Looks can be deceiving - How Geri can help
It's tempting to place a lot of importance on "how an embryo looks" on the day of embryo transfer. And whilst it's true that "better looking" embryos are more likely to implant, judging an embryo purely based on how it looks at one moment in time is not especially accurate, nor is it consistent. A recent (non Genea) Australian study1
showed that even that unit's senior scientists differed in their grading of an embryo. There was only average agreement between different scientists (interobserver variability) and even when the same scientist was shown the same image at different times, there was variability in grading (intraobserver variability).
Additionally, an embryo might, to everyone's agreement, look good and yet have either an error of its chromosomes that will prevent it from implanting, or allow for implantation but lead to miscarriage. Data from Genea's lab show that for even young women, at least one quarter of blastocysts tested by Preimplantation Genetic Screening (PGS) have errors that prevent an ongoing pregnancy.
Putting all this together, if an IVF lab is relying on appearance alone to determine the best embryo for transfer - and (quite rightly) adopting a policy of single embryo transfer to avoid the risks of multiple pregnancy - that lab could be making the wrong choice and it could take that unit's patients longer to get to use the truly "best" embryo. That can lead to time delay and additional cost until a pregnancy is achieved.
PGS can be one way of distinguishing between embryos but what about more sophisticated ways of visualizing embryos? Well - step up Geri to the plate!
Who or what is Geri?
Quite simply, we at Genea believe that Geri is a world leading embryo incubator. Our experts developed Geri in house as we wanted the best outcomes for our patients. Geri provides state of the art conditions for embryos to develop in, but Geri also has another feature - time lapse photography. This means that every embryo grown in Geri has an electronic image taken of it, every five minutes or so. The images are put together to develop a video to show how the blastocyst has developed over the five days from the original egg collection. International studies have already suggested that time lapse imagery of embryos can help to better distinguish between them. For example, two embryos that look the same, may have grown in quite different ways - one might have had very even cell development but the other might not, suggesting quite different implantation potentials. Without time lapse, those developmental features aren't known.
Other time lapse incubators are available, but in most IVF units only a small proportion of their IVF incubators have time lapse capability, meaning that many of their patients will not have access to this technology. The good news for Genea patients is that from the start of 2017, every single embryo grown in a Genea laboratory is grown in a Geri incubator - and that means every Genea patient gets the benefit of time lapse assessment.
Geri - in Australia, available only at Genea Clinics (and Genea Hollywood Fertility in Perth).
Disclaimer: Please note that this is a Genea Group blog and as such information may not be relevant for all clinics. We advise that you consult clinics directly for further information.
1 A. Storr et al., 'Inter-observer and intra-observer agreement between embryologists during selection of a single Day 5 embryo for transfer: amulticenter study', Human Reproduction, vol. 32, no. 2, 2016, pp. 307-314, accessed 18 Jan. 2017.