What Is The Next "Big Thing" In Infertility Care?
Many reproductive specialists feel that the next major advancement that will improve treatment success rate substantially will involve deciding which embryo should be transferred to the uterus. The science that has evolved suggests that many embryos are genetically abnormal, in spite of the fact that microscopically, they appear normal. Determining with certainty which embryo is the “best” one should will allow transfer of a single high quality embryo minimizing multiple birth risk while maintaining high levels success. Investigators are looking at the proteins and metabolites produced by the growing embryos while they are being cultured, checking fluids within the embryo itself, performing detailed high powered microscopic examinations of the embryo, using time lapse photography of the embryo, and performing actual embryo biopsies at different stages of embryonic development followed by comprehensive genetic screening of the cells obtained, all in an effort to determine which embryo is most likely to become a healthy child.
A study published this month in Fertility and Sterility looked at a group of patients who had their embryos biopsied and comprehensively screened for genetic abnormalities which are known to lead to miscarriage or failure of the embryo to implant. After the embryos were screened, only one embryo which did not demonstrate any of the genetic abnormalities being tested, was transferred to the woman’s uterus. This group was compared to a group of women who received two embryos which had been selected in the usual fashion which involved microscopic assessment using well established criteria for embryo grading. The study was designed to compare success rates of the two groups as well as multiple birth rates. The study demonstrated no significant difference in overall success rates and a marked decrease in the rate of twins in the group receiving only one embryo which had been genetically screened.
