May 2020

What role does an embryologist play during fertility treatment?

The laboratory is often referred to as a fertility clinic’s ‘engine room’. This is where our embryologists manage many of the steps involved in IVF. Our role in the IVF process usually begins during the egg retrieval stage. Under a microscope, we carefully examine the fluid your doctor collects from the mature follicles inside your ovary. We identify and extract any healthy eggs we find, before placing them in a laboratory dish with a specially prepared sample of your partner’s sperm (or donor sperm, if required). We then ‘keep watch’, checking for signs of fertilisation (when egg and sperm unite to form an embryo) and monitoring the growth of any embryos that do develop. In some cases, we will inject a single sperm directly into the woman’s egg to increase the chances of fertilisation. This technique is called intracytoplasmic sperm injection (ICSI).

Embryologists are also responsible for freezing and storing embryos. A woman may need to freeze and store her embryos if she has opted for a frozen embryo transfer (rather than a fresh embryo transfer) and/or if she has multiple embryos following egg collection and insemination. Only one embryo is transferred into the womb at a time, so we freeze any extra embryos in case implantation fails and repeat embryo transfers are required in the future. We store embryos at sub-zero temperatures using a process called cryopreservation.

Beyond IVF, we also freeze and store eggs for women who choose to freeze their eggs as a way of preserving their future fertility. We can even freeze sperm. This is actually incredibly important, as it allows us to maintain a bank of donor sperm for single women and couples (including lesbian couples) who rely on sperm donation to start their families.

How do embryologists help ensure a healthy baby?

There are a number of measures we employ in the laboratory to ensure patients are given the best chance of having a healthy baby. First and foremost, our in-house laboratory was specially designed to reduce volatile organic compounds (VOCs) and harmful blue light, ensuring optimal conditions for embryo development. Day-to-day, we also adhere to strict quality-control protocols, which are designed to maintain ideal conditions within the laboratory environment for embryo growth.

Our embryologists also use extra lab procedures that not all fertility clinics offer. We routinely use these techniques as part of our standard practice to optimise embryo development and give your embryo the best chance of successfully implanting in the womb. This includes the use of the EmbryoScope time-lapse system, sequential media and EmbryoGlue.

In some cases, we will employ even more specialised techniques to help us assess your eggs, sperm and embryos, so that we can select the best ones to use during IVF. This includes preimplantation genetic testing (PGT) of embryos. By carefully removing a small number of cells from a developing embryo, we can determine if the embryo is carrying a genetic disease (PGT-M), has the right number of chromosomes (PGT-A) or changes in the size or arrangement of chromosomes (PGT-SR). These tests require a highly experienced embryologist with special skills, so they are not offered by every fertility clinic. While PGT is not suitable for everyone, it can help lead to successful pregnancy in certain couples, such as those with a history of recurrent miscarriage or repeated unsuccessful IVF cycles. Your fertility specialist can advise if PGT is right for you.

In the case of ICSI, our embryologists use microscopes connected to micromanipulation equipment (e.g. micropipettes) to select individual sperm and inject this directly into the woman’s egg. Sometimes, we may use another technique if necessary, called intracytoplasmic morphologically selected sperm injection (IMSI), to help us pick out a healthier sperm based on its shape. We also use polarised light microscopy to assess a structure inside the egg called a ‘spindle’. We call this ‘egg spindle visualisation’. This allows us to identify if an egg is at a certain stage of development (called metaphase II) and therefore, in optimal condition for fertilisation via ICSI treatment.

Each of these lab processes requires exquisite attention to detail, extreme care and exhaustive consideration of multiple variables that can affect the healthy growth and development of embryos, as well as the ‘well-being’ of your eggs and sperm.

Is there a ‘typical workday’ for an embryologist?

No two days are ever the same! Every case is unique — whether we are caring for sperm, eggs, embryos or patients. There are always different challenges to manage or breakthroughs to celebrate. We are constantly amazed by the potential of these tiny-celled structures. And, of course, ongoing advances in the science behind IVF means that we are also continually learning new skills and adapting to new technology as well.

What level of involvement does an embryologist have with patients?

