Enter the Reproductive Medicine Center in Malmö, Sweden
The Swedish Reproductive Medicine Center (RMC) in Malmö is one of Sweden’s largest public reproductive healthcare facilities. In recent years, a major expansion of the clinic’s services has created a significant need to expand the premises and introduce new state-of-the-art equipment.
After many years of careful development and planning, the new center opened in October 2021, giving the “minimum patients” – the embryos at the heart of its IVF work – the perfect environment to thrive in. This required careful preparation of precise requirements.
The RMC opened its doors for the first time in 2007 with a small premises in the hospital area in Malmö with only 15 employees. Over time, the scope of IVF has expanded, in addition to the introduction of new Swedish rules that allow single women, homosexual and transsexual couples, as well as heterosexual couples, to seek IVF treatment.
Over 45 staff at the RMC clinic – including doctors, embryologists, nurses, midwives and secretaries – now see around 28,000 patients annually. The IVF laboratory handles 1200 fresh IVF treatments and 600 frozen cycles annually.
The center can also provide additional treatments, including hormonal replacements and “fertility preservation” of gametes, for example for cancer patients undergoing chemotherapy that can damage their gametes or for transsexual people starting hormone therapy. In addition, RMC has an on-site donor bank that offers donation services.
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In terms of IVF treatments (in vitro fertilization), the RMC clinic is second in size after Gothenburg’s Sahlgrenska IVF clinic.
“Our mission includes many other treatments in addition to IVF, and we have close reproduction research collaborations with Skåne University, but also other fertility clinics in Sweden and Denmark.” explains Dr. Ingela Liljeqvist Soltic, head of unit at the Centre’s laboratory.
“We needed a larger area and new facilities to match our expansion. After seven years of searching for a proper building that could meet the needs of an IVF laboratory, such as the supply of gases and liquid nitrogen, plus easy access for our patients, in the fall of 2021 the clinic was able to move to a newly built facility that is three times larger than ours former premises.”
Precisely controlled environment for sensitive embryos
The relocation and expansion of an IVF clinic, like the Reproductive Medicine Center, requires years of careful planning due to the sensitive nature of the biological samples it works with.
“The core of our work is to provide the right environment for embryos and gametes,” Dr. Soltic explained.
“Eggs and embryos in particular are very sensitive to any fluctuations in the environment. So it is important to keep their environment stable in terms of temperature, pH and gases. That was one of the main focuses when we planned to build the clinic and the clean room. When you build a IVF labs, I think everything has to be built around the oocytes and embryos. Our focus is of course on adult patients, but we also have our ‘little patients’ in the lab – the embryos.”
“Controlled conditions are essential in IVF because the cultural environment can have an impact on the new individual,” she continued.
“The environment must be controlled and maintained optimally every minute of every day, not only to begin with, but because inconsistencies in the environment can affect the individual much later – even several years later, I’m talking about epigenetics, which means that external influences e.g. the environment of the embryos, will affect the genetics.”
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It is important to get used to new equipment and fully understand how it works. We have very good results with PHCbi Incubators.”
Dr Ingela Liljeqvist Soltic, head of unit, the Centre’s laboratory
As soon as an oocyte is collected from a patient, it must be safely placed in an optimal environment and at the appropriate temperature. This must be maintained throughout the process of fertilization and development in the IVF lab, until the moment of transfer back to the uterus or vitrification.
“The entire cleanroom and workflow is built around the oocyte and the logistics of how we handle them,” said Dr. Soltic. – When you make the laboratory bigger, you have to think about how to handle the oocyte, for example to minimize its transport within the lab. It’s all about the environment.”
Intricate development process
RMC quickly realized that expansion into a larger space would be necessary. Still, the particular challenges that come with moving a whole IVF clinic entailed the painstaking work of finding and designing a new facility that would meet the requirements.
– Since we are part of Skåne University Hospital in Malmö, we wanted to be close to the University Hospital, and close to the patients via train and bus stations, easy for them to get to the clinic,” said Dr. Soltic.
