What is the role of an embryologist?
We learn more about why embryologists are essential in assisted reproduction technology and the patient fertility journey.
What is an embryologist?
Embryologists are laboratory scientists who are qualified in handling and manipulating human gametes for the sole purpose of establishing pregnancy using assisted reproductive technologies.
We work predominantly behind the scenes; however, our work significantly contributes to the overall patient fertility journey. Beginning at diagnostics, an embryologist performs an array of sperm tests that will allow for the fertility specialist to determine the possible cause for infertility and prospective treatment.
During therapeutic treatment, the team of embryologists will be designated to various tasks. The day may consist of embryo warming; egg retrievals; sperm preparation; evaluating of embryo development; embryo biopsy for genetic testing; sperm freezing; egg freezing; embryo freezing; embryo transfers and in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) inseminations.
In addition, embryologists occasionally perform egg and ovarian tissue freezing for female oncology patients, as well as sperm and testicular tissue freezing for male oncology patients. This technique allows for oncology patients to preserve their fertility prior to receiving cancer treatment.
A typical day
The day starts by dressing into appropriate laboratory attire (scrubs, scrub cap and laboratory appropriate shoes). Upon entering the laboratory, the embryologist will wash their hands with antiseptic skin cleanser to ensure sterility before all tasks are performed. Equipment that is required for the daily tasks will be switched on to ensure enough time for all to stabilise. Once the equipment has stabilised, the first procedures of the day can begin. This will include assessing the fertilisation of gametes that were inseminated the previous afternoon by means of ICSI or IVF and re-evaluating surplus embryos for potential biopsy and/or freezing.
The first step in the therapeutic treatment includes egg retrievals, where an embryologist will be responsible for locating the eggs in the follicular fluid that is aspirated from the ovarian follicles by the fertility specialist. Thereafter, the eggs are placed in uniquely labelled patient specific culture dishes. Once in these dishes, they will be safely placed in incubators that offer an environment that mimics that of the human body. Preparation of the sperm to be used for the insemination will also take place during the morning.
Specific for the ICSI insemination, the embryologist will remove the outer layer of cells from the eggs to establish maturity and final number of eggs suitable for the procedure. During the ICSI procedure that will be performed later in the day, an embryologist will use a specialised micromanipulator to select the best sperm that will then be injected into a mature egg.
Another form of insemination is IVF, where a calculated amount of prepared sperm is inseminated around a group of eggs and left to fertilise the eggs naturally without further manipulation from an embryologist.
Patients with frozen embryos that are scheduled for a transfer later in the day will have their embryos warmed first thing in the morning and viability is assessed once the warming procedure is completed.
The embryologist designated to embryo evaluation will also evaluate day 3 embryo development to confirm cell division, and day 5 embryo development for the selection of suitable embryos for fresh embryo transfer, biopsy for genetic testing, and/or freezing. Once the suitable embryos have been selected after day 5 embryo evaluation, the embryologist will perform the assigned procedure (biopsy and/or freezing, and embryo transfers). During an embryo transfer, the embryologist will assist the fertility specialist by loading the selected embryos into an embryo transfer catheter, followed by placement of the catheter into the uterus.
Detail orientated and focused
In addition to the above-mentioned procedures, embryologists are also responsible for media preparation, patient contact sessions, data gathering, quality control and troubleshooting.
Due to the intricate nature of the job, an embryologist needs to be detail orientated, focused, work well independently and in a team, and be reliable. Applying these traits alongside experience and continuous professional development will allow for an efficient day in the life of an embryologist.
Without the important role of an embryologist, assisted reproduction technology would not be possible.
This article was written by embryologists: Sindi Masilela, Kimola Kruger, Chantel Gouveia and Jenna Jardim from Vitalab, Johannesburg, Gauteng.
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