Personalized medicine scope towards fertility and reproduction

Personalized medicine was originally set forth to improve and manage cancer treatment based on information obtained from the genetic map, expression, proteins, and metabolites in the bloodstream of each individual. Therefore, monitoring health procedures including prevention, diagnosis and treatment of each person s illness became more efficient. Initial findings in this approach to treat and diagnose cancer were promising and set the ground for expanding the field in to other health-related areas such as diagnosis and treatment of infertility. Generally, the process of fertility and reproduction has got paramount importance in terms of transmission of parental genome to the next generation and the role of multiple factors involved in the process. However, the extreme inefficiency in the procedure and subsequently assisted reproductive techniques as the common methods in infertility treatment in comparison to other fields of clinical medicine exacerbated the condition in which nearly 60-70% of cases are faced with failure. Another factor influencing the breakdown is selecting almost identical and similar procedures for all infertile couples with different etiologies. As a clear instance, intracytoplasmic sperm injection (ICSI) is used for all infertile couples or the most recent approaches in treatment like freezing all embryos for couples and then transferring the frozen embryos in the natural cycle in the coming months are common practices. The justification for this function is the lack of proper uterus preparation in treatment cycles in conjunction with ovarian stimulation with high doses of gonadopines to grow higher and optimal amount of mature eggs lead to lack of synchronization between development of embryos and the endometrium. Hence, in stimulation cycles, the growth of endometrium is always two to three days ahead of the embryo development, so the transfer of the most mature and best embryos will not result in pregnancy. Although this approach was firstly welcomed by physicians and clinics and many studies have been published in support of the approach, subsequent studies have shown that such stable pattern is not the most suitable choice for all infertile couples and benefits individuals with appropriate responses to ovulation induction or the patients afflicted with polycystic ovaries. In individuals with poor ovarian response, better results were obtained through transfer of non-frozen embryos which accentuated the fact that the procedure of embryo transfer is one of the representative examples for personalized medicine. Embryo transfer in ovulation cycles and transfer of embryos in the same ovulation cycles or freezing all embryos and transferring them to natural cycles are firmly contingent up on the characteristics of the mother and the embryo. Personalized medicine entails identifying and presenting biomarkers to select the best embryos and the best endometrial conditions for proper implantation and pregnancy.