Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-29T12:25:02.717Z Has data issue: false hasContentIssue false

Chapter 42 - Troubleshooting in the IVF Laboratory

from Section 9 - Quality Management

Published online by Cambridge University Press:  07 August 2023

Markus H. M. Montag
Affiliation:
ilabcomm GmbH, St Augustin, Germany
Dean E. Morbeck
Affiliation:
Kindbody Inc, New York City
Get access

Summary

A fully equipped laboratory with state-of-the-art air control; meticulously calibrated and maintained incubators and microscopes; culture media and medium supplements scrupulously selected after stringent after-market assays; validated, efficient and effective laboratory protocols and techniques; skilled, experienced, knowledgeable embryologists. What could go wrong? Why and how could there ever be a poor outcome, such as failure of fertilization, oocyte degeneration, arrested development of embryos or low blastocyst formation rate, poor survival of embryos after cryopreservation or low embryo implantation rates? Every laboratory and clinic must be prepared to encounter one, some or all of these undesired events and set out on a systematic analysis of the entire process to identify and address ‘the problem’. In this chapter, some suggested strategies and tools for an effective investigation and focussed troubleshooting are presented. These are designed to assist the embryologist, as well as the entire clinical team, to embark on a structured evaluation of each factor that may underlie, cause and/or contribute to a failure or a suboptimal outcome. Indeed, the engagement of the team is encouraged, providing a valuable perspective in a time when one must resist the temptation to ascribe poor performance in in vitro fertilization (IVF) solely to the laboratory.

Type
Chapter
Information
Principles of IVF Laboratory Practice
Laboratory Set-Up, Training and Daily Operation
, pp. 312 - 323
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wang, W.-H., Meng, L., Hackett, R. J., Odenbourg, R. and Keefe, D. L. Limited recovery of meiotic spindles in living human oocytes after cooling-rewarming using polarized light microscopy. Hum Reprod 2001; 16:2374–8.CrossRefGoogle ScholarPubMed
Cohen, J., Gilligan, A., Esposito., W. and Schimmel, T. Ambient air and its potential effects on conception in vitro. Hum Reprod 1997; 12:1742–9.CrossRefGoogle ScholarPubMed
Hall, J., Gillian, A., Schimmel, T., Cecchi, M. and Cohen, J. The origin, effects and control of air pollution in laboratories used for human embryo culture. Hum Reprod 1998; 13(Suppl. 4):146–55.CrossRefGoogle ScholarPubMed
Sparks, L. E., Guo, Z., Chang, J. C. and Tichenor, B. A. Volatile organic compound emissions from latex paint: 1. Chamber experiment and source, model development. Indoor Air 1999; 9:1017.Google Scholar
Elder, K., Van den Bergh, M. and Woodward, B. Troubleshooting and Problem-Solving in the IVF Laboratory (Cambridge: Cambridge University Press, 2015).CrossRefGoogle Scholar
Gardner, D. K. and Lane, M. Culture systems for the human embryo, in Textbook of Assisted Reproductive Techniques, Laboratory and Clinical Perspectives, ed. Gardner, D. K., Weissman, A., Howles, C. M. and Shoham, Z., 2nd ed., pp. 211–34 (London: Taylor & Francis, 2005).Google Scholar
Ishikawa, K. Guide to Quality Control (Tokyo: JUSE, 1968).Google Scholar
Go, K. J., Patel, J. C. and Dietz, R. Troubleshooting in the clinical embryology laboratory: the art of problem-solving in ART, in Practical Manual of In Vitro Fertilization. Advanced Methods and Novel Devices, ed. Nagy, Z. P., Varghese, A. C. and Agarwal, A., pp. 631–7 (New York: Springer, 2012).Google Scholar
Greenblatt, E. M., Meriano, J. S. and Casper, R. F. Type of stimulation protocol affects oocyte maturity, fertilization rate, and cleavage rate after intracytoplasmic sperm injection. Fertil Steril 1995; 64:557–63.CrossRefGoogle ScholarPubMed
Morbeck, D. E., Paczkowski, M., Fredrickson, J. R., et al. Composition of protein supplements used for human embryo culture. J Assist Reprod Genet 2014; 31:1703–11.CrossRefGoogle ScholarPubMed
Otsuki, J., Nagai, Y. and Chiba, K. Damage of embryo development caused by peroxidized mineral oil and its association with albumin in culture. Fertil Steril 2009; 91:1745–9.Google Scholar
Nijs, M., Franssen, K., Cox, A., et al. Reprotoxicity of intrauterine insemination and in vitro fertilization – embryo transfer disposables and products: a 4-year survey. Fertil Steril 2009; 92:527–35.CrossRefGoogle ScholarPubMed
Alikani, M., Go, K. J., McCaffrey, C. and McCulloh, D. M. Comprehensive evaluation of contemporary assisted reproduction technology laboratory operations to determine staffing levels that promote patient safety and quality care. Fertil Steril 2014; 102:1350–6.Google Scholar
Boone, W. R., Johnson, J. E., Locke, A.-J., Crane IV, M. M. and Price, T. M. Control of air quality in an assisted reproductive technology laboratory. Fertil Steril 1999; 71:150–4.CrossRefGoogle Scholar
Bormann, C. L., Thirumalaraju, P., Kanakasabapathy, M. K., et al. Consistency and objectivity of automated embryo assessments using deep neural networks. Fertil Steril 2020; 113:781–7.CrossRefGoogle ScholarPubMed
Bori, L., Paya, E., Alegre, L., et al. Novel and conventional embryo parameters as input data for artificial neural networks: an artificial intelligence model applied for prediction of the implantation potential. Fertil Steril 2020; 114:1232–41.Google Scholar
Curchoe, C.L., Malmsten, J., Bormann, C., et al. Predictive modeling in reproductive medicine: where will the future of artificial intelligence research take us? Fertil Steril 2020; 114:934–40.CrossRefGoogle ScholarPubMed
Mortimer, D., Cohen, J., Mortimer, S. T., et al. Cairo consensus on the IVF laboratory environment and air quality: report of an expert meeting. Reprod Biomed Online 2018; 36:658–74.Google Scholar
Mortimer, D. and Mortimer, S. T. What’s gone wrong? Troubleshooting, in Quality and Risk Management in the IVF Laboratory, pp. 135–44 (Cambridge: Cambridge University Press, 2005).Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×