Dr. Crystal Chan: Research aimed at enhancing outcomes after in vitro fertilization
Mount Sinai Hospital clinician-scientist helping to improve the health of pregnant women and their babies
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For Dr.
Crystal Chan, a Mount Sinai Hospital researcher in the MSc Clinician
Investigator Program, improving the chances of ‘happy outcome’ for
couples trying to conceive is her mission.
 “It’s highly
rewarding and fulfilling to have a continuous therapeutic relationship
with a patient, from helping them to conceive to labour and birth,”
says Dr. Chan.In addition to her love of medicine, Dr. Chan passionately pursues research, an interest she developed while studying microbiology and genetics during her undergraduate degree in British Columbia. Her residency and medical school experiences have fostered her interest in reproductive biology and infertility, and she is now pursuing obstetrics and gynaecology with a focus on the treatment of infertility. “The
advancement of women’s health through science is a true passion of
mine,” says Dr. Chan. “Infertility is a common condition and its
incidence is increasing in our society due to trends in delayed
childbearing in women. Assisted reproductive technology is a new and
exciting field that has allowed many couples to conceive who would
otherwise be unable to. The technologically driven aspect of this field
and the privilege of helping couples create families are what drew me
to the specialty.”
One of the
most challenging clinical problems associated with in vitro
fertilization (IVF) is multiple pregnancies and the resulting
complication of premature birth. Dr. Chan’s research goal is to reduce
the rate of multiple pregnancies by improving the success of single
embryo transfers.
“We are using
molecular techniques to identify unique markers predictive of embryo
competence and viability, and of uterine receptivity,” says Dr.
Chan.
Current methods to assess uterine receptivity—or the ability of a woman’s uterus to ‘accept’ a viable embryo—involve uterine biopsy, which is invasive and unable to accurately predict pregnancy. However, Dr. Chan’s new method, developed in collaboration with her supervisors Dr. Ted Brown and Dr. Ellen Greenblatt, assesses the uterus non-invasively by gently suctioning fluid from the uterine cavity. “Our method
allows us to determine molecular factors involved in uterine
receptiveness, by comparing genes activated in the receptive versus
non-receptive uterus and without causing potential damage” says Dr.
Chan.
Following
fluid aspiration of a woman’s uterine cavity, Dr. Chan and her
colleagues use gene array technology—a way of analyzing the activity of
thousands of genes in a single sample—to compare the various levels of
30,000 genes in non-receptive versus receptive uterine samples. This
allows them to determine how similar the samples are genetically, and
to pinpoint which key genes may be involved (and at what level of
expression) during the narrow ‘window’ of uterine responsiveness to
viable embryo implantation after IVF.
“We have
identified 250 candidate genes that are involved in the receptive phase
of the uterus,” says Dr. Chan. “These genes will guide the development
of clinical tests that can determine if the uterus is receptive and to
help predict pregnancy. Our ultimate goal is to improve IVF outcomes
and decrease the need to transfer multiple embryos, leading to a
reduction in multiple births and better health for women and their
babies.”
“Dr. Chan is a
truly exceptional individual and a highly motivated and skilled
clinician and researcher,” says Dr. Brown, an Associate Scientist at
Mount Sinai Hospital’s Samuel Lunenfeld Research Institute. “Her work
is addressing a critical issue in IVF that should lead to overall
improvement of IVF success rates, and facilitate the acceptance of
single embryo transfer. Dr. Greenblatt and I are honoured to be her
supervisors.”
Dr. Chan was
also recently selected as the inaugural Fellow forVenture Sinai Women
2, a group begun last month in support of research at Mount Sinai
Hospital and the Lunenfeld.
One in eight
Canadian couples seeks medical treatment for infertility, most often
requiring the help of assisted reproductive technologies (ART). Current
pregnancy rates after ART average around 30 per cent, a figure that has
improved only marginally over the past 20 years. New research in
this area—including the project being pursued by Dr. Chan—is helping to
improve the health of women and increase their chances of conception
and full-term healthy birth.
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