"Biopsy on day 5 at the blastocyst stage is potentially less invasive to the embryo than the standard day-3 biopsy used in preimplantation genetic diagnosis. Day-5 biopsy allows for the natural selection process to occur from day 3 to the day-5 transition, where the embryo starts to rely on its own machinery. And it also allows the benefits of aneuploidy screening," observed Dr. Levens of Shady Grove Fertility in Annandale, Va.
Dr. Scott noted that the ongoing twin gestation rate in the aneuploidy screening group was twice that in controls, reflecting the higher implantation rates achieved through preimplantation genetic diagnosis. A goal in future studies will be to further reduce the embryo transfer number from the mean 1.8 in the latest study in order to attain very high elective single-embryo transfer rates while maintaining high implantation and delivery rates. The eventual goal, he stressed, is to minimize IVF multiple gestations.
"The total cost of IVF probably represents only 10%-15% of the true cost. It’s the obstetrical and pediatric care downstream that’s really expensive, and the bulk of that is for twins and triplets," Dr. Scott explained.
"The economic implications of avoiding multiple gestations are enormous. If we could identify which embryos will make babies before we have to make transfer decisions, we could reduce the number of transfers and avoid all triplets and almost all twins. That would reduce the obstetrical and pediatric costs such that as a society we could provide free care for infertility for everyone in this country – and still save money," he asserted.
Dr. Scott said he and his coworkers have self-funded the development of the 24-chromosome aneuploidy screening system without commercial support.