Let me introduce you to people known as embryologists. In layman terms, they are simply those who make babies in the lab. Early in my career, there was an incident related to work that I will never forget. My dad was out for his evening walk when I ran to catch up with him. He proudly introduced me to a bunch of his senior-citizen friends, “This is my daughter and she makes babies!” I could feel all the old hearts there do a somersault. I was red with embarrassment. “Make babies for other people in a lab with the help of IVF,” I corrected him. My dad laughed, patted my back and said, “Yes, it is the same thing.” In my mind, to prevent such an incident from reoccurring, I vowed to give my dad a few lessons on the essentials of being an embryologist.
People become qualified to become embryologists after a bachelor’s degree in biology or biomedicine and a master’s degree in reproductive science. Several colleges in India and abroad offer the required courses. At the clinic, we are required to change into scrubs before we enter the lab in order to minimize the entry of dust and microorganisms. Scrubs are commonly worn by doctors, nurses, and medical students when at work. They are designed for comfort, and it is almost like being in your pyjamas. Our work is not restricted to the lab, and you may see us zipping in and out of it while wearing a mask. Our work schedules are planned according to the development of embryos. However, we do a lot more than lab work during our daily working hours. The following section of the chapter is a window to the role of an embryologist. It will unmask the person working behind the scenes to make your IVF journey successful. On a lighter note we—embryologists—can be considered your baby’s first babysitter.
Embryologists are key members of the clinical team performing IVF; they are the “baby makers” who work in conjunction with clinicians. Their insight is as important as the clinician’s advice in the process of selection of embryos for transfer. An embryologist’s most important role is to discuss various treatment options available for cases where a natural reproductive procedure is not possible. They specialize in the care of embryos from the time of egg retrieval to the time when the embryo is returned back into the woman’s uterus. This is done while keeping clinical records of the same. They are also required to preserve eggs, sperm cells, and embryos for use at a later date. This method is better known as vitrification.
Responsibilities of an Embryologist
Healthcare scientists working in clinical embryology are typically involved in:
- Collection of eggs and sperms (gametes) from patients for processing
- Micromanipulation and testing of suitability of each gamete
- Preparation of gametes and the environment for IVF
- Facilitation of fertilisation
- Embryo culture and cryopreservation
- Insemination of eggs to create embryos
- Freezing of sperms, eggs, and embryos
- Embryo grading and selection for transfer to the recipient women
- Observation and maintenance of cryobanks
- Compliance with quality control, ethical issues and regulations surrounding gamete and embryo handling
- Care and maintenance of medical equipment
As embryologists are involved solely in the first leg of the long journey, they often remain invisible and behind the scenes. This by no means diminishes their importance as their work, skills, and sincerity impact the lives of the couples seeking fertility treatment. They work with microscopic sizes, and the embryos they handle are the size of a pinprick. A role that requires immense skill and imposes great responsibility, it is imperative to know the credentials of both your doctor and your embryologist.
What your embryologist wants you to know about your IVF treatment.
1. Every Embryo Is Different
Every egg, sperm, and the resulting combination of the two are different. This makes every attempt at IVF using different gametes a different experience. Reasons why some eggs do not fertilize, some embryos do not grow, why some don’t freeze well or survive the thaw are little understood. Not every egg is meant to make a baby, just like not every sperm will fertilize an egg. It must be borne in mind that it is not possible to select the “good” eggs they all look the same and it is a gamble that we need to deal with.
2. Embryologists Can’t Repair Eggs
Embryologists will take care of and nurture your gametes, but cannot repair or make an embryo better by culturing it in the laboratory. However, having a normal body mass index (BMI), not smoking, limiting alcohol consumption, and avoiding narcotics will prove beneficial to the success of IVF. You can also optimize your chances by consulting your clinician a few months before your attempt. This might give you and your partner time to get your emotional, physical and financial health in order.
