06 Jun 10 IVF breakthroughs on the horizon
Infertility research is an exciting field. New techniques and advances happen all the time. So what new IVF breakthroughs will we see in the next few years? Here are 10.
1. PGD/PGS embryo screening – the comeback.
Pre-implantation genetic diagnosis (PGD), more accurately called preimplantation genetic screening (PGS), is a key technique. It checks genes and chromosomes of IVF-created embryos. and can stop couples with a serious inheritable condition (him or her) from passing it on.
Early PGD testing got mixed reviews. But a new approach called Array Comparative Genome Hybridization (a-CGH) has brought real improvements. It’s currently the best option in its field. On the horizon is Next Generation Sequencing (NGS). This method could be even more reliable, accurate and affordable. As our understanding of genetic screening grows, revolutionary times are ahead in the PGD world. It could be IVF’s trump card.
2. Egg freezing.
Freezing human eggs isn’t new. But the technology has got better. New vitrification techniques have transformed the survival rate of frozen eggs, and embryos, to around 95%. Egg freezing is, of course, a popular topic in the media.
Vitrification is basically a faster and more sophisticated way of freezing human gametes, reducing the formation of damaging ice crystals. As more women start families later in life, interest in egg freezing is on the rise. Some critics argue that egg freezing is an irresponsible lifestyle choice. We disagree: people should be allowed to do what they want.
But a dose of realism is needed. Freezing eggs for future fertility treatment doesn’t guarantee a future baby – it’s just the first step in the IVF process. And IVF doesn’t always work.
3. Extending embryo life in the lab.
Researchers in the UK and US have just done something extraordinary. They grew human embryos in the lab for 13 days. When you consider most embryos are transferred at day 5 or 6, that’s impressive.
Why is this important? Because extended cultivation gives an insight into a critical stage of human development. It helps us to understand how young embryos work, just before, during and just after their implantation window. Current UK law says embryos can’t be grown beyond day 14. But if embryos are grown for longer they could provide valuable information – and not just how to select the best ones to transfer.
4. Minimal-stimulation IVF.
Minimal stimulation, or mini IVF, uses lower doses of medication. It’s therefore kinder to your body than standard IVF. We predict a surge in popularity. It costs less than standard IVF, producing, quite often, fewer but better-quality eggs. The downside is that pregnancy rates are lower. But if your AMH levels are poor, it could be the way to go.
It’s optimal to start a mini-IVF cycle on your natural bleed – i.e. not preceded by birth-control pills. A typical minimal-stimulation protocol uses Clomid, Femara or Letrozole pills from day 3 to 7 of your cycle, supplemented by around 75 units daily of Menopur or Gonal-F. The mantra is: gently does it, nice and easy.
5. Egg quality – can you improve it? Really?
Egg quality is a key issue in IVF. A new approach could help women, controversially, improve egg quality. This may sound impossible, but hear us out.
The AUGMENT treatment involves extracting mitochondria from the immature egg cells found in the ovarian lining and adding them to women’s mature eggs. A similar approach has used mitochondria from donor eggs. But it’s a major development to source it from patients themselves. Cutting-edge stuff – and potentially very exciting.
6. Three-person IVF – the start of something big?
It was controversial. It was all over the papers. But now that the UK has approved the use of three-person IVF – the only country in the world to do so – it could pave the way for greater protection from known genetic diseases.
Clunky name, so what is it? The technique uses a modified version of IVF. The healthy mitochondria of a donor woman is mixed with the DNA of the two parents. The baby ends up with just 0.1% of their DNA from the donor.
But there are big concerns it could lead to non-essential embryo editing – modifying the genomes of human embryos for questionable reasons. Designer babies, in other words. It’s an ethical minefield. But if genetic manipulation and editing creates lives and banishes many diseases – which is very likely – the medical benefits will triumph over ethical sniping.
Imagine a world where miscarriages can be prevented simply by altering the genome of a newly formed embryo. That’s the kind of science we’re talking about here. Our lives could change forever.
7. Sperm and eggs – from stem cells.
Artificial sperm and eggs have been successfully grown in a lab using stem cells. It’s easy to underestimate this incredible achievement. Although still in its early stages, this technique could be rolled out to help countless infertile men and women have their own biological children for the first time.
1 in 7 couples have fertility problems. Just imagine how many infertile couples could be helped worldwide. More children, more happy families.
8. Frozen-embryo transfers.
Frozen embryo transfers happen for two reasons. One: your previous cycle (probably a fresh one) didn’t work. Or two: you’re having frozen donated embryos. Either way, success rates for frozen transfers are now nearly the same as for fresh cycles. That’s due to improved vitrification technology, stricter selection of viable embryos to freeze (why freeze no-hopers?) and a belief that cryopreserving embryos toughens them up and primes them for implantation.
FETs are also good news for women prone to overstimulation from fertility drugs, as they can help to reduce the risk of OHSS before and after transfer.
Not everyone gets pregnant after a fresh cycle. We predict frozen embryo transfers will lose their slight image problem and be seen for what they are: a great opportunity, at a reasonable cost, to try again.
9. Womb transplant – then IVF.
Up to 50,000 women in the UK have no viable womb. In the past, adoption or surrogacy were their only options for starting a family. Until now.
Thanks to advances in medical surgery, a womb transplant is now possible. It’s not yet widely available. And it costs a fortune to have one privately. But it allows the recipient to follow the transplant with an IVF cycle to make their dreams come true. A niche sector. But a technology to watch.
10. Embryo adoption
Embryo adoption is on the rise, judging by the number of couples we now help. Using an embryo, created altruistically by an egg and sperm donor, is now a compelling option for couples with dual infertility issues. More clinics now offer double donation. But it’s more common, and cheaper, in clinics outside the UK.
Twenty years ago, donor eggs seemed a big step for couples: now they’re mainstream. Donor embryos have taken the baton. Frozen donated embryos offer a ready-made solution, right there in the cryobank. No synchronised cycles. No wait. Quality assured. Ready to go.
So that’s our summary of the top 10 IVF breakthroughs on the horizon. We look forward to seeing how these exciting developments, and others, improve the outcome of fertility treatment in the years ahead. Watch this space!