Understanding Embryo Transfer Procedure for IVF

Although it may seem obvious that the correct identification of patients and embryos is vital, communication errors do happen and can lead to a catastrophic error, especially if there are patients with similar names undergoing treatment at the same time.
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Understanding Time-Lapse Systems

Time-lapse systems (e.g., Embryoscope™ time-lapse system for IVF) take digital images at set time intervals, e.g., every 5 to 15 minutes. In IVF laboratory, time-lapse systems can be installed into an existing embryo incubator or can be used as a separate stand-alone system that combines incubation with time-lapse. Specialist software compiles the images to create a timed sequence of embryo development that can be digitally displayed on a monitor. Specific events such as timing of cleavage divisions, irregular cleavage, fragmentation, fragment resorption, blastocoele formation, and blastocyst expansion can be visualized without disturbing the culture system.
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Potential Benefits of Blastocyst Transfer

The transfer of blastocysts on Day 5 or 6 has the advantage of allowing better synchrony between the embryo and endometrium, as well as eliminating embryos that cannot develop after activation of the zygote genome due to genetic or metabolic defects.
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Understanding Embryo Grading for IVF

Divergent national strategies define the maximum number of embryos that can be transferred in any one cycle, and elective single embryo transfer (eSET) is recommended for selected patient populations, in order to decrease the incidence of multiple births associated with ART.
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Embryo Viability and Implantation Potential

Analysis of medium that has been used for embryo culture offers further approaches to determine embryo “health”/viability. Three different types of substance have been studied as potential biomarkers:
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Selection of Embryos for Embryo Transfer

Historically, embryo transfer was carried out 2 days (approximately 48–54 hours) after oocyte retrieval, but transfer has been carried out from as early as 1-hour post-ICSI to 5 days later, at the blastocyst stage. Trials of zygote transfer on Day 1 also achieved acceptable pregnancy rates. It seems that the specific timing of transfer may not be crucial for the human implantation process. On Day 2, cleaved embryos may contain from two to six blastomeres. Embryo transfer 1 day later, on Day 3, or on Day 5 at the blastocyst stage is advocated as a means of selecting embryos with higher implantation potential, by the elimination of those that arrest at earlier cleavage stages in vitro.
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Oocyte Retrieval (OCR) and Identification

Each individual treatment cycle involves a number of different stages and manipulations in IVF laboratory, and each case must be assessed and prepared for in advance. The afternoon prior to the procedure (the day after hCG administration) is a convenient time to make the preparations. IVF laboratory staff must ensure that all relevant consent forms are signed by both partners, including consent to special procedures and storage of cryopreserved embryos.
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Sperm Preparation for In-Vitro Fertilization

At the time of oocyte retrieval or intrauterine insemination (IUI), IVF laboratory should already be familiar with the male partner’s semen profile and can refer to features that might influence the choice of sperm preparation method used. Semen is a non-sterile body fluid that can transmit infection, and viral screening tests should be confirmed as negative before the sample is handled for preparation in the IVF laboratory. Aseptic technique should be maintained throughout.
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Accurate Semen Analysis Data and ART

At least 50% of couples referred for infertility investigation and treatment are found to have a contributing male factor. Male factor infertility can represent a variety of defects, which result in abnormal sperm number, morphology or function. Detailed analysis of sperm assessment and function are important for accurate diagnosis. A review of semen analysis is beyond the scope of this blog post, and only details relevant to ART will be described here.
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Early Human Embryos Development

Most of our knowledge about early post-implantation development was gained from an extensive research. Fixed and stained human embryos after pregnancy loss at different stages of gestation provided information about the early human post-implantation period. The Carnegie Collection of Human Development at the National Institute of Child and Human Development in Washington, DC, has made a collection of several thousand serial microscopic cross-sections. Human embryos have been classified into 23 developmental stages based on a number of morphological features, known as the “Carnegie stages.”
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