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(Text on screen): Fertility Authority: Your Most Trusted Source
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Ask the Experts
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What are the advances in genetic testing with IVF?
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Dr. Edward Marut, Fertility Centers of Illinois: Over the last couple of years, FISH, which was based
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on purely a color scheme, has been replaced by three types of techniques, all which are pretty much the same thing.
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They all can look at every single pair of chromosome.
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Microarray comparative genomic hybridization, or array comparative genomic hybridizations, so MA, CGH, ACGH.
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And they're all pretty similar in terms of their approach.
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But they're able to take the cells and look at them more closely and more accurately.
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The approach can be used on a day three embryo,
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but then you still have the same problem with what you do to the embryo.
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If you wait for the embryos to first reach the stage where they have the best quality,
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so the blastocyst stage on day five or even six or even seven,
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cells can be taken from the trophectoderm, which is the outside layer of the embryo,
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so you don't disrupt the inner cell mass where the embryo actually resides.
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They can take several cells, so by taking several cells they get more DNA, they're getting more information,
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it takes care of a problem called mosaicism, which, in the cleaving embryo,
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was a problem of one cell being taken and the one next to it being different.
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That kind of clears itself out by the later stage of development and so that way the accuracy was better,
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the number of chromosomes that could be tested is better, and what even in our hands looked like a 15 percent error rate
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with the previous technique is down to probably 10 percent or less.
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They; we also found that the embryos that were judged to be normal, certainly, were normal.
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Embryos in the past that were judged to be abnormal may have actually been normal.
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So, we may have been discarding some of the normal embryos because of the mosaicism or because of the way they're being tested.
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Once the embryo has been biopsied, because it takes several days to get the results back, they all have to be frozen.
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So, some people will say, "Oh, my God. That's gonna do them in, too."
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But when you look at most places' frozen embryo transfer data, it's literally within percentage points of their fresh technique,
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largely because of vitrification, which is the new, you know, flash frozen quick freeze technique
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where embryos coming out of the tank almost look as good as they did when they went in.
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So, as we went from kind of a cruder method that, still, in the right hands, had benefits,
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now the newer methods which are actually in fewer people's hands, because the technique is as complex as it is,
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that taking cells from the advanced embryo, so the only ones you're testing are the ones likely to implant,
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so that's kind of a practical issue as well.
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Testing them for all 23 pairs of chromosomes, freezing, and then putting them back in a cycle
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where the woman hasn't gone through stimulation, which can actually be a better uterine environment,
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we're seeing implantation rates in our program over 60 percent for single embryo.
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And an ongoing pregnancy rate that approximates 90 percent.
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(Text on screen): Fertility Authority: Your Most Trusted Source
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