(Press-News.org) Amsterdam, May 17, 2013 - Elsevier, a world-leading provider of scientific, technical and medical information products and services, today announced the publication of a recent study in Reproductive BioMedicine Online on 5-day old human blastocysts showing that those with an abnormal chromosomal composition can be identified by the rate at which they have developed to blastocysts, thereby classifying the risk of genetic abnormality without a biopsy. In a new study the same group has undertaken a retrospective study, using their predictive model to assess the likelihood of any embryo transferred resulting in a successful pregnancy, with very encouraging outcomes.
One of the greatest challenges in assisted reproduction is to find the one embryo, which can develop successfully. Now, combining time lapse imaging of IVF embryos cultured for 5 days to the blastocyst stage with trophoblast biopsy, it has proved possible to correlate the rate of blastocyst formation with chromosomal abnormalities. Such an approach should allow early and widely accessible non-invasive identification of the best embryo to place in the uterus.
"Recently the world of IVF has become very excited by the use of time-lapse imaging (TLI) of early human embryo development to follow the change of embryo morphology over time", explains Martin Johnson, Editor of Reproductive BioMedicine Online. "The data can then be compared with the outcome after the embryos are transferred. The hope is that this morphokinetic analysis will enable reproductive specialists to predict more successfully those embryos most likely to generate pregnancies. The advantage of using morphokinetic analysis to predict outcome is its minimal invasiveness."
The majority of embryos that fail to initiate a pregnancy do so because they have abnormal chromosomes. Unfortunately these embryos cannot be recognized by embryologists using conventional microscopy. Only biopsy of one or a few cells of the early embryo followed by preimplantation genetic screening (PGS) can establish whether the number of chromosomes is normal or not.
In their research Alison Campbell and colleagues of CARE Fertility, Nottingham, went one step further, describing the use of morphokinetic analysis to identify those embryos that have an abnormal chromosomal constitution. In that study, they cultured embryos under time lapse imaging to day 5, by which time they formed blastocysts. These were then biopsied by removing a few of the cells from the outer layer of the embryo, which will normally contribute only to the placenta. The biopsy was then analyzed for its chromosomal constitution. The authors then related the chromosomal make up of each embryo to its morphokinetic history. They found that a proportion of embryos with chromosomal abnormalities were delayed in initiating blastocyst formation and also reached the full blastocyst stage later than did normal embryos. The authors conclude that using this approach they could avoid exposing at least a subset of the embryos to invasive biopsy procedures.
"This non-invasive model for the classification of chromosomal abnormality may be used to avoid selecting embryos with high risk of aneuploidy while selecting those with reduced risk," said lead author Alison Campbell.
The same group has now applied this risk classification model retrospectively to examine the pregnancy outcomes in a series of unselected IVF patients without the use of PGS. A significant improvement in both implantation and live birth rates was observed when low risk embryos were transferred.
Scientist Markus Montag of the Department of Gynecological Endocrinology and Fertility Disorders, University Clinics of Heidelberg, said: "The idea of using time-lapse imaging and morphokinetic analysis is intriguing, because having available a completely non-invasive procedure to predict which embryo is euploid or aneuploid would allow the application of this technique for virtually every assisted reproduction cycle. The potential benefit of such an approach is obvious in view of published data on the incidence of aneuploidy even in oocytes from younger women."
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These research papers are:
Modelling a risk classification of aneuploidy in human embryos using non-invasive morphokinetics, by Campbell, A., Fishel, S., Bowman, N., Duffy, S., Sedler, M., Hickman, C.F.L.; Reproductive BioMedicine Online; 26, 477- 485;DOI: 10.1016/j.rbmo.2013.02.006. The article appears in Reproductive BioMedicine Online, Volume 26, Issue 5 (May 2013), published by Elsevier. Available online on ScienceDirect.
Retrospective analysis of clinical pregnancy and live birth rate for IVF embryos classified for aneuploidy risk, without PGS, demonstrates the benefit of a time-lapse imaging derived model, by Campbell, A., Fishel, S., Bowman, N., Duffy, S., Sedler, M., Thornton, S.; This article is available as an Article in Press in Reproductive Biomedicine Online (May 17, 2013), published by Elsevier. Available online on ScienceDirect on May 17.
Notes for Editors
Full text of the articles are available to journalists upon request: contact Greyling Peoples at +31 20 485 3323 or g.peoples@elsevier.com. Journalists wishing to set up interviews with the authors should contact Dr. Alison Campbell or Dr Simon Fishel.
About the authors
Alison Campbell and Simon Fishel
CARE Fertility, John Webster House, 6 Lawrence Drive, Nottingham
Business Park, Nottingham, NG8 6PZ
Alison Campbell, telephone: +44(0)161 2493040, fax: +44(0)1612244283, Alison.campbell@carefertility.com
Simon Fishel, Simon.fishel@carefertility.com
About Reproductive Biomedicine Online
Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients.
It is an official publication of:
The American Association of Bioanalysts (AAB) http://www.aab.org
Alpha – Scientists in Reproductive Medicine, http://alphascientists.org
The American College of Embryology (ACE) http://www.embcol.org
The Global Chinese Association for Reproductive Medicine (GCARM) http://www.gcarm.com
The International Society for In Vitro Fertilization (ISIVF) http://www.isivf.com
The Mediterranean Society for Reproductive Medicine (MSRM) http://www.medreproduction.org
The Preimplantation Genetic Diagnosis International Society (PGDIS) http://www.pgdis.org
The Turkish Society of Reproductive Medicine (TSRM) http://www.tsrm.org.tr
About Elsevier
Elsevier is a world-leading publisher of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close
to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include SciVerse ScienceDirect, SciVerse Scopus, Reaxys, MD Consult and Nursing Consult, which enhance the productivity of
science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.
A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
Breakthrough for IVF?
2013-05-17
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