Training activity information
Details
Perform insemination by IVF
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Considerations
- Insemination volume
- Timescales
- Culture conditions
- Witnessing requirements
- In-house standard operating procedures
- Aseptic technique
- Infection control
- Record keeping and traceability
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
What does success look like?
- Identify what is expected of you in relation to performing the standard In Vitro Fertilisation (IVF) insemination procedure.
- Consider how the learning outcomes apply, specifically in relation to ensuring the correct concentration and handling of sperm and oocytes.
- Discuss with your Training Officer to gain clarity of what is expected of you in relation to the key steps in adding prepared sperm to the COCs and the expected outcomes regarding subsequent fertilisation rates.
What is your prior experience of this activity?
- Think about what you already know about IVF insemination and the required laboratory equipment and media.
- Consider possible challenges you might face during the activity, such as poor sperm motility post-preparation or handling multiple dishes.
- Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example, if there is an unexpected technical issue with the equipment used for sperm addition.
- Acknowledge how you feel about performing this core laboratory procedure.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as practical skills in IVF insemination.
- Identify the specific insights you hope to gain into factors affecting IVF fertilisation rates.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of gamete handling or insemination preparation.
- Identify important information you need to consider before embarking on the activity, such as the specific protocol for IVF insemination, HFEA regulations concerning gamete handling, and confirming that the prepared sperm sample is suitable.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst performing IVF insemination of oocytes?
- Are you encountering situations such as:
- The concentration or motility of the prepared sperm sample for IVF differing from what was expected?
- The number of oocytes being different to expected during the insemination process?
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Did you adjust the sperm concentration used for insemination?
- Consider the steps you are taking in the moment, such as confirming the insemination protocol with a colleague if anything seemed unusual.
- How are you feeling in that moment? For instance, are you feeling concerned about the quality of the gametes you were working with? Is it affecting your confidence in successfully inseminating the oocytes according to protocol?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, were you able to successfully inseminate the oocytes according to protocol? Or are you needing support because an unexpected technical issue with the equipment required senior input?
- What are you learning as a result of the unexpected development? For example, are you gaining insight into assessing gamete quality just prior to insemination and making minor adjustments if necessary?
On action
What happened?
- Begin by summarising the key steps you took when performing the IVF insemination. How did you handle the gametes and what steps did you take to ensure the correct timing of the procedure?
- Consider specific events, actions, or interactions which felt important, such as the final quality check of the prepared sperm sample before addition to the oocytes or the meticulous handling of the dishes.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, pausing the insemination to re-verify the sperm concentration after noticing a potential issue with the media volume.
- How did you feel during this experience, e.g., did you feel focused on sterility and timing or challenged by time pressures?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding performing IVF insemination. What strengths did you demonstrate, e.g., adherence to sterile technique and protocols?
- What skills and/or knowledge gaps were evident, e.g., assessing the subjective quality of the sperm motility just prior to insemination?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development related to IVF insemination achieved? Has your practice improved in ensuring the correct conditions for successful fertilisation?
- Identify any challenges you experienced, such as poor post-wash sperm motility or issues with the culture system, and how you reacted to this. This might include needing to seek advice or clarification on scope of practice regarding a technical issue with the equipment used for sperm addition.
What will you take from the experience moving forward?
- Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving the pre-insemination quality control checks.
- What will you do differently next time you approach performing IVF insemination, for instance, by proactively establishing a dual check on the sperm concentration and motility just before adding to the oocytes?
- Do you need to practise any aspect of the activity further, such as handling multiple culture dishes efficiently or key learning outcomes related to performing insemination procedures?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of performing insemination by IVF since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, how an instance where a subsequent IVF had an unexpectedly low fertilisation rate forced you to re-evaluate the rigour of your checks on sperm concentration and gamete handling during your first attempt at this training activity.
- Considering what you understand about critical timing, strict protocols, and culture conditions for IVF insemination now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your sterile technique and time management based on further learning and experiences? For example, how you proactively integrated specific checks on sperm quality immediately prior to insemination based on further learning.
- Has discussing variables in IVF insemination or factors affecting fertilisation rates with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a timing issue refined your understanding of the critical nature of adherence to protocol in IVF.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent IVF insemination experiences, contributed to your overall confidence and ability in core laboratory procedures, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated skills developed in sterile technique, precise timing, and working with specific laboratory equipment now enable you to confidently perform the IVF insemination procedure during a DOPS assessment.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to performing insemination by IVF? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from your Training Officer immediately if there is an unexpected technical issue with the equipment used for sperm addition or if the pre-insemination quality check reveals poor sperm motility, requiring guidance on proceeding.
- Looking holistically at your training journey, how has this initial IVF insemination experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to performing IVF insemination and practicing in accordance with HFEA regulations? For example, how this foundational experience has supported your development in adherence to strict protocols, precise laboratory technique, and time management, which are crucial for ensuring high fertilisation outcomes.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 5 |
Outcome
Perform IVF insemination. |
| # 7 |
Outcome
Practice in accordance with HFEA regulations. |