Plan Your Family

Traditional morphology

To date the standard method of embryo selection has been morphology. Embryo morphology is assessed and scored based on cleavage kinetics, cell numbers, extent of fragmentation and cytoplasmic anomalies. This criteria is for the purpose of selecting the ‘best’ embryo(s) for transfer.

The goal is to transfer a blastocyst on day 5 of embryo development; however, the decision to do a day 3 versus day 5 transfer is individualized to the patient’s history, ovarian reserve, number of embryos and desire/need for additional assisted reproductive techniques such as CCS/ PGS or PGD.

The number of embryos transferred depends a patient’s age and history. Genesis Fertility Centre is committed to healthy babies and healthy mothers. We are therefore a proponent of singleton pregnancies which have the best outcomes for both.

We have developed mathematical models to help predict how many embryos to transfer based on maternal age, history and embryo quality at the time of transfer to optimize singleton pregnancies and IVF success rates. These models have been presented at international meetings and received international funding.

Eeva�

Eeva™ supplements traditional morphology assessment. A time-lapse video is created of the embryos as they grow in the incubator with observations made every 5 minutes. The video is interpreted by an intelligent computerized algorithm which allows us to know if the embryo reached its developmental milestones as expected or if it has deviated from the expected journey. Eeva™ is the ‘only time-lapse embryo system which is FDA approved’ as a diagnostic device. It has been shown to improve ’embryo selection’ and prediction of blastocyst development and implantation rates. Genesis is proud to have the ‘first pregnancy and delivery from Eeva™ in Canada.

Comprehensive Chromosomal Screening (CCS)

CCS is a diagnostic test to determine if the embryo is ‘normal’ or not prior to embryo transfer. Eggs are fertilized and grown to the day 5/6 stage of embryo development (blastocyst). The embryos are then biopsied to determine if the chromosomal complement is ‘balanced’  or ‘normal’ or ‘viable’. The certainty of this diagnosis is greater than 98%. The most common reason that embryos do not implant or later miscarry is that they were not chromosomally normal. When ‘normal’ embryos are identified, the patient will return for a frozen embryo transfer. When a single ‘normal’ embryo is transferred, pregnancy rates are maximized and miscarriage rates minimized.

	MORPHOLOGY	EEVA™	CCS
USAGE	Traditional method	Supplemental to morphology: time lapse video of embryo development interpreted by a computerized, Stanford University patented Algorithm	Done independently of morphology on blastocysts (day 5/6)
PROS	– Correlation with chromosomally normal embryos ~ 60% – Lower cost – Allows for fresh transfer into the body	– Additional information about embryo development that helps to predict pregnancy rates – Noninvasive – Only FDA approved time lapse instrument approved as a diagnostic medical device	– Diagnostic: confirms whether the embryo is chromosomally balanced ‘normal’ with 98% certainty – Highest pregnancy rates, lowest miscarriage rates by preventing transfer of non-chromosomally ‘normal’ embryos
CONS	– Lower pregnancy rates as compared to Eeva™ and CCS embryo selection methods – Miscarriage rates similar to spontaneous pregnancy	Does not confirm that the embryo is normal	– Invasive: the embryo is biopsied if it makes a blastocyst – Embryos are frozen pre-transfer; the transfer is delayed 1-2 months – Some embryos will not make blastocysts and therefore will not be biopsied nor transferred. If all embryos are abnormal  no transfer will occur
COSTS	No additional cost	$1500 in addition to IVF fees	$~4000-6000 in addition to IVF fees (dependent on testing requirements)