An article in the New York Times reviews the pros and cons of methods of selection of the embryo most likely to result in a health baby.
And this appears to be the future direction of IVF: embryo selection to facilitate single embryo transfer (eSET) resulting in a dramatic reduction of multiple pregnancy without reducing success rates.
Chromosomal testing (PGS) is one of the techniques now coming into use to help fertility clinics answer one of their most vexing questions: Which test-tube embryo or embryos will give a woman the best shot at having a baby?
Another new technique uses time-lapse imaging to study the development pattern of the embryo. Both techniques can potentially provide more information than the approach now used to judge an embryo’s fitness, which is to look at its development under a microscope.
That could increase the efficiency of in vitro fertilization. And if clinics can be nearly certain that an embryo is fit, they might feel more comfortable transferring only one embryo rather than two or more, as is common practice. That would reduce the chances of producing twins or triplets, which face greater health risks than single babies.
But some experts say the new techniques, which can add thousands of dollars to the cost of in vitro fertilization, are being heavily promoted without data supporting that they truly improve pregnancy rates. For some women, a few say, chromosomal testing might even reduce their chances of getting pregnant.
The chromosomal testing is called preimplantation genetic screening (PGS). This is different from a related technique called preimplantation genetic diagnosis (PGD), which tests embryos for specific mutations with the goal of preventing the birth of a baby with a genetic disease. With the chromosomal screening, the goal is mainly to improve birthrates, not influence the traits of the baby.
On time-lapse imaging, Auxogyn, a Silicon Valley start-up, just received clearance from the Food and Drug Administration to market a computerized system that predicts the fittest embryos. It will face off against Unisense FertiliTech, a Danish company that sells a time-lapse system called the EmbryoScope.
At RPMG we are currently testing the Auxogyn system and have been doing PGS since it was first introduced.