Fertility Challenges archivos - IGENOMIX - With science on your side Pioneers in Reproductive Genetics Wed, 29 Dec 2021 11:19:47 +0000 en-US hourly 1 https://www.igenomix.com/wp-content/uploads/2019/10/cropped-ig-icon-1-32x32.png Fertility Challenges archivos - IGENOMIX - With science on your side 32 32 Dealing with male factor https://www.igenomix.com/blog/fertility-challenges/dealing-with-male-factor/ Tue, 26 Jan 2021 06:00:00 +0000 https://www.igenomix.com/?p=13960 Approximately 50 million couples around the world cannot conceive naturally and male factor infertility is a leading cause. According to a study published in the journal Human Reproduction, the quality of human sperm in developed countries has decreased by more than 50% in the last 40 years.  Generally, when couples are faced with infertility issues, it is often assumed [...]

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Approximately 50 million couples around the world cannot conceive naturally and male factor infertility is a leading cause.

According to a study published in the journal Human Reproduction, the quality of human sperm in developed countries has decreased by more than 50% in the last 40 years.

 Generally, when couples are faced with infertility issues, it is often assumed that the failure is due to a factor associated with the woman. However, we know that this is not always the case, as 40% of couples suffer specifically with male factor infertility, 40% from female factor infertility, and the remaining 20% of couples suffer with both male and female infertility factors. Poor sperm quality is the most common cause of male factor infertility. A semen analysis can be performed to evaluate quality by measuring sperm concentration, motility, and morphology. Understanding these parameters is important, as low levels can lead to outcomes such as inability of the sperm to fertilize an egg.

There are many causes that can lead to poor sperm quality, however the most frequent are:

• Infections and presence of antibodies in the body

• Thyroid related problems

• Diabetes

• Drug use (including tobacco)

• Certainmedications that can cause side effects

• Prolonged exposure to contaminants

• Stress

• Chromosomal and / or genetic alteration

• The pituitary and hypothalamus regulate the hormones that control sperm creation from the brain. A malfunction of these glands affects the entire process Malfunction of the pituitary and/hypothalamus (regulators of the hormones that control sperm creation)

• Problems in the testicles, such as underdevelopment and irregular development.

What are the main symptoms and treatments?

Signs such as an extremely low libido, erectile dysfunction, excessively small testicle size, or alteration in semen (watery, clear color, strong odor) may be indicative of male infertility factor. However, in many cases, male factor is asymptomatic and is only discovered after a couple has attempted to conceive without success If a couple is having difficultly conceiving, then it is advised to consult with a reproductive specialist to undergo the tests necessary to confirm or rule out potential problems. The treatments for male infertility factor are very different depending on the diagnosis. In milder cases, forgoing bad habits, maintaining a healthy diet, and exercising regularly may be enough to notice improvements. In other cases, drug treatment with hormones or surgery   may be necessary fix the problem. In more severe cases, it maybe necessary to undergo assisted reproduction and fertility treatments in order to achieve pregnancy.

IGENOMIX: SAT Test and PGT-A

The Sperm Aneuploidy Test (SAT) is a diagnostic test to help study the genetic origin of male infertility.

This test evaluates the percentage of spermatozoa with chromosomal abnormalities in a semen sample.

It analyzes some of the chromosomes most commonly implicated in spontaneous miscarriages and the chromosomes that have the potential to lead to the birth of an affected children with chromosomal abnormalities (chromosomes 13, 18, 21, X and Y).

The SAT Test is a useful tool that can provide personalized genetic information to the infertile couple prior to their fertility treatment.  

Preimplantation Genetic Testing for Aneuploidies (PGT-A) is a genetic test used to screen  embryos, produced during IVF treatment, in order to identify numerical chromosome aneuploidies (abnormalities). This test may be indicated for couples affected by male factor infertility.

This test identifies chromosomally normal embryos and can help improve your chances for a healthy ongoing pregnancy and baby.

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]]> COVID-19 and Assisted Reproduction Treatments https://www.igenomix.com/blog/fertility-challenges/covid-19-and-assisted-reproduction-treatments/ Wed, 18 Nov 2020 09:23:06 +0000 https://www.igenomix.com/?p=12090 The fact that we are living through difficult times worldwide caused by the new pandemic is something that  escapes no one. Our way of life has been affected at all levels, we have all had to adapt in many ways and doubts and questions about what will happen in our immediate future are something that [...]

