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OvaFlow
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Stage 6 of 9

Embryology & PGT

From Day 0 conventional insemination or intracytoplasmic sperm injection (ICSI, injecting a single sperm into an egg) through Day 1 fertilization checks and Day 5 to 7 blastocyst culture, embryologists track every dish and embryo individually. When families use preimplantation genetic testing (PGT), trophectoderm biopsy samples go to a reference genetics lab while embryos are frozen—and every specimen label, biopsy tube and amended report must stay tied to the exact embryo.

5 prototype walkthroughs
Watch the walkthroughSee the whole journey
Embryology: PGT-M readiness, a media recall and warming authorization: a still from the prototype walkthrough. Fictional patient data.
Two biopsy records on one embryo each keep their own lineage, so their results never cross.Prototype walkthroughFictional patient dataOpen the walkthrough

Lineage

Two biopsies, one embryo, two separate records

When one embryo has two biopsy records, each keeps its own accession, report and history. A similar label is never treated as the same sample.

Embryo E02Jordan Patel
  • First biopsyIts own reportReport version 2 carries the lab's corrected identifier.
  • Second biopsyIts own accessionA separate accession and report, never merged with the first.

Results never cross

From the embryology walkthrough. Fictional patient data.

Handoffs and safeguards

Where work slips, and what holds instead

These are the moments the design is built around. Each safeguard stops or holds work; the decision stays with the clinician or the lab.

Where it slips today

  1. A missing family reference sample or a change of genetics lab leaves custom single-gene PGT-M testing unready when embryos reach blastocyst.
  2. A label or barcode on a dish, straw or biopsy tube doesn't match its source record.
  3. An amended PGT report arrives from the reference lab and is missed before frozen transfer planning continues.
  4. A manufacturer culture-media or oil lot recall has to be traced manually through paper bench logs.

What holds in OvaFlow

  • Right patientLabel mismatch stopA specimen or biopsy label that doesn't match its source report stops review.
  • Right patientDuplicate barcode stopA duplicate specimen barcode is handed to the lab's own two-person check in its electronic witnessing system.
All safeguards

See it

Walkthroughs from this stage

Recorded from an interactive design prototype. Every patient, clinician and clinic is fictional, and EMR screens are modeled reconstructions.

Prototype walkthrough · Fictional patient data

Both sides

One stage, seen from both sides

For the clinic team

What the team coordinates

OvaFlow tracks PGT-M readiness, lineage across biopsies, development endpoints, amended PGT reports, label and barcode stops, and culture-media lot recalls.

  • PGT-M reference-lab acceptance and family sample readiness before biopsy
  • Individual embryo lineage across first and second biopsies so results never cross
  • Day 1 through Day 7 lab development endpoints carried cleanly to the clinical plan
  • Culture-media and consumable lot recall trace with a named clinical reviewer per affected case
  • Label mismatch and duplicate barcode stops handed to the lab's electronic witnessing system
Operational checks at this stage (3)
  • Enforce hard stops on specimen label mismatches or duplicate biopsy barcodes in coordination with the lab's electronic witnessing system.
  • Maintain parent-child embryo lineage when a single blastocyst undergoes two trophectoderm biopsies so inventory counts and results never cross.
  • Hold transfer planning whenever an outside genetics reference lab places an accession hold or issues an amended PGT report until a physician signs off, and trace any recalled culture-media lot to affected cases.

People involved

For you and your family

What you experience

In the lab, eggs are fertilized and embryos develop; some families also choose genetic testing.

Questions you may ask here (3)
  • “Why does the number of eggs retrieved differ from the number fertilized on Day 1 and the number of blastocysts on Days 5 to 7?”
  • “When an embryo is biopsied for preimplantation genetic testing (PGT), how does the lab make sure the test tube matches the exact frozen embryo?”
  • “What happens if an embryo has an 'inconclusive' genetic result and is biopsied a second time, or if the genetics lab sends an updated report?”
Words you may hear (6)
PGT
Genetic testing of a few cells from an embryo before transfer.
PGT-M
Genetic testing for a specific inherited condition. It often needs family samples and lab preparation before the cycle starts.
Blastocyst
An embryo at about five to seven days of development.
Embryo biopsy
Removing a few cells from an embryo for genetic testing. One embryo can have more than one biopsy record.
Witnessing
A lab check, often by two people or a dedicated system, that confirms the right sample goes with the right patient. It stays in the lab's own witnessing process; OvaFlow does not perform or replace it.
Lot recall
A manufacturer notice that a batch of lab supplies, such as culture media, may be affected and needs to be traced.

Questions about your own treatment go to your care team. OvaFlow never gives medical advice. In an emergency, call 911.

Read the plain-language guide to IVF

Workflows here

Workflows at Embryology & PGT

Each row opens the capability. Point at, focus or scroll to a row to see it in a recording from this stage.

  1. SafeguardsDesigned stops for the moments that go wrong: wrong chart, stale link, duplicate send, mismatched label.Seen in: Embryology: PGT-M readiness, a media recall and warming authorization
  2. Sources & signed changesEvery instruction traced to its signed source, and every change carried to the work it affects.Seen in: Lab & specialty pharmacy: accession hold, amended PGT, cryo signal

Stories

Stories that pass through here

Fictional people, told end to end.

Fictional patient data

Step-by-step timing & questions

How Embryology & PGT unfolds day by day

Inside the embryology lab, mature oocytes are fertilized on Day 0, checked for two pronuclei on Day 1, and cultured to Day 5–7 blastocysts for transfer, vitrification or trophectoderm biopsy.

Days 0–7 culture · 1–3 wks PGT reference lab

Day 0 to Day 7 embryology bench & PGT biopsy lineage

  1. 01Day 0 (Retrieval day)

    Insemination or ICSI & witnessing

    Patient & family

    After retrieval, the embryology team prepares the sperm sample and pairs it with your mature eggs.

    What holdsWitnessed gamete pairing
    Clinic, EMR & lab

    Two-identifier electronic or dual witnessing verifies egg and sperm dishes before conventional insemination or intracytoplasmic sperm injection (ICSI, injecting a single sperm into an egg).

  2. 02Day 1 (+16–18h)

    Fertilization check (2PN)

    Patient & family

    Your nurse or embryologist calls with your Day 1 update: how many mature eggs fertilized normally.

    What holdsDay 1 count + media lot logged
    Clinic, EMR & lab

    Embryologist records 2-pronuclei (2PN) fertilization counts and links culture-media and oil lot numbers to the cohort.

  3. 03Days 5, 6 & 7

    Blastocyst grading, biopsy & freeze

    Patient & family

    Embryos that reach the blastocyst stage are graded; if you chose PGT, a few outer cells are biopsied before each embryo is frozen.

    What holdsUnique embryo ID & biopsy lineage
    Clinic, EMR & lab

    Each blastocyst gets a unique ID, straw/cane coordinate and biopsy tube barcode; second biopsies link to the same parent embryo.

  4. 04Days 10–21

    PGT report & amendment review

    Patient & family

    Your physician reviews your genetic testing results with you and confirms which embryos are eligible for transfer.

    What holdsPhysician sign-off on latest PGT version
    Clinic, EMR & lab

    Incoming PGT reports—and any subsequent amended report or accession hold—require documented physician sign-off before warming.

Every dish move, sperm-egg pairing, blastocyst biopsy tube, genetics report amendment and consumable media lot stays tied to the individual embryo's lineage.
Worked example: Jordan Patel's label-mismatch stop, two-biopsy lineage, amended PGT report & media lot recall
Worked example · West ClinicFictional patient data

Jordan Patel's label-mismatch stop, two-biopsy lineage, amended PGT report & media lot recall

What the patient sees

Jordan's embryos undergo trophectoderm biopsy for genetic testing. Every embryo's biopsy history and storage location stay matched before any transfer date is confirmed.

What the clinic team sees

In Jordan's walkthrough, a specimen label mismatch halts clinical review; an outside reference-lab accession hold is resolved with confirmation; an amended PGT report requires physician review before transfer planning; and Embryo #3's two biopsy tubes stay tied to one embryo record.

Why it holds: Lab identity, biopsy lineage, report versions and consumable lot numbers are tracked explicitly rather than stitched together from PDFs and spreadsheets.

Where OvaFlow fits

How OvaFlow works beside the clinic's own EMR and lab

Coordination companion

What OvaFlow coordinates

  • Cross-system visibility of PGT-M readiness, accession holds, and versioned/amended genetics reports requiring physician review
  • Parent-embryo lineage tracking across first and second biopsies and culture-media lot recall case lists with named reviewers
  • Label-mismatch and duplicate-barcode workflow stops surfaced alongside the laboratory's electronic witnessing system
System of record

What stays with clinicians & the EMR

  • Performing conventional insemination, intracytoplasmic sperm injection (ICSI), embryo grading, trophectoderm biopsy and vitrification
  • Physical barcode scanning and radio-frequency or optical witnessing inside the lab's own witnessing hardware
  • Genetics laboratory sequencing, ploidy/variant interpretation, and clinical counseling on embryo selection
OvaFlow never prescribes medications, never triages symptoms, and never replaces the clinic's own EMR or electronic witnessing hardware.

Common questions at this stage

Questions from patients, families and clinic teams

View all 4 stage questions & answers
What happens in the embryology lab between Day 0 and Day 7?

On Day 0 (retrieval day), mature metaphase-II oocytes are fertilized by conventional insemination or intracytoplasmic sperm injection (ICSI, injecting a single sperm into an egg). On Day 1 (16–18 hours later), embryologists check for normal fertilization (two pronuclei). Over Days 2 to 4 the embryo divides into a cleavage-stage embryo and then a compacting morula. By Days 5, 6 or 7, embryos that form a fluid-filled cavity with an inner cell mass and outer trophectoderm reach the blastocyst stage, where they can be transferred, vitrified or biopsied.

Sources: [6] SART Patient Guide (2026) · [7] HFEA Patient Guide (2026) · [10] ASRM Practice Committee (2026)

What is the difference between PGT-A, PGT-M and PGT-SR?

Preimplantation genetic testing (PGT) analyzes a small trophectoderm biopsy (typically 5–10 outer cells) from a blastocyst. PGT-A screens for chromosome number changes (aneuploidy); PGT-M tests for a specific single-gene (monogenic) condition known in the family; and PGT-SR checks for structural chromosome rearrangements such as translocations. Biopsied blastocysts are vitrified while the reference genetics lab runs the analysis.

Sources: [4] ASRM Practice Committee (2023) · [7] HFEA Patient Guide (2026)

Why does one embryo sometimes have two biopsy records?

Occasionally a first trophectoderm biopsy returns a 'no-result' or amplification failure from the genetics lab. If the patient and physician decide to warm and re-biopsy that blastocyst, the second biopsy tube must remain linked as a child event of the same parent embryo so the clinic never mistakes two biopsy reports for two separate embryos.

Sources: [4] ASRM Practice Committee (2023) · [9] ASRM Practice Committee (2022)

How does a clinic respond if a culture-media or oil lot is recalled by the manufacturer?

ASRM embryology laboratory guidelines require recording the lot number and expiration Window of every medium, oil and consumable that contacts gametes or embryos. If a manufacturer issues a recall notice, OvaFlow lists every affected episode and assigns a named clinical reviewer to each case rather than relying on manual binder searches.

Sources: [9] ASRM Practice Committee (2022)

Clinical & operational sources for Embryology & PGT (5 primary guidelines)
  1. [4]
    ASRM Practice Committee (2023) — Indications and management of preimplantation genetic testing for monogenic conditions (PGT-M)Custom single-gene test design, family DNA samples, reference-lab acceptance before stimulation, and non-portability of amplified biopsy DNA across labs.
  2. [9]
    ASRM Practice Committee (2022) — Comprehensive guidance for human embryology, andrology, and endocrinology laboratories: management and operationsContinuous specimen witnessing, chain of custody, culture-media lot traceability, warming authorization and cryostorage records.
  3. [10]
    ASRM Practice Committee (2026) — Intracytoplasmic sperm injection (ICSI) for non-male-factor indications: a committee opinionDistinguishing selected indications for intracytoplasmic sperm injection (ICSI, injecting a single sperm into an egg) from conventional insemination.
  4. [6]
    SART Patient Guide (2026) — ART Step-by-Step Guide: Oocyte Retrieval and Embryo Transfer8–12 day stimulation window, 35–36 hour trigger-to-retrieval interval, 15–30 minute sedated retrieval, Day 5–6 blastocyst culture and progesterone support.
  5. [7]
    HFEA Patient Guide (2026) — In vitro fertilisation (IVF) and Pre-implantation Genetic Testing (PGT-M / PGT-SR)Plain-language overview of IVF stages, embryo grading, single embryo transfer and genetic testing options.

Along the spine

Keep walking the journey

Plans can change at almost any point. See how a change of plan is handled.

See it with your team

Follow a biopsy's lineage with us.

We'll go through the prototype walkthroughs for this stage and the questions your team would ask first.

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