Beata Blazkova: The IVF Laboratory – Informed, Consulted, or Involved?

Beata Blazkova, ESHRE-Certified Senior Clinical Embryologist at Prague Fertility Centre, shared on LinkedIn:

”An IVF laboratory can do much more than execute a plan. But does the organisation allow it to?

Clinical decisions, new technologies and treatment strategies all benefit from the expertise of the people who work with embryos every day.

The laboratory clearly belongs at the table. So why is its voice still missing from some of the most important decisions?

The IVF Laboratory: Informed, Consulted, or Involved?

Why the laboratory belongs at the table when clinical and strategic decisions are made.

Even though the word laboratory originates from the Medieval Latin laboratorium, meaning a place of work, an IVF laboratory today is much more than a place where procedures are performed. It is a highly specialised environment in which biological processes are assessed, interpreted and translated into information that can influence clinical decisions.

Yet, within the organisational structure of some IVF clinics, the laboratory is still predominantly perceived as an operational unit, responsible for carrying out procedures defined elsewhere. The laboratory is informed about decisions, asked to assess their feasibility and expected to implement them. But how often is its expertise actually part of the discussion before those decisions are made?

An IVF centre cannot make the most of its collective expertise if its departments only communicate decisions rather than discuss them.

This is part of a broader question about how IVF centres function. The same principle applies to every department involved in patient care, from clinical teams and embryologists to nurses, patient coordinators, patient care professionals and management. Each brings expertise that can influence decisions and the quality of the entire treatment pathway.

The growing complexity of reproductive medicine requires shared expertise

Over the past decades, reproductive medicine has evolved considerably. ICSI, extended embryo culture, vitrification, embryo biopsy, PGT workflows, time-lapse technology and increasingly complex quality and regulatory requirements have transformed the work of IVF laboratories.

Clinical embryology has consequently developed into a distinct and highly specialised discipline. Maintaining expertise across these areas requires continuous professional development and a detailed understanding of the biological and technical aspects of treatment. It would be unrealistic to expect one professional group to have the same depth of expertise in every domain. This is precisely why interdisciplinary collaboration matters.

The ESHRE recommendations on good practice in the IVF laboratory recognise the clinical embryologist’s role in laboratory clinical decisions, communication with healthcare professionals and the interpretation of laboratory findings.

Yet professional recognition alone does not guarantee that this expertise is consistently integrated into everyday decision-making. The question is whether the organisational culture of a clinic allows it to happen.

The laboratory sees information that the clinical assessment cannot provide

Before an IVF cycle begins, clinical prognosis is built on a range of important parameters: maternal age, ovarian reserve, hormonal profile, medical history, semen analysis and previous treatment outcomes. These provide an essential basis for planning. But they cannot reveal the entire biological picture.

During treatment, the laboratory observes what actually happens to the gametes and embryos. Fertilisation, cleavage patterns, developmental kinetics, morphology, fragmentation, abnormal divisions and developmental arrest all provide information about the biological behaviour of the material being treated.

Consider a patient with repeated cycles in which embryos consistently arrest before reaching the blastocyst stage. The clinical team may have a clear picture of the patient’s medical history and ovarian response. The laboratory can contribute a different perspective by analysing the developmental patterns observed across cycles.

These observations do not establish a diagnosis, nor should they independently determine treatment. But they can raise relevant questions, challenge existing assumptions and help the team consider whether a different approach deserves discussion.

The laboratory does not simply report outcomes. It generates biological information that can help explain them.

For this information to have clinical value, it must reach the people making treatment decisions. And it must reach them early enough to matter. A laboratory report sent after a decision has been made is not a substitute for a discussion before that decision is finalised.

Interdisciplinary communication is not an administrative detail

There is a tendency to treat communication between clinical and laboratory teams as a matter of coordination: sharing schedules, reporting fertilisation results, confirming biopsy plans or communicating procedural requirements. These tasks are necessary, but they represent only the operational layer of collaboration.

Meaningful interdisciplinary communication requires something more. It means discussing the biological rationale behind a clinical plan, identifying potential limitations, considering alternative approaches and understanding the consequences of decisions across the entire treatment pathway. It also requires a willingness to question assumptions.

A clinician may propose a treatment strategy based on the patient’s clinical profile. The embryologist may identify laboratory-specific considerations that have not yet been accounted for. A nurse may recognise a concern affecting the patient’s experience. A coordinator may identify a recurring problem in the treatment pathway. Management may see resource or organisational constraints that have consequences for care. None of these perspectives is sufficient on its own. The value emerges when they are brought together before the decision is made.

A multidisciplinary team cannot function as one if its members only exchange instructions.

This should not be interpreted as a transfer of clinical responsibility to the laboratory. Clinical decisions remain clinical decisions. But their quality can be strengthened by incorporating the expertise of the professionals who directly assess gametes and embryos, as well as those who support patients throughout treatment.

The same principle applies to strategic decisions

This is not relevant only to individual treatment cycles. Decisions about introducing new technologies, adopting AI-based tools, changing clinical protocols, expanding treatment indications or investing in laboratory infrastructure all have consequences that extend beyond a single department. The laboratory should therefore be involved while these decisions are being considered.

Take artificial intelligence as an example. Before introducing a new system, the clinic should be clear about the problem it intends to solve. Is the objective to improve workflow consistency, support embryo assessment, reduce workload or improve clinical outcomes? These are different objectives and require different forms of validation.

Technology risks becoming an investment looking for a problem.

The ASRM committee opinion on AI in the IVF laboratory highlights the importance of appropriate validation, real-world evaluation and evidence of clinical benefit. A technology may be technically impressive and still fail to address a meaningful clinical or operational need.

The same applies to performance indicators. Clinical and laboratory outcomes are interconnected. The consensus on clinical and laboratory KPIs developed by SIFES-MR and SIERR illustrates the importance of assessing these dimensions together rather than treating them as unrelated measures.

From being informed to being involved

What does this mean in practice? It means involving the relevant professionals in discussions before decisions are finalised. It means evaluating new technologies with the teams who will use them. It means reviewing clinical and laboratory outcomes together, interpreting performance data across disciplines and creating space for professional disagreement when the evidence or biological observations warrant it. And it means recognising that collaboration is not a sign of uncertainty or unclear responsibilities. It is a sign that the complexity of IVF treatment is being taken seriously.

This does not mean that embryologists need to participate in every management meeting or that every operational decision requires a multidisciplinary discussion. Instead, the priority should be to identify the decisions where the expertise of different professionals can materially change the quality of the outcome.

Ultimately, this discussion should never become a question of professional territory, hierarchy or whose expertise carries more weight. There is too much at stake for that.

The patient is at the centre of everything we do.

And if we truly mean that, the way we work together must reflect it. The patient’s interests must come before departmental boundaries, professional hierarchies and individual agendas.”

References

Online Etymology Dictionary. Laboratory. Online Etymology Dictionary

Arroyo G, et al. ESHRE recommendations on Good Practice in the IVF laboratory. Human Reproduction. 2026;41(8):1245–1269. ESHRE Good Practice Recommendations, 2026

Practice Committee of the American Society for Reproductive Medicine, et al. Artificial intelligence in the in vitro fertilization laboratory: a committee opinion. Fertility and Sterility. 2026;126(3):494–498. ASRM Committee Opinion on AI, 2026

Vaiarelli A, et al. Clinical and laboratory key performance indicators in IVF: A consensus between SIFES-MR and SIERR. Journal of Assisted Reproduction and Genetics. 2023;40:1479–1494. Clinical and Laboratory KPIs in IVF, 202.”

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