2022/01/15

Run out of the hospital
From the Slaughterhouse to Mexico

"I originally wanted to become a panda artificial inseminator, but my professor told me there was no demand for it, so I gave up."

"I think it's important to be aware of the risks and benefits of embryo culture," says Sayaka, laughing. Embryologists are specialists who handle eggs and sperm in incubation labs. They are the key players in infertility treatments such as in vitro fertilization.

Sayaka first turned her attention to human embryo culture when she was a university student. She enrolled in a university with an interest in cell engineering, and during a veterinary medicine class her professor suggested to her, "Why not try humans instead of pandas?"

"In my first year of university, I did an internship in the embryo culture room of an obstetrics and gynecology department, and then I started working part-time there. There, I heard that someone had become pregnant after artificial insemination using sperm that I had prepared. I realized that I had really helped someone. That's when I decided to become an embryologist."

After graduating from university, she got a job at Sanno Hospital in Tokyo, which offers cutting-edge infertility treatments. After three years there, she learned everything she needed to know, and her job was going smoothly. However, Sayaka decided to quit Sanno Hospital. She was strongly attracted by the idea of ​​working as an embryologist in the United States.

"At the time, there were very few Japanese embryologists working overseas, so those around me were strongly opposed to my idea. But I really wanted to try working overseas."

However, although she was promised a trip to the US, things took an unexpected turn: before she could go to the US for her egg freezing project, she had to first establish a track record in Mexico, and before using human eggs in Mexico, she had to practice using cow's eggs in Japan.

"During the six months I trained in Japan, I would travel to the slaughterhouse once every three days, a one-and-a-half hour drive each way, to get some cow ovaries, which are said to be the closest to human ovaries. When about 1 ovaries from cows were collected and brought in on a conveyer belt and filled up a water bottle, the factory manager would treat me to a stew of oxtails that had been simmered for two days (laughs). From there, I would travel an hour and a half back to the laboratory and practice without sleep until the next morning. My skin was ruined, so it was pretty tough."

When she finally arrived in Mexico, she unexpectedly found out that the hospital did not have the equipment necessary for the project. However, Sayaka did not give up. Using high-quality culture medium from Japan, she contributed to the clinic by increasing the success rate of egg freezing and preservation by about 20%, and played an active role as an embryologist.

"In Japan, embryologists are medical technicians and are not in a position to be consulted by doctors. However, in Mexico, doctors and embryologists work on an equal footing, exchanging opinions and providing treatment. Those were fulfilling days."

After returning to Japan, she worked at a clinic in Chiba, and once a month traveled to Thailand, India, and other countries with her colleagues to train embryologists and set up egg banks. Sayaka smiles and says, "I was only able to do this when I was young."

Support as a face-to-face embryologist

Sayaka gradually began to think that she wanted to settle down and work abroad. Then, after experiencing the hardship of not being able to eat Japanese food in Mexico, she chose Hong Kong, which is close to Japan, and came here six years ago. At the time, the embryo incubation room at the center was behind Japan, but she has since raised it to above the world average.

Currently, while managing the lab as head of the incubation room, she also interprets for Japanese patients when they come for consultations, explains medicines, and provides counseling. Infertility treatment is also popular in Hong Kong, and at public hospitals, the waiting period is said to be three years from reservation to treatment. During Sayaka's counseling, depending on the person, she may recommend treatment in Japan, but depending on the results of blood tests, she may say, "It's better to start treatment sooner."
They also give advice like this.

The causes of infertility vary from person to person, but it seems that there are more male infertility patients in Hong Kong than in Japan, and some people come to the hospital after being told they have no sperm at other hospitals. When we concentrate the semen of such patients, centrifuge it, and find sperm after an hour, we can't help but pump our fists in excitement. When we think that we can tell people who once gave up on having children that there is still a chance, we feel happy, as if we have found a ray of hope. If even a small amount of sperm is found, we can perform in vitro fertilization (a method of injecting a single sperm into an egg to fertilize it), and it is possible to become pregnant.

"It's an emotional feeling when we find sperm or when a patient gets a pregnancy test."

It is my duty to protect the eggs.

Sayaka emphasizes that one big difference between Japan and Hong Kong is that in Japan, many women visit clinics alone, whereas in Hong Kong, most patients visit as couples. Japanese women tend to visit clinics alone, even in Hong Kong, but Sayaka says that in order to get the best results, it's best for them to come in with their partner for treatment.

"I understand that there are circumstances where the husband cannot take time off work, but sometimes the wife is alone during the egg retrieval, when an attendant is required. I tell the husband, half threateningly, 'Don't let him do any housework for a few days after the egg retrieval! If he develops side effects and has to be hospitalized, it will cost a lot of money!'"

Sayaka writes a heart mark next to the patient's name when culturing the fertilized eggs as a wish. She has been trained in ICSI, so even though she feels a sense of responsibility, she doesn't get nervous. However, when she takes the fertilized eggs to the doctor to be put back into the body, she feels nervous no matter how old she is, because she is carrying the expectations of the patient, their family, and the doctor on her shoulders.

Her home is within walking distance of the hospital so that she can rush to the scene even in the case of a typhoon with a signal number of 10, if it's for the eggs kept in the incubation room. She is truly a doctor who protects the eggs.

"Just as an obstetrician-gynaecologist feels joy when he sees a baby, as an embryologist I have a deep affection for fertilized eggs. I have no interest in having a child of my own, but my love for eggs is only growing."

At a conference in Mexico. When I was working in Mexico, I sometimes attended conferences together with the hospital director.

I collect animal mascots as a hobby and display them in my locker. Looking at them when I'm busy or in need of some relaxation helps calm my mind.

_

*Featured in Hong Kong LEI vol.47