By Ariadne Toque
In vitro fertilization (IVF) is one of the many methods that those suffering from infertility can use to have children. More specifically, IVF is a form of Assisted Reproductive Technology (ART), treatments that can deal with gametes outside of the body. Even though IVF can give many people the chance to experience parenthood, it comes with many risks and consequences. This procedure can be incredibly expensive as just one cycle of IVF can turn out to be several thousand dollars. IVF is also very time consuming and can be very draining on individuals. On top of this, IVF has a very low success rate and can even result in multiple births, presenting even more risks for the mother and children. However, there is currently a method that is used to increase chances of a successful round of IVF and possibly alleviate some of these risks, genetic testing.
Aneuploidy is a condition in which a person has an abnormal number of chromosomes. This is the most common reason embryos that are developed through IVF are not able to implant into the uterus or are lost in miscarriage. Almost 50% of IVF embryos are aneuploidy, demonstrating how IVF has a low success rate. Preimplantation genetic testing for aneuploidy (PGT-A) is a type of genetic testing that can assess embryos for any chromosomal abnormalities. This test involves a normal procedure of IVF to be done, and five days after the embryo is created and brought up to the blastocyst stage, a biopsy is performed. Cells are taken from the embryo so that they can be tested for any abnormalities that may cause the cycle of IVF to fail. Genetic testing can also search for any abnormalities in the embryo’s DNA, showing any diseases that the child may be predisposed to.
PGT-A has many benefits, the main one being an increased chance of IVF success. Genetic testing allows for only the viable embryos, the embryos that have normal chromosomes known as euploids, to be detected and transferred. However, it is important to note that the success rate increases more significantly in women over the age of 35. A study was done that showed that the IVF success rate with preimplantation genetic screening (PGS) was 69.1% while the IVF success rate with only morphology assessment was 41.7%. Additionally, PGS can reduce the risk of miscarriage and the risk of multiple pregnancies. This all comes to show how genetic testing can greatly improve chances of a healthy pregnancy.
Conversely, PGS also has its consequences. PGS is an invasive procedure and there are concerns that it can cause damage to the embryo. There is also a chance that mosaic embryos have a mixture of normal and abnormal cells, and in the case that there are more normal than abnormal cells, the embryo may still be viable, leading to a decrease in accuracy.
Recently, the use of artificial intelligence (AI) has arisen as a new tool to improve the success of IVF based on the idea of genetic testing. Researchers at Weill Cornell Medicine have developed an AI algorithm called STORK-A that can test for aneuploidy through the use of microscope images of the embryo, maternal age, and the IVF clinic’s score based on its morphology. The algorithm “learns” to correlate specific data to chances of aneuploidy with an accuracy of around 70%. CooperGenomics has also done studies in this area as they developed their PGTaiSM platform that functions exactly like STORK-A. A study done by New York University (NYU) using their latest model of the platform, PGTai 2.0, showed that those who had a PGT-A done with this technology had a live birth rate of 70.3% compared to a 62% for those who did not use the platform. The researchers also found that those who used the platform had an increased implantation rate and pregnancy rate as well as decreased miscarriage rates compared to those who did not.
AI technology could greatly increase the chances of IVF success with less risk compared to the traditional PGT-A. It still allows for only the healthy and normal embryos to be transferred, possibly reducing the need to implant multiple embryos and additional procedures to be done, including more cycles of IVF. This AI technology has also proven to be more accurate than PGT-A, even making the process less subjective since the original methods were purely based on only the judgment of embryologists. The algorithms can also make the procedure more generalizable to more groups of people, making the process of genetic testing more efficient.
Sources:
Hajirasouliha, I., Zaninovic, N., & Rosenwaks, Z. (2019, April 4). Artificial intelligence approach optimizes
embryo selection for IVF. WCM Newsroom. https://news.weill.cornell.edu/news/2019/04/artificial-intelligence-approach-optimizes-embryo-selection-for-ivf
How innovative genetic testing technology is advancing pregnancy success - coopersurgical fertility solutions.
CooperSurgical Fertility Solutions - Genetic Testing For Your Family Planning Journey. (2021, April 23). https://www.coopergenomics.com/during-ivf/how-innovative-genetic-testing-technology-is-advancing-pregnancy-success/
Jim Schnabel. (2022, December 21). Harnessing AI technology for IVF embryo selection. Cornell Chronicle.
https://news.cornell.edu/stories/2022/12/harnessing-ai-technology-ivf-embryo-selection
Lewis, E. (2022, December 26). How does PGS improve IVF success rates?. Infertility Aide.
https://www.infertilityaide.com/blog/how-does-pgs-improve-ivf-success-rates
Oakes, M. (n.d.). Genetic testing improves IVF success. Nebraska Methodist Health System.
https://bestcare.org/news/genetic-testing-improves-ivf-success#:~:text=If%20you%20can%20determine%20which,15%2D20%20percent%20after%20PGS
Recent NYU Fertility Center Study shows coopergenomics’ innovative PGT-A leads to increased pregnancy and live
birth rates - coopersurgical fertility solutions. CooperSurgical Fertility Solutions - Genetic Testing For Your Family Planning Journey. (2021b, June 25). https://www.coopergenomics.com/during-ivf/recent-nyu-fertility-center-study-shows-coopergenomics-innovative-pgt-a-leads-to-increased-pregnancy-and-live-birth-rates/
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