Promising results with new fertility technique

  • Eimear Vize

An assisted reproduction innovation that it is claimed can boost live birth rates by 56% is available in Ireland.

The new technique uses a combination of time-lapse imagery and a new selection model that predicts which embryos have the highest potential for a successful pregnancy. Recent research into the technique has shown very promising results.

Scientists at CARE Fertility clinics in the UK and in Dublin are using a 'super incubator'.  This is called an Embyroscope, which has a built-in microscope, camera and computer, and provides continuous images of the embryo as it develops in a controlled and protected environment.

Whereas standard incubation requires the removal of the embryos from the incubator to observe them - recording approximately six images over five days - the Embyroscope can take more than 5,000 images over the same period without disturbing the embryo.

These time-lapse images allowed the CARE researchers to 'screen' embryos for delays at defined time points that could indicate risk of abnormalities in the structures that hold our genes - chromosomes, which would then allow them to select the low-risk embryos for implantation.

"About 70% of embryos that are conceived naturally or through IVF don't make babies - we're not very efficient as a species - and the most common reason is because they have chromosomal abnormalities, also known as 'aneuploidy'," explains Prof Simon Fishel, Managing Director of the UK CARE Fertility, and a leading specialist in the field of fertility treatment.

"An embryo that ends up with three copies of chromosome 21, instead of the normal two, will develop Down's Syndrome, and three copies of chromosome 13 or 18 will go on and produce babies but with severe consequences - all the other chromosome errors will result as miscarriage or even failure to implant. Given that it's the largest single cause of IVF failure or miscarriage this becomes the most important element to try to discover in embryos."

"Until our discovery, we have had no means except for a very expensive technology, an invasive procedure called embryo biopsy, to look at chromosomes. In routine IVF practice, embryologists worldwide could not differentiate between chromosomally viable and chromosomally abnormal embryos, and have been unwittingly and unintentionally transferring embryos that are not viable."

"But what we now have is a combination of time-lapse images and algorithms relating to ploidy - what we call chromosome status - telling us objectively which embryos have the highest potential for live birth, down to the lowest potential for live birth," he told irishhealth.com

Previous research had shown that the high-tech Embyroscope incubator can increase the success rate of IVF by as much as 20%. It has been hailed as the biggest breakthrough in IVF technology in over a decade because, for the first time, it provided time-lapse embryo imaging of embryos in a closed incubation system with optimum, uninterrupted conditions.

Alison Campbell, Embryology Director at BeaconCARE Fertility in Dublin said: "As the first clinic to introduce Time Lapse Imaging in the UK and Ireland, we already knew that the ability to view detailed images of embryo development helped us with embryo selection and therefore, improved our patients' outcome.

"However, our latest findings have taken this further and using morphokinetic algorithms to predict success (MAPS) we have now demonstrated a 56% uplift in our live birth rates, equivalent to a 78% live birth rate."

Morphokinetic algorithms are calculations about what the embryo should be doing at specific points in time.

Prof Fishel explains: "Morphology is the shape or appearance of cells in the embryo. The time at which it reaches a particular stage is its kinetics, so embryos have to reach certain positions at certain times for us to give it a quality score, that's morphokinetics."

"Our time-lapse studies have revealed many secrets about the viability of embryos as they develop through the early stages, information we could never obtain by routine IVF culture. What we now know is that morphokinetics differ depending on whether the chromosomes were normal or abnormal."

In a study of 69 couples at the CARE fertility clinic in Manchester, the researchers found that 11 babies were born from the low risk group (61% success rate) compared to five from the medium risk group (19% success rate) and none from those deemed high risk.

"In the 35 years I have been in this field this is probably the most exciting and significant development that can be of value to all patients seeking IVF," adds Prof Fishel.

"Continuous incubation technology is more protective of the embryo, it is non-invasive and the fact that it is highly predictive of successful outcome suggests that we have a paradigm shift in the way IVF will be conducted in the future. I have no doubt that the use of MAPS technology and further advances in time-lapse imaging will be of great benefit to all patients requiring IVF treatment."

Located in the Beacon Medical Campus in Dublin, Beacon CARE Fertility is a joint venture between Beacon Medical Group and the UK CARE Fertility.

 

 

 


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