An embryology laboratory is our best attempt to simulate the conditions inside the female reproductive tract where life begins. The Embryoscope is an incubator with an integrated camera, which combines time-lapse imaging of the embryo and the latest incubator technology. It means the development of the embryo can be assessed while maintaining the very best conditions in the incubator. For patients who do not conceive, the images may give more information to both the patients and the embryologists about why they may not have implanted. This will be very useful if another treatment cycle is planned.
PolScope technology combines innovations in polarisation optics (special lighting and lenses) with novel image-processing software and is used as an add-on technique for the ICSI procedure. It uses polarised light to clearly see where the genetic material is stored in the egg. Use of the PolScope has shown that the spindle does not necessarily lie near the polar body. In up to 2/3 of cases, the spindle is not related to the polar body and therefore that spindle may be damaged by the injection needle during the ICSI process. Disruption of the spindle may affect fertilisation and how the embryo divides. Use of the PolScope allows the next generation fertility embryologists at Manipal Ankur to align the spindle prior to injection of the sperm, avoiding damage to the egg's genes. It also allows them to identify eggs without spindles, increasing the information available to the patient and their doctor regarding the quality of the eggs produced. Using the PolScope appears to have a significant effect on the quality of embryos produced during a cycle. Fragmentation of embryos is where there is the appearance of embryo cells falling apart. It is a bad sign and it is also associated with a lower pregnancy rate. It is seen in around 50% of embryos produced using the ICSI process. With the use of the PolScope, the amount of fragmentation is reduced to around 1/3 of embryos generated. Overall this increases the number of quality embryos suitable for use (transfer or cryopreservation).
In order to attach to the wall of the womb, an embryo first has to break out (hatch) from the gel-like shell that it is contained in. This shell is called the zona pellucida and is harder in some embryos than others. Assisted hatching is a procedure in which the zona (shell) of the embryo is opened using the techniques of Micromanipulation. Assisted conception treatments most commonly fail after embryo transfer and this may be because the transferred embryos fail to hatch, perhaps because the zona is affected by cryopreservation (freezing) or in vitro lab culture. To counteract this, assisted hatching aims to improve the chances of successful hatching by creating a hole in the zona pellucida. The use of assisted hatching results in higher pregnancy rates in selected cases. Assisted hatching may be suitable for:
Earlier, embryos were routinely transferred after a two-day culture, in the stage of four cells per embryo. However, the stage of four cells can be reached by numerous potentially defective embryos and it is virtually impossible to distinguish a quality embryo at this early stage. Development of new cultivation media has allowed for prolonged cultivation of the embryos in a laboratory (in vitro). Such extended culture allows for better assessment of the embryos. It is possible to set apart embryos whose development slows down or stops and select the embryo or embryos with adequate development for transfer. Their culture can be extended to up to 5 days following the oocyte collection i.e. the blastocyst stage (a blastocyst is an embryo that consists of more than 100 cells). It is at the blastocyst stage of development (5 days after fertilization) that an embryo would normally move out of the fallopian tube and into the uterus. Once in the uterus, the blastocyst starts to attach to the uterine lining in a process known as implantation. A higher implantation rate has been observed following transfer of blastocysts from the laboratory. Our experience shows that the success of transfer depends on whether the uterine lining is ready to receive the embryos rather than the stage at which the embryos are transferred. Extended cultivation of embryos exceeding 48 hours offers the following positives:
Vitrification is an exciting new technique which is used to cryopreserve (freeze) supernumerary eggs and embryos. An IVF cycle will hopefully produce a number of viable embryos. Those that aren't immediately transferred back to the patient are placed in cryostorage by lowering their temperature to that of liquid nitrogen (-196 ºC). At this temperature, embryos can be stored until they are needed for later transfer. A tiny droplet of cryopreservant fluid containing an embryo holds to its vitrification hook. The problem with freezing any cell in the body is that the fluid inside the cells can form ice crystals that expand and damage the cell membranes. Enormous care must be taken to avoid this. In the past this has meant that eggs and embryos were frozen using a slow programmed decrease of temperature using expensive machinery. With the new vitrification technique using ultrarapid freezing techniques, embryos are cooled at an extreme rate, so that the embryos are flash frozen and preserved intact. Survival rates after vitrification are better than they were with conventional slow freezing. We at manipal ankur have a pioneering technology which enables us to achieve post thaw survival rates of 90% for the frozen embryos and a clinical pregnancy rate of 60 - 70% in frozen thawed cycles. Salient features: