Embryology 101

Today we went in for a no funny business session about ART - that's assisted reproductive technology for the uninitiated. As luck would it, Dr. NFB led the session with the embryologist and the IVF nurse. She got right down to business and explained the general process (stimulation, retrieval, transfer). We already had our consultation with her so this information was not new. Then the embryologist walked through what he does from egg retrieval to embryo transfer. Fascinating. 

He showed pictures of each step from egg (oocyte) to blastocyst and explained what he looks for at each point. Here is what he said (I think - I wrote quickly): 

• Day 0 - The doctor aspirates the follicles first thing in the morning, which includes the egg and follicular fluid. He then finds all of the mature eggs (it is possible to have empty follicles and immature eggs) by looking for a "polar body".
• Day 0 -He incubates the eggs for a few hours and adds the sperm in the early afternoon. If doing IVF, sperm are added to the petri dishes with the eggs and nature takes it course overnight. If doing ICSI, he injects a sperm directly into each egg.
• Day 1 - Checks for fertilization in the morning; late on day 1 cell division begins.
• Day 2 - Hopes to see 4 cell embryos, but 2 and 3 cells are ok. Based on how they are developing he and the doctor decide if we are going to do a 3dt or 5dt. 
• Day 3 - 6, 7, or 8 cell embryos
• Day 4 - He can't count the individual cells anymore so it is referred to as a morula 
• Day 5 - The embryo divides into the cells that will become the baby and the cells that will become the placenta. This stage is called a blastocyst. 
• After day 5 the embryo will start to hatch - this has to occur for implantation and needs to occur in the uterus

It is truly amazing that all of this has to go correctly and then continue to go correctly for months to create a human. How in the world does anyone reproduce?!

There were eight other couples there besides us. They were soooo quiet before the session got started it was making me laugh. Same thing used to happen to me at church. Allison and I spent many a mass stifling our giggles. 

I asked the embryologist who babysits the embryos when he has a day off. He said he grew up as a dairy farmer where there were no days off and so he will be there if there are embryos in his lab. Someone else I know (DAD!) grew up on a dairy farm and now I have every confidence that this guy has his lab in perfect order and is very protective over it. Our embryos will be in excellent hands. 

I tried to add some levity at the end. Some guy asked who gives "all those shots" and the nurse said she would teach both of them how to administer the shots. I then asked if the guys could learn to do it by sticking themselves. The girls laughed, the guys looked scared.