Dr Laura Garcia de Miguel, Medical Director at
Clinica Tambre in Spain, is explaining the importance of communication between the IVF laboratory and the medical team during an IVF treatment.
Dr Garcia, in her presentation, covered the topic of the importance of communication between the laboratory and the medical team during an IVF treatment. Dr Garcia described in-house laboratories, the techniques used at the lab, which moment of your treatment you’ll coincide with the lab team, and the communication process between doctors and the team lab.
In-house laboratories
It’s crucial to remember that not all the centres have a lab in their clinics. Sometimes, the clinics use other laboratories. At Clinica Tambre, there are 2 laboratories, the andrology laboratory and the IVF laboratory. The embryologists on each team are specialized in the tasks they perform, and the laboratory director coordinates everything that is done. In the andrology laboratory, they perform spermiograms to check the general parameters and the quality of the sperm of each patient. At Clinica Tambre, Comet Fertility is used, which is a highly sensitive test, which allows for detecting both single and double chain DNA fragmentation. There is also a possibility to do the genetic matching for recessive mutations for every patient or donor, as well as the Chromsperm to check the genetic chromosome disorders in the sperm. Sperm freezing is also possible, and there is a sperm bank.
In the IVF laboratory, an oocyte retrieval procedure is performed, as well as oocyte preservation, there is also an in-house egg bank, and there is a possibility to do an ICSI procedure and Preimplantation Genetic Testing. There are also performed embryo transfers and vitrification of embryos.
Having in-house laboratories, as well as gamete banks, allows for faster and more efficient coverage of assisted reproduction treatments because communication with doctors, nurses and patient care is more fluid. The procedures are very well-defined, but at the same time, it is easier to personalize each treatment, approaching them from different perspectives, according to professionals from various branches of science.
Patient & lab team – communication
The lab team is in charge of the RI Witness system, which is a security system included in the treatment without additional cost for the patients. It identifies each patient’s samples, and its use aims to avoid possible mistakes when manipulating or identifying the samples by using labels and individual identification cards. Before starting the process, the patients receive a card with personal data that is always used to verify their identity before obtaining a sample. Each tube plate or container is marked with electronic tags that are associated with the patient’s card. These labels and cards are read by RI Witness at each step of the process, confirming the identity of the patient at all times. This system has receivers that verify the data in each phase of the treatment and can detect any alteration in the protocol used to identify the samples and interrupt the process if necessary. Embryologists are also involved in embryo culture and the updates of its development every day. They will do the embryo transfer altogether with a gynaecologist, they perform the spermiograms. They have a significant role in gamete donation treatments.
Regarding seminograms, male patients will meet the andrology team when they come to the clinic for a seminogram where an interview will be conducted to be aware of factors that may affect the sperm, such as medication intake, some exercise, and fever. Afterwards, the sample is frozen, and the doctors discuss the diagnosis with the patient if required. At this point, it may be also necessary to talk to the andrology unit if there are any important abnormalities.
When it comes to embryo culture and updating its development, patients discuss their options with the doctor in choosing traditional (COOK) or time-lapse incubators (GERI). As soon as fertilization takes place, the laboratory staff updates the doctor on the evolution of the embryo and they call the patients to let them know if they have developed till day 1, 2, 3, or 5 days. If the embryos are going to be frozen or genetically tested on day 5, the patients are going to receive a call as well, otherwise, you will meet with the team and doctor in the operating room during the transfer. Before the actual transfer, the patient’s data will be confirmed, and again, the patients will be informed about the embryo quality and other characteristics.
Gamete donation treatment and donor selection is a very rigorous process in which most of the clinic’s team is involved. The doctors and nurses are dedicated to carrying out tests and seeing the patients at different appointments, psychologists complete interviews, and the laboratory team ensures the quality of the gametes. In addition, embryologists are in charge of performing genetic matching techniques between the recipient and the donor or both donors.
Lab team & doctors – communication
From patients’ or couples’ first visit with others, their case is analysed with the laboratory and asked for their opinion. The communication is either done in person, by email, telephone, in addition, every morning, there are clinical sessions, attended by embryologists, the medical team and patient care staff, where the next days of oocyte retrievals, embryo transfers and current cases are discussed. The whole team makes sure that all information and documentation are submitted.
Conclusions
Embryologists, like the rest of the team, have a fundamental rule in infertility clinics. Contrary to what some people may think, they have contact with the patients, they know who each person is, they know their names, and they know their medical history.
The communication between them and fertility specialists is crucial to thoroughly analyse which techniques and technologies will make patients fulfil their dream of having a baby.
