Selecting a Single Embryo for Transfer after In-vitro Fertilization: A Translational Medicine Perspective

Apart from the huge efforts made to develop an embryo in-vitro, the embryologist is faced with an even bigger task to choose an embryo from a cohort that will produce pregnancy. Selecting a single viable one is often a challenge to the embryologists and clinicians involved. This is because the one that is selected may determine outcome of the cycle. It is not in the embryologist interest to choose an unhealthy embryo that will allow patients suffer emotionally or financially. A responsible professional often seeks way to select embryo that will make a baby. There are several methods that have been introduced for this purpose since the birth of Louis Brown in 1978. These methods include the traditional embryo morphology grading system, newer technologies like time lapse monitoring, pre-implantation genetic screening, metabolomics, proteomics and transcriptomics. There are conflicting claims that these newer technologies are superior to the morphology grading system. This paper however, advocates for a holistic system that is capable of analyzing all the pathways in an embryo to provide a general health picture. Newer technologies for embryo selection and the traditional embryo grading system in its present form have not achieved 100% accuracy in selecting a single embryo. Research into a holistic system capable of selecting a single embryo will be ideal and better driven by a translational research team that will provide an interdisciplinary and multifrontier approach. We have described here an elementary version of such a system with the hope that it simplicity, rapid turnaround time and cost effectiveness will encourage it application in IVF. This diagnostic platform may be developed for use in IVF laboratory in the future to select the most appropriate embryo.