At the NYU Fertility Center 48% of cycles in women <35 years result in a live birth. Forty % of these births in women <35 years at the NYU Fertility Center are twin deliveries. A strong criticism of assisted reproductive technologies (ART) is the high incidence of multiple gestations that increase fetal and maternal morbidity and mortality.

Grifo et al recently described their clinic's progression to blastocyst transfer as a means to reduce the high-order multiple rate. The ART community has addressed the need for more single embryo transfers (SET) but also recognizes the lowered pregnancy rates that may ensue. The ability to identify additional markers associated with embryo viability and competence has been the greatest challenge towards promoting SET. In a recent study of 3 and 5 day growth media, we have identified gi|223976 haptoglobin Hp2, mass 41717. Two more proteins were identified in our latest report, gi|90108928 1 Chain H, Orally Available Factor7a Inhibitor, mass 28582, and gi|119573737 hCG1793647 [Homo sapiens] Mass: 6112. This study produced two new specific biomarkers unique to competent embryos: gamma-aminobutyric-acid receptor subunit and tetatricopeptide repeat protein 9.

The IVF growth media protein from 3 and 5 day embryos was extracted with organic solvent and high pressure using ProteoSolve� and the Barocycler� respectively (Pressure BioSciences, West Bridgewater, MA). The protein fraction was trypsinized, and the peptides studied with LCMS (Hitachi NanoFrontier nLC, Dallas, TX).

These new biomarkers of competent embryos should enhance embryo selection and effect more single embryo transfers.