EMBRACE Highlights
NON-INVASIVE:
Simply requires to analayze the culture medium in which the blastocysts are grown
SAFER:
The test requires no embryo manipulation, reducing the risk of damaging embryo
CHROMOSOMAL ANEUPLODY DETECTION:
Identifies blastocysts with an abnormal number of chromosomes
PRIORITISATION SYSTEM:
It helps fertility doctors prioritize the most suitable blastocysts and thereby improve implantation rates and successful pregnancies
What is the EMBRACE test?
- EMBRACE is a prioritisation system based on the analysis of embryonic cell-free DNA released by blastocysts into the surrounding medium during culture in the IVF laboratory.
- The analysis of one drop of culture medium in which the embryo has been developing, otherwise discarded in standard practice, helps clinicians determine which is the most suitable embryo to transfer.
What information does EMBRACE provide?
- EMBRACE is used for chromosomal aneuploidy detection; the aim of the test is to identify the presence of aneuploidy in embryonic cell-free DNA (detection limit: 10Mb).
- For each blastocyst, one culture medium sample is analysed. The algorithm developed by Igenomix uses that result to determine the probability of the blastocyst having a euploid trophectoderm sample.
- This probability, called euploidy score (ES), is used to establish an order of priority for embryo transfer: the embryo with the highest euploidy score will be recommended first for transfer.
- Clinics can choose from several different types of reports, depending on clinician preferences, legislative guidelines, and regional ethical standards.
How does the testing Process work?
Fresh blastocysts
Frozen blastocysts
Main Tips:
- EMBRACE is a prioritization system based on the analysis of the embryonic cfDNA released by the blastocyst to the drop of culture media.
- It helps you decide the best embryo for transfer.
- EMBRACE is not a substitute for TE biopsy.
- Can be performed in media from day-6/7 blastocysts.
- EMBRACE is used for aneuploidy detection (not for PGT-SR or PGT-M cases), with a detection limit of 10Mb.
- Can be applied to fresh cycles or to previously vitrified day-5/6 embryos from previous PGT-A cases.
- Can be applied to blastocysts from IVF or ICSI cases cultured in any type of media or incubator (conventional or time-lapse with individual wells).
- To perform EMBRACE, IVF clinics need to pass a validation (dry-run).
Publication List
The impact of implementing a non-invasive preimplantation genetic testing for aneuploidies (niPGT-A) embryo culture protocol on embryo viability and clinical outcomes.
Sakkas D, Navarro-Sánchez L et al. Human Reprod. 2024; 39(9): 1952–1959.
Culture time to optimize embryo cell-free DNA analysis for frozen-thawed blastocysts undergoing noninvasive preimplantation genetic testing for aneuploidy.
Ardestani G, Banti M et al. Fertil Steril. 2024; 122(3):465-473.
Human embryo live imaging reveals nuclear DNA shedding during blastocyst expansion and biopsy.
Domingo-Muelas A, Skory RM et al.Cell. 2023; 186(15):3166-3181.
Find out moreNon-invasive preimplantation genetic testing for aneuploidies: an update.
Navarro-Sánchez L, García-Pascual C et al. Reprod Biomed Online. 2022; 44(5):817-828.
Multicenter prospective study of concordance between embryo cell-free DNA and trophectoderm biopsies from 1,301 human blastocysts.
Rubio C, Navarro-Sánchez L et al (2020). Am J Obstet Gynecol. 2020; 223(5):751.e1-13.
Embryonic cell-free DNA versus trophectoderm biopsy for aneuploidy testing: concordance rate and clinical implications.
Rubio C, Rienzi L et al. Fertil Steril. 2019; 112(3):510-519.
Find out moreOrigin and composition of cell-free DNA in spent medium from human embryo culture during preimplantation development.
Vera-Rodriguez M, Diez-Juan A et al. Human Reprod. 2018; 33(4):745–756.
Find out moreIVF culture media refresh in a reduced volume on day 4 aimed at improving non-invasive embryo selection does nor affect embryo competence: a prospective analysis of 2,605 embryos.
Maggiulli R, Cimadomo D et al. Reprod Biomed Online. 2022.
Find out morePoster Presentations and Abstracts
ASRM 2024 | Final results of a multicenter study comparing cell-free DNA and Trophectoderm biopsies in 2,539 human blastocysts
ESHRE 2024 | P-109: Non-invasive Genetic Testing (niPGTA) and Laser Assisted Hatching (LAH) may improve pregnancy and ongoing pregnancy rates in patients of advanced maternal age
Find out moreESHRE 2022 | P-177: Non-invasive aneuploidy testing versus conventional morphological embryo selection in good prognosis patients.
Find out moreESHRE 2021 | P- 560: Comparative analysis of non-invasive preimplantation genetic testing of aneuploidies (niPGT-A), PGT-A and IVF cycles without aneuploidy testing: preliminary results.
