Making “Expensive Science Babies” what its like to be an embryologist.
Most people haven’t given infertility a second thought, let alone the profession of embryology, until they are unfortunately faced with the need for infertility care.
An embryologist is a fertility specialist that helps to create embryos to either be used in IVF right away or to be frozen for later use. Embryologists aren’t MDs, but we are highly trained medical professionals, usually holding a Masters degree or a PhD due to the specialized nature of our work, topped off with complex board certifications.
We are the ultimate life-givers, making miracles happen in the form of healthy babies, to couples that have no hope of conceiving without us. Your reproductive endocrinologist would have little to offer you in terms of treatment without the embryology lab. Embryology laboratories are an integral part of a medical practice for infertility. We glean diagnostic information about egg maturity, sperm quality and embryo morphology, and generate embryos for transfer and implantation as a cell-based therapy to alleviate the disease of infertility. Clinical embryologists must make dozens of critical clinical decisions, which impact the outcome of your cycle just as much as the course of “STIMS” prescribed by your physician. We decide which sperm will fertilize which egg, which embryos to biopsy and freeze, among many other things.
Embryology is not a typical 9–5 job. We cannot leave unless the work is done. Our work never ends, as the embryos must be cared for even on weekends and holidays. I truly do consider myself to be a part of YOUR family. Your first “baby sitter.” We cannot make even the smallest mistake (more on that later). We have the “grit” to work under extreme pressure, often going for 5–6 hours at a time without eating, drinking, or using the bathroom!
We are micro-surgeons, performing the most delicate of operations — inserting one single cell (sperm) inside another (egg) in a procedure called ICSI, or removing just a few cells without damaging your “embabies”. We are practicing scientists, continually pushing the boundary of what is possible with IVF and fertility treatment.
We are the only sub-specialty of medicine to have federally mandated reporting requirements to the government. (In 1992, when Congress passed the Fertility Clinic Success Rate and Certification Act (FCSRCA) mandating standard definitions and reporting of ART cycle data to the Centers for Disease Control and Prevention (CDC). The embryologist must also ensure that the laboratory complies with the regulations of federal, state, local and institutional authorities and the recommendations and guidelines of our professional associations.
We perform our work in a very special clean room, often a quite small, and quite warm place, with very low lighting. The embryology lab actually substitutes for a human organ- the fallopian tube (were fertilization takes place in humans), and it is our duty to ensure that the lab environment and all of the instruments in it are functioning just like a human body — within very narrow limits. Specialty equipment functions as the lungs, hearts, and blood of the body- helping us to coax your embryos to grow.
Many of us have dedicated our careers to the concept of “quality control” in the IVF lab. While “Quality Control” has helped us to elevate the field of assisted reproductive technologies to a true science, it is also both mind-numbingly tedious and manual (performed “by hand” and recorded on paper often relegated to the most junior staff). A situation that can lead to horrific mistakes.
We can cause serious, irreparable psychological, emotional, and legal harm to our patients if we give the wrong gametes/embryos to the wrong patients or accidentally destroy reproductive tissue through accident or neglect. Recent, highly publicized events, such as the failure of cryopreservation tanks that destroyed more than 4,000 oocytes and embryos, and pregnancies with the wrong embryos have both providers like me, and patients on edge.
The birth of the first IVF baby, Louise Brown in 1978, was a triumph of science, medicine, perseverance and courage and it established a new profession: clinical embryology. A unique profession that has been the honor and privilege of my life to work in, where every day I contribute to an incomparable outcome: a live-born child.
Originally published as a guest post for the Embryoman Blog.
Dr. Carol Lynn Curchoe is a board certified technical supervisor in clinical embryology. She is the founder of the ART Compass app that centralizes all critical IVF information in a single system accessible by administrators, doctors, patients, and infertility lab staff.