Dawn of Metabolomics: Will There Be Another Octomom?
Whether you love her or hate her, Octomom Nadya Suleman definitely stimulates debate. She successfully gave birth to 8 babies thanks to in vitro fertilization (IVF). But if metabolomics had been standard practice, would her doctor have taken such bold risks in the first place?
Dr. Michael Kamrava implanted 12 embryos in Octomom Suleman’s uterus. Standard practice calls for implanting one-to-two embryos at a time in a patient like Suleman.
“He’s a renegade physician,” said Dr. John Schnorr, with Coastal Fertility Specialists in South Carolina. “He ignored the standards of care as published by the American Society of Reproductive Medicine and simply shouldn’t be allowed to continue practicing medicine.”
Kamrava and Suleman may have been united in aiming for the record books – both say they’re satisfied with the birth of her octuplets – but Kamrava’s willingness to implant so many embryos could have put Suleman and her unborn babies at risk.
Multiples multiply chances of complications for mom and babies
“A multiple pregnancy results in a several-fold increased risk of preterm labor, pre-term delivery and the delivery of an unhealthy baby or babies,” Schnorr said. “Most fertility doctors want you to have as many babies as you desire, one at a time.”
IVF technology is improving every year. So is the likelihood that most embryos implanted in the uterus will result in live births. If doctors can identify viable embryos before implantation, the need for risky multiple implantations – and the risks they pose – may become history.
An embryo viability testing process known as metabolomics may help. The science of metabolomics – a non-invasive embryo assessment for IVF – is helping researchers pinpoint an embryo’s chances of success before implantation. And the margin of error is expected to be very small.
The goal is to get more people pregnant, one embryo at a time.
In IVF pregnancies, roughly 30 percent of live births include multiples, compared with roughly 2-3 percent of spontaneously conceived births. This is largely because doctors implant more than one embryo to stack the odds of a pregnancy “sticking.”
Twins and triplets are a welcome addition to most families, but pregnancies with multiples are much riskier for the mother and her unborn babies than single-embryo pregnancies.
Fertility doctors hope that by identifying highly viable embryos, they’ll help women make their baby dreams come true with one embryo, fewer tries, lowered risk and less emotional stress.
“The holy grail of the field of reproductive endocrinology is to find the single embryo that is viable, chromosomally normal and will yield a 100 percent of a live birth per try,” Schnorr said. “Metabolomics may help us do exactly that.”
How metabolomics works
Scientists think that embryos which result in live births have unique metabolic rates that help distinguish them from embryos that won’t result in live births. By passing light waves through the culture in which embryos are stored, researchers are able to score each embryo’s metabolic rates and rank its viability. The embryo with the highest viability potential would then be implanted in the uterus, giving the pregnancy the best shot at success.
The light waves don’t hurt or damage the embryos. This process could enable doctors to implant a single embryo with incredibly favorable odds of the woman having a successful pregnancy.
All patients undergoing assisted reproduction with more than one embryo could benefit from this technology, Schnorr said.
It seems the days of 12-embryo implantations like Nadya Suleman’s may, thankfully, already be behind us. The good news is that a technology like metabolomics could help reduce the thousands of multiple pregnancies created each year through IVF.
“Metabolomics could prevent the complications from multiple pregnancies that are all too common in infertility treatment,” Schnorr said. “In an ideal world we would use technologies like metabolomics to find and transfer one viable embryo in every IVF cycle resulting in one perfect baby per try.”
Say “goodbye” to the days of Octomom
It is possible that metabolomics may be standard practice sometime in the next seven to ten years. And women may very soon look forward to birthing a healthy baby on the first round of IVF without ever being exposed to the risks of multiple embryo implantations like Octomom and so many women are each year.