Member Article

The future of fertility

Advancements in fertility treatments are constantly taking place, with new innovations in technology and scientific breakthroughs regularly being reported all over the world.

But what’s next for this ever-evolving industry, whose developments hold so much hope for the millions of people who want to become parents?

Here, internationally leading fertility specialist Dr Manuel Fernandez, from the world-leading IVI Fertility clinic, shares his expert thoughts on what the key focusses for industry experts in 2016 will be – and in particular how the industry will continue to address the issue of high rates of twin pregnancies as a result of assisted reproductive treatment:

Single Embryo Transfer (SET)

“2016 is set to be an exciting year for the fertility industry, with many innovations and advancements on the horizon.

One of the key focusses for fertility experts over the coming months will continue to be reducing twin pregnancy rates, by moving to single embryo transfer (SET). This is something which we have made significant progress with over the past couple of years, but which we need to continue to work on throughout 2016.

Approximately one in six IVF pregnancies result in a multiple pregnancy, with recent studies showing that these pregnancies carry a much greater risk of low birth weight, perinatal and infant mortality, and preterm delivery and disability.

Over the past couple of years, the European fertility industry in particular has taken steps to lower these risks by transferring just one embryo per cycle of IVF, instead of multiple embryos which historically has been the method employed.

Research has revealed that this conscious effort to encourage patients to opt for single embryo transfer (SET) has reduced multiple pregnancies by 50 per cent, while at the same time maintaining a high level of overall pregnancy success rates. However, fertility specialists face an ongoing struggle to convince patients that SET is the best option for them – with many still finding the prospect of a multiple pregnancy appealing as they incorrectly believe that it will give them a greater chance of pregnancy success.

Working towards making the process of SET routine will be a crucial advancement within the industry over the next few years. In order to really move this technique on however, we need to continue to demonstrate high pregnancy success rates and be confident we have as much information as possible about the embryos which we select.

To help develop our understanding of the embryos we are implanting, there are a couple of new techniques which can be used such as Compatibility Genetic Testing (CGT) and the use of Time Lapse technology.

• Compatibility Genetic Testing (CGT) – this test enables us to avoid genetic abnormalities by analysing the genetic compatibility of the parents or donor’s gametes. Approximately 600 common recessive autosomal diseases can be tested for, and avoided using CGT.

• Time-lapse Technology – This involves the embryos being cultured within a time-lapse incubator prior to implantation, meaning that each embryo is stored in a closed system which keeps conditions perfectly stabilized within an optimal range. Over the course of 2016, we can expect to see time lapse systems being implemented as the industry’s gold standard technique for helping to improve pregnancy success rates.

A further way in which specialists are looking to continue to develop their understanding of which embryos offer the best chance of pregnancy success is by moving to Blastocyst Transfer, over normal Embryo Transfer.

Blastocyst Transfer

Another industry development which we hope will help to further promote SET in 2016, is the use of blastocyst transfer, instead of embryo transfer.

In simple terms, a blastocyst is an embryo which has been allowed to develop in a lab for around 5-7 days before implantation. This is much longer than with conventional embryo transfer, in which the embryo is transferred to womb at around day three.

The reason fertility specialists are increasingly looking to blastocyst transfer, over regular embryo transfer is because by day 5, the embryo is much more advanced – having divided into many more cells. Our latest research suggests that less than 50 per cent of embryos will successfully develop to the blastocyst stage, meaning that blastocyst transfer is deemed to be a much more selective process, and therefore offers a greater chance of a successful pregnancy.

The move to blastocyst transfer shows how sophisticated the fertility industry, and particularly the IVI Fertility Group, is becoming with embryo selection. If patients are confident that the embryo’s chosen for implantation offer the very best chance of success then they are much more likely to opt for a single embryo to be transferred, which in turn will help significantly to reduce the global rate of multiple pregnancies.

3D ultrasound

A final development which we are particularly championing at IVI this year is an industry-wide move to using 3D ultrasound as standard when examining patients. In many instances, a woman may be struggling to conceive naturally however, she isn’t displaying any obvious symptoms which would indicate a serious problem. At present, the industry norm is to carry out a 2D ultrasound however, at IVI we are increasingly using more advanced 3D ultrasound technology so that we can see the much bigger picture.

There are several conditions which may prevent pregnancy, such as a small or malformed uterine cavity which would not be detectable without 3D scanning however, they are easily treated once they have been diagnosed.

This was posted in Bdaily's Members' News section by George May .