Embryologists are a special breed of scientist
As a fertility patient, you probably won’t get to meet your embryologist these days... but be assured that the scientists working in the lab are looking after your embryos as if they were their own. They’re following your journey and they want your success almost as much as you do!
On any day in an embryology lab, the embryologists are freezing embryos, thawing embryos, preparing for egg collections, reviewing paperwork, doing egg collections, inseminating eggs (ICSI or IVF), preparing sperm, checking for fertilisation, checking for cell division and embryo growth and development, scoring, classifying and grading your embryos, choosing embryos for transfer, for freezing/vitrification...
If you think about a lab that is doing 10-20 egg collections each day... that's a LOT to keep track of!! It might be day 'minus one' for 10 patients (so you're preparing everything for them), day one for another 12 - so that's 12 lots of eggs and sperm and inseminations, day 2 for another 10 - so 10 x fertilisation checks. Day 3, day 4 and day 5 for another 30 patients - if each of them has 5 embryos to check - that's 150 embryos to check and grade and maybe choose for transfer/freezing... then add in a few FETs (Frozen Embryo Transfers) - the lab is a busy place to be!
When I was first employed as an embryologist, I was required to do a Personality Profile test. This was an 8 hour experience involving multiple written tests, IQ tests, EQ tests and interviews. I later learned that a good embryologist has a very specific personality profile and due to the expense of training embryologists, my employer needed to be sure that I fit into the right category before they invested in my training.
I am lead to believe that most people in society, naturally try to cover up their mistakes... the very first before-you've-really-thought-about-it-reponse is in most cases 'Oh crap, how can I make this better before anyone knows what happened'.. and that's really normal and totally ok .... but for an embryologist, that is unacceptable. We are custodians, protectors of your very precious eggs, sperm and embryos, of your possible future... mistakes are not an option. We are human though... so mistakes are inevitable but our first response to any possible problem absolutely HAS to be 'Quick, help me, something's not right here'
It can happen that as you are looking down the microscope into a dish expecting to find 4 eggs in that dish ready to be denuded for ICSI... but you can only see 3... after a quick check of the notes to make sure that there should be 4, the very next step for an embryologist is to call a colleague to have a look.. and when the 4th egg is found, there is absolutely Never a case of 'well, you should have looked harder' it is ALWAYS - great we found the egg!.. and everyone moves on... to me, this is true Team Work.. working together, supporting each other and knowing that the next day, the shoe could be on the other foot.
I sat in a lecture at a SIRT (Scientists in Reproductive Technology) meeting many many years ago in Christchurch New Zealand - I'm thinking it was probably 2004 or 5 or thereabouts... and listened to someone who really resonated with me - an anthropologist who was really interested in the culture of embryologists - who are we - how do we think - what makes us do what we do...
I have been waiting for years to find her work published.. and today, I finally did!
(click here to read the full article titled: When Biological Scientists become health-care workers: emotional labour in embryology)
She investigated what really makes Embryologists 'tick' and how much emotional energy goes into the work of an embryologist.
She commented a lot about how embryologists manage their need for perfection, how it impacts our work, our lives, our mental load and our relationships, both within the workplace and in our private lives. She says:
Mistakes with such irreplaceable material were simply not an option and any embryologist would consider that to make two errors in an entire career would mean no longer being able to ethically justify one's capacity to practise. Technical competency is thus a taken-for-granted aspect of this work and one that approximates perfection
She talks also about the need to be able to rely completely on your co-workers and trust them like you would trust yourself.
One scientist might denude an oocyte before storing it, another might perform ICSI on it, while a third monitored its developmental milestones over the weekend prior to possible replacement. Since the measure of success, a pregnancy, relied equally on everyone's labours, it was thus in everyone's interests to ensure the team worked well
As a bit of an aside... Rather interestingly, this is not what is often referred to in job advertisements as "team work"... a quality that is apparently required and very much appreciated in the management or corporate world. I have always referred to embryology team work as single-disciplinary team work ie everyone on the team has a very similar skill set and we are all working together towards the common goal.. as opposed to multi-disciplinary team work where people bring different skill sets to the game and work together, inputting their own various skills, towards a common goal.
