Scientists in Ireland have discovered a group of genes that could potentially be used to predict the success of IVF treatment. The prospect of a clinical test for IVF success was raised at the annual conference of the European Society for Human Reproduction and Embryology (ESHRE), in Amsterdam, last week.
The group, led by Dr Cathy Allen at the Rotunda Hospital, Dublin, examined the genetic profiles from blood samples taken at eight different stages during the period around conception and the early stages of the IVF cycle to analyse what differences in gene expression were seen at certain points before, during and after pregnancy. The blood samples were from five women who achieved clinical pregnancy, three women who had implantation failure and three subfertile women who conceived spontaneously.
The findings showed that activity levels of genes controlling the growth of new blood vessels, inflammation and the supply of energy to cells were different in women undergoing IVF. There was a marked difference in the expression of 200 genes at the beginning of fertility treatment between women who became pregnant and those who did not. The group concluded that this gene 'signature' was highly predictive of whether IVF worked or not, and could be used to develop a clinically useful predictive tool.
Dr Allen thinks that one of the most difficult decisions to make when undergoing IVF treatment is whether to continue with treatment after a failed attempt, as this can be emotionally and physically draining, as well as expensive. A reliable blood test could help patients and doctors with this decision.
She said: 'This work has generated a unique profile for IVF success and failure... As a practising clinician, I think this might have a use for patients trying to decide whether they should undergo IVF or not. It's going to be a while before we have a clinical test but my gut feeling is it will be useful for identifying the unfavourable profile - those who won't get pregnant'.
Currently, advice from doctors on this decision is based upon factors such as age, lifestyle and hormone levels, but these are not often reliable. A separate team of scientists at Cardiff University has developed a questionnaire, called the FertiSTAT. Based on questions about a woman's menstrual cycle, reproductive health, lifestyle factors, age and length of time for which they have been trying for a baby, the test can be used to judge whether a woman will have fertility problems, and whether changing their lifestyle could improve their chances of pregnancy.
Professor Luca Gianaroli, the ESHRE chairman, said of Dr Allen's findings: 'this test could save a lot of unnecessary treatment. You have to balance the cost of research and the benefits of research.'