Fertility

25th July 2021

World Embryologist Day

A Day in the Life of an Embryologist
by Laboratory Director Lucy Richardson-Dunn

An Embryologist’s preparation for the working day starts before we even leave the house – when getting ready for work we need to make sure we avoid anything scented on our bodies because the smells can affect the precious embryos in the lab – so no perfumes or aftershaves for us!

We arrive at the clinic around half seven in the morning where we change our clothes into our scrubs, carefully tying our hair back in hats and donning special footwear specific for the lab, before thoroughly cleaning our hands – even prior to COVID, the Embryologist must follow a rigorous handwashing routine before, during and after our clinical work.

Upon entering the lab, we will switch our low level yellow filtered lights on and check all of our critical equipment. All our equipment is monitored using an alarm system which is operational twenty-four hours a day, seven days a week and linked to our Senior Embryologist’s mobile phones so we are constantly able to monitor our equipment even after we leave the lab for the day – nonetheless, we will meticulously check and clean all of our equipment to ensure it’s ready for us to handle eggs, sperm and embryos safely.

One of our first jobs of the morning will be to look at the eggs we collected the day before to assess for signs of fertilisation. Yesterday, we would have either added sperm to our eggs to inseminate them via IVF (In Vitro Fertilisation) or used very fine needles connected to a high powered microscope and micromanipulator to inject sperm directly into the eggs using either ICSI (Intracytoplasmic Sperm Injection) or PICSI (Physiological Intracytoplasmic Sperm Injection).

This is an exciting part of the day for us! Once we’ve checked our eggs we get to enjoy another special part of the day – calling our patients to let them know how many eggs have fertilised, talking them through the next stages in embryo development, the plans for embryo transfer and giving them the opportunity to ask any questions they may have.

Around the same time, we’ll be checking our embryos ahead of embryo transfer – another exciting time for us! The embryos which we have grown in the lab for five days are now known as blastocysts. We will determine how advanced they are and take a detailed look at two different cell structures – the first being the Inner Cell Mass (ICM), which are the cells that will ultimately contribute to the fetus and the Trophectoderm cells (TE), which will go on to form the placenta.

The lab at Herts and Essex were pioneers at blastocyst culture, and using many years of experience, we will determine which will be the strongest embryo to be returned to the uterus and which embryos will be suitable for freezing, or ‘vitrification’. We are incredibly proud of our freezing and thawing success rates – around 95% of our embryos will survive this process.

When it is time for transfer later in the day, we will use a glass pipette to carefully move our embryo into a new dish using our state of the art witnessing system for extra security for our patients. Embryo transfer is a super special time – we are able to spend time with our patients and show them their embryo on a screen that links to a microscope in our lab, so what our patients see is exactly what we see down the microscope in the lab. We will also give our patients a photograph of their embryo – what we always hope will be the first photo in their new family scrapbook!

At around about 9am (yes, this is all before 9am so far!) we will start to see patients in our operating theatre for egg collections. It can be a scary time for our patients so it’s so important to us that we spend time with our patients before their procedure so that they know their eggs and future embryos are in the safest of hands! At the same time, we will be ‘washing’ sperm samples to isolate up to a 150 million of the strongest sperm to be used later on in the day for either IVF, ICSI or PICSI.

Some patients will be using frozen eggs, frozen sperm or frozen embryos for their treatment so in the morning we will also be removing them from the freezer, which are large containers full of liquid nitrogen which keep our eggs, sperm and embryos safely frozen. Working with liquid nitrogen can be extremely dangerous so we have to undergo a lot of specialist training to do our job.

Throughout the day, we’ll also be seeing patients for their semen analysis, or sperm tests. Some will be considering trying to start a family and having some initial checks, some will be looking at treatment options, some may be wanting to freeze sperm samples ahead of medical treatment or gender reassignment. But irrespective of the reason for testing, as an Embryologist we will spend as much time as the patient needs to help them understand their results and how they may be able to look at lifestyle adjustments to help improve sperm quality.

In the early afternoon, it is time for us to help sperm and egg meet! This may be through IVF, ICSI or PICSI but after the procedure, the eggs are returned to our high tech incubators overnight. All of our job is highly pressurised – but when you so desperately want the best outcome for every single patient, you may well find yourself thinking about those eggs and willing them on, long after you have left the lab in the evening.

As well as lab work, we will be helping patients source donor sperm, move sperm and embryos into our clinic from other clinics as well as monitoring our results, performing audits, reviewing new scientific advances – in addition to meeting and greeting our beautiful babies! Sadly, COVID has meant that the latter has been put on hold but we still cherish every positive outcome, every single much loved baby born and cannot wait until we can have lots of cuddles back in clinic!

A day in the life of an Embryologist can be stressful but as a team we come together to overcome challenges, to make what might seem impossible happen and we are content that we are small cogs in a big wheel that is fertility treatment. Best job in the whole world!