In my experience, true single-disciplinary team work is not really of benefit anywhere other than in the lab (there must be other places, but I've not worked in them)... in the management and corporate world people are expected to persist, to push their own agenda and to hide their mistakes in an effort to be considered 'the best' and to get the next promotion. People pay a lot of lip-service to the concept of team work, but actually, if you ask for help or collaboration from people who deem themselves your peers - you can be perceived as somehow weaker or less able - because you couldn't do it yourself.
This is something I have struggled with a lot since leaving the lab. I am always the first to say - 'hey, I am having trouble with this', or 'I'm doing this task at the moment - does anyone have anything extra to input?'.. and that has sometimes been perceived by managers as me not knowing my job, or not persisting with tasks... or being lazy and expecting others to do my job... when actually it is my training and my experience of working within what I consider to be true supportive teams, my desire to have input from others who may have a different point of view and together we might reach the common goal sooner and with a better product.
Never in my time in clinical embryology labs did I ever feel that there was any one person who felt themselves to be better or 'higher' than any others, some had more training (embryo biopsy for example), or perhaps more responsibility (team leaders and managers) some had PhDs, some didn't... it never made any difference.. we all did all of the jobs that needed to be done, and we all helped each other. Once I moved away from clinical lab work and into management and education, I never again experienced the level of teamwork and the lack of hierarchy that I had experienced when I was in the embryology lab. We may not have all been friends, and had we met in other circumstances, may not have had much in common.. but the respect and appreciation for the skills and work ethic were very real. The connections that I made with fellow embryologists during my clinical time is strong and forever (even now that we find ourselves in all corners of the globe!)
I feel like embryologists need to protect and preserve this style of team work and this lovely culture against an ever growing tide of corporate style management within the field of IVF. IVF clinic managers used to be embryologists or fertility specialists - these days they're accountants and business managers who seem to have little regard for much other than the 'bottom line'... but I digress....
The article goes on to talk about delivering good news without false hope, bad news with a positive spin and providing empathetic support to patients.
It's not enough for the embryologists to be well trained and of a certain personality type - all of the equipment and consumables (dishes, tubes, pens, incubators, hand-wash, benches, microscopes, culture media, lights, warming stages.. the list goes on and on) must be working P E R F E C T L Y and exactly as they should. The responsibility for all of this lies with the embryologists, the ones using the products and equipment on a daily basis.
excellent scientific standards of quality assurance must underpin all uses of reagents, laboratory equipment and procedure protocols. It was this additional area of responsibility that created a similar care systems and process as for people, oocytes and embryos.
Anything that is required to be at a certain temperature or pH is measured and logged every day (and often multiple times throughout the day). Equipment that is to come into direct contact with gametes (sperm, eggs and embryos) is purchased from companies that run strict quality control and assurance programs (dishes, tubes, catheters, pipettes). Batch numbers are recorded for each and every item and at each and every procedure... (but there's another post coming soon about What is 'safe' in an embryology lab - you'll be very surprised by what's on the list! not to mention what's not!).
And finally there are the observational skills and the fine motor skills of an embryologist - if you need a needle threaded - ask an embryologist!!
Embryologists are manipulating things way smaller than the human eye can see. Sure we do it down a microscope... but it's still our fingers and hands and our movements that are controlling the pipettes that are holding your gametes.
In addition, the physical dexterity and mental alertness, which the practice of embryology demanded, required that all possible hindrances to physical performance were removed. For this reason there was a strong need to care for the self, an unusual and healthy exception to the neglect of self that can be typical of so many other health-care workers
Have you ever met or chatted to an embryologist? Are you at a clinic where you get to talk to your embryologist?
You might meet one amongst the *what seems like 400* people who check your name band on the way into theatre for your egg collection... you might get a very brief chat with one just before your embryo transfer.
But you never *Really* get a chance to talk to them do you??