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]]> The fact that we are living through difficult times worldwide caused by the new pandemic is something that  escapes no one. Our way of life has been affected at all levels, we have all had to adapt in many ways and doubts and questions about what will happen in our immediate future are something that we all have in our heads. As it happens in our own lives, reproductive medicine is not immune to these changes. Not necessarily of how the virus can affect treatment itself, but because of how it has affected assisted reproduction clinics in these past months and the doubts it has generated for many patients who were considering starting or even already undergoing treatment. We know that it is not easy, but in these moments it is when we must remain calm the most. First of all, we are very aware of the uncertainty that has been generated due to the coronavirus, we understand that patients who visit an infertility specialist looking to become pregnant have certain concerns about it. In this sense, from Igenomix we want to help you and send a message making a call to keep calm:
  • First, the articles published to date, as well as the cases studied, show that there is no transmission of COVID-19 from pregnant women to fetuses, indicating normal development the pregnancy.
  • Furthermore, to date, there is no evidence of transmission through assisted reproductive treatments. There is a detailed protocol prepared by health institutions, including ASRM (American Society for Reproductive Medicine) and ESHRE (European Society of Human Reproduction and Embryology) with the measures to be followed to promote the health of patients.
  • It´s important to mention that the prognosis related to COVID-19 in infected pregnant women was not worse when compared to infected non-pregnant women. Therefore, there is no increased risk for pregnant women or women in the process of assisted reproduction treatment.

Can the spread of coronavirus be prevented in cases of pregnant women or patients undergoing treatment?

In this sense, the measures that must be adopted to avoid contagion must follow the same preventive guidelines that the health authorities have prepared for anyone, whether pregnant or not, even under treatment:
  • Wash hands frequently, especially when going outside and returning home.
  • Cough and sneeze covering the mouth and nose with the inside bend of the elbow or with a tissue.
  • Avoid contact with other people and notify the health authorities in case of suspicion of being infected by the virus, avoiding going to health centers.

IGENOMIX and COVID-19:

From IGENOMIX we have always shown a strong commitment to society. As we have commented previously, in the face of the situation generated by the coronavirus, our way of life has changed as we know it. At IGENOMIX we believe that our duty is to break one more barrier, the barrier that prevents us from returning to our lives. To that end, we apply our knowledge in genetics to testing for COVID-19, thereby helping to enable access to a freer society. We have developed a new concept of PCR Test that forgoes the need to go to a health center, thus avoidingpossible infections. If you would like additional information from a scientific point of view, we like to invite you to watch our webinar “COVID-19 and pregnancy: what we need to know in reproductive medicine”, by Carlos Simón MD, Ph.D., Head of Scientific Advisory Board of IGENOMIX If you have any questions, please feel free to contact us through one of our social networks

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]]> Implantation Failure: the importance of determining each woman’s unique personalized embryo transfer timing https://www.igenomix.com/blog/fertility-challenges/implantation-failure/ Wed, 18 Nov 2020 09:18:23 +0000 https://www.igenomix.com/?p=12085 As you may know, research in the field of Reproductive Medicine is one of the areas that has evolved the most in recent years, promoting and insisting more and more on the study of genetics to improve the selection of the best embryos and even the application of artificial intelligence. Unfortunately, in assisted reproduction treatments, [...]

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]]> As you may know, research in the field of Reproductive Medicine is one of the areas that has evolved the most in recent years, promoting and insisting more and more on the study of genetics to improve the selection of the best embryos and even the application of artificial intelligence. Unfortunately, in assisted reproduction treatments, there is always a part that does not depend on science and is related directly to biological factors and the patient herself. In this sense, we still find In Vitro Fertilization (IVF) cycles that end with an embryo implantation failure. Although a good quality embryo is the best starting point for implantation, endometrial receptivity is essential for implantation to be successful. But, before going on, we´d like to explain what implantation failure and endometrial receptivity mean:
  • When we talk about implantation, we are referring to the adhesion of the embryo to the endometrium. Therefore, implantation failure occurs in In Vitro Fertilization treatment cycleswhen good quality embryos are transferred, but a pregnancy is not achieved.
  • On the other hand, when we talk about endometrial receptivity, the first thing you should know is that the inside of the uterus is covered by a tissue called the endometrium. The endometrium is where the embryo implants and develops during pregnancy. The endometrium is receptive when it is ready for implantation to take place. This period of receptivity is what we call the window of implantation (WOI). Sometimes, we find that on the typical day of embryo transfer in an IVF cycle, the WOI is displaced.

