optimising embryo biopsy using laser (saturn5) guys
TRANSCRIPT
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Optimising Embryo Biopsy using the Saturn 5 Laser System
Ms Max SempleSenior Embryologist HPC, Biopsy Practitioner
Guy’s & St. Thomas Hospital, ACU
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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
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Video of Acid D3 Biopsy
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Video of laser D3 Biopsy
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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”
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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
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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
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• 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
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Video of Laser D5 Biopsy
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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
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Comparing laser with acidEffect 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
PrecisionCalibration and QC
Low Difficult
HighSimple
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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)
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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?