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Path To Fertility Blogger Lisa Rosenthal  

Lisa Rosenthal has over twenty-five years of experience in the fertility field, including her current roles as Coordinator of Professional and Patient Communications for RMACT and teacher and founder of Fertile Yoga, a class designed to support, comfort and enhance men and women's sense of self. Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association, where she was Educational Coordinator, Conference Director and Assistant Executive Director

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Election Day - Vote for Fertility RIghts

  
  
  

Vote for Fertility Rights this Election Day

fertility rights for election day from some e cardsYou're going out to vote today.


Seriously, you weren't going to? 


Really?


Why?


Because all the candidates are full of s**t? They’re all the same? They’re all liars?


Oh. You sure about that? Have you looked at their records? At the issues that are important to you? Are you sure that they don’t take a stance on any of those things, like fertility rights? Have you looked to see how each political party has stood up for the things that you care about? You sure they’re the same?


I’m not telling you how to vote today. Vote for whoever you want to vote for. I know I am. And that’s what I can do today. Vote, one vote, for the candidate of my choice. Even if he/she is only the least bad of the bad.

Women’s Reproductive Health and Rights

Because there are differences. And there are certainly differences when it comes to women’s reproductive health and rights. Big differences. Very big, even vast, differences.


Fertility is a part of women’s reproductive health. Fertility treatment is being threatened all over the country, most prominently in North Dakota and Colorado. Maybe more insidiously in your state. Vote with caution for anyone who wants to restrict abortion. Like it or not, abortion and fertility treatment have become linked in the political worlds. Don’t like it, but please understand that a candidate that is anti-abortion will protect your embryos with the same zeal. Which may mean not being able to produce more embryos than you can transfer in that cycle. Which could mean not being able to produce embryos at all, eventually.


If you weren't going out to vote today, go out to vote today.

 

Claim your chance to voice your opinion.

 

 

Follow Lisa on Google+

 

 

Fertility Treatment Threatened in this Election

  
  
  

Election Day Issues: Fertility Treatment Threatened

election day and personhoodWhy is personhood relevant for Election Day and fertility treatment issues? Let's start with a few definitions:

 

Personhood

per·son·hood

ˈpərs(ə)nˌho͝od/

noun

1. the quality or condition of being an individual person.

 

personhood

noun

1. the state or fact of being a person.

2. the state or fact of being an individual or having human characteristics and feelings.


personhood (ˈp£ːsənˌhʊd)

noun

1. (Government, Politics & Diplomacy) the condition of being a person who is an individual with inalienable rights, esp under the 14th Amendment of the Constitution of the United States

 

When I read these definitions, I do not see how embryos qualify for the term “personhood”.  The fourteenth amendment states, Section 1:

 

"All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.”


Born or naturalized. Neither of those terms fit an embryo.

 

I’ve read some great blogs, containing very pertinent comments regarding what the political and personal ramifications of these proposed amendments will be. Keiko Zoll wrote a piece last week that quoted Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine (ASRM). The article, "Personhood Amendments Would Hurt Families Who Want Children," discussed how these proposed amendments will affect fertility patients and beyond.

 

Resolve has taken a very active stance on this subject as well with their #No2Personhood Campaign.

 

I admit to finding rather random points about this as striking, partly because I want to delve a little deeper down into our societal conscience. So here are three thoughts and lots more questions.

 

Women's Choice About Embryos and Embryo Transfer

 

1. Women not having the choice about how many embryos are transferred to her uterus. Couples or singles, not having a choice about what do with unused embryos.

 

Interesting questions that come to mind around all of this. If the embryos are pre-people, aren’t they also pre-children? Wouldn’t that make the disposition of the embryos up to the pre parents? Of course the parents can’t murder or kill a child, which essentially is how this amendment is looking at the issue. So these groups of cells suddenly become autonomous from the genetic parents who have had them created. Exactly who would make the decisions for these embryos? While the amendments would prevent the embryos from being created unless either being placed in the woman’s uterus or donated to another person, it would not address the question of the thousands of embryos presently in cryopreservation.

 

Another aspect of this is that with IVF, there is a push to super ovulate and produce as many eggs as possible, with the idea of creating a fair amount of embryos. Usually more than the one or two needed. Why?

