Genetic test to aid in embryo transfer

Chennai: Though stem cell research on setting right imbalances of infertility couples is yet to take off, a city IVF expert has found a novel way of ascertaining the right time to transfer embryo for implantation in women with a history of recurring implantation failures. The genetic testing of the uterine tissue, offered by the city fertility hospital, helps the fertility experts to discern the proper time to implant the embryo, thus resulting in conceiving.

At present as there are no genetic testing facilities in the state, the samples are airlifted to Delhi for testing and upon receiving the report, the IVF expert transfers the embryo to ensure enhanced opportunity for conception. Normally embryos are transferred between third and fifth day after retrieval and the time is determined as a direct result of embryo development. Embryos with a strong chance of growing in the lab until the fifth day are transferred as blastocysts.

“It is very vital to ascertain the endometrial receptivity as a product of the gene expression of the endometrial lining at specific times during a woman’s cycle. The test – Endometrial Receptivity Array (ERA), examines the cyclical pattern of 238 different genes and determines the personalised window of implantation for each patient ahead of commencing the assisted reproductive treatment,” explains Dr D. Dakshayani, clinical director, Nova IVI Fertility, Chennai.

Claiming that the ERA (costing about Rs 40,000) is not recommended for all patients, she said the genetic evaluation helps in improving the cumulative success rate to 65 per cent. The test involves collecting a sample of uterine tissue with a soft catheter with local anaesthesia and sent to genetic lab for detailed analysis.

On an average over 50,000 IVF cycles occur in India and the success rate of IVF varies from 30 – 50 per cent. About 15 – 25 per cent of the implantation failure is due to implanting embryo at the wrong time in the uterus, often missing the woman’s crucial window of implantation.

Stem cells could hold the key to regenerate the endometrium – a mucous membrane that lines the inside of the uterus (womb) and improve the chances of fertility in women. “This can be thought of… more research ought to be done on the subject,” Dr Dakshayani says on the possibility of addressing the fertility problems of women.“Sometimes men could also be a factor if a women does not conceive. Or the problem could be in both. The cases should be studied individually and also collectively as a couple,” says Dr  D. Jayashree, Gynaecologist.