Repromed has the most active and successful research and development programs in South Australia. Our Scientists and Doctors have made major contributions to global knowledge about the causes of and treatments for fertility problems, which have had positive real impacts for our patients such as:
- Development of metabolomic testing (BeSST embryo selection) of embryos to assist our laboratory team in selecting the highest quality embryos for transfer.
- Development of embryo glue culture media, giving you a higher chance of a successful pregnancy outcome.
- Development of the male fertility pill ‘Menevit’ to assist in the creation of healthy sperm.
- Development of the Egg Timer Ovarian Reserve Test (AMH) in 2004, which is now widely used by many IVF clinics in Australia.
- World-leading research into the impact of lifestyle issues on fertility.
Latest Techniques/Best Practice
Preimplantation Genetic Screening (PGS)
Repromed is the first – and only – clinic in SA to offer Preimplantation Genetic Screening (PGS) testing on site. It allows IVF scientists to confirm the correct genetic material (number of chromosomes) is present in an embryo being transferred. The presence of extra or missing chromosomes is known as aneuploidy and may explain an embryo’s failure to establish or maintain a pregnancy. PGS may assist couples with
- repeated IVF failure
- recurrent miscarriage
- a known chromosome rearrangement (known as a chromosome translocation)
- gender selection for a medical reason
Screening for aneuploidy before an embryo transfer increases the likelihood of selecting the embryo(s) with the best chance of implanting while also reducing the rate of miscarriage or chances of a pregnancy of a baby with a genetic condition. Click here for more information
Extended Embryo Culture and Transfer
Embryos can be grown in the laboratory for up to 5 days after egg retrieval. Extended/blastocyst stage is the term used for either day 4 or day 5 embryo culture and transfer. This is beneficial as it allows the Scientists to further monitor your embryos and choose the most advanced one for transfer. This extended culture and transfer technique that Repromed uses has been proven by Level 1 Medical Evidence to result in higher pregnancy rates.
Cryopreservation is an integral part of an IVF program and allows patients to store oocytes or surplus embryos for subsequent treatment. At Repromed embryos are frozen using a specialised method of rapid freezing known as vitrification which is different to the traditional method of slow freezing. The introduction of day 4 and day 5 vitrification has led to improved survival and pregnancy rates compared to the previous blastocyst slow freezing. This cryopreservation program also provides a viable option for cancer patients needing to preserve their fertility.
BeSST Embryo Selection
The embryo(s) chosen for transfer is routinely selected by an IVF scientist based on the embryos’ development and morphology. At Repromed, selection of an embryo for transfer may now include assessment of the metabolic health of your embryos. To do this, the media solution used to culture your embryo is assessed to determine the quantity of specific nutrients consumed by the embryo which have been shown to relate to embryo viability. This technique is completely non-invasive and therefore does not disturb the embryo. BeSST enables us to more accurately pick the best embryo for transfer based on its metabolic health and has significantly increased pregnancy success rates. This selection method is used in conjunction with embryo development and morphology in patients with multiple good quality embryos available for transfer.
High Magnification Sperm Selection for ICSI
Sperm plays a significant role in determining pregnancy success. Recently several advanced sperm selection techniques including High Magnification Sperm Selection have been developed. High Magnification Sperm Selection requires the sperm to be assessed under a much higher magnification to examine features that are thought to be predictive to sperm health.
TUNEL Sperm Health Test
The TUNEL test determines the health of the sperm by measuring the level of damage to the DNA. Smoking, alcohol, heat, some chemicals and other factors such as paternal BMI and age, can damage the DNA in sperm cells. This increase in DNA damage may influence a couple’s ability to fall pregnant as TUNEL is correlated with pregnancy success. Therefore a TUNEL test is performed in conjunction with a routine semen analysis and provides additional information as to the quality of the sperm. As Repromed is interested in the DNA of live (motile) sperm, the semen is washed to isolate the motile sperm from a preparation. Repromed is the only IVF clinic in South Australia to perform this test.
Ovarian Reserve Testing – AMH
A woman is born with approximately 1 million eggs and during her reproductive life, this number will decline as they are lost through natural attrition and ovulation. The rate of loss varies between women and it is estimated that 10% of women will have accelerated loss. The ovarian reserve or number of eggs remaining can be estimated by a single blood test which measures a woman’s Anti-Mullerian hormone (AMH). This gives an indication of the likely fertility status of a woman to give an estimate of the Ovarian Reserve. The initial design and validation of the AMH test for ovarian reserve was performed in conjunction with Repromed staff and Repromed is the only IVF clinic in South Australia to perform this testing on-site. Click here for more information
Menevit is a supplement which is specifically formulated to support sperm health. It contains a combination of antioxidants that are thought to promote male fertility and therefore increase pregnancy chances. Menevit is the only male preconception supplement clinically shown to help with pregnancy rates and was designed in conjunction with one of Repromed’s Specialists, Associate Professor Dr Kelton Tremellon.
Repromed Genomics Research – predicting the likelihood of a successful pregnancy
The genomics research project will focus on cumulus cell viability markers of oocyte quality to predict the likelihood of pregnancy success and in turn to increase the numbers of single embryo transfers and successful pregnancies (live birth rates) while decreasing multiple births. The project will use cumulus cell gene expression to select a single embryo for transfer based on the genetic information of the cumulus cells which surrounded the oocyte the embryo was derived from. This test will be particularly important for those patients who are to receive a single embryo at transfer but have multiple embryos with similar developmental rates and morphological appearance available on the day of transfer. The test is completely non-invasive to the oocyte as it utilises the cumulus cells collected prior to insemination when they are routinely removed. The cumulus cells then undergo genetic testing of candidate genes already associated with the primary outcomes of the project: pregnancy success resulting in live birth and health outcomes of the babies born. Each oocyte and embryo is tracked individually throughout culture and the gene expression profile of the cumulus mass from each oocyte can then be used to predict the likelihood of a successful, healthy pregnancy resulting in a live birth.
Current clinical trials
The Miniva study: A Study to Assess Minimal Ovarian Stimulation in IVF
As we are better able to grow embryos, we do not need as many eggs to start with. Data analysis from the last two years from our laboratory has shown that pregnancy rates from a fresh embryo transfer in young women do not improve when more than four eggs are collected. An increase in the number of eggs does not translate into increased fresh pregnancy rates, but does increase the risk of complications such as Ovarian Hyper-Stimulation Syndrome (OHSS) and may interfere with egg and endometrial quality. The Miniva study involves low dose stimulation coupled with high quality low intervention embryology. These protocols are designed to produce a small number of eggs which can be fertilised, cultured and the best transferred. The advantages of these protocols are;
- Reduced OHSS
- Increased egg viability
- Reduced number of stimulation injections
- Option of oocyte retrieval operation (OPU) under local anaesthetic
- Good fresh pregnancy rates
- Reduced cost associated with Day Surgery, drugs used in an IVF cycle and laboratory techniques
If you are interested in the study or have any questions you are welcome to contact Dr Deidre Zander-Fox, Clinical Researcher on (08) 8333 8167.