Antimullerian hormone testing

In conjunction with FSH, antral follicle count and ovarian volume, testing of Anti-Mullerian Hormone (AMH) levels has been shown to be a valuable marker in predicting a woman’s ovarian reserve and function.

Cytotoxicity testing

Cytotoxicity testing is a crucial part of the IVF laboratory. EQASRM sends out a variety of samples in order for laboratories to test the sensitivity and validity of the assay they employ. The following are examples of samples that may be sent for testing:

  • Embryo culture medium spiked with various toxins eg formaldehyde, chlorhexidine hand wash, perfume etc.
  • Embryo culture medium spiked with various products used in the IVF lab eg. propanediol, glycerol, lubricant, aqueous creams, hand cleansers, etc.
  • Products commonly used in the IVF lab: Cryopreservation straws, ET and IUI catheters, Semen Collection Devices, Condoms, mineral oil, etc.

Blastocyst grading

  • Footage of two Day 5/6 human blastocysts are recorded and sent to labs for assessment. The blastocysts are recorded whilst in culture medium microdroplets under oil at 37°C. The blastocysts are manipulated and rolled using micropipettes in order to facilitate adequate visualisation of the trophectoderm and inner cell mass. Responses to questions regarding the quality of the TE and ICM for each blastocyst are required as well as their suitability for transfer and or freezing.

Embryo grading

  • Footage of four Day 2/3 human embryos are recorded and sent to labs for assessment. The embryos are recorded whilst in culture medium microdroplets under oil at 37°C. The embryos are rolled using micropipettes in order to facilitate appropriate morphological assessment. Labs are asked to grade the embryo and count the number of viable cells present. Responses to questions relating to each individual embryo, its quality and suitability for freeze or transfer may also be required. This is done to compare how different laboratories assess their embryos and determine what their fate would be.

Embryo time-lapse

  • This scheme has been designed for users of time-lapse monitoring incubators. Time-lapse assessment of embryo morphokinetics is showing immense potential as an effective tool to identify embryos with higher implantation potential or as a de-selection tool for embryos displaying morphokinetic events associated with significantly lower rates of implantation such as direct cleavage (Rubio et al 2012) or abnormal syngamy (Wirka et al 2014). Embryo mophokineticbehaviour has also been shown to be associated with aneuploidy status (Campbell et al 2013).
  • Accurate determination and identification of cellular and developmental events is crucial for time-lapse imaging users. Currently there is limited data on within and between laboratory variability in this field. Participation in our “Embryo time-lapse” scheme would be of great benefit to users of this system for not only peer comparison but also for within lab monitoring using the IQC module.
  • Complete video footage from insemination to Day 5 or 6 of development for 2 embryos is sent on USB to participating labs. Video resolution is such that individual morphokinetic events can be identified easily using the pause/play function on Windows Media Player.
  • Three questions relating to specific timing of events requiring a numerical response are asked and statistics are performed on all results received. An additional three qualitative questions per embryo are also posed and these are summarised in tally form.

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