New technology in IVF

If you base your perception of human progress on what you hear in the news, you would think that it takes place in quantum leaps. However, not all human progress takes place in leaps and bounds. The overall speed of innovation has certainly increased, but quantum leaps are as rare as ever. Progress takes place in an evolutionary way and revolutions are often just a means of making previous quantum leaps more accessible.

The speed of innovation allows us to bring technology from research into practical use in the clinic much faster. The clearest example of a quantum leap was the work, which led to the creation of IVF. Then ultimately the first test-tube baby, Louise Brown over 40 years ago.

Medical science has gone from tenuous research in IVF to being able to offer help to millions of patients. It wasn’t a quantum leap that led to IVF success rates of rising from 1-2% to 40-70% in four decades. That was down to fast evolution.

Take a look at some of the technologies that are evolving to push the success rates upwards

Internet of Things is a fashionable phrase for the modern phenomenon of connecting all kinds of devices via the Internet. From your central heating system, your entertainment needs, your car, your workspace. Everything from the garage door to your alarm clock, in fact.

All this while you sit in the middle of this connectivity, monitoring and controlling it with your phone or your smart watch.

One example of this is the PreBaby Monitor developed by Columbia University Irving Medical Center, USA. Aimed at alleviating tank angst about the status of your embryos and eggs. This online platform allows users to access the real-time temperature status of the cryogenic tanks. Meaning you can monitor your eggs or frozen embryos in storage!

Another example is Embryoscope from Vitrolife, a company based in Sweden. This incubator allows the embryologist to monitor embryo cell development while the embryos are in the incubator. The incubator has a built-in camera that takes pictures of the embryo at timed intervals. These pictures are then combined to create a time-lapse video showing the embryo’s development at every vital stage. By watching when and how the embryos divide the embryology team can assess if development is taking place normally.

No needle IVF and cost reduction

Cost-cutting is another area where new developments are making an impact. An example of fast evolution in clinical practice is the Coral IVF programme, developed by the Columbia University Fertility Center, USA. This is a low-cost IVF fertility treatment, which uses a combination of pills to cause the same effect as hormone injections. IVF can become costly when repeated hormone injections are necessary to stimulate the ovaries to produce multiple follicles. The cost of injections adds up after multiple rounds. The Coral IVF programme offers an alternative for patients who are not responding to injections. The potential for cost savings is 100-fold.

At the forefront of practical genetic medicine

Dr. S. Zev Williams, says, “Reproductive medicine is now really the leading edge of precision medicine. Now we’ve evolved to help couples who don’t have infertility at all but may be carriers for catastrophic genetic diseases and ensure they have healthy children.” Dr. Williams is the Chief of Reproductive Endocrinology and Infertility at Columbia University Irving Medical Center.

Advances in genetic studies also lead to better outcomes overall, using pre-implantation genetic testing (PGT).

Dr. Josh Klein, Extend Fertility says, “We’re leaning heavily on improvements in genetic technology. We are able to say, with a higher degree of confidence, that this embryo is a good one. Or, we can say with confidence that this one shouldn’t be transferred because we don’t think it’s going to implant.”

We’re not at a stage where this technology can correct all genetic defects, but huge advances are going to come in the next decade or so.

Becoming smarter with data

Dr. Klein added, “Not everything is about technological leaps. Some of it is about doing it smarter, doing it better, doing it in the right way at the right times.” This reinforces the idea that practical advantages arise from developmental evolution rather than revolution.

For instance, modern fertility tracking devices function as more sophisticated versions of the ovulation predictor kits. These give women more information about their cycles, like an intelligent calendar.

But what makes modern fertility tracking devices so powerful is that they combine the refinements in data management with opportunities for data gathering provided by the Internet of Things. So wearable devices providing constant data, in real time, are the way forward, and this is already being seen in devices such as the Ava Fertility Tracker.

The shift towards proactivity

Infertility as a result of the ageing process is no longer taking women by surprise. Together with advances in storage and cryo bank technology, this is driving a shift into a proactive approach to fertility in general. It has been commented that It’s not a new thing to make a baby with a frozen egg. But it is a new thing for a 32-year-old to freeze her eggs and use them when she’s 42.

The increasing numbers of women freezing embryos and eggs is a reflection of advancements in the technology. There is increased accessibility and younger women seeing the process as a proactive investment in their fertility future.

What’s next?

The revolution in genetics has already taken place and is ongoing. In fact, we have more information than we know what to do with or how to interpret! This is evidenced by genetic home testing kits, the full results of which, when obtained from each test, are not understood even by experts at the moment.

So, the trick will be in making sure that the pace of evolution in technology increases so that we can take the earliest advantage of the genetic revolution. Technology combined with the Internet and smart management of data will be the driver of the pace of this evolution.

Neil Madden, Editor

The Fertility Hub