Fertility Solutions: Official Blog

Live, Online Seminar Q & A: Ask an Embryologist

Posted in Live Online Seminar: Q & A | Tagged Embryologist, infertility, Online Fertility Seminar February 9, 2012

In February our free, live online seminar was entitled ‘Ask an Embryologist’. Patients were given the opportunity to ask our in-house embryologist questions about infertility treatments. Topics change monthly, with our last two seminars focusing on preimplantation genetic diagnosis and endometriosis. View the live Q & A chat below:

(02/08/2012)

6:56

Hello. Welcome to the chat

Wednesday February 8, 2012 6:56

6:59

Hi

Wednesday February 8, 2012 6:59

7:00

[Comment From Jennifer Jennifer : ]

Could you tell me/us a little bit about what an embryologist does?

Wednesday February 8, 2012 7:00 Jennifer

7:01

Sure. I and my team find the eggs from a patients egg retrieval, fertilize them in the lab. Culture the resulting embryos and transfer back the embryos to the patient. We also freeze embryos for future use by the patient. These are a few of our duties

Wednesday February 8, 2012 7:01

7:02

Wealso work with the physicians to choose the best embryos to give back to the patients to increase their chance of pregnancy

Wednesday February 8, 2012 7:02

7:04

As the lab director I am also responsible for compiling our data, ie : pregnancy rates

Wednesday February 8, 2012 7:04

7:04

[Comment From Lisa Lisa : ]

So you have well versed in the "issues" that can arise with embryos - fragmentation, etc?

Wednesday February 8, 2012 7:04 Lisa

7:04

Yes I have been an embryologist and lab director for over 20 years

Wednesday February 8, 2012 7:04

7:05

Lisa, do you have specific questions about fragmentation?

Wednesday February 8, 2012 7:05

7:06

[Comment From Lisa Lisa : ]

Can you speak a little to the cause or if from one cycle to the next it can improve?

Wednesday February 8, 2012 7:06 Lisa

7:07

Lisa, fragmentation is not well understood but can be caused by the formation of the egg in the follicle, some external stress (temperature or pH) or by chromosomal issues with the sperm or egg or both

Wednesday February 8, 2012 7:07

7:07

[Comment From Stephanie Stephanie : ]

Hello. How long can embryos remain frozen?

Wednesday February 8, 2012 7:07 Stephanie

7:08

Embryos can theoretically remain frozen for ever. All cellular activity stops at ~ -30C. Embryos are frozen in liquid nitrogen at -196C

Wednesday February 8, 2012 7:08

7:09

Fragmentation can change from cycle to cycle.

Wednesday February 8, 2012 7:09

7:09

[Comment From reddy reddy : ]

can I ask questions on miscarriage ?

Wednesday February 8, 2012 7:09 reddy

7:10

Reddy, yes although this is not my greatest area of expertise, I can speak to the embryology side of miscarriage

Wednesday February 8, 2012 7:10

7:10

[Comment From Stephanie Stephanie : ]

Are there any benefits from having your eggs harvested at 29 instead of 30 or 32?

Wednesday February 8, 2012 7:10 Stephanie

7:11

Stephanie, Yes. The younger you are (and your eggs) the more likely they are to produce a pregnancy

Wednesday February 8, 2012 7:11

7:11

[Comment From Lisa Lisa : ]

Is there any significance to embryos arresting between day 2 and 3? I read that that is indicative of an egg issue rather than sperm.

Wednesday February 8, 2012 7:11 Lisa

7:12

Lisa,

It is unusual for embryos to arrest from day 2 to 3. It would be more likely an egg issue.

Wednesday February 8, 2012 7:12

7:13

[Comment From Reddy Reddy : ]

We had miscarriage in 6-7 week , just after we saw Dr. Anna in Woburn office. The reason is unknown, doc. says no fetus formation. Can you tell what does it mean.

Wednesday February 8, 2012 7:13 Reddy

7:14

Reddy,

It is difficult to give a definite answer to this. There may have been an issue (genetic) with the fetus. Many miscarriages are due to genetic problems. Or there may have been a problem with the uterus supporting the pregnancy

Wednesday February 8, 2012 7:14

7:15

[Comment From Sara Sara : ]

How often is implantation failure due to the metabolic rather than chromosomal qualities of the embryo?

Wednesday February 8, 2012 7:15 Sara

7:17

Sara,

Good question! We know that a very high percentage of eggs are chromosomally abnormal but we have very little information besides the growth rate of the embryos on their metabolic rates. The assumption has been that if an embryo grows normally than it's metabolism is normal

Wednesday February 8, 2012 7:17

7:18

[Comment From Sara Sara : ]

Oh, also, since you happen to be the person who would know and we might not be able to get the data from the SART website since you are a new clinic, how is your data comparing for pregnancy for people at 40+? Thanks!

Wednesday February 8, 2012 7:18 Sara

7:19

Sara,

I don't like to give data for broad ranges of ages but like to give data specific to you. Please call me at Fertility Solutions and I will give you our current data for patients that are most like you

Wednesday February 8, 2012 7:19

7:19

[Comment From Judy Judy : ]

If doing fertility preservation/embryo freezing for the future, does PGD, if done, happen prior to freezing, or when ready to use? And, do you also do egg freezing and are there any tests done on just eggs?

