Preimplantation Genetic Testing for Aneuploidy (PGT-A) or for Monogenic disorders (PGT-M) refers to procedures where embryos obtained through an IVF cycle are evaluated for genetic disorders prior to implantation.

PGT-A (formerly known as PGS, Preimplantation Genetic Screening) is used to identify embryos that may be affected by chromosomal abnormalities. PGT-A increases your chances of pregnancy and delivering a healthy baby while it decreases your likelihood to miscarry. PGT-A also enables confident single embryo transfer, avoiding health complications associated with twin or triplet pregnancies. An additional benefit of PGT-A is that it can reduce  the number of IVF cycles you require to achieve pregnancy, potentially reducing the time and costs of extra cycles.

PGT-M (formerly known as PGD, Preimplantation Genetic Diagnosis) is used to help prevent certain diseases or disorders from being passed on to the child from the parent (inherited genetic disorders). In most cases for PGT-M, the parent(s) from which the egg or sperm is provided have been genetically screened and identified to be carriers of potential problems.

By analyzing DNA from each embryo, unaffected embryos can be preferentially selected for transfer. This test is indicated for those at risk of passing on a single gene disorder such as cystic fibrosis, fragile X syndrome, muscular dystrophy, Huntington disease, and many others.

ERA (Endometrial Receptivity Analysis)

ERA is an innovative test that helps pinpoint the exact time when your endometrium is receptive to embryo implanting. This test can help improve chances of pregnancy for those with repeated failed IVF.

ERA involves taking a small sample (biopsy) of endometrial cells at a particular times in your cycle. Cells in the endometrium produce certain types ⁠of genetic material during the window of implantation (WOI).⁠ An ERA can identify which endometrial cells ⁠are “Receptive” or “Nonreceptive” and whether your WOI is open or not. With repeated tests your doctor can determine your precise WOI. ⁠We can then time your embryo ⁠transfer to the most optimal time to maximize chance of achieving pregnancy. 

EndomeTRIO (ERA, EMMA, ALICE)

EndomeTRIO is a series of tests including ERA - described in the section above - and two additional tests: ALICE and EMMA.

ALICE: Analysis of Infectious Chronic Endometriosis

ALICE detects chronic endometritis-causing bacteria and recommends appropriate antibiotics. Endometriosis is a condition affecting 30% of infertile patients that is linked to implantation failure and recurrent miscarriages.

EMMA: Endometrial Microbiome Metagenomic Analysis

EMMA indicates the endometrial microbiome balance. EMMA provides information on the proportions of healthy endometrial bacteria, including those linked to higher pregnancy rates. It will recommend antibiotic and probiotic treatment, if needed, to restore an optimal microbiome. Includes ALICE. 

This innovation is non-invasive and uses ultrasound technology to assess the receptivity of your endometrial lining to embryo transfer in order to increase the probability of successful implantation.

In cases where receptivity is high, we can be more confident in proceeding with transferring the embryo. In cases where we assess receptivity to be low, the best decision may be to cryopreserve the embryo for transfer in a future cycle.

Assisted hatching may be helpful for IVF patients who are older (more than 37 years old) or who have had a prior IVF failure. It is a procedure where we can help the embryo “hatch” from its “shell” by creating a small crack in its outer layer of cells (zona pellucida). There is a body of evidence indicating that assisted hatching can help an embryo implant in the uterus, leading to higher pregnancy rates in some patients.

Assisted hatching can also be done on previously frozen and thawed embryos.