Prospect of Preimplantation Genetic Testing (PGT) without In vitro fertilization (IVF)

Abstract

The objective of this talk is whether it is possible to consistently and reliably capture in-vivo conceived embryos from the uterus to conduct PGT-A, PGT-M and what utility can this method bring to fertility medicine and research. The approach is based on uterine lavage, a procedure developed originally by Buster et. al. in 1983, as a method to conduct embryo donation. Recent trials conducted in Punta Mita, Mexico, utilizing a newly designed medical device and system to perform uterine lavage, indicate that the procedure and method can consistently, safely and reliably be used to capture embryos, conduct PGT-A after trophectoderm biopsy and cryopreserve the embryo for future use. Recent trial results show that uterine lavage may provide an alternative option to IVF for fertile couples who desire a PGT-A, PGT-M prior to the establishment of pregnancy. Implications of uterine lavage: although a nascent technology, studies indicate that uterine lavage may have the potential to provide a new tool to acquire genetic information on embryos. Commercially, the procedure has the potential to provide a low cost, minimally invasive, reproducible and effective way to acquire in-vivo conceived and genetically tested embryos. As a procedure uterine lavage may be useful in commercial applications such as fertility preservation, aneuploidy detection, or detection of genetic diseases such as cystic fibrosis. Uterine lavage may also have utility in addressing some infertility indications such as advanced maternal age or multiple miscarriage. From a research perspective, the study of in-vivo conceived embryos may provide new scientific insights to the field of embryology. Furthermore, comparison studies between in-vivo conceived and IVF-derived embryos may provide researchers enhanced understanding with respect to aneuploidy, mosaicism and other genetic profiles currently only understood from the cohort of IVF-published data. The objective of this talk is whether it is possible to consistently and reliably capture in-vivo conceived embryos from the uterus to conduct PGT-A, PGT-M and what utility can this method bring to fertility medicine and research. The approach is based on uterine lavage, a procedure developed originally by Buster et. al. in 1983, as a method to conduct embryo donation. Recent trials conducted in Punta Mita, Mexico, utilizing a newly designed medical device and system to perform uterine lavage, indicate that the procedure and method can consistently, safely and reliably be used to capture embryos, conduct PGT-A after trophectoderm biopsy and cryopreserve the embryo for future use. Recent trial results show that uterine lavage may provide an alternative option to IVF for fertile couples who desire a PGT-A, PGT-M prior to the establishment of pregnancy. Implications of uterine lavage: although a nascent technology, studies indicate that uterine lavage may have the potential to provide a new tool to acquire genetic information on embryos. Commercially, the procedure has the potential to provide a low cost, minimally invasive, reproducible and effective way to acquire in-vivo conceived and genetically tested embryos. As a procedure uterine lavage may be useful in commercial applications such as fertility preservation, aneuploidy detection, or detection of genetic diseases such as cystic fibrosis. Uterine lavage may also have utility in addressing some infertility indications such as advanced maternal age or multiple miscarriage. From a research perspective, the study of in-vivo conceived embryos may provide new scientific insights to the field of embryology. Furthermore, comparison studies between in-vivo conceived and IVF-derived embryos may provide researchers enhanced understanding with respect to aneuploidy, mosaicism and other genetic profiles currently only understood from the cohort of IVF-published data.