Molecular evaluation of oocyte competence.

Although infertility treatment has progressed a lot over the last 40 years, ART treatments are still only accessible for a happy few. In most countries, the financial pressure and the invasive nature of the ART treatments makes doctors continuing to transfer 2 (or 3) embryos. Using morphological criteria, the embryologist is currently unable to recognize with high certainty which embryo will develop into a healthy child. In Belgium the mean number of fresh cycles needed per patient to reach a live birth was 1.79±1.09(SD) (Data from the Belgian Registry 2009-2011). The downside of the single embryo transfer (SET) policy is that the couples have individually to spend more money and time than with double or triple embryo transfer to reach a pregnancy. Despite reimbursement, there is a 23.7% drop out rate after the first fresh stimulation cycle, and a 46.9% abandonment after the fifth stimulation. These figures illustrate the substantial physical and emotional burden of current ART methods to the patient. A method that could allow the embryologist to make a more accurate choice of which single embryo to replace into the uterus has as yet to emerge from the multiple technical proposals studied over the last years. Within the follicle Biology Research Team, Tom Adriaenssens has been focusing on explorative DNA microarray studies on cumulus cells and on the subsequent validation studies by quantitative QPCR based method that could be routinely used to provide a relative “quality” ranking to oocytes. From the proof of principle study, which is the crown on several years of research, the results of the non-invasive ‘Corona Test’ are extremely encouraging and incite additional molecular research to provide an enhanced treatment outcome in varied groups of infertile patients under ICSI treatment. The non-invasive analysis of oocyte quality could better streamline the embryology work in the ART Centers, reduce the total cost of treatment for social security and reduce the burden of treatment for infertile couples.