By Sujatha Ramakrishnan
New Delhi– In our current era of advanced technologies, with the help of newer in vitro fertilization techniques, several couples are accomplishing the dream of parenthood. Over the years, many progressive technologies have been successfully introduced in the fertility/IVF treatments which have enhanced efficacy of the IVF treatment and given the joy of parenthood to couples who had lost all hopes of having a baby.
One of the biggest innovations in the IVF techniques will be the “Time-Lapse Imaging” of the embryos. It is a major technological advancement that gives us clarity about the growth of embryos and helps to select good embryos and deselect the bad quality embryos. In the time-lapse process, the embryos are under constant surveillance, where a camera is kept above the dish which contains the embryos. During this process, every 10 minutes images are captured and converted into a video which made the work of embryologists more streamlined, as they do not even need to open the incubator to check the embryos behaviour throughout, as it is captured in the time-lapse video which gives great insight. For example, with the help of this technique embryologists have come across an abnormal development of embryos called “Reverse Cleavage” it is described as blastomere fusion or failed cytokinesis. With the help of time-lapse technology, these embryos do not go unnoticed, otherwise, it will result in abortion or implantation failure.
Another big adaptation/leap for embryologists for IVF treatment will be the use of AI techniques to select embryos. AI tech can be used to analyze time-lapse imaging data with sophisticated computer algorithms. This includes the use of AI to evaluate embryo development data, as well as the use of computer vision with image processing software to examine raw time-lapse images and to detect bad quality or features of embryos that cannot be detected by the naked eye. While AI is going to be a big thing soon, but at present, the AI capacity to surpass the manual embryo grading method is underway but with the help of AI fertility facilities can standardize the embryo selection procedure across their fertility treatment centres and clinics. In fact, AI technology provides precision and eliminates human error while choosing the best embryos.
Vitrification is a technology used in the embryo and egg freezing process stored for later usage. The technique vitrification was introduced a decade ago, and this technique allows higher embryo survival rate as compared to slower freezing techniques which have a lower survival rate.
While these above techniques that are focused on the embryos, equal attention needs to be given to the sperms, like the separation techniques for good quality sperms. Technologies like “Magnetic-activated cell sorting” (MACS) used to separate apoptotic sperm with high proportions of fragmented DNA from the rest, thus enhancing the overall quality of the sperm used for fertilization.
During this pandemic, following the Covid-19 guidelines is essential. We want to make sure there is no infection exchange between patients and doctors and cross contamination between gametes and embryos. Embryologists are following a non-contact safe policy when giving instructions, sample collection containers to the patients. Embryologists are trying to handle one sample at a time and during the procedure the embryologists do not share even stationery, which can pass the infection from one person to another person and the labs and facility should constantly be cleaned with non-embryotoxic cleaning material to avoid contamination. Thus, it is advisable to exercise extreme caution.
As embryologists, we recommend the patients get their Covid tests done before starting their IVF treatment and two to three days prior to egg retrieval procedures. If the female is infected with Covid-19 it is recommended to reschedule the IVF cycle. But in some cases, rescheduling the cycle is not advised because some females may have their follicles grown, and if not treated the patient will have a condition called hyperstimulation syndrome that can be harmful. In that case, the embryologist needs to go ahead with the procedure with all kinds of precautions to ensure there is no/ zero contamination. A strict disposal policy is adopted to dispose the body fluids material from an infected patient as it goes in biohazard bags for safety.
When a male patient is infected with the Covid-19 infection, we must check if there is a backup frozen sample semen sample frozen in the early days of this cycle, if yes then we use that sample for IVF treatment and advice the male patient not to be in close contact with his partner as chances of getting Covid infection are more. We can use those frozen samples for IVF treatment. In case we do not have a backup sample, we freeze the oocytes from the female partner who is not Covid positive. Later after getting Covid negative test results, the male patient can come back and give the sample, and the IVF treatment can begin.
Overall, the process of forming an embryo depends on various factors. For starters, it depends on the quality of the gamete. Then it depends on the lab’s physical component, the experience of the embryologist, and the kinds of technologies used for the treatment. While choosing a fertility treatment centre, patients should check, if safety protocols are maintained where the hospital staff and clinical team diligently follow these protocols. (IANS)