 

Because the chances of an egg being retrieved and making it all the way through that process, then the additional steps of being fertilized and then growing to become an embryo that can be transferred are not as high as any of us would like. Depending on many factors, including age, diagnosis and the fertility program that a patient is using, chances of success vary widely. Too widely to be quoted responsibly here.

 

Cryopreservation Decisions for Frozen Embryos

 

2. Men and women not having the choice about creating and cryopreserving embryos

 

Why is this important? How about siblings? How about not having to go through a full IVF cycle again, with its risks, time, and expenses and for women, aging eggs?

 

I’m going to say a few unpopular things here. Politically incorrect things, even. In the US, there are many embryos frozen. Many. Tens of thousands, many. For many years, decades even.

 

While a man or woman can accept that these embryos are not babies and not even babies to be, it is often much harder to dispose of the embryos when they have a baby/child from that collection of embryos running around. They see siblings. They see past the embryo being a possibility of life and fast forward to the embryo being a child.

 

So the men and women who have created these embryos pay to keep them frozen, delaying making a decision about the embryos even long after the decision not to use them has been made.  

 

There are even “abandoned“ embryos, where the men and women who have created them have stopped paying the fees to keep them frozen but the fertility program can’t dispose of them without permission. They don’t answer letter or phone calls and so the embryos cannot be discarded.

 

How do we address this? How do we help men and women in these situations address these complex issues? Also, could we not pretend that these issues are not present?

 

Patients frequently see their embryos as babies to be. Of course they do, they see cells dividing. They know fertilization has taken place and that these embryos are growing. They know that these are the babies that they are hoping for. They sometimes even name them. In the guise of being positive, they negate the reality that these embryos are possibilities because they are told to stay hopeful and see the pregnancy test turn positive. But embryos are not babies. They just aren’t. And maybe we don’t further our cause of defeating legislature like this about “personhood” when we encourage people to be so positive that they see their embryos as babies. Something to consider, no?

 

Fertility Treatment Program Access

           

3. Does bestowing “personhood” on embryos further or diminish men and women’s abilities to have a child? North Dakota has one reproductive endocrinologists' program in the entire state. ONE. This legislature will all but guarantee that men and women in North Dakota will be unable to find help for the disease of infertility in their own state if that fertility program closes due to this amendment.

 

Wouldn’t it be great if we all tried to remember that infertility is a disease? Recognized by the American Medical Association as a disease. A disease that this amendment will prevent people in North Dakota and Colorado from getting appropriate, effective treatment for.

 

This piece of writing is not meant to be comprehensive. This is a huge subject with a lot of inter relating pieces. There are many points of view and many different aspects that are relevant, important and compelling. Please do educate yourself regarding what this amendment is about.

 

You may live someplace where you know this will never happen to you. You may be right.

 

And you may not.

 

This will set precedent and make it easier to pass in other states. That’s what history shows us. So don’t dismiss this conversation just because you don’t live in North Dakota or Colorado. This topic affects all of us.

 

 

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19-Year-Old Donated Cryopreserved Embryo Makes a New Mom!

  
  
  

Cryopreservation History with New Baby

cryopreservation embryo freezingA 19-year-old embryo and we have a new baby! Amazing that an embryo can be frozen through cryopreservation for that long and still create a happy and healthy baby. And family. (Thanks Liz Swire Falker, for bringing this story about the second oldest cyropreserved human embryo in history to my attention!)

 

Kelly Burke, a NASA scientist, used an embryo donated by a couple who had twins in 1994.

 

Amazing is the word.

 

Doubtful that anyone knew that when those embryos were frozen (cryopreserved) that they would be viable this many years later. That in fact, cryopreserved embryos are fast catching up on “fresh” embryos, in terms of pregnancy rates.

 

Yep, totally amazing.

 

Fertility Specialist Dr. Spencer RichlinAnd yesterday, for lunch, I spent time with Drs. Spencer Richlin and Shaun Williams from Reproductive Medicine Associates of Connecticut (RMACT) and an area Obstetrician/Gynecologist, talking about all of these things and more.

 

Really fascinating to hear some of the clinical reasons behind why some things work better than others. Really challenging to keep up in a conversation between physicians and clinicians! Really, really challenging.

