Genesis Fertility Clinic Blog
searching: “embryo”
April 6, 2010
Embryo donation
On Saturday the Globe and Mail had an article on a new embryo donation program in Ontario called Beginnings Family Services. The article includes an interview with Dr. Jason Hitkari of Genesis.
Click here to read the Globe and Mail article.
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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March 20, 2010Embryology
We all started out as one cell. That one cell was formed after a sperm fertilized an egg. That one cell, called a zygote, then divided and divided, and divided becoming an embryo. Then the embryo implanted into our mother’s uterus.
As infertility specialists and embryologist we spend a huge amount of time studying those first few cell divisions – watching, supporting and waiting for the right time to put embryos back into a woman’s uterus. I thought I’d outline those first few amazing days after eggs are retrieved from a woman during IVF treatment until an embryo is placed back into her uterus.
Day 0 – eggs are retrieved. The eggs are cleaned up (dead cells and blood from around them are removed) and 50,000-100,000 sperm are put into the dish with each egg. Fertilization hopefully occurs.
Day 1 – the next morning we check to see if fertilization occurs. On average, 80% of eggs will fertilize.
Day 2 – the single cell embryo will have cleaved/divided twice (once about 35 hours after fertilization and again about 45 hours later). We check the embryos in the morning, and typically each embryo is 2-4 cells. They don’t always follow the clock precisely!
Day 3 – this is the day embryos are often put back in the uterus. From day 2 to 3 they will usually have divided again and are 8 cells. Not all cells divide at the same rate, so we can see embryos with 5 to 12 cells (and more or less) on the morning of day 3.
Day 4 – if we haven’t put the embryos into the uterus on day 3, we keep watching them. This is when embryos start to become complex structures. On this day we see further division, compaction of the cells and the start of formation of a fluid cavity in the centre of the embryo. These embryos are called morulas.
Day 5 – the blastocyst day. On this day the fluid cavity is well defined, the embryos have enlarged and are now 100-200 cells in size. They are beautiful! Many patients will have blastocysts transfer into their uterus on this day.
That’s a simplified schedule of embryo development. It’s an exciting few days in our lives, and our parents lives!
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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November 18, 2009After embryo transfer
During the IVF process, we transfer embryos into a woman’s uterus. There is an approximately two-week interval from the time of embryo transfer until a woman knows whether she is pregnant or not. This is a nerve-wracking two weeks, and couples search for advice on what they can do to improve the chances of success after embryo transfer.
A lot of people worry that standing up after embryo transfer reduces the success of IVF because they fear the embryo will “fall out” or be dislodged. A recent review of all the world literature on bedrest after embryo transfer (be it for 1 hour or 2 weeks) reveals there is no benefit to bedrest on the pregnancy rate after IVF.
The full article can be read on the Wiley InterScience site.
The review also looked at mechanically closing the cervix after embryo transfer and using a fibrin sealant. None of these interventions seemed to help either. There were no newly reported interventions that helped.
So, we’ll continue to do what we do – we have excellent pregnancy rates. We’ll also continue to look for ways we can improve our rates.
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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May 17, 2009CTV Interview
As mentioned in a previous blog, one of the things that Genesis is known for is our work in the area of elective single embryo transfer (eSET). The idea behind eSET is that there are women whose embryos are terrific and whose chance of getting pregnant by putting back a single embryo during IVF is almost as good as putting back two embryos. Why this is so great is that by putting back one embryo, the chance of having twins drops significantly from around 30% to <1%.
I know that many of my patients actually come to see me overtly or secretly wanting twins. My role is to make sure that my patients are informed about the risks of having a multiple gestation and also to discuss with them the option of putting a single embryo back if it is appropriate.
eSET is such an important advancement in infertility that CTV was very interested in covering the story in conjunction with IAAC’s Infertility Awareness Week (which starts next week). The story will be on the Dr.Rhonda Low section of the Wednesday, May 20th news broadcast. The crew from CTV came out to Genesis last week to film some footage with me and our lab staff talking about the pertinent issues around eSET.
The CTV crew came into the clinic on Wednesday and set up the camera in our andrology lab. I think that I was a little stiff but I hope that I got the information I wanted to out – I hope that the editing is generous to me! It was fun to do the “background” shot as well as it involved me and our andrologists looking and acting rather serious. It was a little nerve wracking to be filmed but it was worth it as I think that increasing the public’s knowledge of eSET and the choice women have to increase the likelihood of a healthy term pregnancy by reducing multiples.
I have always believed that women should be fully informed about their fertility choices and I spend a lot of time educating my patients and the public about fertility. In this vein, as part of infertility awareness week, I am participating in a forum called “Taking Charge of Your Fertility, this Wednesday, May 20th. The details can be seen in our “Events” section here on the website. Hope to see some of you there!
Dr. Jason Hitkari, MD, FRCSC
Reproductive Endocrinology & Infertility
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April 16, 2009How long can you freeze sperm?
People often ask “how long can sperm or embryos be frozen?” and “do sperm or embryos go bad if they are frozen too long?” Well, the good news is it seems that sperm and embryos can be frozen for many years without any deterioration. They are frozen in liquid nitrogen (-196 C) which is so cold that all cell processes stop – cells don’t change at this temperature.
In March of this year a healthy baby girl was born in the US using sperm that was frozen 21 years earlier. The father had frozen sperm at age 16 before undergoing chemotherapy for leukemia. His wife underwent the IVF process and, using ICSI, her eggs were fertilized with his frozen sperm. There have been other cases of prolonged sperm freezing with excellent outcomes like this one. The longest successful sperm freeze to my knowledge was 28 years.
Embryos typically don’t get the chance to be frozen for very long as couples typically don’t do IVF, freeze embryos and then wait more than a decade to use them. There have been a half-a-dozen case reports of couples who have used embryos frozen for more than a decade and the outcomes was just as good as for embryos frozen for less time.
A nice study of over 11,000 embryos frozen between 1986 and 2007 published in 2008 concluded “Cryostorage duration did not adversely affect postthaw survival or pregnancy outcome in IVF or oocyte donation patients.” Further, the children born from frozen sperm and embryos seem to be just as healthy as those that were created with IVF/ICSI and transferred fresh, not frozen, into women.
So, overall freezing sperm and embryos doesn’t seem to harm them and they can be frozen for many years. Sperm and egg freezing gives couples options for creating their families over time.
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility