The success of an IVF treatment depends on numerous factors. The patients and the causes of their infertility, the hormone stimulation regimen, culture media, quality and maintenance of equipment and skills of staff are all factors that will influence the outcome. One important factor that can have a detrimental impact on the IVF treatment outcome, but is sometimes overlooked, is the quality of the plastic equipment.
What prevents results from going from good to excellent?
Since the 1980s and 90s the IVF community has succeeded in improving the quality of the IVF-treatment and the number of patients who can bring a baby home is steadily increasing. Still, many clinics encounter difficulties when trying to increase their success rate that extra step from average good to excellent. Despite great efforts such as certification of lab and embryologists and investments in new technology, the implantation rate remains very much the same. One reason for this may well be that there is one or several suboptimal utensils used in the lab.
Suboptimal plastics can have big impact on results
I recall one particular incident from when I worked in the IVF lab myself. To save time during busy weeks we started to aliquot sperm prep medium into test tubes in advance, to be used during the following week. All went well during the first days, but by the end of the week, fertilisation rates decreased. The same thing happened the following week, normal fertilisation rates in the beginning of the week, but decreasing towards the end. We subsequently sent the test tubes for mouse embryo assay to an external laboratory and yes, they were toxic. But dishes or tubes are not necessarily very toxic, sometimes they are just suboptimal, which can be very difficult to detect.
Not properly tested plastics can result in reprotoxicity
The fact that suboptimal or even toxic contact materials are not uncommon in the IVF lab was demonstrated in a study by M Nijs et al1. In this extensive prospective study sperm survival assays were used to test all items used in the lab during 4 years. 13 out of 36 (36.1%) items were found to be reprotoxic.
Today, mouse embryo tested culture dishes and test tubes are available. As embryologists, we should ask how the mouse embryo assay has been performed. Is the assay developed and appropriate for IVF purposes? Read more about how we perform assays.
IVF-certified plastics – what does it mean?
The IVF certification means that all utensils have been appropriately mouse embryo tested and regulatory approved for contact with human gametes and embryos thus are non-toxic and safe. It also means that the test tubes can be used for media and oil aliquoting, without the risk of toxic molecules from the plastic entering the medium or oil.
The solution - use only IVF certified plastics
Every IVF clinic wants the best for their patients, but results will never reach the top levels that we strive for with the use of suboptimal items. Worth considering is also the fact that the effects of suboptimal utensils are cumulative; the negative impact will increase if more than one toxic item is used.
Today it is no longer difficult to find mouse embryo tested labware developed and certified for IVF and in fact, within the European Union, such products must be used if available.
Download white paper and learn more about plastics and their role in IVF
My colleague Göran Mellbin has written a white paper where he gives a comprehensive overview of different types of plastics, how they are made and used in IVF and what to think about to secure that you use safe plastics in your IVF lab.
- Nijs et al. Reprotoxicity of intrauterine insemination and in vitro fertilization-embryo transfer disposables and products: a 4-year survey. Fertil & Steril 92(2), 2009.
Written by Dr. Ann-Helene Jakobsson
Ann-Helene has a PhD in Genetics and started her career in IVF as Lab Manager at the private clinic Fertilitetscentrum in Sweden. Ann-Helene is a popular lecturer at Vitrolife workshops where she makes complicated matters easy to understand.