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Mini-Series: How Terra Fertility is elevating care and supporting outcomes with EmbryoScope and PGT-A Plus  

In modern IVF practice, Time-lapse incubation with EmbryoScope+ and PGT-A Plus genetic testing offer complementary strategies to identify more usable embryos that may help improve transfer success.

Advancements improve identification of useable embryos, and transparency on the process

Co-author: Alexandra Frost and Vitrolife

Chromosome aneuploidy (abnormal chromosome copy number) is a major cause of IVF failure, pregnancy loss and in rare cases, affected live births. Preimplantation genetic testing for aneuploidy (PGT-A), following culture to the blastocyst stage, trophectoderm biopsy, vitrification and testing by next generation sequencing (NGS) based methods for chromosome copy number analysis, is now widely used to identify embryos with normal chromosome copy number (euploid).

The beginning of a year is always a time for reflection on the achievements of the past year and an opportunity to look forward to what the coming year may bring. And for the newly formed Genomics Division here at Vitrolife, 2019 was certainly a busy time that has flown by. The team was well represented at all of the main reproductive genetics and IVF annual meetings including Preimplantation Genetic Diagnosis International Society (PGDIS) meeting in Geneva and Controversies in Preconception, Preimplantation and Prenatal Genetics (CoGen) in Paris. At ESHRE in Vienna, Genomics was represented on the Vitrolife stand, which was a great opportunity to meet customers face-to-face, but equally important for us, to get to know all of our colleagues in other areas! There was a well-attended lunch time symposium at which I represented genomics and, in the evening, I had a lot of fun giving the after-dinner talk reminiscing on 30 plus years of my involvement in the field, since we published the first clinical pregnancies following preimplantation genetic diagnosis or PGD, as it was known then, for a range of X-linked inherited diseases, including Duchenne muscular dystrophy.

Introducing Vitrolife genomics at PGDIS 2019

The International Society for Preimplantation Genetic Diagnosis (PGDIS) was formed in the early 1990s by a group of clinicians and scientists attending the inaugural meeting in Chicago, based in the historic Drake Hotel, and organised by the late Yury Verlinksy and colleagues, who was one of the pioneers of preimplantation genetic diagnosis, recently renamed preimplantation genetic testing (PGT). Last year, I became President of the Society and have been very involved in organising the 18th, now annual, meeting in Geneva, Switzerland. The meeting attracted about 350 attendees from 45 countries including nearly 40 from Russia.

This was an important first opportunity for the newly formed Vitrolife genomics team (who turned up in force!) to meet many of our customers for SNP genotyping and karyomapping for diagnosis of monogenic disease (PGT-M) and next generation sequencing (NGS) based chromosome copy number analysis for detection of aneuploidy (PGT-A). 

When working in an IVF lab there are different ways to assess embryos. You can score embryos using morphology and traditional grading, you can use preimplantation genetic testing (PGT) to get the genetic profiling of embryos prior to implantation, and finally you can analyse morphokinetic parameters of embryo development using time-lapse information. How do we bring together morphology, PGT and time-lapse to improve our embryo selection?  

I joined Vitrolife at the beginning of this year and was very flattered to have been asked to write not only the first blog of the year, but also the first blog from Vitrolife’s Genomics Business Unit – an application area close to my heart.

Living in Cambridge, UK where the structure of DNA was first discovered and where the technique of IVF was pioneered I feel very lucky to be part of this field where we are learning more and more about the role that genetics plays in infertility. Watson and Crick famously discussed their results in the Eagle pub, still popular with Cambridge students today and IVF pioneer Robert Edwards worked in the physiology lab just a few streets away.

Our guest blogger Dr. Gary Harton is well known in the reproductive genetics field, where he has spent his entire career. In this blog post he will take you through the basics, the history, the advantages, the debates and what is yet to be determined when it comes to preimplantation genetic testing in assisted reproduction. 

When working with assisted reproduction we use a lot of different terms and definitions. This blog post will give you an update on the rather new acronym PGT (preimplantation genetic testing) as well as a glossary of common and useful terms.

EmbryoScope time-lapse system is used in combination with preimplantation genetic testing at IVF Riga. Medical Director Dr. Violeta Fodina says that this makes it possible to select only the best embryos for genetic testing, thereby reducing the time to pregnancy and delivery of a child. Watch her story here.