Do we know which are the best days to carry out the embryo transfer?

Thanks to endometrial receptivity tests, we can determine whether or not the endometrium is receptive at a certain moment of the cycle by analyzing a sample of endometrial tissue. Since 2009, IGENOMIX holds the patent for the ERA Test (Endometrial Receptivity Analysis), the first diagnostic test that locates the personalized implantation window of each patient.  By doing so, this allows proper synchronization of the embryo transfer with the receptive period, increasing chances of success by optimizing the chances of pregnancy without losing good quality embryos. Through a computer predictor, designed by IGENOMIX, we classify the data obtained, indicating whether the endometrium is Receptive or Non-receptive. A receptive result indicates that the implantation window is located on the day the biopsy was performed, and the embryo will be able to implant in the uterus in that period of time. When the result indicates that the endometrium is non-receptive, it specifies that your endometrium is either pre-receptive or post-receptive. The results allow us to obtain an estimate of the implantation window for each patient, so that personalized embryo transfer can be performed. The ERA Test is recommended for all patients at the beginning of their assisted reproduction treatments, being especially beneficial for patients with previous implantation failures.

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]]> Embryo Testing: The Difference Between PGT-A and PGT-M https://www.igenomix.com/blog/fertility-challenges/embryo-testing-difference-pgt-and-pgt-m/ Thu, 04 Jul 2019 08:46:28 +0000 https://www.igenomix.com/?p=12177 Success rates for IVF have improved significantly with the advent of PGT-A (preimplantation genetic testing for aneuploidies) of embryos. In order to provide genetic results of an embryo, a biopsy of a blastocyst embryo must be removed by a trained embryologist. Today, this procedure is frequently performed as part of in vitro fertilization. Depending on a patient’s [...]

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Success rates for IVF have improved significantly with the advent of PGT-A (preimplantation genetic testing for aneuploidies) of embryos. In order to provide genetic results of an embryo, a biopsy of a blastocyst embryo must be removed by a trained embryologist. Today, this procedure is frequently performed as part of in vitro fertilization. Depending on a patient’s reproductive history and personal medical history, a reproductive endocrinologist may offer preimplantation genetic testing for aneuploidies and/or Preimplantation Genetic Testing for Monogenic disorders (PGT-M). In this article, we explain the difference between these two types of embryo testing.

Genetic Screening (PGT-A)?

Preimplantation genetic testing for aneuploidies or PGT-A is now frequently referred to as preimplantation genetic testing for aneuploidy or PGT-A. This test screens embryos for chromosomal abnormalities. A chromosomally normal embryo will have 46 chromosomes. Any deviation from this number is likely to result in failed implantation, miscarriage, or a viable chromosome syndrome like Down syndrome.

Although this might sound alarming, chromosomal abnormalities are actually common place. Over a third of all embryos from a 30-year-old woman are detected to have a chromosomal abnormality. As women get older, this proportion rises to approximately 80% abnormal by the time a woman is 40. For this reason, women who try to get pregnant later in life may experience difficulties conceiving, an increased chance for miscarriage, and an increased chance of having a child with a chromosomal syndrome like Down syndrome, compared to a younger woman. As a result, reproductive endocrinologists will often recommend PGT-A to women in their late thirties or early forties.

What is Preimplantation Genetic Testing for Monogenic disorders (PGT-M)?

PGT-M is commonly known as PGT-M or preimplantation genetic testing for monogenic diseases. If a couple has a known genetic disease in their family which is caused by a specific single gene mutation, they can consider Preimplantation Genetic Testing for Monogenic disorders or PGT-M to test each embryo and determine whether each embryo has inherited the mutation and disease predisposition. This embryo testing can also be utilized when both the egg source and sperm source are carriers of the same autosomal recessive disease and wish to identify whether their embryos have inherited both mutations.

How is Embryo Testing Performed?

Both PGT-A and PGT-M require a biopsy of cells from a blastocyst embryo. This procedure is called ‘embryo biopsy’ and is very commonplace in embryology labs across the United States. The vast majority of embryos survive the biopsy although there is a small chance that an embryo could arrest after the biopsy is performed.  There are no studies to suggest an increased risk of birth defects in embryos that are biopsied compared to those that aren’t.

