New Advancements In Embryo Screening Technique Result In Improved Safety And Chance For Success In IVF
Published Data From Leading New Jersey IVF Center Finds Older Cleavage-Stage Biopsy Technique Reduces Embryonic Reproductive Potential While Blastocyst-Stage Biopsy Does Not
BASKING RIDGE, N.J., June 25, 2013 /PRNewswire/ -- Reproductive Medicine Associates of New Jersey, today announced the results of a newly released IVF study which shows that delaying embryonic screening for chromosomal abnormalities until the fifth day of development – the blastocyst stage – significantly improved implantation rates and led to more successful pregnancies. The study was published online in the June edition of Fertility & Sterility.
While many IVF patients choose to have their embryos screened for chromosomal viability, testing has traditionally been conducted on day three, at the cleavage stage of development. Data from the new RMANJ study shows that the practice of cleavage-stage biopsy can impair an embryo's ability to implant and become a healthy pregnancy and delivery.
"At the blastocyst stage, the fifth or sixth day of development, the embryo consists of about 200 cells," said Richard T. Scott, Jr., M.D., FACOG., HCLD., a founding partner of RMANJ. "Testing at this point is much safer, as cells are taken only from the portion of the embryo destined to form the placenta, called the trophectoderm. These cells reveal the same genetic information contained within the cells that will eventually form the fetus, while allowing us to leave the fetal cells untouched and uncompromised."
By contrast, an embryo is made up of six to eight cells at the cleavage stage, which means that traditional testing at this point has required the removal of up to one-sixth of the embryo's total volume.
Added Scott, "Simply put, cleavage-stage biopsy of human embryos may represent a violation of one of the principal precepts of medical ethics – primum non nocere or 'first do no harm'." Based on this data, RMANJ only performs blastocyst-stage biopsy for genetic testing in IVF.
Melanie, a patient from Ocean County, NJ says the advanced care she received at RMANJ made all the difference in achieving pregnancy.
"As a patient, dealing with the term 'unexplained infertility' is really hard. Inside, I knew there was more to my infertility issues than what I had been told in the past. But the research and the advancements in safety and success at RMA helped me get the answers I was looking for. It helped me get a better sense of control over my care. The people and technology gave me the hope and support I needed to be successful, as safely as possible."
Added Eric J. Forman, M.D. and coauthor of the study, "It's critical that embryo biopsy for genetic testing is done at the blastocyst stage to improve both safety and outcomes for patients. This applies to screening for both single gene abnormalities as well as aneuploidy which is an abnormal number of chromosomes. It's also important to note that while time-lapse video imaging platforms have the potential to add to the conventional approach of grading embryos at discrete time points, none has been shown to accurately predict the chromosomal status of embryos. Even embryos that look good and develop in a timely manner may have a high risk of being chromosomally abnormal and result in a failed IVF cycle. You still can't judge a book by its cover. The combination of blastocyst biopsy with comprehensive chromosome screening provides both increased safety and chance for success."
RMANJ pioneered SelectCCS as the new standard of care for infertility patients. This one-of-a-kind 24-chromosome screening platform identifies whether embryos are euploid (normal number of chromosomes) or aneuploid (abnormal number of chromosomes), enabling the selection of only the healthiest embryo for transfer. Used in combination, SelectCCS with Single Embryo Transfer (SET) can help to make "one embryo, one baby" a reality for patients undergoing IVF, providing uncompromising success rates without complications often associated with twin pregnancies and deliveries.
SelectCCS is available to patients nationwide at other IVF programs including, RMANY, RMACT, RMA Pennsylvania, RMA Philadelphia, RMA Michigan, RMA Texas, and several other programs in the US.
About the Study
A total of 116 patients participated in the RMANJ study, with 46 undergoing transfer at the cleavage stage and 70 at the blastocyst stage. All 46 (100%) of the cleavage-stage embryos randomized to the biopsy group were successfully biopsied and evaluated with interpretable results. Sixty-nine (99%) of the 70 blastocysts randomized to the biopsy group were successfully biopsied and produced interpretable results (one failed to amplify). Thus, 46 cleavage stage pairs and 69 blastocyst stage pairs were available for analysis.
Among the cleavage-stage embryos, a total of 14 biopsied embryos (30.4%) and 23 nonbiopsied embryos (50%) implanted and displayed fetal cardiac activity. The absolute reduction in implantation rates was 19.6%. The risk of the procedure may also be expressed by the relative reduction in the probability of an embryo having sustained implantation and progressing to delivery. The decline in implantation rates from 50% to 30.4% represents a relative reduction of 39.1%
Among the 69 blastocyst-stage transfers, two patients were lost to follow up, leaving 67 transfers available for evaluation. When considering all embryos transferred, 34 biopsied embryos (51%) and 36 nonbiopsied embryos (54%) had sustained implantation and progressed to delivery. This nonsignificant difference represents an absolute reduction of 3%.
About Reproductive Medicine Associates of New Jersey
The fertility experts at RMANJ have among the highest IVF success rates in the country, and consistently report pregnancy success rates above the regional and national average. The world-renowned RMANJ laboratory in Basking Ridge has been recognized by both competitors in the field and scientific institutions as a standard of excellence. Since 1999, they have helped bring nearly 30,000 babies to loving families. In addition to serving as the Division of Reproductive Endocrinology at Robert Wood Johnson University Medical School in New Brunswick, NJ, the practice has seven locations in New Jersey. For more information please call RMANJ at 973-656-2089, or visit http://www.rmanj.com.
SOURCE Reproductive Medicine Associates of New Jersey
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