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Optimising embryo biopsy using a laser

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Presentation given by Maxine Semple, Senior Embryologist HPC, Biopsy Practitioner, Guy's and St Thomas' Hospital, ACU titled Optimising embryo biopsy using a laser. Comparison of methods

Presentation given by Maxine Semple, Senior Embryologist HPC, Biopsy Practitioner, Guy's and St Thomas' Hospital, ACU titled Optimising embryo biopsy using a laser. Comparison of methods

Published in: Technology, Business
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  • 1. Optimising Embryo Biopsy using the Saturn 5 Laser System Ms Max Semple Senior Embryologist HPC, Biopsy Practitioner Guy’s & St. Thomas Hospital, ACU
  • 2. Current Practice • D3 biopsy (cleavage stages): Acid Biopsy/ Laser • D5/6 biopsy (Blastocysts): Laser • Predominately the practioners are acid users, but training in laser now
  • 3. Video of Acid D3 Biopsy
  • 4. Video of laser D3 Biopsy
  • 5. Big Brother Watching Embryoscope is used for ALL PGD cases. “Time lapse system can monitor any effects (if any) on embryos biopsied via Laser or acid and practioners”
  • 6. Advances in PGD programme • Guy’s shifting towards TE Bx • Laser replacing acid tyrodes • Invested in the new Saturn 5 laser system • Hands free, programmable system
  • 7. RI Saturn (3) laser system • Manual calibration and alignment challenging • Move embryo into target position physically • Laser using single shots via mouse/foot pedal • Difficult to keep steady
  • 8. • Calibration is quicker and simpler • Automatic alignment using PC (simple user-friendly programme) • Move the target into position for biopsy • Mouse delivers pulse • Multiple functions for biopsy – Single, multiple or biopsy mode • Easier to manipulate embryo RI Saturn (5) laser system
  • 9. Video of Laser D5 Biopsy
  • 10. Comparing laser with acid Effect on embryo/biopsy Acid tyrodes Laser Culture media use More Less Microneedle use More Less Microtool holder Double optimal Single sufficient Biopsy duration Longer Shorter Chemical damage Acid/pH effects None Thermal damage None Precautions to minimise the effect Precision Calibration and QC Low Difficult High Simple
  • 11. Embryo Biopsy by Laser D5 Biopsy (Trophectoderm) D3 Biopsy Laser Ablation Hatching BC D3 Cleavage TE Bx BC Hatched BC Post TE Bx Hatching BC Hatched BC Single Cell Bx
  • 12. QC • Trophectoderm cells can be thermally damaged and may not provide results (DNA damage). • Laser is powerful and potentially embryo lethal. Proper training and competency assessments need to be in place (Guy’s data) • Calibration and preventative maintenance • EQAS – individual practitioners to send ‘typical’ biopsy videos for external assessment. • Time-lapse analysis of all PGD cases to monitor any effects of biopsy (ongoing)
  • 13. Cost of Change • Laser is a significant financial investment • Previously centres use to make their own acid, now commercially available • PGD consortium data (shift from acid to laser) • Long term picture – cost of laser offset against – Reduced procedure times – Reduced consumable costs – Improved outcomes?

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