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IVF is one of modern medicine's dramatic success stories. After a considerable amount of experience, lasers have been successfully integrated into routine IVF practice, and are now found in most advanced and well-equipped IVF (In Vitro Fertilization) labs the world over.

Lasers in the IVF Lab

IVF is one of modern medicine's dramatic success stories . This is especially because of the phenomenal advances that have occurred in the IVF laboratory. Today, infertility treatment is largely based on our ability to manipulate gametes and embryos in vitro in the IVF laboratory. However, advances in IVF (In Vitro Fertilization) are now limited by technical proficiency, which emphasizes why we need to apply new technology that allows for greater precision in gamete handling.

A Succesful Advance 

Given the fact that eggs, sperms and embryos are all microscopic, it is hardly surprising that one of the successful advances in recent times has been the introduction of lasers in the IVF lab, since lasers allow the embryologist to deliver a controlled amount of energy at a specified spot with exquisite precision. After a considerable amount of experience, lasers have been successfully integrated into routine IVF practice.

Laser Benefits 

The advantages of a laser are multiple - it is precise; atraumatic, and non-contact , which means there is no need to touch the egg or embryo when using the laser. At Malpani Infertility Clinic, we use the Saturn IVF laser manufactured by Research-Instruments, UK, one of the pioneers in this field.

Read more- Laser assisted hatching - a photo essay

No More Concerns 

The initial concerns regarding the safety of the laser have now been put to rest after years of extensive experience with lasers in IVF labs the world over. Lasers now allow us to safely perform cellular microsurgery in the IVF lab, and are routinely used for assited hatching in many labs.

Assisted hatching involves using the laser to create a precise opening in the shell ( zona) of the embryo prior to transferring it. Such an opening helps the embryo to
hatch more easily, thus increasing the chances of it implanting successfully in the uterus. 

What's on the Horizon ?

After so many years of using the laser, doctors are now exploring new frontiers with it in the IVF lab - what else can we do with this remarkable tool to help infertile patients ?

We use the laser routinely in our lab for performing embryo biopsies for preimplantation genetic diagnosis ( PGD). The laser allows to create a well-defined opening through the zona, through which it is possible to safely and atraumatically remove a single blastomere from the embryo.

See-  Laser assisted embryo biopsy

Laser in ICSI

Researchers have also used the laser for ICSI ( intracytoplasmic sperm injection). The trickiest part of ICSI is the technical difficulty involved in capturing a single motile sperm and crushing its tail in order to immobilize it prior to injecting it into the egg.

Using a laser beam, this can be performed with much greater ease and speed, thus dramatically reducing the time taken to perform ICSI. This procedure c
an be especially difficult to perform when:

  • There are very few eggs
  • Eggs are fragile- these are easily damaged when the injection pipette is introduced through the zona into the cytoplasm of the embryo

How Laser Helps 

  • Laser assisted ICSI allows us to create a very small opening in the zona, through which the injection pipette carrying the sperm can be easily carried into the egg
  • This technique has been shown to reduce damage to fragile eggs during ICSI, and increase fertilization rates as well
  • It also allows us to perform cellular microsurgery on the embryo. For example, a study has shown that it's possible to achieve a dramatic increase in pregnancies from frozen embryos with laser-assisted removal of dead cells
  • Researchers at the European Hospital in Rome have shown that removing necrotic cells from frozen thawed embryos greatly enhances a patient's chances of becoming pregnant
  • Based on other researchers' work with mouse embryos, the doctors hypothesized that removing dead blastomeres from embryos damaged in the freezing and thawing process would prevent their release of toxic metabolites that are harmful to the survival and development of healthy cells; the embryo as a whole and would result in higher pregnancy rates for their patients
New Realities 

What of the future ? It may be possible to use the laser to actually perform "surgery" on chromosomes in the egg and embryo, thus allowing us to correct and repair genetic defects (for example , it may be possible to remove an extra 21 chromosome found in embryos with trisomy 21). Science fiction ? perhaps, but fiction has a way of soon becoming reality in the IVF (In Vitro Fertilization) lab !

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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