Embryo Donation, Freezing and Success Rates 

infertility doctor Shawn WilliamsWhat I took away about embryo donation and why a frozen embryo will often result in a pregnancy when a fresh does not is the hormone levels that occur when a woman is stimulated to produce more than one egg. That, basically, estradiol is a certain level for one egg to occur and become large enough to ovulate. Therefore, when a woman is stimulated with fertility medications to produce 6-18 (or even more) eggs that the hormone levels go up correspondingly. What follows is that an embryo put back into a woman’s body with hormone levels so much higher than normal is that sometimes the embryo doesn’t implant.

 

And, as I understood it yesterday, sometimes there are slightly higher consequences of lower birth rate babies. Please don’t take this as a reason to be alarmed or upset, especially if you have had a transfer under the circumstances described above. There is research to support these findings (of lower birth rate babies), but we have had over a million IVF babies born and the vast majority of them have been healthy.

 

Amazing.

 

That appears to be the word of the day for me.

 

I am amazed and grateful that a couple in 1994 would be generous enough to freeze their eggs and then so long afterwards be willing to donate them to another woman so that she could fulfill her dream of having a family.

 

Kelly Burke had to answer a lot of questions and went through a procedure that seems similar to adoption to be able to use these embryos. Many of us in the field of infertility and fertility treatment prefer not to use the word adoption and reserve that for children. Embryos, as we all know, often implant and that will frequently result in a healthy pregnancy and child. And sometimes it does not and there is no pregnancy and no baby. That is why many of us feel that the term adoption should be reserved for a baby. The term embryo donation suits this situation better.

 

Whatever you would like to call it, there is a baby that was conceived almost 20 years ago; who has full genetic siblings who are in college and that is nothing short of amazing.

 

Congratulations to all the adults, physicians, clinicians and parents involved for making this happen.

 

Yes, simply amazing.

 

Lisa Rosenthal's Google+

 

 

Embryo Identification, Step by Step with Lab Director of Top Fertility Program

  
  
  

Top Fertility Program Lab Director Answers Questions on Embryo Identification

We know that there are questions that you want to ask when you work with a fertility program. And we know that you are comfortable enough to ask a lot of them. Maybe even most of them. There are a few, though, that you either don't think to ask or just aren't sure how to bring up. None of us want to be that patient. The nutty one. The paranoid one. Rest assured, all of us want to know certain things. 

 

 

We all want to know how we are getting the embryos that were so painstakingly created. We all want to know that we are getting our own embryos. How do we know for sure? Dawn Kelk, PhD, Laboratory Director of Reproductive Medicine Associates answers those questions, today, on PathtoFertility. 

 


Dawn Kelk, Lab Director of Top Fertility Program

The Embryo Question: What We All Want to Know

Here's the question you don't want to ask:  How can I be sure/do I know that these embryos are mine?

 

This question is asked of me not infrequently and don't worry, I don't take offense to it.  I can assure you at RMACT we have multiple, double, triple and even quadruple checks at every stage in our laboratory process.  We pride ourselves on going well beyond the standard of care when handling eggs, sperm and embryos.

 

 

In fact frequently, the lab staff pay closer attention to patient details than the patients themselves.  We ask that you verify and initial a sticker with details of you and your partner's names, last 4 digits of social security number and date of birth. Women are asked to initial a label right before their egg retrieval and men are asked to initial an identical label at the time they produce a fresh semen sample.  Occasionally there may be typos or clerical data entry errors in our computer system when you first register with our program. This may be due to errors communicated from your referring physician or inconsistencies in information on your care card and drivers license.  It is however, very important for the lab to verify and correct your data before we receive your eggs and sperm. 

 

 

We have double checks at every step of the way...

  • 1) The woman verifies and initials a label with both her name and partner's name, last 4 digits of SSN and date of birth at time of egg retrieval.
  • 2) The partner verifies and initials an identical label when producing a fresh semen sample.
  • 3) When the sperm is washed, a second embryologist verifies the sample.
  • 4) When the eggs are inseminated, a second embryologist witnesses, verifies and signs off on the eggs and sperm.
  • 5) When embryos are frozen, a second embryologist witnesses the culture dish and cryovials, verifies and signs off on the paperwork.
  • 6) When embryos are thawed, a second embryologist verifies the cryo vials or straws. The vials are kept until the embryo transfer so that the physician and patient may also verify.
  • 7) At the embryo transfer, the patient is asked by the embryologist to identify themselves. The couple can then see the culture dish through a live video link to the microscope in the embryology lab. They verify the label on the culture dish and they can see the embryos being loaded in to the embryo transfer catheter.

