Stress relief: how diet and lifestyle can help

This month is Stress Awareness Month which has been held every April for the last thirty years, yet events over the last two years have made this event even more essential. Anxieties over COVID and the impact of lockdowns have all taken a toll on our mental health. Multiple studies have shown a major increase in the number of adults reporting symptoms of anxiety, depression, and insomnia.

For those undergoing IVF, however, this has been an even more stressful time, with cancelled appointments, delayed procedures and worries about how the pandemic would impact their fertility treatment. We take a look at where stress, diet and fertility intersect.

Stress and the body

There are many factors that are stressful for mind and body – external pressures such as your job or family responsibilities and internal influences such as our diet or how body is functioning.

Stress affects our body in a myriad of ways: it increases blood pressure levels, spikes our blood sugar, releases stress hormones, and speeds up our heart as we enter a flight or fight response. The problem is that the pressure of modern-day living means we’re continually in a state of full alert.

Diet and fertility stress

A well-balanced diet can help us combat the physiological changes caused by stress. Much of the focus is on stabilising our blood sugar levels.

Prioritising protein: when the body is chronically stressed, it demands protein as that slows down release of sugar into the blood stream and the best sources are lean meat, fish, eggs, beans, pulses, nuts and seeds.

Time your intake: eating regular, well-balanced meals are the key to maintaining energy levels and your mood while staving off tiredness.

Fight the easy fix: highly refined foods such as white bread, pasta, sweets, cereals, as well many tinned or processed products, are full of added, hidden sugars that cause a spike in blood sugar levels.

Avoid emotional eating: try not to reach for food when you’re feeling stressed as it diverts blood flow away from your digestive system and it will probably just leave you feeling bloated and uncomfortable.

Alex Ballard Fertility DieticianAlex Ballard (@alextalksdiet), a Band 7 specialist fertility dietitian in the NHS, specialises in preconception nutrition and works with Aria Fertility, helping patients with general enquiries about fertility and nutrition and how that links to fertility treatment or any other health conditions

“A Mediterranean diet is specifically good for mood; one with oily fish, lots of fruit and veg, nuts and seeds, and whole grains. But I find that just the act of focusing on diet and taking control can also be good for allaying anxiety as the patient is being proactive about improving their own health.”

We work closely with a wide range of practitioners to provide support throughout your fertility journey – click here to visit our Support Hub.

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IVF and Acupuncture: What is the point?

At Aria Fertility Clinic, we recognise the importance of supporting your emotional, mental, and physical wellbeing during your fertility journey. Acupuncture is increasingly popular as a complementary therapy for those undergoing fertility treatment or managing hormonal conditions.

Acupuncture is an ancient tenet of traditional Chinese medicine whereby very fine needles are placed at strategic points on the head and body to release the flow of energy or chi. It is believed to be beneficial in the treatment of a wide range of health conditions, including fertility issues, by correcting energy imbalances in the body.

How does acupuncture aid in fertility treatment

Acupuncture can be used by both men and women during the fertility process. For men, it may prove beneficial when going through ICSI treatment. For women, it’s thought to have several benefits:

  • Increasing blood flow: acupuncture can boost blood circulation to the ovaries and uterus
  • Regulating hormones: acupuncture can improve menstrual regularity, restore ovulation patterns, and regulate the release of key hormones including follicle stimulating hormones. This can be highly beneficial for women suffering from PCOS
  • Reducing stress: acupuncture releases the body’s endorphins which helps to relax patients undergoing fertility treatment. Patients often report they feel more ‘in control’ and proactive

Emma Cannon fertility and women’s health expertEmma Cannon, a fertility and women’s health expert, is a registered acupuncturist and works with men and women who wish to optimise natural conception or support IVF.

“Most of the research into acupuncture and IVF has been focused on the pre- and post-embryo transfer stage,” Emma explains. “Clearly that’s because when you design a study everyone must be at the same stage to produce comparable data. The studies showed promising results, but they never went beyond it. So, I’m more interested in what acupuncture can do outside of embryo transfer.

