IVF is generally accepted as effective first-line therapy for the treatment of infertility. Α major limitation in IVF is the inability to predict embryo reproductive potential or embryo viability before transfer.
Therefore, the most important aspect of IVF is embryo selection: how to determine which embryos in a cohort group are viable and competent.
For IVF, we need to know which embryos would be successfully implanted and make it through pregnancy − versus those that would not. This challenge has led to the “IVF Paradox”: how to maintain or increase pregnancy rates in IVF while reducing the incidence of multiple pregnancies.
Morphology examination remains the primary tool for selecting embryos, although it is well recognized as a sub-optimal method. More recent methods have been investigated to assess embryo viability, including genomic, proteomic, and transcriptomic approaches.
However, these measurements cannot be made directly without an invasive embryo biopsy and take a lot of time. The development of biospectroscopy-based metaboIomics is a new, non-invasive technique that resolves the “IVF Paradox”.
Reducing multiple pregnancies using a new rapid non-invasive embryo selection technique
Το overcome the dangers of multiple births through IVF, many countries have mandated single embryo transfer in IVF. Obviously, we need to be able to predict which embryo would fill the requirements for successful implantation and pregnancy.
The commonly accepted clinical practice and standard of care for assessing embryo viability in IVF are based on the developing embryo's morphological characteristics. Cleavage rates and morphology have been used since the earliest days of IVF, but the method is not very accurate for successfully identifying embryos capable of sustaining an ongoing pregnancy. As a result, new embryo assessment tools, based on either invasive or non-invasive techniques, have been sought-after by IVF clinics to overcome this problem.
Numerous animal and human studies in the past have shown that the embryo changes its surrounding culture media in a manner that can be used to predict if that embryo will implant. The problem for clinical IVF has always been:
- The ability to measure the change without damaging the embryo.
- The ability to measure the change quickly.
- The ability to measure the change consistently and accurately.
Non-invasive Analysis Using Biospectroscopy Based Metabolomics (BSM)
Metabolomics is the new technique that fulfills all 3 of the above criteria. It involves non-invasive metabolomic profiling of the embryos surrounding culture media. Using Near Infrared (NIR) spectroscopy to profile biomarkers of οxidative and energy metabolism (metabolite profiles) enables us to accurately identify embryos with reproductive potential in IVF.
Nowadays, the non-invasive Metabolomic technique is used in conjunction with current clinical practices (e.g., morphology), to aid in identifying viable embryos and improve patient outcomes.
*In collaboration with James T. Posillico Molecular Biometrics LLC, Chester, NJ, USA