Ask an Expert addresses reader questions every week. Today we share expert insight from Kristen, an Embryologist who will answer a few of your top questions. Stay tuned for future posts, as this is part one of the embryology series.
First, let’s get to know our expert a little.
Please tell our readers a little about yourself.
My name is Kristen and I’ve been an Embryologist for 5 and a half years (with a small break for each of my 2 kids). I studied Biomedical Science and have a Master’s degree in Reproductive Medicine, so have always had a passion for fertility and a desire to help others going through such a hard and emotional journey. I’ve always had a massive empathy for our patients coming through for treatment but that grew to a whole new level once I myself started trying to conceive.
My husband and I had our own battle when we started trying 4 years ago due to me having PCOS/high LH/high AMH/anovulatory long cycles and I very quickly learned the sadness, despair and obsession a lot of mamas get. I didn’t cope very well and became very obsessive about trying anything/everything and even doing pregnancy tests multiple times a day! Luckily, we were successful before reaching the IVF stage (because I’d already done the investigations and tracking before starting TTC) and now have a 1 and 3-year-old.
-Share stories and advice to help others going through this tough journey and to give them an idea of what might be expected.
-To share pretty pictures/facts and tips to help the burden.
-To help set realistic expectations, as I know that a big amount of disappointment comes from thinking your eggs/embryos didn’t do well, when in reality a couple of blastocysts on day 5 is fantastic!
I know the questions we get asked every single day and I hope to use my lab experience to educate others and empower anyone going through fertility treatment. You are not alone; you can do this!
What is the hardest part of your job?
I’ve had to get used to giving bad news but it’s still difficult. I make people cry regularly and although I know they aren’t upset with me, it’s difficult having to be the one to tell them that either they didn’t get any fertilization, they won’t be having a transfer as nothing divided or that their last embryo didn’t survive the thaw. Sometimes I still struggle with saying the right thing, although I do realize that in these situations there is likely nothing anyone can say that’s going to make it better which is hard for all of us in the lab.
It’s quite a stressful job with the numerous theater procedures and mental attention that’s involved. If you think about it, there are not many jobs where there is no room for error. This job has ZERO room for error and it gets mentally draining having to stay switched on 100% of the time. We have all had days we have had to step out of the lab and shed a few tears! To stay balanced, they try to roster us in the lab not too many days in a row. We try and switch it up with office days or sperm lab.
How do you view embryos? Do you ever feel responsible for them and get attached?
I don’t get attached but we get so excited when we see beautiful embryos! It’s awful to see them not survive the thaw and we are so sad when we see that. I feel more for the patient than I do for the embryos as I know how precious they are to them.
What type of schooling do you have to go through to become an embryologist?
We all have a science degree but a few of us have post graduate qualifications, and I suspect most in the future will need this as jobs are so competitive. I have a Bachelor degree in Biomedical Science and a Masters in Reproductive Medicine and hope to continue with a PhD one day.
What are your thoughts on PGS? Can this damage the embryos?
There is always a risk with any manipulation and a PGS tested embryo goes through freezing, thawing and biopsying. But for those that do survive, the chances of success are fantastic. For those that have multiple embryos, having them tested will likely change the order of selection and make time to pregnancy quicker and reduce transfer of abnormal embryos.
What do the majority of couples decide to do with leftover embryos? Donate, science, destroy?
The majority choose to discard. If you donate to another person or couple there is counseling that has to be done which a lot of people don’t do or just a lot of people aren’t comfortable with the idea of someone else having their genetic child. Donating to science is an option that’s becoming increasingly more common to see.
Anything else you’d like an IVF beginner to know?
Don’t be upset if you don’t have grade 1 embryos on day 3 – we rarely see them!
Poor embryos can make babies
You will likely lose a lot of embryos along the way
Get your partner (if he’s a male) to increase ejaculation in the weeks leading up to your egg collection, even if it’s just that last week and get him to ejaculate the day before as well, not 2-3 days like used to be recommended – this reduces DNA fragmentation and keeps sperm fresher as they aren’t waiting around as long
Prepare for unexpected results
A lot of people don’t know all that can go wrong
Your success depends on:
Successful stimulation – you may not respond to the drugs.
Collection of eggs – some may not be mature
Fertilization – some or all may not fertilize
Embryo development – you may not get anything that divides or is suitable for embryo transfer
Implantation – even if you have a transfer, you only have a ~30% chance of pregnancy
Thawing – your embryos might not survive
But don’t be too scared! We see so many patients get pregnant quickly! If you aren’t having any success with IVF, don’t feel discouraged, as there are still likely so many other options to try.
I have seen so many patients devastated to get failed fertilization with IVF… then get pregnant next cycle with ICSI.
I have calmed down many women upset that they only got 1 egg and want to know what to do next cycle… and then they get pregnant from that 1 egg!
I hope this helps some of you going through this tough journey. I want you to know, whatever the end of your journey is; it’s going to be OK. If it’s not OK, it’s not the end.
You can find Kristen on Instagram here!