Finally Decoded: The Role of an Embryologist

One of the most common questions being asked to anyone is “What do you do? What is your occupation?” Generally, it is a simple answer – doctor, engineer, banker, teacher, pharmacist, designer etc. For me,  it’s never been simple, as when I answer “Embryologist”, it is almost always met with a variety of expressions, ranging from that of ignorance to curiosity to excitement and wonder. I need to then follow my answer with a brief description of my typical work day.

“What do you do? What is your occupation?” I answer “Embryologist” which is met with a variety of expressions!

This is a blog series, I am planning to pen about embryology and I thought it would be perfect for the first blog to be all about the world of an embryologist and to throw light upon what exactly it is we do.

I welcome you all to the world of scientific magic!

About Embryology – A brief background

It is a stream of biology that involves the development of an embryo. Clinical Embryologists are scientists that work in this area and are involved in fertility treatment and reproductive research.

Clinical embryologists are qualified individuals with both a hands-on and theoretical understanding of Human Reproductive Biology, Embryology, Infertility, Assisted Reproductive Technology (ART).

Embryology is a very fast developing science, and all the advances in IVF in recent years have been in the field of embryology. This makes being an embryologist in today’s world very exciting. Hence, SCIENTIFIC MAGIC!

The role of an embryologist

The role of an Embryologist is of a highly specialised scientist who is responsible for fertilisation of eggs that are extracted from the follicular fluid.  Embryologists must have high attention to detail as their work demands them to take extreme care and consider every single parameter during the process of IVF. Embryologists work along with their team and are responsible for all the laboratory procedures involved in IUI, IVF, ICSI, Cryopreservation and embryo biopsy.

It is the job of an embryologist to make sure that the work is performed in an optimal environment that is closer to a natural environment in a woman’s womb, to help facilitate fertilization of eggs and development of an embryo. An embryologist needs to adhere to strict quality control procedure to ensure all checks and balances are done and maintained for successful procedures.

Role of an embryologist during IVF

Embryologists are scientists and not medical doctors or clinicians. But, they do discuss treatments with patients at many crucial stages during the entire procedure. Typically, the embryologists come into the picture at the time of prior to retrieval of eggs, and their involvement with the patients is very important till the embryo transfer procedure. To give the comfort to the patients, it is important that an embryologist speaks to the patients and keeps them well informed about the process of IVF and their embryos. The patients must gain the confidence that their future babies are in absolutely safe hands and under the best possible care.

The embryologist plays a critical role during the following stages of an IVF cycle.

1. Egg Collection – The embryologists scans the follicular fluid that is extracted from patients’ ovaries. The healthy eggs are then separated immediately from the fluid which is then provided with nutrient-rich media, heat and humidity to replicate, as near as possible, the conditions found in a women’s fallopian tubes.
2. Prepare Sperm Samples – The samples of sperms are immediately sought from the male donor. The embryologists assess the sample for sperm count, motility and morphology levels. It is then washed to segregate the healthy sperms that can be used by the embryologist for fertilization process.
3. Insemination – During this process, the embryologist brings the sperms and eggs together to encourage fertilization. Typically, the embryologist prefers to use the traditional method of natural insemination where the healthy sperms will try to swim and bury themselves into the egg. The strongest sperm actually enters the egg to commence the fertilization process. Where natural insemination or what is known as Conventional IVF is not suitable or possible, ICSI or Intra Cytoplasmic Sperm Injection is used. Through ICSI, the embryologist selects a single sperm and injects directly into the egg. This procedure is done under an inverted microscope and requires considerable skill.
4. Fertilization and Growth Monitoring– After the procedure of insemination is completed, the gametes are stored in a controlled environment with optimal temperatures. They are continuously monitored for signs of fertilization. During this period the nutrients, the media and temperature are all modified to replicate the changing conditions that would naturally occur as the embryo travels through the fallopian tubes to the uterus. The embryos are monitored daily and the growth pattern observed and recorded very diligently.
5. Grading of Embryos – The growing embryos are observed every day and graded as per very detailed criteria followed by each laboratory. Grading of embryos is an extremely important task as it is through this grades that the embryologist selects which embryos should be transferred back into the uterus from a cohort of multiple embryos growing in the lab for each patient.
6. Embryo Transfer – The embryologist, transfers the embryos on Day 2, Day 3 or Day 5 post retrieval. The embryos are examined under the microscope and carefully aspirated into a thin transfer catheter. The loaded catheter is handed over to the clinician who introduces it into the uterus through the cervix where the embryos are placed. This procedure takes a few minutes and does not require anaesthesia.
7. Cryopreservation – Patients who undergo IVF may have several eggs collected. The eggs are then fertilized with a sperm and checked for fertilization. Fertilized eggs are called embryos. A patient may have multiple high-quality embryos eligible for embryo transfer back to the uterus. A certain number of embryos are chosen for embryo transfer, and the supernumerary embryos can be cryopreserved by the embryologist for future use. The cryopreservation process has undergone a radical change in recent years. A process called Vitrification is currently used for freezing eggs and embryos. This process gives near 100% survival rates for the eggs as well as the embryos.
8. Embryo Biopsy –It is now possible to screen the embryos for chromosomal abnormalities or genetic defect. Once the embryos have been screened and deemed free of genetic defects, they can be placed in the uterus. An embryo biopsy can be performed on Day 3 or Day 5 of the embryo. Embryo biopsy is an extremely specialised and skill oriented process. You need a very highly trained embryologist to perform this procedure.

The most satisfying part of being an embryologist

No feeling can be better than you giving a ray of hope to couples who are unable to conceive a child through natural means. It is a great feeling for an embryologist to work on those embryos who will later turn to become adorable children.

The feeling of actually giving those parents something they want most in the entire world is absolutely indescribable. The joy you see on their faces because you, as an embryologist, could help in your own small way in unparalleled.

When working with sperm, eggs and embryos, they are microscopic – so it’s lovely being able to see your work right from the microscopic level to full grown healthy children. You actually get to witness the beautiful process and it never gets old or “routine”.

Embryology is an amazing and fascinating field; it gives you a great sense of pride.

What skills do you need to do the job well?

• You need good hand-eye coordination as well as a really steady hand.
• You need to be methodical about the processes and must be committed to quality. Strict adherence to protocols and procedures is mandatory.
• You have to have a high attention to detail and have respect for patients who entrust you with their sperm, eggs and embryos.
• There are times when it takes hours to find a single sperm for injecting into the egg. An embryologist must develop the virtue of patience and perseverance.
• Embryology is a highly skill dependent science, and you must make it your mission to keep developing your skills and keep abreast with all the cutting edge technologies.
• Above all, you must have a great passion and love for the work you do.

I hope you all have a better insight as to who exactly an embryologist is and what exactly it is we do.

Like I said, it is a scientifically magical world and I cannot wait to help you discover it, through my lens.