By: Brian LoManto, M. Sc. Logistics Director/Laboratory Manager
The World Egg Bank (TWEB) has become the only egg bank in the US that controls every aspect of donor egg banking with the construction of our own, new state of the art medical and laboratory facility. TWEB has had successful partnerships throughout the last 11 years with its partner retrieval clinics. Egg quality, survival, and pregnancy rates have consistently improved year after year. In fact, within the last two years’ quality has become so consistent that using vitrified donor oocytes is now entering the mainstream of IVF. With all of these successes, why would anyone in their right mind decide that building a retrieval center is a good idea? The answer to this question is: Quality.
Without consistent quality, oocyte donation via vitrified oocytes is not possible and there are many aspects other than simply vitrifying and warming (these are the technical terms used in the industry) an egg that contribute to the quality of each individual egg. Make no mistake, at TWEB each individual egg is full of potential, of hope. But in order to maximize potential, the process must be consistent, reliable, thoroughly measured and with TWEB’s in house retrieval center, this is exactly what can be achieved.
The process begins with the selection of the donor. Under the control of the administration at TWEB, each donor is vetted to ensure protection for future generations. Next is the determination for the best type of stimulation protocol, a critically important step as not all women will react the same. Through experience, the medical staff at TWEB has honed in on a process for determining what an ideal stimulation regimen may look like for a particular donor. At the disposal of the medical staff is not only the records of the donor in question, but the data from all past cycles of donors with similar characteristics. Having this wealth of data at their fingertips is crucial to selecting a stimulation that will yield a fair amount of eggs while keeping the donor safe and happy. By bringing stimulation regimes in house TWEB is able to make the best use of the data to increase quality.
Once a stimulation regimen is decided, the donor begins her stimulation. She is monitored by ultrasound and blood testing until it is time for her retrieval at TWEB’s new clinical facility. TWEB has one ultrasonographer who measures the follicles and all hormone levels are performed on one analyzer and all of this information is compiled in the TWEB office. Once the cohort of follicles is mature and ready, the donor is triggered and 36 hours later, eggs are retrieved.
At this point the eggs come into the lab. TWEB has completed the process of building and equipping its own embryology laboratory. The equipment is brand new, state of the art, and has been quality controlled to ensure peak performance. Maintaining an embryology laboratory is somewhat akin to keeping your Lamborghini in racing shape. What it needs most is a really good mechanic. Embryologists, while proudly displaying the hat of scientist, also wear the hat of
mechanic. In reality, about 70% of what an embryologist does is “under the hood” maintenance of the laboratory. The best embryologists are more than a bit obsessive about it. While it is difficult to find a bad embryology laboratory, the making of a great embryology laboratory is apparent. By building its own lab, TWEB is able to be obsessive over its quality control environment. From consistent equipment temperatures, to floors you can eat off of, control of the quality environment is now a variable that has been eliminated.
The final aspect when determining what makes a “good egg” is the vitrification and warming process. While all of the other egg banks in existence today are an off shoot of an IVF clinic, TWEB’s egg bank is its own entity. This means that control over the vitrification and warming is in the hands of two people: The Scientific Director and the Laboratory Manager. Also, unlike any other egg bank in the world, TWEB has one embryologist vitrifying every egg that is retrieved. Handling oocytes and vitrifying correctly is a skill that requires repetition and time to hone and perfect. TWEB has had one embryologist vitrifying every egg since July of 2013, literally thousands of eggs over the last three years vitrified by one person.
Warming the eggs that are so meticulously gathered is the keystone to the process. This is not lost on everyone at TWEB. Warming vitrified oocytes, while more common than it was just a year ago, is in no way ubiquitous within our field. Because of this, TWEB developed a unique process that it has been using for over five years. When a recipient purchases eggs from a clinic that has not done so before, TWEB sends one of our specially trained embryologists to their site on the day of that first warming. This verifier reviews TWEB’s protocols and works with the embryologists using practice material sent to the clinic in advance to ensure complete understanding of the process. In this way, TWEB aids clinics in becoming experts in warming eggs. There is no cost to the clinic or to the recipient for this service; TWEB understands that without people at the end of the process who are confident, all of the sweat expended up to this point is meaningless. It is the final linchpin to giving our recipients the best possible chance at the outcome they deserve.
In order to create a process of the highest quality that is repeatable and consistent every time, the best way is to keep the process as tight as possible. TWEB has successfully accomplished this feat by bringing the entire process under its roof and keeping as few cooks in the kitchen as possible. In this way, TWEB is unique in egg banking and has found the perfect recipe to creating a “good egg”.
