Beyond IVF: The Next Generation of Fertility Solutions

In this Pharmaceutical Executive video interview, Dr. Lawrence B. Werlin, MD, FACOG of HRC Fertility (@md.lawrence.werlin on TikTok), discusses the challenges of addressing fertility misinformation on social media. He emphasizes the importance of providing accurate and reliable information and encourages patients to consult with healthcare professionals. He also discusses the ethical considerations of using social media to share personal and professional experiences in the field of fertility.

What are the most exciting developments in fertility treatment that you anticipate in the next few years?

The radiological procedures, improving the ability of diagnosing certain diseases before you really have to do a surgical procedure, whereas maybe the surgical procedure was the only way to make the diagnosis that will be beneficial, that will occur when you look at genetic testing of embryos, although still obviously an experimental procedure that it is, it will continue to improve right now when we do genetic testing.

First of all, you can look at whether or not the embryo has normal chromosomes, and you can also know its gender as well, and that's important. And then the other thing that you can also know is that if there's a specific disease entity that the couple share, meaning they don't have it, but they share they have the recessive trait. Then you can look for that in the embryo as well and prevent a hereditary disease from occurring. Now, hopefully, as time goes on, you're going to be able to potentially know whether an embryo what its risk is for specific things. So right now, when you do what's called PGTM or PGT pre–Implantation Genetic testing for mono genetic diseases, you're looking at diseases that are caused by a single gene, like cystic fibrosis, like retinitis pigmentosa, whatever it may be, Huntington's disease, things like that. Which are clearly factors that you don't want to be able to transmit, right? You don't want to pass those on. But there are other diseases, like hypertension, like diabetes, like heart disease, that are also genetically involved, but are not caused by a single gene, they may be caused by a cluster of genes, or certain abnormalities in specific genes.

So now I think the technology will occur whereby you're able to now look at an embryo and say, ‘Well, potentially this embryo, although genetically, it looks normal and has normal chromosomes — this embryo is at greater risk for developing diabetes or developing hypertension or developing heart disease’, which will be important. So, a couple may have X number of normal embryos, chromosomally normal embryos, but may be able to choose which embryo will have the least likelihood of having those. Diseases, which would be very important, and hopefully the technology will improve so that we're able to do that. And then there are other things that that may be done that are shortly being done now on an experimental basis, like CRISPR, where they actually are able to resect part of gene abnormalities and remove them from developing tissue. It's not yet approved for things in humans, but will certainly have a better likelihood in the future of being available.