“We use it for women whose endometrium has previously not reached the correct thickness and I might combine acupuncture with a nutritional programme. That can be very effective.”

Emma pointed to another area where they have had good results. “It can be common during an IVF cycle that the follicles do not evenly develop. By improving the blood flow to ovarian arteries, it can improve follicle development and help the other ovary catch up.”

In recent years, several studies have attempted to evaluate the benefit of acupuncture in alleviating infertility or as an adjunct to IVF or ICSI and while we have no conclusive evidence yet, a growing body of scientific research supports its efficacy as a complementary therapy.

What is indisputable, though, is that acupuncture has no adverse effects and anecdotally our patients report that it has been highly beneficial in relieving stress during their fertility journey.

To get in touch with Emma, please visit her website. For more information on the practitioners we work with, please visit our Support Hub.

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What makes an IVF lab exceptional?

The IVF laboratory is a key component to the beating heart of any fertility clinic – it is here where human fertilisation occurs, sparking the creation of embryos and the beginning of life.

With the perfect integration of three highly specialised areas (andrology, embryology and preimplantation genetics), Aria provides a focused and individualised approached to optimising the IVF laboratory environment and managing the most complex of infertility issues.

Led by Laboratory Manager, Xavier Vinals Gonzalez, the scientific team has enhanced embryology processes to deliver high success rates, with a constant focus on patient care and experience as core to the laboratory values.

Digitalised environment

We understand how important it is for us to be able to deliver the best results possible. In doing so, laboratory activities we recognise the importance of an environment with minimised carbon footprint. We recognise the synergies and benefits which can be derived from a fully digitalised environment, such as electronic witnessing (traceability) which eliminates the risk of errors.

Digital traceability is incorporated across each specific stage of the IVF pathway:

Taking sperm processing as an example, conventional preparations have 14 associated steps and 32 failure modes – potential risks to a sample or errors in the process, such as sample mismatch and impairment of sperm function. In Aria’s digital ecosystem, each stage in the process is associated with an electronic tag containing three identifiers for each sample allowing for full traceability. Furthermore, electronic data gets routinely checked in order to test and improve the workflow and efficiency in the laboratory.

Integrating new technologies

IVF is a constantly evolving field, which requires continuous careful assessment of emerging solutions by doctors and scientists. In order to evaluate the incorporation of innovations into the laboratory, a systematic decision strategy which accounts for effectiveness and risk is always followed.

Last year, Aria cryostorage facilities was the first clinic worldwide to introduce a novel monitoring technology. With the aid of such equipment, Francisca Mora, ESHRE certified clinical Embryologist at Aria, developed a study analysing cryokinetic variables, which helped to validate the integrity and lifetime of cryostorage tanks adding a unique high-security level and cryosurveillance to our stored samples.

Aria’s Laboratories have always welcomed advances in the field of IVF, where technology can bring standardisation and precision while enhancing normal functions of eggs, sperm and embryos. Based on the use of microfluidic devices for sperm preparation, embryologist Kimberley Hill, showed a reduced operational risk and improved laboratory workflow. Such devices use the natural properties of sperm to ‘swim up’ (rheotaxis), whilst reducing the associated steps in the process.

Currently, Aria Laboratories continue to evaluate the efficacy of non-invasive genetic testing, time-lapse parameters and artificial intelligence algorithms as predictors of embryo potential with the main focus on delivering high success rates to our patients, whilst minimising multiple pregnancy.

Rigorous quality control

Correct functioning of equipment is imperative for maintaining the functions of eggs, sperm and embryos. Temperature, gas and humidity sensors are distributed along the equipment in the laboratory and monitored 24/7. Should any anomaly be detected, different sensors will trigger an alarm and inform the Embryology Team, which can connect remotely and troubleshoot rapidly.

This digital surveillance system is tested against our weekly manual quality control checks to ensure correct performance. Annually, Aria Laboratories have a planned shut-down where all pieces of equipment are analysed, calibrated and tested; providing us with the reassurance our equipment is functional and we continue to offer a premium quality service with the best results.

