IVF Embryology, Andrology & Hormone Laboratories
At our center we have several fully accredited laboratories. Our hormone laboratory is CLIA accredited and certified, under the direction of Dr. Edward Ramirez. The IVF Embryology laboratory is CAP accredited and under the direction of Eva Ulehlova, MS, ELD, a highly qualified and experienced embryologist.
The hormone laboratory is responsible for the collection, testing and reporting of blood hormone levels in patients undergoing evaluation and/or treatment. We are able to run all the test necessary for both our gynecology and infertility patients. Our patients have the convenience of never having to go to an outside lab for their testing and results are often within the hour.
Utilizing a Tosoh, state-of-the-art analyzer, the laboratory is able to provide results within a few hours of specimen collection. This ability to have results quickly is an essential aspect in the close monitoring of the patient’s response to treatment so that adjustments to medication can be made if necessary. For instance, if a patient is PCOS, and going through an ovulation induction cycle or IVF, she is closely monitored for her estrogen levels. This is because she is at risk for overstimulation which could cause her to have a life threatening condition called OHSS. In this instance, having her blood drawn in our office and the results back within the hour will allow the doctor to determine if her medications need to be reduced.
Our hormone laboratory is under the supervision of a California licensed medical technologist, is fully licensed as a reference laboratory by the state of California (CLIA) and registered as a Moderate complexity laboratory with the Center for Medicaid and State Operations.
The andrology laboratory performs all the evaluation, testing, preparation and storage of sperm specimens for our patients. Diagnostic procedures include semen analysis, preparation of sperm for fertilization and thawing of frozen specimens. Semen cryopreservation(freezing) and storage is provided to patients with additional partner samples when a fresh specimen is not available and in the near future will be available to preserve sperm for men requiring cancer treatment that might render them sterile. The andrology laboratory is also responsible for preparing semen specimens for intrauterine insemination. The andrology laboratory is licensed by the state of California and the federal government (CLIA) and accredited by the College of American Pathologists (CAP) Reproductive Laboratory Program.
Monterey Bay IVF Embryology Laboratory
Since it’s beginnings in 1999, our laboratory has been fully accredited with zero deficiencies by the Commission on Laboratory Accreditation of the College of American Pathologists (CAP), based on the results of on-site inspections. We also maintain a California Tissue Bank License. Since 2008, our laboratory is housed on the first floor of our new facility, within our surgery center. Under the direction of Eva Ulehlova, MS, ELD the IVF laboratory is a central and crucial part of our program. The laboratory is located adjacent to our egg retrieval and embryo transfer rooms. It is equipped with the most state-of-the-art equipment to aid in the processing of patient’s gametes and embryos. Because of day-to-day variations and contamination, the room has continuous Hepa filtration, room conditions are precisely regulated and strict sterile techniques are applied. Ms. Ulehlova is compulsive in her maintenance of our Embryology lab quality control.
The embryology laboratory provides extensive services related to the collection, handling, preparation, culture and storage of human gametes (sperm and eggs). Due to the sensitive nature of its’ duties, the embryology laboratory is located in a secure and sterile area away from the rest of the clinic facilities but in close proximity to the procedure room where the eggs are collected. The laboratory is responsible for identifying oocytes (eggs) in ovarian fluid, culturing these eggs with the partner’s sperm, and observing embryo development prior to embryo replacement into the patient. Our lab operates under strict protocols established by our Laboratory Director, Eva Ulehlova. As such, not only are careful and precise techniques used to handle and process the eggs and embryos, but strict patient identification of all specimens is maintained, repeatedly verified and insured. We maintain the highest quality control standards and have been awarded Accreditation with Distinction from the College of American Pathologists, the premier laboratory accrediting organization in the United States.
Maintenance of Identity in our Embryology Laboratory
- Identification & Maintenance for Gametes & Embryos
This is the prescription document that identifies the patient’s name, ID number and patient color code, patient containment tray and procedure witnessing. The Procedure Requisition is the prescription document that identifies the couples’ name, ID number and the course of treatment the couple has agreed upon with Dr. Ramirez.
- Laboratory Paperwork and Preparation
From the Procedure Requisition, the laboratory prepares the paperwork and culture ware to be used in the case. The culture ware is labeled with the last name, ID number and a unique color for the labeling of all culture ware assigned to each patient by the embryologist. Labeled culture ware, along with eggs and embryos contained therein are then placed into a labeled Patient Containment Tray (PCT), which is placed in a selected incubator for the duration of treatment. Only one patient is placed in a given PCT. The accompanying paperwork is displayed on the outside of the selected incubator. The paperwork, including the Procedure Requisition, confirms the name, ID number and color code to be found on the culture ware. Moreover, the paperwork contains a map of the exact location of each egg and embryo in each culture dish.
- Procedure Witnessing
An accompanying embryologist or nurse witnesses all critical steps in the IVF process. These steps are: egg retrieval, insemination or ICSI and embryo transfer. To verify the fidelity of semen specimen collection, nursing checks the ID of the male patient providing the specimen and requests that the male patient verify his name and ID number along with that of his partner by checking the information on the label of the sample cup and signing in the designated space. The identity of the female patient is verified and witnessed at egg retrieval by the attending embryologist by personal introduction and visually by checking the wrist ID bracelet. In the laboratory, the witnessing embryologist reviews the associated paperwork and the culture ware prior to the execution of the procedure in progress. Finally, at the time of the embryo transfer, the embryologist performing the transfer will announce the patient’s name and the number of embryos to be transferred, when he/she enters the room. This announcement will be confirmed by Dr. Ramirez and often by the patient. We take maintaining sample identity very seriously.