AZ Jan Palfijn Gent Already two pregnancies after brand new Corona test at IVF

AZ Jan Palfijn Ghent has already applied the brand-new Corona test for IVF, which doubles the chance of a pregnancy, in a dozen patients. The first two pregnancies after such a Corona test were diagnosed on Thursday 27 June 2019. AZ Jan Palfijn Ghent is, besides UZ Brussel, the only hospital in Flanders that can offer such a test in its IVF center.

Since the invention of ICSI (intracytoplasmic sperm injection), fertilization is no longer a problem in fertility patients. Nevertheless, the results of the assisted fertilisation techniques (IVF, ICSI, PGD, etc.) remain alarmingly low (max 35-40% per cycle in the reference population), and this due to the fact that the implantation rate per embryo transferred back only at 26-27 lag (in the top centers). The problem was that we really only had the morphology and the development of the embryo as an assessment technique to make the choice of the embryo to be transferred. Going further techniques (eg for the assessment of genetic predisposition) such as pgd and pgs, on the other hand, had the disadvantage that the embryo was hurt, whereby the expected profit was largely neutralized.

A technique developed by a research team from the VUB, the Corona test has been available since the en of May 2019, using gene expression techniques for the first time. It measures the potential of an oocyte to develop into a normal healthy child after ICSI. After testing the corona cells of each oocyte from a woman after hormone stimulation, the embryo from the oocyte with the highest potential will be transferred into the uterus.

After all, it has been possible to establish that certain genes that are known to be important for implantation can also be expressed in the food cells closest to the egg, the so-called corona cells. These cells must in any case be removed before fertilization of the egg cells, and have been destroyed until now. So there is no disadvantage or weakening of the embryo.

Applying this technology in IVF practice has shown that pregnancy rates have doubled (from 27% to 63%) and live birth increased from 23% to 55% after transfer of a single embryo on day 3 (in standard IVF, to achieve an acceptable success rate, usually two embryos are transferred, with consequently also a relatively high number of twin pregnancies). The Corona test also significantly increased the clinical pregnancy rate in comparison to day-5 control group (from 43% to 63% in fresh cycle and 65% to 78% in cumulative transfers).

© AZ Jan Palfijn Ghent © AZ Jan Palfijn Ghent

There are, however, currently some restrictions. For example, gene expression is best expressed in patients who were stimulated with Human menopausal Gonadotrophines, probably because due to the LH component of Human menopausal Gonadotrophines, the oocytes are more mature in this type of stimulation.

In the AZ Jan Palfijn Ghent, a dozen Corona tests have been conducted and the first two pregnancies were diagnosed on Thursday 27 June.

Corona test principle

The Corona test is performed on corona cells from a patient. The test is based on the measurement of five specific gene expressions.

Corona cells are isolated from all oocytes and RNA is then extracted from the corona cells for each of the harvested ooctyes. cDNA synthesis and real time PCR are done using 3 predicitve genes and 2 control genes. PCR results lead to a quantitative ranking for all oocytes.

The test is currently quite expensive (between 700 and 1000 euros), which is why Dr. Wim Decleer, fertility expert at the AZ Jan Palfijn Ghent, is pushing for a reimbursement scheme at the Ministry of Health.

Yet additional research will be necessary because the test has only been applied to patients within the age category of 22 to 38 years, and thus not yet to older IVF patients. But the current results of the Corona test for an IVF treatment can already be called revolutionary. The first IVF patient in AZ Jan Palfijn who became pregnant after the Corona test was also older than 38, which is of course particularly promising for women and couples who have been trying to conceive for a while.