3. Everyone’s IVF Journey and Outcome Are Different
In this process, it is not uncommon to seek comfort and support by reaching out and comparing yourself to others. It can feel reassuring when a person with a story similar to your own ended in success and happiness. However, it is important to keep in mind that everyone’s IVF journey and outcomes are different and contrasting and comparing your experience with that of others may not prove beneficial. The differences can stem from reasons such as semen analysis result, the number of eggs retrieved, etc. Remember, you are you.
4. There Are No Magic Numbers That Will Guarantee Success
The Internet and online forums are often filled with misinformation about the number of eggs retrieved, embryos created, and embryo grading scores. Keep in mind that there are no magic numbers that indicate success. Embryo culture is a process designed for an embryologist to gather information about each individual embryo’s growth pattern and quality in order to effectively evaluate embryos for implantation potential. We pick the best you have. There are no indicators that can guarantee 100% success. Every clinic has a different system that they use to grade embryos. Asking the clinic to explain their grading system to you will help your personal understanding and allow you to decipher the technical terms.
5. Your Embryologist Wants the Best for You
There is no magic pill or protocol that we didn’t tell you about. If we had something we thought would make the process successful for you, we would have told you in the beginning. As we gather information about your journey and your responses we may alter your clinical treatment, but we are always doing our best with the information we have. Embryologists are scientists who are very collaborative. We are unique in the fact that most of us share our trade secrets via publications and meetings. This field is growing and expanding and we are developing new insights at a rapid pace.
What happens in the IVF lab is technical and, in some ways, mysterious because there is no one-and-only-one sure-fire recipe for success. Know that your IVF journey is unique and that while it is always good to be informed, don’t commit the folly of contrasting and comparing your experience against the experiences of others. The goal of IVF is a healthy baby, and your embryologist is part of the team that is trying its best to make this happen.
What qualifications are needed to be an embryologist ?
Until a few years back, masters in any science was accepted as a good qualification to start applying and working in an IVF laboratory. However, things have changed now. Good clinics now accept candidates with a bachelors in any science but it is mandatory to have a masters in Clinical Embryology or equivalent. There are universities in India and abroad (mostly UK and Australia) offering a masters program in embryology. In India this program is for two years, while the same in UK or Australia is for a year each.
The Masters program is a culmination of theory and practical. However, having assessed various fresh graduates over the years it is our belief that these programs give a sound theoretical base but they do not make the candidate proficient enough in handling gametes. Trainees will need robust training and validation at individual clinic to learn the working and challenges of an IVF laboratory. However, it would be safe to say that after graduating from a masters program the candidate needs 6-8 months of training at an IVF centre to be confident in doing procedures and translating what they learnt into practical work.
As a fresher just entering the world of embryology you must remember that embryos work in a mystical way 2+2 may not always be 4. But this is exactly what keeps us going!
Frequently Asked Question (FAQ)
Do I need to be a doctor to become an embryologist?
You do not need a MBBS degree to be an embryologist, Bachelors in any discipline with a Masters in Embryology is prerequisite for most clinics.
Should I look at my Embryologist’s qualification before picking my clinic?
Usually when a couple picks a IVF clinic, they do so on the basis of the doctors credentials. However with the advancement is science and techniques it is always a good idea to take a look at your embryologist’s qualification as well.
What are some things I should keep in mind before picking a IVF clinic, based on the embryology perspective.
Some of the questions you can ask your clinic are :
- Whether they have a full time embryologist or a visiting embryologist : Full time embryologist is the key to maintaining the laboratory health and in turn the success rates
- Whether the clinic does embryology procedures like embryo checks and vitrifications on sunday : Embryo development is a full time phoenomenon. A good clinic will never be shut on sunday, there will be someone from the embryology time visiting and making sure everything is alright.
- How many people are there in the embryology team : If they tell you one great embryologist, that should be a red flag for you right there. One good or bad embryologist cannot do justice to what the embryos have to offer.
Being an embryologist means working for long hours under the microscope?
Yes, everything in an IVF laboratory is done under the microscope. Since the egg, sperm and embryo all are microscopic. However, to ensure that the work load does not get strenuous there will always be a team of embryologist working in a clinic. This will ensure that the work is distributed leaving less room for human errors.