As many as 1.5 million married couples in the United States have a difficult time starting a family, and many of them turn to fertility experts for help. Now a new technology is increasing the odds that an implanted embryo will result in a successful pregnancy and delivery.
Ten month old Olivia is the apple of her sister's eye. The youngest of Chris and Lisa Randle's eight children, Olivia is the result of a new technology that helps fine-tune in-vitro fertilization.
Thomas B. Pool, PhD, HCLD (ABB), Scientific Director at the Fertility Center of San Antonio told Ivanhoe, "We've been looking for over 30 years for some way for an embryo to distinguish itself, for us to learn something about its viability."
A new test can help. It's called "Eeva" or early embryo viability assessment.
Using a time lapse video, Eeva takes pictures of embryos every five minutes for two days. It's capturing the timing of cell division. A highly viable embryo or "Eeva high" will have division at two distinct points.
Pool explained, "If the embryo hits both of those windows correctly, it has a significantly higher chance of continuing to develop, of implanting and making a baby."
Tests using Eeva have shown a 23 percent increase in pregnancies when in-vitro fertilization uses an Eeva "high" embryo.
For both doctors and patients, the Eeva test offers another benefit. "It's a noninvasive test; we don't have to do anything except have the computer look at videos," Pool said.
Lisa Randle, Olivia's mother told Ivanhoe, "It's just a miracle to me to be able to actually see that with my own eyes." A miracle they can now hold.
The Eeva test received FDA approval in late 2014 and has recently become available at fertility clinics nationwide. It costs about $1500 in addition to the cost of the in-vitro fertilization. The system has been in use in Europe for some time already.
Contributors to this news report include: Cyndy McGrath, Supervising Producer; Shari St. Clair, Field Producer; Cortni Spearman, Assistant Producer; and Jamison Koczan, Editor.
BACKGROUND: According to the Centers for Disease Control, one out of every eight couples has trouble getting pregnant. Infertility is the abnormal functioning of a male or female reproductive system. Infertility can be caused by many different factors. In men, sperm count, shape, or motility can lead to infertility. Other factors such as stress, drug use, and age-related testosterone decreases can also affect fertility. In women, infertility can be caused by an ovulation disorder or physical irregularities in the pelvis, such as a blocked fallopian tube. Still in other cases, the cause is unknown. The treatment for infertility can vary from surgery and hormone therapy to In-Vitro fertilization (IVF). IVF involves taking eggs from a woman's ovaries and mixing them with sperm in a tube, fertilizing the eggs. The embryos are then returned to the mother's uterus. Other ways that prospective parents try to resolve the issue of infertility include freezing eggs and sperm, using donor eggs, or finding someone to carry the baby for the couple.
NEW TECHNOLOGY: Eeva is a technology that is allowing doctors to use a camera in order to up the odds of pregnancy in women. Eeva or early embryo viability assessment test uses a video camera to record embryos on a petri dish. Over a two day period, using time lapse technology, the embryos divide from a two-cell to a three-cell embryo and from a three-cell to a four –cell embryo. Pictures are taken every five minutes of this process and the embryos that divide at two critical time points are considered to be more viable or "Eeva highs". The Eeva high embryos have a significantly better chance of continued development, implantation and pregnancy than an "Eeva low" embryo. This doesn't mean that other embryos are not capable of becoming pregnancies, but the Eeva high embryos have a better chance. Many Eeva low embryos form pregnancies but not with the statistical certainty of Eeva high embryos. Thomas Pool, PhD, Scientific Director of the Fertility Center of San Antonio said, "It's a significantly increased chance that she will get pregnant and have an ongoing delivery from the transfer of an Eeva high embryo." On day three, the embryos are assigned a score of Eeva high or Eeva low automatically by the system. According to Pool, the high embryos that were put back into the woman had a 23 percent increased pregnancy rate. Pool also says that this is such a great test because it is non-invasive. He says, "We've been looking for over 30 years for some way for an embryo to distinguish itself, for us to learn something about its viability."
(Source: Thomas Pool, PhD)
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Thomas Pool, Ph.D., Scientific Director of the Fertility Center of San Antonio explains how time lapse technology is giving women a better chance at getting pregnant.
Interview conducted by Ivanhoe Broadcast News in March 2015.
Tell me how EEVA works.
Dr. Pool: EEVA is a time lapse system. It's an old, old tool, but it's just taking continuous images of embryos as they grow. It strings them together into a video, but it has a computer controller that then takes and analyzes those images. Basically what's it doing is its timing several different cell divisions. We know in early development of an embryo as it divides, there is a critical window, it can go too fast or too slow, so it measures those. If the embryo hits both of those windows correctly, it has a significantly higher chance of continuing to develop and make a baby.
It's simply hitting these marks?
Dr. Pool: That's correct.
And once it does that it is considered more viable?
Dr. Pool: Yes, it has a higher potential. The lows are not bad embryos; it's just that they're not highs. They may go onto to develop. We actually have good pregnancy rates with those, but the highs give a significantly higher pregnancy rate.
What kind of rate are you talking about percentage wise? Do you have those numbers?
Dr. Pool: In our study we had a good pregnancy rate from the lows. It was a 50% pregnancy rate just from EEVA lows. But if we could identify one EEVA high embryo to put back, the pregnancy rate went up 23%. Overall, in this small study, what we did is we introduced EEVA; we saw 23% increases in not just pregnancy, but ongoing pregnancy rate and delivery.
So once these are marked as being EEVA highs, they're taken and implanted back into the mother is that correct?
Dr. Pool: Yes. If we have more than one EEVA high, then we can grow them out and cryopreserve or freeze the embryos for future use, but we try to put back at least one EEVA high.
Then there's a better chance she is going to be able to have a baby?
Dr. Pool: Yes, it's a significantly increased chance that she will get pregnant and have an ongoing or a delivery from the transfer of an EEVA high embryo.
How long have you guys been looking for something like this?
Dr. Pool: We've been looking for over 30 years for some way for an embryo to distinguish itself and learn something about its viability. The problem is, not every embryo will make a baby and on the day of transfer, often we'll have three, four or five embryos that are very high quality in their appearance, but not all of them have the same developmental potential. So we've been looking for a number of ways; chemical analysis of culture, media, you name it, to get the embryo to help tell us which one is most viable. The nice thing about this is not only does it do it, but it's a noninvasive test. We don't have to do anything except have the computer look at videos.
What do you mean when you say noninvasive?
Dr. Pool: We don't have to bother the embryo. We don't have to take it out of the incubator and specifically we don't have to operate or remove cells from the embryo. There's other studies we can do on embryos where we actually do microsurgery on the embryos and remove part of the embryo for analysis. In this test, we do nothing but just observe it through this time lapse technology during the first two days of development.
It's almost more natural because you just are able to not invade and see which ones are more viable?
Dr. Pool: Absolutely it's more natural and in fact, the fact that we don't have to take the embryo out of the incubator means we're not exposing the embryo to variations in temperature, to changes in the chemistry of the culture environment, etc. It's a very stable environment over the two days that we make these measurements.
When you put it into the EEVA system, how long is it in that particular system?
Dr. Pool: We load them into the system on the day after we've retrieved eggs, so the morning of day 1, we put them on and we image for two days. When we come in the morning of day three, the score has already been assigned automatically by the system.
How much does this cost?
Dr. Pool: It costs $1500 additional. It's an optional technique that patients can add in their IVF cycle and if so, it runs about $1500.
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