Find out more
Webinars and Lectures
ASRM 2024 | Academy studio:
EMBRACE: what to expect from embryo viability and clinical outcomes in a niPGT-A program
ASRM 2023 | ACADEMY STUDIO
Lessons learnt from EMBRACE niPGT-A user meeting at ESHRE
ESHRE 2023 | Academy studio:
Meet the expert: All you want to know about niPGT-A
ASRM 2022 | ACADEMY STUDIO
EMBRACE Update / New Protocol for EMBRACE
WEBINAR
EMBRACE: OUR JOURNEY FROM CLINICAL STUDIES TO CLINICAL CASES
Listen to Our Users!
FAQ’S
What is CGT | Carrier Genetic Test?
The CGT or Carrier Genetic Testing is a genetic tets which analyzes an individual’s DNA to determine if they are a carrier of a range of autosomal recessive genetic conditions. In biologically female individuals, carrier screening may also include the analysis of genes associated with X-linked conditions. This information can be useful in understanding the risk of having a child with a genetic condition.
Some genetic conditions occur more often in people who trace their ancestry to a particular geographic area. For example, Gaucher disease more frequently affects people of Ashkenazi Jewish ancestry, and sickle cell disease more frequently affects people of African descent. These conditions, however, are not restricted to these groups, and anyone can be a carrier.
Who should consider CGT?
According to the American College of Obstetricians and Gynecologists, carrier screening should be offered to pregnant individuals and to all individuals who are considering pregnancy, regardless of ethnicity and family history.
Carrier screening is available to anyone who wants to learn more about their risk of being a carrier of a genetic condition, including:
- Reproductive couples who are planning to conceive naturally.
- Individuals/couples who are planning an assisted reproduction.
- Patients planning a treatment with sperm/egg donors, and intended recipients of donor sperm/eggs.
- Reproductive couples at increased risk for a specific disorder based on their ethnicity.
What it means to be a “carrier” of a genetic disorder?
A carrier is an individual who has one mutated copy and one normal copy of the same gene.
When a child is conceived, they inherit half of their DNA from each biological parent, resulting in two copies of most genes. However, when variations or alterations manifest in the DNA, genes may fail to function properly, potentially leading to genetic disorders.
Being a carrier of a genetic condition typically does not impact your health because you have another functional copy of the gene, compensating for any changes in the affected one.
Interestingly, many of us are carriers of genetic conditions, but since our health is not usually affected, often remain unaware of our carrier status until undergoing specific genetic screening.
It is not unusual to be the first person in your family to know you’re carrier of a particular disorder. Your chance of being identified as a carrier depends on how many disorders you were screened for, your ethnic background, and your family history.
What is the risk of having an affected child?
Approximately 1-5% of reproductive couples are at risk of having an affected child, either because they are both carriers of the same autosomal recessive condition, or because the egg-source is a carrier of an X-linked condition.
Autosomal recessive inheritance
If both biological parents (individuals who provide the sperm and egg) carry a harmful variant in the same gene, with each pregnancy there is a 25% or 1 in 4 chance that the child will inherit two harmful variants (one from each biological parent) and be affected with the condition.
X-linked inheritance
If the biological mother (the individual providing the egg) is a carrier of an X-linked condition, there is a 25% or 1 in 4 chance of having an affected male and a 25% or 1 in 4 chance of having a carrier female.
What is an Autosomal Recessive Genetic Condition?
For autosomal recessive genetic conditions, the gene in question is located on
one of the ‘autosomes’ (chromosomes 1-22). A recessive genetic condition is
caused by an individual having a harmful spelling mistake (or ‘variant’) in both
copies of a particular gene.
one of the ‘autosomes’ (chromosomes 1-22). A recessive genetic condition is
caused by an individual having a harmful spelling mistake (or ‘variant’) in both
copies of a particular gene.
If an individual has one copy of the gene with a harmful variant and a second,
working copy of the gene, they will be a ‘carrier’ of the condition. This generally
does not have any health implications as the working copy of the gene is able to
compensate for the faulty copy. It will, however, lead to an increased risk of
having a child with the related genetic condition, if the other biological parent
carries a harmful variant in the same gene. Research has shown that over 80%
of people are carriers of at least one genetic condition, often without knowing it.
Some examples of autosomal recessive conditions include cystic fibrosis (CF),
sickle cell anemia, and phenylketonuria (PKU).
What is an X-linked Condition?
X-linked conditions are caused by a harmful variant in a gene located on the X chromosome. As biological females have two X chromosomes, they usually have a second working copy of the gene which can compensate for the faulty copy.
Females with one faulty copy of the gene are considered carriers and can pass the faulty copy on to the next generation. Typically, female carriers are not affected by X-linked conditions, though for some conditions they may develop mild symptoms.
As biological males have only one X chromosome, there is no second copy of the gene to compensate for a faulty copy. If they have a harmful variant in a gene on this chromosome, they will be affected by the related X-linked condition.
Some examples of X-linked conditions include hemophilia, Duchenne muscular dystrophy (DMD), and fragile X- syndrome.
When will my results from the CGT become available?
Once the sample is received at Igenomix, the results will be available in 20 bussines days.
How can I contact a genetic professional to discuss my results?
Once the CGT test is completed, our genetic counselors are available to discuss the implications of the test results and answer any additional questions.
