MAP: a highly scientific business



Stéphane Viville, "infertility specialist"[1], published an article in Le Monde in which he denounced "certain tests (…) available to and paid for by patients, in a large number of French in-vitro fertilisation centres", the "real interest and reliability of which" have not been proven. He opposes the recommendation advocated by some of his colleagues "to carry out extensive genetic tests allowing thorough analysis of the genome of embryos produced by IVF".

 

"In some countries, the practice of MAP is a lucrative business first and foremost", he noted. Some couples "are ready to spend unlimited amounts to reach their goal": namely, "to have" a child. Thus the "desire to have a child" expressed by these couples boosts the MAP market and the "number of innovations claiming to increase pregnancy rates and reduce the length of time to the birth of a healthy baby is constantly rising". However,"for the vast majority" of these new tests, "there is no concrete evidence to confirm proven, tangible benefits in fertility treatment".

 

Referring to the repeated requests made by Professor Frydman, Stéphane Viville is also "in favour of a ‘plan to counter infertility’" but refuses to justify extended pre-implantation screening given the increased risk of chromosomal abnormalities currently screened during the third trimester of pregnancy. The medical interest of genetic tests which, in Professor Frydman’s opinion, should be used more widely has not been borne out by "sound scientific data": "all studies highlighting the ‘positive effect of this analysis’ base their findings on an efficacy evaluation following embryo transfer as opposed to a couple's overall treatment. Studies taking this criterion into account conclude a lack of effect at best and a harmful effect at worst", explained Stéphane Viville.

 

In addition, he states that "early embryos" tend to "have a considerable repair potential", which, whilst not well known, would explain the fact that "even during embryo transfers with mosaic  aneuploidy syndrome[2], normal pregnancies can arise" (see « L’embryon possède une capacité remarquable pour s’auto-corriger »"The embryo possesses a remarkable capacity for self-correction). Hence "comparison of early embryos obtained by IVF is not consistent with a 3-month foetus". Finally, failed implantation is not always due to embryo anomalies - "numerous other causes could be at fault".

 

[1] University Professor, Hospital Practitioner (UP-HP) at the Faculty of Medicine, CHU Strasbourg (University Medical Centre), former Head of the Reproduction Biology Laboratory and former Head of Department at the first Pre-implantation Diagnostic Centre. Scientist at the Institut de génétique et de biologie moléculaire et cellulaire (IGBMC) (Institute of Genetics and Molecular and Cellular Biology), he advocates human embryo research.

[2] Embryos formed with normal and abnormal cells.


Sources: 

Le Monde, Stéphane Viville (15/02/2017)