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title: How Researchers Are Making IVF More Effective
description: Researchers around the world are trying to make in vitro fertilization (IVF) more effective through better testing, AI, and more.
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author: Jamie Ducharme
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article:published_time: 2022-09-08T13:00:35.000Z
article:modified_time: 2026-10-14T09:39:22.578Z
article:section: Health
og:title: How Researchers Are Working to Make IVF More Effective
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twitter:title: How Researchers Are Working to Make IVF More Effective
twitter:description: Researchers around the world are trying to improve IVF through better testing, AI, robotics, and more
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![](https://static.time.com/v3/assets/bltea6093859af6183b/blt23d6127b41f484ec/698a353816d88433aec3afef/IVF-more-effective.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9)


# How Researchers Are Working to Make IVF More Effective

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<!-- video src="https://cdn.jwplayer.com/manifests/DhDUUUt7.m3u8" -->
## Video: New Questions About IVF Testing

[Watch (HLS stream): New Questions About IVF Testing](https://cdn.jwplayer.com/manifests/DhDUUUt7.m3u8) (4:51)

![New Questions About IVF Testing](https://cdn.jwplayer.com/v2/media/DhDUUUt7/poster.jpg?width=720)

_Published 2022-09-07. Each year, tens of thousands of people in the U.S. try to conceive using in vitro fertilization (IVF), a process through which eggs are fertilized in a lab, then transferred to the patient's uterus. Even though IVF has become relatively common, it’s not a sure bet._


![Jamie Ducharme](https://static.time.com/v3/assets/bltea6093859af6183b/bltee90d03f171c21c6/698a0b45db2987baea2650e7/200115_Time_Headshots_Day451258.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1:1)

by 

[Jamie Ducharme](https://time.com/author/jamie-ducharme/)


![Jamie Ducharme](https://static.time.com/v3/assets/bltea6093859af6183b/bltee90d03f171c21c6/698a0b45db2987baea2650e7/200115_Time_Headshots_Day451258.jpg?branch=production&width=96&quality=75&auto=webp)

## Jamie Ducharme


Ducharme is a contributor to TIME.

Sep 8, 2022 1:00 PM UTC

![Jamie Ducharme](https://static.time.com/v3/assets/bltea6093859af6183b/bltee90d03f171c21c6/698a0b45db2987baea2650e7/200115_Time_Headshots_Day451258.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1:1)

by 

[Jamie Ducharme](https://time.com/author/jamie-ducharme/)


![Jamie Ducharme](https://static.time.com/v3/assets/bltea6093859af6183b/bltee90d03f171c21c6/698a0b45db2987baea2650e7/200115_Time_Headshots_Day451258.jpg?branch=production&width=96&quality=75&auto=webp)

## Jamie Ducharme


Ducharme is a contributor to TIME.

Sep 8, 2022 1:00 PM UTC

Each year, tens of thousands of people in the U.S. try to conceive using [in vitro fertilization](https://time.com/4753310/ivf-10-times-lessons/) (IVF), a process through which eggs are fertilized in a lab, then transferred to the patient’s uterus. Even though IVF has become relatively common, it’s not a sure bet: About 70% of people younger than 35 who were first-time IVF patients in 2019 and used their own eggs had a baby within two years, [according to a fertility industry report](https://www.sartcorsonline.com/rptCSR%5FPublicMultYear.aspx?ClinicPKID=0). Success rates decline as patients get older.


Given the physical, financial, and emotional tolls of failed cycles, researchers around the world are working to make IVF more effective. “In medicine, nobody can guarantee success,” says Dr. Zev Williams, director of the [Columbia University Fertility Center](https://www.obgyn.columbia.edu/profile/s-z-williams-md). “The question is, how close can we get?”

## Baby steps toward better tests

Some of those efforts focus on how to improve screening tests meant to help patients optimize their chances of having a healthy baby through IVF. One of the most common tests is called preimplantation genetic testing for aneuploidies (PGT-A). After eggs are fertilized to create embryos, clinicians take biopsies to look for aneuploidies, or chromosomal abnormalities that may increase the risk of IVF failure, miscarriage, or genetic disorders at birth. Proponents of PGT-A argue that it increases the odds of success by identifying embryos most likely to result in a healthy pregnancy.


But these tests are controversial. Some [studies](https://www.nejm.org/doi/full/10.1056/NEJMoa2103613) suggest PGT-A does not increase the likelihood of giving birth and [results in enough false positives](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798592/) that viable embryos are routinely discarded—potentially making it harder for people to get pregnant because they have fewer embryos to work with. Genetic tests also add even more fees to [an already pricey process](https://time.com/4319409/cheap-ivf-belgium/).