The biopsied cells are shipped to a lab for testing while the remaining blastocyst embryo is frozen and stored until the results are returned. From here, the patient can make a plan for how to use the frozen embryos. Once results are reported back to the patient, they will work with their doctor to select an embryo for a future transfer. Most doctors will recommend that the couple choose an embryo free from chromosomal abnormalities. If PGT-M was utilized to test for a specific single gene disease, the patient will typically choose to transfer an embryo that is unaffected with the specific disease.

When Should You Consider PGT-A or PGT-M?

Couples can benefit from embryo testing for a variety of reasons. For example, if a woman is experiencing recurrent miscarriage either naturally or as part of IVF, it may be useful for doctors to screen her embryos for chromosomal abnormalities. Furthermore, there is increasing evidence that PGT-A is useful for women over the age of 35 undergoing IVF treatment. As discussed above, PGT-M is useful for couples who have a known genetic mutation in their family. Remember, if you have any questions or concerns about embryo testing, consult with your fertility specialist. They will be able to advise you as to which test is appropriate given your fertility history and specific circumstances.

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]]> What PGT-A Testing Statistics Mean for Older Mothers https://www.igenomix.com/blog/fertility-challenges/pgt-a-testing-statistics-older-mothers/ Thu, 27 Jun 2019 07:47:34 +0000 https://www.igenomix.com/?p=12169 Statistically, today there are more mothers in their late 30s and early 40s than there were decades ago. This is for a number of reasons – for instance, many women are choosing to focus on their careers before starting a family. However, higher pregnancy rates also have a connection to better assisted reproductive technology. For example, [...]

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Statistically, today there are more mothers in their late 30s and early 40s than there were decades ago. This is for a number of reasons – for instance, many women are choosing to focus on their careers before starting a family. However, higher pregnancy rates also have a connection to better assisted reproductive technology. For example, preimplantation genetic testing for aneuploidies, or PGT-A, has substantially improved pregnancy success for women over the age of 35. Currently, PGT-A testing statistics show that the procedure reduces the chance of miscarriage by 30–40%. In this article, we discuss PGT-A screening in more detail and explore how it’s helping older mothers conceive.

What is Preimplantation Genetic Screening?

Preimplantation genetic screening is an optional component of the IVF process. PGT-A determines which embryos are ‘euploid’, which means they have the normal number of 46 chromosomes. In contrast, non-viable embryos are ‘aneuploid’, which means they have too many or too few chromosomes. If an embryo is aneuploid, the pregnancy is unlikely to be viable. By identifying which embryos are euploid, doctors can significantly improve the chances of a healthy pregnancy.

How is Having a Baby Later Connected to Aneuploid Embryos?

As women get older, the number of euploid eggs declines which reduced their chances of a healthy ongoing pregnancy. Throughout women’s 20s, egg quality will remain relatively stable. However, after age 34, PGT-A testing statistics have shown that at least 40% of embryos will be aneuploid, or chromosomally abnormal. By age 35-37 years, approximately 54% o embryos will be chromosomally abnormal. And by age 45, over 90% of embryos will be chromosomally abnormal.

How PGT-A Testing Statistics Show that Pregnancy Success for Older Mother is Getting Better

If you’re undergoing fertility treatment, PGT-A will help doctors to identify the best quality embryos. For older mothers, this substantially improves the chances of successful implantation. In contrast to leaving it to chance, a nicely graded euploid embryo could have a 70% chance of a positive pregnancy whether the woman is 20 or 40 years old.

Furthermore, studies have shown that PGT-Acan shorten the IVF timeline. Previously, fertility specialists would only expect 1 of 3 embryos from a 39-year-old to be genetically normal. Without PGT-A, selecting the correct embryo would have been luck of the draw. If a pregnancy results in miscarriage, it can take as long as three months for prospective mothers to be in a position to try again. However, if doctors can select a euploid embryo from the outset, it reduces the chance of miscarriage to 5%.

Now, PGT-A testing statistics show that more older mothers are having successful pregnancies. For example, a new study found that women aged 38-42 had a similar live birth rate to women 37 or younger if a euploid embryo was transferred. After a frozen euploid embryo transfer, live birth rates were very similar for both groups – 60% live birth rate for women aged 38-42 and 64% live birth rate for women under 38 years. As such, PGT-A can dramatically improve your chances of IVF success.

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]]> How PGT-A can Improve Success Rates with Chromosomally Normal Embryos https://www.igenomix.com/blog/fertility-challenges/pgt-a-improve-success-rates-with-chromosomally-normal-embryos/ Thu, 28 Mar 2019 09:32:00 +0000 https://www.igenomix.com/?p=13080 If you’re having fertility treatment, you’ll want to make sure the chances of conception are as high as possible. As a result, a common question many women ask when undergoing IVF treatment is how doctors select the best embryo. Until recently, this was based on morphology – which simply put, is how the embryo looks under the [...]

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If you’re having fertility treatment, you’ll want to make sure the chances of conception are as high as possible. As a result, a common question many women ask when undergoing IVF treatment is how doctors select the best embryo. Until recently, this was based on morphology – which simply put, is how the embryo looks under the microscope. However, now, doctors have developed a test to assess the genetics of an embryo. This test is known as preimplantation genetic screening or PGS. The test is also called preimplantation genetic testing for aneuploidy or PGT-A. Through identifying the best quality embryos, this test can improve success rates with chromosomally normal embryos.

What Does ‘Chromosomally Normal’ Mean?

Before going into exactly how PGT-A works, it’s useful to discuss why you might want to consider adding the test to your IVF treatment. Essentially, PGT-A can help doctors select a chromosomally normal, high-quality embryo to implant into the uterus. Chromosomes are the containers that carry our genetic information or DNA. When doctors say ‘chromosomally normal’, what they are referring to are embryos with the complete set of 46 chromosomes required to grow a healthy baby.

If an embryo has any deviation from 46 chromosomes – whether there is an extra or missing chromosome – it will be likely to result in a failed implantation, biochemical pregnancy, miscarriage, or a pregnancy affected by a chromosomal syndrome. While women of any age are at risk of producing embryos with chromosomal imbalances, the risk increases as the egg source ages. This is why women who have babies later in life are more likely to have a pregnancy with a chromosomal imbalance. It’s for this reason that older women may wish to include PGT-A as part of their IVF treatment. However, PGT-A is available to patients of any age.

So What is PGT-A Exactly?

In the past, fertility specialists would transfer an embryo into the uterus three days after fertilization. Now, research has shown that success rates with chromosomally normal embryos improve if they transfer a few days later. Now, doctors generally transfer the embryo at around five or six days into development, at blastocyst stage. Not only does this improve viability, but it also gives doctors the opportunity to perform a biopsy with a low risk of embryo arrest. The embryo biopsy can be utilized to perform preimplantation genetic screening or PGT-A. This test can identify chromosomally normal embryos, which increase the chances of a healthy pregnancy.

To perform the biopsy, an embryologist removes 2-10 cells from the precursor placenta cells of the blastocyst embryo, called the trophectoderm. These outer cells are what eventually will become the placenta. It’s important to know that the inner ball of cells, called the inner cell mass – which are what will grow into your baby – are not biopsied in this procedure.

How Do These Tests Improve My Chances of Conceiving?

As we’ve covered above, PGT-A helps doctors select a chromosomally normal embryo to transfer to the uterus. PGT-A improves success rates because chromosomally normal embryos are much more likely to implant and result in pregnancy. Furthermore, PGT-A also reduces the chances of miscarriage, as the most common cause is chromosome abnormality.

Is There Evidence About Success Rates with Chromosomally Normal Embryos?

Yes – a study conducted by the Colorado Center for Reproductive Medicine found that women ages 38-42 had a similar live birth rate to women 37 or younger if a chromosomally normal embryo was transferred. The study found that women with advanced maternal age (ages 38-42) had a chromosomal error rate of about 62% compared to women under 38 who had a chromosomal error rate of 37%. Women in both age groups had frozen embryo transfers of chromosomally normal embryos and the live birth rates were very similar for both groups – 60% live birth rate for women 38-42 and 64% live birth rate for women under 38 years.

If It’s So Effective, Why Doesn’t Everyone Do It?

Every IVF case is unique – therefore, some women may choose to not include PGT-A in their treatment. PGT-A can be an expensive addition to the costs already associated with IVF. Considering that the process isn’t 100% accurate – currently, accuracy rates sit at around 98% – some people decide against making the investment. Moreover, as the research we mention infers, PGT-A does not majorly impact implantation success in every case. As with all IVF treatment, even with PGT-A the top success rates with chromosomally normal embryos does not exceed 60–70%.

