What every Gynaecologist should know about what happens in an IVF lab?

The gynaecologist in an infertility clinic is responsible for the clinical part of the treatment. However, it is critical for every gynaecologist to know what goes on in the IVF Lab.

Dr. Sai, Senior Embryologist, Malpani Infertility Clinic Pvt. Ltd.

The gynaecologist in an infertility clinic is responsible for the clinical part of the treatment. However , it is critical for every gynaecologist to know what goes on in the IVF Lab. This is especially true for gynecologists who want to start doing IVF ! First of all , let's have a look at the tools which an IVF Lab uses.

1. Equipment
2. Culture Medium
3. Disposables
Finally, we will discuss the importance of keeping

4. Sterile Culture Conditions ; and
5. Quality Control

1. Equipment

   CO2 Incubator :

   

   • Basic Operations of a CO2 Incubator :
   A Gynaecologist should know the basic functions of a CO2 Incubator such as :
   • Setting up values for CO2 % and Temperature.
   • Measurement of CO2 % with fyrite ; and measurement of temperature.
   This is very important, as variation in pH and temperature affects the embryo quality, and thereby the pregnancy rate.
   • Calibration of CO2 and Temperature, if required.
   • Pressure setting of CO2 Gas cylinder.
   • The need to frequently clean the incubator; and change the water.
   • The CO2 Incubator should have a backup power supply, in case of power failure.

   Laminar Flow Workstation :

   
   A Gynaecologist Should know :

   • Pressure settings for the flow.
   • Frequency for change of HEPA filter.
   • Frequency for servicing of the unit.

   MicroManipulator :

   

   • Basic operation of Micromanipulator.
   • Frequency of servicing.
   • Change of lamp, in case it burns out.
   • How to focus the microscope and setup the pipettes.

   Stereozoom Microscope :

   

   • Basic Focusing of specimen.
   • Frequency of servicing.
   • Change of lamp, when it burns out.

   Centrifuge Machine :

   

   • Basic Operation of machine.
   • Frequency of Servicing.

   Binocular Microscope :

   

   • Basic Focusing of specimen.
   • How to change the lamp, when it is burnt out.

2. Culture Medium :

   

   A Gynaecologist should know the following about the culture medium :

   • Components of Culture medium
   • Selection of proper medium for every procedure - Egg collection, Micromanipulation, Embryo Culture, Blastocyst Culture, Sperm preparation, Sperm Freezing and Embryo Freezing.

3. Disposables:

   A gynaecologist should know the list of disposables that are required for embryo culture.
   Selection of proper disposables is critical.
   All disposables used for embryo culture should be of IVF Grade.

4. Sterile Culture Conditions:

   Culture Conditions include :
   • IVF Lab cleanliness :
   = Daily Cleaning of IVF lab with proper disinfectant is mandatory.
   = The disinfectant should be non-toxic and odourless.
   • CO2 Incubator Cleanliness :
   Regular Cleaning and disinfection of CO2 Incubator should be performed.
   • Aseptic precautions while handling Gametes and embryos :
   = One should wash his/her hands properly before handling the dishes containing
   embryos.
   = Gloves should be worn, while preparing dishes and handling culture medium.

5. Quality Control Quality control is essential to ensure proper functioning and maintenance of all equipments.

   • Regular measurement of CO2 % of Incubator, to ensure pH of 7.2-7.4.
   • Temperature measurement of CO2 Incubator, Heat baths, Stage warmers to ensure

   a steady temperature of 37 C.

   • Proper Maintenance of Culture medium and Disposables :

   Stock Keeping for Culture medium and disposables with reorder level, to avoid shortage.

   = Keeping track of shelf life of culture media and disposables.

   = Proper maintenance of refrigerator ,including regular temperature measurement for storage of culture medium.

   • All equipments should have backup power supply, in case of power failure.
   • Record Keeping for all the procedures.