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Beginnings: The Breakthrough Moment

Jamie Grifo, IVF Pioneer

“When I got into this field in 1988, there was the problem of inefficiency.”

Jamie Grifo.  

When I got into this field in 1988, there was the problem of inefficiency — low success rates, high miscarriage rates, high failure rates, and the age-related decline in fertility that we saw. And we knew that most of it was being caused by what happens to eggs as they get older. You miscarry more as you get older: It’s like 20 percent at 20 and 40 percent at 40. The risk for Down syndrome in a pregnancy is one in 1,250 in a 25-year-old — that’s a low number but not zero — and it’s one in 100 in a 40-year-old.

Then around 2007 a novel technique came into place called array comparative genomic hybridization, which is a way that you can take a cell or a number of cells from an embryo and compare it to a control normal and determine if the proper number of chromosomes are there. It has limits, but you can check all the chromosomes. It’s not 100 percent accurate; it misses subtle things. And once we could do that, what we learned is that most of the embryos we were putting back in IVF, depending on the age of the woman, were chromosomally abnormal, and that’s why they weren’t getting people pregnant — that’s why we’re putting back too many embryos and making multiples and still having a lot of miscarriages. Once that leap was made, then we learned how to freeze embryos better using vitrification, and biopsy embryos so you can get more than one cell to get a more accurate diagnosis on the embryo. And then we started biopsying and freezing and then putting back only one chromosomally normal-tested embryo, we started seeing that you get the same pregnancy rate independent of age if you have the embryo. That was the technical leap. It was kind of like the perfect storm of being able to grow embryos longer in culture without harming them in any way, being able to biopsy them without harming them, and being able to freeze them so that they would survive — 99 percent survival.

The misrepresentation of the story was always that when I did the first embryo biopsy, it was like, “Okay, we’re doing designer babies now. What does this mean for society?” Which is one interpretation of it, and a very misguided one. It’s not about doing genetic engineering, it’s about making sure that the baby is healthy, and we’re able to do that now. Not select for traits, not select for hair color and eye color and the Arnold Schwarzenegger genes and all that junk that people think they want that they really don’t. It’s really that they want a healthy baby, without the trauma, without the miscarriage, without getting news at 18 weeks that their baby has Down syndrome and then figuring out what to do. Ten thousand babies later, you don’t want to know all the heartaches I’ve lived through and all the disappointments and sad things that people go through. To have those 10,000 miracles out there doing amazing things because they’ve got parents who get it. You’ve got parents who’ve struggled and parents who understand the gift. I mean, these patients are doing something right. We just get the privilege to help them. And it is a privilege. Really — I’m the luckiest guy in the world.