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Poor quality embryos in an IVF treatment cycle

Posted Jul 13 2012 10:57pm
Colocação do espermatozóide na micropipeta pel...
When the quality of embryos in an IVF cycle is poor, the patient is understandably upset and wants an explanation. A good embryologist will sit down and try to explain to the patient what the various causes for poor embryo morphology are. However, a lot of doctors will try to pull a fast one by telling the patient an untruth.

One of the commonest reasons doctors trot out for poor quality embryos is poor sperm quality. They tell the patient - it's because your husband sperm morphology was abnormal ; or because his sperm DNA fragmentation levels were very high, that your embryos are of poor quality.

Actually this is not true. Remember that the reason we are doing ICSI in the first place is because the husband has poor sperm morphology ! Once the sperm is injected inside the egg, it then has a very limited role to play in embryo development, no matter what it's DNA fragmentation level is , or how abnormal it looks.

In reality, the commonest reason for poor embryo quality is poor lab conditions. Running an IVF lab is a complicated exercise , which requires full-time expertise; close monitoring of the equipment; and the use of quality controlled  culture media and high quality plastic disposables. Unfortunately, a number of IVF clinics will cut corners when providing IVF treatment. Thus, they may not use good-quality medium;  or their incubators may shut down because of electricity failure ; or they may not have full-time embryologists , to make sure that quality control is being maintained. If strict attention is not paid to quality control. It's very likely that the embryos will be unhappy in the IVF lab , and will therefore start fragmenting.

When this happens , rather than tell the patient the truth , the doctor is very likely to come up with all sorts of excuses and pretexts. It's very easy to blame abnormal sperm for abnormal embryos , and in fact this makes logical sense to the patient , who is willing to accept this explanation. However, this is not true , as can be proven by the fact that if you repeat the ICSI cycle in a better IVF clinic , you are much more likely to end up with good-looking embryos.

If your embryos are of poor quality, it’s a good idea to ask the embryologist to show you the embryos of the other patients, who are being treated at the same time. If all the embryos are of poor quality, this clearly points to a lab problem, rather than a problem with you or your husband !

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