 

 

Occasionally we do catch a clerical error at the time of the embryo transfer when we ask the patient to state their name, last 4 digits of social security number and date of birth. That means that one or both partners did not properly verify their information at the beginning of the cycle. When we ask you to verify your information, please check it carefully as it ensures that no mistake is made. Rest assured though, even if there is a clerical mistake, it can be caught and you will not receive the incorrect embryos. That is why we have so many checks in the system, not to be repetitive, but to be completely thorough.

 

 

We need a patient who is using donor sperm to know her donor sperm number. We understand that this is all a lot to remember, but again it ensures complete safety.  Believe me, when you can't or don't verify completely, the laboratory staff does stress out about it and lose sleep.

 

 

If you have questions, we are available to answer them. Standard protocol demands that the lab identify the patient before egg retrieval and embryo transfer. At RMACT, we choose to go beyond through a live video link to the lab; you will identify your name and information on the embryo culture dish and we will give you a close-up look at your actual embryo(s) for transfer. You will see your embryo(s) being loaded into the catheter for your transfer and we will provide you with a photograph of the embryo(s) that we transfer.

 

 

What else would you like to know about the lab? Are there concerns that you have that have not been addressed here?  Feel free to ask and we will do our best to explain and clarify.

 

 

Dawn Kelk, PhD
Laboratory Director 
Reproductive Medicine Associates of Connecticut

 

 

Reproductive Medicine Associates of CT have the following credentials:

Licensed as a Surgery Center by the State of Connecticut

CLIA (Clinical Laboratory Improvements Amendments) accredited

CAP (College of American Pathologists) accredited

AAAHC (Accreditation Association of Ambulatory Healthcare) accredited

AIUM (American Institute for Ultrasound in Medicine)

We are members of SART (Society for Assisted Reproductive Technology), and also submit data to SART and the CDC (Centers for Disease Control)

 

 

 

 

 

 

 

 

The Frozen Embryo Dilemma - What to Do? Let Us Know Your Opinion

  
  
  

What Is Your Opinion on the Frozen Embryo Dilemma?

Frozen EmbryosInfertility often leads to fertility treatment.

 

Fertility treatment leads to stimulating ovaries to creating more eggs (ovum).

 

More successfully retrieved ovum can mean more embryos created. 

 

That's certainly the expectation, even the hope, with fertility treatment. 

 

Here's the next hope and expectation, we get pregnant. That happens a lot. That is the whole point of treatment. That is the best outcome, that a pregnancy has been created.

How Cryopreservation Works

Very often, there are extra embryos and almost always, they are frozen (cryopreserved). This is a method that suspends the growth and division of the embryo. Typically, a woman, prospective parent, or couple will decide that they would like a second and even third or fourth child and those embryos can then be thawed (removed from cryopreservation, warmed gradually and start to grow and divide again) and, with a high level of success, another successful pregnancy can occur. 

 

This is a scenario that happens all over the United States, as well as in many other countries all over the world.

 

I used the word dilemma in the title of today's blog.

 

Here's the dilemma. 

 

When family building is done, what do we do about the frozen embryos?

 

Why is it a dilemma?

 

For some people, it's not. I haven't met too many of those people in over 24 years of being in the field of infertility. 

 

Most of us struggle with what to do with what can be full genetic siblings to our children.

 

There are limited choices. As best I understand them, here they are: 

 

  1. Keep them frozen (there are costs associated with this, but there are cases of embryos frozen for over a decade or more)
  2. Allow them to thaw and discard them
  3. Donate them to another person experiencing infertiilty
  4. Donate them for scientific research

 

Those choices seem stark to me. Maybe it's because they are in a numbered list and the number four doesn't seem very high.

 

There really aren't a lot of choices. Four is not a lot of choices. Especially since, for most of us, the choices aren't all that great. Maybe I should say the choices aren't all that comfortable. 

