Dr Joseph Azoury

What happens in an IVF lab?

1. Oocyte pick-up

Oocyte pick-up is the process through which the doctor aspirates the oocytes from the mother’s ovaries and gives them to the embryology lab. This process is very quick however it is relatively painful and has to be performed under local anaesthesia.

 


2. Sperm collection and preparation

Semen is generally collected by masturbation the same day of the oocyte pick-up. In case there are difficulties of ejaculation or in case of azoospermia (absence of spermatozoids in the semen), sperm cells can be aspirated or taken directly from the testes by PESA or biopsy. Semen is then washed and prepared in the andrology lab before the fertilization step.


3. Oocyte fertilization: Conventional IVF and ICSI

Oocyte fertilization consists in joining the sperm of the father with the oocyte of the mother in order to obtain an embryo.
In conventional IVF (In Vitro fertilization), the oocyte is put in the presence of a big number of sperm cells and the best sperm cell enters the oocyte and fertilizes it. This technique requires a minimum concentration of motile sperm that is not always available in severe male infertility cases.
In ICSI (Intra Cytoplasmic sperm injection), the embryologist selects a sperm cell depending on its morphology and motility and using a needle, injects it inside the egg. This technique is much more delicate than conventional IVF and requires much more effort and time but it guarantees a higher fertilization rate and is the only technique that can bypass severe male infertility.

IVF-and-ICSI

 


4. Embryo culture: Conventional incubators and the Embryoscope

After fertilization, the embryo spends 3 to 5 days in the IVF lab. During this time, the embryo undergoes its early development that consists mainly in a series of cell multiplication. 
Early embryo development is only possible in specific gas, PH and temperature conditions. That’s why; embryo culture takes place in specialized incubators. 


When the embryologist wants to check on an embryo that is cultured in a conventional incubator, he has to take it out of these specific conditions and check it under the microscope. This conditions change may be harmful for the embryo quality.
 The embryoscope is equipped with an integrated camera and the embryologist can check on the embryo without taking it out of the incubator. Hence, the embryo remains in stable conditions during all its early development and its quality is not affected.

For more information about the embryoscope advantages please click here

Embryo-culture

 


5. Blastomere and trophoectoderm biopsy for PGD

Sometimes, a Pre-implantation Genetic Diagnosis (PGD) is required before transferring back the embryos to the woman’s uterus. PGD is performed on cleaving stage embryos (Day 3) or blastocysts (day 5). One or more cells are taken out from the embryo using a very delicate biopsy technique and sent to the genetic lab for testing.

This technique is often used for sex selection purposes. Azoury IVF Clinic embryologists have a big experience in this technique. However we do not promote it for ethical reasons.

Pgd

 


6. Assisted Zona Pellucida Hatching

The Zona Pellucida is the envelope that protects the embryo. As the embryo grows, the Zona Pellucida becomes more and more thin so the embryo can “get out of it” and implant. Sometimes, the Zona Pellucida is very thick and does not allow the embryo to get out of it. In this case, it is recommended to perform a Laser-assisted Zona Pellucida Hatching, that renders the zona thinner before transferring the embryo. However, it is not recommended to use this technique on all embryos especially the ones that are presenting a thin zona because internal cells of the embryo can be damaged by the laser shots. We at Azoury IVF clinic, perform assisted Hatching when it is necessary in a routine way, without asking the patient and without charging extra money for it.

Assisted-Zona-Pellucida-Hatching

 


7. Embryo Transfer


Embryo transfer can be performed any day after IVF, before the embryo has completely hatched out of its protecting Zona Pellucida. Embryo transfer is a very quick procedure and it is normally painless. The embryo is transferred to the cavity of the uterus, the closest possible to the endometrium. The transfer is monitored by ultrasound to allow a clear view of the exact place where the embryo is being released.