“In addition to this, we still had to deal with technical challenges, such as our need to obtain and transport liquid nitrogen frequently – weekly and sometimes bi-weekly. We also need the supply of large quantities of gas such as carbon dioxide and nitrogen to supply all incubators. The new clinic is built for the possibility of expanding the lab space and the amount of instruments, such as incubators. Incubators that support each workstation, while processing gametes and embryos, but also for embryo culture up to 6 days.”
Just drawing up suitable plans for the empty property’s interior required another two years.
I read that PHCbi used a different conductor for the gas in their incubators, which made them quicker to get back to the environment I needed. It was exactly what I was looking for in a working incubator.”
Dr Ingela Liljeqvist Soltic, head of unit, the Centre’s laboratory
“We had to decide how to make the new location comfortable and attractive for the patients, of course, but also for the laboratory staff working in the clean room to achieve the best environment and situation for the oocytes and embryos,” said Dr. Soltic.
New incubation capacity
A crucial part of the planning was to ensure that the center was equipped with the appropriate technology. Incubators act as artificial wombs and are considered essential pieces of equipment. Oocytes and embryos require precise control of temperatures and conditions for survival and culture.
The RMC clinic has acquired 11 of PHCbi’s latest, most compact (50 L) Multigas Incubator, MCO-50M-PE. RMC also has incubators from former PHC companies, Sanyo and Panasonic. These were provided by PHC Europe’s Swedish specialist IVF distributor, Vitrotech.
“When I started at the clinic, we had 50 liter Sanyo and Panasonic incubators,” said Dr. Soltic. “I think they are robust incubators in terms of stability, but Vitrotech explained some new PHCbi Multigas incubators.”
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Every day the embryologist faces the challenge of ensuring that the environment for the culture conditions remains as stable as possible. One of the main priorities when drawing up plans for the new lab was to find a way to limit environmental fluctuations. The idea was to install more work incubators to significantly reduce any impact from doorways.
“I read that PHCbi used a different conductor for the gas in their incubators, which made them quicker to get back to the environment I needed. This convinced me to get them to the new IVF lab as working incubators.” said Dr. Soltic.
The compact 50 L PHCbi Multigas Incubators were easy to connect to the external alarm system used by RMC, facilitating monitoring of carbon dioxide gas concentration and temperature.
“All instruments and devices in the IVF lab, which take care of the germ cells and embryos, must be monitored by an external measurement and alarm system. A smaller incubator chamber helps to maintain a stable environment and get a quick return to the desired environment after opening, but when you have an incubator with a smaller chamber, it is not as easy to incorporate a system that constantly monitors the gas and temperature,” She added.
Service and support
Vitrotech organized installationensure that the equipment was securely connected to the gas supply.
“Everything was new in the facility. The gas supply also needed to be established“, Dr. Soltic said. “Vitrotech made sure PHCbi was in place.”
Since October 2021, Dr. Soltic and her team worked with the new PHCbi incubators.
– It took some time to get used to them. Although we had a Panasonic before, the PHCbi has a different display and commands. It is important to get used to new equipment and fully understand how it works.” She said.
“We have very good results with PHCbi Incubators; they tend to be robust. It is also very important to have a close and good relationship with Serv Tech. We are very dependent on the incubators working as they should, and when they don’t, we need fast support, via phone or on-site visit.”
“Based on the results of the new PHCbi incubators, I will consider purchasing PHCbi to replace the older incubators in the future. It has been a huge experience and challenge to build a new IVF clinic and move the existing clinic to the new premises . It’s really good to be here and the future looks good.” added Dr. Soltic.
I have good contact with the Service Technician. He helps both by phone and during a visit here. It is also very important to have a close and reliable contact with the Serv Tech person.”
Dr Ingela Liljeqvist Soltic, head of unit, the Centre’s laboratory
About PHC Europe BV
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