 

Often, choice number one is used because it's a type of non-decision. It's literally freezing time until another decision is made. It's possible to keep embryos frozen forever if you're willing to pay the costs associated. But then what? Someone, at some time, will need to make a decision about what to do about the embryos.

 

That's the dilemma. 

 

What to do about the embryos.

 

It's a very personal choice. Let's start there.

Making Powerful Choices During Fertility Treatment

One of the problems is that while we're in the middle of fertility treatment, there are so many powerful things that we need to consider. Compromises, life changing decisions that we need to make. While the emphasis is on the pregnancy and the baby, what to do with extra embryos often becomes almost always an afterthought. It's not the point. And often, in the middle of fertility treatment, almost everything except becoming pregnant is not the point.

 

And then we become pregnant, maybe more than once. Our families are built. 

 

Hence the frozen embryo dilemma.

 

So, please, share with us. Anonymously if you like. 

 

What are your feelings about frozen embryos? 

 

What would you do?

 

What have you done?

 

What do you wish you had known to ask or consider or think about?

 

 

 

Egg to Embryo: Path to Fertility

  
  
  
Todays blog is all about what we need. Seeing it, identifying it, holding it close in our hearts, breath, and our dreams. Seeing it clearly and knowing that it's what's necessary, appropriate and even reasonable.

First, let's review the egg to embryo process. An embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination. In humans, it is called an embryo until about eight weeks after fertilization (i.e. ten weeks LMP), and from then it is instead called a fetus.  The development of the embryo is called embryogenesis. In organisms that reproduce sexually, once a sperm fertilizes an egg cell, the result is a cell called the zygote that has half of the DNA of each of two parents. In plants, animals, and some protists, the zygote will begin to divide by mitosis to produce a multicellular organism. The result of this process is an embryo.
 
So, back to the egg.  One good egg. That's all you need. One. You don't even need a whole good fertility treatment cycle. You just need one viable egg. For that matter, you don't even need one good egg. Just one viable egg to make one viable embryo. Our IVF Lab Director, Dr. Dawn Kelk, will even tell you that they don't always look good even when it turns out that they are good. A day three embryo will sometimes look much better on day four or five.
 
Same thing with dating or buying a house, getting into the right college or finding the right job. You don't expect or need to have eight perfect husbands or homes, etc. You expect and hope for one. The right one. That's all that you need is one. In fact, more is unnecessary and  can even be confusing.
 
So let's go with the one embryo that is viable. That embryo needs to have cells that divide and multiply and therefore grow. It needs to implant in the uterus, find the nourishment that it needs and that is provided there,  and it needs to continue to grow and divide and multiply. Seeing, in the mind's eye, that the uterus is a warm, nourishing organ. A healthy organ, one that is capable and able. Letting your finger tips rest lightly on the lower belly and allow this to be true. Breathing into lower belly and letting the inhale bring in new blood, fresh oxygen and energy, expanding your vision of healthy, capable and able.
 
Healthy capable and able. And with every breath in, you are nourishing and providing for your body in a way that sustains life. Every breath providing just what is needed, perfectly balanced. Every exhale releasing what is not needed and what your body is done with. Our mantra, often in Fertile Yoga, is "Inhale, nourishment, exhale, gratitude". Nourishment with breath is for everything that the breath provides. Gratitude on the exhale for having provided for the body perfectly and lovingly. Inhale, exhale. Nourishment, gratitude.
 
Starting the week off with breath, mindfulness and gratitude. Happy Monday.

Higher Pregnancy Rates with Preimplantation Genetic Screening @ RMA

  
  
  
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Higher Pregnancy Rates with Preimplantation Genetic Diagnosis

Reproductive Medicine Associates of Connecticut (RMACT) is among a select group of fertility centers throughout the USA offering this new genetic screening resulting in higher pregnancy rates.

Affiliated doctors at Reproductive Medicine Associates of New Jersey and the Robert Wood Johnson Medical School offered IVF patients under the age of 43 who had had less than one failed prior cycle the opportunity to participate in the randomized trial.  Twenty-eight patients participated in the trial and all received routine IVF care through embryo culture to day five of embryo development.  At that point, patients were randomized with  13 enrolled for PGD with aneuploidy screening (AS) and 15 enrolled as controls.   There was no difference in maternal age between the study patients and the controls.

