Embryos Lab
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Referred Dr :
Date :
Sperm Source
Ejaculate
Frozen ejaculate
Testicular Aspiration
Testicular biopsy
Frozen biopsy
Semen Parameters
Count:
Motility:
Morphology:
Semen Processing
Density gradient
Sperm wash
Notes:
Oocyte retrieval
Clinician :
choose
{foreach $clinician as $one}
{$one.name}
{/foreach}
Embryologist :
choose
{foreach $embryologist as $one}
{$one.name}
{/foreach}
Duration :
No. of oocyte collected :
Follicular fluid volume :
Blood content :
+
++
+++
Oocyte maturity
Oocyte Quality
MII
MI
G.V
Atretic
Other
Quality
Zona
Cytoplasm
P.V.S
Other
choose
{foreach $oocytequality as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $oocytezona as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $oocytecytoplasm as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $oocytepvs as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $oocyteother as $one}
{$one->name}
{/foreach}
Delete
Fertilization assessments
Growth
Fertilized
unfertilized
Degenerated
Media
Oil
Incubator
CO2
choose
{foreach $growthmedia as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $growthoil as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $growthincubator as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $growthco2 as $one}
{$one->name}
{/foreach}
Delete
Embryo Scoring and Grading
Embryo Transfer
Embryo Freezing
Embryo scoring and grading
ICSI done by :
choose
{foreach $embryologist as $one}
{$one.name}
{/foreach}
Add New
NO
Day1
Day2
Day3
Day4
Day5
Day6
Delete
stage
grade
stage
grade
stage
grade
stage
grade
stage
grade
stage
grade
Embryo Transfer
Clinician :
choose
{foreach $clinician as $one}
{$one.name}
{/foreach}
Embryologist :
choose
{foreach $embryologist as $one}
{$one.name}
{/foreach}
Day:
--Select Day--
1
2
3
4
5
6
Date:
No of embryos
1
2
3
4
Stage
choose
{foreach $stages as $one}
{$one->stage}
{/foreach}
Delete
choose
{foreach $stages as $one}
{$one->stage}
{/foreach}
Delete
choose
{foreach $stages as $one}
{$one->stage}
{/foreach}
Delete
choose
{foreach $stages as $one}
{$one->stage}
{/foreach}
Delete
Grade
choose
{foreach $grades as $one}
{$one->grade}
{/foreach}
Delete
choose
{foreach $grades as $one}
{$one->grade}
{/foreach}
Delete
choose
{foreach $grades as $one}
{$one->grade}
{/foreach}
Delete
choose
{foreach $grades as $one}
{$one->grade}
{/foreach}
Delete
Embryo Transfer Characterization
Catheter Type
Difficulty
Blood
Duration
Jet Place
L.A.H
Type
Day
choose
{foreach $embryocathetertype as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $embryodifficulty as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $embryoblood as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $embryojetplace as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $embryolah as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $embryotype as $one}
{$one->name}
{/foreach}
Delete
choose
{foreach $day_array as $one}
{$one}
{/foreach}
Embryo Freezing
No Of Straws :
No Of Embryos :
Location :
Add New
Straw
1
2
3
4
5
Delete
stage
grade
stage
grade
stage
grade
stage
grade
stage
grade
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