One Avon mother is doubly-blessed this Mother's Day and has a rare story to tell: Caroline Marks and her husband Ed are celebrating Caroline’s first year as a mother—of twins no less—and the couple was able to actually witness their children's conception and first five days of formation.
The Marks were one of the first couples ever to take advantage of a new technology, the EmbryoScope, to watch as Caroline’s fertilized eggs were first fertilized, and then developed before being implanted.
The couple used the assistance of the Cleveland Clinic's Fertility Center, now one of 10 labs in the country, and the first in Ohio, with the EmbryoScope -- technology used to monitor embryo development from conception to time of the transfer.
The device was called an "amazing new technology like we've never seen before," by NBC's Brian Williams when the couple was featured on NBC's Nightly News in March.
Hoping for a family
The couple met in college in 1999 when Ed was at the University of Notre Dame and Caroline was studying at St. Mary’s College. The two married in 2008 and had been trying to start a family since 2010. In November of 2011 they completed a round of IUI (intrauterine insemination) but it proved unsuccessful. Two months later they tried in vitro fertilization (IVF) and that too was unsuccessful.
In April of 2012 they were ready for another round of IVF when Cleveland Clinic fertility specialist Dr. Nina Desai told them about EmbyroScope.
Approved by the FDA in 2011, the The EmbryoScope is a fertility device used to continuously monitor and record embryo development in 20 minute intervals from conception to the time of transfer. Previously, embryologists viewed the eggs once a day.
Click here to see Dr. Desai's explanation of the tecnology on NBC Nightly News.
The combination incubator/camera combo is the equivalent of an in-vitro nanny-cam and can capture odd or problematic behavior that could have previously been overlooked.
You could say that the Marks had an early start on keeping an eye on their children.
“It’s for growth and monitoring in real time at the lab,” Caroline said.
Before the eggs were implanted in April 2012, the Marks were able to go to the lab and watch as the fertilized egg began to split in the first five days.
Numerous eggs were fertilized at the lab. Since Caroline was only 31 at the time, the Marks elected to transplant only two of the eggs. Older women might opt to implant more for a better implantation rate. The eggs were transferred on the sixth day after inception.
“We opted for two,” Ed said. “We wanted to see how things would progress first.”
Although two eggs were transferred, only one implanted. Improbably, that one implanted egg naturally divided, resulting in twins.
“When we went for an ultrasound at seven weeks, we saw two heart beats,” Caroline said.
“It’s extremely rare,” Ed said of the probability of the situation.
A technological advantage
In December of 2012, Caroline and Ed welcomed two healthy baby girls, Charlotte and Claire, into the world. While they were most certainly bequeathed with gifts and love from friends and family alike as most babies are, the Marks also received a CD with photos that resulted from the new technology, the kind of item most new parents don't have.
The device opens up a whole new area of understanding in embryo development and identifying selection.
The high-tech device allows the incubation of up to 72 embryos at a time. The built in camera provides automated and continuous time lapse imaging every 20 minutes of fertilized oocytes without leaving the climate controlled environment, allowing embryologists better idea of which fertilized eggs have the best chance of survival.
Patients can watch the moment of fertilization as well as the first time the eggs split.
The Clinic might even be able to benefit from the Marks' situation.
“We couldn’t tell there were going to be twins (from the EmbryoScope),” Caroline said.
“We talked with Dr. Desai,” Ed said. “With the technology they could go back to see if there was anything they could see.”
Caroline said it was a “little strange” showing family and friends the photos from the first days of the fertilized eggs existence.
“But we’re hoping to reach out to other people about the technology,” she said.
The couple will not rule out expanding their family since they still have fertilized eggs in frozen storage. And they found the experience incredible.
“You see all these embryos growing,” Caroline said. “It was breathtaking to see that at first, to see the inception.”
They are also grateful for the Cleveland Clinic’s assistance.
“We never gave up on them, and they never gave up on us,” Caroline said.
Editor's note: The attached video if from a lab in Denmark as an example of how the EmbryScope works.