The pioneering work of Robert G. Edwards and Patrick Steptoe to treat infertility caused by blocked fallopian tubes made history 39 years ago, with the first successful in-vitro fertilization that resulted in a healthy pregnancy and live-birth. Their work, later granting Edwards with a Nobel prize was a major stepping stone in the world of reproductive medicine. Since then, IVF technology has become more common and accessible and is helping each year thousands of people struggling with infertility to conceive. In Canada alone, there were over 28,000 IVF cycles in 2015 which resulted in 6,215 live births.
In celebration of 4 decades of Assisted Reproductive Technology (ART) we gathered some of the latest developments in the field that are now available for couples trying to conceive:
1. Preimplantation genetic screening (PGS) – is a highly specialized genetic testing for screening chromosomal abnormalities in embryos. On day five after fertilization occurs, the embryologist will remove few cells from the developing embryo that will be used to verify the presence of all 23 chromosomes. The results will allow selection of embryo/s with a normal number of chromosomes. These embryos are more likely to result in an ongoing pregnancy with a lower risk of miscarriages. The process of PGS is illustrated in this great animated video.
2. Preimplantation Genetic Diagnosis (PGD) – Similar to PGS, the embryologist will remove few cells from the developing embryo to perform the testing. In PGD the lab will test for a specific genetic condition (cystic fibrosis, for example) before transferring the embryo to the uterus. PGD allows couples that carry a genetic disease to ensure their offspring will not be affected by this disease.
3. INVOcell – This new technology allows reducing IVF costs for couples. In regular IVF the embryo will be grown in an incubator for few days before implanted in the uterus. In this technique that was recently approved in the US and Canada, the sperm and egg are mixed in a lab and are placed in a tiny capsule that is inserted into the vagina for a five days incubation period. After five days the capsule is removed, and the embryos are implanted inside the uterus as usual. Utilizing the biological environment in women’s vagina to support embryo development offers a more natural, cost-effective alternative to regular IVF.
4. Egg Vitrification – The process of freezing cells or tissues (also known as cryopreservation) has been around for decades. Scientists can successfully cryopreserve embryos and sperm cells for many years. However, egg freezing remained very challenging due to their high water content and the formation of ice crystals in the freezing process. Recently, scientists developed a new freezing process called Vitrification which is a very rapid freezing process that involves the use of new cryoprotectants that protects the cells from the formation of ice crystals and the damage of freezing. This technology brings hope to many cancer patients who would be deemed infertile by the cancer treatment. These women now have the option to preserve their fertility potential by storing their eggs before the cancer treatment. This technology also empowers women who wish to preserve their fertility and delay childbearing (fertility preservation options)
5. Time Lapse Embryoscope – is an incubator that incorporates a time lapse microscope camera. This special incubator monitors embryo development at set intervals that are critical for embryo development without the need of removing the embryos from the incubator. The information is analyzed by a computer and allows embryologist with an additional, more accurate decision-making tool for embryo selection for transferring.
6. DNA Fragmentation Index (DFI)– Traditionally, sperm quality is usually measured by several factors: sperm concentration, motility, and morphology. DNA fragmentation provides a good indication of male infertility that can supplement the conventional examinations. Scientist found a correlation between high levels of DNA fragmentation in sperm and its function. This testing gives a clearer indication which of the couples will benefit from Intracytoplasmic Sperm Injection (ICSI), where the sperm is directly injected into a mature egg rather than regular IVF.
7. Endometrial Receptivity Array (ERA)– Endometrium is the lining that covers the cavity of the uterus. It plays a central role in embryo implantation. Impaired implementation is the leading cause of IVF failure. Scientists developed a novel diagnostic test called Endometrial Receptivity Array (ERA) to evaluate the level of implementation receptivity by molecular analysis of the endometrial tissue. The biopsy of the endometrial tissue is analyzed for the expression of 238 genes involved in implementation. The ERA results will allow determining the optimal preparation to achieve a “receptive” endometrium and optimize the chances for implementation.
The world of Assisted Reproductive Technology has sure come a long way since the first IVF, helping millions of couples in their quest to become parents. We are excited to offer the most advanced technologies to help our patients achieve their dream of starting a family.