Your IVF Treatment is Your Journey

Everyone’s IVF journey is completely unique to them. Your fertility doctor will make special recommendations depending on you and your partner’s circumstances. Therefore, before making any decisions about your treatment, carefully consult with a health professional and gather as much research as you can. With the right information, you can make sure you go into your fertility treatment feeling informed and empowered.

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]]> What is PGD Testing and How Does it Work? https://www.igenomix.com/blog/fertility-challenges/what-is-pgd-testing-and-how-does-it-work/ Wed, 20 Mar 2019 11:36:01 +0000 https://www.igenomix.com/?p=517 If there is a genetic condition present in your family, you may want to explore options to reduce the risk of passing the condition on to your baby. Therefore, your fertility doctor may bring up the option of PGD testing. However, many medical processes can leave people feeling uncertain and anxious. Below, we break down [...]

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]]> If there is a genetic condition present in your family, you may want to explore options to reduce the risk of passing the condition on to your baby. Therefore, your fertility doctor may bring up the option of PGD testing. However, many medical processes can leave people feeling uncertain and anxious. Below, we break down the details of the PGD testing procedure. With this information, you can gain a deeper understanding of IVFand PGD procedures, so you and your partner can enter into the process feeling confident and empowered. The PGD Testing Cycle Explained Preimplantation genetic diagnosis, or PGD testing, is a procedure that allows couples with a hereditary genetic condition to significantly reduce the risk of passing it onto their children. In many cases, PGD can help prospective parents prevent their baby from being born with a serious genetic condition. PGD testing is utilized during an in vitro fertilization or IVF cycle. Below, we explain IVF with preimplantation genetic diagnosis in more detail, so prospective parents can get a clearer picture of how it works. Step 1: Case Review and Probe Development Each PGD test is custom-designed based on the specific disease and mutation that is inherited in a family. The patient or couple will provide their genetic testing results and information to the lab. The lab will review the results and accept the case if PGD is possible. Next, the lab will require DNA samples from the egg source, sperm source, and likely additional family members like parents or children. These samples will be used to develop the probe. This process typically takes a number of weeks. Step 2: Stimulation of the Ovaries Once the probe is complete, the reproductive endocrinologist will prescribe fertility medication to stimulate the egg source’s ovaries, causing them to produce several eggs at once. As it is likely that a number of a couple’s embryos will inherit the genetic abnormality, the patient will have a higher chance of producing normal unaffected embryos if they begin the processes with a larger quantity of eggs. Step 3: Egg Collection Next, a doctor will perform the egg retrieval. After egg retrieval, an embryologist will assess the eggs. Step 4: Fertilization Next, a doctor will fertilize each egg in the laboratory. This is done either with conventional fertilization, where the eggs and sperm are put together in a culture dish or through intracytoplasmic sperm injection (ICSI). ICSI is a procedure where specialist injects a single sperm cell into each egg cell. ICSI is typically the recommended method of fertilization if PGD is being utilized. Step 5: Culture and Biopsy Eggs that fertilize are then kept in the laboratory for five to six days until they reach blastocyst stage.  A blastocyst embryo typically contains about 100-150 cells. When each embryo achieves blastocyst stage, the embryologist will perform a biopsy, removing approximately 2-10 cells from the embryo. The blastocyst will be vitrified and remain at the clinic, while the cells from the biopsy are placed in a test tube and sent to a lab for PGD testing. Step 6: PGD Testing Once the PGD lab receives the biopsy samples, the PGD lab will use the probe that was developed to test embryos for the inherited mutation. It is also possible to use the same biopsy sample to test for chromosomal errors in embryos with PGS. The PGD lab will provide results for each embryo to the clinic. Step 7: Embryo Transfer Next, the patient will discuss the results of their IVF + PGD cycle with their doctor.  If the patient has normal embryos that are unaffected with the condition PGD was utilized for, they may decide to proceed with transferring an unaffected embryo.  They may also decide to undergo additional retrievals and IVF cycles to create more embryos. Step 8: Pregnancy Twelve days after the embryo transfer procedure, the patient who underwent the embryo transfer will be given a pregnancy test. If the test is positive, the implantation has been successful. Is PGD testing always successful? As many prospective parents know, IVF does not always result in pregnancy. Many factors affect the chances of conception, all of which depend on your individual circumstances. If you want to better understand your chances of conceiving with IVF + PGD it is important to have a detailed conversation with your physician and ask for data on pregnancy rates.PGD testing is 98% accurate in the majority of cases. Therefore, doctors recommend confirmatory testing during pregnancy to establish the results of PGD. Testing during pregnancy has an even higher accuracy than PGD for single gene conditions.