Research and development

The importance of research and development activities is well embedded in our daily work and philosophy. Journal clubs and quality review meetings are organised between departments to track new practices and developments in the field. It is key for us to be able to provide an individualised and exceptional experience to our patients, which requires managing each case independently.

Within the embryology department, Miriam Alvarez’s interest resides in reviewing literature and research with a goal of potential adaptation of the laboratory procedures for cases of autoimmune disorders to maximise the chances of success when embarking on the IVF journey.

Aria Laboratories are proud to be able to provide an excellent and evidence-based approach to infertility cases, which would not be possible without the cohesive integration with the clinical, nursing & patient support teams.

To find out more about our work, call +44 (0) 203 263 6025 to arrange a consultation.

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Natural Killer Cell Testing in Recurrent Pregnancy Loss and Recurrent Implantation Failure

Natural killer cells, or NK cells, are part of our body’s immune system, helping us to fight infection and disease. Every organ has NK cells including the uterus where they are known as uNK cells.

uNK cells play a role in helping the body become pregnant by inflaming the lining of the uterus so the embryo can implant. It is thought that too few or too many uNK cells can cause infertility and miscarriage.

However, there is currently no clear evidence about the exact role that uNK cells play in miscarriage and what should be considered an ideal level or an imbalance.

The value of measuring natural killer cells either in blood or from the uterus, therefore, remains controversial and confusing. Here, reproductive medicine specialist Dr Amanda Tozer reviews Natural Killer Cell testing in Recurrent Pregnancy Loss (RPL) and Recurrent Implantation Failure (RIF).

The main reasons for this are:

  1. Whilst there is an association between elevated NK cells and RPL and RIF, there is no established causal effect
  2. There are no clearly established values for what constitutes elevated levels of NK cells
  3. There are no clear guidelines on which NK cells should be measured and from where (blood or uterus)
  4. Current evidence is not strong enough to support the use of either IVIG or intralipid with larger randomised controlled trials being needed

Below, Dr Tozer summarises what we do know at this stage:

CD 56 NK Cells

In peripheral blood, 90% of NK cells are CD56dim and 10% are CD56bright which is the opposite in the uterus. There are varying studies that suggest there is no correlation between the uterine NK cell levels and those in peripheral blood as well as studies that suggest there is a correlation.

Studies have shown an increase in the number of peripheral blood NK CD56 with high rates in recurrent implantation failure and recurrent pregnancy loss

A cut off level of >12% has been used for CD56 but levels of up to 29% have been seen in normal healthy individuals

CD 3 Cells (Pan T Cells)

High values may be found in women with RPL. Cut off values are set at 85%

CD19+/5+ (B-1 Cells)

When CD19 express cells known as CD5 they are classified as B-1 cells and are often involved in autoimmune disorders, Women with elevations of CD19+/5+ may be at risk of thyroiditis and premature menopause. Cut off values are >10%

CD19 (B cells)

Frequently found to be elevated in women with an immune cause for RIF or RPL. Cut off values are >12%

NK Cytotoxicity

This is the ability of agents to suppress the killing of target cells by the patients NK cells

Results are expressed as ratios of 12.5:1, 25:1 and 50:1. A reduction in cytotoxicity to <20% is desirable

Intralipid

The active ingredient in intralipid is purified soybean oil and purified egg phospholipids. A number of studies have assessed the use of intralipid in women with RPL and RIF who have elevated NK cells. Intralipid has been shown to be effective in decreasing NK cell activation and reducing production of proinflammatory cytokines with the aim of promoting healthy implantation and placentation. Studies have reported variable outcomes with clear evidence to support its use being limited. No studies have reported any serious adverse events.

Studies have shown intralipid to be comparable to using IVIG. IVIG is expensive, has an associated risk of anaphylaxis and, (albeit low) a risk of infection transmission. IVIG is not offered at ARIA.

To discuss this in more detail, book a consultation with Amanda or any of our fertility experts.

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Functional fertility explained

When you embark on your fertility journey, you may have seen the term ‘a holistic approach to fertility treatment’ and be unsure what it means.