Almost 10 years ago, Dr. Norbert Gleicher, founder of the Center for Human Reproduction in New York City, [became so disenchanted with PGT-A](https://academic.oup.com/humrep/advance-article-abstract/doi/10.1093/humrep/deac052/6556291) that he began getting patients’ permission to implant embryos the test had flagged as having a high chance of failure. “Lo and behold, we started seeing healthy, chromosomally normal pregnancies,” he says.

Some embryos with certain chromosomal abnormalities self-correct during pregnancy, Gleicher and colleagues from Rockefeller University demonstrated in [a small study](https://www.nature.com/articles/s41556-021-00660-7) published last year. Of 32 women in the study, only five gave birth—but the results demonstrate that at least some imperfect embryos can lead to normal pregnancies, Gleicher says. That’s especially important for older IVF patients, who typically have fewer embryos to start and thus need as many as possible to maximize their chances of conceiving. “Imagine how many embryos are out there that are currently not being transferred,” Gleicher says.

That question haunts California resident Lital Gilad-Shaoulian, who went through PGT-A testing when she decided to try for a fourth child at age 39\. She was surprised to learn that the test classified all of her embryos as abnormal, especially since her three older children were all conceived through IVF. “I remember telling myself, ‘\[The results\] are wrong,’” she says.

For years, she repeated the emotional and costly process of harvesting and fertilizing eggs, only for most of the resulting embryos to be deemed abnormal. Finally, after consulting with clinicians at the Center for Human Reproduction, she convinced her local doctor to move ahead with one of her highest-graded but abnormal frozen embryos—a scary decision, but one she felt was worth a try.

She got pregnant, which Gilad-Shaoulian remembers shocked her doctor. Additional chromosomal testing at 10 weeks of pregnancy came back normal. And about 18 months ago, she gave birth to a baby girl. Her daughter had some unrelated health issues following a delivery complication, but Gilad-Shaoulian says she is developing normally and is “perfect” and “so smart.”


While genetic testing may be right for some people, Gilad-Shaoulian wishes she’d never done it. “There’s possibly tens of thousands of good embryos that are thrown away from people who are working so hard and are so eager to have a baby,” she says. “I’ve been there. I know.”

Experts like Williams, however, stand by the utility of testing. While some embryos in the gray area between viable and nonviable may result in a healthy baby, he says preimplantation testing can identify those that are very unlikely to succeed, which can come with significant benefits for patients.

In 2022, Williams’ team at Columbia [developed new technology](https://www.nih.gov/news-events/news-releases/nih-funded-researchers-develop-same-day-test-detect-abnormal-fetal-chromosomes) to deliver genetic test results in hours rather than days or weeks, potentially allowing viable embryos to be transferred on the same day they’re tested. While the test can’t fix any problems it detects, Williams says quickly identifying a patient’s best embryos can help them get pregnant faster, with fewer expensive failed cycles and emotionally difficult miscarriages. “The big difference will be how long does it take to get pregnant, and how many losses does she have to go through before she gets pregnant?” Williams says.


Other researchers are also trying to tweak PGT-A to make it more effective. Currently, clinicians take biopsies from what becomes the placenta, so “you really don’t know what goes on inside the cells that go on to form the baby,” says Kylie Dunning, a reproductive biologist at the University of Adelaide in Australia. Dunning recently [co-authored a paper](https://academic.oup.com/humrep/article/37/1/14/6422203) describing a new approach: taking a molecular photograph of the embryo to assess fetal cells, rather than those that form the placenta. She believes that will clarify which embryos are truly nonviable. “Hopefully, that will result in more patients taking home a baby,” she says.

Another research team, this one led by scientists from Australia’s RMIT University and Monash IVF, published a [pair of studies](https://www.sciencedaily.com/releases/2021/08/210823110334.htm) in 2021 describing another possible target for pre-IVF testing. They described a “golden window” for treatment: the several-day period in a woman’s natural reproductive cycle when levels of a molecule called PCX are lowest. PCX makes the surface of the womb slippery, potentially preventing embryos from attaching. Theoretically, if clinicians can determine when PCX levels are lowest and transfer embryos then, it could improve the chances of pregnancy.


Study co-author Guiying Nie, a reproductive biologist, says her team is still working to validate its findings, so no such test is currently available to patients. The challenge is finding a fast, non-invasive way to test PCX levels. Some kind of imaging test could work, she says, but it’s too soon to say.

A similar screening technique, called endometrial receptivity analysis, analyzes tissue from a uterine biopsy to try to determine the best time for an IVF cycle, but some research suggests [it’s not as accurate as promised](https://www.nytimes.com/2021/12/18/health/ivf-era-test-igenomix.html).

## Looking beyond tests

There is a limit to what any test can do, Williams says, so his lab is trying to find other ways of boosting success rates. For example, his clinic uses a robotic arm to prepare the tiny trays where embryos grow to eliminate human error.

