Researching IVF Treatments - Yale Medicine Explains

Transcript

• 00:08- IVF is the most effective solution for treating infertility.
• 00:12IVF involves removing an egg from a patient's body.
• 00:17It also includes ovarian stimulation,
• 00:19which means medications to grow as many eggs as possible
• 00:23and fertilize them,
• 00:25and then use the generated embryos that are healthy
• 00:28to achieve a pregnancy by transferring one back to the uterus.
• 00:34We have seen an immense increase in success rates.
• 00:36When you do everything right in today's world,
• 00:39you can reach the 60% implantation rates.
• 00:46Fertilization failures can happen due to an issue in the sperm primarily
• 00:52or to the laboratory processes.
• 00:55This is generally circumvented by a process called ICSI,
• 00:58which intracytoplasmic sperm injection.
• 01:01Rather than putting the sperm around the egg and hoping for the best,
• 01:04you just choose a good sperm,
• 01:06take it with a needle and put it into the egg,
• 01:08and then you're sure that the sperm got into the egg.
• 01:12So fertilization happens.
• 01:14What can impair,
• 01:16what can make it difficult to achieve a pregnancy is
• 01:19some autoimmune diseases, systemic diseases,
• 01:22Asherman syndrome, endometriosis, PCOS.
• 01:25If there are fibroids that are going into the cavity of the uterus
• 01:28or there are polyps, adhesions within the uterus,
• 01:31they could really decrease the chance of an implantation.
• 01:35Ovarian aging is two things.
• 01:38One, decreasing the number of eggs that are present in the ovary,
• 01:43and the other one is the decreasing quality of those eggs.
• 01:47Every woman is born with a number of eggs,
• 01:50and they don't make new eggs after being born.
• 01:53As the age increases, the pool of eggs that are available,
• 01:56the number of eggs that are available in the ovary decreases.
• 01:59So if someone doesn't have many eggs
• 02:01and doesn't generate many eggs, that really impacts the outcome of IVF.
• 02:05When we say quality of eggs, we mean one thing specifically.
• 02:09How many chromosomes there are in the egg?
• 02:12Every cell in your body should have 46 chromosomes
• 02:15other than gametes, sperm or egg.
• 02:17Sperm or egg should have 23 chromosomes each
• 02:20so that they come together they make 46.
• 02:23What happens with age, though?
• 02:25Eggs start to make mistakes from the mother stem cell egg as they divide.
• 02:32Despite the incredibly high success rates that we have achieved,
• 02:36there is still more to be done,
• 02:38and that requires additional discoveries
• 02:40regarding the eggs or the function of the sperm or the uterus,
• 02:43and Yale is committed to that kind of scientific pursuit,
• 02:47both in a clinical and basic science.
• 02:55Personalized medicine is a
• 02:57really important aspect of infertility care.
• 02:59Every patient is unique in their needs.
• 03:03You may have five patients, all 38 years old.
• 03:06They may have different ovarian reserves.
• 03:08Their partners may have different sperm counts.
• 03:11Their uterus may be different.
• 03:13And so you need to really analyze them
• 03:16individually with all the parameters that applies to them.
• 03:20We are using now a lot of big data analysis.
• 03:23We were able to develop a predictive model for our patients.
• 03:27It's called Fortune IVF.
• 03:28It's available as an app.
• 03:29It's available as an online tool,
• 03:32and you enter your hormone value, your weight, your age, your partner's age and predict
• 03:37how many healthy embryos they can generate.
• 03:41The patient can use those tools
• 03:43generated by AI and big data
• 03:46to predict how hard they have to work to get there.
• 03:48It helps them plan their time, finances, other decisions about their life,
• 03:53and physicians also use this to see should I offer my patient two cycles, three cycles.
• 03:58Does she have coverage? Does she have time?
• 04:01So it's a very helpful tool.
• 04:02I really think the the field of IVF and infertility is at is at its peak,
• 04:08and it can only get better.
• 04:09I don't know if there are any other little niches in medicine
• 04:12that has been so successful in such a short time,
• 04:15and has brought so much happiness to patients.