By A Ground-Breaking IVF Technique a non-Invasive Chromosomal Screening is set to make an impact
Dr. Sam Balu, head of the genomics department at Lilac Insights, a genetic diagnostic testing company, and Dr.SatishPatki, senior IVF consultant at Patki Hospital, jointly announced the success of a ground-breaking IVF technique called “non-invasive chromosomal screening (NICS)” of the pre-implantation blastocyst embryos. In-vitro fertilization (IVF), wherein a woman’s or girl’s eggs are fertilized in a lab with a man’s sperm and then grown in an incubator, is already a recognized treatment for infertile couples. On the fifth day following egg extraction, the most advanced form of the embryo, known as a ball of many cells with a fluid-filled chamber as the blastocyst, develops.
It is known that between 30 and 40 percent of IVF-created embryos have chromosomal abnormalities (aneuploid). Therefore, these embryos are rejected after being placed in the mother’s womb and only chromosomally normal embryos (euploids), if the uterus is receptive, are implanted. Pre-implantation genetic testing (PGT), which determines the blastocyst’s chromosomal status, is currently an invasive procedure. Dr.Patki informed the media on Sunday that in PGT, a little needle was used to retrieve some blastocyst cells for an embryo biopsy, which was then examined under a microscope and examined chromosomally.
However, he said, this method had the drawback of being intrusive, stressful, and potentially damaging to the embryo. In addition, a qualified embryologist and sophisticated equipment, including a laser machine, were required, according to Dr.Patki. He stated that the new technology, called NICS, was completely non-invasive.
Since the birth of the first child by in vitro fertilization (IVF) in 1978, methods have significantly advanced. Due to technical developments, the success rate of IVF has increased from a low single-digit to about 55–60 percent. For many couples who have had trouble becoming pregnant naturally, IVF has been a gift. The amount of aneuploid embryos created by IVF is one of its largest issues, even though it has shown to be helpful. IVF produces about 30 to 40 percent of chromosomally defective embryos, and their transfer leads to miscarriage or other pregnancy losses. To increase overall success rates by reducing implantation failure or miscarriage brought on by the transfer of such aneuploid embryos, researchers from all over the world are continuously working to develop new technologies that can detect aneuploid embryos with a high sensitivity before implantation.
One such method is NICS (Non-Invasive Chromosomal Screening), which isolates cell-free embryonic DNA and tests for chromosomal aneuploidies using the embryos’ wasted culture material. The advantage of NICS lies in its non-invasive character, which prevents any biopsy from interfering with the development of the embryos, protecting their integrity. By employing cell-free embryonic DNA, 60 percent of which is ICM (Inner Cell Mass) in origin, NICS considerably lowers the false positive rate. Only a small number of genomics businesses in India provide NICS, and several methods have been used to assess it. One such approach is called Multiple Annealing and Looping Based Amplification Cycles (MALBAC), and it is often employed in reproductive genetics. The MALBAC technology has received worldwide validation. As a result, it has applications in a variety of fields, including forensics, microbial research, cancer research, and IVF.
NICS and Lilac Insights were introduced at IHR a year ago. More than 200 blastocysts have been examined thus far. The results are positive even if they are still in their early stages. Finances are one of the barriers, but I’m certain that as more clinics launch NICS, it will become more accessible. NICS is not the IVF industry’s golden goose because it also faces obstacles including high sensitivity to contamination and a greater incidence of mosaicism. But as is customary in medicine, the test’s advantages should exceed its drawbacks. The main drawback of existing PGS technologies at the moment is how frequently they report false negatives.
Veteran medical professionals believe that the use of NICS or any PGS technology should be extended to all couples choosing IVF, rather than being restricted to the high-risk pair (i.e. advanced maternal age or recurrent pregnancy losses). Despite being a relatively new technology, NICS has already affected patient care. NICS will become more crucial as time goes on and there are more data points available. It will improve patient care if it is included in IVF cycles at clinics throughout India
