Robert G. Edwards and Patrick Steptoe made history 39 years ago when their ground-breaking idea to treat infertility caused by blocked fallopian tubes with in-vitro fertilization resulted in a healthy pregnancy and live-birth. Their work, which later granted Edwards with a Nobel prize revolutionized the world of reproductive medicine. And since then, IVF technology has become more common and accessible and is helping each year thousands of people struggling with infertility to conceive. According to CDC data, In the US alone, there were over 208,000 IVF cycles in 2014 which resulted in 70,354 live births.
In celebration of 4 decades of Assisted Reproductive Technology (ART) here’s a roundup of 6 cutting edge technologies in the field that are now available for couples trying to conceive:
1. Embryo screening and diagnosis - On day five after fertilization the embryologist will remove few cells from the embryo for special genetic tests:
Preimplantation genetic screening (PGS) - This test allows to select embryos that are more likely to result in an ongoing pregnancy and less risk of miscarriages by verifying the presence of all 23 chromosomes in the embryo. The process of PGS is illustrated in this great animated video.
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.
2. INVOcell - This technology replaces the need in an incubator to grow the embryos with a more natural approach. 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, 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. Read more
3. Time Lapse Embryoscope - is a special incubator incorporates a time lapse microscope camera for optimal embryo monitoring. The time laps microscope monitors embryo development at set intervals that are critical for embryo development without 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. This technology was taken one step further with an app allowing IVF patients to watch their embryos in real-time
4. DNA Fragmentation Index (DFI)- Sperm quality is usually measured by several factors: sperm concentration, motility, and morphology. DNA fragmentation provides another way to evaluate sperm quality. Scientists 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.
5. 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 treatment 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 time frame when the endometrium is "receptive" and as a result to better time the embryo transfer for increased chances of implementation.
6. In-vitro maturation (IVM) - is a revolutionary fertility treatment developed to provide a safer and a cheaper alternative to conventional IVF. Conventional IVF usually involves hormone injections to stimulate egg maturation to allow retrieval of eggs that are ready for fertilization. In this technique, called (IVM) the eggs are removed while they are still immature and are matured in the laboratory. Regular IVF had low success rates until recent finding by Robert Gilchrist, who found a way to increase the number of embryos produced by IVM by 50 per cent. The new growth factor compound, called, Cumulin increased egg maturation and boosted the IVM success rate for fertilization from 40 per cent up to 61 per cent.
Since the first test-tube baby in 1978, reproductive medicine has sure come a long way. Today, the world of reproductive medicine is facing more challenges with the rise of infertility rates, and childbearing age. There is a growing demand to find better, safer, more accessible and affordable fertility treatments to help more patients achieve their dream of starting a family.