Making babies – the role of the embryologist

IVF treatment involves a team of doctors, embryologists, nurses and support staff. The advice and expertise of an embryologist makes a vital contribution to a patient’s treatment and experience.

Lucy Pullan is a trainee embryologist and has been working at Bourn Hall for four years. Her role includes egg collection, fertilisation assessment, embryo grading and transfer, semen analysis and providing feedback to the patients about their progress.

After her degree in human biology at Bristol Lucy worked in the histology department at Southend Hospital. She enjoyed the lab work there but wanted to have more patient contact – and now she has a job that she loves at Bourn Hall Norwich.

I love being a trainee embryologist

Reproductive science was one of the modules I had enjoyed during my degree, but it is quite a competitive field to get into. I was going to study a masters and went to the Bourn Hall Cambridge clinic for work experience. While I was there a job came up in the Norwich clinic as a practitioner, which gave me the practical skills of working in an embryology lab. Then Bourn Hall offered to train me to become a clinical embryologist, which was amazing timing. I relocated to Norwich and I love it up here.

I am a trainee while I am on my course, so a lot of my time is spent studying and training. I am allowed to do more of the lab aspect such as egg collections, semen analysis scoring of embryos and embryo transfers and freezing.

I don’t do ICSI yet (where the sperm is injected into an egg) but that is something which I will hopefully learn next year; you do have to be a bit more experienced for that.

One of my favourite parts of the work is going into theatre and telling the patient about their embryos. Face-to-face contact with the patient is limited but communication with patients both over the phone and through email is increasing, and it is really important to them.

Sometimes there is just one embryo available, but if there are several there may a discussion to be had: will one embryo or two embryos be transferred? Are any of the embryos suitable for freezing? We give the patients and the doctor as much information as possible, so everyone can be involved in the decision.

Even embryos with a poor grade can become healthy babies, but if there is a choice, we want to pick the one most likely to succeed.

Sometimes we have a treatment cycle where the eggs fail to fertilise or the embryos have developed poorly – that might be an indicator as to why they haven’t been getting pregnant. You can learn a lot from a failed cycle, and we would make a note on the patient records, which the doctors can then use to improve the chances of success on a second cycle.

Research into surgical sperm retrieval

Dr Thanos has submitted a number of papers to the ACE conference and I am going to do a project as part of my training, so we may try and get that published.

For my project I am going to compare the outcomes between patients that have had surgical sperm retrievals (SSR) after a zero sperm count, known as azoospermia. This can occur when there is an obstruction in the tube, perhaps after a vasectomy reversal or because they are a carrier of the cystic fibrosis gene and don’t have a vas deferens. Or it can be non-obstructive, where there is something going on in the testicle. I am going to compare the two groups and look at the ICSI outcomes after using the sperm. Mr Oliver Wiseman, the andrologist and male fertility specialist at Bourn Hall, has been collecting data over the last ten years, which is great; it is a big dataset and that makes it more robust.

Being part of the Bourn Hall family

I love my job. I came into it for the patients and although for us it is our day-to-day, for them it is a huge thing and can be a difficult and emotional experience. I always try to really remember how daunting this can be for the patient and how I would feel if that was me getting advice on my embryos.

Pre-Covid some patients would bring their babies in which was special. We don’t get that at the moment sadly, but patients do send in thank you cards and pictures, and we pin them all on a baby board in our team room which is really lovely.