“As an embryologist, we’re scientists working behind the scenes directly with your eggs, sperm, and embryos. Our partnership with clinicians helps to provide excellent care in creating the best environment for your gamete while they are outside your body.” –Ashley Wong

I began working in clinical embryology in the late 1990’s. I am passionate about providing excellent care for couples and creating the “best” and “safest” environment for patients, eggs, sperm and pre-embryos that is possible. I hope this caring and quality environment translates into the most nurturing beginning that these pre-embryos can have and thus if they eventually grow into a fetus, baby, infant, child and adult I know I did my best to make their beginning the healthiest possible.

Over the years, I have noticed that the embryologists within the fertility clinics are often kept behind closed doors with little to no interaction with patients. We are “lab geeks” and our strengths often do not include human interaction or communications. We are often detail orientated, task driven, highly technical and academic. If we were communicative and connected, we probably would have been drawn to a different occupation. Most of us are happy to work long hours in a reduced light environment with no windows working with cells and bodily fluids. Our success or failure on a daily basis is measured by concrete outcomes; specifically, the number of eggs retrieved, the number of eggs fertilized, blastocysts formed, embryos frozen, patients pregnant, the number of embryos implanted and babies born. That doesn’t mean that we aren’t invested in your success or family beyond statistics! The reason many of us work in this field is that we are invested in the bigger picture of helping create that family that you are dreaming of. Many of us could work in a hospital or clinical or cancer research laboratories with other specimens, but have chosen this area of medicine to work because we are inspired!

In the spirit of opening some of those “closed doors” and helping patients and babies born from IVF understand how they begin, I’m providing an inside look at how the embryologists and fertility lab contribute to your fertility journey. I hope that after reading some of the standards that IVF laboratories adhere to you are reassured of the integrity of your gametes and that the professionals behind the scenes are invested in your treatment and success.

The IVF laboratory is accountable to the Center for Disease Control (CDC) for maintaining a safe environment for patients and gametes. There are a few different agencies that accredit IVF laboratories for the CDC. These agencies make sure that IVF laboratories uphold the standards of care that are critical to quality care for patients. These agencies use a variety of tools to uphold these standards including on-site inspections every two years, self- inspections, blind proficiency testing at least two times a year, procedure requirements, training programs and peer support systems. This translates into a highly regulated environment that has as many standards, if not more than, a hospital laboratory. Many embryologists also work under the regulation of the FDA and different professional/ state licensing organizations.

These regulations are developed and evolved by professionals in the field and laboratory professionals. They are specific to the IVF laboratory but flexible enough to accommodate each clinic. Some of these provisions regulate the patient identification process, semen collection and handling, specimen labeling and education requirements of embryologists. What does this mean for you in layman’s terms?

When a female shows up to have her eggs retrieved, there is a specific process to identify her. This identification process then requires a professional to verify her identification with a physician order. This physician order is similar to a prescription that you would take to a pharmacy but is the instruction sheet for how the laboratory should process her eggs. That physician order is then used by the lab to verify against the label of her dishes, paperwork and cryopreservation containers. Your “new patient” registration forms where you provide your demographic information is also a critical step in the process and is the basis for most of your labels and information that are generated down the road.

Labs must use two unique identifiers for each specimen. This usually includes name, birth date, collection date, social security number or a random unique assigned number and color code. Often this color code and unique number are assigned to the IVF patient’s whole case and when gametes are set to interact (like sperm and egg fertilization event) used to “match” specimens. Typically there are two technicians that verify that the specimens match. Some labs go above and beyond the regulations to put in place “good laboratory practices” that they believe ensure a higher level of security. This may include a special computer or digitized systems that document and witness specimen interaction. This would include egg collection from the female, sperm collection from male, fertilization event, embryo transfer to female and placement of eggs or embryos on/in their cryopreservation container. The CDC requires us to take surgical pauses at critical interactions to make sure clinical staff and laboratory staff communicate about patient care and specimen identification. We also have practices in place to only work on one case or specimen at a time at each workstation and schedule procedures to maximize efficiency and accuracy.

Embryologists also learn from collaboration and continue to grow and improve our systems. We are lucky that professionals in our field are very good about sharing in a professional setting their hard earned knowledge. We are very collaborative and often share what works, and what doesn’t to make your experience more successful. I think this is unique in a culture where entrepreneurialism is encouraged and if you have a unique product or gift, you exclusively market it. We care more about building families than our own personal success and tell others what worked for us. We also discuss what mistakes we have made, hazards we see and cases we have failed on. Our sharing is also regulated by HIPAA and maintains your confidentiality at all times.

I hope this peek into the embryology profession reassures you that there is a laboratory team that is invested in your success and safety. There are regulating agencies that monitor, test, inspect and accredit the professionals working on your case. These professionals are held to a high standard and they take their responsibility to care for each patient, couple and eggs/pre-embryos very serious. Specimen labeling, interactions, and professional standards continue to evolve and improve with the industry because embryologist and laboratory professionals have input on increasing the standards. Embryologists are typically driven and inspired professionals, that want to support your journey and success.

ABOUT GUEST CONTRIBUTOR

Ashley Haine Wong lives in Minnesota where she works as embryologist and lab supervisor for Midwest Center for Reproductive Health. She is married and a mother of three childrenTrevor (16 years old), Grayson (14 years old), and Avari (11 years old). She has an extensive working history in the human embryology field. Ashley trained at the University of Minnesota holding both a Bachelor of Science and a Master of Science degree. In addition, she has a Technical Supervisor Certificate from the American Association of Bioanalysts and is a member of ASRM, College of Reproductive Biology (CRB) and the Society of Reproductive Biologists and Technologist (SRBT). Ashley describes her fertility career as extremely gratifying and what brings her joy and love. She hopes to inspire her patients as she helps them create a family of their own.

For more information or to contact Ashley, she can be reached via email, Facebook, Twitter, LinkedIn, or website.