Danny Daphnis, PhD
Scientific Director at Mediterranean Fertility Institute, Mediterranean Fertility Institute
Category:
Embryo Implantation, Embryo Transfer
‘When you’re talking to your gynaecologist or your IVF specialist or embryologist, remember that when they’re talking about good quality embryos or good quality eggs or very good endometrium, it’s always about indications. The only proof of a good embryo or a good endometrium is a pregnancy, a healthy pregnancy.’
‘I’m quite a strict person, I will never grade a blastocyst as AA, or I will never give 8 cell embryo a grade 1 because I believe that if I do give this spectacular grading, it’s just like saying to the patient you’re going to get pregnant, and I know that IVF is never 100%. Therefore, I tend not to be so gracious with my gradings.’Blastocyst transfer is not always the best solution because not all day-3 embryos will grow on to become blastocysts. More studies have shown that around 40% of day-3 embryos will reach the blastocyst stage. That means you have quite a bit of embryo wastage, as we call it, so if you have 10 day-3 embryos, only 4 of them will reach the blastocyst stage. Dr Daphnis advises that these are general statistics, it doesn’t mean that it applies to you necessarily, but you should always keep that in mind. If the embryo does reach the blastocyst stage, it still doesn’t mean it will give you a baby. Therefore, it’s a good way for an embryologist to be able to select the best one, but that doesn’t mean that by doing a blastocyst transfer, we shall get a pregnancy. However, if there is a good quality blastocyst, then the chances of pregnancy and implantation rate might increase. Time-lapse incubators are incubators in which the embryologists do not have to open and close them to look at the embryos, they already have a camera inside them, so we can look at embryonic development throughout the time that we have these embryos in the laboratory. That means we can consider looking at embryonic development from day 0 to day 5 and seeing how they develop. We try to find patterns that might help us select the best embryos, and we try to see how we can make what we call a non-invasive selection of the embryos just by looking at how they’re developing. Artificial intelligence (AI) has been thrown into all these time-lapse incubators. These incubators are trying to predict the clinical pregnancy outcomes using a light microscope. They’re trying to find the patterns in how the embryos are dividing. If, for example, they divide too fast, then it might be good, whereas if they’re dividing too slow, it might be wrong, if they’re dividing all together, for example, instead of going from 1 cell to 2 cells to 3 cells and then to 4 cells, then that might have a detrimental effect. All these things are being looked at, at the moment. Finally, Dr Daphnis added that technology is thrown into embryology, and hopefully, all this technology will help us make a non-invasive selection of the best embryos to transfer back to patients to achieve a healthy pregnancy.
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