Patients typically get very little exposure to what is going on behind a lab’s doors. Understandably, this can make IVF even more daunting for patients. That’s why, at Newlife IVF, our embryologists make a point of staying in close contact with patients throughout their fertility journey. We are very mindful of the fact that patients have entrusted us with their future, and that their eggs, sperm and embryos are incredibly precious to them. Our embryologists are always available to speak to patients and answer their questions. Our goal is to keep patients well informed at all times about the status of their embryos and how everything is proceeding in the lab, so that they feel reassured that their embryos are being properly cared for.

What is the best part about being an embryologist?

Being able to help couples achieve what they want most in the world is extremely rewarding. It’s incredible to be able to watch a life begin under the microscope and emerge months later as a healthy baby. Embryology is a fascinating field that is constantly evolving, and I feel a great sense of pride at being part of such a life-changing science.

Ready to start your fertility journey?

At Newlife IVF, you can rest assured that an experienced embryologist will be part of your fertility team. You can visit our team page to read more about Dr Tiki Osianlis and some of the other embryologists at Newlife IVF. If you’re ready to take the next step in your fertility journey, you can start today by making an appointment with one of our fertility specialists — call (03) 8080 8933 or book online.

The first point to make is that the cost of fertility treatment will always vary from couple to couple. This is because the type of treatment offered depends on the specific cause(s) of a couple’s fertility issues. But even when treatment is similar (e.g. standard IVF), the total cost of treatment can still differ because not every couple will achieve success straightaway. One couple may achieve success in just one treatment cycle while another couple may require two or more cycles. The latter scenario will lead to additional costs for storage of frozen embryos and repeat stimulation cycles or frozen embryo transfers (FET). Further, the cost of a round of treatment and ancillary costs, like storage fees, vary by provider.

In Australia, private fertility clinics typically fall into one of two service models: ‘budget’ or ‘premium’. So how do you choose between them – and is there an alternative to a low-cost or high-cost clinic? Before I answer that, let me explain some important differences between low and higher-cost clinics.

How do budget clinics differ from other providers?

A budget clinic is typically able to offer fertility treatment at low or no out-of-pocket costs by restricting the types of services they provide. For example, they may not offer care for all types of fertility issues, excluding those that incur a higher cost to the clinic. They may also choose not to offer specialised services such as pre-implantation genetic testing (PGT), donor conception (requiring donor eggs, sperm or embryos), surrogacy, or embryo freezing and storage.

Some budget clinics may also only offer standard medication protocols. For example, a woman who is 30 years old, within a specific weight range and has a certain number of eggs, may be assigned ‘Protocol A’ treatment without the option for an individualised treatment plan. Further, the doctors who consult at budget clinics are often on rotation, so you may see a different doctor for each of your appointments, much like an outpatient clinic at a public hospital. Budget clinics may also limit the number of IVF cycles that the clinic can start at any given time, which can lead to significant delays in treatment initiation and sometimes even a missed opportunity to conceive.

In contrast, non-budget clinics are more likely to offer all types of fertility treatment and extend their care to patients with more complex fertility issues. These clinics may also offer additional services such as PGT. The other benefit of these clinics is that you can choose which fertility specialist you want to manage your care. This specialist will provide personalised care specific to your needs and remain with you throughout your entire treatment journey. Lastly, these clinics don’t usually restrict the number of IVF cycles they can run at any one time, meaning you will be able to start treatment when you’re ready, rather than when the clinic can fit you in.

Do success rates vary between low-cost and higher-cost clinics?

Variations in each clinic’s patient populations make it difficult to draw a direct comparison between the success rates of two clinics. For example, some clinics may have a higher proportion of easy-to-treat patients versus patients with complicated fertility issues, which is likely to impact their success rates. Further, clinics can report ‘success’ in different ways, e.g. pregnancy rates may be reported as per egg collection OR per embryo transfer. Similarly, some clinics may report ‘success’ as a positive pregnancy test at the end of a treatment cycle, while others may report success only when a live pregnancy is seen on an early ultrasound (clinical pregnancy) or if a baby is born (live birth rate). Thus, if you are comparing ‘results’ between clinics, it’s important to check that they are using the same definition to report success.