Prospective Randomized Controlled Trial Demonstrates Preimplantation Genetic Diagnosis with Aneuploidy Screening Increases Pregnancy Rates

The AS patients’ embryos underwent four-hour trophectoderm screening for 24 chromosomes so that only chromosomally normal embryos would be transferred, while control patients had embryo transfer without further intervention.  Clinical pregnancy rates following transfer were significantly higher for AS patients than for controls (92% vs. 60%) and sustained implantation rates for AS patients were also higher than for controls (75% vs. 56%).

Preliminary results suggest that blastocyst biopsy with 24 chromosome aneuploidy screening and fresh embryo transfer may optimize embryo selection and eventually facilitate single embryo transfer.  The researchers are continuing the current study in order to determine whether there are specific groups of patients who may or may not benefit from this technique.

R.T. Scott
O-05  A Prospective Randomized Controlled Trial Demonstrating Significantly Increased Clinical Pregnancy Rates

Read more in the next week or so to learn what this may mean for you on your path to fertility.  

Infertility and the Price of Egg Donation and Embryos- Beyond Money

  
  
  
  This week I'll be offering up different points of view from professionals in the infertility field regarding egg donation. To be very clear, egg donationis not the only controversial issue when it comes to infertility. Far from it, I believe that every step that the medical and scientific community has taken in advancing medical treatment has been met with reactions that vary from awe to horror. Unlike other medical treatments for other diseases, infertility advancement is often met with a lot of resistance.

Unlike other medical treatments, in the business of infertility, we make embryos. Human embryos. And unlike blood, tissue, plasma or a kidney, a human embryo has the possibility of a human life. I believe that is really the crux of the issue. That how we manipulate a cell or a group of cells is relatively uncharged emotionally and ethically. Once, however, those cells hold the possibility of life, it's a whole other story. You all know that there are all sorts of religious arguments against infertility treatment and conception. And yes, the Catholic Church is front and center on that opposition. The Catholic Church does not stand alone, not by any means, however. Many other Christians, Jews, Muslims, Buddhists, and other religions have one objection or another. Some of these objections have nothing to do with the embryo, but how one gets there. That there is intervention at all. Some objections have to do with the interruption of the "natural" process that occurs in conception.

It seems a natural progression, given that I was and will be talking about egg donation, to talk about embryos. In fact the conversation takes a dramatic and more highly charged turn when we discuss embryos. What we currently can do to ensure that embryos are healthy is a landscape that is changing as we speak. How we can manipulate embryos, what the long term outcomes of manipulation are, what to do with embryos that we don't choose to use, and these are all only the most obvious questions.

I know that this is another slippery slope; I seem to be finding them a lot these days. This bears thinking about so that we can make informed decisions. So that we can look ahead before we create embryos to see a final outcome. Given the amount of legislature and proposed legislature out there, it is imperative that we understand our ethical, religious, legal rights and stances. This is not a place to go without thinking deeply. Deciding about embryos is also about listening to your heart and having respect for underlying responses and emotions.

Stay tuned for more this week about these issues, as layers of understanding are uncovered. These are issues that concern all of us, whether you are trying to conceive or not, as they are part of how society sees itself. What we deem to be responsible or moral. I'd like to hear what you have to think, always.

Infertility Laboratory Director Talks About Embryo Safety and ID

  
  
  
Here's the question you don't want to ask:  How can I be sure/do I know that these embryos are mine?

This question is asked of me not infrequently and don't worry, I don't take offense to it.  I can assure you at RMACT we have multiple, double, triple and even quadruple checks at every stage in our laboratory process.  We pride ourselves on going well beyond the standard of care when handling eggs, sperm and embryos.

In fact frequently, the lab staff pay closer attention to patient details than the patients themselves.  We ask that you verify and initial a sticker with details of you and your partner's names, last 4 digits of social security number and date of birth. Women are asked to initial a label right before their egg retrieval and men are asked to initial an identical label at the time they produce a fresh semen sample.  Occasionally there may be typos or clerical data entry errors in our computer system when you first register with our program. This may be due to errors communicated from your referring physician or inconsistencies in information on your care card and drivers license.  It is however, very important for the lab to verify and correct your data before we receive your eggs and sperm. 

We have double checks at every step of the way....

