In The Fam­ily Way

DOC­TOR MICHAEL DOYLE OF THE POP­U­LAR IN­TER­NA­TIONAL IVF CEN TRE CT FER­TIL­ITY EX­PLAINS IN LAY­MAN’S TERMS HOW IVF TECH­NOL­OGY CON­TIN­UES TO EVOLVE AND RE­SULT IN EVEN BET­TER RE­SULTS FOR PROSPEC­TIVE GAY PAR­ENTS

Pride Life Magazine - - SPONSORED FEATURE -

The key chal­lenge of IVF has al­ways been to cre­ate the health­i­est em­bryos pos­si­ble and to iden­tify the ones that are most likely to de­velop well and re­sult in a suc­cess­ful preg­nancy. Given the health risk of mul­ti­ple births for both the car­rier and the fu­ture ba­bies, the goal is to trans­fer the low­est pos­si­ble num­ber (of­ten only one now) and still achieve the max­i­mal im­pact (high­est preg­nancy rate).

Twenty years ago the best we could do was to grow em­bryos for three days be­fore im­plant­ing them into the car­rier’s womb, as few would sur­vive longer in the lab­o­ra­tory. How­ever at that early stage of de­vel­op­ment it was im­pos­si­ble to pre­dict which em­bryos would fur­ther de­velop, and that meant trans­fer­ring a higher num­ber of em­bryos and “hop­ing for the best.” Un­for­tu­nately of­ten the re­sult was no preg­nancy, and when it was achieved, mul­ti­ple preg­nan­cies were com­mon. PA­TIENCE IS A VIRTUE – ALSO WHEN IT COMES TO EM­BRYO REAR­ING Over time, science gained a bet­ter un­der­stand­ing of the nu­tri­ent sources for em­bry­onic de­vel­op­ment and skilled em­bry­ol­o­gists were able to sus­tain em­bryos for 5- 6 days so they could reach the crit­i­cal “blas­to­cyst” phase. At this stage it is much eas­ier to de­ter­mine which em­bryos will re­sult in healthy live births, based on their rate of cel­lu­lar growth and other grad­able qual­i­ties.

Even with th­ese far more ef­fec­tive blas­to­cyst trans­fers, how­ever, it was demon­strated that many of th­ese highly graded em­bryos still had chro­mo­so­mal ab­nor­mal­i­ties that led to re­duced im­plan­ta­tion or in­creased mis­car­riage. This her­alded our next break­through – the abil­ity to biopsy (be­fore em­bryo trans­fer) each blas­to­cyst to en­sure that the ge­net­ics (chro­mo­somes) con­tained in each cell’s nu­clear DNA were nor­mal. This pre-im­plan­ta­tion ge­netic screen­ing (PGS) could thereby in­crease im­plan­ta­tion rates and add a new level of safety, as well as re­as­sur­ance that if the em­bryo were able to im­plant, sub­se­quent mis­car­riage would be less com­mon. DNA SE­QUENC­ING OF EM­BRYOS WITH­OUT UN­PLEAS­ANT TRADE­OFFS Early PGS tech­niques (par­tic­u­larly when done on 3-day old em­bryos) were as­so­ci­ated with sev­eral draw­backs, in­clud­ing the risk of fe­tal com­po­nent. Also, since some clin­ics are able to per­form same-day PGS and get the DNA re­sults back within 24 hours, there is no longer the need to un­nec­es­sar­ily freeze all the em­bryos while wait­ing for the PGS re­sults. This is key be­cause de­spite some un­proven claims to the con­trary, we be­lieve that fresh em­bryos do bet­ter than frozen. GET­TING THE COM­PLETE PIC­TURE WITH SI­MUL­TA­NE­OUS NU­CLEAR AND MI­TO­CHON­DRIAL DNA TEST­ING The most cur­rent state-of-the-art fer­til­ity treat­ments take nu­clear DNA PGS to the next step by eval­u­at­ing the “other kind of DNA” con­tained in the em­bry­onic cell’s cy­to­plasm (not the nu­cleus) – the mi­to­chon­drial DNA, which di­rects the abil­ity of the em­bryo to per­form crit­i­cal func­tions like cell di­vi­sion and im­plan­ta­tion. There­fore even if an em­bryo has nor­mal nu­clear DNA it is far less likely to con­tinue to grow af­ter the trans­fer and suc­cess­fully im­plant if mi­to­chon­drial DNA is not at ap­pro­pri­ate lev­els. This lat­est gen­er­a­tion PGS of­fers a far more pre­cise anal­y­sis of the po­ten­tial of each em­bryo than tra­di­tional PGS, with no trade­offs.

I am proud that CT Fer­til­ity is one of the few fer­til­ity clin­ics in the world that of­fers rou­tine si­mul­ta­ne­ous nu­clear and mi­to­chon­drial DNA test­ing as part of its PGS pro­gram. We be­lieve that the tech­nol­ogy is af­ford­ing more of our clients an added level of re­as­sur­ance, choice and con­trol, and reaf­firms our com­mit­ment to in­crease suc­cess with­out es­ca­lat­ing costs.

Go to: www.ct­fer­til­ity.com

HUGO AND MAR­CUS AND THEIR CHIL­DREN

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