TRUE STORY: Here's what happens behind the scenes at an IVF centre

PHOTOGRAPH: Singapore Health

Some describe it as “the best job in the world” because very often, there is real cause for celebration at work. This is because embryo-sitters, as Ms Melinda Chan likes to describe her job, “babysit” embryos that they have fertilised scientifically in a petri dish. 

Ms Chan is Chief Embryologist, KKIVF (KK In Vitro Fertilisation) Centre, Department of Reproductive Medicine, KK Women’s and Children’s Hospital (KKH). 

She has worked at KKH for 14 years and currently leads a team of embryologists who oversee the entire culture of embryos at the hospital. 

Her day starts early. Embryologists are usually in by 7.30am to get equipment ready for procedures. An hour later, doctors arrive to surgically extract eggs from patients. 

These are transferred to the embryologists in the in vitro fertilisation (IVF)laboratory and must be kept at a constant temperature of 37°C at all times. 

At this stage, the eggs are microscopic and cannot be seen with the naked eye, so everything is done with microscopes. 

 

Read more: REVIEW: 10 best hawker and kopitiam stalls for a cheap and good local breakfast in Singapore

 

“We scan for the eggs and transfer them to a dish containing a solution of nutrients suitable for growth. They are then left to rest and kept warm in the incubator,” said Ms Chan. 

The embryologist uses either IVF or intra-cytoplasmic sperm injection (ICSI) to fertilise the eggs in a petri dish. 

IVF is a process where sperm and eggs are placed in a dish and left to let fertilisation take place naturally. ICSI is a process where a single sperm is injected directly into an egg. The fertilised eggs will be left to grow in the laboratory. A doctor will implant selected embryos into the patient a few days later.

On handling the all-important fusion, Ms Chan said: “Even though a sperm is injected directly into an egg, it doesn’t guarantee fertilisation. Nature plays a big role in whether the egg accepts the sperm. It happens instinctively. After working here for so long, we know it’s really not within our control. It’s a combination of a lot of events taking place.” 

She said not all IVF cycles result in pregnancies, and the IVF success rate worldwide is about 40 per cent. 

“No one can exactly pinpoint what went wrong. Implantation is also a big question mark. The patient may receive the best looking embryos but may not get pregnant. This is because not all embryos that look good will develop into babies. At the same time, factors in the uterus may affect implantation.” 

Ms Chan is one of 10 embryologists at KKH and among the 50 or so in Singapore. KKIVF Centre, the largest fertility centre here, offers a wide range of testing, diagnostic and treatment procedures. 

KKH was also where Asia’s first IVF baby was born in 1983. 

 

Read more: Is someone watching you on your webcam?

 

Ms Chan came into the field of Embryology with prior experience in cell culture, which “proved useful”. 

She has a degree in Biological Science – a requirement for anyone considering the field (there is currently no degree course in Embryology). 

Ms Chan later went on to complete her postgraduate studies in Clinical Embryology overseas. Embryologists also undergo stringent on-the-job training for at least two years, where everything needs to be very precise. 

“My boss always jokes that embryologists need to be a little ‘obsessive-compulsive’ because we always have to check and re-check. Going the extra mile – doing checks – is part and parcel of our job.” 

Ms Chan likes what she does, and finds it rewarding. 

Married to a radiographer, with three children herself, she knows all too well the joys of parenthood. 

“The ultimate thing for us is to help couples who have had challenges conceiving, take one step closer to having a child. We’re so happy when they get pregnant. It’s always a thrill to check for pregnancy updates. It is a constant motivation for us, and when couples fail a cycle, we look back to see how we can help them the next time.” 

Apart from their lab work, embryologists are not directly in touch with patients during the rest of their pregnancy journey, so they are always thrilled when patients return later with their babies or children to visit them. 

“It reminds us of the purpose of our work and why we are here,” Ms Chan said.

All information in this article is accurate as of November 2016, originally published in Singapore Health. Get all the latest updates on healthcare in Singapore at www.singhealth.com.sg.