New techniques of ART that could help fulfill parenthood dream

By Dr Mahesh Koregol

The world of Assisted Reproductive Technology (ART) has come a long way since the birth of the first IVF baby in 1978. Over the years, Assisted Reproductive Technology (ART) has proved to be a boon for people yearning for parenthood. There have been many technological advances paving the way ever since and has grown exponentially in the last few years.

India is poised to be one of the leaders in the world of ART with prompt growth in the number of ART centres and ART-related treatments performed annually.

Infertility is the most generic disease amongst 30-40 years of age group amongst couples in India. The expansion and propagation of Assisted Reproductive Technology (ART) have been facilitated by the introduction of newer techniques that are contributing towards the advancement of this science. Though In Vitro Fertilization (IVF) and Intrauterine insemination (IUI) are the most common forms of ART known to people, fertility clinics across the country have many other developed techniques to increase the success rates in case of criticality.

Here are a few of the latest techniques in the field of ART that has made the dream of parenthood easier for many couples:

Pre-implantation Genetic Testing (PGT): PGT is a test that encompasses all types of genetic testing and is practiced on couples who do not possess any genetic disorder but are having difficulty in conceiving. Key factors determining if the process should be opted are advance maternal age, recurrent abortions, recurrent implantation failure or severe male factor infertility. Couples with any of these parameters are at a higher chance of a genetic abnormality of embryo. This series of tests under the PGT umbrella involves scrutinising the embryos created by in-vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI) for any abnormalities. With PGT tests, fertility experts check for chromosomal abnormalities in the DNA of the cells of the embryos. Embryos without any chromosomal abnormalities are picked and placed in the womb of the mother to ensure successful conception.

There are three types of PGT testing:

a) PGT – Aneuploidy (PGT-A): Formerly known as Pre-implantation Genetic Screening (PGS), it is a test that screens for the presence of all 46 chromosomes. This test gives the fertility specialist information about embryos’ genetic health to help them select the best embryo for transfer and improve the patient’s chance of achieving a successful pregnancy

b) PGT- Monogenic (PGT-M): This testing helps identify single-gene disorders such as cystic fibrosis, BRCA (the breast cancer gene), etc. Through this screening, fertility specialists are able to rule out the risk of transmitting any genetic disorders to the potential offspring.

c) PGT- Structural Rearrangements (PGT-SR): This testing enables fertility specialists to assess chromosomal rearrangements such as chromosome translocations, inversions, etc. Individuals with chromosome rearrangements are at an increased risk of producing embryos with the incorrect amount of genetic material, which typically do not lead to a successful pregnancy.

Endometrial Receptivity Analysis Testing (ERA): This is a test that helps doctors to determine the ideal time to implant the embryo. It helps in judging the Endometrial Receptivity, which is the stage when the endometrium is ready to allow the embryo implantation. There is a limited time frame when this stage occurs, which is called “Window of implantation”. This could be anywhere around 24 to 48 hours. ERA Test can assist doctors to schedule the implantation around the peak time of the patients’ optimal endometrial receptivity. A small sample of the endometrial lining is tested to determine which day would be best to transfer the embryo. This is especially useful for women who have suffered from recurrent implantation failures and helps in increasing their chances of pregnancy.

Magnetic Activated Cell Sorting (MACS): This technique is used in cases of male-factor infertility. It can detect the sperms with high DNA fragmentation, which are more likely to undergo programmed cell death (damaged sperm). In this procedure, the semen sample from the patient is passed through a column with weak magnetic fields around it, where the damaged sperms are drawn towards the walls whereas the healthy sperms pass through. Then only the viable sperm is used in IVF or IUI treatment to improve the success rates.

Time Lapse Imaging of Embryo: Time lapse imaging, or popularly known as Embryoscope, is essentially an incubator with a built-in camera that takes pictures of the embryo at timed intervals, while the embryo is still inside the incubator. It enables doctors to study the continuous development of the embryo at vital stages over several days without exposing it to any temperature or humidity alterations. This enables them to identify the embryo’s maximum potential for pregnancy.

Assisted Reproductive Technologies help couples all over the world, who face problems in conceiving a child, and these newer techniques in the industry has improved treatment outcome tremendously. Therefore, staying aware of these advancements in ART can always be beneficial to map out pregnancies in a better way and also enable couples to make an informed choice.

(The author is a Fertility Consultant at Nova IVF)