Co-author: Alexandra Frost and Vitrolife
One of Dr. Denis Vaughan’s IVF patients had a history of poor embryo development during fertility treatments - the 43-year-old patient didn’t have many eggs left, and only a couple remaining embryos. They all stopped growing during the IVF process, around day four. In labs across the country, this common if not devastating occurrence results in a simple conversation with patients - “it didn’t work out.” But Vaughan, Reproductive Endocrinologist and Assistant Professor at Harvard, got to have a very different conversation in his new facility, Terra Fertility in Boston, thanks to cutting-edge technology.
Enter: Vitrolife Group’s EmbryoScope and PGT-A Plus (Pre-Implantation Genetic Testing) technologies that include ploidy analysis. “I was able to put up videos of the embryo’s development and show the exact point where it stopped growing. Then, we were able to talk about the reasons why that might have happened,” Vaughan says. He is experiencing how being able to be that open with patients and showing them exactly what’s going on changes their path and helps them process loss as well.
“She had failed cycles at other clinics and hadn’t gotten that insight or explanation, even though it was a similar outcome. She found it very meaningful that we were able to explain that…was able to visualize it…it made it real for her,” he says. And it ultimately informed her choice to pursue donor egg treatment instead, potentially saving her time and money.
The reason this conversation went this well was because of EmbryoScope, an incubator with a camera inside that allows closer monitoring of embryos. At Vaughan’s clinic, where he works with co-founders Dr. Emily Seidler and Dr. Pietro Bortoletto, this technology gives time-lapsed views of an embryo in its first few days of development, freeing up laboratory teams, minimizing potential handling errors and giving more transparency to patients.
Beyond this, ploidy predictivity is higher with EmbryoScope allowing for greater accuracy and giving providers more confidence when selecting the best embryo for transfer. In a study published in the Journal of assisted reproduction and genetics, data showed PN observation with EmbryoScope increased ploidy status predictivity from 28.3% to 80.4%. This can be the difference between a successful pregnancy for some patients.
While many IVF patients have access to EmbryoScope, the addition in Vaughan’s lab of another groundbreaking technology, PGT-A Plus, adds another layer of information for patients. Currently, around 70% of their patients opt for PGT-A genetic testing, which he calls “pretty standard” across the U.S., but the additional testing (the “Plus”) provides more embryo insights.
“PGT-A Plus effectively adds an extra layer of analysis on top of that, which is called SNP analysis, or a single nucleotide polymorphism. It looks at specific targeted regions of the DNA within the embryo, and [purports] to reduce the risk of false positives,” he says. Vaughan adds, “This would hopefully allow us to transfer more embryos that have a chance of resulting in a baby.”
In that same study from the Journal of assisted reproduction and genetics, the combined use of EmbryoScope and ploidy analysis with PGT-A Plus resulted in a significantly higher number of euploid/diploid embryos identified for transfer consideration. Using static observation (no time-lapse), PGT-A Plus’ ploidy analysis found 60% of abnormally fertilized oocytes (AFOs) otherwise not considered for transfer to be euploid/diploid. When EmbryoScope (time-lapse technology) was used to assess PN status, ploidy testing found 20% of AFOs to be euploid/diploid that could be considered for transfer. This shows that both EmbryoScope and ploidy analysis utilized together can increase accuracy in PN status and help identify more viable embryos.
Vaughan notes that PGT-A Plus is likely not as effective in those under 35 as it is for those over 38, and 35-38 is currently a “gray zone.”
“After 38, at least half of the embryos tend to be aneuploid or chromosomally abnormal. From a selection standpoint, it helps us select which embryo to transfer.”
In a world with emerging technologies vying to be front and center in helping patients, Vaughan has adopted a three-step system in evaluating what makes the cut, as EmbryoScope and PGT-A Plus testing did. These include:
Is this going to improve outcomes for the patient, increase live birth rates?
Is it going to improve the patient experience?
Is it going to improve efficiencies in the clinic?
“Ideally, we will get at least two out of three to be positive the technology [will help the patient]," he says. He looks forward to seeing more published evidence showing the improvements he's already witnessing from the tech to increase adoption and push us into the future of reproductive assistance.
Download the brochure to learn more about these two innovative solutions from Vitrolife Group and how they could benefit your practice
Ploidy analysis is rapidly becoming standard in PGT-A testing—and clinics using Vitrolife’s EmbryoScope™ alongside advanced genetics are seeing why. Together, time-lapse imaging with EmbryoScope + ploidy insight through Igenomix’s PGT-A Plus delivers a clearer, more confident path to embryo selection.
See how companies like Terra Fertility are realizing the advantage of using them together:
Identify more euploid/diploid embryos that might otherwise be discarded
Reduce false positives with enhanced genetic insight
Increase transparency for patients with visual embryo development
Improve lab efficiency with continuous, uninterrupted culture
No risk. See if your IVF lab is eligible to participate.
For clinics in North America, see if your IVF center is eligible to participate in a 90-day EmbryoScope trial to measure the impact it can have in your lab.