  • 1) The woman verifies and initials a label with both her name and partner's name, last 4 digits of SSN and date of birth at time of egg retrieval.
  • 2) The partner verifies and initials an identical label when producing a fresh semen sample.
  • 3) When the sperm is washed, a second embryologist verifies the sample.
  • 4) When the eggs are inseminated, a second embryologist witnesses, verifies and signs off on the eggs and sperm.
  • 5) When embryos are frozen, a second embryologist witnesses the culture dish and cryovials, verifies and signs off on the paperwork.
  • 6) When embryos are thawed, a second embryologist verifies the cryo vials or straws. The vials are kept until the embryo transfer so that the physician and patient may also verify.
  • 7) At the embryo transfer, the patient is asked by the embryologist to identify themselves. The couple can then see the culture dish through a live video link to the microscope in the embryology lab. They verify the label on the culture dish and they can see the embryos being loaded in to the embryo transfer catheter.

Occasionally we do catch a clerical error at the time of the embryo transfer when we ask the patient to state their name, last 4 digits of social security number and date of birth.  That means that one or both partners did not properly verify their information at the beginning of the cycle.  When we ask you to verify your information, please check it carefully as it ensures that no mistake is made. Rest assured though, even if there is a clerical mistake, it can and is caught and you will not receive the incorrect embryos. That is why we have so many checks in the system, not to be repetitive, but to be completely thorough.

We need a patient who is using donor sperm to know her donor sperm number. We understand that this is all a lot to remember, but again it ensures complete safety.  Believe me, when you can't or don't verify completely, the laboratory staff does stress out about it and lose sleep. 

If you have questions, we are available to answer them. Standard protocol demands that the lab identify the patient before egg retrieval and embryo transfer. At RMACT, we choose to go beyond and through live video link to the lab, you will identify your name and information on the embryo culture dish and we will give you a close-up look at your actual embryo(s) for transfer.  You will see your embryo(s) being loaded into the catheter for your transfer and we will provide you with a photograph of the embryo(s) that we transfer.  What else would you like to know about the lab? Are there concerns that you have that have not been addressed here?   Feel free to ask and we will do our best to explain and clarify.

Dawn Kelk, PhD
Laboratory Director
Reproductive Medicine Associates of Connecticut

 

Reproductive Medicine Associates of CT have the following credentials:

Licensed as a Surgery Center by the State of Connecticut

CLIA (Clinical Laboratory Improvements Amendments) accredited

CAP (College of American Pathologists) accredited

AAAHC (Accreditation Association of Ambulatory Healthcare) accredited

AIUM (American Institute for Ultrasound in Medicine)

We are members of SART (Society for Assisted Reproductive Technology), and also submit data to SART and the CDC (Centers for Disease Control)

 

 

 

Fertility Lab Director Has Protocols that Let Her Sleep at Night

  
  
  
  Our laboratory director, at RMACT,  Dawn Kelk, PhD, sometimes tosses and turns at night. How come? Because as tight as her protocols are in the lab, she is always concerned about clerical error, patient error or any other type of error.

I have to tell you, that is my kind of lab director. Relaxed is a really good state of being in a lot of places. The person handling my embryos doesn't need to be that relaxed. She needs to be really, really diligent. And even more than that, she needs to have procedures and protocols in place to catch anyone when for a moment they are not being diligent. That's right, the yoga teacher's into procedures and protocols. Me, I should be relaxed when I teach you, guide you through gentle poses and guided meditation. Dawn, we want diligent. Tomorrow, you will get to hear first hand from her what the procedures are that are followed, every single time.  

Some of us feel like the lab is a big, black hole where our sperm and eggs disappear, someone waves a magic wand and they reappear as embryos. I think while a lot of us understand how the actual procedures work; some of it is an enigma. Lab culture, co-culture, how is an embryo graded, what does the grading mean, how are the embryo's stored. Dr. Kelk is going to start a conversation with you, tomorrow, with the basics of lag procedure. I love it because it's a great way for you to relax, to know that she is on top of how her lab is run, how things are checked, rechecked, triple checked, quadruple checked, and even then sometimes tosses and turns at night, worrying about you.

Great time to ask questions as well, as this is a conversation. We want you to feel comfortable, and yes, relaxed about how your embryos are being handled. So ask away!

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