An embryologist is often a key part of the fertility treatment journey but, unlike doctors and nurses, patients may not have as much face-to-face time with them. Here, Alease Daniel, an embryologist based in North Carolina, answers the question what an embryologist does, and shares some of her day-to-day.
How do you become an embryologist?
Unlike nursing or med school, there is no set degree or program required to become an embryologist in the United States. Federally, the only current requirement is 24 hard science credit hours—although most fertility clinics require a four-year degree in science. This means that embryologists have a variety of backgrounds, with some of the most popular degrees being Biology and Animal Science. Traditionally, embryologists are trained on the job, but with demand continuing to grow, a few training programs have opened up across the country.
What does an embryologist do?
Embryologists start the day bright and early, often before the rest of the clinical staff, to prepare. We typically begin with quality control (QC), to ensure all incubators, gasses, microscopes, lasers and other equipment is working appropriately. Once we’ve established QC, we start with procedures that are time sensitive. This includes day-one checks (to see if an egg has successfully fertilized or not), embryo thaws for frozen embryo transfers (FET) scheduled for the day, embryo checks for fresh transfers and handling the eggs from the retrieval procedures. Each of these tasks require a different culture media,(to support the eggs, sperm and growing embryos in their development) set up and skill level to complete. The most important part of anything we do in the lab is verifying patient information at every step of the process, with each lab having their own system to accomplish this without errors.
Procedures like embryo biopsy, embryo freezing and intracytoplasmic sperm injection (ICSI) aren’t as time sensitive during the day and can be completed in between the more pressing procedures. Most procedures are done before lunch, leaving the afternoon to prepare for the next day. Since it takes hours for culture media to equilibrate in the incubator, dishes for procedures must be labeled and made the day before. The afternoon is also the time we send patients updates about their embryos in the lab, attend clinic meetings and complete charting.
An embryologist’s role in a fresh embryo transfer
Once QC has been completed, we look to see what patients have fresh transfers for the day. Those patients' dishes are taken out of the incubator and checked for blast formation. For patients that have blasts, we immediately notify either the patient or the doctor that they have an embryo for transfer as planned. This allows the patient time to travel and fill their bladder and allows the physician preparation time for the transfer. Before transfer, we make sure all the materials we need for transfer are ready. This includes culture media, dishes, syringes and the embryo catheter. We also take time to grade the embryo and take a picture for the patient. Once the patient is in the procedure room, we verify the plans in the presence of the physician and the patient, verify identity and answer any questions the patient may have. We then head back to the lab to prepare the catheter for transfer. We move the chosen embryo into an isolated dish with fresh media, flush the catheter and wait to hear that the physician is ready for the embryo. During that time, the physician is placing a speculum to visualize the cervix, cleaning the cervix and positioning the outer catheter in the uterus. When we’re both ready, the embryologist will load the embryo into the catheter, bring it into the procedure room for the physician to thread into the catheter and use the syringe to place the embryo into the uterus.
While we spend most of our time behind the scenes, we are right behind our patients sharing in their failures, joys and frustrations with infertility.