At Aria Fertility Clinic, we offer cutting-edge scientific solutions to infertility; our medical team is led by highly experienced fertility and gynaecology specialists and backed by the latest technology incorporated in our IVF laboratory. Yet we recognise that emotional, mental, and physical factors can all play a role in your experience, and we work closely with leading complementary practitioners and counsellors.

Emma Cannon fertility and women’s health expertRecently, we spoke to Emma Cannon, a fertility and women’s health expert, registered acupuncturist, founder of the Emma Cannon Clinic, and a mentor and speaker in fertility matters. She explains how she supports men and women who are contemplating or undergoing fertility treatment.

“Covid has added a layer of stress to fertility treatment. I gave a talk recently to IVF doctors and nurses and discussed what fertility treatment needs to look like in 2022 and safety is primary. By this, I mean not just physical safety during the Covid pandemic, but the importance of providing emotional safety for patients.

“There was a lot of talk when we went into lockdown that there would be a baby boom, and this seemed very unlikely. Fear does not induce good fertility. So, it’s important that people feel safe. If you’re not going to get this from external sources, it is something that must be cultivated internally and that is how I help patients.”

Infertility and past trauma

“If you have formed a belief in your childhood that you’re not good enough, you spend your whole life trying to compensate – by getting good grades in school, doing well at university, or getting a great job.

“Everything you do dispels this belief buried deep down that you’re not good enough. But suddenly, after being successful all your life, you experience difficulties in conceiving. Sometimes it’s the first time my patients may have failed at anything their whole life.

“Very quickly they go into a trauma response and these old belief systems get triggered. I work with patients so they aren’t in this fight or flight mode.”

Women and the self-blame of infertility

“Most people tend to catastrophise, and they often make the situation worse by the meaning they attach to it. This can be particularly true for women who are much quicker to say what’s wrong with me.

“By the time they reach the IVF clinic, they are often convinced that there is something really wrong with them. What I tried to do is unravel their past so they can come to fertility treatment from a fresh place rather than projecting onto the future.

“Typically, I will see the individual or couple for an initial consultation via Zoom. Often, I may refer them to a fertility clinic that would be a good fit for them and then we create a holistic programme for them. I have two acupuncturists that offer pop-up clinics in central London and our emotional support sessions are carried out via Zoom. Generally, I work with them individually at that point.

“I can’t cure their fertility issues, which is the role of IVF or other fertility treatments, but I can give them back their trust in the fertility process.”

To get in touch with Emma, please visit her website. For more information on the practitioners we work with, please visit our Support Hub.

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The value in endometrial scratching

Currently rated as amber by the Human Fertilisation & Embryology Authority, the UK’s IVF regulator, the value of IVF add-on endometrial scratching has come under the spotlight in recent months.

Endometrial scratching is rated amber by the HFEA because there is conflicting evidence from randomised controlled trials (RCTs) in terms of its effectiveness in improving the chances of conception for those undergoing fertility treatment.

What is endometrial scratching?

Endometrial scratching is termed as a fertility treatment ‘add-on’ as it is performed in conjunction with in vitro fertilisation (IVF). It is used in preparation for a round of IVF with your fertility doctor ‘scratching’ the lining of the uterus known as the endometrium. During the first stage of conception, an embryo attaches to the endometrium in a process known as implantation.

By ‘damaging’ the endometrium, the body’s natural healing process is triggered and an inflammatory response is produced, releasing growth factors, hormones and proinflammatory cytokines.

It is a quick, simple, low-cost procedure performed without anaesthetic. It can cause some discomfort and bleeding, but more serious risks such as infection or uterine perforation are very rare.

Some studies have suggested that endometrial scratching makes the uterus more receptive to implantation. However, as indicated by the HFEA, other trials into endometrial scratching have found no evidence that it increases the chance of conceiving through IVF.

The latest research into endometrial scratching

Published in the journal Human Fertility in December 2021, were the results of a new survey of fertility doctors in the UK, Australia and New Zealand into their perception of endometrial scratching value.

