The IVF Laboratory
On the leading edge of reproductive science, Pacific Fertility Center’s laboratory is exceptional in several areas: the level of training and certification of the staff, the quality of laboratory standards and the vital area of lab security. Our internationally known laboratory director Dr. Joe Conaghan sets the standards and directs this outstanding team.
All ovum retrievals and transfers take place in our private center in San Francisco. Our state-of-the-art laboratory handles the eggs, sperm and embryos.
Quality of care
The laboratory is accredited by the College of American Pathologists in conjunction
with the American Society for Reproductive Medicine. We are inspected annually to ensure
that the laboratory is run and managed to the required standards. All laboratory staff are
required to show excellence in all procedures and participate in continuous training and
ongoing programs of education. As part of the inspection process, the laboratory is
expected to have an effective quality assurance plan and the Director and Supervisors are
required to be Board certified in their specialty.
Lab Security or Avoiding Mix-ups in the IVF Laboratory
It is difficult to imagine a circumstance where a mix-up in a medical situation could have a more damaging effect than in an IVF laboratory. For this reason, we take this issue very seriously and devote considerable time and effort into designing a system in which a mistake cannot happen. Please click on IVF Security and Lab Mix-ups for complete information about our policies.
Laboratory access
The laboratory is maintained as a "clean-room" where the incoming air is highly purified to provide a dust and chemical free environment. Embryologists dress to operating room standard, with full scrubs, facemask, cap and overshoes. The laboratory is closed to everyone but the Embryologists who perform all maintenance and custodial activities themselves. When it is necessary to have visitors in the laboratory, they are escorted by laboratory staff, but only after putting on scrub suits or white "bunny" suits, caps and booties. Any outside objects that enter the lab are cleaned with alcohol.
Scheduling procedures
When a procedure is scheduled by a Physician, a requisition form is sent to the
laboratory documenting the exact patient having the treatment and the nature of the
procedures to be performed. A weekly Embryologists/Physicians meeting establishes the
requisition form, but the form only comes to the laboratory when the patient has been
committed to a particular treatment such as an intrauterine insemination or in vitro
fertilization.
Preparation for in vitro fertilization
The laboratory prepares for all procedures approximately 24 hours ahead of the
scheduled time. A laboratory "chart" is made up that begins with the requisition
form and will contain details of all procedures for the individual patient. Petri dishes
of culture fluids are prepared according to individual needs and the dishes are labeled
carefully with unique identifying information for the patient. Further, dishes are color
coded and inspected by the laboratory Supervisor, before being placed in the incubator. By
the time of the egg retrieval procedure, the dishes of fluid have equilibrated at body
temperature (37°C) and are ready to receive the eggs.
Egg retrieval
During an egg retrieval procedure, your Physician drains fluid from each ovarian
follicle and hands tubes of fluid to an Embryologist. The eggs or oocytes are surrounded
by nourishing cumulus cells and are quickly and easily identified in the fluid. Each
oocyte is carefully transferred into a petri dish of culture fluid and the dishes are
returned to the incubator. The retrieval procedure takes about 15 or 20 minutes and the
Embryologist will let you know how many eggs have been collected. The eggs are kept in the
incubator for 4 hours before being introduced to the sperm.
Figure 1. A human egg after collection from the ovary
Sperm preparation
Most of the sperm samples received by the laboratory have been collected by
masturbation. Occasionally, sperm are collected surgically by an Urologist who will either
take small tissue biopsies from the testicle from which sperm can be extracted, or
aspirate fluid rich in sperm from the epididymis where sperm are stored. These procedures
are only necessary for men who cannot ejaculate or those with no sperm in their semen
sample.
Once the sperm sample is in the laboratory, it is processed by allowing the sperm to
swim out of the seminal fluid and into some culture fluid. Processing the sample in this
way allows only strong swimming sperm to be collected, and these are used to inseminate
the oocytes.
Insemination
It is normal to place each egg in a fresh drop of culture fluid containing 100,000
sperm, 4-6 hours after the retrieval procedure. The Embryologist performing the
insemination is directly observed by the Supervisor to ensure that there is no possibility
of a mistake. After the records, sperm and eggs have been double checked, and a decision
has been reached regarding an appropriate number of sperm to be used, the eggs are placed
individually in sperm containing droplets of culture fluid. The eggs are then returned to
the incubator for 16 hours. During this time the sperm begin to work their way through the
cumulus cells to reach the shell of the egg, the zona pellucida. The zona is a thick shell
that allows only 1 sperm to penetrate the egg. Once a sperm is in, the zona becomes
impenetrable to other sperm.
If there is a reason to expect that the sperm cannot fertilize the eggs on their own,
it is possible to inject a single sperm into each oocyte using a procedure called intra
cytoplasmic sperm injection (ICSI). This technique is employed for individuals with low
sperm counts, abnormally shaped or poor swimming sperm, and for surgically retrieved
sperm.
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