As cases of infertility across the globe rise, Assisted Reproductive Technology (ART) is getting more advanced and accepted in society. “Dealing with infertility is certainly not easy and the growing acceptance of ART is due to the increasing occurrence of infertility in both males and females”, says Dr Parul Katiyar, fertility expert, Nova IVF.0
“There are many ART treatments available that help to deal with infertility. The cornerstone of most ART procedures is Invitro fertilization (IVF) and recent advancements in the treatment have helped to improve the success rates of the IVF treatment and also solve abnormalities due to genetic issues in the fertile couples as well as couples who choose ART if they are discordant to particular communicable diseases,” she told indianexpress.com.
Various advanced techniques of ART in evaluating embryos
Numerous grading systems have been developed to support the embryological grading and also help to determine the chromosomal status of the embryo. These advancements help to evaluate the embryo quality in both direct and indirect ways much before a woman conceives, thereby reducing the chances of miscarriages and chromosomal abnormalities.
Pre-implantation Genetic Testing (PGT)
This technique goes through all types of genetic testing on the embryo, and is useful for couples who do not possess any genetic disorder but are having difficulty in conceiving or even for couples who suffer from a genetic disease or carry the genes that can cause genetic disease like in the offspring. “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. In this technique, the chances of passing a known genetic disorder get reduced from the parent to the offspring,” Dr Katiyar explains.
Endometrial Receptivity Analysis Testing (ERA)
It’s one the first diagnostic tests that determine each woman’s unique personalised embryo transfer timing, therefore synchronising the embryo transfer with the individualised window of implantation. An endometrial biopsy will be taken by your doctor in a mock embryo transfer cycle prior to your IVF cycle. This sample will then be analysed to assess endometrial receptivity and the optimal day for embryo transfer. “The sample will be sent to a lab where molecular analysis is completed to determine the best time to attempt embryo implantation in a future transfer cycle. Generally, the endometrial receptivity analysis is recommended if you’ve undergone two or more IVF cycles that were not successful, where the embryos were of good quality,” she explains.
Magnetic activated cell sorting (MACS)
This technique is used in cases of male factor infertility. It is a sperm washing technique, which helps in separating healthy sperms from sperms having DNA damage. When a man is producing millions of sperms, there is a risk that some of them could have damaged DNA. The sperms with high DNA damage are more likely to suffer from poor health and can cause male infertility, recurrent miscarriage, poor embryo quality. Therefore, we need to separate those sperms. “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 healthy sperm is used in IVF or IUI treatment to improve the success rates,” she says.
Time Lapse imaging of embryo
It is an emerging non-invasive embryo selection technique used in reproductive biology. 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, says the expert.