State of the A.R.T. Lab

The Embryology Laboratory of Assisting Nature is the core of the IVF Unit with highly trained Embryologists and its structure contributes to the excellent quality of the services provided, to the safety of the procedures and to the serene environmental working conditions.

According to ISO Standards, strict checking is ensured by daily measuring and controlling Laboratory Parameters, such as temperature, gas concentration (CO2, O2, N2) and pH, by our Embryologists. Additionally, the implementation of quality control (QC) and quality management systems in IVF, with a continuous monitoring and alarming system (by SMS and e-mail), guarantees uninterrupted optimal culture conditions for the embryos.

The Hepa filters in the IVF Lab provide high quality filtrated air under positive pressure. When entering the Lab, the staff passes through air shower that contributes to the removal of the volatile organic particles. Furthermore, the Lab is covered with antimicrobial Corian, which does not release toxic compounds for the gametes and embryos and is constantly under low light intensity and stable environmental temperature. The IVF Lab with state of the art equipment and certified culture media offers the optimisation of our results. Our high-quality benchtop incubators offer individual chambers for each patient, which is of great importance since opening a chamber for evaluating the embryos of one patient, or doing any kind of manipulation, does not disrupt the ideal culture conditions for the rest of the patients.

The absolute transparency, traceability and identification of the gametes in each step throughout the process is ensured by the use of most modern RI Witness whose function is based on RFID (Radio Frequency Identification) Technology to track and record patient samples at each step of the ART process. An RI Witness card represents each couple. This card is inserted in the OR’s RI Witness Antenna and informs the Laboratory staff about the patient who is in the OR before every operation. Since then, an RI Witness tag follows every dish or tube with the couple’s genetic material or embryos and fills the patients, doctors and the embryologists with total confidence about the safety of the embryos.

All ART procedures are recorded with every detail and are always available online in our database with secure access with each staff’s personal password. Finally, all statistical results are easily obtained per ART type, year, or even protocol for analysis and discussion through our database on PC, i-pad and smartphones.

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Innovation

RI Witness using RFID (Radio Frequency Identification) technology to track and record patient samples at each step of the ART process works as a safeguard and a reassurance for both the clinic and the patients.

Advances in reproductive medicine over the last 10 years have allowed men who were previously considered absolutely sterile to father biological children. It turns out that men who have no sperm in the ejaculate because of problems with sperm production, a condition called Non-Obstructive Azoospermia (NOA), actually may have small pockets of sperm production within the testicle. In fact, greater than 60% of men with NOA actually do produce small amounts of sperm inside the testicle that can be used with ICSI (Intracytoplasmic Sperm Injection) to create a baby.

The implementation of quality control (QC) and quality management systems in IVF, andrology and cryopreservation labs is considered as a mandatory part of the guidelines and even the law. OCTAX Log & Guard™ is a monitoring and alarming system which has been specifically designed to meet the needs of quality control in A.R.T.

Ensuring the maintenance of the ideal conditions in an embryo culture, is of a great importance, as they are of the most crucial factors that determine further survival and development.  These conditions are maintained in special incubators that allow continuous control and stability of all the important parameters, such as temperature, pH, humidity and concentrations of O2 and CO2 in the embryo atmosphere.

Techniques

IUI is the simplest and most cost-effective IVF method, during which the enriched semen is inserted in the female uterus with a catheter (tubal patency is a prerequisite). There is a natural fertilization, with no further intervention. Pregnancy rates are 12-18%.

Sperm Selection Methods. IMSI, PICSI, DFI & FERTILE. Most of the new methods of sperm selection in IVF treatments (IVF, ICSI, IUI) are based nowadays on systems that mimic the natural environment of the body.

The first step for an In Vitro Fertilization program is stimulation of the ovaries with medication. This is necessary for the development of many follicles and lasts about 12-14 days. The stimulation protocol is chosen based on each couple’s medical history (age, previous attempts, etc). Monitoring is done every 2-3 days with hormone determination & ultrasound examination for the appropriate dose of drugs. When most of the follicles reach 18-20 mm in diameter, the last injection is given, which will result in the final maturation of the oocytes and ovulation.

Blastocyst is the embryo on the 5th day of culture. At this point, it consists of 120-200 cells and a cavity called blastocoele. Cell differentiation has already begun giving two kinds of cells the trophectoderm and the inner cell mass. The trophectoderm gives rise to the placenta and the inner cell mass forms the embryo.

Preimplantation Genetic Testing consists of two slightly different methods. PGD (Preimplantation Genetic Diagnosis) for fertile couples that are carriers of genetic diseases. PGS (Preimplantation Genetic Screening) for infertile couples. Embryos that undergo Preimplantation Genetic Testing are biopsied on Day 3 after Oocyte Retrieval or Day 5. A small hole is created to the zona pelucida using laser and with a micropipette one blastomere is removed in each embryo. On Day 5 Biopsy trophectoderm cells are removed (that give rise to the placenta), then genetic testing follows.

When a woman desires to vitrify her oocytes, firstly she has to undergo multiple ovulation induction, in order to maturate a satisfying number of oocytes. This stage of the therapy requires about 10-12 days since the first day of the menstrual cycle. Then, the doctor collects the oocytes after the oocyte pick up procedure. The oocytes can be vitrified only after their suitable elaboration in the lab and only if they are assessed as mature.

Nowadays, cryopreservation of embryos is considered a usual and effective application in the Assisted Reproduction Technology, thanks to the method of vitrification. This technique is usually preferred in ART cycles that there is a surplus of good quality embryos or in cases when for some reason, embryo transfer is not recommended.

Fertility cryopreservation is nowadays a matter that does not concern only women, but men as well. The first step for sperm cryopreservation is the collection of the sample. Sperm is collected in a special room (men’s room) next to the laboratory in the clinic and then delivered to the Laboratory staff. The embryologists evaluate the concentration and motility of the sperm sample and then the cryopreservation procedure begins.