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If You’re Considering In Vitro Fertilization, Chances are You’ll Have ONE Healthy, Happy Baby!

When it comes to In Vitro Fertilization, we’ve come a long way in achieving successful, safe pregnancies.

The first In Vitro Fertilization (IVF) procedure was performed in 1978, and since then the scientific breakthroughs in this area have grown by leaps and bounds. Initially, pregnancy rates were extremely low, but with more than 100,000 cycles performed each year in the United States, pregnancy rates have increased significantly, with some facilities achieving birth rates over 50 percent.

IVF does not necessarily result in multiple births.

IVF increases the number of eggs a woman produces in a cycle. These eggs are then fertilized outside the body to create embryos, which are later replaced back into the woman’s uterus. This procedure is typically utilized for women who have abnormal tubes, issues related to male infertility, or couples with unexplained infertility (when other methods have failed.)

Couples who may be thinking about fertility treatment and hear the words “In Vitro Fertilization” may worry about ending up with a large number of children, similar to the cases that have been in the news over the past few years. One of the key components to avoiding this issue is to select a board-certified reproductive endocrinologist who is a member of the American Society of Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technologies (SART). This organization holds its members to high standards and also provides guidelines to limit the number of embryos replaced in order to minimize the risks associated with multiple pregnancies.

Experts agree that a singleton pregnancy (one baby) is the safest type of pregnancy. Twins and high
order multiples (triplets or more) are concerning due to higher rates of premature delivery and complications for both the mother and the babies. Many successful IVF programs have decreased the
number of embryos replaced by growing the embryos longer in an incubator (for up to 6 days) and by replacing only the strongest embryos.

Scientific improvements in IVF have allowed doctors to reduce the number of embryos placed into a woman’s uterus and have seen significantly better pregnancy outcomes. However, the rate of twins after IVF is still averaging around 30 percent of patients. Due to the better pregnancy outcomes when women carry just one healthy baby to full term, scientists have now begun focusing on how to reduce the number of embryos placed back in a women’s uterus during an IVF cycle. They are doing
this by advancing the genetic testing options of the embryos; the main testing process is called Pre-implantation Genetic Diagnosis (PGD).

Comprehensive Chromosome Screening

The newest advancement in PGD testing is known as Comprehensive Chromosome Screening (CCS). This test has been scientifically proven to accurately determine normal from abnormal embryos by looking at all 24 human chromosomes. It is significantly more accurate than previous technology, such as FISH, which could only test a few chromosomes and is significantly less accurate.

As women age, they are more likely to have embryos with abnormal chromosomes due to changes in their eggs. An embryo may have an extra chromosome called trisomy or one less chromosome called monosomy.

Women under 35 years of age can expect that the majority of their embryos will contain the correct number of chromosomes, while women over 40 years of age can expect the opposite. Most abnormal embryos do not result in a baby, but some do. The most common of these abnormalities is known as Trisomy 21 (Down’s syndrome). Additionally, women over 40 have miscarriage rates above 50 percent due to the increased rate of abnormal embryos.

CCS gives physicians the opportunity to determine if an embryo has normal chromosomes before it is ever placed in a women’s uterus. A recent study has shown that by performing CCS and transferring only a single normal embryo leads to an improved pregnancy rate and reduced miscarriage rate over those women where a single non-tested embryo was transferred.

The CCS technology is definitely on the cutting edge of advancing the fertility treatment field but is only available at a limited number of practices. Here are a few websites that provide more information for individuals or couples thinking about seeking fertility treatment and have questions about CCS, PGD and also any other form of fertility treatment: www.asrm.org and www.sart.org.

WENDY SCHILLIGNS, MD, FACOG

Dr. Schillings is a board certified reproductive endocrinologist, obstetrician and gynecologist. She leads all aspects of patient care at RMAPA. In addition, she formerly led the medical team at RE & I Specialist with the Lehigh Valley Physician Group. Dr. Schillings is chief of the Division of Reproductive Endocrinology and Infertility at Lehigh Valley Hospital Health Network and Clinical Associate Professor of Obstetrics and Gynecology at Penn State College of Medicine.