Training activity information
Details
Perform oocyte and embryo vitrification
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
- Methods for cryopreservation
- In-house standard operating procedures
- Aseptic technique
- Use of media
- Troubleshooting
- Witnessing requirements
- Patient consent for training and storage
- Viral screening requirements
- HFEA regulations
- Record keeping and traceability
- Health and safety
- Infection control
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 carrying out the vitrification procedure for oocytes and embryos.
- Consider how the learning outcomes apply, specifically in relation to practicing safely in accordance with statutory and regulatory requirements and appraising the impact of cryopreservation on viability.
- Discuss with your Training Officer to gain clarity of what is expected of you in relation to successful vitrification, including the immediate outcome and the potential for future viability.
What is your prior experience of this activity?
- Think about what you already know about the principles of vitrification and its application to oocytes and embryos.
- Consider possible challenges you might face during the activity, such as specific challenges encountered during the vitrification process for oocytes and embryos.
- 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 the embryo is fully hatched and you require extra reassurance.
- Acknowledge how you feel about undertaking the delicate procedure of oocyte and embryo vitrification.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop, such as specific practical skills related to vitrification techniques.
- Identify the specific insights you hope to gain into the factors that influence the success of oocyte and embryo vitrification and its impact on their viability.
What additional considerations do you need to make?
- Consult actions identified following previous experiences of cryobiology or handling liquid nitrogen.
- Identify important information you need to consider before embarking on the activity, such as consulting the SOPs specifically for oocyte and embryo vitrification or checking particular pieces of equipment/consumables required for this specific type of vitrification.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst performing the delicate steps of vitrification?
- Are you encountering situations such as:
- The cryoprotectant solution appears cloudy or viscous
- Difficulty achieving the required speed of transfer onto the vitrification carrier
- An oocyte or embryo exhibits physical damage during handling or exposure to the solution
How are you reacting to the unexpected development?
- How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to delicate handling or timing?
- Consider the steps you are taking in the moment, such as immediately stopping the process to check the timing of cryoprotectant exposure or that the correct solution is being used.
- How are you feeling in that moment? For instance, are you finding it difficult to maintain sterile technique while working quickly? Is it affecting your confidence in the overall vitrification procedure?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully vitrifying multiple oocytes within the correct timeframe whilst maintaining sterile technique? Or are you needing support because a large number of oocytes to freeze is overwhelming at this stage in your training?
- What are you learning as a result of the unexpected development? For example, are you gaining insight into the critical importance of timing in cryoprotectant exposure?
On action
What happened?
- Begin by summarising the key steps you took when performing the vitrification process for both oocytes and embryos.
- Consider specific events, actions, or interactions which felt important, such as how you ensured rapid cooling during the transfer onto the vitrification carrier.
- Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded.
- How did you feel during this experience, e.g., focused on the rapid timing required for cell integrity?
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding performing the delicate steps of vitrification. What strengths did you demonstrate, e.g., maintaining sterile technique and rapid handling?
- What skills and/or knowledge gaps were evident, e.g., unfamiliarity with specific vitrification devices?
- Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in maintaining sterile technique and temperature control throughout the process?
- Identify any challenges you experienced, such as difficulty achieving the required speed of transfer onto the device and how you reacted to this. This might include needing to seek advice or clarification on scope of practice regarding potential damage to the oocyte during handling and how you reacted to this.
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 execution speed and consistency of the vitrification procedure.
- What will you do differently next time you approach vitrification?
- Do you need to practise any aspect of the activity further, such as handling specific devices or managing the precise timing of steps or key learning outcomes related to the properties of cryoprotectants and the thermodynamics of vitrification?
Beyond action
Have you revisited the experiences?
- How have your subsequent experiences of oocyte and embryo vitrification since completing this specific training activity led you to revisit your initial approach or decisions during that activity?
- Considering what you understand about cryoprotectants, thermodynamics of vitrification, and critical timing 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 technique related to handling cryoprotectants, critical timing, or minimal volume strategies based on further learning and experiences?
- Has discussing performing oocyte and embryo vitrification or the technical challenges and factors affecting success 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 technical challenge during cryoprotectant exposure refined your understanding of the strict adherence to protocols and critical timing required.
How have these experiences impacted upon current practice?
- How has the learning from this initial training activity, in combination with subsequent oocyte and embryo vitrification experiences, contributed to your overall confidence and ability in executing precise, time-sensitive laboratory procedures, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated skills in executing precise, time-sensitive laboratory procedures and confidence in handling delicate oocytes and embryos now enables you to confidently and proficiently perform technical vitrification steps during observed assessments.
- How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to handling oocytes and embryos during cryopreservation? 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 immediately when an unexpected factor compromises the strict timing or integrity of the vitrification process (e.g., solution viscosity or observed cell damage), recognising that maintaining strict protocol adherence is critical.
- Looking holistically at your training journey, how has this initial oocyte and embryo vitrification experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to performing cryopreservation, thawing and warming of gametes and appraising the impact of cryopreservation on viability? For example, how this foundational experience has supported your development in fine motor skills, ability to work under pressure, strict adherence to protocols, and understanding the physiological changes during cryopreservation, and has contributed to your ability to critically appraise different vitrification protocols or consumables.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Perform cryopreservation, thawing and warming of gametes and embryos. |
| # 3 |
Outcome
Practice safely in accordance with the statutory and regulatory requirements of micromanipulation and cryopreservation. |
| # 4 |
Outcome
Appraise the impact of cryopreservation on viability of gametes and embryos. |