Comprehensive Chromosomal Screening (CCS) & Genetic Testing
At the Center for Advanced Reproductive Medicine & Fertility, our primary goal is to help our patients conceive a healthy pregnancy, and our fertility experts have found that the best chance for such a pregnancy involves Comprehensive Chromosome Screening (CCS). This technology involves the analysis of chromosomes in growing embryos to help determine several issues such as:
- If the embryo is developing normally and healthily
- The potential for an embryo’s successful implantation
- The gender of any viable embryos in the batch
What Does CCS Really Do?
CCS is a procedure that involves a biopsy of the embryo’s outer layer of cells at Day 5 or 6 of development; i.e. the blastocyst stage, so that reproductive genetic scientists can then examine these biopsies to make sure they are healthy — meaning that they have the right structure and number of chromosomes (23 pairs). When embryos have too many or too few chromosomes, it is called aneuploidy (AN-yoo-ploy-dee), which most commonly affects women over 35 and can result in serious, life-long illnesses or conditions for the child, such as Down Syndrome. Often, though, embryos with aneuploidy do not implant in the uterus or, if they do implant, result in miscarriages.
Previous technologies involving types of Pre-implantation Genetic Diagnosis (PGD) and other genetic screenings would require a cell biopsy at Day 3 of development, when embryos may not have enough time to accurately demonstrate their ability to implant and yield a healthy pregnancy. At that point, an embryo is only composed of about eight cells, and a biopsy of one of those eight cells removes a significant portion of the embryo. Moreover, that single embryonic cell might not necessarily represent the full embryo, or that cell may be the most important cell driving the embryo’s growth.
By Day 5, embryos have roughly 200 cells, and embryologists are able to remove more cells to view the cellular structure and chromosomes without compromising the embryo. At Day 5 the embryo is more mature and its true makeup is more evident than at Day 3. Excising 5-10 cells out of 200 cells is also less risky than removing 1 of 8 cells on day 3. Additionally, the cells that are biopsied for genetic screening are the trophoblastic cells (the cells that form the placenta), not necessarily part of the fetus, but they still provide the information necessary to show the embryo’s chromosomal makeup. For these reasons, CCS is generally viewed as a safer and more accurate procedure than past genetic screening tests.
If there is a concern of genetic disorders, particularly due to a family history of hereditary illnesses (single gene defects), our genetic screening lab can also run PGD testing with the larger group of biopsied cells. This way we can determine that embryos have 23 pairs of structurally intact chromosomes, and that the embryos aren’t predisposed to certain genetic illnesses, like Cystic Fibrosis, Alpha-Thalassemia, Sickle Cell Anemia and Tay-Sachs Disease, among many others.
Who Needs CCS?
CCS-tested embryos that are found to be healthy have an increased likelihood of implantation in the uterus, which of course, indicates the beginning of a successful pregnancy. This is a great asset for women who have had difficulty getting and/or staying pregnant.
Everyone could benefit from a genetic preview of their child. CCS is particularly beneficial for women who:
- Have diminished ovarian reserve (egg quality or quantity), such as women aged 35 or older.
- Have experienced recurrent miscarriages and unsuccessful fertility treatments, including IVF.
- Have had a prior pregnancy with aneuploidy (when cells of an embryo have too many or too few chromosomes).
- Are known carriers, or whose partners are known carriers, of genetic conditions or diseases.
- Are looking into family balancing, i.e. the ability to choose, among chromosomally normal embryos, the gender of their next child, assuming of course that there are embryos of that desired gender.
In summary, CCS is the best option for any patient who wishes to take every step possible to optimize the health of her future child by taking advantage of the most advanced technology available today.
How Much Does Genetic Screening Cost?
It is true that in vitro fertilization may already involve costs to the patient, and thus it may seem like paying for CCS is an extra expense, as it is rarely covered by insurance except in cases that may involve known genetic diseases. The reality is that through CCS you are investing in the success of your pregnancy. While there may be additional costs “up front”, the result is likely to be a higher chance of implantation than you might have received if your doctors had simply chosen the “best-looking” embryo of the bunch, and thus a better chance for having a healthy baby. And if through CCS you find that you have several chromosomally normal embryos, you are now able to have options for gender selection should you wish for subsequent pregnancies.
Depending upon how many embryos are yielded, it is a good idea to ask your doctor (and your insurance company) about embryo batching. In this situation, you could possibly undergo more than one egg retrieval and fertilization process to produce several embryos, and thus increase the likelihood that you will have one or more chromosomally normal embryo(s) available. Embryo batching also increases the likelihood of success if you are using CCS for family balancing, since you have a better chance of a healthy male embryo or healthy female embryo with more eggs retrieved. This may be the most cost-effective strategy, but that certainly depends on your family goals and medical needs.
Update: Be sure to talk to your insurance company about the possibility of going through two IVF processes without an embryo transfer. Some insurers, such as Aetna, may not cover the second IVF process (monitoring, egg retrieval, fertilization) if no embryo transfer took place. Our financial experts can help you determine the best options for you.
Contact Us for Optimal Embryo Selection
The Center for Advanced Medicine & Fertility provides highly successful treatment alternatives for all forms of female and male infertility. Our in vitro fertilization packages include those involving CCS, a technique that empowers our patients to select their embryos with the greatest potential for implantation, pregnancy, and a healthy baby. For more information about CCS and family balancing, call our office at 732-339-9300 or click here to request an appointment with our fertility doctors in Edison, Cranford and Princeton, New Jersey.