Should I undergo IVF 3.0(PGS+ERA)?

Investing substantially, the goal is success in one attempt. Given so many examinations, which one is most appropriate for me? Is it advisable for me to proceed?
Author: Stork Fertility Center
Translator: Phillip

For each client experiencing fertility challenges, the most important answer revolves around optimizing the chances of successful IVF pregnancies. Having invested significantly and aiming for success in one attempt, amid so many examinations, which ones are the ones that I need? Personalized IVF tells you that there is no absolute answer to medical treatment, only the best solution is the one that is agreed upon by both parties after a non-leading consultation.

This article explores the most popular IVF 3.0 (PGS+ERA), what is IVF 3.0? IVF 3.0 involves the fusion of sperm and egg outside the body, leading to embryo development in vitro. Subsequently, these embryos undergo chromosomal screening (PGS), ensuring the selection of embryos with normal chromosomes for transfer. Additionally, utilizing a molecular platform to analyze gene expression, pinpoints the optimal uterine receptivity window (ERA) for transfer. This precise timing is used for personalized embryo transfer (pET).

In the 2019 Taiwan Society of Reproductive Medicine, the following data was mentioned, about 42% of IVF failures are due to embryo chromosome abnormality, 12% are due to window of implantation (WOI) displacement, 18% are due to embryo chromosome abnormality coupled with WOI displacement, and the remaining 28% are due to other reasons that are yet to be identified, as shown in the chart below.

The main cause of chromosome abnormality in embryos usually comes from errors in the meiotic division of older eggs, rather than from parental chromosome inheritance as traditionally believed. The second major reason is WOI displacement. In addition to having normal embryonic chromosomes, a successful IVF baby must transfer at the right time, known as the window of implantation.

According to the above chart, 72% of IVF failures are due to chromosomal abnormalities or shifting of the window of implantation, so by eliminating these two major factors, a higher success rate can be achieved. Am I a suitable candidate for IVF 3.0? The chart below tells us.

  • "Non-P/Non-E" denotes the absence of PGS and ERA
  • "Non-P/E" denotes the absence of PGS but ERA was performed
  • "P/E" denotes both the presence of PGS and ERA

As you can see from the graph above when the eggs are >38 years old, the pregnancy rate for those with PGS and ERA is much higher than for those who do not have PGS and ERA.

Therefore, when the egg age exceeds 38 years, it is highly recommended to undergo IVF 3.0 (PGS+ERA), as it significantly enhances the chances of pregnancy.

What about eggs younger than 38 years old? According to Our experience, although the decrease in egg age helps to obtain a higher percentage of normal embryo chromosomes, and the percentage of abnormalities in the window of conception is not significantly higher (compared to the older age groups), but who wants to be a gambler? If you want to have more than 90% certainty, further testing is not a bad idea, and up to 72% of IVF failures are due to embryo chromosomes and the window of implantation. We have summarized the following criteria for your reference, to choose the most suitable plan for you, considering the chips in hand (number of embryos) and psychological and financial factors, to choose the best personalized IVF.

The following is a summary of the groups of clients who are strongly recommended to choose IVF 3.0:

  • Obesity (BMI>=30)

  • Thin endometrium (<6mm)

  • Failed IVF treatment before

  • Repeated Miscarriages

  • Advanced maternal age (>38 years old)

  • Customers who hold high expectations and aim for a successful outcome in one attempt

  • Embryos are scarce and precious, with a principle of avoiding wastage.

IVF pregnancy rates have increased again, thanks to adequate pre-screening, as follows:

  • Hysterosalpingography (HSG)

  • Hysteroscopy

  • Immunological assessments

  • Endometrial Receptivity Analysis (ERA)

  • Preimplantation Genetic Testing for Aneuploidy (PGT-A)

Which of the above items are you missing? Doing all of the key steps is a step toward success.

*This article only reflects the treatment status at the time of writing, and the actual situation should be discussed with the doctor.