# Test that doubles the chance of success with IVF



## Wraakgodin

http://www.dailymail.co.uk/pages/live/articles/technology/technology.html?in_article_id=432870&in_page_id=1965

A simple test which more than doubles the chance of having a healthy baby could transform the face of IVF.

Scientists have found a way to test the genetic make-up of a woman's eggs, allowing the best to be chosen.

A trial of the method has produced more than 30 healthy babies and dramatically increased the success rate of the fertility treatment.

In future, researchers hope this will reduce both the cost of IVF and the heartache for women who repeatedly fail to become pregnant.

Fertility expert Dr Simon Fishel said the technique moved science closer to the "holy grail" of IVF.

"To make IVF safer and also more effective is one of the major breakthroughs we have been waiting for for many years,' he added.

"The holy grail for us is one egg, one embryo, one baby, and this gets us closer to that holy grail."

Perfected by doctors in Las Vegas, comparative genomic hybridisation (CGH) counts the number of chromosomes in an egg.

Healthy eggs should have 23 chromosomes, but many have more or less than this, greatly increasing the risk of miscarriage.

Up to 75 per cent of miscarriages are thought to be due to embryos having the wrong number of chromosomes, with eggs from older women particularly likely to be defective.

But until now, there has been no way of accurately counting the chromosomes. Current techniques look for genetic flaws linked to individual diseases, rather than the bigger picture.

CGH, a technique already used in cancer research, involves taking the genetic material from a cell found just below the surface of the egg.

Grown in the lab, it can be used to pinpoint the number of chromosomes in the egg itself, allowing doctors to pick the best for treatment.

In trials at the Sher Institute for Reproductive Medicine in Las Vegas, doctors used CGH to screen the eggs of 35 women.

Healthy eggs, containing the right number of chromosomes, were then picked for IVF treatment and 28 of the women became pregnant.

While two miscarried, 26 went on to give birth, having a total of 32 healthy babies between them.

Overall, the women had a 74 per cent chance of having a baby - more than twice the success rate of IVF, New Scientist magazine reports.

Dr Fishel's Care fertility clinic in Nottingham is now trying out CGH on British women.

So far, 19 have had genetic material collected from their eggs, which is being analysed by the Las Vegas scientists. One of the women, Julie Clarke, has been trying for a baby for six years and has already had an unsuccessful course of IVF.

She said: "Every stage of my IVF seemed to be textbook and when it didn't work, I was devastated.

"That's why this trial is so exciting. They will put back the embryos they believe have the best chance of making it.

"There are no guarantees but this test gives a little bit more hope."

It is not known how much CGH would cost commercially but current genetic tests cost around £2,000. A course of IVF costs around £3,000.

In future, the technique could also allow doctors to reduce the number of embryos they implant in a woman at one time, cutting the chance of risky twin and triplet pregnancies.

But other fertility experts warned that more work has to be done.

Richard Kennedy, of the British Fertility Society, said: "It is an attractive proposal to be able to screen an embryo to see if it has all its chromosomes.

"But it is early days to say this would be applicable to lots of patients having IVF treatment."

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## Betty M

And in the Guardian: http://www.guardian.co.uk/medicine/story/0,,2003345,00.html

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## mayve

Just a bit of FYI for anyone who wants more info. I called Care Nottingham today and was told that the trials are still underway and they are not currently looking for additional trial candidates. More importantly, if all goes as planned the CGH testing availability may be as of late summer/ early autumn. The woman I spoke with suggested to keep consulting their website for updated information.

(Side note: she also said that today they received hundreds of calls!!)

I also called the Sher Institute Las Vegas and was told that some of their affiliate centers will start CGH testing this spring (March/April). I have yet to inquire about the candidate selection process or pricing but will post my findings at soonest.

For an explaination regarding the difference between PGD and CGH testing I came across the following:

http://cat.inist.fr/?aModele=afficheN&cpsidt=16463440

"Numerical chromosome errors are known to be common in early human embryos and probably make a significant contribution to early pregnancy loss and implantation failure in IVF patients. Over recent years fluorescent in situ hybridization (FISH) has been used to document embryonic aneuploidies. Many IVF laboratories perform preimplantation genetic diagnosis (PGD) with FISH to select embryos that are free from some aneuploidies in an attempt to improve implantation, pregnancy and live birth rates in particular categories of IVF patients. _The usefulness of FISH is limited because only a few chromosomes can be detected simultaneously in a single biopsied cell. Complete karyotyping at the single cell level can now be achieved by comparative genomic hybridization (CGH). _ CGH enables not only enumeration of all chromosomes but gives a more complete picture of the entire length of each chromosome and has demonstrated that chromosomal breakages and partial aneuploidies exist in embryos. CGH has provided invaluable information about the extent of mosaicism and aneuploidy of all chromosomes in early human conceptuses. CGH has been applied to clinical PGD and has resulted in the birth of healthy babies from embryos whose full karyotype was determined in the preimplantation phase."

Let's hope that this testing will be available for all who are in need of it and it will serve to arrive at a 70% success rate for all women who undertake IVF!

Mayve

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## Charlies-Mum

Whilst I'm widely impressed (and hope to god that this does become more widely available!) I'm afraid I'm a little pessimistic.

Chromosome abnormalities are only one factor in IVF not succeeding. Having an embryo of normal karyotype does not guarantee a healthy baby. Some of the articles I've been reading on this subject seem to 'convieniently forget' that genetic disorders and birth defects can occur in a baby with normal karyotype, often causing implantation to be rejected or miscarriage (or even present the parents with another difficult choice later on). 

Sorry to put a downer on this exciting topic  but it's fantasy fiction to assume that this will 'solve' many peoples conception problems.

I do look forward to seeing this technology develop and hope that it does allow many people to become parents to healthy children 

Deb


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## mayve

Good point Deb

An additional consideration is whether or not the CGH is coupled with PGD (don't even know if that is at all feasible or would even be recommended due to the stress on the cells),  because chromosomal defects can be brought on by the sperm and it is not only the egg that can be affected. I posed the same inquiry to the Sher Institute ... when they reply I'll post. 

Mayve


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## three_stars

HI -  Very interesting this is moving forward with clinical trials over in UK as well.  I know DR SHer was dropping hints about this last year on the SIRM site in USA.  WIll be a huge step forward although there are all the other obstacles as well such at uterine problems and so forth.  I seem to recall he mentioned that they may be able to apply CGH to the whole embryo as well as just the egg?  WIll have to read up on it more but will follow this thread for more info too.  Thanks for starting it.

bonnie / b123


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