The Laurel Fertility Care Embryology Laboratory
Anyone with questions about the embryology or andrology laboratories at Laurel Fertility Care may speak with Dr. Angle by calling our office at 415-673-9199 or by completing the Meet the Lab Director form here ».
The embryology laboratory at Laurel Fertility Care reflects the current state-of-the-art technology for IVF facilities. Our IVF laboratory is located off a side corridor; reducing traffic to and around the laboratory. The positive pressure room has its own source of air that enters through specialized filters. Once in the room the air is again filtered by two air handlers that remove volatile organic compounds and other potentially harmful substances.
Each patient’s eggs and embryos are maintained within their own small microchamber under low oxygen conditions. The chambers are, in turn, kept within a large incubator. These chambers allow us to culture embryos under very precise conditions and keep the environment around each patient’s embryos stable, even when the doors to the big incubator chamber are open and closed during the routine work day.
One of the instruments our laboratory uses every day is an addition to our microscope that allows us to visualize the nucleus of the egg when we are performing a procedure called Intracytoplasmic sperm injection (ICSI). During ICSI a single sperm is injected into the interior of the egg. A concern about ICSI is that the procedure may disrupt the nucleus, and subsequently the chromosomes of the egg. Normally the nucleus cannot be seen using our routine optics. However by passing polarized light through the egg and using special software we are able to see a bright white spot where the nucleus of the egg is (about 7 o’clock on the egg in the picture to the right). This allows us to avoid injecting a sperm into the egg’s nucleus.
Additional procedures we perform in our laboratory on a regular basis besides ICSI include:
- Assisted Hatching which is a procedure that allows us to drill a small hole in the outer membrane of the egg (the white ring around the egg in the photo above and to the right). There is some evidence that this aids implantation for older patients and particularly for frozen embryos.
We routinely culture embryos to day 5, or the blastocyst stage (see photo to the right), if we think we have enough healthy embryos to ensure that we will get blastocysts. For us, this means that we have at least 4 good quality embryos on day 3. Approximately 70% of our patients have a blastocyst transfer on day 5 of the cycle.- We use a new method of freezing eggs and embryos called ultra-rapid freezing or vitrification. With this method we recover 99+% of the embryos that we freeze, 95% of our embryos survive with 100% of the cells/embryos intact, and for anyone who has had embryos frozen by this method in the past four years we have had an FET transfer in 100% of our patients. Almost 70% of our patients end up with frozen embryos by the conclusion of a cycle.
- Using this technology, starting in 2008, we became one of the first programs in the Bay Area to routinely cryopreserve oocytes (eggs) for cancer patients and patients who wish to bank their oocytes for the future.
- We also biopsy polar bodies from eggs and cells from embryos on either day 3 or day 5 for genetic or chromosome determination. This process is called Pre-Implantation Genetics Diagnosis (when analyzing the cells for a particular gene) or Pre-Implantation Genetics Screening (when looking at chromosome number). We send the cells that we remove at the time of biopsy to reference laboratories around the country and the world to have them analyzed for either specific inheritable gene mutations or for chromosomal analysis. PGD can be useful for patients who have a family history linked to a very specific disease. If the DNA structure of the mutation is known our reference labs can create a probe and test for the presence of that gene mutation in the embryos. PGS, or chromosomal screening, can be useful for patients who have had a history of repeated miscarriage with documentation of chromosomal abnormalities, women who are older and most likely to have eggs with chromosomal abnormalities (aneuploidy), or couples who are interested in knowing the sex of their embryos.
We believe there isn’t a procedure being routinely done in the IVF industry that isn’t being done, as well or better, in our laboratory. Dr. Angle, our laboratory director has a Master’s of Science in Zoology during which she studied embryo production of compounds involved in implantation, a PhD in reproductive physiology where she studied sperm immunophysiology and she is certified as a High Complexity Laboratory Director by the American Board of Bioanalysts. In addition our laboratory is licensed by the State of California, registered with CLIA and with the FDA and is certified and inspected by the College of American Pathologists.
