Next he considered having a patient swallow the capsule and letting the embryos grow over the two to three days it would take the device to wind its way through the digestive tract. But he feared the intestinal environment would be too toxic. “Also, it would be a nightmare for the embryologist to retrieve the device later,” he says.
He came to the most logical place last. “I didn’t think about it initially because I worried the capsule could lead to infections or irritate the cervix and interfere with embryo transfers,” he says. Those concerns were unfounded; instead, he found that the vagina provided the best consistent temperature, pH, and oxygen balance and enabled easy insertion and removal of a device. He also believed that embryos would benefit from the slight temperature variations that women undergo throughout the day, which embryos that are created during natural conception experience as they grow in the uterus.
Although INVOcell is designed to stay in the vaginal canal on its own, doctors have the option of adding a diaphragm net to catch it, just in case. If it somehow works its way out completely, patients are advised to wash it off and push it back up.
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In the meantime, patients still have to get used to the idea.
Anne Swart, 38, of Berkeley, California says she and her husband decided against using INVOcell to help them conceive their second child after enduring two miscarriages, even if it meant paying close to $25,000 out of pocket for IVF, including sperm injection and genetic testing. “It hasn’t been around in the U.S. for a long time and just felt risker,” she says. “We didn’t want to go through more heartbreak. We just wanted to do everything to give us the best chance.”
The main challenge with marketing INVOcell is that it’s recommended mostly for younger women with uncomplicated fertility issues and partners with normal sperm counts, says Fady Sharara, a fertility doctor from Reston, Virginia, who’s only treated one patient with INVOcell after advertising it for a year. “My patients are older, and they want to get the maximum amount of eggs with IVF, so they can do genetic testing to make sure they have a normal embryo to transfer,” he says. “They have a small pot of money. They say, ‘I can’t afford to try INVOcell and then IVF later.’”
The lab also provides important feedback on growing embryos that’s impossible with INVOcell’s “in the dark” approach, adds Michael Tucker, the director of IVF and embryology labs at Shady Grove Fertility, the largest fertility center in the U.S. He argues that modern lab technology, including time-lapse imaging of developing embryos, helps embryologists pick the best ones to transfer to the uterus. “The idea of INVOcell is clever, but in a diagnostic sense, you lose so much,” he says. “You have no idea what’s happening inside the body. You don’t know if fertilization was normal. There’s something to be said [for] following the entire process.”