Monday, 8 April 2013

Monday morning has started off great!
4 oocyte retrievals and a couple of embryo transfers and a very pleasant surprise which i shall come to later!!
the embryos were transferred into two surrogate mothers,one was for an INDIAN NRI couple and the other was for a candian couple.

a lot of folks still dont believe that it is possible to make an embryo which consequently results in the birth of a baby outside the womb in a petri dish,so i shall explain here how this is possible!

what are all the instruments in the ivf lab?
very important-a good Lab must have a good embryologist(:

Laminar flow is a clean air filtration unit which is like a box in which the handling of the the Gametes is done,this is how it looks like in my lab!
 inside the laminar flow,the following equipment are arranged
The stereo zoom is an optical microscope variant designed for low magnification observation of a sample using incident light illumination rather than transillumination,we use it for collection of oocytes from the follicular fluid and for adding washed sperm to the oocytes and for embryo transfer.
Unlike a compound light microscope, illumination in a stereo microscope most often uses reflected illumination rather than transmitted illumination, that is, light reflected from the surface of an object rather than light transmitted through an object and has a megnification of 100X.
the stereozoom has a heating stage so that the gametes are always at 37 degree celcius.
below is a picture of the German made C16 Gas boy which is used for short time storage of gametes at 37 degree centigrade and 5% co2 to mimic the environment in utero
another very important instrument in the lab is the Micromanipulator
it is a device which is used to physically interact with a sample under a microscope, where a level of precision of movement is necessary that cannot be achieved by the unaided human hand. It may typically consist of an input joystick, a mechanism for reducing the range of movement and an output section with the means of holding a microtool to hold, inject, cut or otherwise manipulate the object as required(sperm)Micromanipulation first saw clinical use(1992) in IVF for purposes of assisted fertilization in the treatment of male factor infertility, where fertilization potential was low in cases of poor sperm quality. The ultimate evolution of this approach has been the development of the single sperm injection procedure referred to as Intracytoplasmic Sperm Injection, or ICSI. Sperm of virtually any quality and from any level of the male reproductive tract may be used with the only criterion for use being that the sperm is alive even if it is not moving (motile). Dead sperm may be able to achieve fertilization; however, the DNA or genetic material from such sperm is too degenerate to form a viable embryo. Immature sperm from the testicle or the epididymis can be retrieved for use with ICSI for men who possess no sperm in their ejaculated semen (azoospermia).

finally after ivf or ICSI the Fertilised embryo is placed in large incubators in petri dishes for anywhere between 2 to 5 days before being transferred inside the uterus.
above pic of a petridish inside the Incubator
above pic is of the bigger incubator which is used for culture of embryos.
now for the surprise,i was pleasantly surprised to see one of my patients Oksana from ukraine seated in the lounge,i was surprised because she did not have an appointment and she currently lives with her Husband in Dubai and her treatment was not due yet.
apparently she had to come all the way from Dubai to pick up her shots and Oral medication because no medical store/Doctor was willing to give her the drugs even when she had a proper prescription,unless she took the treatment with them locally in Dubai which seems unfair and like an arm twisting tactic to me.
so we gave her the medication and she flies back to Dubai later in the evening.she always has lots of questions and is very keen to have a baby,unfortunately she cannot carry a pregnancy because of a hysterectomy she had to undergo because of cervical cancer.
but she has intact ovaries and we are going to be transferring their gametes into a surrogate mother.surrogacy as a recognised method of treatment is essential for such women to be able to have their own genetically related children.
she will return in about 2 weeks for her OPU.
we wish her the Best in her endeavour to start her family.