PG07: State Of The Art Micromanipulation Techniques In The IVF Lab

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Developed in Cooperation with the Society of Reproductive Biologists and Technologists

ACGME COMPETENCY
Patient Care 

NEEDS ASSESSMENT AND COURSE DESCRIPTION 
Controversies exist concerning the benefit of certain micromanipulation procedures that are performed on embryos of in vitro fertilization (IVF) patients. In addition, qualified, competent lab directors across the country are not always in agreement as to the best way to provide quality patient care. Even when these micromanipulation procedures are performed in excellent labs by experienced embryologists, they are not always performed with the same methods. The outcomes also vary greatly, leading to more controversy about their efficacy. Relatively new techniques like trophectoderm biopsy and blastocyst collapsing prior to vitrification are now being performed. Many of these techniques and procedures have been presented in lecture form, along with some very impressive statistics. However, there remains a group of embryologists who have purchased expensive micromanipulation equipment and feel compelled to attempt to duplicate these techniques in their lab without ever having seen these procedures performed. This can certainly lead to poor quality care for the infertile patient.

This course, aimed at physicians and laboratory scientists and technicians, will use videos to demonstrate some of these new techniques, allowing participants to watch and ask questions so that they can duplicate the procedures with more skill. Alternative ways to perform some of these microtechniques will be demonstrated for those embryologists who do not have the benefit of the most costly micro-instruments, allowing them to learn the best way to perform these techniques with other effective but less expensive methods and instrumentation. 

LEARNING OBJECTIVES
At the conclusion of this course, participants should be able to:

1. Establish the efficacy of assisted hatching (AH) as a micromanipulation technique in their lab, analyze the benefit of a laser in accomplishing the technique, and summarize how to improve their performance of AH without the benefit of a laser.
2. List the alternatives available for opening the zona pellucida and explain the method that works best with the equipment and staff in their own lab.
3. Decide how best to prepare the embryo on day 3 for a safe and effective biopsy of cells on day 5 and list the benefits and limitations of applying this technique.
4. Decide which embryos to vitrify and when, explain the benefits of blastocyst collapsing and list reasons why blastocysts should not be collapsed.
5. Describe a micromanipulation system that could work best in their own lab and discuss whether there are better choices for a particular culture system.