aspirations of countless couples struggling with infertility.

Embryology refers to the field of study focused on the development of embryos outside the human body, known as embryogenesis. It is a crucial stage for the growth and development of embryos. Advancements in embryology have paved the way for improving processes of fertility treatments.

The field of embryology comprises a comprehensive understanding of both theoretical and practical knowledge required for creating embryos outside the human body. This expertise encompasses the capability to identify and employ the most suitable laboratory techniques and execute them with precision and safety.

Embryologists, recognised as specialists in clinical embryology, are the scientific professionals who provide crucial support in the creation of embryos outside the uterus. By understanding technology and underlying biological systems, embryologists perform tasks such as handling of eggs and sperm, and fertilising them to form embryos, assessing the quality of embryos and selecting embryos with maximum implantation potential.

Special care is necessary to preserve the viability of embryos, as mishandling can result in the loss of their potential for a successful pregnancy.

Moreover, embryologists also ensure that the environment of the embryology laboratory is ideal for the proper growth and development of the embryos. Stringent monitoring of various factors such as air quality, CO2 levels in the incubator, temperature, humidity, and liquid nitrogen levels is performed as well as precise freezing and thawing conditions are given special care.

Embryos are carefully examined under a microscope, and the selection of the most favourable ones is primarily based on their visual characteristics and developmental progress.

However, the implantation process is a perplexing stage for embryologists as not all grown embryos are successful in implanting themselves into the uterus. The failure of implantation can be attributed to various factors, including the quality of the egg, sperm, or embryo itself, external culture conditions in the laboratory, and the hormonal support necessary to sustain implantation.

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For successful implantation, it is crucial that a viable embryo reaches the receptive endometrium at the right time. The endometrium has a limited period of receptivity known as the implantation window, and it is essential to accurately identify this window, select the most suitable embryo, and synchronise the embryo transfer with the optimal time of endometrial receptivity.While poor embryo quality has been identified as a significant factor contributing to implantation failure, it's important to note that even with good embryo quality, achieving a 100 per cent implantation success rate is not guaranteed.

At present, the success of a couple's fertility journey hinges on the precise selection of optimal sperm, high-quality eggs from the pool selected and the implantation of the most suitable embryo. Embryologists are the cornerstone and essential component of all fertility processes.

In addition to their core responsibilities, Clinical Laboratory Experts also offer Preimplantation Genetic Testing (PGT) services. PGT is particularly beneficial for women who have experienced multiple miscarriages, couples who are carriers of genetic diseases, or those who have previously had a child with a genetic disorder.The purpose of pre-implantation genetic diagnosis is to identify genetically healthy embryos before the transfer process. With the help of specialised tools, a single cell is removed from the embryo before the transfer and studied, in order to allow only genetically normal embryos to be transferred.

The embryology department holds significant importance in determining the overall performance of an IVF clinic. The recent passing of the Assisted Reproductive Technology (Regulation) Bill, 2021 by the parliament has emphasised the need for training and expertise among embryologists. The reinforcement of this bill by state governments is a positive step that will contribute to improving the quality of treatment available to patients.

The bill mandates that professionals in the field of ART should have a minimum of three years of experience. It also sets requirements for staff and infrastructure, as well as clinical guidelines for ART treatment and patient protocols.These measures will have a positive impact on the treatment received by patients, ensuring higher quality standards. Moreover, restrictions on donor cycles in IVF, such as limiting the number of eggs retrievable from a donor, may lead more couples to choose self-cycles.

Embryologists are indeed the unsung heroes working behind the scenes and play a pivotal role in the success of each and every fertility treatment. They possess the expertise and skills necessary to handle and care for delicate embryos.

In a way, embryologists can be considered the world's first babysitters, as they provide the essential care and support needed during the critical early stages of life outside the womb. Their dedication and contributions are integral to making the miracle of IVF possible.

(Authored by Dr Sujatha, Embryologist, Nova IVF Fertility)

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