To honor World Embryology Day, we talked with Erica Paganetti, Senior Embryologist and Embryology Lab Manager for Reproductive Medicine Associates of Connecticut. Erica shares what a Day in the Life of an Embryologist is all about and why she chose this important line of work. Help us celebrate the scientists who bring life into the world.
Why did you become an embryologist? I have been an embryologist since June 19, 2006. As with most embryologists, it was a happy accident. Following graduation with my BS, I was looking for a laboratory position while I worked on applying to medical school. I thought the job sounded cool and rewarding, especially with the knowledge that my aunt had struggled with fertility issues in the past. Fortunately for me, I was extremely lucky to be hired as a junior embryologist by my first laboratory director. She must have seen something special in me and I thank her every day for giving me such an amazing opportunity. I fell in love with the job and never looked back.
Where did you study and for how many years? I originally studied biology and chemistry at Springfield College in MA. Funny enough, I originally went to school for physical therapy. But I decided to make a change junior year with the intention of attending medical school. In between graduation with my BS in Biology and applying to medical school, I was lucky enough to get my first embryology position. Since becoming an embryologist, I have obtained my MS in Reproductive Clinical Science from Eastern Virginia Medical School, and I am now working toward my PhD at the same institution.
As far as embryology skills are concerned, you can only learn to become an embryologist through on-the-job training. It takes many years of observation, training, and practice to develop into a fully trained embryologist. Even after 14 years, I am still learning new tips and tricks to perfect my own skills.
What does a typical day look like for you? Our day starts out by checking all equipment for appropriate performance: incubators, microscopes, refrigerators, freezers, etc. Once everything has been checked, calibrated, and determine safe for use, we are able to begin embryo assessments.
In the morning, we evaluate embryos for fertilization, cleavage, eligibility for transfer and/or cryopreservation, etc. Following embryo grading, additional morning procedures begin such as vaginal oocyte retrieval (VOR), semen preparation, embryo thawing, biopsy, embryo cryopreservation, and oocyte assessment.
As we approach the afternoon, we prepare for embryo transfers and insemination procedures. The oocytes we collected during VOR in the morning, now need to be fertilized. This can occur through conventional insemination, where we add a small amount of sperm to drops containing oocytes which allows for interaction between the gametes and hopefully fertilization. The other method is intracytoplasmic sperm injection (ICSI), where we inject one sperm into one egg individually with the same hope of fertilization. Embryo transfers are also taking place simultaneously, in which we place the embryo(s) back into the uterus for implantation. Sprinkled into this afternoon workload is additional biopsy and cryopreservation of embryos, oocyte cryopreservation, and culture dish preparation for patients coming up the following day.
I know it sounds like a lot to accomplish in one day. But we have a wonderful team of embryologists each day that shares these responsibilities, with specific assignments to keep the workflow moving efficiently. After many years of doing this, it becomes second nature. I am sure many of my colleagues would say the same thing, but I can feel when it is time for something to happen. Our work consumes us because we all know it is beyond important. We double-check, triple-check, and quadruple-check everything throughout the day, and then do a final check once everything is done.
What is your favorite part of your job? Over the past 14 years I have come to love every aspect of our job. I truly enjoy the benchwork, with my absolute favorite procedures being cryopreservation and embryo transfer. But as I have progressed in my career, and had a family of my own, this has evolved into a more emotional answer. I have had the amazing opportunity to help my very own friends build their families. This means I am now able to meet these amazing little babies and watch them grow up before my very eyes. I cannot describe how wonderful this is, and for this reason, I am truly honored to be an embryologist. All jobs are important, but mine feels truly special.
What are some of the biggest changes to the world of IVF in your career? The world of IVF is one of the fastest paced areas in medicine. Changes are constant, with more and more technical advances being incorporated into treatment every year.
But I must say the evolution of preimplantation genetic testing (PGT) has significantly impacted our jobs as embryologists. When I was a brand-new embryologist in 2006, we only performed biopsy on about 1-2 patients per month. It was all hands-on deck. Every embryologist came in at 4:00-5:00am to prepare and assist in this special procedure. Now ~70% of our patients utilize this technology during their cycles, and the process has become very routine.
Cryopreservation has also changed immensely, making a huge impact for our patients. Slow freezing was used in the past and often took hours to complete per patient, with reasonable survival rates and clinical outcomes. The addition of vitrification has reduced the time to ~15-30min per patient (depending on the number of embryos) and provided excellent survival rates with the potential for better clinical outcomes in a frozen embryo transfer cycle.
How do you reassure patients that their eggs, sperm, or embryos are safely stored? (safety of the lab).Every IVF laboratory has very strict equipment monitoring protocols. We spend hours each day measuring our equipment to confirm that each device is safe for use. In addition to physical monitoring by staff, alarm systems are used to continuously monitor equipment 24hrs per day, 7 days per week. These alarm systems call, text, and e-mail staff members if any piece of equipment is out of range: cryo tanks, incubators, refrigerators/freezers, etc. When this happens, staff immediately performs a physical check to determine if there is an issue. Any equipment of concern is removed from use until service is performed to fix the problem.