I have poor survival

Poor survival of vitrified cells can be the result of several things. Like all issues in the IVF lab, one has to troubleshoot in a calm controlled manner.

First off, there are over 35 clinics successfully using the ICE Vitrification system/media so we are confidant that there is nothing wrong with the media/system, and the problem lies elsewhere. Dealing with past issues has led us to realize that the main problems lie with either not following the protocol or poor embryo/egg quality to begin with. Keep in mind that the ICE Vitrification system is very different than other vitrification systems, and different rules may apply.

Poor egg/embryo quality can come from a variety of means. These include stimulation protocols, patient demomgraphics, embryo culture, etc. Although some patient's cells may not freeze well, this is not usually the case. Even though your fresh embryos do very well, they could be right on the edge of doing well, and stressing them by vitrification will be enough to result in poor survival and/or pregnancy rates.

The most common problems arise from not following or understanding the protocol. This is not so easy, as people often do not realize that they are not following the protocol.

For example, during the vitrification process embryos are placed in vitrification solutions at room temperature. The dishes with the cells are placed in the hood which has a metal base. The temperature in the lab is 23C, standard room temperasture. However, the temperature of the metal hood surface, where the dish is on, is cooler, a chilly 19C. The metal surface acts like a heat sink and is cool to the touch, much cooler than room temperature. Due to the reduced temperature at the level of the cells, they do not dehydrate enough and load with cryoprotectants during the incubation time in the protocol, so that after vitrification and warming many of the cells die, most likely from intracellular ice formation. Even though the technician thought they followed the protocol, they did not.

This is but one example of what can go wrong. Another common problem is from faulty heat sealing of the cryo-straws. See "Help, my straws are exploding" for more details. The protocols are revised from time to time to address these potential problems. However, it is mandatory that the operator understands and follows the protocols, to ensure the best results. Please contact us with any and all questions you may have about anything in the protocols. There are specific reasons for everything in the protocol. If you don't understand something we can help. A complete understanding of the protocol is the first step to obtaining great results.