Why every IVF clinic needs a full time embryologist

There are many IVF clinics in India now, but very few have a full time embryologist. This is because it takes years of experience to become an expert embryologist - and there just aren't many qualified embryologists around. This article by Dr Saiprasad Gundeti explains why a Full time Embryologist is Better than a travelling Embryologist !

This is a guest article by Saiprasad Gundeti, Head Embryologist, Malpani Infertility Clinic Pvt. Ltd.

An embryologist ? What's that ? And why do I need one ? Doesn't my IVF doctor have all the expertise needed to do IVF for me ?

The truth is that the heart of the IVF clinic is the lab - and the star of the IVF lab is the embryologist. He is the unsung hero of IVF - the person who fertilises your eggs and nurtures your embryos in the lab, so that your doctor can transfer your embryos into your uterus. Sadly, because he works behind the scenes, most patients are completely unwaware of the key role this skilled professional plays in ensuring the success of your IVF treatment.

There are many IVF clinics in India now, but very few have a full time embryologist. This is because it takes years of experience to become an expert embryologist , and there just aren't that many qualified embryologists around.

This is why most IVF clinics in India depend upon the services of travelling embryologists. There are just a handful of them - but they manage to cover clinics all across the length and breadth of the clinic between them. They have very tight travel schedules; and spend about 1-2 days at each clinic, where they perform the lab procedures needed for the IVF treatment cycle; and then move on to their next assignment. Travelling embryologists are very competent and skilled as they inject hundreds of eggs nearly everyday - but a competent full time embryologist is a much more valuable asset to an IVF clinic.

Here are some of the reasons why.

• A full time Embryologist can give 24/7 attention to one centre, which helps doctors to treat their patients effectively.
• Drs Malpani can take their own time for your egg Collection and embryo transfer, thereby ensuring that all the eggs are retrieved and the embryos are transferred properly into the uterus.
• Clinics which use travelling embryologists have only a limited time for all procedures , as the embryologist has only 1-2 days to spend at the center , because he has commitments at other clinics. Imagine the chaos when 10 egg collections have to be done over 2 days ! This is stressful for doctors and patients - and the embryologist ! If the patient is unable to produce a semen sample, he may have to undergo a complex procedure like TESA, due to lack to time.
• We treat you based on your own natural menstrual cycle. This ensures better ovarian stimulation and thereby better quality eggs.
• By contrast , clinics who use travelling embryologists have to do IVF cycles in batches. They need to manipulate your menstrual cycle , in order to do all egg collections on the same day. This sometimes may affect the egg quality (especially in older women; poor ovarian responders; and patients with PCOD).
• Since many egg collections are being done on one day, the risk of clerical error and sample mixup is increased enormously in these clinics . As you can imagine, it's hard to maintain good quality control when hundreds of eggs are being injected in one day !
• We have an active freezing program. A full time embryologist will vitrify the supernumerary embryos and these can give patients a much better cumulative pregnancy rate.
• When the embryologist has to travel to another clinic in 2 days, it's not possible for him to freeze your spare embryos. These are often discarded; or donated to another couple ( often without your knowledge)
• It is much easier for us to coordination and perform donor egg IVF treatments, as we do not need to depend upon a travelling embryologist's availability . This is why cycle coordination is much better
• It is also much easier for us to liaise with global programs. We can accept frozen embryos and frozen sperm samples all through the year !
• We can treat patients flying in from other cities and countries to suit their convenience. This is a major boon for patients with very limited leaves !
• It is also much easier for us to offer additional procedures such as TESE and PESA

Documentation

We routinely provide a complete IVF summary with photographs of embryos to our patients . On the other hand, record keeping for IVF cycles is very poor in clinics without a full time embryologist , because of a lack of time. Because of this lack of documentation, when things go wrong you have no way of figuring out what the problem was.

Quality Control : Maintenance of equipment.

The maintenance of our delicate and high-tech IVF lab equipment (CO2 incubators, microscopes and micromanipulators ) is done by me. I have a much better sense of how to ensure quality control and take care of my equipment as compared to someone who uses this equipment intermittently. Clinics without a full time embryologist will have to depend on technicians or ward boys to take care of the equipment , which may lead to improper functioning when the treatment cycle is tarted.