For about a year, Darla Macey-Nicholson and her husband tried for a child – a final addition to round out a family that currently includes two girls and a boy. But with seemingly little luck, and Ms. Macey-Nicholson's 40th birthday approaching, the couple turned to the professionals.
Acting on a doctor's recommendation that they explore the option of in vitro fertilization (IVF), Ms. Macey-Nicholson visited a Vancouver fertility clinic in December. One month later, she is pregnant.
Ms. Macey-Nicholson, an Abbotsford resident, credits the pregnancy to a new technology offered by Vancouver's Genesis Fertility Centre called Early Embryo Viability Assessment, or Eeva for short. Essentially an add-on option to IVF treatment that tests for the embryos most viable for implantation, the technology is being hailed by supporters as a safe and non-invasive way to increase a couple's chances of conceiving.
However, some critics say there have not been enough clinical studies of the technology to draw definitive conclusions, while others have raised questions over the ethics surrounding IVF in general.
Genesis Fertility is the first clinic in Canada, and the first commercial clinic in North America, to offer the patented technology.
Eeva, the flagship product of reproductive health company Auxogyn, works like this: Using microscopes and time-lapse imaging – a photo is taken every five minutes – an embryologist can observe an embryo's cell-division process, looking at the speed and quality of the divisions. From there, it can be predicted which will develop into a blastocyst, or cell cluster, for implantation. Without this technology, embryologists used regular snapshots – effective, but "we don't get the whole story," said Genesis Fertility embryologist Herman Rodriguez.
Ms. Macey-Nicholson said she feels "unbelievably blessed" to have gotten pregnant so quickly.
"A lot of women go through this lengthy, tedious process and I was very lucky," she said. "Knowing that we had used Eeva just gave us a little bit more, that sense of confidence, that there's a better chance it would work out."
Sonya Kashyap, medical director at Genesis Fertility, cited studies that showed researchers were able to predict blastocyst formation with 87-per-cent certainty using Eeva, compared to 57 per cent using the criteria in the "snapshot" method.
"If we pick embryos that are chromosomally normal, it will have three advantages: It will reduce miscarriage rates, it will increase probability of pregnancy from a single [IVF] cycle, making that cycle way more cost effective, and, hopefully, pick the healthiest embryo," she said. "That's the potential."
IVF costs between $7,000 and $15,000 per cycle. Genesis Fertility will offer Eeva for $1,500, Dr. Kashyap said.
A 2012 study published in the Oxford journal on human reproduction looked at time-lapse monitoring as a tool for clinical embryo assessment. The study said the technology offers novel clinical opportunities for continuous monitoring of embryos and the flexible evaluation of known cell formations. However, a lack of larger, randomized clinical studies means it remains to be seen which parameters are of significance and whether embryo selection using dynamic parameters improves clinical outcome, the study stated.
Meanwhile, Margaret Somerville, director of the McGill Centre for Medicine, Ethics and Law, questioned the ethical implications of any embryonic screening process.
"The thing we've got to realize is these are early human lives and we've got to maintain respect for human embryos," she said. "They're not just products or things that we put through a screening process."