In vitro fertilization (IVF) is a technology that makes it possible for the emergence of a new human life outside the woman's body. At the start of the embryological stage of IVF, from germ cell of the patients embryologists obtain viable embryos, which in the end are transferred into the female’s uterine cavity. For the normal formation and development, human embryos need a high stability of the environment conditions and protection from the impact of adverse factors.
These functions, which in the natural conception are maintained by the mother's body, in the artificial insemination are fulfilled by incubators and other systems of the embryology laboratory. Therefore, proper organization and facilities of the embryology laboratory considerably determine the comfort and safety of embryos, and this, in turn, determines the performance of the entire clinic for reproductive medicine. Here we shall take a briefly look at some of the distinctive features of organization of the Embryology Laboratory of the Clinic.
Embryology lab is a work space with a high density of biomedical technology and communications. Creation of such a space is layered and requires special skills and knowledge. Our new embryologic laboratory was designed with the help of L.A. Levkov, a leading expert on standardization and planning of reproduction clinics in the CIS. Recommendations of the European and American associations for reproductive medicine were taken in consideration in the design.
Our new embryology laboratory, which began operation in the fall of 2013, was designed on the principle of clean rooms. Thus, we have work areas, which are hermetically sealed from the outside premises and in which a high level of cleanliness is kept. To achieve the required cleanliness, above all there should be a clean air coming into the lab. So first the air is forced through the stage filters installed in the draw-in ventilation system, and just before getting to the lab passes final purification through HEPA filters that trap particles larger than 0.1 micron.
In addition to cleaning the air, our ventilation system ensures another important function – keeping of the excess air pressure in the laboratory premises. It is necessary in order to create an air barrier, which at the time of opening of doors and windows prevents transfer to the laboratory of dust particles, bacteria and even volatile chemical compounds that can be toxic to the embryos.
Selection of non-toxic building and finishing materials while creating the laboratory is an essential point associated with the safety of embryos. It is known that some materials may release into the environment of a whole range of organic volatile substances. These substances even in small concentrations may be harmful to embryos. Therefore, our laboratory uses only secure inert materials, with appropriate medical certification. As an example, medical wall panels in the laboratory are made of aluminum covered with a special coating.
For normal development outside of the mother’s body, embryos must continuously be in favorable conditions that are supported by special devices, CO2 incubators. Inside the CO2 incubators constant temperature (37° C), relative humidity (95%) and a special gas composition are maintained. Gas environment inside the incubator is important with the same extent as the temperature, so in our laboratory there was designed highly reliable, centralized system for continuous gas supply. We also care about the air purity in incubators and therefore use high-purity gases produced in Germany.
Although most of the time embryos are placed in CO2 incubators, nonetheless, they are sometimes retrieved for manipulations and regular inspections. Accordingly, the stable conditions are required not only in CO2 incubators, but indoors the embryological laboratory as well. In our laboratory temperature and humidity are maintained at a constant level.
All the steps in the procedure of artificial insemination are fulfilled by the embryologists with the use of the newest special equipment installed in the laboratory. In order to ensure sterile work, the embryologists use laminar flow cabinets, in the working chamber of which sterile air stream protects embryos and eggs from infecting by microorganisms. Surface of laminar flow cabinets, in which operations with embryos are carried out, is constantly heated to a temperature of 37 C that is critically needed for the safety and the normal development of the embryos. Each laminar flow cabinet is equipped with a special laminar stereomicroscope required for monitoring the embryos in the process of manipulation. Most of the time the embryos are kept in incubators – special chambers, in which optimal conditions for development – temperature of 37 C, humidity and special gaseuos atmosphere are maintained at a high level of stability.
In our laboratory, we use several types of incubators: classic CO2 incubators, dual gas incubators, compact desk incubators. For detailed evaluation of the quality of embryos, powerful inverted microscopes with a special high-contrast optical system are required. For in-depth assessment and selection of sperm cells (IMSI), the optical-electronic system with a maximum magnification of more than 6000 times is installed on one of the microscopes, which allows differentiating the tiniest details of the structure of spermatozoa. For carrying out of the assisted hatching procedure, in our laboratory we use the laser unit and special lens, integrated into the inverted microscope.
The ICSI procedure is performed with the use of micromanipulators, installed on each inverted microscope. These devices are designed for microsurgical manipulation of live cells and can convert hand movements of the embryologist into the finest movements of microinstruments at increments of around 1 micron. The newest technology for monitoring embryos, used in our embryological practice, time-lapse monitoring, is based on the use of individual microscopes, which are located directly inside the incubator and are connected to a computer system that continuously gets shots of the current state of the embryos and stores them in the database.
The embryos inside incubators are kept in special solutions with exact chemical composition. These solutions are called culture mediums. Emergence of the IVF technology has become possible due to the development of such culture media. Culture media provide the developing embryo with energy and structural resources, create proper physiological conditions for development of the embryo. Each batch of culture media after production is tested on murine embryos and only then gets in embryology laboratories. In our laboratory, we use cultural media of two world leaders in their production - COOK medical (Australia) and LifeGlobal (United States). The tactic of parallel use of two dublicating lines of culture media is aimed at improving the reliability of embryo culturation processes in our laboratory.
Safety of embryos is the basic condition for operation of our laboratory, thus, continuous operation of CO2 incubators should be ensured even under conditions of emergency power cutoff. For this purpose, centralized uninterruptible power supply system Eaton is implemented in our clinic, which in the event of power cutoff can manage operation of all systems of the embryology laboratory for 6 hours, running of the gas generator Generac, after the exhaustion of the capacity of the batteries, is designed.
Monitoring and alerting systems used in the laboratory deserve special attention. In our CO2 incubators there are installed sensors of temperature and pH of the medium in which the embryos are placed. Data from these sensors is continuously monitored by the system OCTAX Log&Guard. In case of deviations from the optimal parameters, the engineers and embryologists immediately receive automatic SMS alerts. GSM-alarm system units are also connected to each of the key systems of the embryology laboratory, this provides the possibility to monitor their state remotely.
Whatever perfect and equipped our laboratory may seem, we do not miss the opportunity to make it even better and thus are always glad to hear constructive criticism and suggestions for development. Therefore we engage foreign specialists to conduct an external audit. Since the launch of our laboratory, such world-renowned experts as Sessilia Sjoblom (world leader in standardization of embryologic laboratory according to ISO, Australia) and Lars Johansson (Director of clinical embryology and quality control of the company ORIGIO, Germany) have already visited our laboratory.