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]]> How PGS can Improve Success Rates with Chromosomally Normal Embryos https://www.igenomix.com/blog/fertility-challenges/how-pgs-can-improve-success-rates-with-chromosomally-normal-embryos/ Mon, 18 Mar 2019 11:00:22 +0000 https://www.igenomix.com/?p=475 If you’re having fertility treatment, you’ll want to make sure the chances of conception are as high as possible. As a result, a common question many women ask when undergoing IVF treatment is how doctors select the best embryo. Until recently, this was based on morphology – which simply put, is how the embryo looks under the [...]

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]]> If you’re having fertility treatment, you’ll want to make sure the chances of conception are as high as possible. As a result, a common question many women ask when undergoing IVF treatment is how doctors select the best embryo. Until recently, this was based on morphology – which simply put, is how the embryo looks under the microscope. However, now, doctors have developed a test to assess the genetics of an embryo. This test is known as preimplantation genetic screening or PGS. The test is also called preimplantation genetic testing for aneuploidy or PGT-A. Through identifying the best quality embryos, this test can improve success rates with chromosomally normal embryos. What Does ‘Chromosomally Normal’ Mean? Before going into exactly how PGS works, it’s useful to discuss why you might want to consider adding the test to your IVF treatment. Essentially, PGS can help doctors select a chromosomally normal, high-quality embryo to implant into the uterus. Chromosomes are the containers that carry our genetic information or DNA. When doctors say ‘chromosomally normal’, what they are referring to are embryos with the complete set of 46 chromosomes required to grow a healthy baby. If an embryo has any deviation from 46 chromosomes – whether there is an extra or missing chromosome – it will be likely to result in a failed implantation, biochemical pregnancy, miscarriage, or a pregnancy affected by a chromosomal syndrome. While women of any age are at risk of producing embryos with chromosomal imbalances, the risk increases as the egg source ages. This is why women who have babies later in lifeare more likely to have a pregnancy with a chromosomal imbalance. It’s for this reason that older women may wish to include PGS as part of their IVF treatment. However, PGS is available to patients of any age. So What is PGS Exactly? In the past, fertility specialists would transfer an embryo into the uterus three days after fertilization. Now, research has shown that success rates with chromosomally normal embryos improve if they transfer a few days later. Now, doctors generally transfer the embryo at around five or six days into development, at blastocyst stage. Not only does this improve viability, but it also gives doctors the opportunity to perform a biopsy with a low risk of embryo arrest. The embryo biopsy can be utilized to perform preimplantation genetic screening or PGS. This test can identify chromosomally normal embryos, which increase the chances of a healthy pregnancy. To perform the biopsy, an embryologist removes 2-10 cells from the precursor placenta cells of the blastocyst embryo, called the trophectoderm. These outer cells are what eventually will become the placenta. It’s important to know that the inner ball of cells, called the inner cell mass – which are what will grow into your baby – are not biopsied in this procedure. How Do These Tests Improve My Chances of Conceiving? As we’ve covered above, PGS helps doctors select a chromosomally normal embryo to transfer to the uterus. PGS improves success rates because chromosomally normal embryos are much more likely to implant and result in pregnancy. Furthermore, PGS also reduces the chances of miscarriage, as the most common cause is chromosome abnormality. Is There Evidence About Success Rates with Chromosomally Normal Embryos? Yes – a study conducted by the Colorado Center for Reproductive Medicine found that women ages 38-42 had a similar live birth rate to women 37 or younger if a chromosomally normal embryo was transferred. The study found that women with advanced maternal age (ages 38-42) had a chromosomal error rate of about 62% compared to women under 38 who had a chromosomal error rate of 37%. Women in both age groups had frozen embryo transfers of chromosomally normal embryos and the live birth rates were very similar for both groups – 60% live birth rate for women 38-42 and 64% live birth rate for women under 38 years. If It’s So Effective, Why Doesn’t Everyone Do It? Every IVF case is unique – therefore, some women may choose to not include PGS in their treatment. PGS can be an expensive addition to the costs already associated with IVF. Considering that the process isn’t 100% accurate – currently, accuracy rates sit at around 98% – some people decide against making the investment. Moreover, as the research we mention infers, PGS does not majorly impact implantation success in every case. As with all IVF treatment, even with PGS the top success rates with chromosomally normal embryos does not exceed 60–70%. Your IVF Treatment is Your Journey Everyone’s IVF journey is completely unique to them. Your fertility doctor will make special recommendations depending on you and your partner’s circumstances. Therefore, before making any decisions about your treatment, carefully consult with a health professional and gather as much research as you can. With the right information, you can make sure you go into your fertility treatment feeling informed and empowered.

