Carole Lawrence Lab Director PCRM Edmonton Obje jectiv ives - - PowerPoint PPT Presentation

AN INT INTRODUCT CTION TO THE HE ART LA LABORATORY

Carole Lawrence – Lab Director PCRM Edmonton

Obje jectiv ives

Initial work up of couple – lab component Infertility treatments that involve the lab 2 The IVF Laboratory

• What does it look like

3 Embryos 4

• The gametes
• how do we perform fertilization
• The embryo
• normal in-vitro growth
• Testing the embryo
• Vitrifying (freezing) the embryo

Safety and security 5 1

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Androlo logy Laboratory ry

Se Semen ass ssessment

There may be a male factor contributing to the infertility

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Have a look at the semen sample

Current Reference Values – WHO 5th Edition – Laboratory Manual for the examination of Human Semen

• Sperm concentration > 15 million/mL
• Motility > 40%
• Morphology > 4% normal forms

POCT – at home semen analysis kits are currently in development

Advantages – removes the embarrassment factor and increase compliance to be tested Disadvantages – all methods to date are incomplete and still require laboratory analysis

Concentration and Motility Morphology

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Se Semen Analy lysis is

Accredit itatio ion

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Semen Analysis

Accredited by: the Alberta College of Physicians

Diagnostic Accreditation Program (DAP)

Addit itio ional l se servic ices – Androlo logy Lab

Sperm Cryopreservation

Cancer patient Gender transitioning patient Prior to fertility affecting medications Pre-vasectomy Pursuing ART treatment and travels frequently

Sperm Washing for Intrauterine Inseminations (IUI) Maintain a bank of anonymous donor sperm ordered by patients

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IUI with partner sperm

• Semen sample washed by lab
• Success rates 10-12% per cycle with no
• bvious male factors
• low invasiveness – low cost

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IUI with donor sperm

• Donor sperm sample thawed and

washed by lab

• Success rates 20-25% per cycle
• low invasiveness – low cost + cost
• f donor sperm ($600-$800)

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Lab in involv lved fert rtilit ility treatments

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Conventional IVF

• Cumulative pregnancy rate 70-75% per cycle
• Very lab based treatment
• Invasive and +++ cost

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IVF with ICSI

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Washing of semen sample by Density Gradient centrifugation

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Sp Sperm rm preparatio ion for r IU IUI I and IV IVF

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Su Surgic icall lly Retri rieved Sp Sperm

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Embry ryolo logy Laboratory ry

Coll llectin ing the oocyt ytes

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Conventio ional l IV IVF

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ICS ICSI I Micr icromanip ipula latio ion Rig ig

ICS ICSI

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Good embryo development Poor embryo development

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Embry ryo develo lopment

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Embry ryo transfer to the patie ient

Preserv rvin ing the excess embry ryos

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Embry ryo Bio iopsy for r Genetic ic Testin ing

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All sperm preparations are double witnessed All oocyte and embryo movements are double witnessed All oocyte inseminations are double witnessed All incubators are alarmed and hooked to a call out system Lab environmental conditions are monitored by a call out system Labs are secure areas with limited access

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Sa Safety and Se Securit ity

Storage Bank is monitored with temperature probes and call out system

Big iggest misc isconceptio ion

The lab cannot make bad sperm and bad

• ocytes good and cannot turn bad sperm and

bad oocytes into good embryos

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Th Thank you for r your r attentio ion!