I hope you enjoyed part 1 of this series. It can be found here if you haven’t had the chance to read it yet. Last week we talked about the beginning stages of IVF where the sperm and eggs are collected. This week we will go through the insemination process used to combine them both in order to fertilize the eggs to create embryos.
So, we have a nice little dish of eggs waiting in the embryology incubator, and a tube of swimmers prepared and waiting in the andrology incubator – what happens next? Just like in any old love story there has to be some introductions made. Sometimes they just need putting in the same room together and other times they may need a little extra help.
In the case of a couple that do not appear to have any significant male factor issues we
quite simply take the dish that has the eggs in it and add a known quantity of sperm to the same dish and let them go to town. The IVF Witness tags check that we have got the right eggs and sperm added together, but we also read the name on the dishes and tubes as well – no room for errors here at all. I like to wish them luck – they have a big job to do!
Sometimes though, there needs to be a little more coaxing involved getting the job done – and we will resort to Intracytoplasmic Sperm Injection (ICSI)in order to help them on their way.
When the eggs are initially retrieved they are surrounded by cells called cumulus cells – a nice healthy egg will look very fluffy like a cloud. These cells are very helpful in allowing the sperm and eggs to interact in conventional insemination. To allow for the eggs to be injected with the sperm though we have to remove those cells so we can see which eggs are mature. Removing the cells also lets us know exactly where we are adding the sperm, and makes sure that we don’t put anything other than the sperm into the eggs. The injection process itself uses sophisticated equipment and a high quality microscope to be able to select healthy and normal looking sperm, pick them up in a very fine glass needle, and then inject them right into the center of the eggs.
The insemination occurs between 6-8 hours after the egg retrieval, so basically later in the afternoon on the same day. After either method of insemination the eggs are just placed back into the incubator for overnight culture. The best place for the eggs and embryo once we have taken them out of you is the incubator, so the less time they are out of there the better.
Every job that needs to be done during the day gets written into the laboratory diary at the start of the day, and gets checked off as it is done. We are a very close knit team, and we will check on each other and coordinate who does what each day so that there is no chance of missing anything.
The end of each day is generally spent making new culture dishes for the following day’s procedures. Not every patient needs a new dish each day, but whenever they do it is made at least 16 hours prior to it being needed to allow it to get acclimated to the conditions within the incubator.
Stay tuned for part 3 where I will talk about what happens after the eggs and sperm have had a chance to get to know each other.