Success rates may also not reflect the different ways patients can journey through IVF. For example, if a couple has all their embryos frozen because the woman is at risk of ovarian hyperstimulation, some clinics may record this stimulated cycle as one where the woman failed to proceed to embryo transfer. This doesn’t reflect that a fresh transfer was deliberately not attempted and that embryos were frozen for use in future FET cycles. Likewise, if pregnancy rates are reported after a FET cycle, it is not always clear if the embryo underwent PGT, which is likely to increase the chance of success.

I can only afford fertility treatment with a budget clinic – is it worth it?

Despite some limitations, there is a definite place for budget fertility clinics in Australia. If cost alone is the only barrier to starting fertility treatment, then a budget IVF clinic may still offer you a better chance of starting a family than trying to conceive on your own.

However, you should be mindful that the prices listed on a clinic’s website may not accurately reflect the total costs that you will incur throughout your care. The following questions are a great place to start when enquiring about treatment costs:

Are there additional fees for freezing surplus embryos?
What ongoing costs are associated with storing frozen embryos?
How much does a frozen embryo transfer cycle cost?
What fees do you charge for advanced lab procedures, such as intracytoplasmic sperm injection (ICSI) or PGT?

How do Newlife IVF’s fees compare to other providers?

One of the reasons we established Newlife IVF was so that we could offer patients high-quality fertility care at reasonable prices. As a doctor-owned clinic, we do not have the pressure of shareholders nor the need to meet the same profit margins required by larger, corporate fertility clinics. Not only do we offer premium fertility care at an affordable price, but our ‘routine’ treatments also include advanced lab techniques that other clinics typically bill as ‘add-ons’ on top of their standard service costs.

Some of these advanced techniques include the use of the EmbryoScope time-lapse system, sequential media and EmbryoGlue for all IVF treatments, as well as egg spindle visualisation for all ICSI procedures. These extra lab techniques help us to select the best embryo to transfer into the womb, improve the chance of the embryo implanting, while also providing more information about egg quality and embryo development. We include these techniques as standard because we want to give our patients the best chance of success, right from their very first treatment. If the first cycle is not successful, we use information gathered from the EmbryoScope and/or egg spindle visualisation to provide our patients with meaningful feedback, and to help inform future treatment decisions.

What additional value does Newlife IVF offer?

At Newlife, we pride ourselves on offering our patients a highly personalised fertility journey. We find our patients’ feedback speaks volumes about the exceptional standard of care we provide. Below are the top three things our patients say differentiate Newlife IVF from other IVF providers:

Even though we are a new clinic, it’s clear that our fertility specialists, and supporting clinical, technical and administrative teams all have a wealth of experience in caring for patients who need help building a family.
Our attentive and caring staff offer regular feedback and support throughout a patient’s treatment journey, so they feel confident we are looking after them and their embryos, which makes them feel less like a ‘number’.
Our patients appreciate coming to the same fertility clinic and seeing their dedicated doctor for all of their appointments. Since Newlife IVF isn’t located in a large hospital, it feels less clinical and more personal.

How can Newlife IVF help individuals and couples who have not found success elsewhere?

If you’ve not been successful elsewhere, one of our highly-skilled fertility specialists can offer a fresh perspective and a second opinion.

Further, our in-house laboratory was specially designed to reduce volatile organic compounds (VOCs) and harmful blue light in order to provide ideal conditions for embryo growth. We also employ extra lab procedures that you may not have had access to at your previous clinic. These procedures are included as standard to optimise embryo development and give your embryo the best chance of successfully implanting in the womb.

Last word

Our best advice is not to take treatment fees at face value. Not all IVF clinics are equal, and the cost of care doesn’t necessarily equate to the overall value a clinic provides throughout your fertility journey. You can receive premium fertility care at affordable prices by choosing an independent provider with leading fertility specialists and a commitment to best scientific practice. At Newlife IVF, we offer high-quality care at reasonable prices, so you can focus on the task of falling pregnant without the worry of undue financial duress.

You can book an initial fertility consultation with one of our fertility specialists by calling (03) 8080 8933 or booking online.

The talent behind the microscope – the role of an embryologist