“Single Embryo Transfer (SET) with Aneuploidy Screening: Same Delivery Rate, Better Obstetrical Outcome” Selected for Oral Presentation as Prize Paper at 61st Annual Clinical Meeting
NEW ORLEANS, LA – May 8, 2013 – Eric J. Forman, M.D., Reproductive Endocrinologist and Infertility Fellow at Robert Wood Johnson Medical School/Reproductive Medicine Associates of New Jersey (RMANJ), today presented research demonstrating that screening embryos for chromosomal abnormalities, then transferring just one chromosomally normal (euploid) embryo during IVF offers delivery rates that are equivalent to the more standard procedure of transferring two embryos with no screening, while also resulting in fewer incidents of twins and thus healthier obstetrical and pediatric outcomes. The paper was awarded third prize in the category of current clinical and basic investigation by the Committee on Scientific Program Awards at the American College of Obstetricians and Gynecologists 61st Annual Clinical Meeting in New Orleans, May 4-8, 2013.
“With infertility treatments generating 18 percent of all twin deliveries in the U.S., reducing the burden of care that these deliveries often create has been a pursuit of reproductive endocrinologists, ob/gyns, and managed care providers for some time. But a safe and effective pathway to singleton deliveries in IVF has been elusive until now,” said Forman. “Single embryo transfer with comprehensive chromosome screening has the potential to be revolutionary in the world of IVF, allowing patients to maintain excellent delivery rates while not taking on the treatment-related risk of multiples. And for ob/gyns, it means fewer high-risk pregnancies handed off to them, reducing the healthcare burden across the spectrum.”
According to Forman, less than ten percent of IVF patients opt for SET, choosing instead to transfer two or more embryos to achieve the best chance at pregnancy, despite the inherent risks associated with multiple births. But as more patients learn about the equivalent success rates of SET when paired with comprehensive chromosomal screening, those numbers are likely to increase.
Richard T. Scott, Jr., M.D., FACOG, HCLD, and co-founder of RMANJ, says that by integrating knowledge of the entire IVF process with advanced technologies, enhanced embryo selection is making successful SET outcomes broadly achievable.
“Up to this point, double embryo transfer has reliably resulted in higher delivery rates per single fresh cycle than SET, making it the standard of care, despite multiple risk factors,” he said. “Today, however the synchronous transfer of a single euploid embryo provides delivery rates of 55 to 65 percent through maternal ages of 42, exceeding national delivery rates.” Dr. Scott added, “The Blastocyst Euploid Selective Transfer (BEST) Trial, now in-press, is just one of the many leadership research initiatives RMANJ has undertaken to support both infertility providers and patients. In fact, RMANJ recently submitted 33 abstracts for this year’s American Society for Reproductive Medicine annual meeting in Boston, MA.”
About the Study
To reach their findings, Forman and his team at RMANJ Basking Ridge randomized 175 women up to age 43 to either have SET with comprehensive chromosome screening for preimplantation aneuploidy assessment, or a double embryo transfer (DET) with no screening. Delivery rates were equivalent (SET 61% vs. DET 65%) with no twins after SET and 53 percent multiples after DET. After the first 49 deliveries (26 SET, 23 DET), patients undergoing euploid SET reported a longer mean gestation (38.7 vs. 37 weeks) and increased newborn birth weight (3422 vs. 2593 grams). Newborns after SET had a lower rate of NICU admission (8% vs. 35%) and spent less total time in the NICU than those after DET (13 days vs. 280 days). There was a trend toward more deliveries prior to 34 weeks after DET (0% vs. 17%). As was reported at Dr. Forman’s presentation today, results through the first 100 deliveries demonstrated a three-fold increased risk of preterm delivery after DET compared with euploid SET.
Forman pointed out that the type of chromosomal screening used for the study, which was done on fresh blastocysts, is only available at the few clinics associated with RMANJ, but should become more widely available soon. Studies on the cost implications of the methodology are underway as well.
“Currently, embryo biopsy and comprehensive chromosome screening adds an additional cost to the IVF cycle,” he said. “Research is ongoing at RMANJ to determine overall healthcare savings due to the improved obstetrical outcomes when the screening is combined with SET, which could ultimately lower costs across the continuum.”