Wednesday February 8, 2012 7:19 Judy

7:22

Judy, PGD is usually done prior to freezing. It is possible to freeze at day 3 after PGD, thaw after PGD results are obtained and transfer but usually we transfer in the fresh cycle at day 5. Yes we do egg freezing. We can do PGD on the polar bodies from the eggs. This only gives information about the egg and not the embryo once it is fertilized

Wednesday February 8, 2012 7:22

7:22

[Comment From Lisa Lisa : ]

At what point is an embryo more likely to arrest? Earlier than day 3 or later?

Wednesday February 8, 2012 7:22 Lisa

7:23

Lisa,

Most embryos arrest after day 3 if they arrest

Wednesday February 8, 2012 7:23

7:23

[Comment From Venezia Venezia : ]

Why do some MDs recommend day 3 embryo transfer and others prefer day 5 embryo transfer?

Wednesday February 8, 2012 7:23 Venezia

7:24

Venezia,

It depends on their lab usually. Some labs are much better at getting embryos to grow to day 5 than others. My lab is designed and the culture system I use to do day 5 transfers

Wednesday February 8, 2012 7:24

7:25

[Comment From Sara Sara : ]

How much do you think it stresses embryos to be pushed out to day 5? A negligible amount, or a real amount?

Wednesday February 8, 2012 7:25 Sara

7:26

Sara, I don't think there is any additional stress on embryos to be pushed to day 5. There is likely a "cohort" of embryos in each cycle. Culturing to day 5 allows embryos to "self select" to a degree.

Wednesday February 8, 2012 7:26

7:27

[Comment From Venezia Venezia : ]

So do you freeze embryos on day 5 too?

Wednesday February 8, 2012 7:27 Venezia

7:28

Venezia,

I freeze over 90% of our embryos on day 5. Embryos at day 5 (blastocyst) tend to do better than day 3 embryos when frozen and thawed

Wednesday February 8, 2012 7:28

7:28

[Comment From Lisa Lisa : ]

When you speak of chromasomally abnormal eggs - do women in the general population (ie, no fertility issues), also carry chromasomally abnormal eggs with the majority ending up with a normal egg to conceive ? Or is it typically that women with infertility are more likely to carry abnormal eggs?

Wednesday February 8, 2012 7:28 Lisa

7:30

Lisa, We have lots of data on infertile women because we have done many PGD cycles on IVF patients. The data we have for "general population" is from egg donors. Egg donors have chromosomally abnormal eggs also but not at as high a rate as IVF patients

Wednesday February 8, 2012 7:30

7:31

[Comment From Venezia Venezia : ]

If a woman only makes 5 eggs and only has 3 embryos would you still do a day 5 embryo transfer?

Wednesday February 8, 2012 7:31 Venezia

7:33

Venezia,

It depends on several factors. First is the embryo quality on day 3. If the 3 embryos are very good quality (cell number and little fragmentation) and if the patient has never done a day 5 transfer then it is something we would discuss with the patient as a possibility

Wednesday February 8, 2012 7:33

7:33

[Comment From Sara Sara : ]

Is there any way that supplements or nutrition can change eggs, in your opinion? If a woman is having trouble at 39 but then has excellent nutrition and a less stressful life for a couple years, is it possible that some good eggs could develop?

Wednesday February 8, 2012 7:33 Sara

7:34

Sara, I do not know of any definitive studies that demonstrate this but I do know there are some clinics that recommend supplements to some patients and have shown a positive response

Wednesday February 8, 2012 7:34

7:34

[Comment From Sara Sara : ]

My next question was also about freezing: if "pushing" an embryo out to day 5 isn't really a real stress as long as it's done in a good environment, how about freezing?

Wednesday February 8, 2012 7:34 Sara

7:36

Sara, freezing at any stage is a stress on the embryo. BUT, the current freezing protocols are designed to minimize the stress and have high survival rates after thawing.

Wednesday February 8, 2012 7:36

7:37

Also, before we freeze embryos we look at them. We try to freeze only good quality embryos to increase the chances of embryos survival post thaw

Wednesday February 8, 2012 7:37

7:39

I'm sorry but our time is up. I hope this has been helpful. Please feel free to call me at Fertility Solutions and I'd be happy to answer any other questions you might have.

Thank you for joining the chat!

Wednesday February 8, 2012 7:39

7:39

[Comment From Sara Sara : ]

Thanks for all these responses. I wanted to know, when the embryos go through the catheter, is there a significant amount of liquid they 'arrive' with in the uterus, is it completely unlikely that they will run off into a non viable place with the medium they're delivered in? I guess I've just always wondered how the ten minutes can be long enough after the transfer, before getting up?

Wednesday February 8, 2012 7:39 Sara

7:42

OK, one last question. The embryos are in a tiny amount of culture media. 10 micro liters or so. The uterus can hold many times more fluid than that so they do not run out. They do spend some time floating around in the uterus before they attach but that happens in natural conception also.

Thanks again.

Wednesday February 8, 2012 7:42

7:43

blog comments powered by Disqus