Stephanie Pritchard, MT (ASCP) – Laboratory Manager
After receiving her BS in Medical Technology from the University of Delaware in 1994, Stephanie spent some time working at MedLab and Johns Hopkins in their Hematology, Chemistry, and Stat labs prior to coming to Delaware Institute for Reproductive Medicine, PA. Stephanie is certified by the American Society for Clinical Pathology and inspects other IVF laboratories for the College of American Pathologists – CAP.
Mark Gibbs – IVF Laboratory Supervisor
Mark matriculated through Pennsylvania State University and Thomas Jefferson University, majoring in Microbiology and Laboratory Technology. At PSU he did work and research on the composition of the male contraceptive pill, this was where he found his passion for the Reproductive field. His early and extensive training in infertility came from the Philadelphia Fertility Institute/Pennsylvania Reproductive Associates/Fertility Testing Laboratory under the tutelage of Dr. Stephen L. Corson, M.D., Dr. Kathryn J. Go, Ph.D., and Joel L. Marmar, M.D.
Charlotte Lott – Embryologist
Charlotte has been with DIRM since 2001. She holds a B.A. in Biological Sciences from the University of Delaware and an MPH from Walden University. Charlotte is also our Third Party Reproduction Coordinator.
In vitro maturation (IVM) is when a woman’s eggs are collected and matured outside the body. This is done as part of an in vitro fertilization (IVF) procedure.
A woman’s eggs (also called oocytes) are formed before she is born. These eggs stay in a resting state in her ovaries until puberty, when normal hormonal changes cause an egg to mature (ripen) and be released each month.
When a woman undergoes IVF, she usually takes medicine to cause more than 1 egg to mature at the same time. These eggs are collected before they are released from the ovary, and are then paced with sperm in the laboratory in hopes of fertilization. In some cases, some or all of the oocytes (eggs) that are collected are not mature and ready to be fertilized. In years past, these eggs were not able to be used for IVF.
Advances in science have allowed embryologists to take these immature eggs and sometimes “ripen” them in vitro (in the laboratory). This is called IVM. The eggs may be frozen for later use (as immature eggs, mature eggs, or embryos after they have been combined with sperm and fertilized). Or, they may be matured, fertilized, and placed into a woman’s uterus in hopes of pregnancy.
Why use IVM?
To prevent ovarian hyperstimulation syndrome (OHSS) IVM may be considered for women with polycystic ovary syndrome (PCOS) or PCO- like ovaries. These women are at greatest risk of OHSS. OHSS is an exaggerated response to medicines used to induce ovulation, especially after the use of injectable gonadotropin agents when hCG is used for final follicular maturation. However, using different medication for final follicular maturation called leuprolide (GnRH agonist) instead of hCG greatly reduces this risk and can be used as an alternative to IVM.
Intracystoplasmic Sperm Injection (ICSI) may be required when the male has very low numbers of motile sperm and/or abnormally shaped sperm, or when there are problems with the sperm penetrating the egg. Problems with sperm penetration may be due to a toughening or thickening of the outer shell (zona pellucida) of the egg. ICSI also can be effective when there are antisperm antibodies in the semen (products of the immune system which may otherwise attack and destroy sperm before it can reach the egg), or when previous attempts at fertilization using IVF techniques were unsuccessful. ICSI may also be used when an infertility cycle relies on a limited number of sperm, including frozen sperm collected prior to cancer treatment, or those obtained from the male’s tissue using microsurgical techniques. Semen analysis and prior history will help us determine whether ICSI is necessary. However, recently the technology of single sperm injection has applied to almost all patients undergoing IVF treatment.
While ICSI provides substantial benefit, there are some risks associated, such as damage to the egg during the injection process. In addition, some evidence suggests that males with semen deficiencies may have a higher frequency of chromosomal abnormalities, which could possibly be passed on to their male offspring.
Assisted hatching (AHA) is a procedure in which the zona pellucida (outer covering) of the embryo is partially opened, usually by application of an acid or laser, to facilitate embryo implantation and pregnancy.
Preimplantation Genetic Testing (PGT) helps identify embryos that have recognizable chromosomal abnormalities prior to transfer to the uterus. PGT can be used for patients of all ages who have unexplained fertility, severe male factor, advanced maternal age and several failed IVF cycles with poor quality embryos. This procedure benefits families who have a known history of certain genetic abnormalities.
On the fifth day of embryo development, a single cell is taken from an embryo through an opening made in the shell of the embryo through assisted hatching. The DNA from that single cell is then analyzed for any chromosomal abnormalities. The analysis usually takes 48-72 hours to complete. The embryologist will determine which embryos are to be transferred based upon the results of the analysis.
Elective single-embryo transfer (eSET) is when a woman undergoing IVF chooses to have a single embryo transferred when multiple embryos are available.