Asked and Answered: Here’s a Behind-the-Scenes Look at Philly’s Cutting-Edge Fertility Lab

The fertility process can be such an emotionally fraught journey. From the patient’s perspective, the majority of the process is focused on making it to the all-important egg retrieval. But what happens once those eggs go off to the laboratory?

The lab is one of the most vital, though usually unseen, aspects of the fertility process. Main Line Fertility, a practice with six locations in the region, has a state-of-the-art laboratory that combines innovation and compassion to support every patient’s path to parenthood. Here’s a behind-the-scenes look at their lab for a clearer understanding of this leading-edge process.

After the Egg Retrieval

Day 0, as it is known, is the day of the retrieval. The doctor extracts the ovarian follicles, and the embryologists extract the eggs from the fluid. Later that same day, the embryologist adds the sperm to the dish, and then the lab does a fertilization check–basically ensuring the sperm is on the move. After that, it stays in incubators while nature (with a boost from science) takes its course until day five.

The status of each step in the process is communicated to the patient by the embryologist through the patient portal. “If it gets to a point where they need more guidance through the process than the portal is allowing, we will speak to them on the phone,” says lab supervisor Jennifer Jones.

Christian Toman, an embryologist in the Main Line lab, and his wife are undergoing IVF at the center, so he says he understands that fertility is an emotional, mental, physical and time-intensive process. Patients are coming to the office for appointments, blood draws, and ultrasounds for months and then taking medicine at home for weeks. “Often, we’re the end of the road for the patient. We’re the last stop in a long process that has led them there, even though it’s our first time talking with them,” Toman says. “I empathize with the process even more now.”

The Importance of Genetic Testing

Day 5 embryos that make it to “fully expanded blastocyst” are ready for implantation into the uterus, but most of Main Line Fertility’s patients opt for genetic testing, which results in frozen embryos. The lab biopsies a sample of three to five cells from each embryo, which are frozen and sent to a testing company. The embryos are cryopreserved and stay in the Main Line lab while the patient and embryologists await the genetic results.

Patients are often counseled to opt for genetic testing based on their age, but it can also maximize the potential of a successful cycle.

“With genetic testing, a patient is increasing their chances of creating a pregnancy by transferring a chromosomally normal embryo,” Jones says.

Unfortunately, the embryologists sometimes have to deliver bad news when a patient has no fertilized embryos, none to freeze, or none that test normal. “We do hope for the best, we want everyone to have at least that one shot, at least one embryo, and it’s hard when they don’t,” Jones says.

Once the genetic testing results are in, the lab also provides a “grade” for each embryo based on size and cell development, and the sex of each embryo, if the patient chooses to know.

“The patient is as involved in that process as they want to be,” Toman says.

The patient then preselects which embryo they want thawed for an upcoming transfer. The remaining embryos stay frozen for possible future transfers.

Safety Protocols

With all these delicate steps in the process, safety is taken extremely seriously at the lab, starting with constantly checking the patient ID against the egg and embryo IDs.

“We are so vigilant about checking people’s IDs all the time,” Jones says. “We want to make sure this is the safest, secure process for everyone.”

Each patient is identified not only by their name and date of birth, but additional qualifiers. Every cycle has a unique number associated with the resulting embryos, and then each embryo has a specific number. “Because we do so much genetic testing, we have four unique identifiers for each embryo,” Jones says.

The lab has multiple layers of safety protocols. Thermal cameras monitor the lab 24 hours a day to make sure everything is in the right temperature range. “We also have multiple layers of alarm systems to ensure the safety of the eggs and embryos themselves,” Toman says.

The embryologists also work in tandem at every step in the process. “Nothing an embryologist does in the lab is ever done alone. Anytime a specimen, from eggs moving to a retrieval dish to a culture dish, when sperm is added, when an embryo is frozen or thawed, there are two embryologists at every transition,” Jones says. “Every step is documented. I can look back in a week and see when I inseminated a patient’s eggs, who was the witness, and that all the protocols were followed.”

Build your family with Main Line Fertility, where you’ll find personal support, an inclusive environment and the latest technology.