Jasmine was almost 40 when she and her husband decided to try for a sibling for their five-year-old daughter Chan. She began to get concerned when, after a few months, nothing happened. She finally convinced her family physician to refer her to a fertility specialist. “My doctor wanted me to wait but I felt this huge sense of urgency. At my age I knew time was of the essence.”

Over the course of the next two years, Jasmine experienced two miscarriages and one failed in vitro fertilization or IVF. (IVF is a procedure in which egg and sperm are combined in the laboratory to form embryos. The resulting embryos are transferred back into the woman’s uterus).

“The emotional toll this takes can be brutal,” said Jasmine. “One thing you desperately need during your fertility journey is a fertility doctor who really understands what you are going through and treats you as partner in the process.

“With all the breakthroughs in fertility treatment, we can help most women achieve a pregnancy, depending on age,” says Dr Gary Nakhuda, a reproductive specialist and medical director at Olive Fertility Centre. “There are so many more tools in our tool kit for treating infertility especially with IVF.”

Until recently fertility experts were only been able to judge the health of an embryo by its appearance. “While we’re able to get good success rates with this approach, in some cases embryos that look normal don’t result in a successful pregnancy. This can be because the embryo isn’t chromosomally normal.” explains Dr Nakhuda.

If an embryo has too few or too many chromosomes (a condition known as aneuploidy) the embryo will either never implant in the uterus, or result in a miscarriage or a baby with conditions such as Down syndrome.

A new test called Comprehensive Chromosomal Screening (CCS) is allowing fertility specialists to determine with much greater accuracy which embryos in IVF have the normal number of chromosomes and are the most likely to result in a successful pregnancy.

Studies have shown that IVF with CCS can achieve

• Pregnancy rates as high as 70%

• Miscarriage rate as low as 10%.

• A very low risk of chromosomal problems such as Down's syndrome (diagnostic accuracy of CCS is about 99%

Olive Fertility: Mitochondrial DNA Qualification

To further improve on the results of CCS, Olive Fertility is pioneering another technique for screening embryos with mitochondrial DNA quantification.

It appears that around a third of embryos with the correct number of chromosomes still fail to lead to a successful pregnancy. Recent studies have shown that embryos with a higher concentration of mitochondrial DNA have a reduced chance of implantation. Mitochondria are the energy producing engines within our cells, but surprisingly, an abundance of mitochondria appears to be associated with lower implantation potential.

A study from the University of Oxford, which was recently presented at the annual meeting of the European Society of Human Reproduction and Embryology in Helsinki, suggested that screening embryos for their levels of mitochondrial DNA could help doctors select those that are most likely to result in a healthy pregnancy.

Olive Fertility Clinic, with offices in Vancouver and Surrey, has been using this screening technique, along with CCS, for a number of months and seeing success rates of over 70% per transfer.

“We are very proud of our lab and our science and are totally committed to using any evidence based techniques that will increase the chances of a pregnancy and healthy baby,” said Dr Nakhuda, a physician at Olive Fertility.

Jasmine had eight eggs retrieved and one of the healthy embryos was transferred into her uterus after fertilization (the other embryos can remain frozen for future pregnancies if desired.)

“I found out shortly after that I was pregnant. At our ultrasound, we saw one sac and a little heartbeat. At our second ultrasound 2 weeks later, we saw the baby moving. Our miracle baby boy was born 8 months later!”

The main advice that Jasmine would give women who are trying to start or add to their family is don’t wait too long, as it gets more difficult with age.

“And if you are having fertility issues, look around until you find a fertility specialist that you really feel comfortable with. Look for someone who is knowledgeable, empathetic, and focused on being part of your team. There are so many more options for treatment these days.”

As more and more women are delaying starting a family until their thirties and even forties, the rate of infertility is rising. Many women don’t realize that their fertility peaks in the mid-twenties and drops off sharply after 35: a healthy woman at age 30 has about a 20% chance per month of conceiving. By the time she reaches 40, her chances drop to about 5% per month.

“Frequently women and even MDs don’t know that a woman over 35 and her partner should have a full fertility workup if they haven’t conceived after six months of unprotected intercourse,” said Dr. Nakhuda.

“The biological clock starts ticking much more quickly at this age. So the sooner a problem is diagnosed, the more quickly the treatment can start.”

Fertility evaluation and testing is covered by MSP in British Columbia with a referral from a family physician or a walk in clinic.

Olive Fertility Centre is of Canada’s largest fertility clinics, offering an advanced IVF lab, personal care teams and innovative programs that include the EmbryoScope, comprehensive chromosome screening (CCS), egg freezing, and prenatal NIPT testing.

For more information go to www.olivefertility.com.

WHAT DOES CCS INVOLVE?

With CCS, an egg is fertilized in the laboratory and the embryo is grown for 5 days at which point 5-10 cells are taken from the part of the embryo that will form the placenta (thus leaving the cells that are destined to become the fetus untouched).
The embryo is then frozen and the biopsied cells are sent to a specialized laboratory for testing. The results usually return in 10-14 days identifying which embryos are chromosomally normal. A healthy embryo can be transferred in the next menstrual cycle.