Routine frozen embryo transfer – the way of the future?

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Fresh is best. It sounds logical and is promoted by some clinics as the ‘gold standard’. But it is a mantra that could be stood on its head in terms of the most effective use of IVF embryos to maximise the chance of an on-going pregnancy and health baby.

The traditional practice of IVF is to transfer the ‘best looking’ embryo into the uterus immediately after a stimulated cycle.

Following the development of techniques for freezing and thawing embryos, in the 1980s, if a couple has more embryos that appear to be developing normally in the lab, they can be frozen for later use. More recently, we have seen dramatic improvements in the techniques for freezing these so-called excess embryos. In 2006, Genea was the first clinic group in Australia to introduce a new freezing method called vitrification – or snap freezing – as standard practice.

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RIP the “Colorado Protocol”

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When IVF doesn’t quickly work, patients become convinced that there is something wrong with their uterus or body that leads to the “rejection” of their embryos. Of course this may be true for some women, but in fact the problem is usually one on the side of the embryo – even high grade blastocysts have up to a 50% chance of having chromosome errors that prevent implantation or lead to miscarriage. Well done studies repeatedly suggest that so-called “implantation failure” is far more likely to actually be a problem of embryos.

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Sydney IVF reborn as Genea – World leaders in fertility

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Sydney IVF is now longer based only in Sydney – but has a presence across Australia and across the world. And Sydney IVF is not just about IVF. Hence the announcement today that Sydney IVF is reborn as Genea – World leaders in fertility.

More details very soon – but for now, here’s some of the media response to the annoucement, which coincided with some recent new success rates:

A story in today’s Daily Telegraph in Sydney
A segment from ABC Radio Sydney (702): Mark702

What is the long term outcome for couples with recurrent miscarriage?

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…or “Why genetic anomalies of embryos are more likely to be important than taking steroids”

I’ve been very lazy with my blog lately but have decided to use my recent trip to the international conference ESHRE in Stockholm to give you some feedback about current activites.

One study that caught my eye was a Danish study that looked at the outcomes of couples who had had at least three early pregnancy miscarriages and how often they will ultimately go on to have a live birth.

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Chromosome screening gives new life to IVF success

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WHEN Selena Klasnja fell pregnant, she did not feel the hope and excitement experienced by most women. Instead, she held her breath, waiting to see if the pregnancy would last.

Mrs Klasnja, 41, spent 13 years trying for a baby, suffering repeated miscarriages which could not be explained.

”As soon as the pregnancy was detected, in a week or two I would have miscarriage,” she said. ”It was awful, you can’t imagine.”

It was only through the use of a new technique pioneered by Sydney IVF experts that she finally gave birth to her identical twin boys, Snape and Blake.

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Single embryo transfer

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Reading IVF literature from around the world, I am still intrigued that in many countries it is considered appropriate to routinely transfer multple embryos in IVF cycles. This includes the view by many clinicians that twins are “acceptable”. Now twins can be very cute – but the higher rates of complications from premature delivery, developmental delay, anomalies and deaths that occur from twins compared to single pregnancies means that a couple’s chance of a healthy baby per IVF cycle is higher through single embryo transfer than it is from multiple embryo transfer.

If you are skeptical, read this article that looked at a large data set of IVF cycles across Australia and form your own opinion.

Single Blastocyst Transfer Optimizes Live Healthy Baby Rates

“It can’t do any harm…”

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One of the commonest statements I hear about so-called natural therapies is they don’t do any harm. Many people have a degree of scepticism as to whether they do anything, but an understandable reluctance to move to high powered mainstream medicine and on the well-meant advice from friends etc, I can readily see why people take natural therapy pathways.

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“IVF Breakthrough……”

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The media loves a good news story. In health, it’s usually a “breakthrough”. Every other night on the news, there is a story that announces some new breakthrough in cancer treatment. If only it were that easy – if the news stories were accurate, we would have already eliminated cancer several times over.

In medicine, it’s more usually gradual improvements, tested over time. That’s frustrating for patients, who hear of new research and then call their clinician the next day to have it implemented. Unfortunately, the news report is often a small piece of very early research, or it’s the outcome of a clinical research trial where the technology or drug in question may not be available for some years.

With regard to IVF, I can promise you that at Sydney IVF we are early adopters, so if a new treatment is genuinely shown to be helpful and can be implemented, we have usually already implemented it or have tested it.

Sometimes we have been applying new technologies long before the news announces a “Breakthrough!” Take today’s’ Sydney Sunday Telegraph story, which announces that a new technique of embryo testing is about to be introduced, called CGH. Not only has Sydney IVF been using this technology for over a year, with several successful ongoing pregnancies, the paper’s stable mate, the Sydney Daily Telegraph, announced the introduction of the very same technology by Sydney IVF when it was launched in 2009.