Clinical Embryology Techniques

Explore computer assisted semen analysis (CASA) that automates semen analysis, assessing motility, progressive motility, pH, morphology, and additional sperm parameters with imaging and software.

Identify forward progressive sperm motility and straight path as independent predictors of fertility, using CASA to measure motility, linearity, and mean velocity.

Zona pellucida thickness variation links to embryo viability, and automated image analysis provides quantitative, objective evaluation to improve IVF embryo selection and pregnancy outcomes with a thinner zona pellucida.

IVF management software consolidates data from labs, ultrasound, and registration into a secure, family-oriented system, streamlining documentation, consent, scheduling, billing, and treatment planning.

Intracytoplasmic sperm injection (ICSI) injects a single sperm into the oocyte cytoplasm to overcome fertilization failures, bypassing the zona pellucida in vitro.

IMSI, or intracytoplasmic morphologically selected sperm injection, selects morphologically normal sperm at high magnification before Icsi to improve fertilization and embryo development compared with traditional Icsi.

Understand when to use IMSI for couples with oligo teratoma or DNA fragmentation after failed ICSI IVF, then select healthy sperm under high magnification and transfer zygote to the uterus.

Assess the advantages and disadvantages of ICSI and IMC. High-magnification sperm morphology assessment aims to reduce fetal malformations, while prolonged IMC exposure and high costs constrain its use.

Physiological intracytoplasmic sperm injection (pixie) selects hyaluronic acid-binding mature sperm for ICSI, improving selection and reducing DNA damage and chromosomal aneuploidies.

Explain the PICSI principle of selecting mature sperm by hyaluronan binding in a dish to emulate natural fertilization, and review limitations and evidence on live birth outcomes.

Explore laser assisted hatching for embryos and the zona pellucida's role in fertilization and implantation during IVF/ICSI. Compare chemical and laser methods and note which patients may benefit.

Time lapse systems (TLS) continuously image embryos during incubation, allowing quality assessment without removing them, preserving the culture environment and aiding embryo selection for ART, though at added cost.

Explore the EmbryoScope, an incubator with built-in microscope and time-lapse imaging that monitors embryos every ten minutes across seven video cards, delivering about 5000x more data for improved selection.

Describe the four semen fractions—pre-ejaculatory, prostatic, vas deferens/epididymis, and seminal vesicle—and where most sperm reside. Emphasize collecting the first portion and mixing well before semen analysis.

Assess male fertility with semen analysis, a cost-effective, skill-sensitive test that examines sperm production, vas deferens function, and prostate involvement. It also helps evaluate vasectomy outcomes or reversals.

Explore essential semen analysis terminologies used in clinical embryology, including oligospermia, asthenozoospermia, teratozoospermia, and azoospermia. Learn about related conditions such as hypospermia and hyperspermia.

Perform sperm motility and vitality assessment using a meckler chamber, counting 200 sperm at 40x, classifying progressively motile, non-progressive, and immotile sperm, and evaluating vitality with a stain.

Prepare sperm by separating motile sperm from semen using wash, swim-up, or gradient methods in sterile laminar airflow, avoiding centrifugation damage for IUI, IVF, or ICSI.

Learn gradient tube techniques to isolate motile sperm using two-gradient and mini-gradient columns, preparing density gradients, and managing thawed semen with centrifugation and debris separation.

Sperm capacitation is a natural post-ejaculation process enabling fertilization by motility changes and acrosome-ready membranes, with in vitro washing, density gradient or swim-up to yield motile sperm for art.

Identify sperm selection methods after IVF, including hyaluronic acid binding for mature sperm and annexin V–based magnetic sorting, plus birefringence, electrophoresis, and density gradient or swim-up techniques.

Intrauterine insemination, a first-line, simple and inexpensive artificial insemination, places washed sperm near the oocyte in natural or stimulated cycles, requiring ovulation, a patent fallopian tube, and normal semen parameters.

Assess ovarian reserve, prior ovarian response, and medical history of ovulation, including polycystic ovarian disease, with hormone profile highlighting estrogen, LH surge, trigger, and luteal phase support for IUI.

Explore how antral follicle count and anti-müllerian hormone predict egg count and guide tailored ovarian stimulation, from natural cycles to low-dose protocols, while avoiding ovarian hyperstimulation syndrome and cycle cancellation.

Explain the two cell two gonadotrophin concept: FSH on granulosa cells and LH on theca cells drive follicle growth and maturation, governed by FSH thresholds and windows for follicle selection.

Clomiphene citrate is used as an ovulation inducer, alone or with FSH/HMG, with low-dose protocols, and letrozole offers an alternative for CC-resistant PCOS.

Use intrauterine insemination to aid pregnancy with donor sperm, address unexplained infertility, endometriosis, or mild male factor, and bypass the cervix by placing sperm directly into the uterus.

Assess the risks and preparation for IUI, including infection, spotting, and the potential for multiple pregnancy with fertility medicines. Learn about timing, ovulation checks, semen preparation, and the procedure.

Set up an IVF laboratory by addressing location, people, and procedures to create a safe, pathogen-free environment that protects gametes and embryos.

Identify essential IVF laboratory equipment and conditions, including incubators with CO2 and pH control, laminar flow, micromanipulation systems, cryopreservation, sterilization, and rigorous maintenance.

Quality control and quality assurance in the IVF laboratory ensure equipment and materials function, monitor temperature, pH, and osmolarity of culture media, and support protocol optimization to help infertile couples.

Maintain CO2 incubators by monitoring CO2 and temperature, keeping logs, and cleaning and decontaminating. Manage water for humidity, perform sperm survival tests, and rely on maintenance contracts and backup power.

Learn quality control of culture medium and disposables by documenting shelf life and batch numbers, monitoring a 20-day shelf life, maintaining reorder levels, and ensuring clean, temperature-controlled refrigerator storage.

Master sterile culture conditions for IVF labs, emphasizing cleanliness, incubator upkeep, non-toxic disinfectants like hydrogen peroxide, aseptic handling, and meticulous labeling to prevent sample mix-ups.