PROGRAMME
Clinical Embryologist Course
Course for clinical embryologist offered by the Latin American Network of Assisted Reproduction
Objectives:
I – Update the theoretical formation of the clinical embryologists of the RED or other interested professionals in this area.
II – Discuss, update and interchange practical information.
I. Female Gametes
a. Anatomy of the female reproductive function
b. Oogenesis
Basic Endocrinology of the oogenesis
Principles of Meiosis (arrest and release of meiosis)
Growth and development of human oocytes
Follicular development
c. Functional Marking: biochemistry, genetic and molecular
d. Collection, identification and preparation of oocytes for IVF/ICSI
e. Culture and oocyte maturation
f. External factors that may affect the oocyte quality
g. Normal oocyte features
h. Endocrinologycal repercussions in the ovarian working alterations
i. Ovarian patology
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II. Male Gametes
a. Anatomy of the male reproductive function
b. Spermatogenesis
Basic endocrinology of the spermatogenesis
Principles of meiosis
Growth and development of human spermatozoa
c. Semen composition
Biochemistry and physiology of the semen
d. Semen laboratory assessment
Semen collection
Instruments for the semen assessment
Counting chambers
Electronic gadget
Macroscopic measures
Sperm motility
Sperm concentration
Sperm morphology
- Classical criteria
- Kruger strict criteria
e. Additional studies for male factor evaluation
Detection of sperm antibodies
Hypo-osmotic swelling test (HOS)
Sperm recovery test
Sperm survival test
Chromatine test
Acrossomal test
Sperm-culture, determination of Chlamydia and Mycoplasma
f. Standard normal semen according to WHO
g. Semen preparation:
Basic techniques for sperm recuperation
- Standard swim-up or layering
- Density gradients
Spermatozoa from ejaculate
Retrogade ejaculation and electroejaculation
Epididymal sperm
Testicular sperm
Immature spermatozoa
Semen for IUI/IVF/ICSI
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III. Fertilization, zygote formation and embryonary development.
III.1. Fertilization:
a. Sperm-oocyte interaction
b. Spermatozoa activation
c. Oocyte activation
d. Cortical reaction
e. Fusion
III.2. Zygote formation
f. Pronucleous formation
h. Syngamy
III.3. Embryonic development and implantation
i. First stage of the development
j. Zygote genome activation
k. Imprinting
l. Compaction
m. Blastocyst formation
n. Embryo implantation
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IV. Clinical aspects of the reproductive function and infertility
IV.1. Female reproductive function
a. Infertile woman investigation
- General examination
- Infertility signs
- Normal ovulation outline
- Ovulation evaluation
- Ultrasonografic evaluation
- Endocrinological evaluation
b. Non-ovulatory infertility
- Diagnosis
- Causes
- Regimen of ovarian stimulation
c. Protocols of ovarian stimulation for artificial insemination
In vitro fertilization and ICSI
IV.2. Male reproductive function
a. Infertile man investigation
- General examination
- Infertility signs
- Normal semen parameter (According to WHO)
- Sperm analysis interpretation
- Sperm patology
- Endocrinological evaluation
- Endocrinological repercussions of the male gametogenesis alterations
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I
I. Assisted Reproduction Laboratory Organization
a. Basic equipment
Incubators
Filters in the laboratory
Flow hoods
Centrifuges
Osmometers
Freezing machine
Liquid Nitrogen storage Dewars
Microscopes
Micromanipulators
Electrical appliances
Importance of filters in incubators and in the laboratory
Different types of filters: advantages and disadvantages
b. Quality control
b.1: Microbiology and ART
Infectious diseases and ART
Gamete donation and disease transmission
Infection control and disease transmission
Sterilization and Disinfection (Chemical and physical agents)
b.2: Material supply and culture media
b.3: Quality control system
Equipment control and environment
Procedure control (standard manuals)
Bioassays
Health and safety in the IVF laboratory
c – Rules for accrediting a laboratory in RED LARA
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II. Embryo culture and tissues
a. Oocyte collection
- Protocols for ovarian stimulation
- Oocyte identification and classification
b. Insemination
- IVF
- ICSI
c. Fertilization assessment
d. Embryo culture
- Culture media
- Protein supplements
- Culture under oil
- Tissue culture systems
e. Embryo grading
- Pronuclei
- Early cleavage
- Cleaved embryos
- Blastocyst
d. Embryo transfer
- Embryo selection criteria
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I. Micromanipulation and assisted reproduction
a. Micromanipulation techniques:
- PZD
- SUZI
- ICSI
- Assisted Hatching
- Embryo Biopsy
b. Equipment for micromanipulation:
- Micropipettes
- Micromanipulators, microscopes and others
c. Micromanipulation Protocols
- Equipment preparation
- Protocols
d. ICSI Indications
- Sperm source
• Ejaculate
• Epididymus
• Testis
e. Risk and inheritance after ICSI
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II. Manipulation and its use in ART
a. Multi potent stem cells
- types of cells
b. Embryonic stem cells
- generation
- application
c. Cloning
- cloning methodology
• reproductive cloning
• non-reproductive cloning (therapeutic)
- problems with cloning
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I. Principles of Cryobiology
a. Effects of reduced temperature
b. Ice formation.
c. Cryoprotectors
d. Factors that affect the freezing
- Cooling rate
- Seeding
- Removal of cryoprotectant
e. Freezing protocols
- slow
- rapid
- ultra-rapid (vitrification)
f. Thawing protocols
g. Storage and safety in freezing samples
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II. Gamete cryopreservation
II.1. Oocytes
a. Principles of oocyte cryopreservation
b. Effects of cryopreservation of oocytes
c. Immature oocyte freezing
d. Freezing protocols
e. Thawing protocols
II.2. Spermatozoa
a. Effects of cryopreservation of sperm
b. Freezing protocols
c. Epididymal and testicular sperm freezing
d. Methods to improve survival
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III. Embryo cryopreservation.
a) Freezing in different embryo stages
b) Cryoprotectors
c) Embryo transfer
d) Cryopreservation program benefits
e) Freezing protocols
f) Thawing protocols
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IV. Gonadal tissue cryopreservation
IV.1. Ovarian tissue
a. Follicles cryopreservation and survival
b. Grafting strategies
c. Freezing protocols
d. Current status of the freezing results
IV.2. Testis tissue
a. Semen cryopreservation of patients with cancer
b. Grafting strategies
c. Freezing protocols
d. Current status of the freezing results
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I. Genetic in infertility
a. Gene expression
b. Structural and numeric chromosomal abnormalities
c. Genetic disorder
- Down Syndrome
- Cystic Fibrosis
- Others
d. Preimplantation diagnosis
- Material selection for PGD
- polar body and blastomere Biopsy
- FISH - PCR
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II. Ethic and legislation in Reproductive Biology
a. Medicine and ethics
b. Bio-ethics theory
c. Bio-ethics principle
d. Bio-ethics position in relation to:
- Respect to the human being and the embryo manipulation
- Gamete and embryo donation
- Freezing embryos
- Sex selection
- Cloning
- Research with human embryos
- Surrogacy
- Genetic counselling
e. Laws in Assisted Reproduction Techniques
- Latin America / USA / Europe
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