“We don’t have good evidence that endometrial scratching helps people to have a baby from IVF, and it’s a painful procedure associated with a cost for the patient too,” explains one of the study’s authors Sarah Lensen, postdoctoral research fellow at the University of Melbourne.

The study’s authors believe that earlier studies that found value in endometrial scratching lacked randomised controlled trials and were too small scale. Later larger, high-quality studies have cast doubt on these, meaning there’s no conclusive evidence that it boosts your chance of conception.

Yet, many fertility clinics continue to recommend this add-on. As identified in the study, many fertility specialists believe that it is valuable for patients who have unsuccessfully undergone more than one IVF cycle with good-quality embryos due to implantation failure.

“The idea of the scratch is that it might help these women who could theoretically have suboptimal endometrium, to achieve pregnancy,” Sarah says. “Secondly, people who have had multiple embryo transfers without success are often looking for something new to try that might help them to conceive.”

For more advice on endometrial scratching, call 0203 263 6025 to arrange an appointment with Dr Amanda Tozer at Aria Fertility Clinic.

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The implications of fertility treatment

Infertility and its treatment can affect all aspects of people’s life and can cause frustration, anxiety, depression, guilt, and feelings of worthlessness.

In a 2016 study into the impact of fertility treatment carried out by Fertility Network UK, respondents felt on average sad, frustrated, and worried nearly all the time and 42% experienced suicidal feelings as a result of fertility problems and/or the treatment they are undergoing. The study also found that 70% reported some detrimental impact on their relationship.

The Human Fertilisation and Embryology Authority (HFEA), the UK’s fertility regulator  acknowledge the importance of counselling being attended before you donate eggs, sperm or embryos or have treatment with donated eggs, sperm, embryo. It is a mandatory requirement that fertility clinics offer access to counselling when embarking on any fertility treatment.

Tracey Sainsbury Fertility Counsellor at Aria ClinicAt Aria, we work closely with Senior Fertility Counsellor Tracey Sainsbury who provides implications counselling for individuals and couples around all fertility issues. Implications counselling aims explore the psychological as well as the social, legal, and ethical implications around your treatment.

“I am not a tick box type of counsellor – I like to take my patients on a journey,” Tracey explains. “And every person’s journey is different – usually because experiences from the past can be triggered.” It’s estimated that 80 to 90% of people undergoing fertility treatment experience anxiety and depression.”

Managing the emotional rollercoaster of IVF

The IVF process can be a highly emotional time for both the individual and the couple, marked by highs and lows and alternating feelings of excitement, hope, disappointment or uncertainty.

“Often people have a fantasy around how they had hoped to conceive, it rarely includes assisted conception. There can be a grief response to the loss of fantasy around embracing assisted conception, even when they are keen to get started.” Tracey clarifies. “For couples, they will usually have put life on hold, telling themselves I’ll stay in this job because of maternity leave or we won’t book that holiday because we may be pregnant.”

“For women, in particular, we live in a prenatal world and suddenly everyone around them seems to be pregnant and that can feel persecutory. Then, they arrive in clinic and they are hopeful but maybe annoyed that they even have to be there in the first place. They may also feel relief because someone else is now going to take charge.

“Fertility treatment can be very traumatising and the thing with trauma is that we can be retraumatised. So, anything relating to family, hopes, dreams can bring up past trauma even from a very long time ago.”

Managing stress during your fertility treatment

“Sometimes the greatest risk to mental health is social media as it promotes this sense that you should be zen-like and positive, but fertility treatment is very stressful, Tracey explains. “So, we say be stressed but learn how to manage it well.”

Tracey promotes patient autonomy and there is no prescribed amount of fertility counselling that she recommends. For some patients this can be an initial appointment to discuss strategies for managing any stress you experience during your treatment journey. However, fertility treatment can bring to the surface long-buried trauma and emotions or put pressure on relationships and some patients – either as couples or individuals – may have weekly sessions throughout the many weeks and months that they undergo treatment.

Tracey offers a reduced fee for counselling appointments for people exploring or progressing fertility treatment with Aria. The cost is £50 per appointment, appointments are always provided online via Zoom or Teams and last around 50-60 minutes. Patients do not have to register with her private practice, and she has access to their notes, so she is aware of their fertility journey so far.