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]]> What is an ERA Test and How It Can Help You https://www.igenomix.com/blog/fertility-challenges/what-is-an-era-test-and-how-it-can-help-you/ https://www.igenomix.com/blog/fertility-challenges/what-is-an-era-test-and-how-it-can-help-you/#comments Fri, 07 Dec 2018 10:57:53 +0000 https://www.igenomix.com/?p=472 When you’ve been trying to conceive for a while and you turn to the in vitro fertilization process to help build your family, you want to make every effort to have the best possible outcome. While IVF is known to have high success rates, knowing the ideal time to transfer your embryo can be incredibly [...]

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]]> When you’ve been trying to conceive for a while and you turn to the in vitro fertilization process to help build your family, you want to make every effort to have the best possible outcome. While IVF is known to have high success rates, knowing the ideal time to transfer your embryo can be incredibly helpful. This is especially true if you’ve had a history of 2 or more unsuccessful embryo transfers. If the embryos you’re transferring are good quality (whether they are your own or you are using donor eggs or donor embryos), but they haven’t implanted, the ERA test can be worth speaking to your doctor about to see if it’s something he or she would recommend. What is an Endometrium? The endometrium is the tissue that lines the uterus, and it typically thickens in anticipation for an embryo to implant during your menstrual cycle. If the egg is not fertilized or if an embryo does not implant, the uterine lining sheds itself, which is when a woman gets her period. Before the ERA test was developed, your doctor could only observe your endometrial lining with an ultrasound. While this is helpful in measuring how thick or thin your lining is, the ERA test can help provide additional insight into both the environment and quality of your endometrium. This information can be invaluable when it comes to IVF. What is Endometrial Receptivity? According to Carlos Simon, a clinical researcher and Gynaecologist who was a part of the research that helped develop the ERA Test, taking into consideration the timing between the development of an embryo and the status of the endometrial lining can be key in achieving a pregnancy. Endometrial Receptivity is the stage in which Endometrium is prepared to allow the embryo’s implantation, this stage occurs in a limited time fragment named “Window of Implantation”. ERA testing bases endometrial receptivity on several factors that includes 248 genes. This helps determine your best window of implantation. What’s important to realize is your window can differ from someone else’s. Having this additional intel can assist your doctor so that he or she can personalize your care and IVF protocol. This means your embryo transfer would be scheduled and tailored around exactly when your endometrial receptivity is at its most optimal for implantation. What Exactly is the ERA Test? Now that you know what your endometrium lining and endometrial receptivity are, let’s discuss exactly what an ERA Test is. During your fertility journey, you may have heard terms such as “ERA Biopsy”, “ERA Testing” or just “ERA”, but you may not have heard what these three letters stand for or how they can help you. ERA is short for Endometrial Receptivity Analysis. It is a genetic test performed on a very small sample of a woman’s endometrial lining to determine which day would be the best day to transfer the embryo during an IVF cycle. The sample taken is also referred to as an ERA biopsy and the whole procedure in general is called either an ERA Test or ERA Testing. Who Should Consider the ERA Test? The ERA test is something best discussed with your doctor to determine if it’s right for you and your diagnosis or fertility history. Some factors worth considering are: Patients who have had 2 or more unsuccessful embryo transfers Patients who have had concerns with endometrial lining (example: thin endometrial lining) Patients who have had had unsuccessful implantation with high quality embryos In general, any patient who has gone through an IVF treatment could be favored by her endometrial diagnosis previous to receiving her embryos The ERA test has been found to improve global pregnancy rates up to 73% in the personalized transfers made according to the test results (Fertility and Sterility, September 2013). Knowing this can be empowering since, as an informed patient, you can take an active part in your fertility care. If you feel that an ERA biopsy might be a fit, speak to your doctor to discuss it. Infertility treatment is always evolving, and your medical team is there to work with you to find what would work best for you to reach your goals!

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