We provide embryo screening for couples going through IVF. Embryo screening analyzes the DNA of an embryo to flag genetic risks for certain monogenic and common chronic conditions.

Each embryo has differences in its DNA — siblings only share 50% of their DNA with each other, while identical twins have 100% of the same DNA. Since each embryo has different DNA, each embryo has different genetic risks. When you conceive at home, random chance determines your child's genetics.

When you create embryos through IVF, you can potentially forecast your child's genetics, choosing the healthiest of several possible embryos.

Many diseases are influenced by genetic variations in an individual’s genome. We refer to these diseases as “genetic diseases,” because the risk of developing such a disease can be impacted by your genetic makeup. To understand the genetic basis underlying these diseases, we need to understand how genetic variations contribute to disease.

Consider all the diseases you’ve ever heard of to be on a spectrum. On one end of the spectrum, we have monogenic, or single-gene disorders. This means having a mutation in one single gene can cause a genetic disease, such as Cystic fibrosis or Huntington’s disease. On the other end, we have polygenic diseases, which are diseases influenced by the combined effects of many genes. This end of the spectrum includes more common diseases in the population, such as coronary heart disease and type 2 diabetes. Since many genes are involved, the genetic basis of polygenic diseases are more complex than monogenic diseases.

To learn more, check out our guide on monogenic and polygenic disease

In the past couple of decades genetic testing options available prior to conception and during pregnancy have rapidly evolved. Patients often feel uninformed about which test(s) they should consider before conceiving and during pregnancy. Each genetic test has benefits and limitations. There is no test that can look for everything. This guide outlines genetic testing options that are available to you prior to conception (preconception tests) and during a future pregnancy (prenatal tests).

The polygenic risk estimates presented here model the effect of prioritizing embryos to reduce the risk of a single disease. In general, if you are trying to reduce the risk of multiple diseases simultaneously, the risk reduction you achieve for each polygenic disease will be more limited — if, for example, the embryo at lowest risk of coronary artery disease is not at lowest risk of breast cancer, you cannot minimize the risk of both diseases at once.

When it comes to monogenic diseases, however, because each individual monogenic disease is individually rare, it is generally possible to reduce the risk of many monogenic diseases simultaneously via whole-genome embryo screening.

Estimating the risk reduction possible via embryo screening can be very complex depending on your family history and carrier status. If you have questions about what's possible with embryo screening for your family, we encourage you to speak with one of our Genetic Counselors.

At a high level there are four steps to the IVF + screening process:

• IVF Embryos are created through IVF. This involves taking medications to prepare the ovaries for egg collection and fertilizing the eggs with sperm to form embryos. 
• Embryo Sampling Five to ten cells are carefully sampled by a trained embryologist from each embryo. DNA from the sampled cells are analyzed to report on each embryo’s genetic risk.
• Genetic Report Receive a genetic risk report for each embryo with guidance from a genetics expert.
• Embryo Transfer Based on the embryos’ genetic health, patients and their care team can select the embryo with the lowest genetic risk and the best chance of IVF success. The remaining embryos can be frozen for future use.

For a more in-depth discussion, check out our guide on the IVF process.

While it's ultimately a personal decision, there are many factors to consider:

• Experience You want to go with a fertility clinic with a sufficient amount of practice and expertise.
• Fertility Doctor Fertility doctors are board-certified reproductive endocrinologists specialized in diagnosing and providing fertility treatments.
• Laboratory The lab is one of the most important pieces of your journey. The best IVF lab maintains the quality of the gametes and embryos and also employs highly qualified embryologists and lab professionals. A high quality lab can improve your chances of IVF success.
• Personnel experience IVF treatment takes a small village to coordinate care for patients. This goes beyond your fertility doctor to include embryologists, nurse and patient coordinators, and financial coordinators. A well-run, efficient and compassionate care team can elevate your overall patient experience to make you feel supported and cared for while a disorganized team can lead to costly clinical and clerical errors.
• Size of Clinic In a large practice, it is very common to have a group practice. This is when a group of physicians work as a collaborative team to assist the patients. They also ask each other for second opinions and have weekly discussions about difficult cases. Smaller clinics are more “high-touch” and personal because the team is smaller. If you go with a smaller clinic, you likely will have a relationship with every clinic provider and staff.

For more information on how to evaluate these factors, check out our article on choosing a clinic.

{capitalizedDisease} is a complex polygenic disease, which means both genetics and environmental factors play a role. Our genetic risk scores capture a portion of these genetic factors. Selecting the embryo with the lowest score is not a guarantee, but it may reduce the risk your child develops the disease.

To estimate how much it may reduce the risk, we simulated thousands of families with the same history of {disease} as yours. These simulations included both the genetic and environmental factors. We evaluated each simulated family, determining both which embryo had the lowest risk score and which embryos developed the disease later on in life. Often the lowest-risk embryo never developed the disease while other higher-risk embryos did. However sometimes the lowest-risk embryos developed the disease while higher-risk embryos did not. Aggregating over thousands of family, we calculated how often the lowest-risk embryo was affected versus how often a random embryo was affected. These percentages are the risk reductions displayed above.

To learn more about our techniques, check out our whitepaper on how family history impacts disease prevalence.

Having family members that have been diagnosed with a rare monogenic condition may significantly increase the chance your child will be affected. Accurately estimating your child's risk depends on the specific condition and your precise family history. To estimate this risk accurately, we recommend talking to one of our genetic counselors.

A recent study estimates that 25-30 million in the United States are affected by rare diseases, with 85% of these diseases being monogenic. Our screens cover many but not all of these diseases. By analyzing lists of monogenic diseases and their prevalence, we estimate that our screens cover rare diseases affecting approximately 4% of the US population.

It's important to note that this estimate will evolve as we improve our ability to identify the genetic causes of rare diseases. For more details about monogenic diseases or for questions about screening for a specific rare disease, we recommend talking one of our genetic counselors.