Call +44 (0) 203 263 6025 to find out more about the support we can offer at Aria Clinic.

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New genetic risk factors identified in PCOS

A new study has identified new genetic risk factors in the development of polycystic ovary syndrome (PCOS). PCOS is the most common endocrine disorders affecting women and it can lead to difficulty getting pregnant.

Published in the journal Human Reproduction, genome-wide association studies were conducted by researchers at the Institute of Genomics of the University of Tartu to search for these variants in PCOS.

Polycystic ovary syndrome is often diagnosed through irregular periods, high levels of androgen hormones or enlarged ovaries known as polycystic ovaries, but the exact causes of PCOS remain unknown.

The study’s author analysed the genetic data of over 233,000 women from Estonia and Finland. Triin Laisk, Associate Professor at the Institute of Genomics, determined that PCOS “is a multifactorial condition, meaning both genetics and environmental or lifestyle factors increase the risk”.

The study found two new rare genetic variants that increase the risk for PCOS, which will probably affect the gene CHEK2. CHEK2 has been also linked to ovarian reserve and variation in age at menopause.

PCOS and fertility

One in five women in the UK suffer from PCOS and it can be a common cause of female infertility as it affects how the ovaries function. Although polycystic ovaries contain small antral follicles with eggs in them, the follicles often do not mature properly so there is no ovulation. Cysts can form instead.

Women will often experience irregular menstrual cycles and gradual worsening of excess facial and body hair growth as the result of high testosterone levels. Although the infertility rate can be high with PCOS, the good news is that the chance of getting pregnant using fertility treatments is good.

Women with PCOS usually require ovulation induction to conceive. Fertility treatment options include the use of medication such as Clomid or Letrozole. IVF is one of the most common fertility treatments for those suffering from PCOS and has a good success rate. The initial stage is taking medication to stimulate ovulation and then injections are given which will help the body to release an egg before they are harvested for fertilisation.

For more advice on PCOS and fertility treatment, call +44 (0) 203 263 6025 to arrange a consultation at Aria Fertility.

 

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What are mosaic embryos?

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New research has found that mosaic embryos, currently ruled out for IVF selection, could self-correct and lead to healthy pregnancies.

During embryo selection, a test known as preimplantation genetic testing for aneuploidy (PGT-A) is used to screen aneuploid embryos which have an incorrect number of chromosomes. This is performed to reduce the risk of miscarriage.

Embryos with the correct number of chromosomes are called euploid and have a higher chance of leading to a successful pregnancy than those with the incorrect number of chromosomes or aneuploid embryos.

What are mosaic embryos?

Previously, embryos were categorised as normal or abnormal, but in the mid-2010s, embryologists discovered that blastocysts aren’t necessarily 100% euploid or 100% aneuploid: sometimes they’re a mixture.

The term mosaic embryos were coined to describe embryos that have a mix of normal and abnormal cells. Data suggests that mosaic embryos account for up to 20% of all PGT-A-tested embryos.

Mosaic embryos can have different proportions of normal and abnormal cells and there is a criterion ranging from low-level mosaic where 20 to 40% of the cells are abnormal to high-level mosaic.

What did the study into aneuploid embryos find?

Scientists at the laboratory of synthetic embryology at Rockefeller University, New York found that some aneuploid embryos can self-correct. They transferred embryos that had failed the PGT-A screen into women who’d given their consent. Genetic tests performed a few months later found there were no longer any signs of aneuploidy.

The next stage of the study was to understand how the ‘faulty’ embryos developed. Using human embryonic stem cells, they generated artificial human embryos and studied their development. They found that the proportion of the aneuploid cells decreased and the aneuploid cells that remained were in the outer layer which eventually becomes part of the placenta.

As this research shows, the science behind embryo selection continues to evolve and PGT-A is one tool to help us choose which embryos to transfer. Throughout the process, we provide you with all the information you need to make these important decisions.

