Next Generation Sequencing to Improve IVF Success Rates
For women and couples struggling to conceive a child, in vitro fertilization (IVF) has long been an alternative to natural conception. IVF was first successfully used in 1978 and now more than five million babies have been born this way. The technique helps women who can’t conceive naturally by fertilizing an egg with sperm outside of the body. Embryos are created this way and then implanted in the woman’s uterus. Although there have been millions of success stories with IVF, there have been many more failures. Now, a new technique for screening the chromosomes of the embryos may help drastically improve success rates for IVF procedures.
IVF is Imperfect
Success rates are not very high for IVF, although it has worked for millions of women and couples. The success rate is only about 33 percent for women under the age of 35 and it decreases with age. By 40, a woman only has a 12.5 percent chance of having a viable pregnancy from IVF. The reason that so many embryos created by IVF fail to result in a pregnancy is related to chromosomal abnormalities. Doctors have so far had no way of knowing for certain which embryos will be successful and which will fail. To counteract this uncertainty, most women getting IVF treatments have several embryos implanted together in the hopes that at least one will lead to a viable pregnancy. This is why IVF sometimes results in multiple births, even as high as octuplets.
Next Generation Sequencing
The answer to the problem of low IVF success rates is next generation sequencing. The term refers to a collection of the most modern techniques for investigating DNA and chromosomes. They are considered high-throughput, which means they can be done quickly and less expensively than ever before. With these techniques, testing the chromosomes of embryos created by IVF is easier and more accessible than ever.
A few cells are taken from each embryo created for an IVF treatment and are tested using a modern, next generation sequencing technique. The test counts the number of chromosomes in the embryos’ cells. Those with too many or too few chromosomes are not likely to be viable. By using this type of testing a doctor can know for certain which embryo should be used for implantation for the greatest odds of achieving a successful pregnancy. It eliminates guess work and the need to implant multiple embryos.
The first baby to be born using next generation sequencing along with IVF came into the world in 2013. The test is now cheaper and more available than ever before and has opened up the door for improving success rates for IVF. Some experts believe that it will help IVF success rates approach those of natural conception. Time and more research will tell if the improvements are as great as expected.
For couples struggling with conception and relying on IVF to help them have a baby, the news about more widespread and affordable embryo testing is exciting. To be able to select for a viable embryo could help many more women have children, but it also raises ethical questions that must be answered in the future. Selecting for embryos that will actually lead to pregnancy is ethically sound, but the question is one of drawing a line. Should we select for disease-free embryos? For eye and hair color? For now, it is enough to know that modern next generation sequencing techniques make the possibility of pregnancy for millions of women more of a reality.
If you’re undergoing intrauterine insemination (IUI) and haven’t yet conceived, you may be wondering how many cycles you should try before doing in vitro fertilization, also called IVF. Here’s what you should know to help you maximize your chances of becoming pregnant via these assisted reproductive treatments:
What’s the difference between IUI and IVF?
Intrauterine insemination (IUI) is often recommended for couples or women struggling with infertility. This is also a technique used by same-sex couples and single women who need donor sperm to conceive. Moreover, IUI is one of the simpler fertility treatments and doesn’t require any surgery.How IUI works: sperm (of the partner or donated) is placed into the uterus with the help of a thin catheter. The process must be performed during ovulation to maximize chances of conception. Fertility drugs might be suggested to stimulate ovulation.
The IVF procedure is more complex and involves minor surgery. During the procedure, the ovaries are first stimulated using fertility medications. Then, after the eggs have been retrieved under anesthetic, they are fertilized with sperm in a lab. Once the embryos are ready, they are transferred into the uterus.
When you should stop trying IUI and do IVF instead
IUI is often the first treatment suggested to those who want to conceive as it’s less invasive and demanding than IVF. It’s also much more affordable. But what if no pregnancy occurs after several rounds of IUI? How many times should you attempt to conceive via IUI before moving on to IVF?
This is a question that many couples and single women face when trying to become pregnant using this fertility treatment. The thing is that you will probably need to undergo several attempts before you successfully get pregnant. Although some lucky women will conceive on their first attempt, for others, pregnancy will only occur after trying a number of times.
If you are a woman under 35, most doctors will suggest 3 to 6 cycles of IUI before moving to IVF. Recommendations for those who are 35 or over are often a little different as your fertility at this age will be reduced and, therefore, your chances of conceiving via IUI might be too low. Accordingly, don’t hesitate to have a chat with your doctor to check what option is best for you and to see if you should try IVF instead.
Additionally, it’s best to talk with your practitioner and partner about the number of attempts that you’re willing to try, even before starting the first treatment. It can actually be helpful to know your limits. Some people feel that three is enough, while for others this number might be as high as 6 or even more.
What are the success rates of IUI and IVF?
To help you know when to stop IUI and move to IVF instead, it’s best to know a few stats.
Although the odds of pregnancy depend on several factors (such as age and fertility) statistically, IUI has lower success rates than IVF.
So, if you undergo IUI, you’ll be interested to know that:
– For women under 35, the probability of a successful pregnancy via this procedure is 10-20% per cycle. This is 10% between 35 and 40, and 2 to 5% at age 40 and over.
– The odds of successfully conceiving rises with the number of attempts. Therefore, you have about a 60% chance of having a baby after trying 3 times. This increases to 80% after 6 IUI cycles.
If you choose instead to try IVF with your own eggs:
– About 40% of women under the age of 35 successfully become pregnant. This is between 10 and 15% for those over 40.
Should you try IUI or IVF?
Still wondering whether you need IUI or IVF? If you recognize yourself in the following, you should try IUI:
• You have normal ovulation, or ovulation issues that can be solved via fertility medications;
• You have one or two unblocked fallopian tubes;
• You have a good ovarian reserve;
• You’re using donor sperm and don’t have serious infertility issues;
• You’re a single woman or a same-sex couple using donor sperm;
• You have a partner with ejaculation problems.
However, if you are in your late thirties or older, you should perhaps skip IUI and opt for IVF directly. Why? This is due to the fact that, after 35, a woman’s fertility gradually decreases. Be careful, you might not have the time to risk several cycles of IUI that could be unsuccessful!
In short, you should go straight to IVF if you:
• Are over the age of 38-40. IUI is more successful with younger women;
• Are using donor eggs;
• Have trouble ovulating;
• Have severe endometriosis;
• Have blocked or damaged fallopian tubes, or they have been removed;
• Need intracytoplasmic sperm injection (ICSI) to conceive (because the male partner has low sperm count);
• You or your partner has a genetic disorder.
If you’re considering having a baby via a fertility treatment, it’s always best to take the time to know and understand your options. Your decision will be based on your budget, your age, fertility, and preferences. The whole process may be tough, demanding and tiring. However, when you are finally holding your little one in your arms for the first time, you’ll know that it was all worth it.