Infertility is frustrating and painful, but if there is a silver lining to being infertile today, it is that this field of medicine is seeing some amazing improvements resulting in more pregnancies and more healthy babies. We talked about many advancements on yesterday’s Creating a Family show with Dr. Eric Forman, Reproductive Endocrinologist at Reproductive Medicine Associates of New Jersey, and Assistant Professor, Department of Obstetrics, Gynecology & Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, in New Jersey. He was co-author of the cover story in July 2014 issue of Contemporary OBGYN Magazine, “The New IVF Paradigm”.
Four Amazing Advancements in In Vitro Fertilization (IVF)
1. Chromosomal Testing at Day 5
Back in the olden days (a couple of years ago) chromosomal testing of embryos happened at around Day 3 of culture. At that stage of development, the embryo only has 6-8 cells, so only one cell could be removed.
It is now possible to biopsy the embryo at around Day 5 (the blastocyst stage, when the embryo has 75-100 cells and you can distinguish when cells will go on to develop into a fetus and which will become the placenta. More cells means more cells can be removed during the biopsy from those that are destined to become the placenta, thus increasing the accuracy of the test results.
2. Testing All Chromosomes
Way back when, it was only possible to test for 5 to 9 of the embryo’s chromosomes for abnormalities. With the current testing methods, all 23 pairs of chromosomes. Plus, current testing results are significantly more accurate.
3. Quicker Test Results
Chromosomal test results used to take days, now they can take hours. This time reduction opens up the possibility of testing at a later developmental stage, which allows more cells to be removed without harming the embryo.
4. Better Freezing Techniques
With the current cryopreservation technique, vitrification, 97-98% of embryos can be successfully frozen and thawed. Gone are the days of significant loss when thawing.
Fly in the Ointment
These advances on the field of infertility medicine are truly spectacular. Now if only we could make it more affordable. Comprehensive Chromosomal Screening (CSS) can add $3-4,000 to an IVF cycle.
Dr. Forman said that health insurance, for those lucky few that have fertility treatment coverage, usually does not cover CSS. This makes no economic sense. CSS allows patients to transfer a single embryo with confidence that they are not impairing their chances of success. Single embryo transfer significantly reduces the risk of twins. The medical cost of twins (average of $100,000+) far exceeds the cost a singleton birth ( average $20,000). Chromosomal screening would be cost effective.