Other companies are also turning some tasks over to robots. Startup [TMRW](https://www.tmrw.org/) created automated tanks for storing frozen eggs and embryos, ideally eliminating [mishaps like freezer failures](https://time.com/5198546/families-affected-freezer-failure-fertility-clinic/). Sensors in the tanks detect changes in storage conditions, then alert staff so they can fix problems before they become critical.


[Artificial intelligence also holds promise](https://time.com/collection/life-reinvented/5492063/artificial-intelligence-fertility/) for fertility. Research teams are trying to teach AI systems to select the best embryos for transplantation by analyzing images of them, and various consumer apps use AI to help women pinpoint when they’re most likely to conceive based on fluctuations in hormone levels and other factors.

## Making fertility care more convenient

Improving the logistics of fertility care is also important. New York-based New Hope Fertility offers a program called “[At Home IVF](https://www.newhopefertility.com/ivf/at-home-ivf/),” which makes the process as remote-friendly as possible. A patient starts with an online consultation, then, when appropriate, gets fertility medication delivered to their door. Patients only need to come into the clinic for major appointments like egg harvesting and embryo transfers.

Some clinics, including New Hope, also offer what’s known as “mini” IVF, a process that is similar to traditional IVF but uses fewer or lower-dose fertility drugs to keep costs down. Because patients receive fewer stimulating drugs, they may produce fewer eggs that can be fertilized—but mini IVF can be the right choice for patients with budgetary constraints or certain health conditions, [according to the Cleveland Clinic](https://consultqd.clevelandclinic.org/mini-stimulation-procedure-makes-ivf-more-affordable/).


Williams’ lab has also been working to make IVF more convenient for couples. They developed a new transport technique, using a substance that keeps sperm samples warm and viable for several hours, to allow men to produce samples at home and then drop them off at the clinic, rather than going through the process in a medical office. It may seem like a small shift, but Williams says sperm samples tend to be higher quality when they’re collected at home, potentially because men feel more at ease.

Every refinement counts when it comes to fertility care. “We really fight for every percent improvement in success rates,” Williams says, because each one can be life-changing for families.


## Transcript

The first baby conceived using in vitro fertilization or IVF was born in 1978 since then IVF has become relatively, but it's far from a sure bet. There's several steps along the way designs to increase the chance of having a healthy baby. One of these is a common screening test called preimplantation genetic testing for aneuploidies or P GTA. After eggs are fertilized to create embryos clinician, take biopsies to look for any employees or chromosomal abnormalities that increase the risk of IVF failure miscarriage. Or genetic disorders at Birth, you take an embryo, you grow that embryos are around a 5 or 6 when it's called, but a blastocyst and the biopsy of the outer shell and take around 7.

So I know cells are tested to see where they have the correct number of chromosomes or not. If you have extra chromosomes are missing chromosome. That is the most common cause of pregnant but test sleepy. GTA are controversial and not all fertility, specialist advice or patients to use them. Dr. Norman clature has had his doubts about the test. He says he began to notice that rates of pregnancy from IVF began to decline about 10 years ago around the same time as pgt-a testing became more common. A very large number of embryos that off the testing a supposedly showing from a normal Adnan Malik.

This I really show called pose positives. How do we know that? We know that for variety of reasons, but the most obvious reason is That we already in 2014 started transferring some of those so-called abnormal a and lo and behold we have healthy babies. We came to the conclusion. That not only. may this testing not improve IVF outcomes, but for certain patient specially older women, it may actually reduce chances of conception All my kids are IVF product, my oldest is a girl. And then I have two boys and I wanted a girl. So the reason I went, I decided to do the testing is because he wanted and curl, my doctor called, and he's like, I'm sorry, they're abnormal, which I had no clue what it means, didn't work.

And I remember saying to myself, that can't be, it just doesn't make sense. It's so easy with me and then we kept trying and it was devastating. I have a professor that's helping me with all of this and Israel he told me stop texting these embryos and he referred me to the clinic in New York and I consulted with them and they told me you don't need to do any more obvious. You have beautiful embryos. My doctor here who is amazing? He was really hesitant at first eventually I was able to convince him to give it a shot. Every appointment. He was shocked and it's hard to beat. He was he was completely shocked, even said I'm about to cry.

And then 10 weeks game blood test was completely normal. She's turning 18 months in just a few days. And she's the best thing that ever happened to us for me. I would not have done the genetic testing again, Although Dr. Gliders Clinic has had some success without testing other researchers, stand by the test ability to detect abnormal embryos which helps protect patients from pregnancy loss with abnormal. It's going to be abnormal. A big difference will be how long does it take to get pregnant? And how many losses does she have to go through before she gets pregnant? It's a mistake to minimize the emotional burden of going to a transfer that are either unsuccessful or resulting in a pregnancy.

In medicine. Nobody can guarantee success. The question is, how close can we get? The fertility experts, take different approaches, embryonic testing. They share a common goal to give their patients the best possible chance of welcoming a healthy baby.

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