Peter Attia· MD
So, you have really good resolution of where the follicles are. Yeah. Okay. So, you're not running the risk of sucking everything out of the ovary. No. No. And we're just getting fluid, right? We're not touching the tissue of the ovary. Just the fluid and the follicles. Okay. But if the g it's only a 16 gauge needle. Yeah. Does that mean you're puncturing the follicle? Each follicle gets punctured before it enters the needle. Yeah. The fluid. Yeah. So, you do it one at a time. Yeah. You go ping into a follicle, burst it open, and the egg because a 16 gauge needle is probably only a millimeter across. Yeah. You suck out all the fluid and you don't have to take it out each time, right? You can go from follicle to follicle to follicle. You just have to go in typically twice. Once on the right and once on the left. Yeah. I mean, again, this is that that's pretty interesting that that works. Yeah. If you It's easiest maybe to just like watch a video of it and then you get the idea. Yeah. I'm just thinking of all the things that could go wrong and how like the needle could get gked up with like tissue and then you got to pull it out and put it back in. All those things can happen. You know, there's always a small risk of bleeding, small risk of infection, small risk of injury and other organs. And this is happening. You do this on both sides because presumably you're stimulating both sides. Yeah. Okay. So, how long does that procedure typically take? Half an hour. Okay. and you've got the embryologist next to you and he or she is under the microscope going check check and he or she is validating that you indeed are getting ripened eggs and they look different presumably, right? Like those are easy to identify under a light microscope. Basically, they tell us they got eggs. We don't know if they're mature yet. We know nothing about them yet. I see. But long we get the eggs, they go to the lab and then the rest of the process happens there. So at the at the retrieval, we're just aspirating all the follicles, trying to get as many eggs as possible. Okay. So then let's just assume that the woman is doing this not to just freeze her eggs, but because she wants to get pregnant. Would you then go ahead and when she wakes up have a discussion that says, "We got this many eggs. How many would you like to fertilize? How many would you like to freeze?" That discussion has happened way upstream. Yeah. Typically, we're free fertilizing all of them. Got it. Okay. Yeah. Yeah. There's no reason not to fertilize. Okay. So, uh tell me the time cores now and how you move from retrieval to fertilization. Right. So, then the the eggs are sitting in the petri dish in the lab. What's the medium? It is this proprietary medium that it is proprietary. Yes. Not so meaning each lab will have its own medium. There are commercial companies that make it but the exact exact components of it not entirely known. So there are different companies that have different mediums. Uh yes, I believe there's more than one. Um, but it's meant to kind of emulate the the the fluid in the tubes like where fertilization would normally happen. So, so so how much um how much of a a competitive advantage is it for an embryologist? Like how many options do they have to choose from commercially of media? I don't think there are that many media companies. Yeah, I see. Yeah. Is this a huge area of innovation in the field? It must be. Oh, really? Really? I mean, I would have guessed this would be so important. I