As you may recall from the last few lessons, many crucial steps in the IVF process are completed by a clinic’s laboratory. There is a wide range in laboratory quality, and being treated at a clinic with a world-class laboratory can double a patient’s chances of success during any given IVF cycle.
We think of the laboratory as a mill because its workflow is linear: it must fertilize eggs, cultivate embryos, occasionally be able to biopsy those embryos for genetic testing, and then be able to freeze embryos (or eggs) and thaw them for future use. The continuum, along with rates of mere “competence” and “excellence” look something like the chart below. Ultimately, under the best circumstances, patients should be treated at a clinic with a laboratory that can:
Fertilize at least 75 - 80% of mature retrieved eggs, depending upon their fertilization technique (higher for ICSI)
Grow 60% of fertilized eggs into blastocyst embryos (or 70% to cleavage stage embryos)
Perform successful PGT biopsy and in 95% of embryos collect enough cells that the sample can be properly read
Freeze embryos and have 99% of blastocysts (or 90% of cleavage stage embryos) thaw intact
It’s crucial that a clinic’s laboratory operates 7 days a week and has multiple embryologists on staff. In circumstances where patients had to wait for the laboratory to re-open on Monday, success rates were needlessly lower, as you can see in the study below.
IVF is complicated and, while we wish we could say that it's possible to absorb all the details during the 5 - 30 minute visits with your doctor, that's really not the case. This comprehensive guide to IVF boils down every major issue you'll encounter -- a high level overview of the IVF process, a deeper dive into the IVF process, IVF success rates and how they differ depending on diagnosis and age, the medication protocols that can be used during IVF, the choice of inseminating eggs either using ICSI fertilization or conventional insemination, the pros and cons of growing embryos to Day 3 cleavage stage or Day 5 blastocyst stage, the decisions around genetic screening of embryos, deciding which embryo to transfer, deciding how many embryos to transfer at once, the ways the IVF laboratory can impact your odds of success and the things you need to know up front to avoid going to the wrong lab for you, the risks of IVF, and the costs of IVF. We're always sure to provide details about how data might be different depending on different unique types of patients -- because in the world of fertility, it's really not one-size-fits-all. We truly believe this guide is the foundation every fertility patient should start with when they're navigating the world of treatments.