Fertility technology you may to consider want with IVF:

Embryo Freezing

Often more than two or three embryos are produced in an IVF cycle. Good quality 'spare' embryos can be frozen, and later thawed to give another chance of pregnancy. Freezing and thawing have to be done under special conditions: >90% of embryos can survive the procedure. When embryos are to be thawed the woman's menstrual cycle is monitored with blood tests to make sure the embryos are replaced at the right time of the menstrual cycle.

Thaw cycle of IVF

When there have been embryos frozen following in vitro fertilisation, they can be thawed and transferred into the uterus at a later stage. This usually entails several bloods tests to time ovulation during a natural cycle. In some cases it is necessary to control a cycle using drugs to prepare the uterus for implantation. Embryos are transferred into the uterus at the appropriate time, as they are in an IVF cycle.

ICSI is a variation of IVF. Instead of the sperm and eggs being mixed together, a single sperm is injected into each mature egg. ICSI may be used, for example, when sperm quality is too poor for conventional IVF to work. ICSI allows almost any man with sperm, either in his semen or in his testes, to try IVF.

Genetic carrier screening gives individuals and couple’s information about their risk of having a child with a genetic condition.

We now offer the option to do genetic testing through Invitae, either for your own information or to check compatibility with your partner or potential donor.

Genetic screening identifies whether you are a carrier of a range of inherited conditions. Most people are carriers of one or more genetic conditions, even though no one in their family has the condition. Being a carrier is important if the person using the sperm is also a carrier of the same condition.

Invitae’s carrier screening includes:

• Severe and prevalent disorders seen across all ethnicities
• Enhanced SMA testing to help identify silent carriers
• Comprehensive Fragile X analysis, including AGG interruptions
• Full gene sequencing with deletion and duplication analysis leading to a 99% detection rate for most genes
• Actionable results; no reporting of variants of unknown significance

Pre-implantation genetic testing can identify genetic abnormalities in embryos at the blastocyst stage, (a blastocyst is an embryo that has been developed in the laboratory for five or six days after fertilisation). This allows us to select the 'best' embryos which are most likely to be free of genetic conditions and chromosomal abnormalities for transfer to the uterus.

Types of PGT:

PGT-M:  formerly called PGD, pre-implantation genetic testing for monogenic/single gene disorders. When used by people who have a chance of passing serious genetic disorders on to their children, PGT means that couples can have a child that is fully theirs genetically without the child inheriting the particular genetic disorder.  Examples of conditions that may be are caused by a change in single gene may be excluded by this test: neurofibromatosis type 1; Marfan syndrome; cystic fibrosis; Tay Sachs; Huntington's; muscular dystrophy; Beta-thalessemia, Fragile X and Spinal Muscular Atrophy.  

PGT-SR: chromosome structural rearrangement (eg translocation carrier).  This can assist people who have a high chance of pregnancy loss or a lower chance of pregnancy because of translocations between chromosomes.

PGT-A: aneuploidy testing (formerly called PGS). Because many blastocysts have the wrong number of chromosomes, (a condition known as aneuploidy), PGT is a powerful tool for selecting a good embryo for transfer. Aneuploidy can lead to miscarriages, birth defects and other complications.

Useful to know:

Ethics Committee approval is required to carry out PGD for any other reason, (such as ‘saviour siblings’). PGD cannot be used for gender selection in New Zealand.

Photographs embryos every 10 minutes to capture developmental milestones in the embryo’s life that are missed when embryos are only inspected once a day. 

Benefits of TiMI:

• Picks up unusual and detrimental events that escape a daily snap-shot inspection.

• Identifies 10-15% of embryos with very low potential.

• Several studies show that TiMI increases the chance of pregnancy using the first embryo transferred by up to 10%.

• Embryos are not removed from their incubator, therefore they develop in an uninterrupted environment.

Who can benefit from TiMI?

• People who expect to have several good quality embryos to choose from.

• People who have had low quality embryos previously and want more information about their embryo development.

Embryo selection with TiMI does not increase the overall chance of a baby from all the embryos available, but it can reduce the time to pregnancy by giving a better choice of which embryo to use first.

How can TiMI & PGT work together?

Preimplantation genetic testing (PGT) is the strongest embryo selection tool we have since we know that many normal appearing embryos have the wrong number of chromosomes (aneuploidy).

The challenge with PGT is that it requires blastocysts on day 5 or 6 for testing – probably 3 or more. TiMI complements PGT because it provides the best undisturbed environment we have available in order to get as many blastocysts as possible. While the extra information we gain from watching the embryos with TiMI is helpful when not using PGS, it does not add to the selection process when PGS is used.

The challenge most patients face is knowing how many embryos they’ll have to work with. If the number is few, then TiMI is a safe way to increase your chances. If there are 3 or more blastocysts, then PGS alone or in combination with TiMI may be the better option.