For more advice on IVF and embryo selection, call +44 (0) 203 263 6025 to arrange a consultation at Aria Fertility.

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Aria Fertility launch ‘game changer’ study into non-invasive approaches to improve chances of conception

Globally, we are starting families later than ever. Although most couples do get pregnant within the first 12 months of trying, it is estimated that one in seven couples may have difficulty conceiving.

Though the latest data from the Human Fertilisation and Embryology Authority (HFEA) reveals that the rate of successful IVF treatments continues to rise, it also noted that the chance of having a baby after one treatment cycle for women under 35 years of age is 31.3%.

Fertility clinics are increasingly focusing on the biopsychosocial dimension of fertility and, using a unique and cutting-edge approach, Aria’s Laboratories are conducting an innovative study to investigate how non-invasive data could be used to tailor and maximise IVF treatments.

Mr Stuart Lavery, Consultant Gynaecologist and a Founding Director of Aria Fertility, explains: “Aria Fertility was born through the vision of leading clinicians and embryologists who have combined their experience and vision to deliver truly market-leading fertility care, whilst combining the latest technological advances and pioneering research in the field of embryology.

“Using a unique and cutting-edge approach, Aria’s Laboratories are conducting an innovative study to investigate how non-invasive data could be used to tailor and maximise IVF treatments.”

The Safe Assessment of Embryos (SAFE) study aims to integrate information on individual’s sleep quality, lifestyle habits, laboratory and clinical data, together with non-invasive genetic information and the most advanced algorithms for embryo selection using artificial intelligence (AI).

Embryo selection explained

Once embryos are created in in vitro, embryo selection is a decisive stage in IVF treatment. The healthier the embryo selected, the higher the chance of a successful pregnancy result.

There are several methods embryologists use to select for the best embryo. One method used in routine practice involves looking at the appearance of the cells which make up the embryo (morphological assessment). Another method involves tracking the growth of the embryo in a special incubator that records images over time (morpho-kinetic assessment).

One emerging method to score embryos involves AI, which can be used to rank the embryos most likely to become a baby. Even though all methods are valid, there are currently discrepancies between IVF laboratories when it comes to their criteria, use and implementation.

Currently, genetic data from the embryo is obtained through a biopsy of the embryo, where some cells are removed and sent for analysis. Although being invasive, preimplantation genetic testing of aneuploidies (PGT-A, formerly known as PGS) is considered the gold standard technique to check embryos for abnormalities in the number of chromosomes – key factor for successful pregnancy.

Chief Investigator and Laboratory Manager at Aria, Xavier Viñals Gonzalez explains why the SAFE study is unique. “The SAFE study proposes to use the culture medium, which is the nutrient fluid that embryos are placed in to grow, to gain genetic information in a non-invasive manner. Embryos gain their nutrients from the culture medium to grow, and they then secrete certain markers into the medium. Previous studies have connected these with embryo’s genetic makeup.

“In routine treatment, the culture medium is discarded after the embryos have been transferred or cryopreserved. Our laboratory will measure these markers in the medium to see whether they are predictive of a live birth.”

Sleep and fertility

Previous studies have shown that sleep quality and length to be associated with variations in fertility hormones, number of eggs collected during fertility treatment, egg maturation, and quality of semen.

Dr Sara McNeillis, Sleep Medicine and Anaesthesia Consultant, joins Aria’s study to investigate the vastly unexplored area of sleep disorders and infertility. With the aid of a smart watch, individuals sleep quality and patterns will be measured and further complemented with sleep questionnaires. Also, participants will be encouraged to record information on lifestyle habits while they are enrolled in the study.

Joining the fertility study

To be eligible to participate in this study, individuals must be between the ages of 18 and 44 and planning to have IVF with a single embryo transfer. Given its non-invasive nature, being part of the SAFE study will not impact individual’s treatment in any way. Results from this research could be the biggest game changer not only for how we analyse data to predict successful outcomes in IVF but also for patients to understand their options during their reproductive journey.

To find out more about our study and the work of the Aria embryologists, call us on +44 (0) 203 263 6025 to speak to one of the team.

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